| (i) subject to subparagraph (G) of this paragraph,
a forensic medical examination in accordance with Government Code,
Chapter 420, Subchapter B, when the examination has been requested
by a law enforcement agency under Code of Criminal Procedure, Article
56.06, or is conducted under Code of Criminal Procedure, Article 56.065.
If a sexual assault survivor is age 18 or older and has not reported
the assault to a law enforcement agency, a hospital shall provide
this forensic medical examination, when the sexual assault survivor
has arrived at the facility not later than 96 hours after the time
the assault occurred and has consented to the examination;
(ii) a private area, if available, to wait or speak
with the appropriate medical, legal, or sexual assault crisis center
staff or volunteer until a physician, nurse, or physician assistant
is able to treat the survivor;
(iii) access to a sexual assault program advocate,
if available, as provided by Code of Criminal Procedure, Article 56.045;
(iv) the information form required by Health and Safety
Code, §323.005;
(v) a private treatment room, if available;
(vi) if indicated by the history of contact, access
to appropriate prophylaxis for exposure to sexually transmitted infections;
and
(vii) the name and telephone number of the nearest
sexual assault crisis center.
(E) The hospital must obtain documented consent before
providing the forensic medical examination and treatment.
(F) Upon request, the hospital shall submit to the
department its plan for the provision of service to sexual assault
survivors. The plan must describe how the hospital will ensure that
the services required under subparagraph (D) of this paragraph will
be provided.
(i) The hospital shall submit the plan by the 60th
day after the department makes the request.
(ii) The department will approve or reject the plan
not later than the 120th day following the submission of the plan.
(iii) If the department is not able to approve the
plan, the department will return the plan to the hospital and will
identify the specific provisions of statutes or rules with which the
hospital's plan failed to comply.
(iv) The hospital shall correct and resubmit the plan
to the department for approval not later than the 90th day after the
plan is returned to the hospital.
(G) A person may not perform a forensic examination
on a sexual assault survivor unless the person has the basic training
described by Health and Safety Code, §323.0045, or the equivalent
education and training.
(H) Basic Sexual Assault Forensic Evidence Collection
Training.
(i) A person who performs a forensic examination on
a sexual assault survivor must have at least basic forensic evidence
collection training or the equivalent education.
(ii) A person who completes a continuing medical or
nursing education course in forensic evidence collection that is approved
or recognized by the appropriate licensing board is considered to
have basic sexual assault forensic evidence training for purposes
of this chapter.
(iii) Each health care facility that has an emergency
department and that is not a health care facility designated in a
community-wide plan as the primary health care facility in the community
for treating sexual assault survivors shall develop a plan to train
personnel on sexual assault forensic evidence collection.
(I) Sexual Assault Survivors Who Are Minors. This chapter
does not affect participating entities of children's advocacy centers
under Family Code, Chapter 264, Subchapter E, or the working protocols
set forth by their multidisciplinary teams to ensure access to specialized
medical assessments for sexual assault survivors who are minors. To
the extent of a conflict with Family Code, Chapter 264, Subchapter
E, that subchapter controls.
(f) Governing body.
(1) Legal responsibility. There shall be a governing
body responsible for the organization, management, control, and operation
of the hospital, including appointment of the medical staff. For hospitals
owned and operated by an individual or by partners, the individual
or partners shall be considered the governing body.
(2) Organization. The governing body shall be formally
organized in accordance with a written constitution and bylaws which
clearly set forth the organizational structure and responsibilities.
(3) Meeting records. Records of governing body meetings
shall be maintained.
(4) Responsibilities relating to the medical staff.
(A) The governing body shall ensure that the medical
staff has current bylaws, rules, and regulations which are implemented
and enforced.
(B) The governing body shall approve medical staff
bylaws and other medical staff rules and regulations.
(C) In hospitals that provide obstetrical services,
the governing body shall ensure that the hospital collaborates with
physicians providing services at the hospital to develop quality initiatives,
through the adoption, implementation, and enforcement of appropriate
hospital policies and procedures, to reduce the number of elective
or nonmedically indicated induced deliveries or cesarean sections
performed at the hospital on a woman before the 39th week of gestation.
(D) In hospitals that provide obstetrical services,
the governing body shall ensure that the hospital implements a newborn
audiological screening program, consistent with the requirements of
Health and Safety Code, Chapter 47 (Hearing Loss in Newborns), and
performs, either directly or through a referral to another program,
audiological screenings for the identification of hearing loss on
each newborn or infant born at the facility before the newborn or
infant is discharged. These audiological screenings are required to
be performed on all newborns or infants before discharge from the
facility unless:
(i) a parent or legal guardian of the newborn or infant
declines the screening;
(ii) the newborn or infant requires emergency transfer
to a tertiary care facility prior to the completion of the screening;
(iii) the screening previously has been completed;
or
(iv) the newborn was discharged from the facility not
more than 10 hours after birth and a referral for the newborn was
made to another program.
(E) In hospitals that provide obstetrical services,
the governing body shall adopt, implement, and enforce policies and
procedures related to the testing of any newborn for critical congenital
heart disease (CCHD) that may present themselves at birth. The facility
shall implement testing programs for all infants born at the facility
for CCHD. In the event that a newborn is presented at the emergency
room following delivery at a birthing center or a home birth that
may or may not have been assisted by a midwife, the facility shall
ascertain if any testing for CCHD had occurred and, if not, shall
provide the testing necessary to make such determination. The rules
concerning the CCHD procedures and requirements are described in §§37.75
- 37.79 of this title.
(F) The governing body shall determine, in accordance
with state law and with the advice of the medical staff, which categories
of practitioners are eligible candidates for appointment to the medical
staff.
(i) In considering applications for medical staff membership
and privileges or the renewal, modification, or revocation of medical
staff membership and privileges, the governing body must ensure that
each physician, podiatrist, and dentist is afforded procedural due
process.
(I) If a hospital's credentials committee has failed
to take action on a completed application as required by subclause
(VIII) of this clause, or a physician, podiatrist, or dentist is subject
to a professional review action that may adversely affect his medical
staff membership or privileges, and the physician, podiatrist, or
dentist believes that mediation of the dispute is desirable, the physician,
podiatrist, or dentist may require the hospital to participate in
mediation as provided in Civil Practice and Remedies Code (CPRC),
Chapter 154. The mediation shall be conducted by a person meeting
the qualifications required by CPRC §154.052 and within a reasonable
period of time.
(II) Subclause (I) of this clause does not authorize
a cause of action by a physician, podiatrist, or dentist against the
hospital other than an action to require a hospital to participate
in mediation.
(III) An applicant for medical staff membership or
privileges may not be denied membership or privileges on any ground
that is otherwise prohibited by law.
(IV) A hospital's bylaw requirements for staff privileges
may require a physician, podiatrist, or dentist to document the person's
current clinical competency and professional training and experience
in the medical procedures for which privileges are requested.
Cont'd... |
