By: Nixon S.B. No. 847
99S0080/1
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the practice of integrative or complementary health
1-2 care by licensed health care practitioners.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Title 71, Revised Statutes, is amended by adding
1-5 Article 4512r to read as follows:
1-6 Art. 4512r. PATIENT RIGHTS ACT
1-7 Sec. 1. LEGISLATIVE FINDINGS. The legislature finds that:
1-8 (1) patients have a right to seek nonconventional
1-9 health care treatments;
1-10 (2) licensed health care practitioners should be
1-11 allowed a reasonable and responsible degree of latitude in the
1-12 kinds of therapies they offer their patients; and
1-13 (3) parity should exist in the regulation of licensed
1-14 health care practitioners in various schools of thought in health
1-15 care.
1-16 Sec. 2. DEFINITIONS. In this article:
1-17 (1) "Board" means a state board, agency, or
1-18 association that regulates, licenses, certifies, or registers any
1-19 health or allied health profession, including medicine, dentistry,
1-20 podiatry, chiropractic, optometry, psychology, nursing,
1-21 occupational therapy, and physical therapy.
1-22 (2) "Conventional practice" means the reasonable
1-23 health care methods of diagnosis, treatment, or intervention that
1-24 are routinely offered by most licensees as generally accepted
2-1 methods of practice, based on training, experience, and review of
2-2 the applicable scientific literature.
2-3 (3) "Integrative or complementary practice" means
2-4 those reasonable health care methods of diagnosis, treatment, or
2-5 intervention that are not acknowledged to be conventional but that
2-6 may be offered by a licensee in addition to, or as an alternative
2-7 to, conventional practice, based on the licensee's training,
2-8 experience, and review of scientific literature.
2-9 (4) "Licensee" means any health or allied health care
2-10 professional that is regulated, licensed, certified, or registered
2-11 by a state board, agency, or association.
2-12 Sec. 3. TREATMENT PLANS. (a) A licensee may offer a
2-13 treatment plan tailored for the individual needs of the patient
2-14 that has stated objectives by which patient progress may be
2-15 evaluated.
2-16 (b) A treatment plan shall include any appropriate history,
2-17 examination findings, testing reports, and data obtained from other
2-18 health care professionals regarding the patient being treated. The
2-19 treatment plan shall also consider the advisability of additional
2-20 steps such as testing, consultation or referral, the use of other
2-21 treatment modalities, and whether follow-up care is required to
2-22 maintain any benefits that might be obtained.
2-23 (c) A treatment plan is reasonable if the treatment, whether
2-24 conventional or integrative or complementary, provides a potential
2-25 for therapeutic gain in the patient's health or medical condition
2-26 that is not reasonably outweighed by the risk of the treatment.
3-1 Sec. 4. INFORMED CONSENT. (a) Prior to offering treatment
3-2 to a patient, a licensee must inform the patient or the patient's
3-3 legal guardian, verbally or in writing, of:
3-4 (1) any significant safety risks of the proposed
3-5 treatment and whether the treatment is known to have a significant
3-6 adverse impact on the patient's nutritional status or on another,
3-7 concurrent health care treatment;
3-8 (2) the possibility of unknown interactions with
3-9 health status and other treatments if there are no specific adverse
3-10 effects which are generally recognized in the health community and
3-11 which have been thoroughly documented in peer-reviewed journals;
3-12 and
3-13 (3) future health changes the patient might expect if
3-14 the patient were to refuse, delay, or fail to complete the
3-15 treatment.
3-16 (b) The patient's record must document the notification
3-17 under Subsection (a) of this section.
3-18 Sec. 5. GUIDELINES FOR THE PROVISION OF CONVENTIONAL OR
3-19 INTEGRATIVE OR COMPLEMENTARY CARE. (a) A licensee shall not be
3-20 judged by a licensing agency to have engaged in unprofessional
3-21 conduct or be found to have failed to practice in a safe and
3-22 acceptable manner primarily on the basis of the type of treatment
3-23 the licensee employed, which may have been integrative or
3-24 complementary, if:
3-25 (1) the treatment employed met the reasonableness test
3-26 in Section 3(c) of this article;
4-1 (2) the treatment employed was within the licensee's
4-2 training and scope of practice;
4-3 (3) the treatment employed was part of a documented
4-4 treatment plan;
4-5 (4) the patient gave informed consent as provided in
4-6 Section 4 of this article; and
4-7 (5) the licensee followed the guidelines specified in
4-8 the applicable health practice licensing act with regard to
4-9 sanitation, patient assessment, and documentation, and other
4-10 applicable, nonconflicting sections of the specific licensing act.
4-11 (b) The licensee may continue to use a treatment, including
4-12 an integrative or complementary practice, provided the licensee
4-13 continues to document in the patient's record the patient's care
4-14 and progress toward the stated objectives based on periodic reviews
4-15 at reasonable intervals in view of the individual circumstances.
4-16 Sec. 6. INVESTIGATION PROCEDURE. (a) Prior to commencing a
4-17 disciplinary inquiry or action regarding quality of care issues
4-18 against a licensee, a licensing agency must notify the licensee of
4-19 the nature of the complaint and the identity of the person filing
4-20 the complaint if that person is other than an individual patient or
4-21 a legal guardian of a patient.
4-22 (b) Each licensing agency shall appoint a review panel to
4-23 ensure that treatment protocols are fairly and accurately
4-24 evaluated. A majority of the members of the panel shall be
4-25 practitioners thoroughly trained in the subspeciality of the
4-26 licensee being evaluated.
5-1 SECTION 2. This Act takes effect September 1, 1999.
5-2 SECTION 3. The importance of this legislation and the
5-3 crowded condition of the calendars in both houses create an
5-4 emergency and an imperative public necessity that the
5-5 constitutional rule requiring bills to be read on three several
5-6 days in each house be suspended, and this rule is hereby suspended.