By: RodrÃguez S.B. No. 919
(In the Senate - Filed February 15, 2017; February 28, 2017,
read first time and referred to Committee on Health & Human
Services; April 24, 2017, reported adversely, with favorable
Committee Substitute by the following vote: Yeas 9, Nays 0;
April 24, 2017, sent to printer.)
Click here to see the committee vote
COMMITTEE SUBSTITUTE FOR S.B. No. 919 By: Uresti
A BILL TO BE ENTITLED
AN ACT
relating to the authority of an advanced practice registered nurse
or physician assistant to sign a death certificate in limited
situations.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 193.005, Health and Safety Code, is
amended by amending Subsections (a), (b), and (c) and adding
Subsection (a-1) to read as follows:
(a) A person required to file a death certificate or fetal
death certificate shall obtain the required medical certification
from the decedent's [an] attending physician, or, subject to
Subsection (a-1), a physician assistant or advanced practice
registered nurse of the decedent, if the death occurred under
[medical attendance for] the care of the person in connection with
the [and] treatment of the condition or disease process that
contributed to the death.
(a-1) A physician assistant or advanced practice registered
nurse may only complete the medical certification for a death
certificate or fetal death certificate under this section if:
(1) a patient who has executed a written certification
of a terminal illness has elected to receive hospice care and is
receiving hospice services, as defined under Chapter 142, from a
qualified hospice provider; or
(2) a patient is receiving palliative care.
(b) The attending physician, physician assistant, or
advanced practice registered nurse 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, the physician assistant,
and the advanced practice registered nurse described by Subsection
(a) are [is] unavailable;
(2) the attending physician, the physician assistant,
or the advanced practice registered nurse described by Subsection
(a) 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 2. Section 671.001(d), Health and Safety Code, is
amended to read as follows:
(d) A registered nurse, including an advanced practice
registered nurse, or physician assistant may determine and
pronounce a person dead in situations other than those described by
Subsection (b) if permitted by written policies of a licensed
health care facility, institution, or entity providing services to
that person. Those policies must include physician assistants who
are credentialed or otherwise permitted to practice at the
facility, institution, or entity. If the facility, institution, or
entity has an organized nursing staff and an organized medical
staff or medical consultant, the nursing staff and medical staff or
consultant shall jointly develop and approve those policies. The
executive commissioner of the Health and Human Services Commission
shall adopt rules to govern policies for facilities, institutions,
or entities that do not have organized nursing staffs and organized
medical staffs or medical consultants.
SECTION 3. Section 671.002(a), Health and Safety Code, is
amended to read as follows:
(a) A physician who determines death in accordance with
Section 671.001(b) or a registered nurse, including an advanced
practice registered nurse, or physician assistant who determines
death in accordance with Section 671.001(d) is not liable for civil
damages or subject to criminal prosecution for the physician's,
registered nurse's, or physician assistant's actions or the actions
of others based on the determination of death.
SECTION 4. 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, 2017.
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