82R4458 JAM-D
 
  By: Hopson H.B. No. 614
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to allowing health care providers to provide services
  across state lines in catastrophic circumstances.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle A, Title 3, Occupations Code, is
  amended by adding Chapter 115 to read as follows:
  CHAPTER 115.  HEALTH OR VETERINARY SERVICES PROVIDED IN
  CATASTROPHIC CIRCUMSTANCES
         Sec. 115.001.  SHORT TITLE. This chapter may be cited as the
  Uniform Emergency Volunteer Health Practitioners Act.
         Sec. 115.002.  DEFINITIONS. In this chapter:
               (1)  "Disaster relief organization" means an entity
  that provides emergency or disaster relief services that include
  health or veterinary services provided by volunteer health
  practitioners and that:
                     (A)  is designated or recognized as a provider of
  those services under a disaster response and recovery plan adopted
  by an agency of the federal government or the division; or
                     (B)  regularly plans and conducts its activities
  in coordination with an agency of the federal government or the
  division.
               (2)  "Division" has the meaning assigned by Section
  418.004, Government Code.
               (3)  "Emergency" means an event or condition that is a
  disaster as defined by Section 418.004, Government Code.
               (4)  "Emergency declaration" means a declaration of
  emergency issued by a person authorized to do so under the laws of
  this state, a political subdivision of this state, or a
  municipality or other local government within this state.
               (5)  "Emergency Management Assistance Compact" means
  the interstate compact approved by Congress (Pub. L. No. 104-321)
  as provided by Chapter 778, Health and Safety Code.
               (6)  "Entity" means a person other than an individual.
               (7)  "Health facility" means an entity licensed under
  the laws of this or another state to provide health or veterinary
  services.
               (8)  "Health practitioner" means an individual
  licensed under the laws of this or another state to provide health
  or veterinary services.
               (9)  "Health services" means the provision of
  treatment, care, advice or guidance, or other services or supplies
  related to the health or death of individuals or human populations,
  to the extent necessary to respond to an emergency, including:
                     (A)  with respect to the physical or mental
  condition or functional status of an individual or the structure or
  function of the body:
                           (i)  preventive, diagnostic, therapeutic,
  rehabilitative, maintenance, or palliative care; and
                           (ii)  counseling and assessment procedures
  or other related services;
                     (B)  the sale or dispensing of a drug, a device,
  equipment, or another item to an individual in accordance with a
  prescription; and
                     (C)  funeral, cremation, cemetery, or other
  mortuary services.
               (10)  "Host entity" means an entity operating in this
  state that uses volunteer health practitioners to respond to an
  emergency.
               (11)  "License" means an authorization by a state
  agency to engage in health or veterinary services that are unlawful
  without the authorization. The term includes authorization under
  the laws of this state to an individual to provide health or
  veterinary services based on a national certification issued by a
  public or private entity.
               (12)  "Scope of practice" means the extent of the
  authorization to provide health or veterinary services granted to a
  health practitioner by a license issued to the practitioner in the
  state in which the principal part of the practitioner's services
  are rendered, including any conditions imposed by the licensing
  authority.
               (13)  "Veterinary services" means the provision of
  treatment, care, advice or guidance, or other services or supplies
  related to the health or death of an animal or to animal
  populations, to the extent necessary to respond to an emergency,
  including:
                     (A)  diagnosis, treatment, or prevention of an
  animal disease, injury, or other physical or mental condition by
  the prescription, administration, or dispensing of a vaccine, a
  drug, surgery, or therapy;
                     (B)  use of a procedure for reproductive
  management; and
                     (C)  monitoring and treatment of animal
  populations for diseases that have spread or demonstrate the
  potential to spread to humans.
               (14)  "Volunteer health practitioner" means a health
  practitioner who provides health or veterinary services,
  regardless of whether for compensation. The term does not include a
  practitioner who receives compensation under a preexisting
  employment relationship with a host entity or affiliate that
  requires the practitioner to provide health services in this state,
  unless the practitioner is not a resident of this state and is
  employed by a disaster relief organization providing services in
  this state while an emergency declaration is in effect.
         Sec. 115.003.  APPLICABILITY TO VOLUNTEER HEALTH
  PRACTITIONERS. This chapter applies to volunteer health
  practitioners who are registered with a system that complies with
  Section 115.005 and who provide health or veterinary services in
  this state for a host entity while an emergency declaration is in
  effect.
         Sec. 115.004.  REGULATION OF SERVICES DURING EMERGENCY. (a)
  While an emergency declaration is in effect, the division by order
  may limit, restrict, or otherwise regulate:
               (1)  the duration of practice by volunteer health
  practitioners;
               (2)  the geographical areas in which volunteer health
  practitioners may practice;
               (3)  the types of volunteer health practitioners who
  may practice; and
               (4)  any other matters necessary to coordinate
  effectively the provision of health or veterinary services during
  the emergency.
         (b)  An order issued under Subsection (a) may take effect
  immediately, without prior notice or comment, and is not a rule
  within the meaning of Chapter 2001, Government Code.
         (c)  A host entity that uses volunteer health practitioners
  to provide health or veterinary services in this state shall:
               (1)  consult and coordinate its activities with the
  division to the extent practicable to provide for the efficient and
  effective use of volunteer health practitioners; and
               (2)  comply with laws in addition to this chapter
  relating to the management of emergency health or veterinary
  services.
         Sec. 115.005.  VOLUNTEER HEALTH PRACTITIONER REGISTRATION
  SYSTEMS. (a) To qualify as a volunteer health practitioner
  registration system, a system must:
               (1)  accept applications for the registration of
  volunteer health practitioners before or during an emergency;
               (2)  include information about the licensing and good
  standing of health practitioners that is accessible by authorized
  persons;
               (3)  be capable of confirming whether a health
  practitioner is licensed and in good standing before health or
  veterinary services are provided by the practitioner under this
  chapter; and
               (4)  meet one of the following conditions:
                     (A)  be an emergency system for advance
  registration of volunteer health care practitioners established by
  a state and funded through the United States Department of Health
  and Human Services under Section 319I, Public Health Service Act
  (42 U.S.C. Section 247d-7b);
                     (B)  be a local unit consisting of trained and
  equipped emergency response, public health, and medical personnel
  formed under Section 2801, Public Health Service Act (42 U.S.C.
  Section 300hh);
                     (C)  be operated by a:
                           (i)  disaster relief organization;
                           (ii)  licensing board;
                           (iii)  national or regional association of
  licensing boards or health practitioners;
                           (iv)  health facility that provides
  comprehensive inpatient and outpatient health care services,
  including a tertiary care and teaching hospital; or
                           (v)  governmental entity; or
                     (D)  be designated by the division as a
  registration system for purposes of this chapter.
         (b)  While an emergency declaration is in effect, the
  division, a person authorized to act on behalf of the division, or a
  host entity may confirm whether volunteer health practitioners used
  in this state are registered with a registration system that
  complies with Subsection (a). Confirmation is limited to obtaining
  the identity of the practitioners from the system and determining
  whether the system indicates that the practitioners are licensed
  and in good standing.
         (c)  On request by a person in this state authorized under
  Subsection (b) or a similarly authorized person in another state, a
  registration system located in this state shall notify the person
  of the identity of volunteer health practitioners and whether the
  practitioners are licensed and in good standing.
         (d)  A host entity is not required to use the services of a
  volunteer health practitioner even if the practitioner is
  registered with a registration system that indicates that the
  practitioner is licensed and in good standing.
         Sec. 115.006.  RECOGNITION OF VOLUNTEER HEALTH
  PRACTITIONERS LICENSED IN OTHER STATES. (a) While an emergency
  declaration is in effect, a volunteer health practitioner
  registered with a registration system that complies with Section
  115.005 who is licensed and in good standing in another state may
  practice in this state to the extent authorized by this chapter as
  if the practitioner were licensed in this state.
         (b)  A volunteer health practitioner qualified under
  Subsection (a) is not entitled to the protections of this chapter if
  the practitioner is licensed in more than one state and any license
  of the practitioner is suspended, revoked, or subject to an agency
  order limiting or restricting practice privileges or has been
  voluntarily terminated under threat of sanction.
         Sec. 115.007.  NO EFFECT ON CREDENTIALING AND PRIVILEGING.
  (a) In this section:
               (1)  "Credentialing" means obtaining, verifying, and
  assessing the qualifications of a health practitioner to provide
  treatment, care, or services in or for a health facility.
               (2)  "Privileging" means the authorizing by an
  appropriate authority, such as a governing body, of a health
  practitioner to provide specific treatment, care, or services at a
  health facility subject to limits based on factors that include
  license, education, training, experience, competence, health
  status, and specialized skill.
         (b)  This chapter does not affect credentialing or
  privileging standards of a health facility and does not preclude a
  health facility from waiving or modifying those standards while an
  emergency declaration is in effect.
         Sec. 115.008.  PROVISION OF VOLUNTEER HEALTH OR VETERINARY
  SERVICES; ADMINISTRATIVE SANCTIONS. (a) Subject to Subsections (b)
  and (c), a volunteer health practitioner shall adhere to the scope
  of practice for a similarly licensed practitioner established by
  the licensing provisions or other laws of this state.
         (b)  Except as otherwise provided by Subsection (c), this
  chapter does not authorize a volunteer health practitioner to
  provide a service that is outside the practitioner's scope of
  practice, even if a similarly licensed practitioner in this state
  would be permitted to provide the service.
         (c)  The division may modify or restrict the health or
  veterinary services that a volunteer health practitioner may
  provide under this chapter. An order under this subsection may take
  effect immediately, without prior notice or comment, and is not a
  rule within the meaning of Chapter 2001, Government Code.
         (d)  A host entity may restrict the health or veterinary
  services that a volunteer health practitioner may provide under
  this chapter.
         (e)  A volunteer health practitioner does not engage in
  unauthorized practice unless the practitioner has reason to know of
  any limitation, modification, or restriction under this section or
  that a similarly licensed practitioner in this state would not be
  permitted to provide the service.  A volunteer health practitioner
  has reason to know of a limitation, modification, or restriction or
  that a similarly licensed practitioner in this state would not be
  permitted to provide a service if:
               (1)  the practitioner knows the limitation,
  modification, or restriction exists or that a similarly licensed
  practitioner in this state would not be permitted to provide the
  service; or
               (2)  from all the facts and circumstances known to the
  practitioner at the relevant time, a reasonable person would
  conclude that the limitation, modification, or restriction exists
  or that a similarly licensed practitioner in this state would not be
  permitted to provide the service.
         (f)  In addition to the authority granted by the law of this
  state other than this chapter to regulate the conduct of health
  practitioners, a licensing board or other disciplinary authority in
  this state:
               (1)  may impose administrative sanctions on a health
  practitioner licensed in this state for conduct outside of this
  state in response to an out-of-state emergency;
               (2)  may impose administrative sanctions on a
  practitioner not licensed in this state for conduct in this state in
  response to an in-state emergency; and
               (3)  shall report any administrative sanction imposed
  on a practitioner licensed in another state to the appropriate
  licensing board or other disciplinary authority in any other state
  in which the practitioner is known to be licensed.
         (g)  In determining whether to impose an administrative
  sanction under Subsection (f), a licensing board or other
  disciplinary authority shall consider the circumstances in which
  the conduct took place, including any exigent circumstances, and
  the practitioner's scope of practice, education, training,
  experience, and specialized skill.
         Sec. 115.009.  RELATION TO OTHER LAWS. (a) This chapter does
  not limit rights, privileges, or immunities provided to volunteer
  health practitioners by laws other than this chapter. Except as
  otherwise provided by Subsection (b), this chapter does not affect
  requirements for the use of health practitioners under the
  Emergency Management Assistance Compact.
         (b)  The division, under the Emergency Management Assistance
  Compact, may incorporate into the emergency forces of this state
  volunteer health practitioners who are not officers or employees of
  this state or a political subdivision of this state.
         Sec. 115.010.  REGULATORY AUTHORITY. The division may adopt
  rules to implement this chapter. In adopting rules, the division
  shall consult with and consider the recommendations of the entity
  established to coordinate the implementation of the Emergency
  Management Assistance Compact and shall consult with and consider
  rules adopted by similarly empowered agencies in other states to
  promote uniformity in the application of this chapter and to make
  the emergency response systems in the various states reasonably
  compatible.
         Sec. 115.011.  LIMITATIONS ON CIVIL LIABILITY FOR VOLUNTEER
  HEALTH PRACTITIONERS. (a) Subject to Subsection (c), a volunteer
  health practitioner who provides health or veterinary services
  under this chapter is not liable for damages for an act or omission
  of the practitioner in providing those services.
         (b)  A person is not vicariously liable for damages for an
  act or omission of a volunteer health practitioner if the
  practitioner is not liable for the damages under Subsection (a).
         (c)  This section does not limit the liability of a volunteer
  health practitioner for:
               (1)  wilful misconduct or wanton, grossly negligent,
  reckless, or criminal conduct;
               (2)  an intentional tort;
               (3)  breach of contract;
               (4)  a claim asserted by a host entity or by an entity
  located in this or another state that employs or uses the services
  of the practitioner; or
               (5)  an act or omission relating to the operation of a
  motor vehicle, vessel, aircraft, or other vehicle.
         (d)  A person who operates, uses, or relies on information
  provided by a volunteer health practitioner registration system
  under this chapter is not liable for damages for an act or omission
  relating to that operation, use, or reliance unless the act or
  omission is an intentional tort or is wilful misconduct or wanton,
  grossly negligent, reckless, or criminal conduct.
         SECTION 2.  In applying and construing Chapter 115,
  Occupations Code, as added by this Act, a court or governmental
  entity shall take into consideration the need to promote uniformity
  of the law with respect to the subject matter of this Act among
  states that enact similar uniform laws.
         SECTION 3.  This Act takes effect September 1, 2011.