1-1     By:  Nelson                                            S.B. No. 279
 1-2           (In the Senate - Filed January 18, 2001; January 22, 2001,
 1-3     read first time and referred to Committee on Health and Human
 1-4     Services; February 19, 2001, reported favorably by the following
 1-5     vote:  Yeas 7, Nays 0; February 19, 2001, sent to printer.)
 1-6                            A BILL TO BE ENTITLED
 1-7                                   AN ACT
 1-8     relating to sanctions imposed against certain facilities regulated
 1-9     by the Texas Department of Health.
1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11           SECTION 1.  Section 241.053, Health and Safety Code, is
1-12     amended to read as follows:
1-13           Sec. 241.053.  DENIAL OF APPLICATION, SUSPENSION, REVOCATION,
1-14     PROBATION, OR REISSUANCE OF LICENSE.  (a)  The department, after
1-15     providing notice and an opportunity for a hearing to the applicant
1-16     or license holder, may deny, suspend, or revoke a hospital's
1-17     license if the department finds that the hospital:
1-18                 (1)  failed to comply with:
1-19                       (A)  a provision of this chapter;
1-20                       (B)  a rule adopted under this chapter;
1-21                       (C)  a special license condition;
1-22                       (D)  an order or emergency order by the
1-23     commissioner of health; or
1-24                       (E)  another enforcement procedure permitted
1-25     under this chapter;
1-26                 (2)  has a history of noncompliance with the rules
1-27     adopted under this chapter relating to patient health, safety, and
1-28     rights which reflects more than nominal noncompliance; or
1-29                 (3)  has aided, abetted, or permitted the commission of
1-30     an illegal act.
1-31           (b)  A hospital whose license is suspended or revoked may
1-32     apply to the department for the reissuance of a license.  The
1-33     department may reissue the license if the department determines
1-34     that the hospital has corrected the conditions that led to the
1-35     suspension or revocation of the hospital's license, the initiation
1-36     of enforcement action against the hospital, the assessment of
1-37     administrative penalties, or the issuance of a court order
1-38     enjoining the hospital from violations or assessing civil penalties
1-39     against the hospital.  A hospital whose license is suspended or
1-40     revoked may not admit new patients until the license is reissued.
1-41           (c)  A hospital must apply for reissuance in the form and
1-42     manner required in the rules adopted under this chapter.
1-43           (d)  Administrative hearings required under this section
1-44     shall be conducted under the board's formal hearing rules and the
1-45     contested case provisions of Chapter 2001, Government Code.
1-46           (e)  Judicial review of a final decision by the department is
1-47     by trial de novo in the same manner as a case appealed from the
1-48     justice court to the county court.  The substantial evidence rule
1-49     does not apply.
1-50           (f)  If the department finds that a hospital is in repeated
1-51     noncompliance under Subsection (a) but that the noncompliance does
1-52     not endanger public health and safety, the department may schedule
1-53     the hospital for probation rather than suspending or revoking the
1-54     hospital's license.  The department shall provide notice to the
1-55     hospital of the probation and of the items of noncompliance not
1-56     later than the 10th day before the date the probation period
1-57     begins.  The department shall designate a period of not less than
1-58     30 days during which the hospital will remain under probation.
1-59     During the probation period, the hospital must correct the items
1-60     that were in noncompliance and report the corrections to the
1-61     department for approval.
1-62           (g)  The department may suspend or revoke the license of a
1-63     hospital that does not correct items that were in noncompliance or
1-64     that does not comply with the applicable requirements within the
 2-1     applicable probation period.
 2-2           SECTION 2.  Section 243.011, Health and Safety Code, is
 2-3     amended to read as follows:
 2-4           Sec. 243.011.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
 2-5     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
 2-6     license for a violation of this chapter or a rule adopted under
 2-7     this chapter.
 2-8           (b)  The denial, suspension, or revocation of a license by
 2-9     the department and the appeal from that action are governed by the
2-10     procedures for a contested case hearing under Chapter 2001,
2-11     Government Code.
2-12           (c)  If the department finds that an ambulatory surgical
2-13     center is in repeated noncompliance with this chapter or rules
2-14     adopted under this chapter but that the noncompliance does not
2-15     endanger public health and safety, the department may schedule the
2-16     center for probation rather than suspending or revoking the
2-17     center's license.  The department shall provide notice to the
2-18     center of the probation and of the items of noncompliance not later
2-19     than the 10th day before the date the probation period begins.  The
2-20     department shall designate a period of not less than 30 days during
2-21     which the center will remain under probation.  During the probation
2-22     period, the center must correct the items that were in
2-23     noncompliance and report the corrections to the department for
2-24     approval.
2-25           (d)  The department may suspend or revoke the license of an
2-26     ambulatory surgical center that does not correct items that were in
2-27     noncompliance or that does not comply with this chapter or the
2-28     rules adopted under this chapter within the applicable probation
2-29     period.
2-30           SECTION 3.  Section 244.011, Health and Safety Code, is
2-31     amended to read as follows:
2-32           Sec. 244.011.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
2-33     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
2-34     license for:
2-35                 (1)  a violation of this chapter or a rule adopted
2-36     under this chapter; or
2-37                 (2)  a history of continuing noncompliance with this
2-38     chapter or the rules adopted under this chapter.
2-39           (b)  The denial, suspension, or revocation of a license by
2-40     the department and the appeal from that action are governed by the
2-41     procedures for a contested case hearing under Chapter 2001,
2-42     Government Code.
2-43           (c)  If the department finds that a birthing center is in
2-44     repeated noncompliance under Subsection (a) but that the
2-45     noncompliance does not endanger public health and safety, the
2-46     department may schedule the center for probation rather than
2-47     suspending or revoking the center's license.  The department shall
2-48     provide notice to the center of the probation and of the items of
2-49     noncompliance not later than the 10th day before the date the
2-50     probation period begins.  The department shall designate a period
2-51     of not less than 30 days during which the center will remain under
2-52     probation.  During the probation period, the center must correct
2-53     the items that were in noncompliance and report the corrections to
2-54     the department for approval.
2-55           (d)  The department may suspend or revoke the license of a
2-56     birthing center that does not correct items that were in
2-57     noncompliance or that does not comply with the applicable
2-58     requirements within the applicable probation period.
2-59           SECTION 4.  Section 245.012, Health and Safety Code, is
2-60     amended to read as follows:
2-61           Sec. 245.012.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
2-62     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
2-63     license for a violation of this chapter or a rule adopted under
2-64     this chapter.
2-65           (b)  The denial, suspension, or revocation of a license by
2-66     the department and the appeal from that action are governed by the
2-67     procedures for a contested case hearing under Chapter 2001,
2-68     Government Code.
2-69           (c)  The department may immediately suspend or revoke a
 3-1     license when the health and safety of persons are threatened.  If
 3-2     the department issues an order of immediate suspension or
 3-3     revocation, the department shall immediately give the chief
 3-4     executive officer of the abortion facility adequate notice of the
 3-5     action and the procedure governing appeal of the action.  A person
 3-6     whose license is suspended or revoked under this subsection is
 3-7     entitled to a hearing not later than the 14th day after the
 3-8     effective date of the suspension or revocation.
 3-9           (d)  If the department finds that an abortion facility is in
3-10     repeated noncompliance with this chapter or rules adopted under
3-11     this chapter but that the noncompliance does not endanger public
3-12     health and safety, the department may schedule the facility for
3-13     probation rather than suspending or revoking the facility's
3-14     license.  The department shall provide notice to the facility of
3-15     the probation and of the items of noncompliance not later than the
3-16     10th day before the date the probation period begins.  The
3-17     department shall designate a period of not less than 30 days during
3-18     which the facility will remain under probation.  During the
3-19     probation period, the facility must correct the items that were in
3-20     noncompliance and report the corrections to the department for
3-21     approval.
3-22           (e)  The department may suspend or revoke the license of an
3-23     abortion facility that does not correct items that were in
3-24     noncompliance or that does not comply with this chapter or the
3-25     rules adopted under this chapter within the applicable probation
3-26     period.
3-27           SECTION 5.  Section 248.051, Health and Safety Code, is
3-28     amended to read as follows:
3-29           Sec. 248.051.  [LICENSE] DENIAL, SUSPENSION, PROBATION, OR
3-30     REVOCATION OF LICENSE.  (a)  The department may deny, revoke, or
3-31     suspend a license issued under this chapter for a violation of this
3-32     chapter or the rules adopted under this chapter.
3-33           (b)  Except as provided by Section 248.052, the procedures by
3-34     which the department denies, revokes, or suspends a license and by
3-35     which those actions are appealed are governed by the department's
3-36     rules for a contested case hearing and by Chapter 2001, Government
3-37     Code.
3-38           (c)  If the department finds that a special care facility is
3-39     in repeated noncompliance with this chapter or rules adopted under
3-40     this chapter but that the noncompliance does not endanger public
3-41     health and safety, the department may schedule the facility for
3-42     probation rather than suspending or revoking the facility's
3-43     license.  The department shall provide notice to the facility of
3-44     the probation and of the items of noncompliance not later than the
3-45     10th day before the date the probation period begins.  The
3-46     department shall designate a period of not less than 30 days during
3-47     which the facility will remain under probation.  During the
3-48     probation period, the facility must correct the items that were in
3-49     noncompliance and report the corrections to the department for
3-50     approval.
3-51           (d)  The department may suspend or revoke the license of a
3-52     special care facility that does not correct items that were in
3-53     noncompliance or that does not comply with this chapter or the
3-54     rules adopted under this chapter within the applicable probation
3-55     period.
3-56           SECTION 6.  Section 251.062, Health and Safety Code, is
3-57     amended to read as follows:
3-58           Sec. 251.062.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
3-59     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
3-60     license issued under this chapter for a violation of this chapter
3-61     or a rule adopted under this chapter.
3-62           (b)  The denial, suspension, or revocation of a license by
3-63     the department and the appeal from that action are governed by the
3-64     procedures for a contested case hearing under Chapter 2001,
3-65     Government Code.
3-66           (c)  If the department finds that an end stage renal disease
3-67     facility is in repeated noncompliance with this chapter or rules
3-68     adopted under this chapter but that the noncompliance does not
3-69     endanger public health and safety, the department may schedule the
 4-1     facility for probation rather than suspending or revoking the
 4-2     facility's license.  The department shall provide notice to the
 4-3     facility of the probation and of the items of noncompliance not
 4-4     later than the 10th day before the date the probation period
 4-5     begins.  The department shall designate a period of not less than
 4-6     30 days during which the facility will remain under probation.
 4-7     During the probation period, the facility must correct the items
 4-8     that were in noncompliance and report the corrections to the
 4-9     department for approval.
4-10           (d)  The department may suspend or revoke the license of an
4-11     end stage renal disease facility that does not correct items that
4-12     were in noncompliance or that does not comply with this chapter or
4-13     the rules adopted under this chapter within the applicable
4-14     probation period.
4-15           SECTION 7.  Subchapter E, Chapter 251, Health and Safety
4-16     Code, is amended by adding Section 251.0621 to read as follows:
4-17           Sec. 251.0621.  EMERGENCY SUSPENSION.  The department may
4-18     issue an emergency order to suspend a license issued under this
4-19     chapter if the department has reasonable cause to believe that the
4-20     conduct of a license holder creates an immediate danger to the
4-21     public health and safety.  An emergency suspension is effective
4-22     immediately without a hearing on notice to the license holder.  On
4-23     written request of the license holder, the department shall conduct
4-24     a hearing not earlier than the 10th day or later than the 30th day
4-25     after the date the hearing request is received to determine if the
4-26     emergency suspension is to be continued, modified, or rescinded.
4-27     The hearing and any appeal are governed by the department's rules
4-28     for a contested case hearing and Chapter 2001, Government Code.
4-29           SECTION 8.  Section 577.016, Health and Safety Code, is
4-30     amended to read as follows:
4-31           Sec. 577.016.  DENIAL, SUSPENSION, PROBATION, OR REVOCATION
4-32     OF LICENSE.  (a)  The department may deny, suspend, or revoke a
4-33     license if the department finds that the applicant or licensee has
4-34     substantially failed to comply with:
4-35                 (1)  department rules;
4-36                 (2)  this subtitle; or
4-37                 (3)  Chapters 104 and 225.
4-38           (b)  The department must give the applicant or license holder
4-39     notice of the proposed action, an opportunity to demonstrate or
4-40     achieve compliance, and an opportunity for a hearing before taking
4-41     the action.
4-42           (c)  The department may suspend a license for 10 days pending
4-43     a hearing if after an investigation the department finds that there
4-44     is an immediate threat to the health or safety of the patients or
4-45     employees of a private mental hospital or mental health facility
4-46     licensed under this chapter.  The department may issue necessary
4-47     orders for the patients' welfare.
4-48           (d)  The department shall send the license holder or
4-49     applicant a copy of the department's decision by registered mail.
4-50     If the department denies, suspends, or revokes a license, the
4-51     department shall include the findings and conclusions on which the
4-52     department based its decision.
4-53           (e)  A license holder whose license is suspended or revoked
4-54     may not admit new patients until the license is reissued.
4-55           (f)  If the department finds that a private mental hospital
4-56     or mental health facility is in repeated noncompliance under
4-57     Subsection (a) but that the noncompliance does not endanger public
4-58     health and safety, the department may schedule the hospital or
4-59     facility for probation rather than suspending or revoking the
4-60     license of the hospital or facility.  The department shall provide
4-61     notice to the hospital or facility of the probation and of the
4-62     items of noncompliance not later than the 10th day before the date
4-63     the probation period begins.  The department shall designate a
4-64     period of not less than 30 days during which the hospital or
4-65     facility will remain under probation.  During the probation period,
4-66     the hospital or facility must correct the items that were in
4-67     noncompliance and report the corrections to the department for
4-68     approval.
4-69           (g)  The department may suspend or revoke the license of a
 5-1     private mental hospital or mental health facility that does not
 5-2     comply with the applicable requirements within the applicable
 5-3     probation period.
 5-4           SECTION 9.  This Act takes effect immediately if it receives
 5-5     a vote of two-thirds of all the members elected to each house, as
 5-6     provided by Section 39, Article III, Texas Constitution.  If this
 5-7     Act does not receive the vote necessary for immediate effect, this
 5-8     Act takes effect September 1, 2001.
 5-9                                  * * * * *