By:  Nelson                                            S.B. No. 279
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to sanctions imposed against certain facilities regulated
 1-3     by the Texas Department of Health.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Section 241.053, Health and Safety Code, is
 1-6     amended to read as follows:
 1-7           Sec. 241.053.  DENIAL OF APPLICATION, SUSPENSION, REVOCATION,
 1-8     PROBATION, OR REISSUANCE OF LICENSE.  (a)  The department, after
 1-9     providing notice and an opportunity for a hearing to the applicant
1-10     or license holder, may deny, suspend, or revoke a hospital's
1-11     license if the department finds that the hospital:
1-12                 (1)  failed to comply with:
1-13                       (A)  a provision of this chapter;
1-14                       (B)  a rule adopted under this chapter;
1-15                       (C)  a special license condition;
1-16                       (D)  an order or emergency order by the
1-17     commissioner of health; or
1-18                       (E)  another enforcement procedure permitted
1-19     under this chapter;
1-20                 (2)  has a history of noncompliance with the rules
1-21     adopted under this chapter relating to patient health, safety, and
1-22     rights which reflects more than nominal noncompliance; or
1-23                 (3)  has aided, abetted, or permitted the commission of
1-24     an illegal act.
1-25           (b)  A hospital whose license is suspended or revoked may
 2-1     apply to the department for the reissuance of a license.  The
 2-2     department may reissue the license if the department determines
 2-3     that the hospital has corrected the conditions that led to the
 2-4     suspension or revocation of the hospital's license, the initiation
 2-5     of enforcement action against the hospital, the assessment of
 2-6     administrative penalties, or the issuance of a court order
 2-7     enjoining the hospital from violations or assessing civil penalties
 2-8     against the hospital.  A hospital whose license is suspended or
 2-9     revoked may not admit new patients until the license is reissued.
2-10           (c)  A hospital must apply for reissuance in the form and
2-11     manner required in the rules adopted under this chapter.
2-12           (d)  Administrative hearings required under this section
2-13     shall be conducted under the board's formal hearing rules and the
2-14     contested case provisions of Chapter 2001, Government Code.
2-15           (e)  Judicial review of a final decision by the department is
2-16     by trial de novo in the same manner as a case appealed from the
2-17     justice court to the county court.  The substantial evidence rule
2-18     does not apply.
2-19           (f)  If the department finds that a hospital is in repeated
2-20     noncompliance under Subsection (a) but that the noncompliance does
2-21     not endanger public health and safety, the department may schedule
2-22     the hospital for probation rather than suspending or revoking the
2-23     hospital's license.  The department shall provide notice to the
2-24     hospital of the probation and of the items of noncompliance not
2-25     later than the 10th day before the date the probation period
2-26     begins.  The department shall designate a period of not less than
 3-1     30 days during which the hospital will remain under probation.
 3-2     During the probation period, the hospital must correct the items
 3-3     that were in noncompliance and report the corrections to the
 3-4     department for approval.
 3-5           (g)  The department may suspend or revoke the license of a
 3-6     hospital that does not correct items that were in noncompliance or
 3-7     that does not comply with the applicable requirements within the
 3-8     applicable probation period.
 3-9           SECTION 2.  Section 243.011, Health and Safety Code, is
3-10     amended to read as follows:
3-11           Sec. 243.011.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
3-12     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
3-13     license for a violation of this chapter or a rule adopted under
3-14     this chapter.
3-15           (b)  The denial, suspension, or revocation of a license by
3-16     the department and the appeal from that action are governed by the
3-17     procedures for a contested case hearing under Chapter 2001,
3-18     Government Code.
3-19           (c)  If the department finds that an ambulatory surgical
3-20     center is in repeated noncompliance with this chapter or rules
3-21     adopted under this chapter but that the noncompliance does not
3-22     endanger public health and safety, the department may schedule the
3-23     center for probation rather than suspending or revoking the
3-24     center's license.  The department shall provide notice to the
3-25     center of the probation and of the items of noncompliance not later
3-26     than the 10th day before the date the probation period begins.  The
 4-1     department shall designate a period of not less than 30 days during
 4-2     which the center will remain under probation.  During the probation
 4-3     period, the center must correct the items that were in
 4-4     noncompliance and report the corrections to the department for
 4-5     approval.
 4-6           (d)  The department may suspend or revoke the license of an
 4-7     ambulatory surgical center that does not correct items that were in
 4-8     noncompliance or that does not comply with this chapter or the
 4-9     rules adopted under this chapter within the applicable probation
4-10     period.
4-11           SECTION 3.  Section 244.011, Health and Safety Code, is
4-12     amended to read as follows:
4-13           Sec. 244.011.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
4-14     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
4-15     license for:
4-16                 (1)  a violation of this chapter or a rule adopted
4-17     under this chapter; or
4-18                 (2)  a history of continuing noncompliance with this
4-19     chapter or the rules adopted under this chapter.
4-20           (b)  The denial, suspension, or revocation of a license by
4-21     the department and the appeal from that action are governed by the
4-22     procedures for a contested case hearing under Chapter 2001,
4-23     Government Code.
4-24           (c)  If the department finds that a birthing center is in
4-25     repeated noncompliance under Subsection (a) but that the
4-26     noncompliance does not endanger public health and safety, the
 5-1     department may schedule the center for probation rather than
 5-2     suspending or revoking the center's license.  The department shall
 5-3     provide notice to the center of the probation and of the items of
 5-4     noncompliance not later than the 10th day before the date the
 5-5     probation period begins.  The department shall designate a period
 5-6     of not less than 30 days during which the center will remain under
 5-7     probation.  During the probation period, the center must correct
 5-8     the items that were in noncompliance and report the corrections to
 5-9     the department for approval.
5-10           (d)  The department may suspend or revoke the license of a
5-11     birthing center that does not correct items that were in
5-12     noncompliance or that does not comply with the applicable
5-13     requirements within the applicable probation period.
5-14           SECTION 4.  Section 245.012, Health and Safety Code, is
5-15     amended to read as follows:
5-16           Sec. 245.012.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
5-17     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
5-18     license for a violation of this chapter or a rule adopted under
5-19     this chapter.
5-20           (b)  The denial, suspension, or revocation of a license by
5-21     the department and the appeal from that action are governed by the
5-22     procedures for a contested case hearing under Chapter 2001,
5-23     Government Code.
5-24           (c)  The department may immediately suspend or revoke a
5-25     license when the health and safety of persons are threatened.  If
5-26     the department issues an order of immediate suspension or
 6-1     revocation, the department shall immediately give the chief
 6-2     executive officer of the abortion facility adequate notice of the
 6-3     action and the procedure governing appeal of the action.  A person
 6-4     whose license is suspended or revoked under this subsection is
 6-5     entitled to a hearing not later than the 14th day after the
 6-6     effective date of the suspension or revocation.
 6-7           (d)  If the department finds that an abortion facility is in
 6-8     repeated noncompliance with this chapter or rules adopted under
 6-9     this chapter but that the noncompliance does not endanger public
6-10     health and safety, the department may schedule the facility for
6-11     probation rather than suspending or revoking the facility's
6-12     license.  The department shall provide notice to the facility of
6-13     the probation and of the items of noncompliance not later than the
6-14     10th day before the date the probation period begins.  The
6-15     department shall designate a period of not less than 30 days during
6-16     which the facility will remain under probation.  During the
6-17     probation period, the facility must correct the items that were in
6-18     noncompliance and report the corrections to the department for
6-19     approval.
6-20           (e)  The department may suspend or revoke the license of an
6-21     abortion facility that does not correct items that were in
6-22     noncompliance or that does not comply with this chapter or the
6-23     rules adopted under this chapter within the applicable probation
6-24     period.
6-25           SECTION 5.  Section 248.051, Health and Safety Code, is
6-26     amended to read as follows:
 7-1           Sec. 248.051.  [LICENSE] DENIAL, SUSPENSION, PROBATION, OR
 7-2     REVOCATION OF LICENSE.  (a)  The department may deny, revoke, or
 7-3     suspend a license issued under this chapter for a violation of this
 7-4     chapter or the rules adopted under this chapter.
 7-5           (b)  Except as provided by Section 248.052, the procedures by
 7-6     which the department denies, revokes, or suspends a license and by
 7-7     which those actions are appealed are governed by the department's
 7-8     rules for a contested case hearing and by Chapter 2001, Government
 7-9     Code.
7-10           (c)  If the department finds that a special care facility is
7-11     in repeated noncompliance with this chapter or rules adopted under
7-12     this chapter but that the noncompliance does not endanger public
7-13     health and safety, the department may schedule the facility for
7-14     probation rather than suspending or revoking the facility's
7-15     license.  The department shall provide notice to the facility of
7-16     the probation and of the items of noncompliance not later than the
7-17     10th day before the date the probation period begins.  The
7-18     department shall designate a period of not less than 30 days during
7-19     which the facility will remain under probation.  During the
7-20     probation period, the facility must correct the items that were in
7-21     noncompliance and report the corrections to the department for
7-22     approval.
7-23           (d)  The department may suspend or revoke the license of a
7-24     special care facility that does not correct items that were in
7-25     noncompliance or that does not comply with this chapter or the
7-26     rules adopted under this chapter within the applicable probation
 8-1     period.
 8-2           SECTION 6.  Section 251.062, Health and Safety Code, is
 8-3     amended to read as follows:
 8-4           Sec. 251.062.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
 8-5     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
 8-6     license issued under this chapter for a violation of this chapter
 8-7     or a rule adopted under this chapter.
 8-8           (b)  The denial, suspension, or revocation of a license by
 8-9     the department and the appeal from that action are governed by the
8-10     procedures for a contested case hearing under Chapter 2001,
8-11     Government Code.
8-12           (c)  If the department finds that an end stage renal disease
8-13     facility is in repeated noncompliance with this chapter or rules
8-14     adopted under this chapter but that the noncompliance does not
8-15     endanger public health and safety, the department may schedule the
8-16     facility for probation rather than suspending or revoking the
8-17     facility's license.  The department shall provide notice to the
8-18     facility of the probation and of the items of noncompliance not
8-19     later than the 10th day before the date the probation period
8-20     begins.  The department shall designate a period of not less than
8-21     30 days during which the facility will remain under probation.
8-22     During the probation period, the facility must correct the items
8-23     that were in noncompliance and report the corrections to the
8-24     department for approval.
8-25           (d)  The department may suspend or revoke the license of an
8-26     end stage renal disease facility that does not correct items that
 9-1     were in noncompliance or that does not comply with this chapter or
 9-2     the rules adopted under this chapter within the applicable
 9-3     probation period.
 9-4           SECTION 7.  Subchapter E, Chapter 251, Health and Safety
 9-5     Code, is amended by adding Section 251.0621 to read as follows:
 9-6           Sec. 251.0621.  EMERGENCY SUSPENSION.  The department may
 9-7     issue an emergency order to suspend a license issued under this
 9-8     chapter if the department has reasonable cause to believe that the
 9-9     conduct of a license holder creates an immediate danger to the
9-10     public health and safety.  An emergency suspension is effective
9-11     immediately without a hearing on notice to the license holder.  On
9-12     written request of the license holder, the department shall conduct
9-13     a hearing not earlier than the 10th day or later than the 30th day
9-14     after the date the hearing request is received to determine if the
9-15     emergency suspension is to be continued, modified, or rescinded.
9-16     The hearing and any appeal are governed by the department's rules
9-17     for a contested case hearing and Chapter 2001, Government Code.
9-18           SECTION 8.  Section 577.016, Health and Safety Code, is
9-19     amended to read as follows:
9-20           Sec. 577.016.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
9-21     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
9-22     license if the department finds that the applicant or licensee has
9-23     substantially failed to comply with:
9-24                 (1)  department rules;
9-25                 (2)  this subtitle; or
9-26                 (3)  Chapters 104 and 225.
 10-1          (b)  The department must give the applicant or license holder
 10-2    notice of the proposed action, an opportunity to demonstrate or
 10-3    achieve compliance, and an opportunity for a hearing before taking
 10-4    the action.
 10-5          (c)  The department may suspend a license for 10 days pending
 10-6    a hearing if after an investigation the department finds that there
 10-7    is an immediate threat to the health or safety of the patients or
 10-8    employees of a private mental hospital or mental health facility
 10-9    licensed under this chapter.  The department may issue necessary
10-10    orders for the patients' welfare.
10-11          (d)  The department shall send the license holder or
10-12    applicant a copy of the department's decision by registered mail.
10-13    If the department denies, suspends, or revokes a license, the
10-14    department shall include the findings and conclusions on which the
10-15    department based its decision.
10-16          (e)  A license holder whose license is suspended or revoked
10-17    may not admit new patients until the license is reissued.
10-18          (f)  If the department finds that a private mental hospital
10-19    or mental health facility is in repeated noncompliance under
10-20    Subsection (a) but that the noncompliance does not endanger public
10-21    health and safety, the department may schedule the hospital or
10-22    facility for probation rather than suspending or revoking the
10-23    license of the hospital or facility.  The department shall provide
10-24    notice to the hospital or facility of the probation and of the
10-25    items of noncompliance not later than the 10th day before the date
10-26    the probation period begins.  The department shall designate a
 11-1    period of not less than 30 days during which the hospital or
 11-2    facility will remain under probation.  During the probation period,
 11-3    the hospital or facility must correct the items that were in
 11-4    noncompliance and report the corrections to the department for
 11-5    approval.
 11-6          (g)  The department may suspend or revoke the license of a
 11-7    private mental hospital or mental health facility that does not
 11-8    comply with the applicable requirements within the applicable
 11-9    probation period.
11-10          SECTION 9.  This Act takes effect immediately if it receives
11-11    a vote of two-thirds of all the members elected to each house, as
11-12    provided by Section 39, Article III, Texas Constitution.  If this
11-13    Act does not receive the vote necessary for immediate effect, this
11-14    Act takes effect September 1, 2001.
11-15                         COMMITTEE AMENDMENT NO. 1
11-16          Amend S.B. 279 (engrossed version) as follows:
11-17          (1)  Between the enacting clause and SECTION 1 of the bill
11-18    (page 1, between lines 4 and 5), insert the following appropriately
11-19    numbered section:
11-20          SECTION ____. Section 241.051, Health and Safety Code, is
11-21    amended by adding Subsection (f) to read as follows:
11-22          (f)  Information obtained or compiled by the department in
11-23    connection with a complaint or investigation that is confidential
11-24    by law remains confidential and is not subject to disclosure under
11-25    Chapter 552, Government Code.
11-26          (2)  Between SECTIONS 7 and 8 of the bill (page 9, between
 12-1    lines 17 and 18), insert the following appropriately numbered
 12-2    section:
 12-3          SECTION ____. Section 577.013, Health and Safety Code, is
 12-4    amended by adding Subsection (f) to read as follows:
 12-5          (f)  Information obtained or compiled by the department in
 12-6    connection with a complaint or investigation that is confidential
 12-7    by law remains confidential and is not subject to disclosure under
 12-8    Chapter 552, Government Code.
 12-9          (3)  Strike SECTION 9 of the bill (page 11, lines 10 through
12-10    14), and substitute the following appropriately numbered sections:
12-11          SECTION ____. Sections 241.051(d) and (e) and 577.013(d) and
12-12    (e), Health and Safety Code, are repealed.
12-13          SECTION ____. (a)  Except as provided by this section, this
12-14    Act takes effect immediately if it receives a vote of two-thirds of
12-15    all the members elected to each house, as provided by Section 39,
12-16    Article III, Texas Constitution.  If this Act does not receive the
12-17    vote necessary for immediate effect, this Act takes effect
12-18    September 1, 2001.
12-19          (b)  The changes in law made by this Act to Sections 241.051
12-20    and 577.013, Health and Safety Code, take effect September 1, 2001.
12-21    77R16790 GJH-D                                                 Gray