By: Klick, Lambert, Morales Shaw H.B. No. 173
        (Senate Sponsor - Johnson)
         (In the Senate - Received from the House May 1, 2023;
  May 1, 2023, read first time and referred to Committee on Business &
  Commerce; May 24, 2023, reported favorably by the following vote:  
  Yeas 8, Nays 2; May 24, 2023, sent to printer.)
Click here to see the committee vote
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the licensing and regulation of genetic counselors;
  requiring an occupational license; authorizing a fee.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 51.2031(a), Occupations Code, is amended
  to read as follows:
         (a)  This section applies only to the regulation of the
  following professions by the department:
               (1)  athletic trainers;
               (2)  behavior analysts;
               (3)  dietitians;
               (4)  genetic counselors;
               (5)  hearing instrument fitters and dispensers;
               (6) [(5)]  midwives;
               (7) [(6)]  orthotists and prosthetists; and
               (8) [(7)]  speech-language pathologists and
  audiologists.
         SECTION 2.  Subtitle I, Title 3, Occupations Code, is
  amended by adding Chapter 508 to read as follows:
  CHAPTER 508.  LICENSED GENETIC COUNSELORS
  SUBCHAPTER A.  GENERAL PROVISIONS
         Sec. 508.001.  SHORT TITLE.  This chapter may be cited as the
  Licensed Genetic Counselor Act.
         Sec. 508.002.  DEFINITIONS.  In this chapter:
               (1)  "Advisory board" means the Licensed Genetic
  Counselor Advisory Board.
               (2)  "Certifying entity" means the American Board of
  Medical Genetics and Genomics, the American Board of Genetic
  Counseling, or another entity that is nationally accredited to
  issue credentials in the practice of genetic counseling and is
  approved by the department.
               (3)  "Commission" means the Texas Commission of
  Licensing and Regulation.
               (4)  "Department" means the Texas Department of
  Licensing and Regulation.
               (5)  "Executive director" means the executive director
  of the department.
               (6)  "Licensed genetic counselor" means a person
  licensed under this chapter to engage in the practice of genetic
  counseling.
         Sec. 508.003.  PRACTICE OF GENETIC COUNSELING.  (a)  In this
  chapter, "practice of genetic counseling" means providing
  professional services described by Subsection (b) for compensation
  to communicate genetic information to an individual, family, group,
  or other entity:
               (1)  on the documented referral by:
                     (A)  a physician licensed in this state; 
                     (B)  a physician assistant licensed in this state;
                     (C)  an advanced practice registered nurse
  licensed in this state; or 
                     (D)  a person acting under authority delegated
  under Subchapter A, Chapter 157; or 
               (2)  by a patient's self-referral.
         (b)  The practice of genetic counseling:
               (1)  consists of:
                     (A)  obtaining and evaluating individual, family,
  and medical histories to determine the risk for a genetic or medical
  condition or disease in a patient, the patient's offspring, or
  other family members of the patient;
                     (B)  discussing the features, natural history,
  means of diagnosis, genetic and environmental factors, and
  management of risk for a genetic or medical condition or disease;
                     (C)  identifying, coordinating, ordering, and
  explaining the results of genetic laboratory tests and other
  diagnostic studies as appropriate for genetic assessment;
                     (D)  integrating the results of laboratory tests
  and other diagnostic studies with medical histories to assess and
  communicate risk factors for a genetic or medical condition or
  disease;
                     (E)  evaluating a patient's or family member's
  response to a genetic or medical condition or disease, including
  the risk of recurrence, and providing patient-centered counseling
  and anticipatory guidance;
                     (F)  identifying and using community resources
  that provide medical, educational, financial, and psychosocial
  support and advocacy; and
                     (G)  providing written documentation of medical,
  genetic, and counseling information for a patient's family members
  and health care providers; and
               (2)  does not include the diagnosis of disorders.
         Sec. 508.004.  PRACTICE OF MEDICINE NOT AUTHORIZED.  This
  chapter does not authorize the practice of medicine as defined by
  the law of this state.
         Sec. 508.005.  APPLICABILITY; EXEMPTIONS.  (a)  This chapter
  does not apply to a physician licensed to practice medicine in this
  state unless the physician is a licensed genetic counselor.
         (b)  A person may engage in the practice of genetic
  counseling without holding a license under this chapter if the
  person:
               (1)  is licensed, certified, or registered to practice
  in this state in a health care-related occupation and:
                     (A)  acts within the occupation's scope of
  practice; and
                     (B)  does not use the title "genetic counselor" or
  represent or imply that the person is licensed as a genetic
  counselor under this chapter;
               (2)  is a student or intern:
                     (A)  pursuing a course of study or engaged in a
  training program for an occupation regulated by this state and
  acting within the occupation's scope of practice; or
                     (B)  enrolled in a graduate-level supervised
  genetic counseling training program approved or accepted by the
  department and engaged in an activity constituting the practice of
  genetic counseling as a required part of the training program; or
               (3)  is a genetic counselor who:
                     (A)  is certified by a certifying entity;
                     (B)  is not a resident of this state;
                     (C)  performs an activity or provides a service in
  this state for not more than 30 days during any year; and
                     (D)  meets any other requirement established by
  commission rule.
         (c)  A student or intern described by Subsection (b)(2)
  includes a person who:
               (1)  is trained as:
                     (A)  a genetic counselor and has applied to take
  the certification examination; or
                     (B)  a doctoral medical geneticist and has applied
  to take the certification examination; and
               (2)  has not failed the certification examination more
  than twice.
  SUBCHAPTER B.  LICENSED GENETIC COUNSELOR ADVISORY BOARD
         Sec. 508.051.  LICENSED GENETIC COUNSELOR ADVISORY BOARD.
  (a)  The advisory board consists of nine members appointed by the
  presiding officer of the commission with the approval of the
  commission, as follows:
               (1)  six licensed genetic counselors, each of whom has
  at least two years of experience practicing genetic counseling as a
  genetic counselor and is:
                     (A)  licensed under this chapter; or
                     (B)  certified by a certifying entity;
               (2)  one physician who has experience with genetic
  counseling; and
               (3)  two members who represent the public.
         (b)  Appointments to the advisory board shall be made without
  regard to the race, color, disability, sex, religion, age, or
  national origin of the appointee.
         Sec. 508.052.  DUTIES OF ADVISORY BOARD.  The advisory board
  shall provide advice and recommendations to the department on
  technical matters relevant to the administration of this chapter.
         Sec. 508.053.  TERMS; VACANCY. (a) Members of the advisory
  board serve staggered six-year terms, with the terms of three
  members expiring February 1 of each odd-numbered year.
         (b)  A member of the advisory board may not serve more than
  two consecutive six-year terms.
         (c)  If a vacancy occurs during a term of a member of the
  advisory board, the presiding officer of the commission, with the
  commission's approval, shall appoint a replacement who meets the
  qualifications for the vacant position to serve for the remainder
  of the term.
         Sec. 508.054.  PRESIDING OFFICER. The presiding officer of
  the commission shall designate a member of the advisory board to
  serve as the presiding officer of the advisory board for a term of
  two years. The presiding officer of the advisory board may vote on
  any matter before the advisory board.
         Sec. 508.055.  MEETINGS. The advisory board shall meet as
  requested by the presiding officer of the commission or the
  executive director.
         Sec. 508.056.  GROUNDS FOR REMOVAL. A member of the advisory
  board may be removed as provided by Section 51.209.
         Sec. 508.057.  COMPENSATION; REIMBURSEMENT. (a) A member
  of the advisory board may not receive compensation for service on
  the advisory board.
         (b)  A member of the advisory board is entitled to
  reimbursement for actual and necessary expenses incurred in
  performing functions as a member of the advisory board, subject to
  any applicable limitation on reimbursement provided by the General
  Appropriations Act.
  SUBCHAPTER C.  POWERS AND DUTIES
         Sec. 508.101.  GENERAL POWERS AND DUTIES. (a) The
  commission shall adopt rules consistent with this chapter for the
  administration and enforcement of this chapter.
         (b)  The department shall:
               (1)  administer and enforce this chapter;
               (2)  evaluate the qualifications of license
  applicants;
               (3)  provide for the examination of license applicants;
               (4)  issue licenses;
               (5)  in connection with a hearing under this chapter,
  issue subpoenas, examine witnesses, and administer oaths under the
  laws of this state; and
               (6)  investigate persons engaging in practices that
  violate this chapter.
         Sec. 508.102.  CONFIDENTIALITY OF COMPLAINT AND
  DISCIPLINARY INFORMATION. (a) Except as provided by Subsection
  (b), all information and materials subpoenaed or compiled by the
  department in connection with a complaint and investigation are
  confidential and not subject to disclosure under Chapter 552,
  Government Code, and not subject to disclosure, discovery,
  subpoena, or other means of legal compulsion for their release to
  anyone other than the department or its employees or agents
  involved in discipline of a license holder.
         (b)  Information described by Subsection (a) may be
  disclosed in accordance with Chapter 51 to:
               (1)  persons involved with the department in a
  disciplinary action against a license holder;
               (2)  a respondent or the respondent's authorized
  representative;
               (3)  a governmental agency, if:
                     (A)  the disclosure is required or permitted by
  law; and
                     (B)  the agency obtaining the disclosure protects
  the identity of any patient whose records are examined;
               (4)  a professional genetic counselor licensing or
  disciplinary board in another jurisdiction;
               (5)  peer assistance programs approved by the
  commission under Chapter 467, Health and Safety Code;
               (6)  law enforcement agencies; and
               (7)  persons engaged in bona fide research, if all
  individual-identifying information has been deleted.
         (c)  As provided by Chapter 51, notices of alleged violations
  issued by the department, commission, or executive director, and
  final disciplinary actions, including warnings and reprimands, by
  the department, commission, or executive director are not
  confidential and are subject to disclosure in accordance with
  Chapter 552, Government Code.
         (d)  Notwithstanding any other law, the requirements of
  Chapter 51 related to the confidentiality of complaint and
  investigation information for a health-related program are
  applicable to complaint and investigation information under this
  chapter.
         Sec. 508.103.  STANDARDS OF ETHICAL PRACTICE. The
  commission shall adopt rules under this chapter that establish
  standards of ethical practice.
         Sec. 508.104.  ASSISTANCE FILING COMPLAINT. The department,
  in accordance with Section 51.252, shall provide reasonable
  assistance to a person who wishes to file a complaint with the
  department regarding a person or activity regulated under this
  chapter.
         Sec. 508.105.  FEES. The commission by rule shall set fees
  in amounts reasonable and necessary to cover the costs of
  administering this chapter.
  SUBCHAPTER D.  LICENSING REQUIREMENTS
         Sec. 508.151.  LICENSE REQUIRED.  (a)  Except as provided by
  Section 508.005, a person may not act as a genetic counselor or
  engage in the practice of genetic counseling in this state unless
  the person holds a license under this chapter.
         (b)  Except as provided by Section 508.005, unless a person
  holds a license under this chapter, the person may not:
               (1)  use the title or represent or imply that the person
  has the title "genetic counselor," "certified genetic counselor,"
  "licensed genetic counselor," "gene counselor," "genetic
  consultant," or "genetic associate"; or
               (2)  use any other word, abbreviation, or insignia
  indicating or implying that the person is a licensed genetic
  counselor.
         (c)  This chapter may not be construed to prohibit a
  physician or an employee or other person acting under a physician's
  delegated authority from representing to a patient or the public
  that the physician, employee, or person provides genetic
  counseling.
         Sec. 508.152.  LICENSE APPLICATION.  An applicant for a
  license must:
               (1)  submit an application in the manner and on a form
  prescribed by the department;
               (2)  successfully complete a state-approved criminal
  background check; and
               (3)  pay the application fee set by the commission.
         Sec. 508.153.  LICENSE ELIGIBILITY. To be eligible for a
  genetic counselor license, a license applicant must present
  evidence to the department that the applicant:
               (1)  has passed an examination by a certifying entity
  or an equivalent examination in genetic counseling approved by the
  department;
               (2)  is currently certified by a certifying entity in
  genetic counseling or medical genetics;
               (3)  has met the educational requirements of a
  certifying entity, which must include a master's degree in genetic
  counseling or medical genetics or an equivalent educational
  standard adopted by the certifying entity;
               (4)  is in compliance with all professional, ethical,
  and disciplinary standards established by the certifying entity;
  and
               (5)  is not subject to any disciplinary action by the
  certifying entity.
         Sec. 508.154.  ISSUANCE OF LICENSE. The department shall
  issue a genetic counselor license to an applicant who:
               (1)  complies with the requirements of this chapter;
               (2)  meets any additional requirements the commission
  establishes by rule; and
               (3)  pays the required fees.
         Sec. 508.155.  TERM. A license issued under this chapter
  expires on the second anniversary of the date of issuance.
         Sec. 508.156.  RENEWAL.  Before the expiration of a license,
  a license may be renewed by:
               (1)  submitting an application for renewal;
               (2)  paying the renewal fee imposed by the commission;
  and
               (3)  providing verification to the department of
  continued certification by a certifying entity, which signifies
  that the applicant for renewal has met any continuing education
  requirements established by the certifying entity.
  SUBCHAPTER E.  DISCIPLINARY PROCEDURES
         Sec. 508.201.  GROUNDS FOR DISCIPLINARY ACTION.  In
  accordance with Section 51.353, the commission or executive
  director may deny, revoke, or suspend a license, refuse to renew a
  license, place on probation a person whose license has been
  suspended, or reprimand a license holder for a violation of this
  chapter, a rule adopted under this chapter, or an order of the
  commission or executive director.
  SUBCHAPTER F.  ENFORCEMENT PROCEDURES
         Sec. 508.251.  ENFORCEMENT PROCEEDINGS. The commission,
  department, or executive director may enforce this chapter, a rule
  adopted under this chapter, or an order of the commission or
  executive director as provided by Subchapters F and G, Chapter 51.
         SECTION 3.  (a)  As soon as practicable after the effective
  date of this Act, the presiding officer of the Texas Commission of
  Licensing and Regulation shall appoint nine members to the Licensed
  Genetic Counselor Advisory Board in accordance with Chapter 508,
  Occupations Code, as added by this Act. In making the initial
  appointments, the presiding officer of the commission shall
  designate three members for terms expiring February 1, 2025, three
  members for terms expiring February 1, 2027, and three members for
  terms expiring February 1, 2029.
         (b)  Notwithstanding Section 508.051, Occupations Code, as
  added by this Act, a person who meets the requirements of Section
  508.153, Occupations Code, as added by this Act, may be appointed as
  an initial licensed genetic counselor member of the Licensed
  Genetic Counselor Advisory Board, regardless of whether the person
  holds a license issued under Chapter 508, Occupations Code, as
  added by this Act.
         SECTION 4.  Not later than May 1, 2024, the Texas Commission
  of Licensing and Regulation shall adopt the rules, procedures, and
  fees necessary to administer Chapter 508, Occupations Code, as
  added by this Act.
         SECTION 5.  (a)  Except as provided by Subsection (b) of this
  section, this Act takes effect September 1, 2023.
         (b)  Section 508.151, Occupations Code, as added by this Act,
  and Subchapter F, Chapter 508, Occupations Code, as added by this
  Act, take effect September 1, 2024.
 
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