TX
Texas Senate Bill SB1625

Texas 2017 - 85th Regular

Texas Senate Bill SB1625 Compare Versions

OldNewDifferences
1-S.B. No. 1625
1+By: Uresti S.B. No. 1625
2+ (Cortez, Oliverson, Guerra)
23
34
5+ A BILL TO BE ENTITLED
46 AN ACT
57 relating to the Texas Physician Assistant Board and the licensing
68 and regulation of physician assistants.
79 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8- SECTION 1. Section 157.0512, Occupations Code, is amended
9- by amending Subsections (e) and (f) and adding Subsection (f-1) to
10- read as follows:
11- (e) A prescriptive authority agreement must, at a minimum:
12- (1) be in writing and signed and dated by the parties
13- to the agreement;
14- (2) state the name, address, and all professional
15- license numbers of the parties to the agreement;
16- (3) state the nature of the practice, practice
17- locations, or practice settings;
18- (4) identify the types or categories of drugs or
19- devices that may be prescribed or the types or categories of drugs
20- or devices that may not be prescribed;
21- (5) provide a general plan for addressing consultation
22- and referral;
23- (6) provide a plan for addressing patient emergencies;
24- (7) state the general process for communication and
25- the sharing of information between the physician and the advanced
26- practice registered nurse or physician assistant to whom the
27- physician has delegated prescriptive authority related to the care
28- and treatment of patients;
29- (8) if alternate physician supervision is to be
30- utilized, designate one or more alternate physicians who may:
31- (A) provide appropriate supervision on a
32- temporary basis in accordance with the requirements established by
33- the prescriptive authority agreement and the requirements of this
34- subchapter; and
35- (B) participate in the prescriptive authority
36- quality assurance and improvement plan meetings required under this
37- section; and
38- (9) describe a prescriptive authority quality
39- assurance and improvement plan and specify methods for documenting
40- the implementation of the plan that include [includes] the
41- following:
42- (A) chart review, with the number of charts to be
43- reviewed determined by the physician and advanced practice
44- registered nurse or physician assistant; [and]
45- (B) if the agreement is between a physician and
46- an advanced practice registered nurse, periodic face-to-face
47- meetings between the advanced practice registered nurse [or
48- physician assistant] and the physician at a location determined by
49- the physician and the advanced practice registered nurse; and
50- (C) if the agreement is between a physician and a
51- physician assistant, periodic meetings between the physician
52- assistant and the physician [or physician assistant].
53- (f) The periodic face-to-face meetings described by
54- Subsection (e)(9)(B) must:
55- (1) include:
56- (A) the sharing of information relating to
57- patient treatment and care, needed changes in patient care plans,
58- and issues relating to referrals; and
59- (B) discussion of patient care improvement; and
60- (2) be documented and occur:
61- (A) except as provided by Paragraph (B):
62- (i) at least monthly until the third
63- anniversary of the date the agreement is executed; and
64- (ii) at least quarterly after the third
65- anniversary of the date the agreement is executed, with monthly
66- meetings held between the quarterly meetings by means of a remote
67- electronic communications system, including videoconferencing
68- technology or the Internet; or
69- (B) if during the seven years preceding the date
70- the agreement is executed the advanced practice registered nurse
71- [or physician assistant] for at least five years was in a practice
72- that included the exercise of prescriptive authority with required
73- physician supervision:
74- (i) at least monthly until the first
75- anniversary of the date the agreement is executed; and
76- (ii) at least quarterly after the first
77- anniversary of the date the agreement is executed, with monthly
78- meetings held between the quarterly meetings by means of a remote
79- electronic communications system, including videoconferencing
80- technology or the Internet.
81- (f-1) The periodic meetings described by Subsection
82- (e)(9)(C) must:
83- (1) include:
84- (A) the sharing of information relating to
85- patient treatment and care, needed changes in patient care plans,
86- and issues relating to referrals; and
87- (B) discussion of patient care improvement;
88- (2) be documented; and
89- (3) take place at least once a month in a manner
90- determined by the physician and the physician assistant.
91- SECTION 2. Subchapter B, Chapter 204, Occupations Code, is
10+ SECTION 1. Subchapter B, Chapter 204, Occupations Code, is
9211 amended by adding Section 204.0585 to read as follows:
9312 Sec. 204.0585. EXECUTIVE SESSION. After hearing all
9413 evidence and arguments in an open meeting, the physician assistant
9514 board may conduct deliberations relating to a license application
9615 or disciplinary action in an executive session. The board shall
9716 vote and announce its decision in open session.
98- SECTION 3. Section 204.059, Occupations Code, is amended by
17+ SECTION 2. Section 204.059, Occupations Code, is amended by
9918 amending Subsection (b) and adding Subsection (d) to read as
10019 follows:
10120 (b) The training program must provide the person with
10221 information regarding:
10322 (1) the law governing physician assistant board
10423 operations;
10524 (2) the [this chapter and the physician assistant
10625 board's] programs, functions, rules, and budget of the physician
10726 assistant board;
10827 (3) the scope of and limitations on the rulemaking
10928 authority of the physician assistant board;
11029 (4) [(2)] the results of the most recent formal audit
11130 of the physician assistant board;
11231 (5) [(3)] the requirements of:
11332 (A) laws relating to open meetings, public
11433 information, administrative procedure, and disclosing conflicts of
11534 interest; and
11635 (B) other laws applicable to members of the
11736 physician assistant board in performing their duties; and
11837 (6) [(4)] any applicable ethics policies adopted by
11938 the physician assistant board or the Texas Ethics Commission.
12039 (d) The executive director of the medical board shall create
12140 a training manual that includes the information required by
12241 Subsection (b). The executive director shall distribute a copy of
12342 the training manual annually to each physician assistant board
12443 member. On receipt of the training manual, each board member shall
12544 sign and submit to the executive director a statement acknowledging
12645 receipt of the training manual.
127- SECTION 4. Subchapter D, Chapter 204, Occupations Code, is
46+ SECTION 3. Subchapter D, Chapter 204, Occupations Code, is
12847 amended by adding Section 204.1525 to read as follows:
12948 Sec. 204.1525. CRIMINAL HISTORY RECORD INFORMATION
13049 REQUIREMENT FOR LICENSE ISSUANCE. (a) The physician assistant
13150 board shall require that an applicant for a license submit a
13251 complete and legible set of fingerprints, on a form prescribed by
13352 the board, to the board or to the Department of Public Safety for
13453 the purpose of obtaining criminal history record information from
13554 the Department of Public Safety and the Federal Bureau of
13655 Investigation.
13756 (b) The physician assistant board may not issue a license to
13857 a person who does not comply with the requirement of Subsection (a).
13958 (c) The physician assistant board shall conduct a criminal
14059 history record information check of each applicant for a license
14160 using information:
14261 (1) provided by the individual under this section; and
14362 (2) made available to the board by the Department of
14463 Public Safety, the Federal Bureau of Investigation, and any other
14564 criminal justice agency under Chapter 411, Government Code.
14665 (d) The physician assistant board may:
14766 (1) enter into an agreement with the Department of
14867 Public Safety to administer a criminal history record information
14968 check required under this section; and
15069 (2) authorize the Department of Public Safety to
15170 collect from each applicant the costs incurred by the Department of
15271 Public Safety in conducting the criminal history record information
15372 check.
154- SECTION 5. Section 204.153(a), Occupations Code, is amended
73+ SECTION 4. Section 204.153(a), Occupations Code, is amended
15574 to read as follows:
15675 (a) To be eligible for a license under this chapter, an
15776 applicant must:
15877 (1) successfully complete an educational program for
15978 physician assistants or surgeon assistants accredited by the
16079 Committee on Allied Health Education and Accreditation or by that
16180 committee's predecessor or successor entities;
16281 (2) pass the Physician Assistant National Certifying
16382 Examination administered by the National Commission on
16483 Certification of Physician Assistants;
16584 (3) hold a certificate issued by the National
16685 Commission on Certification of Physician Assistants;
16786 (4) [be of good moral character;
16887 [(5)] meet any other requirement established by
16988 physician assistant board rule; and
17089 (5) [(6)] pass a jurisprudence examination approved
17190 by the physician assistant board as provided by Subsection (a-1).
172- SECTION 6. Section 204.156, Occupations Code, is amended by
91+ SECTION 5. Section 204.156, Occupations Code, is amended by
17392 amending Subsection (a) and adding Subsection (a-1) to read as
17493 follows:
17594 (a) A license issued under this chapter is valid for a term
176- of two or more years, as determined by physician assistant board
95+ of one or two years, as determined by physician assistant board
17796 rule.
17897 (a-1) On notification from the physician assistant board, a
17998 person who holds a license under this chapter may renew the license
18099 by:
181100 (1) paying the required renewal fee;
182101 (2) submitting the appropriate form; and
183102 (3) meeting any other requirement established by board
184103 rule.
185- SECTION 7. Subchapter D, Chapter 204, Occupations Code, is
104+ SECTION 6. Subchapter D, Chapter 204, Occupations Code, is
186105 amended by adding Section 204.1561 to read as follows:
187106 Sec. 204.1561. CRIMINAL HISTORY RECORD INFORMATION
188107 REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a
189108 license issued under this chapter shall submit a complete and
190109 legible set of fingerprints for purposes of performing a criminal
191110 history record information check of the applicant as provided by
192111 Section 204.1525.
193112 (b) The physician assistant board may administratively
194113 suspend or refuse to renew the license of a person who does not
195114 comply with the requirement of Subsection (a).
196115 (c) A license holder is not required to submit fingerprints
197116 under this section for the renewal of the license if the holder has
198117 previously submitted fingerprints under:
199118 (1) Section 204.1525 for the initial issuance of the
200119 license; or
201120 (2) this section as part of a prior renewal of a
202121 license.
203- SECTION 8. Subchapter D, Chapter 204, Occupations Code, is
122+ SECTION 7. Subchapter D, Chapter 204, Occupations Code, is
204123 amended by adding Section 204.158 to read as follows:
205124 Sec. 204.158. REFUSAL FOR VIOLATION OF BOARD ORDER. The
206125 physician assistant board may refuse to renew a license issued
207126 under this chapter if the license holder is in violation of a
208127 physician assistant board order.
209- SECTION 9. Subchapter E, Chapter 204, Occupations Code, is
128+ SECTION 8. Subchapter E, Chapter 204, Occupations Code, is
210129 amended by adding Section 204.210 to read as follows:
211130 Sec. 204.210. PROTECTION FOR REFUSAL TO ENGAGE IN CERTAIN
212131 CONDUCT. (a) A person may not suspend, terminate, or otherwise
213132 discipline, discriminate against, or retaliate against:
214133 (1) a physician assistant who refuses to engage in an
215134 act or omission as provided by Subsection (b); or
216135 (2) a person who advises a physician assistant of the
217136 physician assistant's rights under this section.
218137 (b) A physician assistant may refuse to engage in an act or
219138 omission relating to patient care that would constitute grounds for
220139 reporting the physician assistant to the physician assistant board
221140 under Section 204.208 or that violates this chapter or a rule
222141 adopted under this chapter if the physician assistant notifies the
223142 person at the time of the refusal that the reason for refusing is
224143 that the act or omission:
225144 (1) constitutes grounds for reporting the physician
226145 assistant to the physician assistant board; or
227146 (2) is a violation of this chapter or a rule adopted
228147 under this chapter.
229148 (c) An act by a person under Subsection (a) does not
230149 constitute a violation of this section if a medical peer review
231150 committee determines:
232151 (1) that the act or omission the physician assistant
233152 refused to engage in was not:
234153 (A) conduct reportable to the physician
235154 assistant board under Section 204.208; or
236155 (B) a violation of this chapter or a rule adopted
237156 under this chapter; or
238157 (2) that:
239158 (A) the act or omission in which the physician
240159 assistant refused to engage was conduct reportable to the physician
241160 assistant board or a violation of this chapter or a rule adopted
242161 under this chapter; and
243162 (B) the person:
244163 (i) rescinds any disciplinary or
245164 discriminatory action taken against the physician assistant;
246165 (ii) compensates the physician assistant
247166 for any lost wages; and
248167 (iii) restores to the physician assistant
249168 any lost benefits.
250169 (d) A physician assistant's rights under this section may
251170 not be nullified by a contract.
252171 (e) An appropriate licensing agency may take action against
253172 a person who violates this section.
254- SECTION 10. Section 204.313(a), Occupations Code, is
255- amended to read as follows:
173+ SECTION 9. Section 204.313(a), Occupations Code, is amended
174+ to read as follows:
256175 (a) In an informal meeting under Section 204.312, at least
257176 two panelists shall be appointed to determine whether an informal
258177 disposition is appropriate. At least one of the panelists must be a
259178 licensed physician assistant.
260- SECTION 11. Section 157.0512, Occupations Code, as amended
261- by this Act, applies only to a prescriptive authority agreement
262- entered into on or after the effective date of this Act. An
263- agreement entered into before the effective date of this Act is
264- governed by the law in effect on the date the agreement was entered
265- into, and the former law is continued in effect for that purpose.
266- SECTION 12. (a) Except as provided by Subsection (b) of
179+ SECTION 10. (a) Except as provided by Subsection (b) of
267180 this section, Section 204.059, Occupations Code, as amended by this
268181 Act, applies to a member of the Texas Physician Assistant Board
269182 appointed before, on, or after the effective date of this Act.
270183 (b) A member of the Texas Physician Assistant Board who,
271184 before the effective date of this Act, completed the training
272185 program required by Section 204.059, Occupations Code, as that law
273186 existed before the effective date of this Act, is only required to
274187 complete additional training on the subjects added by this Act to
275188 the training program required by Section 204.059, Occupations Code.
276189 A board member described by this subsection may not vote,
277190 deliberate, or be counted as a member in attendance at a meeting of
278191 the board held on or after December 1, 2017, until the member
279192 completes the additional training.
280- SECTION 13. Not later than September 1, 2019, the Texas
193+ SECTION 11. Not later than September 1, 2019, the Texas
281194 Physician Assistant Board shall obtain criminal history record
282195 information on each person who, on the effective date of this Act,
283196 holds a license issued under Chapter 204, Occupations Code, and did
284197 not undergo a criminal history record information check based on
285198 the license holder's fingerprints on the initial application for
286199 the license. The Texas Physician Assistant Board may suspend the
287200 license of a license holder who does not provide the criminal
288201 history record information as required by the board and this
289202 section.
290- SECTION 14. Section 204.210, Occupations Code, as added by
203+ SECTION 12. Section 204.210, Occupations Code, as added by
291204 this Act, applies only to an act or omission that occurs on or after
292205 the effective date of this Act. An act or omission that occurs
293206 before the effective date of this Act is governed by the law in
294207 effect on the date the act or omission occurred, and the former law
295208 is continued in effect for that purpose.
296- SECTION 15. This Act takes effect September 1, 2017.
297- ______________________________ ______________________________
298- President of the Senate Speaker of the House
299- I hereby certify that S.B. No. 1625 passed the Senate on
300- May 10, 2017, by the following vote: Yeas 30, Nays 0;
301- May 25, 2017, Senate refused to concur in House amendments and
302- requested appointment of Conference Committee; May 26, 2017, House
303- granted request of the Senate; May 28, 2017, Senate adopted
304- Conference Committee Report by the following vote: Yeas 31,
305- Nays 0.
306- ______________________________
307- Secretary of the Senate
308- I hereby certify that S.B. No. 1625 passed the House, with
309- amendments, on May 23, 2017, by the following vote: Yeas 145,
310- Nays 0, two present not voting; May 26, 2017, House granted request
311- of the Senate for appointment of Conference Committee;
312- May 28, 2017, House adopted Conference Committee Report by the
313- following vote: Yeas 117, Nays 29, two present not voting.
314- ______________________________
315- Chief Clerk of the House
316- Approved:
317- ______________________________
318- Date
319- ______________________________
320- Governor
209+ SECTION 13. This Act takes effect September 1, 2017.