SRC-CDH C.S.S.B. 422 75(R)BILL ANALYSIS Senate Research CenterC.S.S.B. 422 By: Cain Health & Human Services 2-18-97 Committee Report (Substituted) DIGEST Currently, with the growing number of mergers and affiliations, as well as the expansion of hospital services beyond a main building, questions have arisen regarding the breadth of a hospital license, primarily because requiring individual licensure for additional facilities located on or near the main hospital campus drives up health care costs. In addition, as the marketplace evolves, special hospitals, such as pediatric and rehabilitation hospitals, increasingly perform surgery related to the services provided by the facility, a function that is not presently recognized in Texas statutory law. This legislation amends the definition of hospital "premises" to mean either a single building or multiple buildings where inpatients receive hospital services, provided that certain conditions are met, in an effort to allow a hospital to hold a single license for multiple on-site facilities. S.B. 422 also defines "comprehensive medical rehabilitation hospital" and "pediatric and adolescent hospital" to clarify these facilities' ability to provide surgery and related ancillary services. PURPOSE As proposed, C.S.S.B. 422 establishes the licensure of a hospital with multiple premises under a single license; and defines "comprehensive medical rehabilitation hospital," "pediatric and adolescent hospital," and "premises." RULEMAKING AUTHORITY This bill does not grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 241.003, Health and Safety Code, to define "comprehensive medical rehabilitation hospital" to mean a general hospital that specializes in providing medical rehabilitation services, including surgery and related ancillary services. Defines "pediatric and adolescent hospital" to mean a general hospital that specializes in providing services to children and adolescents, including surgery and related ancillary services. Defines "premises" to mean a single building where inpatients receive hospital services; or multiple buildings where inpatients receive hospital services, provided that certain conditions are met. Makes conforming changes. SECTION 2. Amends Section 241.022, Health and Safety Code, by adding Subsection (f), to prohibit a hospital from including offsite outpatient services in its license application. SECTION 3. Amends Section 241.026, Health and Safety Code, by adding Subsection (f), to provide that a comprehensive medical rehabilitation hospital or a pediatric and adolescent hospital is required to have an emergency treatment room, but is not required to have an emergency department. SECTION 4. Emergency clause. Effective date: upon passage. SUMMARY OF COMMITTEE CHANGES Amends SECTION 1, Section 241.003, Health and Safety Code, to define "comprehensive medical rehabilitation hospital" and "pediatric and adolescent hospital." Redefines "premises" to clarify which hospital buildings qualify as on-site premises. Deletes the amendment to the definition of "special hospital." Amends SECTION 2, Section 241.022, Health and Safety Code, to prohibit a hospital from including offsite outpatient services in its license application, rather than prohibiting anything in this chapter from being construed to require a hospital to do the same. Amends SECTION 3, by deleting the effective date and amending Section 241.026, Health and Safety Code, to require a comprehensive medical rehabilitation or a pediatric and adolescent hospital to have an emergency treatment room, but not an emergency department. Adds SECTION 4, to include a revised effective date.