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