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The committee met to take up and consider the bills listed below.
 
SB 203 – Nelson, Relating to the continuation and functions of the Texas Health Services Authority as a quasi-governmental entity and the electronic exchange of health care information.

  • Reflects Sunset Commission recommendations
  • Continues THSA until 2021; after that it will function as a non-profit
  • Adds a board member to represent local health information exchanges
  • THSA has become financially self-sufficient over time and will be able to function completely independently after a few more years
  • Committee substitute ensure the authority continues to have the opportunity to advise HHSC on health information issues even after it is fully independent; also some technical cleanup
  • Committee substitute adopted
  • Sen. Lois Kolkhorst asked if the program from HB 300 (82R) can continue after THSA is independent
    • Yes; that was a unanimous decision made by Sunset; language in the bill continues the voluntary certification program
  • Bill left pending

 
SB 292 – Nelson, Relating to a request for a waiver of the waiting period before human remains may be cremated.

  • Bill passed the Senate unanimously last session
  • Will help families with religious beliefs who require cremating loved ones in a timely fashion
  • Counties must establish a written policy describing how a waiver for an expedited cremation will be carried out, in particular over holidays and weekends
  • Sen. Charles Perry asked about potential criminal issues; would the counties be able to work around
    • It does not require an expedited cremation, just requires counties to have a policy
  • Bill left pending

 
SB 538 – Schwertner, Relating to the control of infectious diseases.

  • Based on recommendations of the Governor’s Infectious Disease Task Force and DSHS
  • Will give the tools necessary to effectively respond to and contain infectious disease outbreaks
  • Laid out committee substitute but there will likely be additional changes to substitute in the near future
  • Current substitute provides a clear command structure by allowing the Governor to declare a state of infectious disease emergency; gives DSHS commissioner authority over local public health decisions
  • During an emergency DSHS would be required to work with local health authorities
  • Creates a mechanism to enforce control measures
  • Currently DSHS has the authority to issue control orders but lacks authority to enforce them
  • Continues the task force as an advisory body to the governor and adds urban and rural local public health entities
  • Allows DSHS or a local authority to release the name or location of an individual with a highly infectious disease to local responders
  • Requires DSHS to review CDC recommendations for disease control measures in animals and livestock
  • Allows cremation of remains without standard procedure
  • Allows DSHS to test blood containing an infectious disease without a control order
  • Grants DSHS authority to stop a common carrier if someone on board is believed to have an infectious disease
  • Sen. Judith Zaffirini noted there were concerns over what would constitute an emergency; substitute has addressed those concerns
    • Yes; the language has been tightened
  • Zaffirini asked if the committee substitute will have a fiscal note
    • Do not believe so
  • Sen. Jose Rodriguez asked about the 24 hour period in which an individual must be made aware of their rights; would it be possible to allow law enforcement to handle that  instead of a health official; the health official may not have sufficient time; concern was from hospitals
    • Thinks it is best to have a health official who knows the issue to describe the situation
  • Rodriguez asked about cost for warrantless detention
    • The facility will bear the costs; believe most warrantless detentions will be at the person’s residence instead of a facility
  • Rodriguez asked if the person with the infection will be billed
    • Do not believe they can bill that back

 
Dr. Brett Giroir, Texas A&M Health Science Center

  • The task force considered many issues that occur in these situations
  • Discussed members of the infectious disease task force and noted their expertise
  • The Ebola emergency demonstrated needs for profound changes in infectious disease situations
  • The report reflects the best scientific assessments and was unanimously adopted by the task force members
  • Enabling the Governor to declare an emergency, creation of a stock pile of personal protective equipment, stopping common carriers and care of pets and livestock provisions were specific recommendations from the task force
  • The bill makes DSHS accountable for implementing recommendations, bill establishes the task force as an ongoing advisory body to the Governor
  • Perry asked what types of diseases would this affect
    • Very narrow set of circumstances that are very rare when health officials do not have much experience; MERS, anthrax, smallpox, avian influenza, etc.; very rare, high consequence events
  • Kolkhorst noted it is a delicate balance to keep the public good in mind versus protecting individual liberties
  • Sen. Donna Campbell noted this is proactive legislation that is dealing with decreasing the risk of acute life-threatening exposure; definitely need to be proactive
  • Chairman Charles Schwertner asked what is different about infectious disease that it could warrant a state of emergency
    • The idea of local control is very important in the state; the state health official has far more experience in these high impact situations than local health officials; these kinds of diseases are not local issues, they are statewide, potentially national issues; does not take away the local incident command structure at all
  • Schwertner asked about warrantless detention currently used and how the bill interacts with those situations
    • It is currently practiced in the state that a person with a mental health risk to themselves or others can be detained for up to 48 hours; currently not even the state’s top physician can implement an enforceable control order to keep a person in their home

 
Lisa Cornelius, Infectious Disease Medical Office, DSHS

  • Schwertner asked how the witness would advise the Governor were an infectious disease to present itself
    • The state keeps its awareness of potential issues and has resources such as the task force and the CDC and would use those resources in developing what to advise the Governor on
  • Zaffirini asked for ways to improve the substitute
    • The substitute has good changes
  • Schwertner noted the state of emergency being declared would allow for improved coordination across agencies

 
Dr. Donald K. Murphy, Pediatric Infectious Diseases, Cook Children’s

  • For the bill
  • Applauded Schwertner for taking on this task
  • Many physician groups including TMA support the bill
  • Concerns about clarity of exactly what constitutes an emergency
  • Concerns that with Dr. Lakey leaving, not having a strong physician leading DSHS the state may not have the expertise needed to handle these situations

 
Dr. Phillip Huang, Health Authority, Travis County Health Department

  • Strongly support the practice of local control
  • Would like the bill to support local authorities in working with the state to address these issues
  • Schwertner noted the state of emergency would only be used with a serious an imminent threat of an infectious disease; the bill does not mandate that the state takeover in a state of emergency
  • Campbell noted she appreciates local control but these situations can be so dire that they require the state to have authority

 
Charles Reed, Dallas County

  • Not opposed to the bill
  • There is legislation that needs to be enacted to clarify roles in certain events
  • Disagree with the characterization that there was not a clear chain of command in the Ebola outbreak
  • Agree that there needs to be better information sharing
  • Schwertner noted the substitute does require DSHS and the Governor to work with local health authorities when determining whether to declare a state of emergency and once one has been declared

 
Donald Lee, Texas Conference of Urban Counties

  • Need some action to bring the right perspectives from locals into the state perspective
  • Appreciates the changes in the substitute
  • Local control is important

 
Betty Stewart, Self

  • Discussed the differences between functional medicine versus allopathic medicine

 
Joe Palmer, Self

  • Against the bill
  • Concerned about the method by which power in this bill would be taken
  • There is not a one-size-fits-all solution to this problem
  • Should not be expanding government power for warrantless detention; if a warrant can be given at 2AM for a blood draw of an intoxicated person it can be done for other issues

 
Dr. Diana Martinez, Harris County Public Health and Environmental Services

  • Need local control in these situations
  • Have been working with stakeholders to communicate concerns with the bill
  • Appreciate changes made in substitute to take local expertise into account
  • Bill needs to preserve the power of the local health authority

 
Judy Powell, Parental Guidance Center

  • There are no provisions for detaining children separately in the bill; need to codify something about what happens when a single parent becomes ill or provisions for keeping families together or provisions for parental or guardian visits for children in detention
  • Home quarantine should be the default

 
Peter McCarthy, Texas Health Freedom Coalition

  • Opposes the bill
  • The language in the bill is vague and overly broad

 
Reed King, Self

  • Opposed to elements within the bill
  • The bill has overly broad and vague language
  • Control orders have nothing to do with the state of emergency; not linked together legally
  • The bill would allow law enforcement to make the determination whether a control order applies to any individual
  • There are no legal protections to prevent a person from being charged for medical services they may not have asked for

 
Bill left pending
 
SB 519 – Schwertner, Relating to the registration of dental support organizations; imposing a fee; providing a civil penalty.

  • Concerns DSOs
  • Provide business support services to dentists
  • Many dentists opt to contract with DSOs so dentists can focus on caring for patients
  • Last session many members became concerned with influence DSOs have over dentists and the practice of dentistry
  • Bill does not outlaw DSOs or subject them to burdensome regulation; just asks them to raise their hand and be counted
  • DSOs must register with Secretary of State
  • Committee substitute cleans up language related to surveys conducted by the Dental Board; clarifies that the list of support services is not limiting; requires DSOs to furnish a list of services they supply to dentists

 
 
Steve Bresnen, Association of Dental Support Organizations

  • In support of the bill

 
Bill Bingham, Texas Dental Association

  • Support the concept of the bill
  • Look forward to continuing to work with the author

 
Bill left pending
 
SB 460 – Schwertner, Relating to the licensing and regulation of pharmacists and pharmacies.

  • Updates pharmacy act to close loopholes and update language
  • Primarily a cleanup bill
  • Some policy changes
    • Allows pharmacists to refill a 30 day prescription without authorization in a disaster
    • Allows the board to inspect financial documents
    • Clarifies that the board may inspect records for entities practicing outside of the normal pharmacy setting
    • Prevents pharmacists with revoked licenses in other states from practicing in Texas
    • Requires pharmacists with 90 day expired licenses to be re-licensed
    • Requires pharmacists to report to the board any address changes
  • Committee substitute makes some changes related to deletions in the occupations code

 
Rene Garza, Pharmacist

  • In support
  • Concerned about the depth of the reach for financial information; confident that legislative intent will satisfy those concerns
  • Schwertner noted there are issues with structures of compounding pharmacies and shell companies; current statute makes it difficult to find out who is behind shell companies; addressing this through increased financial disclosures

 
Allan Horn, CVS Health

  • Share similar concerns on the financial disclosures
  • Have to be careful about giving out pricing information to a board that contains competitors
  • Will be working with the author on narrowing language

 
Bill left pending
 
Bills previously left pending
 
SB 219 – Schwertner, Relating to the provision of health and human services in this state, including the powers and duties of the Health and Human Services Commission and other state agencies, and the licensing of certain health professionals; clarifying certain statutory provisions; authorizing the imposition of fees.

  • The HHSC clarification bill
  • Concerns were raised about changes impacting CH. 262 of the Family Code; language has been agreed to that will make the language more clear
  • Withdrew the committee amendment from last week’s hearing
  • New committee amendment laid out
  • Same amendment from last week correcting drafting errors and oversights; also addresses Family Code issue; clarifies that an emergency order can take multiple forms; stakeholders have approved the changes
  • Committee amendment adopted
  • Committee substitute reported favorably to full Senate

 
SB 114 – Taylor, Van, Relating to the applicability of adverse licensing, listing, or registration decisions by certain health and human services agencies.

  • Rodriguez asked about the intent to ensure relevant agencies share information about providers who have a record of harming patients; should also include other provider groups such as ASCs, dialysis facilities, birthing center, narcotic treatment centers, others; will that amendment be acceptable
    • Yes
  • Bill reported favorably to full Senate

 
SB 373 – West, Relating to increased oversight by the Department of State Health Services of hospitals that commit certain violations.

  • Bill reported favorably to full Senate