Texas 2017 - 85th Regular

Texas Senate Bill SB1240 Compare Versions

Only one version of the bill is available at this time.

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1	1	85R5151 MAW-F
2	2	By: Rodríguez S.B. No. 1240
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the prescriptive authority of certain psychologists;
8	8	authorizing a fee.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 501.002, Occupations Code, is amended by
11	11	adding Subdivision (2-a) to read as follows:
12	12	(2-a) "Prescription drug" and "prescription drug
13	13	order" have the meanings assigned by Section 551.003.
14	14	SECTION 2. Section 501.003(c), Occupations Code, is
15	15	amended to read as follows:
16	16	(c) The practice of psychology:
17	17	(1) includes providing or offering to provide services
18	18	to an individual or group, including providing computerized
19	19	procedures, that include the application of established
20	20	principles, methods, and procedures of describing, explaining, and
21	21	ameliorating behavior;
22	22	(2) addresses normal behavior and involves
23	23	evaluating, preventing, and remediating psychological, emotional,
24	24	mental, interpersonal, learning, and behavioral disorders of
25	25	individuals or groups, as well as the psychological disorders that
26	26	accompany medical problems, organizational structures, stress, and
27	27	health;
28	28	(3) includes:
29	29	(A) using projective techniques,
30	30	neuropsychological testing, counseling, career counseling,
31	31	psychotherapy, hypnosis for health care purposes, hypnotherapy,
32	32	and biofeedback; [and]
33	33	(B) evaluating and treating mental or emotional
34	34	disorders and disabilities by psychological techniques and
35	35	procedures; and
36	36	(C) acting under the authority granted by a
37	37	prescriptive authority certificate issued under Section 501.353;
38	38	and
39	39	(4) is based on:
40	40	(A) a systematic body of knowledge and principles
41	41	acquired in an organized program of graduate study; and
42	42	(B) the standards of ethics established by the
43	43	profession.
44	44	SECTION 3. Section 501.051(b), Occupations Code, is amended
45	45	to read as follows:
46	46	(b) To ensure adequate representation on the board of the
47	47	diverse fields of psychology, the governor in making appointments
48	48	under Subsection (a)(1) shall appoint:
49	49	(1) at least two members who provide psychological
50	50	services, at least one of whom holds a prescriptive authority
51	51	certificate issued under Section 501.353;
52	52	(2) at least one member who conducts research in the
53	53	field of psychology; and
54	54	(3) at least one member who teaches as a member of the
55	55	faculty of a psychological training institution.
56	56	SECTION 4. Subchapter D, Chapter 501, Occupations Code, is
57	57	amended by adding Section 501.163 to read as follows:
58	58	Sec. 501.163. ADVISORY COMMITTEE ON PRESCRIPTIVE
59	59	AUTHORITY. (a) The board shall appoint an advisory committee on
60	60	prescriptive authority for psychologists.
61	61	(a-1) Effective September 1, 2017, the advisory committee
62	62	consists of six members as follows:
63	63	(1) three members who each hold a prescriptive
64	64	authority certificate issued under Section 501.353;
65	65	(2) one member who is a psychiatrist;
66	66	(3) one member who is a pediatrician; and
67	67	(4) one member who represents the public.
68	68	(a-2) This subsection and Subsection (a-1) expire September
69	69	1, 2020.
70	70	(b) Effective September 1, 2020, the advisory committee
71	71	consists of six members as follows:
72	72	(1) five members who each hold a prescriptive
73	73	authority certificate issued under Section 501.353; and
74	74	(2) one member who represents the public.
75	75	(c) The advisory committee shall make recommendations to
76	76	the board regarding the regulation of psychologists who hold
77	77	prescriptive authority certificates issued under Section 501.353,
78	78	including recommendations concerning board rules to establish:
79	79	(1) eligibility requirements; and
80	80	(2) standards of practice for certificate holders.
81	81	(d) Chapter 2110, Government Code, does not apply to the
82	82	composition or duration of the advisory committee.
83	83	SECTION 5. Subchapter H, Chapter 501, Occupations Code, is
84	84	amended by adding Section 501.353 to read as follows:
85	85	Sec. 501.353. PRESCRIPTIVE AUTHORITY CERTIFICATE. (a) The
86	86	board shall issue a prescriptive authority certificate to a
87	87	psychologist who:
88	88	(1) meets the eligibility requirements of Subsection
89	89	(b);
90	90	(2) submits an application on a form prescribed by the
91	91	board; and
92	92	(3) pays the fee set by the board.
93	93	(b) To be eligible for a prescriptive authority certificate
94	94	a psychologist must:
95	95	(1) have completed a postdoctoral training program in
96	96	psychopharmacology from an institution of higher education or a
97	97	provider of continuing education approved by the board that
98	98	includes instruction in:
99	99	(A) basic life sciences;
100	100	(B) neuroscience;
101	101	(C) clinical and research pharmacology and
102	102	psychopharmacology;
103	103	(D) clinical pathophysiology;
104	104	(E) physical assessments and laboratory
105	105	examinations;
106	106	(F) clinical pharmacotherapeutics; and
107	107	(G) ethical and legal issues relevant to
108	108	prescriptive authority and associated research;
109	109	(2) complete the supervised experience required by the
110	110	board; and
111	111	(3) pass a nationally recognized examination approved
112	112	by the board in the area of prescriptive authority.
113	113	(c) A psychologist who holds a prescriptive authority
114	114	certificate is authorized to:
115	115	(1) issue a prescription drug order;
116	116	(2) administer or dispense a prescription drug;
117	117	(3) order tests to monitor the use of prescription
118	118	drugs; and
119	119	(4) represent that the psychologist holds a
120	120	prescriptive authority certificate.
121	121	(d) The board shall adopt rules to protect the health of
122	122	patients by requiring a psychologist who holds a prescriptive
123	123	authority certificate to consult with a patient's treating
124	124	physician before the psychologist issues a prescription drug order
125	125	for or administers or dispenses a prescription drug to the patient.
126	126	SECTION 6. Section 481.002(39), Health and Safety Code, is
127	127	amended to read as follows:
128	128	(39) "Practitioner" means:
129	129	(A) a physician, dentist, veterinarian,
130	130	podiatrist, scientific investigator, psychologist, or other person
131	131	licensed, registered, or otherwise permitted to distribute,
132	132	dispense, analyze, conduct research with respect to, or administer
133	133	a controlled substance in the course of professional practice or
134	134	research in this state;
135	135	(B) a pharmacy, hospital, or other institution
136	136	licensed, registered, or otherwise permitted to distribute,
137	137	dispense, conduct research with respect to, or administer a
138	138	controlled substance in the course of professional practice or
139	139	research in this state;
140	140	(C) a person practicing in and licensed by
141	141	another state as a physician, dentist, veterinarian, psychologist,
142	142	or podiatrist, having a current Federal Drug Enforcement
143	143	Administration registration number, who may legally prescribe
144	144	Schedule II, III, IV, or V controlled substances in that state; or
145	145	(D) an advanced practice registered nurse or
146	146	physician assistant to whom a physician has delegated the authority
147	147	to prescribe or order a drug or device under Section 157.0511,
148	148	157.0512, or 157.054, Occupations Code.
149	149	SECTION 7. Section 481.073(a), Health and Safety Code, is
150	150	amended to read as follows:
151	151	(a) Only a practitioner defined by Section 481.002(39)(A)
152	152	and an agent designated in writing by the practitioner in
153	153	accordance with rules adopted by the board may communicate a
154	154	prescription by telephone. A pharmacy that receives a
155	155	telephonically communicated prescription shall promptly write the
156	156	prescription and file and retain the prescription in the manner
157	157	required by this subchapter. A practitioner who designates an
158	158	agent to communicate prescriptions shall maintain the written
159	159	designation of the agent in the practitioner's usual place of
160	160	business and shall make the designation available for inspection by
161	161	investigators for the Texas Medical Board, the State Board of
162	162	Dental Examiners, the State Board of Veterinary Medical Examiners,
163	163	the Texas State Board of Examiners of Psychologists, the board, and
164	164	the department. A practitioner who designates a different agent
165	165	shall designate that agent in writing and maintain the designation
166	166	in the same manner in which the practitioner initially designated
167	167	an agent under this section.
168	168	SECTION 8. Section 481.074(d), Health and Safety Code, is
169	169	amended to read as follows:
170	170	(d) Except as specified in Subsections (e) and (f), the
171	171	board, by rule and in consultation with the Texas Medical Board and
172	172	the Texas State Board of Examiners of Psychologists, shall
173	173	establish the period after the date on which the prescription is
174	174	issued that a person may fill a prescription for a controlled
175	175	substance listed in Schedule II. A person may not refill a
176	176	prescription for a substance listed in Schedule II.
177	177	SECTION 9. Sections 481.076(a) and (c), Health and Safety
178	178	Code, are amended to read as follows:
179	179	(a) The board may not permit any person to have access to
180	180	information submitted to the board under Section 481.074(q) or
181	181	481.075 except:
182	182	(1) an investigator for the board, the Texas Medical
183	183	Board, the Texas State Board of Podiatric Medical Examiners, the
184	184	State Board of Dental Examiners, the State Board of Veterinary
185	185	Medical Examiners, the Texas Board of Nursing, [or] the Texas
186	186	Optometry Board, or the Texas State Board of Examiners of
187	187	Psychologists;
188	188	(2) an authorized officer or member of the department
189	189	or authorized employee of the board engaged in the administration,
190	190	investigation, or enforcement of this chapter or another law
191	191	governing illicit drugs in this state or another state;
192	192	(3) the department on behalf of a law enforcement or
193	193	prosecutorial official engaged in the administration,
194	194	investigation, or enforcement of this chapter or another law
195	195	governing illicit drugs in this state or another state;
196	196	(4) a medical examiner conducting an investigation;
197	197	(5) a pharmacist or a pharmacy technician, as defined
198	198	by Section 551.003, Occupations Code, acting at the direction of a
199	199	pharmacist or a practitioner who is a physician, dentist,
200	200	veterinarian, podiatrist, optometrist, psychologist, or advanced
201	201	practice nurse or is a physician assistant described by Section
202	202	481.002(39)(D) or an employee or other agent of a practitioner
203	203	acting at the direction of a practitioner and is inquiring about a
204	204	recent Schedule II, III, IV, or V prescription history of a
205	205	particular patient of the practitioner, provided that the person
206	206	accessing the information is authorized to do so under the Health
207	207	Insurance Portability and Accountability Act of 1996 (Pub. L.
208	208	No. 104-191) and rules adopted under that Act;
209	209	(6) a pharmacist or practitioner who is inquiring
210	210	about the person's own dispensing or prescribing activity; or
211	211	(7) one or more states or an association of states with
212	212	which the board has an interoperability agreement, as provided by
213	213	Subsection (j).
214	214	(c) The board by rule shall design and implement a system
215	215	for submission of information to the board by electronic or other
216	216	means and for retrieval of information submitted to the board under
217	217	this section and Sections 481.074 and 481.075. The board shall use
218	218	automated information security techniques and devices to preclude
219	219	improper access to the information. The board shall submit the
220	220	system design to the director, [and] the Texas Medical Board, and
221	221	the Texas State Board of Examiners of Psychologists for review and
222	222	comment a reasonable time before implementation of the system and
223	223	shall comply with the comments of those agencies unless it is
224	224	unreasonable to do so.
225	225	SECTION 10. Section 483.001(12), Health and Safety Code, is
226	226	amended to read as follows:
227	227	(12) "Practitioner" means:
228	228	(A) a person licensed or certified by the Texas
229	229	Medical Board, State Board of Dental Examiners, Texas State Board
230	230	of Podiatric Medical Examiners, Texas Optometry Board, Texas State
231	231	Board of Examiners of Psychologists, or State Board of Veterinary
232	232	Medical Examiners to prescribe and administer dangerous drugs;
233	233	(B) a person licensed by another state in a
234	234	health field in which, under the laws of this state, a licensee may
235	235	legally prescribe dangerous drugs;
236	236	(C) a person licensed in Canada or Mexico in a
237	237	health field in which, under the laws of this state, a licensee may
238	238	legally prescribe dangerous drugs; or
239	239	(D) an advanced practice registered nurse or
240	240	physician assistant to whom a physician has delegated the authority
241	241	to prescribe or order a drug or device under Section 157.0511,
242	242	157.0512, or 157.054, Occupations Code.
243	243	SECTION 11. Sections 576.025(b), (c), (e), and (f), Health
244	244	and Safety Code, are amended to read as follows:
245	245	(b) Consent to the administration of psychoactive
246	246	medication given by a patient or by a person authorized by law to
247	247	consent on behalf of the patient is valid only if:
248	248	(1) the consent is given voluntarily and without
249	249	coercive or undue influence;
250	250	(2) the treating physician, a treating psychologist
251	251	who holds a prescriptive authority certificate, or a person
252	252	designated by the physician or psychologist, provided the following
253	253	information, in a standard format approved by the department, to
254	254	the patient and, if applicable, to the patient's representative
255	255	authorized by law to consent on behalf of the patient:
256	256	(A) the specific condition to be treated;
257	257	(B) the beneficial effects on that condition
258	258	expected from the medication;
259	259	(C) the probable health and mental health
260	260	consequences of not consenting to the medication;
261	261	(D) the probable clinically significant side
262	262	effects and risks associated with the medication;
263	263	(E) the generally accepted alternatives to the
264	264	medication, if any, and why the physician or psychologist
265	265	recommends that they be rejected; and
266	266	(F) the proposed course of the medication;
267	267	(3) the patient and, if appropriate, the patient's
268	268	representative authorized by law to consent on behalf of the
269	269	patient is informed in writing that consent may be revoked; and
270	270	(4) the consent is evidenced in the patient's clinical
271	271	record by a signed form prescribed by the facility or by a statement
272	272	of the [treating] physician or psychologist described by
273	273	Subdivision (2), or a person designated by the physician or the
274	274	psychologist, that documents that consent was given by the
275	275	appropriate person and the circumstances under which the consent
276	276	was obtained.
277	277	(c) If the [treating] physician or psychologist described
278	278	by Subsection (b)(2) designates another person to provide the
279	279	information under Subsection (b), then, not later than two working
280	280	days after that person provides the information, excluding weekends
281	281	and legal holidays, the physician or psychologist shall meet with
282	282	the patient and, if appropriate, the patient's representative who
283	283	provided the consent, to review the information and answer any
284	284	questions.
285	285	(e) In prescribing psychoactive medication, a [treating]
286	286	physician or psychologist described by Subsection (b)(2) shall:
287	287	(1) prescribe, consistent with clinically appropriate
288	288	medical care, the medication that has the fewest side effects or the
289	289	least potential for adverse side effects, unless the class of
290	290	medication has been demonstrated or justified not to be effective
291	291	clinically; and
292	292	(2) administer the smallest therapeutically
293	293	acceptable dosages of medication for the patient's condition.
294	294	(f) If a physician or psychologist described by Subsection
295	295	(b)(2) issues an order to administer psychoactive medication to a
296	296	patient without the patient's consent because the patient is having
297	297	a medication-related emergency:
298	298	(1) the physician or psychologist shall document in
299	299	the patient's clinical record in specific medical or behavioral
300	300	terms the necessity of the order and that the physician or
301	301	psychologist has evaluated but rejected other generally accepted,
302	302	less intrusive forms of treatment, if any; and
303	303	(2) treatment of the patient with the psychoactive
304	304	medication shall be provided in the manner, consistent with
305	305	clinically appropriate medical care, least restrictive of the
306	306	patient's personal liberty.
307	307	SECTION 12. Section 301.002(2), Occupations Code, is
308	308	amended to read as follows:
309	309	(2) "Professional nursing" means the performance of an
310	310	act that requires substantial specialized judgment and skill, the
311	311	proper performance of which is based on knowledge and application
312	312	of the principles of biological, physical, and social science as
313	313	acquired by a completed course in an approved school of
314	314	professional nursing. The term does not include acts of medical
315	315	diagnosis or the prescription of therapeutic or corrective
316	316	measures. Professional nursing involves:
317	317	(A) the observation, assessment, intervention,
318	318	evaluation, rehabilitation, care and counsel, or health teachings
319	319	of a person who is ill, injured, infirm, or experiencing a change in
320	320	normal health processes;
321	321	(B) the maintenance of health or prevention of
322	322	illness;
323	323	(C) the administration of a medication or
324	324	treatment as ordered by a health care practitioner legally
325	325	authorized to prescribe the medication or treatment [physician,
326	326	podiatrist, or dentist];
327	327	(D) the supervision or teaching of nursing;
328	328	(E) the administration, supervision, and
329	329	evaluation of nursing practices, policies, and procedures;
330	330	(F) the requesting, receiving, signing for, and
331	331	distribution of prescription drug samples to patients at practices
332	332	at which an advanced practice registered nurse is authorized to
333	333	sign prescription drug orders as provided by Subchapter B, Chapter
334	334	157;
335	335	(G) the performance of an act delegated by a
336	336	physician under Section 157.0512, 157.054, 157.058, or 157.059; and
337	337	(H) the development of the nursing care plan.
338	338	SECTION 13. Section 551.003(34), Occupations Code, is
339	339	amended to read as follows:
340	340	(34) "Practitioner" means:
341	341	(A) a person licensed, certified, or registered
342	342	to prescribe, distribute, administer, or dispense a prescription
343	343	drug or device in the course of professional practice in this state,
344	344	including a physician, dentist, podiatrist, psychologist, or
345	345	veterinarian but excluding a person licensed under this subtitle;
346	346	(B) a person licensed by another state, Canada,
347	347	or the United Mexican States in a health field in which, under the
348	348	law of this state, a license or certificate holder in this state may
349	349	legally prescribe a dangerous drug;
350	350	(C) a person practicing in another state and
351	351	licensed by another state as a physician, dentist, veterinarian,
352	352	psychologist, or podiatrist, who has a current federal Drug
353	353	Enforcement Administration registration number and who may legally
354	354	prescribe a Schedule II, III, IV, or V controlled substance, as
355	355	specified under Chapter 481, Health and Safety Code, in that other
356	356	state; or
357	357	(D) an advanced practice registered nurse or
358	358	physician assistant to whom a physician has delegated the authority
359	359	to prescribe or order a drug or device under Section 157.0511,
360	360	157.0512, or 157.054.
361	361	SECTION 14. Section 501.051(b), Occupations Code, as
362	362	amended by this Act, does not affect the entitlement of a member
363	363	serving on the Texas State Board of Examiners of Psychologists
364	364	immediately before the effective date of this Act to continue to
365	365	serve for the remainder of the member's term. With the first
366	366	appointment of a member described by Section 501.051(a)(1),
367	367	Occupations Code, to be made by the governor on or after the
368	368	effective date of this Act, the governor shall appoint a member to
369	369	the board who has the qualifications required by Section
370	370	501.051(b), Occupations Code, as amended by this Act.
371	371	SECTION 15. (a) Not later than December 1, 2017, the Texas
372	372	State Board of Examiners of Psychologists shall appoint members of
373	373	the advisory committee in accordance with Section 501.163(a-1),
374	374	Occupations Code, as added by this Act.
375	375	(b) Not later than June 1, 2018, the advisory committee
376	376	shall make initial recommendations to the Texas State Board of
377	377	Examiners of Psychologists as described by Section 501.163(c),
378	378	Occupations Code, as added by this Act.
379	379	(c) Not later than December 1, 2020, the Texas State Board
380	380	of Examiners of Psychologists shall appoint members to the advisory
381	381	committee so that the composition of the committee complies with
382	382	Section 501.163(b), Occupations Code, as added by this Act.
383	383	SECTION 16. Not later than September 1, 2018, the Texas
384	384	State Board of Examiners of Psychologists shall adopt rules and
385	385	procedures necessary to implement Section 501.353, Occupations
386	386	Code, as added by this Act.
387	387	SECTION 17. This Act takes effect September 1, 2017.