84R8619 SCL-D
By: Bell H.B. No. 1473
A BILL TO BE ENTITLED
AN ACT
relating to the authority of an advanced practice registered nurse
and a physician assistant to sign or issue certain documents.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 38.001(c), Education Code, is amended to
read as follows:
(c) Immunization is not required for a person's admission to
any elementary or secondary school if the person applying for
admission:
(1) submits to the admitting official:
(A) an affidavit or a certificate signed by a
physician who is duly registered and licensed to practice medicine
in the United States, an advanced practice registered nurse who is
licensed to practice advanced nursing in this state, or a physician
assistant licensed to practice under that license in this state, in
which it is stated that, in the physician's, nurse's, or physician
assistant's opinion, the immunization required poses a significant
risk to the health and well-being of the applicant or any member of
the applicant's family or household; or
(B) an affidavit signed by the applicant or, if a
minor, by the applicant's parent or guardian stating that the
applicant declines immunization for reasons of conscience,
including a religious belief; or
(2) is a member of the armed forces of the United
States and is on active duty.
SECTION 2. Section 51.9192(d), Education Code, is amended
to read as follows:
(d) A student to whom this section applies or a parent or
guardian of the student is not required to comply with Subsection
(c) if the student or a parent or guardian of the student submits to
the institution:
(1) an affidavit or a certificate signed by a
physician who is duly registered and licensed to practice medicine
in the United States, an advanced practice registered nurse who is
licensed to practice advanced nursing in this state, or a physician
assistant licensed to practice under that license in this state in
which it is stated that, in the physician's, nurse's, or physician
assistant's opinion, the vaccination required would be injurious to
the health and well-being of the student; or
(2) an affidavit signed by the student stating that
the student declines the vaccination for bacterial meningitis for
reasons of conscience, including a religious belief, or
confirmation that the student has completed the Internet-based
process described by Subsection (d-3) for declining the vaccination
on that basis, if applicable to the student.
SECTION 3. Section 51.933(d), Education Code, is amended to
read as follows:
(d) No form of immunization is required for a person's
admission to an institution of higher education if the person
applying for admission:
(1) submits to the admitting official:
(A) an affidavit or a certificate signed by a
physician who is duly registered and licensed to practice medicine
within the United States, an advanced practice registered nurse who
is licensed to practice advanced nursing in this state, or a
physician assistant licensed to practice under that license in this
state in which it is stated that, in the physician's, nurse's, or
physician assistant's opinion, the immunization required poses a
significant risk to the health and well-being of the applicant or
any member of the applicant's family or household; or
(B) an affidavit signed by the applicant or, if a
minor, by the applicant's parent or guardian stating that the
applicant declines immunization for reasons of conscience,
including a religious belief; or
(2) is a member of the armed forces of the United
States and is on active duty.
SECTION 4. Sections 62.109(b) and (f), Government Code, are
amended to read as follows:
(b) A person requesting an exemption under this section must
submit to the court an affidavit stating the person's name and
address and the reason for and the duration of the requested
exemption. A person requesting an exemption due to a physical or
mental impairment must attach to the affidavit a statement from a
physician, advanced practice registered nurse, or physician
assistant. The affidavit and physician's, nurse's, or physician
assistant's statement may be submitted to the court at the time the
person is summoned for jury service or at any other time.
(f) An affidavit accompanying a request for an exemption
from jury service because of a physical or mental impairment may be
presented by the affiant or by a friend or relative of the affiant.
The affidavit must state:
(1) the name and address of the physician, advanced
practice registered nurse, or physician assistant whose statement
accompanies the affidavit;
(2) whether the request is for a permanent or
temporary exemption;
(3) the period of time for which a temporary exemption
is requested; and
(4) that as a direct result of the physical or mental
impairment it is impossible or very difficult for the affiant to
serve on a jury.
SECTION 5. Section 89.001, Health and Safety Code, is
amended by amending Subdivision (1) and adding Subdivisions (1-a)
and (7-a) to read as follows:
(1) "Advanced practice registered nurse" has the
meaning assigned by Section 301.152, Occupations Code.
(1-a) "Community corrections facility" means a
facility established under Chapter 509, Government Code.
(7-a) "Physician assistant" means an individual who
holds a license issued under Chapter 204, Occupations Code.
SECTION 6. Sections 89.011(a), (b), and (d), Health and
Safety Code, are amended to read as follows:
(a) The governing body of a jail or community corrections
facility, through the community supervision and corrections
department, shall require that each employee or volunteer working
or providing services in a jail or a community corrections
facility, who meets the screening guidelines prescribed by
department [board] rule, present to the governing body a
certificate signed by a physician, an advanced practice registered
nurse, or a physician assistant that states that:
(1) the employee or volunteer has been tested for
tuberculosis infection in accordance with department [board]
rules; and
(2) the results of the test indicate that the person
does not have tuberculosis.
(b) In lieu of a screening test, an employee or volunteer
with a history of a positive screening test may provide:
(1) documentation of that positive test result and of
any diagnostic and therapeutic follow-up; and
(2) a certificate signed by a physician, an advanced
practice registered nurse, or a physician assistant that states
that the person does not have tuberculosis.
(d) An employee or volunteer is exempt from the screening
test required by this section if:
(1) the screening test conflicts with the tenets of an
organized religion to which the individual belongs; or
(2) the screening test is medically contraindicated
based on an examination by a physician, an advanced practice
registered nurse, or a physician assistant.
SECTION 7. Section 89.012(b), Health and Safety Code, is
amended to read as follows:
(b) If the employee or volunteer has tuberculosis, the
governing body may not permit the person to begin or continue the
person's employment duties or volunteer services unless the person
is under treatment for the disease by a physician, an advanced
practice registered nurse, or a physician assistant and the person
provides to the governing body a certificate signed by the
attending physician, nurse, or physician assistant stating that the
patient is noninfectious.
SECTION 8. Sections 192.003(a) and (c), Health and Safety
Code, are amended to read as follows:
(a) The physician, advanced practice registered nurse,
physician assistant, midwife, or person acting as a midwife in
attendance at a birth shall file the birth certificate with the
local registrar of the registration district in which the birth
occurs.
(c) If there is no physician, advanced practice registered
nurse, physician assistant, midwife, or person acting as a midwife
in attendance at a birth and if the birth does not occur in a
hospital or birthing center, the following in the order listed
shall report the birth to the local registrar:
(1) the father or mother of the child; or
(2) the owner or householder of the premises where the
birth occurs.
SECTION 9. Sections 193.005(a), (b), and (c), Health and
Safety Code, are amended to read as follows:
(a) A person required to file a death certificate or fetal
death certificate shall obtain the required medical certification
from an attending physician, advanced practice registered nurse, or
physician assistant if the death occurred under medical attendance
for the care and treatment of the condition or disease process that
contributed to the death.
(b) The attending physician, advanced practice registered
nurse, or physician assistant shall complete the medical
certification not later than five days after receiving the death
certificate.
(c) An associate physician, the chief medical officer of the
institution where the death occurred, or the physician who
performed an autopsy on the decedent may complete the medical
certification if:
(1) the attending physician, advanced practice
registered nurse, or physician assistant is unavailable;
(2) the attending physician, advanced practice
registered nurse, or physician assistant approves; and
(3) the person completing the medical certification
has access to the medical history of the case and the death is due to
natural causes.
SECTION 10. Section 504.201(d), Transportation Code, is
amended to read as follows:
(d) Except as provided by Subsection (d-1), the initial
application for specialty license plates under this section must be
accompanied by a written statement from a physician [who is]
licensed to practice medicine, an advanced practice registered
nurse licensed to practice advanced nursing, or a physician
assistant licensed to practice under that license in this state or
in a state adjacent to this state or who is authorized by applicable
law to practice medicine or advanced nursing or as a physician
assistant, as applicable, in a hospital or other health facility of
the Department of Veterans Affairs. If the applicant has a
mobility problem caused by a disorder of the foot, the written
statement may be issued by a person licensed to practice podiatry in
this state or a state adjacent to this state. In this subsection,
"podiatry" has the meaning assigned by Section 681.001. The
statement must certify that the person making the application or on
whose behalf the application is made is legally blind or has a
mobility problem that substantially impairs the person's ability to
ambulate. The statement must also certify whether a mobility
problem is temporary or permanent. A written statement is not
required as acceptable medical proof if:
(1) the person with a disability:
(A) has had a limb, hand, or foot amputated; or
(B) must use a wheelchair; and
(2) the applicant executes a statement attesting to
the person's disability before the county assessor-collector.
SECTION 11. Section 681.003(c), Transportation Code, is
amended to read as follows:
(c) Subject to Subsections (e) and (f), the first
application must be accompanied by a notarized written statement or
written prescription of a physician licensed to practice medicine,
an advanced practice registered nurse licensed to practice advanced
nursing, or a physician assistant licensed to practice under that
license in this state or a state adjacent to this state, or
authorized by applicable law to practice medicine or advanced
nursing or as a physician assistant, as applicable, in a hospital or
other health facility of the United States Department of Veterans
Affairs, certifying and providing evidence acceptable to the
department that the person making the application or on whose
behalf the application is made is legally blind or has a mobility
problem that substantially impairs the person's ability to
ambulate. The statement or prescription must include a
certification of whether the disability is temporary or permanent
and information acceptable to the department to determine the type
of disabled parking placard for which the applicant is
eligible. The department shall determine a person's eligibility
based on evidence provided by the applicant establishing legal
blindness or mobility impairment.
SECTION 12. Section 681.004(d), Transportation Code, is
amended to read as follows:
(d) A disabled parking placard issued to a person with a
temporary disability expires after the period set by the department
and may be renewed at the end of that period if the disability
remains as evidenced by a physician's, advanced practice registered
nurse's, or physician assistant's statement or prescription
submitted as required for a first application under Section
681.003(c).
SECTION 13. Section 14(b), Texas Local Fire Fighters
Retirement Act (Article 6243e, Vernon's Texas Civil Statutes), is
amended to read as follows:
(b) An application for disability retirement must be filed
with the board of trustees of the retirement system of which the
applicant is a member. The application must contain a sworn
statement of the member's medical condition, signed by a physician,
advanced practice registered nurse, or physician assistant
attending the member, and a sworn statement of the circumstances
under which the disability arose, signed by the member or another
person who has reason to know those circumstances. The application
also may contain other pertinent information to enable the board to
determine whether the member is eligible for disability retirement.
SECTION 14. Section 6.06(a), Chapter 183 (S.B. 598), Acts
of the 64th Legislature, Regular Session, 1975 (Article 6243e.1,
Vernon's Texas Civil Statutes), is amended to read as follows:
(a) An application for disability retirement must be
accompanied by a written statement, on a form approved by the board
of trustees, signed by a physician, advanced practice registered
nurse, or physician assistant of the member's choice. The member
shall pay any costs of or fees for obtaining the physician's,
nurse's, or physician assistant's statement and shall file the
application and statement with the fund. As soon as possible after
the application is filed, the medical board shall evaluate the
medical and other pertinent information concerning the member's
application.
SECTION 15. Section 8(f), Chapter 451 (S.B. 737), Acts of
the 72nd Legislature, Regular Session, 1991 (Article 6243n,
Vernon's Texas Civil Statutes), is amended to read as follows:
(f) A member receiving a disability retirement allowance
shall periodically file a report with the retirement board
concerning continued proof of disability. The retirement board
shall adopt rules establishing the required supporting information
to accompany the reports, the content of the reports, and deadlines
for filing the reports. The report shall include:
(1) a current statement of the member's physical or
mental condition stating the existence of continued disability,
signed by the member's attending physician, advanced practice
registered nurse, or physician assistant; and
(2) a statement of all employment activities pursued
in the preceding year.
SECTION 16. Section 7.03(a)(1), Chapter 452 (S.B. 738),
Acts of the 72nd Legislature, Regular Session, 1991 (Article
6243n-1, Vernon's Texas Civil Statutes), is amended to read as
follows:
(1) A member receiving a disability retirement benefit
is required to file a report to the board concerning continued proof
of disability one year after the date on which the board originally
awarded the member disability retirement. The report shall
include:
(A) a current statement of the member's physical
or [and/or] mental condition, signed by the member's attending
physician, advanced practice registered nurse, or physician
assistant; and
(B) a statement of all employment activities
pursued in the preceding one-year period and a copy of federal
income tax returns applicable to the one-year period.
SECTION 17. This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect September 1, 2015.