| 1 | 1 | | 2019S0340-1 03/05/19 |
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| 2 | 2 | | By: Campbell S.B. No. 1657 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to level of care designations for rural hospitals that |
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| 8 | 8 | | provide maternal care. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subchapter H, Chapter 241, Health and Safety |
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| 11 | 11 | | Code, is amended by adding Section 241.1831 to read as follows: |
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| 12 | 12 | | Sec. 241.1831. LEVEL OF CARE DESIGNATIONS FOR MATERNAL CARE |
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| 13 | 13 | | IN RURAL HOSPITALS. (a) In this section: |
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| 14 | 14 | | (1) "Rural hospital" means a hospital that has fewer |
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| 15 | 15 | | than 50 beds and: |
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| 16 | 16 | | (A) is: |
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| 17 | 17 | | (i) designated by the Centers for Medicare |
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| 18 | 18 | | and Medicaid Services as a critical access hospital, sole community |
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| 19 | 19 | | hospital, or rural referral center; and |
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| 20 | 20 | | (ii) not located in an area defined by the |
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| 21 | 21 | | federal Office of Management and Budget as a metropolitan |
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| 22 | 22 | | statistical area; or |
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| 23 | 23 | | (B) is located in a county with a population of |
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| 24 | 24 | | not more than 60,000. |
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| 25 | 25 | | (2) "Telemedicine medical service" has the meaning |
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| 26 | 26 | | assigned by Section 111.001, Occupations Code. |
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| 27 | 27 | | (b) A rural hospital must have available at all times for |
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| 28 | 28 | | consultation, either in person or as a telemedicine medical |
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| 29 | 29 | | service, a family medicine physician, an obstetrics and gynecology |
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| 30 | 30 | | physician, or a maternal fetal medicine physician who: |
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| 31 | 31 | | (1) for a rural hospital assigned a Level I level of |
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| 32 | 32 | | care designation: |
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| 33 | 33 | | (A) is licensed by the Texas Medical Board; |
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| 34 | 34 | | (B) has obstetrics training and experience; and |
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| 35 | 35 | | (C) has maternal care and obstetrical surgical |
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| 36 | 36 | | privileges; or |
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| 37 | 37 | | (2) for a rural hospital assigned a Level II level of |
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| 38 | 38 | | care designation: |
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| 39 | 39 | | (A) is licensed by the Texas Medical Board; |
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| 40 | 40 | | (B) has obstetrics training and experience; |
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| 41 | 41 | | (C) has maternal care and obstetrical surgical |
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| 42 | 42 | | privileges; and |
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| 43 | 43 | | (D) is available to provide medical services or |
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| 44 | 44 | | telemedicine medical services to a patient of the hospital not |
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| 45 | 45 | | later than 30 minutes after the time the hospital contacts the |
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| 46 | 46 | | physician. |
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| 47 | 47 | | (c) This section does not affect the authority of a |
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| 48 | 48 | | physician to delegate to a certified registered nurse anesthetist |
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| 49 | 49 | | under Section 157.058, Occupations Code. |
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| 50 | 50 | | (d) The department by rule shall establish a process by |
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| 51 | 51 | | which a rural hospital may appeal its level of care designation to |
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| 52 | 52 | | the department. |
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| 53 | 53 | | (e) Except as specifically provided by this section, a rural |
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| 54 | 54 | | hospital is subject to all other requirements for a level of care |
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| 55 | 55 | | designation under this chapter. |
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| 56 | 56 | | SECTION 2. As soon as practicable after the effective date |
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| 57 | 57 | | of this Act, the Department of State Health Services shall adopt |
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| 58 | 58 | | rules as necessary to implement Section 241.1831, Health and Safety |
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| 59 | 59 | | Code, as added by this Act. |
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| 60 | 60 | | SECTION 3. This Act takes effect September 1, 2019. |
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