By Truan                                        S.B. No. 1517

      75R3402 SKB-F                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to the repeal of certain advisory committees of the Texas

 1-3     Department of Health.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Section 773.112(a), Health and Safety Code, is

 1-6     amended to read as follows:

 1-7           (a)  The board by rule shall adopt minimum standards and

 1-8     objectives to implement emergency medical services and trauma care

 1-9     systems.  The board by rule shall provide for the designation of

1-10     trauma facilities and for triage, transfer, and transportation

1-11     policies [that reflect the recommendations of the technical

1-12     advisory committee].  The board [and the technical advisory

1-13     committee] shall consider guidelines adopted by the American

1-14     College of Surgeons and the American College of Emergency

1-15     Physicians in adopting rules under this section.

1-16           SECTION 2.  Section 241.003, Health and Safety Code, is

1-17     amended to read as follows:

1-18           Sec. 241.003. DEFINITIONS.  In this chapter:

1-19                 (1)  "Board" means the Texas Board of Health.

1-20                 (2)  ["Council" means the Hospital Licensing Advisory

1-21     Council.]

1-22                 [(3)]  "Department" means the Texas Department of

1-23     Health.

1-24                 (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

2-26     representative of those entities.

2-27                 (8) [(9)]  "Physician" means a physician licensed by

 3-1     the Texas State Board of Medical Examiners.

 3-2                 (9) [(10)]  "Podiatrist" means a podiatrist licensed by

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

 3-4                 (10) [(11)]  "Special hospital" means an establishment

 3-5     that:

 3-6                       (A)  offers services, facilities, and beds for

 3-7     use for more than 24 hours for two or more unrelated individuals

 3-8     who are regularly admitted, treated, and discharged and who require

 3-9     services more intensive than room, board, personal services, and

3-10     general nursing care;

3-11                       (B)  has clinical laboratory facilities,

3-12     diagnostic X-ray facilities, treatment facilities, or other

3-13     definitive medical treatment;

3-14                       (C)  has a medical staff in regular attendance;

3-15     and

3-16                       (D)  maintains records of the clinical work

3-17     performed for each patient.

3-18           SECTION 3.  Section 241.026(a), Health and Safety Code, is

3-19     amended to read as follows:

3-20           (a)  The board [, with the advice of the council,] shall

3-21     adopt and enforce rules to further the purposes of this chapter.

3-22     The rules at a minimum shall address:

3-23                 (1)  minimum requirements for staffing by physicians

3-24     and nurses;

3-25                 (2)  hospital services relating to patient care;

3-26                 (3)  fire prevention, safety, and sanitation

3-27     requirements in hospitals;

 4-1                 (4)  patient care and a patient bill of rights;  and

 4-2                 (5)  compliance with other state and federal laws

 4-3     affecting the health, safety, and rights of hospital patients.

 4-4            SECTION 4.  Sections 142.016(b) and (c), Health and Safety

 4-5     Code, are amended to read as follows:

 4-6           (b)  [The Board of Nurse Examiners and the department shall

 4-7     consult with an advisory committee in developing, modifying, or

 4-8     renewing the memorandum of understanding.  The advisory committee

 4-9     shall be appointed by the Board of Nurse Examiners and the

4-10     department and at a minimum shall include:]

4-11                 [(1)  one representative from the Board of Nurse

4-12     Examiners and one representative from the department to serve as

4-13     cochairmen;]

4-14                 [(2)  one representative from the Texas Department of

4-15     Mental Health and Mental Retardation;]

4-16                 [(3)  one representative from the Texas Department of

4-17     Human Services;]

4-18                 [(4)  one representative from the Texas Nurses

4-19     Association;]

4-20                 [(5)  one representative from the Texas Association for

4-21     Home Care, Incorporated, or its successor;]

4-22                 [(6)  one representative from the Texas Hospice

4-23     Organization, Incorporated, or its successor;]

4-24                 [(7)  one representative of the Texas Respite Resource

4-25     Network or its successor; and]

4-26                 [(8)  two representatives of organizations such as the

4-27     Personal Assistance Task Force or the Disability Consortium that

 5-1     advocate for clients in community-based settings.]

 5-2           [(c)]  The department shall prepare guidelines according to

 5-3     the memorandum of understanding required by Subsection (a) for

 5-4     licensed home and community support services agencies in providing

 5-5     personal assistance services to clients.

 5-6           SECTION 5.  Sections 3 and 5, Opticians' Registry Act

 5-7     (Article 4551-1, Vernon's Texas Civil Statutes), are amended to

 5-8     read as follows:

 5-9           Sec. 3.  DEFINITIONS.  In this Act:

5-10                 (1)  "Board" means the Texas Board of Health.

5-11                 (2)  "Contact lens dispensing" means the fabrication,

5-12     ordering, mechanical adjustment, dispensing, sale, and delivery to

5-13     the consumer of contact lenses prescribed by and dispensed in

5-14     accordance with a prescription from a licensed physician or

5-15     optometrist, together with appropriate instructions for the care

5-16     and handling of the lenses.  The term does not include the taking

5-17     of any measurements of the eye or the cornea or evaluating the

5-18     physical fit of the contact lenses, unless that action is directed

5-19     or approved by a licensed physician.

5-20                 (3)  "Contact lens prescription" means a written

5-21     specification by a licensed physician or optometrist for

5-22     therapeutic, corrective, or cosmetic contact lenses that states the

5-23     refractive power of the product and other information as required

5-24     by:

5-25                       (A)  the physician or the Texas State Board of

5-26     Medical Examiners; or

5-27                       (B)  the optometrist or the Texas Optometry

 6-1     Board.

 6-2                 (4)  ["Council" means the Advisory Council of the

 6-3     Opticians' Registry.]

 6-4                 [(5)]  "Department" means the Texas Department of

 6-5     Health.

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

 6-7     dispenser" means a person who provides or offers to provide

 6-8     spectacle or contact lens dispensing services or products to the

 6-9     public.

6-10                 (6) [(7)]  "Spectacle dispensing" means the design,

6-11     verification, fitting, adjustment, sale, and delivery to the

6-12     consumer of fabricated and finished spectacle lenses, frames, or

6-13     other ophthalmic devices, other than contact lenses, prescribed by

6-14     and dispensed in accordance with a prescription from a licensed

6-15     physician or optometrist.  The term includes:

6-16                       (A)  prescription analysis and interpretation;

6-17                       (B)  the taking of measurements of the face,

6-18     including interpupillary distances, to determine the size, shape,

6-19     and specifications of the spectacle lenses or frames best suited to

6-20     the wearer's needs;

6-21                       (C)  the preparation and delivery of work orders

6-22     to laboratory technicians engaged in grinding lenses and

6-23     fabricating spectacles;

6-24                       (D)  the verification of the quality of finished

6-25     spectacle lenses;

6-26                       (E)  the adjustment of spectacle lenses or frames

6-27     to the intended wearer's face;  and

 7-1                       (F)  the adjustment, repair, replacement,

 7-2     reproduction, or duplication of previously prepared spectacle

 7-3     lenses, frames, or other specially fabricated optical devices,

 7-4     other than contact lenses.

 7-5                 (7) [(8)]  "Spectacle prescription" means a written

 7-6     specification by a licensed physician or optometrist for

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

 7-8     of the product and other information as required by the physician

 7-9     or optometrist.

7-10           Sec. 5.  DUTIES OF BOARD[; ADVISORY COUNCIL].  (a)  The board

7-11     shall adopt procedural rules to implement the registration

7-12     procedures under this Act. The board also may adopt substantive and

7-13     procedural rules relating to:

7-14                 (1)  the minimum requirements for the registration of

7-15     dispensing opticians;

7-16                 (2)  the probation, suspension, denial, or revocation

7-17     of a registration;

7-18                 (3)  the setting of fees under this Act;  and

7-19                 (4)  the adoption of forms required by this Act.

7-20           (b)  The board may not adopt substantive rules relating to

7-21     this Act other than substantive rules described by Subsection (a)

7-22     of this section.

7-23           [(c)  The board shall appoint a nine-member advisory council

7-24     to be known as the Advisory Council of the Opticians' Registry to

7-25     advise the board on matters relating to implementation of this Act.

7-26     The members shall be appointed from different geographical areas to

7-27     ensure representation of urban and rural interests.]

 8-1           [(d)  The board shall appoint members of the council as

 8-2     follows:]

 8-3                 [(1)  three must be opticians eligible for registration

 8-4     under this Act, one of whom is eligible only as a contact lens

 8-5     dispensing optician, one of whom is eligible only as a spectacle

 8-6     dispensing optician, and one of whom is eligible for registration

 8-7     in either category;]

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

 8-9     this state whose practice is limited to ophthalmology;]

8-10                 [(3)  two must be optometrists licensed and practicing

8-11     in this state; and]

8-12                 [(4)  two must be consumers who do not have, and whose

8-13     spouses do not have, a direct or indirect interest in any health

8-14     care related business or trade association.]

8-15           [(e)  The council shall annually elect a chairman and

8-16     vice-chairman.]

8-17           [(f)  A council member is not entitled to compensation for

8-18     service on the council, but is entitled to the per diem and

8-19     transportation allowance for state officials set in the General

8-20     Appropriations Act for each day that the member engages in the

8-21     business of the council.]

8-22           [(g)  Members are appointed for staggered terms of six years,

8-23     with three terms beginning March 1 of each odd-numbered year.

8-24     Members shall serve until the expiration of the term to which they

8-25     have been appointed or until their successors have qualified.  A

8-26     member may not serve more than two consecutive terms.]

8-27           SECTION 6.  Section 1, Chapter 752, Acts of the 69th

 9-1     Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas

 9-2     Civil Statutes), is amended to read as follows:

 9-3           Sec. 1.  DEFINITIONS.  In this Act:

 9-4                 (1)  "Massage therapy" means the manipulation of soft

 9-5     tissue.  The term includes, but is not limited to, effleurage

 9-6     (stroking), petrissage (kneading), tapotement (percussion),

 9-7     compression, vibration, friction, nerve strokes, and Swedish

 9-8     gymnastics, either by hand or with mechanical or electrical

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

9-10     include the use of oil, salt glows, heat lamps, hot and cold packs,

9-11     tub, shower, or cabinet baths.  Equivalent terms for massage

9-12     therapy are massage, therapeutic massage, massage technology,

9-13     myo-therapy, body massage, body rub, or any derivation of those

9-14     terms.  Massage therapy is a health care service when the massage

9-15     therapy is for therapeutic purposes.  As used in the Act, the terms

9-16     "therapy" and "therapeutic" do not include diagnosis, the treatment

9-17     of illness or disease, or any service or procedure for which a

9-18     license to practice medicine, chiropractic, physical therapy, or

9-19     podiatry is required by law.  Massage therapy does not constitute

9-20     the practice of chiropractic.

9-21                 (2)  "Massage therapist" means an individual who

9-22     practices or administers massage therapy to a patron of either

9-23     gender for compensation.  The term includes a registered massage

9-24     therapist, therapeutic massage practitioner, massage technician,

9-25     masseur, masseuse, myo-therapist, body massager, body rubber, or

9-26     any derivation of those titles.

9-27                 (3)  "Massage therapy instructor" means an individual

 10-1    who is a registered massage therapist, who is instructing one or

 10-2    more students in massage therapy, and whose instruction is approved

 10-3    by the department.

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

 10-5    business that advertises massage therapy or offers massage therapy

 10-6    as a service.

 10-7                (5)  "Department" means the Texas Department of Health.

 10-8                (6)  "Board" means the Texas Board of Health.

 10-9                (7)  ["Advisory Council" means the Advisory Council on

10-10    Massage Therapy.]

10-11                [(8)]  "Person" means an individual, partnership,

10-12    corporation, association, or other legal entity.

10-13                (8) [(9)]  "Massage school" means an entity or

10-14    organization with at least two instructors that teaches, at a

10-15    minimum, the course of instruction required for registration as a

10-16    massage therapist under this Act.

10-17                (9) [(10)]  "Instructor" means an individual who

10-18    instructs one or more students in any section of the course of

10-19    instruction required for registration as a massage therapist.

10-20                (10) [(11)]  "Applicant" means a person, including a

10-21    massage school, a massage therapy instructor, or a massage

10-22    establishment, that applies for registration under this Act.

10-23                (11) [(12)]  "Examiner" means a registered massage

10-24    therapist who administers the practical portion of the state

10-25    examination to applicants for registration as massage therapists.

10-26                (12) [(13)]  "Internship program" means a program

10-27    supervised by a massage therapy instructor in which a student

 11-1    provides massage therapy to the general public.  The massage

 11-2    therapy may be for compensation in an amount set by the massage

 11-3    school or massage therapy instructor and paid to the massage school

 11-4    or massage therapy instructor.

 11-5                (13) [(14)]  "Sexually oriented business" has the

 11-6    meaning assigned by Section 243.002, Local Government Code, unless

 11-7    another meaning applies under local law.

 11-8          SECTION 7.  Section 2A(i), Chapter 752, Acts of the 69th

 11-9    Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas

11-10    Civil Statutes), is amended to read as follows:

11-11          (i)  An internship program must meet the qualifications

11-12    established by the board [with the advice of the advisory council].

11-13          SECTION 8.  Sections 7(a), (d), (e), and (f),  Chapter 752,

11-14    Acts of the 69th Legislature, Regular Session, 1985 (Article 4512k,

11-15    Vernon's Texas Civil Statutes), are amended to read as follows:

11-16          (a)  The board [, with the advice of the advisory council,]

11-17    shall adopt rules consistent with this Act, including rules

11-18    relating to the definition of "unprofessional conduct" as that term

11-19    is used by Section 11(a)(4) of this Act, as necessary for the

11-20    performance of its duties under this Act. The board shall adopt the

11-21    rules in the manner provided by the Administrative Procedure and

11-22    Texas Register Act (Article 6252-13a, Vernon's Texas Civil

11-23    Statutes).

11-24          (d)  The department shall prepare and administer a state

11-25    examination as required to implement this Act.  The department may

11-26    hire examiners [with the recommendation of the advisory council].

11-27    An examiner is entitled to compensation and the state per diem

 12-1    allowance as set by the General Appropriations Act for

 12-2    transportation and related expenses incurred by the examiner in

 12-3    engaging in the business of the department.

 12-4          (e)  [The board and department shall cooperate with the

 12-5    advisory council in the administration of this Act, and shall make

 12-6    available to the advisory council reports, statistical information,

 12-7    and other information as reasonably necessary for the advisory

 12-8    council to perform its duties under this Act.]

 12-9          [(f)]  The department shall regulate all massage school and

12-10    massage therapy instructor hours.

12-11          SECTION 9.  Section 2.03, Medical Radiologic Technologist

12-12    Certification Act (Article 4512m, Vernon's Texas Civil Statutes),

12-13    is amended to read as follows:

12-14          Sec. 2.03.  DEFINITIONS.  In this Act:

12-15                (1)  ["Advisory board" means the Medical Radiologic

12-16    Technologist Advisory Board.]

12-17                [(2)]  "Department" means the Texas Department of

12-18    Health.

12-19                (2) [(3)]  "Radiologic technology" means the

12-20    administration of radiation to a person for medical purposes.

12-21                (3) [(4)]  "Radiation" means ionizing radiation in

12-22    amounts beyond normal background levels from sources such as

12-23    medical and dental radiologic procedures.

12-24                (4) [(5)]  "Radiologic procedure" means any procedure

12-25    or article intended for use in the diagnosis of disease or other

12-26    medical or dental conditions in humans (including diagnostic X-rays

12-27    or nuclear medicine procedures) or the cure, mitigation, treatment,

 13-1    or prevention of disease in humans that achieves its intended

 13-2    purpose through the emission of radiation.

 13-3                (5) [(6)]  "Practitioner" means a doctor of medicine,

 13-4    osteopathy, podiatry, dentistry, or chiropractic who is licensed

 13-5    under the laws of this state and who prescribes radiologic

 13-6    procedures for other persons.

 13-7                (6) [(7)]  "Medical radiologic technologist" means a

 13-8    person certified under this Act, other than a practitioner, who,

 13-9    under the direction of a practitioner, intentionally administers

13-10    radiation to other persons for medical purposes.

13-11                (7) [(8)]  "Certification" means an authorization to

13-12    administer radiation to a person for medical purposes.

13-13                (8) [(9)]  "General certification" means an

13-14    authorization to perform radiologic procedures authorized by this

13-15    Act.

13-16                (9) [(10)]  "Limited certification" means an

13-17    authorization to perform radiologic procedures that are limited to

13-18    specific parts of the human body.

13-19                (10) [(11)]  "Temporary certification, general or

13-20    limited," means an authorization to perform radiologic procedures

13-21    for a limited period, not to exceed one year.

13-22                (11) [(12)]  "Registered Nurse" means a person licensed

13-23    by the Board of Nurse Examiners to practice professional nursing.

13-24                (12) [(13)]  "Direct supervision" means supervision and

13-25    control by a medical radiologic technologist or a practitioner who

13-26    assumes legal liability for a student employed to perform a

13-27    radiologic procedure and enrolled in a program that meets the

 14-1    requirements adopted by rule under Section 2.05 of this Act, and

 14-2    who is physically present during the conduct of a radiologic

 14-3    procedure to provide consultation or direct the action of the

 14-4    student.

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

 14-6    training or any other program offered by an organization approved

 14-7    by the Texas Board of Health that:

 14-8                      (A)  has a specified objective;

 14-9                      (B)  includes planned activities for the

14-10    participants;  and

14-11                      (C)  uses an approved method for measuring the

14-12    progress of the participants.

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

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

14-15    Board of Health under Section 2.05(f) of this Act.

14-16                (15) [(16)]  "Registrant" means an individual, other

14-17    than a practitioner or medical radiologic technologist, who meets

14-18    the requirements of Section 2.05(f) of this Act.

14-19          SECTION 10.  Section 1, Chapter 829, Acts of the 69th

14-20    Legislature, Regular Session, 1985 (Article 4512l, Vernon's Texas

14-21    Civil Statutes), is amended to read as follows:

14-22          Sec. 1.  DEFINITIONS.  In this Act:

14-23                (1)  ["Advisory board" means the Respiratory Care

14-24    Practitioners Advisory Board.]

14-25                [(2)]  "Board of health" means the Texas Board of

14-26    Health.

14-27                (2) [(3)]  "Department" means the Texas Department of

 15-1    Health.

 15-2                (3) [(4)]  "Respiratory care" means the treatment,

 15-3    management, control, diagnostic evaluation, and care of patients

 15-4    who have deficiencies and abnormalities associated with the

 15-5    cardiorespiratory system.

 15-6                (4) [(5)]  "Respiratory care practitioner" means a

 15-7    person permitted or certified under this Act to practice

 15-8    respiratory care.

 15-9                (5) [(6)]  "Respiratory care procedure" means

15-10    respiratory care provided by the therapeutic and diagnostic use of

15-11    medical gases, humidifiers, and aerosols, the administration of

15-12    drugs and medications to the cardiorespiratory system, ventilatory

15-13    assistance and ventilatory control, postural drainage, chest

15-14    drainage, chest percussion or vibration, breathing exercises,

15-15    respiratory rehabilitation, cardiopulmonary resuscitation,

15-16    maintenance of natural airways, and the insertion and maintenance

15-17    of artificial airways.  The term includes a technique employed to

15-18    assist in diagnosis, monitoring, treatment, and research, including

15-19    the measurement of ventilatory volumes, pressures and flows, the

15-20    specimen collection of blood and other materials, pulmonary

15-21    function testing, and hemodynamic and other related physiological

15-22    forms of monitoring or treating, as ordered by the patient's

15-23    physician, the cardiorespiratory system.

15-24          SECTION 11.  Section 3(d), Chapter 829, Acts of the 69th

15-25    Legislature, Regular Session, 1985 (Article 4512l, Vernon's Texas

15-26    Civil Statutes), is amended to read as follows:

15-27          (d)  The [After consultation with the advisory board, the]

 16-1    board of health by rule shall establish examination requirements

 16-2    for a certificate under this Act.  The board of health may use the

 16-3    entry level examination prepared by the National Board for

 16-4    Respiratory Care or an equivalent examination.

 16-5          SECTION 12.  The following are repealed:

 16-6                (1)  Sections 12.072, 12.073, 12.074, 31.017, 36.015,

 16-7    43.015, 87.006, 241.081, 241.082, 241.083, 241.084, 241.085,

 16-8    311.038, 431.208, 502.013, 773.006, 773.118, and 773.172, Health

 16-9    and Safety Code;

16-10                (2)  Section 13, Texas Asbestos Health Protection Act

16-11    (Article 4477-3a, Vernon's Texas Civil Statutes);

16-12                (3)  Section 10, Chapter 796, Acts of the 72nd

16-13    Legislature, Regular Session, 1991 (Article 4447bb, Vernon's Texas

16-14    Civil Statutes);

16-15                (4)  Sections 8 and 9,  Chapter 752, Acts of the 69th

16-16    Legislature, Regular Session, 1985 (Article 4512k, Vernon's Texas

16-17    Civil Statutes);

16-18                (5)  Section 2.04, Medical Radiologic Technologist

16-19    Certification Act (Article 4512m, Vernon's Texas Civil Statutes);

16-20    and

16-21                (6)  Sections 2 and 14, Chapter 829, Acts of the 69th

16-22    Legislature, 1985 (Article 4512l, Vernon's Texas Civil Statutes).

16-23          SECTION 13.  This Act takes effect September 1, 1997.

16-24          SECTION 14.  The importance of this legislation and the

16-25    crowded condition of the calendars in both houses create an

16-26    emergency and an imperative public necessity that the

16-27    constitutional rule requiring bills to be read on three several

 17-1    days in each house be suspended, and this rule is hereby suspended.