§ Authorizes the Texas Department of Protective and Regulatory Services (DPRS) to prioritize its investigations in MHMR facilities and community centers.

§ Establishes the Texas Board of Orthotics and Prosthetics (board) as part of the Texas Department of Health (TDH). Sets forth powers and duties of the board.

§ Prohibits the practice of prosthetics or orthotics without a license issued by the board. Sets forth license requirements.

§ Changes general provisions regarding the Department of Protective and Regulatory Services (DPRS) in response to review by the Sunset Commission; updates child care provisions, expedites the involuntary termination of parental rights in cases of abuse and neglect; requires DPRS to develop a permanency plan for each child under its conservatorship; expedites beginning the adoption process; promotes judicial efficiency in termination and adoption cases; and encourages closer cooperation among child advocacy organizations in the promotion of adoption.

§ Continues DPRS and sets it for review in the year 2009, as recommended by the Sunset Advisory Commission.

Child Care Provisions

§ Defines "children who are related to the caregiver" to include children, grandchildren, siblings, great-grandchildren, nieces, or nephews of the caregiver.

§ Exempts a home which gives care exclusively to children who are related to the caregiver from regulation as a registered family home.

§ Authorizes DPRS to inspect registered family homes, in addition to other regulated facilities, as necessary.

§ Requires DPRS to review the results of the inspection with the facility and give the facility an opportunity to respond to the inspection.

§ Requires DPRS to coordinate child care facility inspections performed by an agency or subdivision of the state to eliminate redundant inspections.

§ Requires DPRS to:

§ promulgate minimum training standards for regulated facilities, including recognizing symptoms of child abuse and neglect.

§ regulate assessment services to determine the placement needs of a child who requires substitute care.

§ create a central registry containing relevant inspection information on licensed day-care centers, licensed group day-care homes, and registered family homes from other state agencies and political subdivisions, if feasible.

§ Requires the registry to be available to state and local government entities for enforcement purposes.

§ Requires DPRS to search the central registry of reported cases of child abuse or neglect, before issuing or renewing a license, registration, or certification.

§ make background and criminal history checks for directors, owners and operators of child-care facilities and registered homes.

§ Provides penalties for license and registration violations by child care facilities.

Care for the Elderly or Disabled

§ Updates provisions regarding injury, abuse, and neglect of the elderly and disabled in relation to guardians or attorneys ad litem, priorities of investigation, interaction between DPRS and the Texas Department of Mental Health and Mental Retardation.

Investigations of Abuse and Neglect

§ Expands the grounds upon which parental rights can be terminated to include:

§ the adjudication of a parent on laws of another state substantially equivalent to Texas' laws on endangering a child;

§ a finding that the child has been constructively abandoned as evidenced by a lack of regular or significant contact between the child and parent for six months; or

§ the failure of the parent, for nine months, to comply with court ordered actions supporting reunification of a parent and a child in DPRS custody.

§ Requires the DPRS to prepare and disseminate statistics by county certain child abuse or neglect reports.

§ Increases the penalty for the offense of making a false child abuse or neglect report from a Class B to a Class A misdemeanor.

§ Requires DPRS, upon request, to remove from its records information about alleged abuse and neglect that has been found not to have been committed.

§ Requires DPRS to enter into pilot program agreements, under which the sheriff or law enforcement agency shall conduct investigations of reports or abuse.

§ Requires DPRS to:

§ develop a flexible response system in abuse and neglect investigations;

§ begin locating qualified adoptive parents when DPRS decides to seek termination of parental rights;

§ monitor foster parent performance and sets forth provisions required in contracts for substitute care services; and

§ consider placing the child in the home of the child's noncustodial parent.

§ Requires interview with a child who is an alleged victim of physical or sexual abuse to be audiotaped or videotaped, unless the investigating agency determines otherwise for good cause.

Court Proceedings

§ Expands the list of the attorneys able to represent DPRS in court in family law cases, and allows DPRS to contact for the attorneys' services.

§ Prohibits the court from proceeding to final trial in a suit to terminate the parent-child relationship while a criminal trial is pending for a child directly related to the grounds upon which termination is sought, unless the court determines proceeding is in the best interest of the child.

§ Authorizes the court to appoint a master for a court handling child protection cases, in order to process cases within a reasonable period of time or to accelerate the trial schedule to result in a final order, if the court finds probable cause that certain crimes have been committed against the child.

§ Requires the court to inform each parent, in open court, that his or her parental rights and duties may be subject to restriction or termination.

§ Requires DPRS to develop a permanency plan for each child under its conservatorship.

§ Requires a child to attend permanency hearings unless excused by the court.

§ Requires the court to dismiss a suit terminating parental rights the Monday after the first anniversary DPRS was given conservatorship of the child, unless an extension is granted. Limits an extension to 180 days.

§ Notwithstanding the time limits, authorizes DPRS to retain jurisdiction over the child in the best interest of a child. Authorizes a final order naming DPRS managing conservator without terminating parental rights. Requires the case to be reviewed every six months.

§ Throughout the suit, requires DPRS to keep interested parties informed of hearings and case status, including the child's attorney ad litem and volunteer advocate.

Substitute Care

§ Requires the Health and Human Services Commission (HHSC) to adopt result-oriented standards for substitute care services for children.

§ Authorizes HHSC commissioner to establish caseload standards and other standards relating to caseloads, after considering recommendations of the caseload standards advisory committee. Establishes provisions for purchase of substitute care for children, through a competitive bidding process.

§ Prohibits an officer, employee, or paid consultant of a Texas trade association in the field of health care and their spouses from being a licensed pharmacist member of the Texas State Board of Pharmacy or an employee of the board.

§ Adds new provisions for pharmacy technicians, including allowing the board to set standards for training programs for pharmacy technicians.

§ Prohibits a person from operating a pharmacy unless he or she obtains a license to operate a pharmacy.

§ Provides civil penalties for unlawfully operating a pharmacy or unlawfully engaging in the practice of pharmacy.

§ Deletes the requirement for a professional undergraduate degree and allows the board to define the requirement for a professional practice degree to practice pharmacy and expands grounds for disciplinary actions against a license holder or a person seeking a pharmacy license.

§ Prohibits a store or business from advertising as a pharmacy or providing pharmacy services unless the facility is a licensed pharmacy.

§ Provides that drug product selection does not apply to the refill of a prescription for a narrow therapeutic index drug and that a prescription for a narrow therapeutic index drug may be refilled only by using the same drug product last dispensed.

§ Allows the imposition of administrative penalties by the Texas Department of Health (TDH) for violations to regulations of massage therapists and establishments, respiratory care practitioners, medical radiologic technologists, and dispensing opticians.

§ Requires each health and human services agency (agency) to acquire goods and services by any procurement method approved by the Health and Human Services Commission (HHSC) that provides the best value to the agency. Requires HHSC to adopt rules and procedures for the acquisition of goods and services, and coordinate the procurement practices of all health and human services agencies. Authorizes established procurement methods to meet the state competitive bidding requirements.

§ Requires each applicable agency to notify the state auditor and consult with and receive approval from HHSC before considering factors other than price and meeting specifications for goods or services in excess of $100,000.

§ Authorizes a public disproportionate share hospital to acquire goods and services through the HHSC procurement process.

§ Authorizes the state auditor or Texas Department of Health (TDH) to audit the public hospital's acquisitions of goods and services to the extent that state or federal money is used.

§ Authorizes a state or local governmental entity to allow a public or private hospital to purchase goods or services by participating in an entity's contracts.

§ Authorizes a public or private hospital to purchase goods or services through a group purchasing program. Requires TDH to adopt rules to allow a public or private hospital to make purchases through group purchasing programs.

§ Requires a state agency or local unit of government that expends funds received by TDH, unless otherwise noted, to use a procurement method approved by HHSC that provides the best value. Authorizes TDH to allow a state agency, local unit of government, or entity that expends funds received by TDH to participate in a TDH contract or group purchasing program.

§ Authorizes a state agency, local agency, local mental health authority, or local mental retardation authority that expends public money for mental health or mental retardation goods or services to participate in a TDH contract or group purchasing program.

§ Requires the Texas Department of Health (TDH) to conduct criminal background checks on the owner, administrator, and chief financial officer of all home and community support agencies that are not state owned or operated. Requires TDH to evaluate and consider all information collected during the application process.

§ Requires TDH to find that a home and community support services agency which provides only long-term care Medicaid waiver services that are publicly funded has satisfied licensing requirements if the agency is certified by another state agency with health and safety standards. Prohibits TDH from assessing an administrative penalty against these agencies.

§ Requires TDH to find that a home and community support services agency that provides home health, hospice, or personal assistance services only to persons enrolled in Texas Department of Mental Health and Mental Retardation (MHMR) programs has satisfied licensing requirements if it meets MHMR standards. Prohibits TDH from assessing an administrative penalty against these agencies.

§ Requires TDH to provide an analysis of enforcement actions against home and community support agencies at each meeting of the Home and Community Support Services Advisory Council.

§ Authorizes TDH to assess an administrative penalty against a person who violates the rule on home and community support agencies. Requires TDH to establish, by rule, a schedule of penalties for each possible violation.

§ Requires TDH to provide written notice of the violation to the alleged to have violator. Authorizes a person the option of accepting the determination of TDH or making a written request for a hearing on that determination.

§ Sets forth requirements for TDH on notification and payment of administrative penalties. Establishes judicial review of an alleged violation and a process for refunding penalties of violations overturned in court.

§ Authorizes the attorney general to collect reasonable expenses and costs for bringing an action against a person who allegedly committed a violation or enforcing an administrative penalty.

§ Deletes the option of a qualified dialysis technician administering medication to a client of a home and community support services agency.

§ Provides for the certification of acudetox specialists, defined as persons who practice acupuncture for the limited purpose of treating alcoholism, substance abuse, and chemical dependency.

§ Authorizes the Texas State Board of Medical Examiners (medical board) to certify an acudetox specialist.

§ Establishes notification and record keeping requirements for a program that includes the services of an acudetox specialist.

§ Requires each physician, optometrist, and therapeutic optometrist who performs an eye examination and fits a patient for contact lenses to give a contact lens prescription to the patient on request, with certain exceptions.

§ Prohibits a person, other than the prescribing individual, from selling, delivering, or dispensing contact lenses to a patient unless the person receives an original contact lens prescription.

§ Provides that contact lenses may only be dispensed by the following persons: a physician, optometrist, therapeutic optometrist, pharmacist, or an optician who holds a valid permit.

§ Authorizes the Texas Board of Health to suspend or revoke a person's permit, place the permit holder on probation, or impose an administrative penalty.

§ Prohibits a prescription from being modified.

§ Requires an optician to obtain a contact lens dispensing permit from the Texas Board of Health (board) before dispensing contact lenses.

§ Provides that a person commits a Class B misdemeanor if the person violates this Act.

§ Authorizes a court, in addition to granting injunctive relief or other legal relief, to impose a civil penalty for a violation.

§ Establishes the liability of physicians, optometrists, or therapeutic optometrists.

§ Requires a health care regulatory agency to forward information gathered in a complaint to another health care regulatory agency if it believes the information may be grounds for conducting an investigation or disciplinary proceeding against a health care provider.

§ Establishes the type of information that may be grounds for investigative or disciplinary action, and requires that privileged or confidential information be maintained.

§ Requires a health care regulatory agency to establish and implement written procedures to ensure that required information is forwarded not later than the 15th day after the agency determines the information is relevant.

§ Requires the midwifery board to establish education requirements and practice guidelines for midwives.

§ Requires the Texas Department of Health to maintain a roster of all person documented as midwives in this state.

§ Requires a midwife to encourage a client to seek medical care through consultation or referral if certain determinations are made.

§ Requires a midwife who attends the birth of a child to administer to that child prophylaxis approved by the Texas Board of Health for the prevention of ophthalmia neontorum, except under certain conditions.

§ Authorizes the Texas Department of Health to assess an administrative penalty for violations.

§ Adds denying or suspending on an emergency basis a license or order of recognition to the actions which the Texas State Board of Social Worker Examiners (board) must undertake for certain reasons.

§ States that a suspension is effective immediately if the board suspends a license or order of recognition on an emergency basis. Requires the board to provide an opportunity for a hearing within 20 days of the suspension.

§ Subjects a person whose license or order of recognition has expired to sanctions for violations during the time in which the license or order of recognition was unexpired.

§ Authorizes the board to conduct an investigation of a complaint and reach a decision on its validity, regardless of the status of the license or order of recognition of the person against whom the complaint is issued.

§ Prohibits a hospital authority and the governing body from transferring the assets of the authority without due compensation except to the municipality or county that created the authority to fund or support health-related projects.