89R1115 RDR-F     By: Noble H.B. No. 1503       A BILL TO BE ENTITLED   AN ACT   relating to the licensing and regulation of genetic counselors;   requiring an occupational license; authorizing a fee.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 51.2031(a), Occupations Code, is amended   to read as follows:          (a)  This section applies only to the regulation of the   following professions by the department:                (1)  athletic trainers;                (2)  behavior analysts;                (3)  dietitians;                (4)  genetic counselors;                (5)  hearing instrument fitters and dispensers;                (6) [(5)]  midwives;                (7) [(6)]  orthotists and prosthetists; and                (8) [(7)]  speech-language pathologists and   audiologists.          SECTION 2.  Subtitle I, Title 3, Occupations Code, is   amended by adding Chapter 508 to read as follows:   CHAPTER 508.  LICENSED GENETIC COUNSELORS   SUBCHAPTER A.  GENERAL PROVISIONS          Sec. 508.001.  SHORT TITLE.  This chapter may be cited as the   Licensed Genetic Counselor Act.          Sec. 508.002.  DEFINITIONS.  In this chapter:                (1)  "Advisory board" means the Licensed Genetic   Counselor Advisory Board.                (2)  "Certifying entity" means the American Board of   Medical Genetics and Genomics, the American Board of Genetic   Counseling, or another entity that is nationally accredited to   issue credentials in the practice of genetic counseling and is   approved by the department.                (3)  "Commission" means the Texas Commission of   Licensing and Regulation.                (4)  "Department" means the Texas Department of   Licensing and Regulation.                (5)  "Executive director" means the executive director   of the department.                (6)  "Licensed genetic counselor" means a person   licensed under this chapter to engage in the practice of genetic   counseling.          Sec. 508.003.  PRACTICE OF GENETIC COUNSELING.  (a)  In this   chapter, "practice of genetic counseling" means providing   professional services described by Subsection (b) for compensation   to communicate genetic information to an individual, family, group,   or other entity:                (1)  on the documented referral by:                      (A)  a physician licensed in this state;                       (B)  a physician assistant licensed in this state;                      (C)  an advanced practice registered nurse   licensed in this state; or                       (D)  a person acting under authority delegated   under Subchapter A, Chapter 157; or                 (2)  by a patient's self-referral.          (b)  The practice of genetic counseling:                (1)  consists of:                      (A)  obtaining and evaluating individual, family,   and medical histories to determine the risk for a genetic or medical   condition or disease in a patient, the patient's offspring, or   other family members of the patient;                      (B)  discussing the features, natural history,   means of diagnosis, genetic and environmental factors, and   management of risk for a genetic or medical condition or disease;                      (C)  identifying, coordinating, ordering, and   explaining the results of genetic laboratory tests and other   diagnostic studies as appropriate for genetic assessment;                      (D)  integrating the results of laboratory tests   and other diagnostic studies with medical histories to assess and   communicate risk factors for a genetic or medical condition or   disease;                      (E)  evaluating a patient's or family member's   response to a genetic or medical condition or disease, including   the risk of recurrence, and providing patient-centered counseling   and anticipatory guidance;                      (F)  identifying and using community resources   that provide medical, educational, financial, and psychosocial   support and advocacy; and                      (G)  providing written documentation of medical,   genetic, and counseling information for a patient's family members   and health care providers; and                (2)  does not include the diagnosis of disorders.          Sec. 508.004.  PRACTICE OF MEDICINE NOT AUTHORIZED.  This   chapter does not authorize the practice of medicine as defined by   the law of this state.          Sec. 508.005.  APPLICABILITY; EXEMPTIONS.  (a)  This chapter   does not apply to a physician licensed to practice medicine in this   state unless the physician is a licensed genetic counselor.          (b)  A person may engage in the practice of genetic   counseling without holding a license under this chapter if the   person:                (1)  is licensed, certified, or registered to practice   in this state in a health care-related occupation and:                      (A)  acts within the occupation's scope of   practice; and                      (B)  does not use the title "genetic counselor" or   represent or imply that the person is licensed as a genetic   counselor under this chapter;                (2)  is a student or intern:                      (A)  pursuing a course of study or engaged in a   training program for an occupation regulated by this state and   acting within the occupation's scope of practice; or                      (B)  enrolled in a graduate-level supervised   genetic counseling training program approved or accepted by the   department and engaged in an activity constituting the practice of   genetic counseling as a required part of the training program; or                (3)  is a genetic counselor who:                      (A)  is certified by a certifying entity;                      (B)  is not a resident of this state;                      (C)  performs an activity or provides a service in   this state for not more than 30 days during any year; and                      (D)  meets any other requirement established by   commission rule.          (c)  A student or intern described by Subsection (b)(2)   includes a person who:                (1)  is trained as:                      (A)  a genetic counselor and has applied to take   the certification examination; or                      (B)  a doctoral medical geneticist and has applied   to take the certification examination; and                (2)  has not failed the certification examination more   than twice.   SUBCHAPTER B.  LICENSED GENETIC COUNSELOR ADVISORY BOARD          Sec. 508.051.  LICENSED GENETIC COUNSELOR ADVISORY BOARD.   (a)  The advisory board consists of nine members appointed by the   presiding officer of the commission with the approval of the   commission, as follows:                (1)  six licensed genetic counselors, each of whom has   at least two years of experience practicing genetic counseling as a   genetic counselor and is:                      (A)  licensed under this chapter; or                      (B)  certified by a certifying entity;                (2)  one physician who has experience with genetic   counseling; and                (3)  two members who represent the public.          (b)  Appointments to the advisory board shall be made without   regard to the race, color, disability, sex, religion, age, or   national origin of the appointee.          Sec. 508.052.  DUTIES OF ADVISORY BOARD.  The advisory board   shall provide advice and recommendations to the department on   technical matters relevant to the administration of this chapter.          Sec. 508.053.  TERMS; VACANCY. (a) Members of the advisory   board serve staggered six-year terms, with the terms of three   members expiring February 1 of each odd-numbered year.          (b)  A member of the advisory board may not serve more than   two consecutive six-year terms.          (c)  If a vacancy occurs during a term of a member of the   advisory board, the presiding officer of the commission, with the   commission's approval, shall appoint a replacement who meets the   qualifications for the vacant position to serve for the remainder   of the term.          Sec. 508.054.  PRESIDING OFFICER. The presiding officer of   the commission shall designate a member of the advisory board to   serve as the presiding officer of the advisory board for a term of   two years. The presiding officer of the advisory board may vote on   any matter before the advisory board.          Sec. 508.055.  MEETINGS. The advisory board shall meet as   requested by the presiding officer of the commission or the   executive director.          Sec. 508.056.  GROUNDS FOR REMOVAL. A member of the advisory   board may be removed as provided by Section 51.209.          Sec. 508.057.  COMPENSATION; REIMBURSEMENT. (a) A member   of the advisory board may not receive compensation for service on   the advisory board.          (b)  A member of the advisory board is entitled to   reimbursement for actual and necessary expenses incurred in   performing functions as a member of the advisory board, subject to   any applicable limitation on reimbursement provided by the General   Appropriations Act.   SUBCHAPTER C.  POWERS AND DUTIES          Sec. 508.101.  GENERAL POWERS AND DUTIES. (a) The   commission shall adopt rules consistent with this chapter for the   administration and enforcement of this chapter.          (b)  The department shall:                (1)  administer and enforce this chapter;                (2)  evaluate the qualifications of license   applicants;                (3)  provide for the examination of license applicants;                (4)  issue licenses;                (5)  in connection with a hearing under this chapter,   issue subpoenas, examine witnesses, and administer oaths under the   laws of this state; and                (6)  investigate persons engaging in practices that   violate this chapter.          Sec. 508.102.  CONFIDENTIALITY OF COMPLAINT AND   DISCIPLINARY INFORMATION. (a) Except as provided by Subsection   (b), all information and materials subpoenaed or compiled by the   department in connection with a complaint and investigation are   confidential and not subject to disclosure under Chapter 552,   Government Code, and not subject to disclosure, discovery,   subpoena, or other means of legal compulsion for their release to   anyone other than the department or its employees or agents   involved in discipline of a license holder.          (b)  Information described by Subsection (a) may be   disclosed in accordance with Chapter 51 to:                (1)  persons involved with the department in a   disciplinary action against a license holder;                (2)  a respondent or the respondent's authorized   representative;                (3)  a governmental agency, if:                      (A)  the disclosure is required or permitted by   law; and                      (B)  the agency obtaining the disclosure protects   the identity of any patient whose records are examined;                (4)  a professional genetic counselor licensing or   disciplinary board in another jurisdiction;                (5)  peer assistance programs approved by the   commission under Chapter 467, Health and Safety Code;                (6)  law enforcement agencies; and                (7)  persons engaged in bona fide research, if all   individual-identifying information has been deleted.          (c)  As provided by Chapter 51, notices of alleged violations   issued by the department, commission, or executive director, and   final disciplinary actions, including warnings and reprimands, by   the department, commission, or executive director are not   confidential and are subject to disclosure in accordance with   Chapter 552, Government Code.          (d)  Notwithstanding any other law, the requirements of   Chapter 51 related to the confidentiality of complaint and   investigation information for a health-related program are   applicable to complaint and investigation information under this   chapter.          Sec. 508.103.  STANDARDS OF ETHICAL PRACTICE. The   commission shall adopt rules under this chapter that establish   standards of ethical practice.          Sec. 508.104.  ASSISTANCE FILING COMPLAINT. The department,   in accordance with Section 51.252, shall provide reasonable   assistance to a person who wishes to file a complaint with the   department regarding a person or activity regulated under this   chapter.          Sec. 508.105.  FEES. The commission by rule shall set fees   in amounts reasonable and necessary to cover the costs of   administering this chapter.   SUBCHAPTER D.  LICENSING REQUIREMENTS          Sec. 508.151.  LICENSE REQUIRED.  (a)  Except as provided by   Section 508.005, a person may not act as a genetic counselor or   engage in the practice of genetic counseling in this state unless   the person holds a license under this chapter.          (b)  Except as provided by Section 508.005, unless a person   holds a license under this chapter, the person may not:                (1)  use the title or represent or imply that the person   has the title "genetic counselor," "certified genetic counselor,"   "licensed genetic counselor," "gene counselor," "genetic   consultant," or "genetic associate"; or                (2)  use any other word, abbreviation, or insignia   indicating or implying that the person is a licensed genetic   counselor.          (c)  This chapter may not be construed to prohibit a   physician or an employee or other person acting under a physician's   delegated authority from representing to a patient or the public   that the physician, employee, or person provides genetic   counseling.          Sec. 508.152.  LICENSE APPLICATION.  An applicant for a   license must:                (1)  submit an application in the manner and on a form   prescribed by the department;                (2)  successfully complete a state-approved criminal   background check; and                (3)  pay the application fee set by the commission.          Sec. 508.153.  LICENSE ELIGIBILITY. To be eligible for a   genetic counselor license, a license applicant must present   evidence to the department that the applicant:                (1)  has passed an examination by a certifying entity   or an equivalent examination in genetic counseling approved by the   department;                (2)  is currently certified by a certifying entity in   genetic counseling or medical genetics;                (3)  has met the educational requirements of a   certifying entity, which must include a master's degree in genetic   counseling or medical genetics or an equivalent educational   standard adopted by the certifying entity;                (4)  is in compliance with all professional, ethical,   and disciplinary standards established by the certifying entity;   and                (5)  is not subject to any disciplinary action by the   certifying entity.          Sec. 508.154.  ISSUANCE OF LICENSE. The department shall   issue a genetic counselor license to an applicant who:                (1)  complies with the requirements of this chapter;                (2)  meets any additional requirements the commission   establishes by rule; and                (3)  pays the required fees.          Sec. 508.155.  TERM. A license issued under this chapter   expires on the second anniversary of the date of issuance.          Sec. 508.156.  RENEWAL.  Before the expiration of a license,   a license may be renewed by:                (1)  submitting an application for renewal;                (2)  paying the renewal fee imposed by the commission;   and                (3)  providing verification to the department of   continued certification by a certifying entity, which signifies   that the applicant for renewal has met any continuing education   requirements established by the certifying entity.   SUBCHAPTER E.  DISCIPLINARY PROCEDURES          Sec. 508.201.  GROUNDS FOR DISCIPLINARY ACTION.  In   accordance with Section 51.353, the commission or executive   director may deny, revoke, or suspend a license, refuse to renew a   license, place on probation a person whose license has been   suspended, or reprimand a license holder for a violation of this   chapter, a rule adopted under this chapter, or an order of the   commission or executive director.   SUBCHAPTER F.  ENFORCEMENT PROCEDURES          Sec. 508.251.  ENFORCEMENT PROCEEDINGS. The commission,   department, or executive director may enforce this chapter, a rule   adopted under this chapter, or an order of the commission or   executive director as provided by Subchapters F and G, Chapter 51.          SECTION 3.  (a)  As soon as practicable after the effective   date of this Act, the presiding officer of the Texas Commission of   Licensing and Regulation shall appoint nine members to the Licensed   Genetic Counselor Advisory Board in accordance with Chapter 508,   Occupations Code, as added by this Act. In making the initial   appointments, the presiding officer of the commission shall   designate three members for terms expiring February 1, 2027, three   members for terms expiring February 1, 2029, and three members for   terms expiring February 1, 2031.          (b)  Notwithstanding Section 508.051, Occupations Code, as   added by this Act, a person who meets the requirements of Section   508.153, Occupations Code, as added by this Act, may be appointed as   an initial licensed genetic counselor member of the Licensed   Genetic Counselor Advisory Board, regardless of whether the person   holds a license issued under Chapter 508, Occupations Code, as   added by this Act.          SECTION 4.  Not later than May 1, 2026, the Texas Commission   of Licensing and Regulation shall adopt the rules, procedures, and   fees necessary to administer Chapter 508, Occupations Code, as   added by this Act.          SECTION 5.  (a) Except as provided by Subsection (b) of this   section, this Act takes effect September 1, 2025.          (b)  Section 508.151, Occupations Code, as added by this Act,   and Subchapter F, Chapter 508, Occupations Code, as added by this   Act, take effect September 1, 2026.