By:  Truan                                            S.B. No. 1517

                                A BILL TO BE ENTITLED

                                       AN ACT

 1-1     relating to the repeal of certain advisory committees of the Texas

 1-2     Department of Health.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  Subsection (a), Section 773.112, Health and

 1-5     Safety Code, is amended to read as follows:

 1-6           (a)  The board by rule shall adopt minimum standards and

 1-7     objectives to implement emergency medical services and trauma care

 1-8     systems.  The board by rule shall provide for the designation of

 1-9     trauma facilities and for triage, transfer, and transportation

1-10     policies [that reflect the recommendations of the technical

1-11     advisory committee].  The board [and the technical advisory

1-12     committee] shall consider guidelines adopted by the American

1-13     College of Surgeons and the American College of Emergency

1-14     Physicians in adopting rules under this section.

1-15           SECTION 2.  Section 241.003, Health and Safety Code, is

1-16     amended to read as follows:

1-17           Sec. 241.003.  DEFINITIONS.  In this chapter:

1-18                 (1)  "Board" means the Texas Board of Health.

1-19                 (2)  ["Council" means the Hospital Licensing Advisory

1-20     Council.]

1-21                 [(3)]  "Department" means the Texas Department of

1-22     Health.

1-23                 (3) [(4)]  "General hospital" means an establishment

 2-1     that:

 2-2                       (A)  offers services, facilities, and beds for

 2-3     use for more than 24 hours for two or more unrelated individuals

 2-4     requiring diagnosis, treatment, or care for illness, injury,

 2-5     deformity, abnormality, or pregnancy; and

 2-6                       (B)  regularly maintains, at a minimum, clinical

 2-7     laboratory services, diagnostic X-ray services, treatment

 2-8     facilities including surgery or obstetrical care or both, and other

 2-9     definitive medical or surgical treatment of similar extent.

2-10                 (4) [(5)]  "Governmental unit" means a political

2-11     subdivision of the state, including a hospital district, county, or

2-12     municipality, and any department, division, board, or other agency

2-13     of a political subdivision.

2-14                 (5) [(6)]  "Hospital" includes a general hospital and a

2-15     special hospital.

2-16                 (6) [(7)]  "Medical staff" means a physician or group

2-17     of physicians and a podiatrist or group of podiatrists who by

2-18     action of the governing body of a hospital are privileged to work

2-19     in and use the facilities of a hospital for or in connection with

2-20     the observation, care, diagnosis, or treatment of an individual who

2-21     is, or may be, suffering from a mental or physical disease or

2-22     disorder or a physical deformity or injury.

2-23                 (7) [(8)]  "Person" means an individual, firm,

2-24     partnership, corporation, association, or joint stock company, and

2-25     includes a receiver, trustee, assignee, or other similar

 3-1     representative of those entities.

 3-2                 (8) [(9)]  "Physician" means a physician licensed by

 3-3     the Texas State Board of Medical Examiners.

 3-4                 (9) [(10)]  "Podiatrist" means a podiatrist licensed by

 3-5     the Texas State Board of Podiatric Medical Examiners.

 3-6                 (10) [(11)]  "Special hospital" means an establishment

 3-7     that:

 3-8                       (A)  offers services, facilities, and beds for

 3-9     use for more than 24 hours for two or more unrelated individuals

3-10     who are regularly admitted, treated, and discharged and who require

3-11     services more intensive than room, board, personal services, and

3-12     general nursing care;

3-13                       (B)  has clinical laboratory facilities,

3-14     diagnostic X-ray facilities, treatment facilities, or other

3-15     definitive medical treatment;

3-16                       (C)  has a medical staff in regular attendance;

3-17     and

3-18                       (D)  maintains records of the clinical work

3-19     performed for each patient.

3-20           SECTION 3.  Subsection (a), Section 241.026, Health and

3-21     Safety Code, is amended to read as follows:

3-22           (a)  The board[, with the advice of the council,] shall adopt

3-23     and enforce rules to further the purposes of this chapter.   The

3-24     rules at a minimum shall address:

3-25                 (1)  minimum requirements for staffing by physicians

 4-1     and nurses;

 4-2                 (2)  hospital services relating to patient care;

 4-3                 (3)  fire prevention, safety, and sanitation

 4-4     requirements in hospitals;

 4-5                 (4)  patient care and a patient bill of rights; and

 4-6                 (5)  compliance with other state and federal laws

 4-7     affecting the health, safety, and rights of hospital patients.

 4-8            SECTION 4.  Subsections (b) and (c), Section 142.016, Health

 4-9     and Safety Code, are amended to read as follows:

4-10           (b)  [The Board of Nurse Examiners and the department shall

4-11     consult with an advisory committee in developing, modifying, or

4-12     renewing the memorandum of understanding.  The advisory committee

4-13     shall be appointed by the Board of Nurse Examiners and the

4-14     department and at a minimum shall include:]

4-15                 [(1)  one representative from the Board of Nurse

4-16     Examiners and one representative from the department to serve as

4-17     cochairmen;]

4-18                 [(2)  one representative from the Texas Department of

4-19     Mental Health and Mental Retardation;]

4-20                 [(3)  one representative from the Texas Department of

4-21     Human Services;]

4-22                 [(4)  one representative from the Texas Nurses

4-23     Association;]

4-24                 [(5)  one representative from the Texas Association for

4-25     Home Care, Incorporated, or its successor;]

 5-1                 [(6)  one representative from the Texas Hospice

 5-2     Organization, Incorporated, or its successor;]

 5-3                 [(7)  one representative of the Texas Respite Resource

 5-4     Network or its successor; and]

 5-5                 [(8)  two representatives of organizations such as the

 5-6     Personal Assistance Task Force or the Disability Consortium that

 5-7     advocate for clients in community-based settings.]

 5-8           [(c)]  The department shall prepare guidelines according to

 5-9     the memorandum of understanding required by Subsection (a) for

5-10     licensed home and community support services agencies in providing

5-11     personal assistance services to clients.

5-12           SECTION 5.  Sections 3 and 5, Opticians' Registry Act

5-13     (Article 4551-1, Vernon's Texas Civil Statutes), are amended to

5-14     read as follows:

5-15           Sec. 3.  DEFINITIONS.  In this Act:

5-16                 (1)  "Board" means the Texas Board of Health.

5-17                 (2)  "Contact lens dispensing" means the fabrication,

5-18     ordering, mechanical adjustment, dispensing, sale, and delivery to

5-19     the consumer of contact lenses prescribed by and dispensed in

5-20     accordance with a prescription from a licensed physician or

5-21     optometrist, together with appropriate instructions for the care

5-22     and handling of the lenses.  The term does not include the taking

5-23     of any measurements of the eye or the cornea or evaluating the

5-24     physical fit of the contact lenses, unless that action is directed

5-25     or approved by a licensed physician.

 6-1                 (3)  "Contact lens prescription" means a written

 6-2     specification by a licensed physician or optometrist for

 6-3     therapeutic, corrective, or cosmetic contact lenses that states the

 6-4     refractive power of the product and other information as required

 6-5     by:

 6-6                       (A)  the physician or the Texas State Board of

 6-7     Medical Examiners; or

 6-8                       (B)  the optometrist or the Texas Optometry

 6-9     Board.

6-10                 (4)  ["Council" means the Advisory Council of the

6-11     Opticians' Registry.]

6-12                 [(5)]  "Department" means the Texas Department of

6-13     Health.

6-14                 (5) [(6)]  "Dispensing optician" or "ophthalmic

6-15     dispenser" means a person who provides or offers to provide

6-16     spectacle or contact lens dispensing services or products to the

6-17     public.

6-18                 (6) [(7)]  "Spectacle dispensing" means the design,

6-19     verification, fitting, adjustment, sale, and delivery to the

6-20     consumer of fabricated and finished spectacle lenses, frames, or

6-21     other ophthalmic devices, other than contact lenses, prescribed by

6-22     and dispensed in accordance with a prescription from a licensed

6-23     physician or optometrist.  The term includes:

6-24                       (A)  prescription analysis and interpretation;

6-25                       (B)  the taking of measurements of the face,

 7-1     including interpupillary distances, to determine the size, shape,

 7-2     and specifications of the spectacle lenses or frames best suited to

 7-3     the wearer's needs;

 7-4                       (C)  the preparation and delivery of work orders

 7-5     to laboratory technicians engaged in grinding lenses and

 7-6     fabricating spectacles;

 7-7                       (D)  the verification of the quality of finished

 7-8     spectacle lenses;

 7-9                       (E)  the adjustment of spectacle lenses or frames

7-10     to the intended wearer's face; and

7-11                       (F)  the adjustment, repair, replacement,

7-12     reproduction, or duplication of previously prepared spectacle

7-13     lenses, frames, or other specially fabricated optical devices,

7-14     other than contact lenses.

7-15                 (7) [(8)]  "Spectacle prescription" means a written

7-16     specification by a licensed physician or optometrist for

7-17     therapeutic or corrective lenses that states the refractive power

7-18     of the product and other information as required by the physician

7-19     or optometrist.

7-20           Sec. 5.  DUTIES OF BOARD[; ADVISORY COUNCIL].  (a)  The board

7-21     shall adopt procedural rules to implement the registration

7-22     procedures under this Act.  The board also may adopt substantive

7-23     and procedural rules relating to:

7-24                 (1)  the minimum requirements for the registration of

7-25     dispensing opticians;

 8-1                 (2)  the probation, suspension, denial, or revocation

 8-2     of a registration;

 8-3                 (3)  the setting of fees under this Act; and

 8-4                 (4)  the adoption of forms required by this Act.

 8-5           (b)  The board may not adopt substantive rules relating to

 8-6     this Act other than substantive rules described by Subsection (a)

 8-7     of this section.

 8-8           [(c)  The board shall appoint a nine-member advisory council

 8-9     to be known as the Advisory Council of the Opticians' Registry to

8-10     advise the board on matters relating to implementation of this Act.

8-11     The members shall be appointed from different geographical areas to

8-12     ensure representation of urban and rural interests.]

8-13           [(d)  The board shall appoint members of the council as

8-14     follows:]

8-15                 [(1)  three must be opticians eligible for registration

8-16     under this Act, one of whom is eligible only as a contact lens

8-17     dispensing optician, one of whom is eligible only as a spectacle

8-18     dispensing optician, and one of whom is eligible for registration

8-19     in either category;]

8-20                 [(2)  two must be physicians licensed and practicing in

8-21     this state whose practice is limited to ophthalmology;]

8-22                 [(3)  two must be optometrists licensed and practicing

8-23     in this state; and]

8-24                 [(4)  two must be consumers who do not have, and whose

8-25     spouses do not have, a direct or indirect interest in any health

 9-1     care related business or trade association.]

 9-2           [(e)  The council shall annually elect a chairman and

 9-3     vice-chairman.]

 9-4           [(f)  A council member is not entitled to compensation for

 9-5     service on the council, but is entitled to the per diem and

 9-6     transportation allowance for state officials set in the General

 9-7     Appropriations Act for each day that the member engages in the

 9-8     business of the council.]

 9-9           [(g)  Members are appointed for staggered terms of six years,

9-10     with three terms beginning March 1 of each odd-numbered year.

9-11     Members shall serve until the expiration of the term to which they

9-12     have been appointed or until their successors have qualified.  A

9-13     member may not serve more than two consecutive terms.]

9-14           SECTION 6.  Section 1, Chapter 752, Acts of the 69th

9-15     Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas

9-16     Civil Statutes), is amended to read as follows:

9-17           Sec. 1.  DEFINITIONS.  In this Act:

9-18                 (1)  "Massage therapy" means the manipulation of soft

9-19     tissue.  The term includes, but is not limited to, effleurage

9-20     (stroking), petrissage (kneading), tapotement (percussion),

9-21     compression, vibration, friction, nerve strokes, and Swedish

9-22     gymnastics, either by hand or with mechanical or electrical

9-23     apparatus for the purpose of body massage.  Massage therapy may

9-24     include the use of oil, salt glows, heat lamps, hot and cold packs,

9-25     tub, shower, or cabinet baths.  Equivalent terms for massage

 10-1    therapy are massage, therapeutic massage, massage technology,

 10-2    myo-therapy, body massage, body rub, or any derivation of those

 10-3    terms.  Massage therapy is a health care service when the massage

 10-4    therapy is for therapeutic purposes.  As used in the Act, the terms

 10-5    "therapy" and "therapeutic" do not include diagnosis, the treatment

 10-6    of illness or disease, or any service or procedure for which a

 10-7    license to practice medicine, chiropractic, physical therapy, or

 10-8    podiatry is required by law.  Massage therapy does not constitute

 10-9    the practice of chiropractic.

10-10                (2)  "Massage therapist" means an individual who

10-11    practices or administers massage therapy to a patron of either

10-12    gender for compensation.  The term includes a registered massage

10-13    therapist, therapeutic massage practitioner, massage technician,

10-14    masseur, masseuse, myo-therapist, body massager, body rubber, or

10-15    any derivation of those titles.

10-16                (3)  "Massage therapy instructor" means an individual

10-17    who is a registered massage therapist, who is instructing one or

10-18    more students in massage therapy, and whose instruction is approved

10-19    by the department.

10-20                (4)  "Massage establishment" means any place of

10-21    business that advertises massage therapy or offers massage therapy

10-22    as a service.

10-23                (5)  "Department" means the Texas Department of Health.

10-24                (6)  "Board" means the Texas Board of Health.

10-25                (7)  ["Advisory Council" means the Advisory Council on

 11-1    Massage Therapy.]

 11-2                [(8)]  "Person" means an individual, partnership,

 11-3    corporation, association, or other legal entity.

 11-4                (8) [(9)]  "Massage school" means an entity or

 11-5    organization with at least two instructors that teaches, at a

 11-6    minimum, the course of instruction required for registration as a

 11-7    massage therapist under this Act.

 11-8                (9) [(10)]  "Instructor" means an individual who

 11-9    instructs one or more students in any section of the course of

11-10    instruction required for registration as a massage therapist.

11-11                (10) [(11)]  "Applicant" means a person, including a

11-12    massage school, a massage therapy instructor, or a massage

11-13    establishment, that applies for registration under this Act.

11-14                (11) [(12)]  "Examiner" means a registered massage

11-15    therapist who administers the practical portion of the state

11-16    examination to applicants for registration as massage therapists.

11-17                (12) [(13)]  "Internship program" means a program

11-18    supervised by a massage therapy instructor in which a student

11-19    provides massage therapy to the general public.  The massage

11-20    therapy may be for compensation in an amount set by the massage

11-21    school or massage therapy instructor and paid to the massage school

11-22    or massage therapy instructor.

11-23                (13) [(14)]  "Sexually oriented business" has the

11-24    meaning assigned by Section 243.002, Local Government Code, unless

11-25    another meaning applies under local law.

 12-1          SECTION 7.  Subsection (i), Section 2A, Chapter 752, Acts of

 12-2    the 69th Legislature, Regular Session, 1985 (Article 4512k,

 12-3    Vernon's Texas Civil Statutes), is amended to read as follows:

 12-4          (i)  An internship program must meet the qualifications

 12-5    established by the board [with the advice of the advisory council].

 12-6          SECTION 8.  Subsections (a), (d), (e), and (f),  Section 7,

 12-7    Chapter 752, Acts of the 69th Legislature, Regular Session, 1985

 12-8    (Article 4512k, Vernon's Texas Civil Statutes), are amended to read

 12-9    as follows:

12-10          (a)  The board[, with the advice of the advisory council,]

12-11    shall adopt rules consistent with this Act, including rules

12-12    relating to the definition of "unprofessional conduct" as that term

12-13    is used by Section 11(a)(4) of this Act, as necessary for the

12-14    performance of its duties under this Act.  The board shall adopt

12-15    the rules in the manner provided by the Administrative Procedure

12-16    and Texas Register Act (Article 6252-13a, Vernon's Texas Civil

12-17    Statutes).

12-18          (d)  The department shall prepare and administer a state

12-19    examination as required to implement this Act.  The department may

12-20    hire examiners [with the recommendation of the advisory council].

12-21    An examiner is entitled to compensation and the state per diem

12-22    allowance as set by the General Appropriations Act for

12-23    transportation and related expenses incurred by the examiner in

12-24    engaging in the business of the department.

12-25          (e)  [The board and department shall cooperate with the

 13-1    advisory council in the administration of this Act, and shall make

 13-2    available to the advisory council reports, statistical information,

 13-3    and other information as reasonably necessary for the advisory

 13-4    council to perform its duties under this Act.]

 13-5          [(f)]  The department shall regulate all massage school and

 13-6    massage therapy instructor hours.

 13-7          SECTION 9.  Section 2.03, Medical Radiologic Technologist

 13-8    Certification Act (Article 4512m, Vernon's Texas Civil Statutes),

 13-9    is amended to read as follows:

13-10          Sec. 2.03.  DEFINITIONS.  In this Act:

13-11                (1)  ["Advisory board" means the Medical Radiologic

13-12    Technologist Advisory Board.]

13-13                [(2)]  "Department" means the Texas Department of

13-14    Health.

13-15                (2) [(3)]  "Radiologic technology" means the

13-16    administration of radiation to a person for medical purposes.

13-17                (3) [(4)]  "Radiation" means ionizing radiation in

13-18    amounts beyond normal background levels from sources such as

13-19    medical and dental radiologic procedures.

13-20                (4) [(5)]  "Radiologic procedure" means any procedure

13-21    or article intended for use in the diagnosis of disease or other

13-22    medical or dental conditions in humans (including diagnostic X-rays

13-23    or nuclear medicine procedures) or the cure, mitigation, treatment,

13-24    or prevention of disease in humans that achieves its intended

13-25    purpose through the emission of radiation.

 14-1                (5) [(6)]  "Practitioner" means a doctor of medicine,

 14-2    osteopathy, podiatry, dentistry, or chiropractic who is licensed

 14-3    under the laws of this state and who prescribes radiologic

 14-4    procedures for other persons.

 14-5                (6) [(7)]  "Medical radiologic technologist" means a

 14-6    person certified under this Act, other than a practitioner, who,

 14-7    under the direction of a practitioner, intentionally administers

 14-8    radiation to other persons for medical purposes.

 14-9                (7) [(8)]  "Certification" means an authorization to

14-10    administer radiation to a person for medical purposes.

14-11                (8) [(9)]  "General certification" means an

14-12    authorization to perform radiologic procedures authorized by this

14-13    Act.

14-14                (9) [(10)]  "Limited certification" means an

14-15    authorization to perform radiologic procedures that are limited to

14-16    specific parts of the human body.

14-17                (10) [(11)]  "Temporary certification, general or

14-18    limited," means an authorization to perform radiologic procedures

14-19    for a limited period, not to exceed one year.

14-20                (11) [(12)]  "Registered Nurse" means a person licensed

14-21    by the Board of Nurse Examiners to practice professional nursing.

14-22                (12) [(13)]  "Direct supervision" means supervision and

14-23    control by a medical radiologic technologist or a practitioner who

14-24    assumes legal liability for a student employed to perform a

14-25    radiologic procedure and enrolled in a program that meets the

 15-1    requirements adopted by rule under Section 2.05 of this Act, and

 15-2    who is physically present during the conduct of a radiologic

 15-3    procedure to provide consultation or direct the action of the

 15-4    student.

 15-5                (13) [(14)]  "Education program" means clinical

 15-6    training or any other program offered by an organization approved

 15-7    by the Texas Board of Health that:

 15-8                      (A)  has a specified objective;

 15-9                      (B)  includes planned activities for the

15-10    participants; and

15-11                      (C)  uses an approved method for measuring the

15-12    progress of the participants.

15-13                (14) [(15)]  "Authorized person" means a person who

15-14    meets or exceeds the minimum educational standards of the Texas

15-15    Board of Health under Section 2.05(f) of this Act.

15-16                (15) [(16)]  "Registrant" means an individual, other

15-17    than a practitioner or medical radiologic technologist, who meets

15-18    the requirements of Section 2.05(f) of this Act.

15-19          SECTION 10.  Section 1, Chapter 829, Acts of the 69th

15-20    Legislature, Regular Session, 1985 (Article 4512l, Vernon's Texas

15-21    Civil Statutes), is amended to read as follows:

15-22          Sec. 1.  DEFINITIONS.  In this Act:

15-23                (1)  ["Advisory board" means the Respiratory Care

15-24    Practitioners Advisory Board.]

15-25                [(2)]  "Board of health" means the Texas Board of

 16-1    Health.

 16-2                (2) [(3)]  "Department" means the Texas Department of

 16-3    Health.

 16-4                (3) [(4)]  "Respiratory care" means the treatment,

 16-5    management, control, diagnostic evaluation, and care of patients

 16-6    who have deficiencies and abnormalities associated with the

 16-7    cardiorespiratory system.

 16-8                (4) [(5)]  "Respiratory care practitioner" means a

 16-9    person permitted or certified under this Act to practice

16-10    respiratory care.

16-11                (5) [(6)]  "Respiratory care procedure" means

16-12    respiratory care provided by the therapeutic and diagnostic use of

16-13    medical gases, humidifiers, and aerosols, the administration of

16-14    drugs and medications to the cardiorespiratory system, ventilatory

16-15    assistance and ventilatory control, postural drainage, chest

16-16    drainage, chest percussion or vibration, breathing exercises,

16-17    respiratory rehabilitation, cardiopulmonary resuscitation,

16-18    maintenance of natural airways, and the insertion and maintenance

16-19    of artificial airways.  The term includes a technique employed to

16-20    assist in diagnosis, monitoring, treatment, and research, including

16-21    the measurement of ventilatory volumes, pressures and flows, the

16-22    specimen collection of blood and other materials, pulmonary

16-23    function testing, and hemodynamic and other related physiological

16-24    forms of monitoring or treating, as ordered by the patient's

16-25    physician, the cardiorespiratory system.

 17-1          SECTION 11.  Subsection (d), Section 3, Chapter 829, Acts of

 17-2    the 69th Legislature, Regular Session, 1985 (Article 4512l,

 17-3    Vernon's Texas Civil Statutes), is amended to read as follows:

 17-4          (d)  The [After consultation with the advisory board, the]

 17-5    board of health by rule shall establish examination requirements

 17-6    for a certificate under this Act.  The board of health may use the

 17-7    entry level examination prepared by the National Board for

 17-8    Respiratory Care or an equivalent examination.

 17-9          SECTION 12.  The following are repealed:

17-10                (1)  Sections 12.072, 12.073, 12.074, 31.017, 36.015,

17-11    43.015, 87.006, 241.081, 241.082, 241.083, 241.084, 241.085,

17-12    311.038, 431.208, 502.013, 773.006, 773.118, and 773.172, Health

17-13    and Safety Code;

17-14                (2)  Section 13, Texas Asbestos Health Protection Act

17-15    (Article 4477-3a, Vernon's Texas Civil Statutes);

17-16                (3)  Section 10, Chapter 796, Acts of the 72nd

17-17    Legislature, Regular Session, 1991 (Article 4447bb, Vernon's Texas

17-18    Civil Statutes);

17-19                (4)  Sections 8 and 9,  Chapter 752, Acts of the 69th

17-20    Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas

17-21    Civil Statutes);

17-22                (5)  Section 2.04, Medical Radiologic Technologist

17-23    Certification Act (Article 4512m, Vernon's Texas Civil Statutes);

17-24    and

17-25                (6)  Sections 2 and 14, Chapter 829, Acts of the 69th

 18-1    Legislature, 1985 (Article 4512l, Vernon's Texas Civil Statutes).

 18-2          SECTION 13.  This Act takes effect September 1, 1997.

 18-3          SECTION 14.  The importance of this legislation and the

 18-4    crowded condition of the calendars in both houses create an

 18-5    emergency and an imperative public necessity that the

 18-6    constitutional rule requiring bills to be read on three several

 18-7    days in each house be suspended, and this rule is hereby suspended.

 18-8                         COMMITTEE AMENDMENT NO. 1

 18-9          Amend S.B. No. 1517 as follows:

18-10          (1)  Strike SECTION 4 of the bill.

18-11          (2)  Renumber subsequent sections appropriately.

18-12    75R14413 SKB-D                                             Berlanga