By: Ashby (Senate Sponsor - Schwertner) H.B. No. 746
(In the Senate - Received from the House May 6, 2013;
May 7, 2013, read first time and referred to Committee on Health
and Human Services; May 15, 2013, reported favorably by the
following vote: Yeas 8, Nays 0; May 15, 2013, sent to printer.)
A BILL TO BE ENTITLED
AN ACT
relating to the registration of volunteer health practitioners and
the services of volunteer health practitioners during disasters.
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) "Department" means the Department of State Health
Services.
(2) "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.
(3) "Division" has the meaning assigned by Section
418.004, Government Code.
(4) "Emergency" means an event or condition that is a
disaster as defined by Section 418.004, Government Code.
(5) "Emergency declaration" means a declaration of
emergency issued by the governor or a designee of the governor.
(6) "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.
(7) "Entity" means a person other than an individual.
(8) "Health facility" means an entity licensed under
the laws of this or another state to provide health or veterinary
services.
(9) "Health practitioner" means an individual
licensed under the laws of this or another state to provide health
or veterinary services.
(10) "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.
(11) "Host entity" means an entity operating in this
state that uses volunteer health practitioners to respond to an
emergency.
(12) "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.
(13) "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.
(14) "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.
(15) "Volunteer health practitioner" means a health
practitioner who provides health or veterinary services without
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 the system administered by
the department under 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
SYSTEM. (a) The department shall administer a volunteer health
practitioner registration system that:
(1) accepts applications for the registration of
volunteer health practitioners before or during an emergency;
(2) includes information about the licensing and good
standing of health practitioners that is accessible by authorized
persons;
(3) is 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) includes information regarding the results of a
criminal history record information check performed on the
volunteer health practitioners listed in the system.
(b) To satisfy a requirement of Subsection (a) or (c), the
department may:
(1) use information available in the Texas disaster
volunteer registry maintained by the department; or
(2) enter into agreements with disaster relief
organizations or the verification systems of other states for the
advance registration of volunteer health practitioners under 42
U.S.C. Section 247d-7b.
(c) While an emergency declaration is in effect, a state
agency that grants a license to a health practitioner shall
coordinate with the department to provide licensing or criminal
history record information for volunteer health practitioners
seeking registration under this chapter.
(d) If an applicant for registration under this chapter has
an unacceptable licensing or criminal history, the department may
not allow the applicant to register and the applicant may not serve
as a volunteer health practitioner under this chapter.
(e) 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 the registration system under
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 and have an acceptable criminal history.
(f) On request by a person in this state authorized under
Subsection (e) or a similarly authorized person in another state,
the department shall notify the person of the identity of volunteer
health practitioners registered with the registration system and
whether the practitioners are licensed and in good standing and
have an acceptable criminal history.
(g) A host entity is not required to use the services of a
volunteer health practitioner even if the practitioner is
registered with the registration system and the system indicates
that the practitioner is licensed and in good standing and has an
acceptable criminal history.
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 the registration system under Section 115.005 who
is licensed and in good standing in another state and has an
acceptable criminal history 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 the 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.
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