1-1 By: Moncrief, et al. S.B. No. 94
1-2 (In the Senate - Filed December 14, 1998; January 26, 1999,
1-3 read first time and referred to Committee on Health Services;
1-4 March 1, 1999, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 0; March 1, 1999,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 94 By: Moncrief
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to home health services; providing administrative
1-11 penalties.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Section 142.001, Health and Safety Code, is
1-14 amended to read as follows:
1-15 Sec. 142.001. DEFINITIONS. In this chapter:
1-16 (1) "Administrative support site" means a facility or
1-17 site where a home and community support services agency performs
1-18 administrative and other support functions but does not provide
1-19 direct home health, hospice, or personal assistance services.
1-20 (2) "Alternate delivery site" means a facility or
1-21 site, including a residential unit or an inpatient unit:
1-22 (A) that is owned or operated by a hospice;
1-23 (B) that is not the hospice's principal place of
1-24 business;
1-25 (C) that is located in the geographical area
1-26 served by the hospice; and
1-27 (D) from which the hospice provides hospice
1-28 services.
1-29 (3) "Bereavement" means the process by which a
1-30 survivor of a deceased person mourns and experiences grief.
1-31 (4) "Bereavement services" means support services
1-32 offered to a family during bereavement.
1-33 (5) "Branch office" means a facility or site in the
1-34 geographical area served by a home and community support agency
1-35 where home health or personal assistance services are delivered or
1-36 active client records are maintained.
1-37 (6) "Certified agency" means a home and community
1-38 support services agency that:
1-39 (A) provides a home health service; and
1-40 (B) is certified by an official of the
1-41 Department of Health and Human Services as in compliance with
1-42 conditions of participation in Title XVIII, Social Security Act (42
1-43 U.S.C. Section 1395 et seq.).
1-44 (7) "Certified home health services" means home health
1-45 services that are provided by a certified agency.
1-46 (8) "Chief financial officer" means an individual who
1-47 is responsible for supervising and managing all financial
1-48 activities for a home and community support services agency.
1-49 (9) "Controlling person" means a person who controls a
1-50 home and community support services agency or other person as
1-51 described by Section 142.0012.
1-52 (10) "Council" means the Home and Community Support
1-53 Services Advisory Council.
1-54 (11) [(10)] "Counselor" means an individual qualified
1-55 under Medicare standards to provide counseling services, including
1-56 bereavement, dietary, spiritual, and other counseling services, to
1-57 both the client and the family.
1-58 (12) [(11)] "Home and community support services
1-59 agency" means a person who provides home health, hospice, or
1-60 personal assistance services for pay or other consideration in a
1-61 client's residence, an independent living environment, or another
1-62 appropriate location.
1-63 (13) [(12)] "Home health service" means the provision
1-64 of one or more of the following health services required by an
2-1 individual in a residence or independent living environment:
2-2 (A) nursing;
2-3 (B) physical, occupational, speech, or
2-4 respiratory therapy;
2-5 (C) medical social service;
2-6 (D) intravenous therapy;
2-7 (E) dialysis;
2-8 (F) service provided by unlicensed personnel
2-9 under the delegation of a licensed health professional;
2-10 (G) the furnishing of medical equipment and
2-11 supplies, excluding drugs and medicines; or
2-12 (H) nutritional counseling.
2-13 (14) [(13)] "Hospice" means a person licensed under
2-14 this chapter to provide hospice services, including a person who
2-15 owns or operates a residential unit or an inpatient unit.
2-16 (15) [(14)] "Hospice services" means services,
2-17 including services provided by unlicensed personnel under the
2-18 delegation of a registered nurse or physical therapist, provided to
2-19 a client or a client's family as part of a coordinated program
2-20 consistent with the standards and rules adopted under this chapter.
2-21 These services include palliative care for terminally ill clients
2-22 and support services for clients and their families that:
2-23 (A) are available 24 hours a day, seven days a
2-24 week, during the last stages of illness, during death, and during
2-25 bereavement;
2-26 (B) are provided by a medically directed
2-27 interdisciplinary team; and
2-28 (C) may be provided in a home, nursing home,
2-29 residential unit, or inpatient unit according to need. These
2-30 services do not include inpatient care normally provided in a
2-31 licensed hospital to a terminally ill person who has not elected to
2-32 be a hospice client.
2-33 (16) [(15)] "Inpatient unit" means a facility that
2-34 provides a continuum of medical or nursing care and other hospice
2-35 services to clients admitted into the unit and that is in
2-36 compliance with:
2-37 (A) the conditions of participation for
2-38 inpatient units adopted under Title XVIII, Social Security Act (42
2-39 U.S.C. Section 1395 et seq.); and
2-40 (B) standards adopted under this chapter.
2-41 (17) [(16)] "Independent living environment" means:
2-42 (A) a client's individual residence, which may
2-43 include a group home or foster home; or
2-44 (B) other settings where a client participates
2-45 in activities, including school, work, or church.
2-46 (18) [(17)] "Interdisciplinary team" means a group of
2-47 individuals who work together in a coordinated manner to provide
2-48 hospice services and must include a physician, registered nurse,
2-49 social worker, and counselor.
2-50 (19) [(18)] "Investigation" means an inspection or
2-51 survey conducted by a representative of the department to determine
2-52 if a licensee is in compliance with this chapter.
2-53 (20) [(19)] "Palliative care" means intervention
2-54 services that focus primarily on the reduction or abatement of
2-55 physical, psychosocial, and spiritual symptoms of a terminal
2-56 illness.
2-57 (21) [(20)] "Person" means an individual, corporation,
2-58 or association.
2-59 (22) [(21)] "Personal assistance service" means
2-60 routine ongoing care or services required by an individual in a
2-61 residence or independent living environment that enable the
2-62 individual to engage in the activities of daily living or to
2-63 perform the physical functions required for independent living,
2-64 including respite services. The term includes health-related
2-65 services performed under circumstances that are defined as not
2-66 constituting the practice of professional nursing by the Board of
2-67 Nurse Examiners through a memorandum of understanding with the
2-68 department in accordance with Section 142.016 and health-related
2-69 tasks provided by unlicensed personnel under the delegation of a
3-1 registered nurse.
3-2 (23) [(22)] "Place of business" means an office of a
3-3 home and community support services agency that maintains client
3-4 records or directs home health, hospice, or personal assistance
3-5 services. The term does not include an administrative support
3-6 site.
3-7 (24) [(23)] "Residence" means a place where a person
3-8 resides and includes a home, a nursing home, a convalescent home,
3-9 or a residential unit.
3-10 (25) [(24)] "Residential unit" means a facility that
3-11 provides living quarters and hospice services to clients admitted
3-12 into the unit and that is in compliance with standards adopted
3-13 under this chapter.
3-14 (26) [(25)] "Respite services" means support options
3-15 that are provided temporarily for the purpose of relief for a
3-16 primary caregiver in providing care to individuals of all ages with
3-17 disabilities or at risk of abuse or neglect.
3-18 (27) [(26)] "Social worker" means an individual
3-19 licensed [certified] as a social worker under Chapter 50, Human
3-20 Resources Code.
3-21 (28) [(27)] "Support services" means social,
3-22 spiritual, and emotional care provided to a client and a client's
3-23 family by a hospice.
3-24 (29) [(28)] "Terminal illness" means an illness for
3-25 which there is a limited prognosis if the illness runs its usual
3-26 course.
3-27 (30) [(29)] "Volunteer" means an individual who
3-28 provides assistance to a home and community support services agency
3-29 without compensation other than reimbursement for actual expenses.
3-30 SECTION 2. Subchapter A, Chapter 142, Health and Safety
3-31 Code, is amended by adding Sections 142.0011 and 142.0012 to read
3-32 as follows:
3-33 Sec. 142.0011. SCOPE, PURPOSE, AND IMPLEMENTATION. (a) The
3-34 purpose of this chapter is to ensure that home and community
3-35 support services agencies in this state deliver the highest
3-36 possible quality of care. This chapter and the rules adopted under
3-37 this chapter establish minimum standards for acceptable quality of
3-38 care, and a violation of a minimum standard established or adopted
3-39 under this chapter is a violation of law. For purposes of this
3-40 chapter, components of quality of care include:
3-41 (1) client independence and self-determination;
3-42 (2) humane treatment;
3-43 (3) continuity of care;
3-44 (4) coordination of services;
3-45 (5) professionalism of service providers;
3-46 (6) quality of life; and
3-47 (7) client satisfaction with services.
3-48 (b) The department shall protect clients of home and
3-49 community support services agencies by regulating those agencies
3-50 and:
3-51 (1) adopting rules relating to quality of care and
3-52 quality of life;
3-53 (2) strictly monitoring factors relating to the
3-54 health, safety, welfare, and dignity of each client;
3-55 (3) imposing prompt and effective remedies for
3-56 violations of this chapter and rules and standards adopted under
3-57 this chapter;
3-58 (4) enabling agencies to provide services that allow
3-59 clients to maintain the highest possible degree of independence and
3-60 self-determination; and
3-61 (5) providing the public with helpful and
3-62 understandable information relating to agencies in this state.
3-63 Sec. 142.0012. CONTROLLING PERSON. (a) A person is a
3-64 controlling person if the person, acting alone or with others, has
3-65 the ability to directly or indirectly influence, direct, or cause
3-66 the direction of the management, expenditure of money, or policies
3-67 of a home and community support services agency or other person.
3-68 (b) For purposes of this chapter, "controlling person"
3-69 includes:
4-1 (1) a management company or other business entity that
4-2 operates or contracts with others for the operation of a home and
4-3 community support services agency;
4-4 (2) a person who is a controlling person of a
4-5 management company or other business entity that operates a home
4-6 and community support services agency or that contracts with
4-7 another person for the operation of a home and community support
4-8 services agency; and
4-9 (3) any other individual who, because of a personal,
4-10 familial, or other relationship with the owner, manager, or
4-11 provider of a home and community support services agency, is in a
4-12 position of actual control or authority with respect to the agency,
4-13 without regard to whether the individual is formally named as an
4-14 owner, manager, director, officer, provider, consultant,
4-15 contractor, or employee of the agency.
4-16 (c) A controlling person described by Subsection (b)(3) does
4-17 not include an employee, lender, secured creditor, or other person
4-18 who does not exercise formal or actual influence or control over
4-19 the operation of a home and community support services agency.
4-20 (d) The department may adopt rules that specify the
4-21 ownership interests and other relationships that qualify a person
4-22 as a controlling person.
4-23 SECTION 3. Subsection (a), Section 142.003, Health and
4-24 Safety Code, is amended to read as follows:
4-25 (a) The following persons need not be licensed under this
4-26 chapter:
4-27 (1) a physician, dentist, registered nurse, or
4-28 physical therapist licensed under the laws of this state who
4-29 provides home health services to a client only as a part of and
4-30 incidental to that person's private office practice;
4-31 (2) a registered nurse, licensed vocational nurse,
4-32 physical therapist, occupational therapist, speech therapist,
4-33 medical social worker, or any other health care professional as
4-34 determined by the department who provides home health services as a
4-35 sole practitioner;
4-36 (3) a registry that operates solely as a clearinghouse
4-37 to put consumers in contact with persons who provide home health,
4-38 hospice, or personal assistance services and that does not maintain
4-39 official client records, direct client services, or compensate the
4-40 person who is providing the service;
4-41 (4) an individual whose permanent residence is in the
4-42 client's residence;
4-43 (5) an employee of a person licensed under this
4-44 chapter who provides home health, hospice, or personal assistance
4-45 services only as an employee of the license holder and who receives
4-46 no benefit for providing the services, other than wages from the
4-47 license holder;
4-48 (6) a home, nursing home, convalescent home, assisted
4-49 living [personal care] facility, special care facility, or other
4-50 institution for individuals who are elderly or who have
4-51 disabilities that provides home health or personal assistance
4-52 services only to residents of the home or institution;
4-53 (7) a person who provides one health service through a
4-54 contract with a person licensed under this chapter;
4-55 (8) a durable medical equipment supply company;
4-56 (9) a pharmacy or wholesale medical supply company
4-57 that does not furnish services, other than supplies, to a person at
4-58 the person's house;
4-59 (10) a hospital or other licensed health care facility
4-60 that provides home health or personal assistance services only to
4-61 inpatient residents of the hospital or facility;
4-62 (11) a person providing home health or personal
4-63 assistance services to an injured employee under Title 5, Labor
4-64 Code [the Texas Workers' Compensation Act (Article 8308-1.01 et
4-65 seq., Vernon's Texas Civil Statutes)];
4-66 (12) a visiting nurse service that:
4-67 (A) is conducted by and for the adherents of a
4-68 well-recognized church or religious denomination; and
4-69 (B) provides nursing services by a person exempt
5-1 from licensing by Article 4528, Revised Statutes, because the
5-2 person furnishes nursing care in which treatment is only by prayer
5-3 or spiritual means;
5-4 (13) an individual hired and paid directly by the
5-5 client or the client's family or legal guardian to provide home
5-6 health or personal assistance services;
5-7 (14) a business, school, camp, or other organization
5-8 that provides home health or personal assistance services,
5-9 incidental to the organization's primary purpose, to individuals
5-10 employed by or participating in programs offered by the business,
5-11 school, or camp that enable the individual to participate fully in
5-12 the business's, school's, or camp's programs;
5-13 (15) a person or organization providing
5-14 sitter-companion services or chore or household services that do
5-15 not involve personal care, health, or health-related services;
5-16 (16) a licensed health care facility that provides
5-17 hospice services under a contract with a hospice;
5-18 (17) a person delivering residential acquired immune
5-19 deficiency syndrome hospice care who is licensed and designated as
5-20 a residential AIDS hospice under Chapter 248; or
5-21 (18) the Texas Department of Criminal Justice.
5-22 SECTION 4. Subsections (c) and (d), Section 142.004, Health
5-23 and Safety Code, are amended to read as follows:
5-24 (c) The board by rule shall require that, at a minimum,
5-25 before the department may approve a license application, the
5-26 applicant must provide to the department:
5-27 (1) documentation establishing that, at a minimum, the
5-28 applicant has sufficient financial resources to provide the
5-29 services required by this chapter and by the department during the
5-30 term of the license;
5-31 (2) a list of the management personnel for the
5-32 proposed home and community support services agency, a description
5-33 of personnel qualifications, and a plan for providing continuing
5-34 training and education for the personnel during the term of the
5-35 license;
5-36 (3) documentation establishing that the applicant is
5-37 capable of meeting the minimum standards established by the board
5-38 relating to the quality of care;
5-39 (4) a plan that provides for the orderly transfer of
5-40 care of the applicant's clients if the applicant cannot maintain or
5-41 deliver home health, hospice, or personal assistance services under
5-42 the license; [and]
5-43 (5) identifying information on the home and community
5-44 support services agency owner, administrator, and chief financial
5-45 officer to enable the department to conduct criminal background
5-46 checks on those persons;
5-47 (6) identification of any controlling person with
5-48 respect to the applicant; and
5-49 (7) documentation relating to any controlling person
5-50 identified under Subdivision (6), if requested by the department
5-51 and relevant to the controlling person's compliance with any
5-52 applicable licensing standard required or adopted by the board
5-53 under this chapter.
5-54 (d) Information received by the department relating to the
5-55 competence and financial resources of the applicant or a
5-56 controlling person with respect to the applicant is confidential
5-57 and may not be disclosed to the public.
5-58 SECTION 5. Subchapter A, Chapter 142, Health and Safety
5-59 Code, is amended by adding Section 142.005 to read as follows:
5-60 Sec. 142.005. COMPLIANCE RECORD IN OTHER STATES. The
5-61 department may require an applicant or license holder to provide
5-62 the department with information relating to compliance by the
5-63 applicant, the license holder, or a controlling person with respect
5-64 to the applicant or license holder with regulatory requirements in
5-65 any other state in which the applicant, license holder, or
5-66 controlling person operates or operated a home and community
5-67 support services agency.
5-68 SECTION 6. Subsection (a), Section 142.006, Health and
5-69 Safety Code, is amended to read as follows:
6-1 (a) The department shall issue a home and community support
6-2 services agency license to provide home health, hospice, or
6-3 personal assistance services for each place of business to an
6-4 applicant if:
6-5 (1) the [each] applicant [who]:
6-6 (A) [(1)] qualifies for the license to provide
6-7 the type of service that is to be offered by the applicant;
6-8 (B) [(2)] submits an application and license fee
6-9 as required by this chapter; and
6-10 (C) [(3)] complies with all applicable licensing
6-11 standards required or adopted by the board under this chapter; and
6-12 (2) any controlling person with respect to the
6-13 applicant complies with all applicable licensing standards required
6-14 or adopted by the board under this chapter.
6-15 SECTION 7. Subsection (d), Section 142.009, Health and
6-16 Safety Code, is amended to read as follows:
6-17 (d) The reports, records, and working papers used or
6-18 developed in an investigation made under this section are
6-19 confidential and may not be released or made public except:
6-20 (1) to a state or federal agency;
6-21 (2) to federal, state, or local law enforcement
6-22 personnel;
6-23 (3) with the consent of each person identified in the
6-24 information released;
6-25 (4) in civil or criminal litigation matters or
6-26 licensing proceedings as otherwise allowed by law or judicial rule;
6-27 [or]
6-28 (5) on a form developed by the department that
6-29 identifies any deficiencies found without identifying a person,
6-30 other than the home and community support services agency;
6-31 (6) on a form required by a federal agency if:
6-32 (A) the information does not reveal the identity
6-33 of an individual, including a patient or a physician or other
6-34 medical practitioner;
6-35 (B) the service provider subject to the
6-36 investigation had a reasonable opportunity to review the
6-37 information and offer comments to be included with the information
6-38 released or made public; and
6-39 (C) the release of the information complies with
6-40 any other federal requirement; or
6-41 (7) as provided by Section 142.0092.
6-42 SECTION 8. Subchapter A, Chapter 142, Health and Safety
6-43 Code, is amended by adding Sections 142.0091, 142.0092, and
6-44 142.0093 to read as follows:
6-45 Sec. 142.0091. SURVEYOR TRAINING. (a) The department shall
6-46 provide specialized training to representatives of the department
6-47 who survey home and community support services agencies. The
6-48 training must include information relating to:
6-49 (1) the conduct of appropriate surveys that do not
6-50 focus exclusively on medical standards under an acute care model;
6-51 and
6-52 (2) acceptable delegation of nursing tasks.
6-53 (b) In developing and updating the training required by this
6-54 section, the department shall consult with and include providers of
6-55 home health, hospice, and personal assistance services and
6-56 consumers of home and community support services.
6-57 Sec. 142.0092. CONSUMER COMPLAINT DATA. (a) The department
6-58 shall maintain records or documents relating to complaints directed
6-59 to the department by consumers of home health, hospice, or personal
6-60 assistance services. The department shall organize the records or
6-61 documents according to standard, statewide categories as determined
6-62 by the department. In determining appropriate categories, the
6-63 department shall make distinctions based on factors useful to the
6-64 public in assessing the quality of services provided by a home and
6-65 community support services agency, including whether the complaint:
6-66 (1) was determined to be valid or invalid;
6-67 (2) involved significant physical harm or death to a
6-68 patient;
6-69 (3) involved financial exploitation of a patient; or
7-1 (4) resulted in any sanction imposed against the
7-2 agency.
7-3 (b) The department shall make the information maintained
7-4 under this section available to the public in a useful format that
7-5 does not identify individuals implicated in the complaints.
7-6 Sec. 142.0093. RETALIATION PROHIBITED. (a) A person
7-7 licensed under this chapter may not retaliate against another
7-8 person for filing a complaint, presenting a grievance, or providing
7-9 in good faith information relating to home health, hospice, or
7-10 personal assistance services provided by the license holder.
7-11 (b) This section does not prohibit a license holder from
7-12 terminating an employee for a reason other than retaliation.
7-13 SECTION 9. Subsection (a), Section 142.011, Health and
7-14 Safety Code, is amended to read as follows:
7-15 (a) The department may deny a license application or suspend
7-16 or revoke the license of a person who:
7-17 (1) fails to comply with the rules or standards for
7-18 licensing required by this chapter; or
7-19 (2) engages in conduct that violates Section 161.091.
7-20 SECTION 10. Subsections (a) and (d), Section 142.017, Health
7-21 and Safety Code, are amended to read as follows:
7-22 (a) The department may assess an administrative penalty
7-23 against a person who violates:
7-24 (1) this chapter or a rule adopted under this chapter;
7-25 or
7-26 (2) Section 161.091, if the violation relates to the
7-27 provision of home health, hospice, or personal assistance services.
7-28 (d) The department by rule shall establish a schedule of
7-29 appropriate and graduated penalties for each violation based on:
7-30 (1) the seriousness of the violation, including the
7-31 nature, circumstances, extent, and gravity of the violation and the
7-32 hazard or safety of clients;
7-33 (2) the history of previous violations by the person
7-34 or a controlling person with respect to that person;
7-35 (3) whether the affected home and community support
7-36 services agency had identified the violation as a part of its
7-37 internal quality assurance process and had made appropriate
7-38 progress on correction;
7-39 (4) the amount necessary to deter future violations;
7-40 (5) efforts made to correct the violation; and
7-41 (6) any other matters that justice may require.
7-42 SECTION 11. Subchapter A, Chapter 142, Health and Safety
7-43 Code, is amended by adding Sections 142.018 and 142.019 to read as
7-44 follows:
7-45 Sec. 142.018. REPORTS OF ABUSE, EXPLOITATION, OR NEGLECT.
7-46 (a) In this section, "abuse," "exploitation," and "neglect" have
7-47 the meanings assigned by Section 48.002, Human Resources Code.
7-48 (b) A home and community support services agency that has
7-49 cause to believe that a person receiving services from the agency
7-50 has been abused, exploited, or neglected by an employee of the
7-51 agency shall report the information to:
7-52 (1) the department; and
7-53 (2) the Department of Protective and Regulatory
7-54 Services or other appropriate state agency as required by Sections
7-55 48.036 and 48.082, Human Resources Code.
7-56 (c) This section does not affect the duty or authority of
7-57 any state agency to conduct an investigation of alleged abuse,
7-58 exploitation, or neglect as provided by other law.
7-59 Sec. 142.019. CERTAIN PHYSICIAN REFERRALS PROHIBITED. A
7-60 physician may not refer a patient to a home and community support
7-61 services agency if the referral violates 42 U.S.C. Section 1395nn
7-62 and its subsequent amendments.
7-63 SECTION 12. Subchapter B, Chapter 531, Government Code, is
7-64 amended by adding Section 531.0431 to read as follows:
7-65 Sec. 531.0431. HOME HEALTH CARE RATES. In setting payment
7-66 rates for home health care providers, the commission and each
7-67 appropriate health and human services agency shall focus on the
7-68 provision of quality, cost-effective services to the residents of
7-69 this state.
8-1 SECTION 13. Subchapter C, Chapter 48, Human Resources Code,
8-2 is amended by adding Section 48.0381 to read as follows:
8-3 Sec. 48.0381. NOTIFICATION OF LICENSING OR CONTRACTING
8-4 AGENCY. (a) On determining after an investigation that an elderly
8-5 or disabled person has been abused, exploited, or neglected by an
8-6 employee of a home and community support services agency licensed
8-7 under Chapter 142, Health and Safety Code, the department shall:
8-8 (1) notify the state agency responsible for licensing
8-9 the home and community support services agency of the department's
8-10 determination;
8-11 (2) notify any health and human services agency, as
8-12 defined by Section 531.001, Government Code, that contracts with
8-13 the home and community support services agency for the delivery of
8-14 health care services of the department's determination; and
8-15 (3) provide to the licensing state agency and any
8-16 contracting health and human services agency access to the
8-17 department's records or documents relating to the department's
8-18 investigation.
8-19 (b) Providing access to a confidential record or document
8-20 under this section does not constitute a waiver of confidentiality.
8-21 SECTION 14. If, before implementing any provision of this
8-22 Act, a state agency determines that a waiver or authorization from
8-23 a federal agency is necessary for implementation of that provision,
8-24 the agency affected by the provision shall request the waiver or
8-25 authorization and may delay implementing that provision until the
8-26 waiver or authorization is granted.
8-27 SECTION 15. To the extent of any conflict, this Act prevails
8-28 over another Act of the 76th Legislature, Regular Session, 1999,
8-29 relating to nonsubstantive additions to and corrections in enacted
8-30 codes.
8-31 SECTION 16. (a) This Act takes effect September 1, 1999.
8-32 (b) Subsection (a), Section 142.011, and Subsections (a) and
8-33 (d), Section 142.017, Health and Safety Code, as amended by this
8-34 Act, apply only to conduct occurring on or after the effective date
8-35 of this Act. Conduct occurring before the effective date of this
8-36 Act is covered by the law in effect when the conduct occurred, and
8-37 the former law is continued in effect for that purpose.
8-38 SECTION 17. The importance of this legislation and the
8-39 crowded condition of the calendars in both houses create an
8-40 emergency and an imperative public necessity that the
8-41 constitutional rule requiring bills to be read on three several
8-42 days in each house be suspended, and this rule is hereby suspended.
8-43 * * * * *