83R5203 SLB-D
By: Ashby H.B. No. 746
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, 2013.