Texas 2019 - 86th Regular

Texas House Bill HB4418 Compare Versions

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

Old	New	Differences
1	1	86R12993 JG-F
2	2	By: Stickland H.B. No. 4418
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the authority of an advanced practice registered nurse
8	8	to sign or issue certain documents.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 38.001(c), Education Code, is amended to
11	11	read as follows:
12	12	(c) Immunization is not required for a person's admission to
13	13	any elementary or secondary school if the person applying for
14	14	admission:
15	15	(1) submits to the admitting official:
16	16	(A) an affidavit or a certificate signed by a
17	17	physician who is duly registered and licensed to practice medicine
18	18	in the United States or an advanced practice registered nurse who is
19	19	licensed to practice advanced practice registered nursing in the
20	20	United States[,] in which it is stated that, in the physician's or
21	21	advanced practice registered nurse's opinion, the immunization
22	22	required poses a significant risk to the health and well-being of
23	23	the applicant or any member of the applicant's family or household;
24	24	or
25	25	(B) an affidavit signed by the applicant or, if a
26	26	minor, by the applicant's parent or guardian stating that the
27	27	applicant declines immunization for reasons of conscience,
28	28	including a religious belief; or
29	29	(2) is a member of the armed forces of the United
30	30	States and is on active duty.
31	31	SECTION 2. Section 51.9192(d), Education Code, is amended
32	32	to read as follows:
33	33	(d) A student to whom this section applies or a parent or
34	34	guardian of the student is not required to comply with Subsection
35	35	(c) if the student or a parent or guardian of the student submits to
36	36	the institution:
37	37	(1) an affidavit or a certificate signed by a
38	38	physician who is duly registered and licensed to practice medicine
39	39	in the United States or an advanced practice registered nurse who is
40	40	licensed to practice advanced practice registered nursing in the
41	41	United States in which it is stated that, in the physician's or
42	42	advanced practice registered nurse's opinion, the vaccination
43	43	required would be injurious to the health and well-being of the
44	44	student; or
45	45	(2) an affidavit signed by the student stating that
46	46	the student declines the vaccination for bacterial meningitis for
47	47	reasons of conscience, including a religious belief, or
48	48	confirmation that the student has completed the Internet-based
49	49	process described by Subsection (d-3) for declining the vaccination
50	50	on that basis, if applicable to the student.
51	51	SECTION 3. Section 51.933(d), Education Code, is amended to
52	52	read as follows:
53	53	(d) No form of immunization is required for a person's
54	54	admission to an institution of higher education if the person
55	55	applying for admission:
56	56	(1) submits to the admitting official:
57	57	(A) an affidavit or a certificate signed by a
58	58	physician who is duly registered and licensed to practice medicine
59	59	within the United States or an advanced practice registered nurse
60	60	who is licensed to practice advanced practice registered nursing in
61	61	the United States in which it is stated that, in the physician's or
62	62	advanced practice registered nurse's opinion, the immunization
63	63	required poses a significant risk to the health and well-being of
64	64	the applicant or any member of the applicant's family or household;
65	65	or
66	66	(B) an affidavit signed by the applicant or, if a
67	67	minor, by the applicant's parent or guardian stating that the
68	68	applicant declines immunization for reasons of conscience,
69	69	including a religious belief; or
70	70	(2) is a member of the armed forces of the United
71	71	States and is on active duty.
72	72	SECTION 4. Sections 62.109(b) and (f), Government Code, are
73	73	amended to read as follows:
74	74	(b) A person requesting an exemption under this section must
75	75	submit to the court an affidavit stating the person's name and
76	76	address and the reason for and the duration of the requested
77	77	exemption. A person requesting an exemption due to a physical or
78	78	mental impairment must attach to the affidavit a statement from a
79	79	physician or advanced practice registered nurse. The affidavit and
80	80	physician's or advanced practice registered nurse's statement may
81	81	be submitted to the court at the time the person is summoned for
82	82	jury service or at any other time.
83	83	(f) An affidavit accompanying a request for an exemption
84	84	from jury service because of a physical or mental impairment may be
85	85	presented by the affiant or by a friend or relative of the affiant.
86	86	The affidavit must state:
87	87	(1) the name and address of the physician or advanced
88	88	practice registered nurse whose statement accompanies the
89	89	affidavit;
90	90	(2) whether the request is for a permanent or
91	91	temporary exemption;
92	92	(3) the period of time for which a temporary exemption
93	93	is requested; and
94	94	(4) that as a direct result of the physical or mental
95	95	impairment it is impossible or very difficult for the affiant to
96	96	serve on a jury.
97	97	SECTION 5. Section 89.001, Health and Safety Code, is
98	98	amended by amending Subdivision (1) and adding Subdivision (1-a) to
99	99	read as follows:
100	100	(1) "Advanced practice registered nurse" has the
101	101	meaning assigned by Section 301.152, Occupations Code.
102	102	(1-a) "Community corrections facility" means a
103	103	facility established under Chapter 509, Government Code.
104	104	SECTION 6. Sections 89.011(a), (b), and (d), Health and
105	105	Safety Code, are amended to read as follows:
106	106	(a) The governing body of a jail or community corrections
107	107	facility, through the community supervision and corrections
108	108	department, shall require that each employee or volunteer working
109	109	or providing services in a jail or a community corrections
110	110	facility, who meets the screening guidelines prescribed by
111	111	department rule, present to the governing body a certificate signed
112	112	by a physician or an advanced practice registered nurse that states
113	113	that:
114	114	(1) the employee or volunteer has been tested for
115	115	tuberculosis infection in accordance with department rules; and
116	116	(2) the results of the test indicate that the person
117	117	does not have tuberculosis.
118	118	(b) In lieu of a screening test, an employee or volunteer
119	119	with a history of a positive screening test may provide:
120	120	(1) documentation of that positive test result and of
121	121	any diagnostic and therapeutic follow-up; and
122	122	(2) a certificate signed by a physician or an advanced
123	123	practice registered nurse that states that the person does not have
124	124	tuberculosis.
125	125	(d) An employee or volunteer is exempt from the screening
126	126	test required by this section if:
127	127	(1) the screening test conflicts with the tenets of an
128	128	organized religion to which the individual belongs; or
129	129	(2) the screening test is medically contraindicated
130	130	based on an examination by a physician or an advanced practice
131	131	registered nurse.
132	132	SECTION 7. Section 89.012(b), Health and Safety Code, is
133	133	amended to read as follows:
134	134	(b) If the employee or volunteer has tuberculosis, the
135	135	governing body may not permit the person to begin or continue the
136	136	person's employment duties or volunteer services unless the person
137	137	is under treatment for the disease by a physician or an advanced
138	138	practice registered nurse and the person provides to the governing
139	139	body a certificate signed by the attending physician or advanced
140	140	practice registered nurse stating that the patient is
141	141	noninfectious.
142	142	SECTION 8. Sections 192.003(a) and (c), Health and Safety
143	143	Code, are amended to read as follows:
144	144	(a) The physician, advanced practice registered nurse,
145	145	midwife, or person acting as a midwife in attendance at a birth
146	146	shall file the birth certificate with the local registrar of the
147	147	registration district in which the birth occurs.
148	148	(c) If there is no physician, advanced practice registered
149	149	nurse, midwife, or person acting as a midwife in attendance at a
150	150	birth and if the birth does not occur in a hospital or birthing
151	151	center, the following in the order listed shall report the birth to
152	152	the local registrar:
153	153	(1) the father or mother of the child; or
154	154	(2) the owner or householder of the premises where the
155	155	birth occurs.
156	156	SECTION 9. Section 408.025, Labor Code, is amended by
157	157	adding Subsection (a-2) to read as follows:
158	158	(a-2) An advanced practice registered nurse who is licensed
159	159	to practice advanced practice registered nursing in this state may
160	160	complete and sign a report or record that is required to be filed or
161	161	provided under Subsection (a).
162	162	SECTION 10. Section 504.201(d), Transportation Code, is
163	163	amended to read as follows:
164	164	(d) Except as provided by Subsection (d-1), the initial
165	165	application for specialty license plates under this section must be
166	166	accompanied by a written statement from a physician [who is]
167	167	licensed to practice medicine or an advanced practice registered
168	168	nurse licensed to practice advanced practice registered nursing in
169	169	this state or in a state adjacent to this state or who is authorized
170	170	by applicable law to practice medicine or advanced practice
171	171	registered nursing, as applicable, in a hospital or other health
172	172	facility of the Department of Veterans Affairs. If the applicant
173	173	has a mobility problem caused by a disorder of the foot, the written
174	174	statement may be issued by a person licensed to practice podiatry in
175	175	this state or a state adjacent to this state. In this subsection,
176	176	"podiatry" has the meaning assigned by Section 681.001. The
177	177	statement must certify that the person making the application or on
178	178	whose behalf the application is made is legally blind or has a
179	179	mobility problem that substantially impairs the person's ability to
180	180	ambulate. The statement must also certify whether a mobility
181	181	problem is temporary or permanent. A written statement is not
182	182	required as acceptable medical proof if:
183	183	(1) the person with a disability:
184	184	(A) has had a limb, hand, or foot amputated; or
185	185	(B) must use a wheelchair; and
186	186	(2) the applicant executes a statement attesting to
187	187	the person's disability before the county assessor-collector.
188	188	SECTION 11. Section 681.003(c), Transportation Code, is
189	189	amended to read as follows:
190	190	(c) Subject to Subsections (e) and (f), the first
191	191	application must be accompanied by a notarized written statement or
192	192	written prescription of a physician licensed to practice medicine
193	193	or an advanced practice registered nurse licensed to practice
194	194	advanced practice registered nursing in this state or a state
195	195	adjacent to this state, or authorized by applicable law to practice
196	196	medicine or advanced practice registered nursing, as applicable, in
197	197	a hospital or other health facility of the United States Department
198	198	of Veterans Affairs, certifying and providing evidence acceptable
199	199	to the department that the person making the application or on whose
200	200	behalf the application is made is legally blind or has a mobility
201	201	problem that substantially impairs the person's ability to
202	202	ambulate. The statement or prescription must include a
203	203	certification of whether the disability is temporary or permanent
204	204	and information acceptable to the department to determine the type
205	205	of disabled parking placard for which the applicant is
206	206	eligible. The department shall determine a person's eligibility
207	207	based on evidence provided by the applicant establishing legal
208	208	blindness or mobility impairment.
209	209	SECTION 12. Section 681.004(d), Transportation Code, is
210	210	amended to read as follows:
211	211	(d) A disabled parking placard issued to a person with a
212	212	temporary disability expires after the period set by the department
213	213	and may be renewed at the end of that period if the disability
214	214	remains as evidenced by a physician's or advanced practice
215	215	registered nurse's statement or prescription submitted as required
216	216	for a first application under Section 681.003(c).
217	217	SECTION 13. Section 14(b), Texas Local Fire Fighters
218	218	Retirement Act (Article 6243e, Vernon's Texas Civil Statutes), is
219	219	amended to read as follows:
220	220	(b) An application for disability retirement must be filed
221	221	with the board of trustees of the retirement system of which the
222	222	applicant is a member. The application must contain a sworn
223	223	statement of the member's medical condition, signed by a physician
224	224	or advanced practice registered nurse attending the member, and a
225	225	sworn statement of the circumstances under which the disability
226	226	arose, signed by the member or another person who has reason to know
227	227	those circumstances. The application also may contain other
228	228	pertinent information to enable the board to determine whether the
229	229	member is eligible for disability retirement.
230	230	SECTION 14. The heading to Section 6.06, Chapter 183 (S.B.
231	231	598), Acts of the 64th Legislature, Regular Session, 1975 (Article
232	232	6243e.1, Vernon's Texas Civil Statutes), is amended to read as
233	233	follows:
234	234	Sec. 6.06. APPLICATION; [PHYSICIAN'S] STATEMENT; MEDICAL
235	235	BOARD ACTION.
236	236	SECTION 15. Section 6.06(a), Chapter 183 (S.B. 598), Acts
237	237	of the 64th Legislature, Regular Session, 1975 (Article 6243e.1,
238	238	Vernon's Texas Civil Statutes), is amended to read as follows:
239	239	(a) An application for disability retirement must be
240	240	accompanied by a written statement, on a form approved by the board
241	241	of trustees, signed by a physician or advanced practice registered
242	242	nurse of the member's choice. The member shall pay any costs of or
243	243	fees for obtaining the physician's or advanced practice registered
244	244	nurse's statement and shall file the application and statement with
245	245	the fund. As soon as possible after the application is filed, the
246	246	medical board shall evaluate the medical and other pertinent
247	247	information concerning the member's application.
248	248	SECTION 16. Section 8(f), Chapter 451 (S.B. 737), Acts of
249	249	the 72nd Legislature, Regular Session, 1991 (Article 6243n,
250	250	Vernon's Texas Civil Statutes), is amended to read as follows:
251	251	(f) A member receiving a disability retirement allowance
252	252	shall periodically file a report with the retirement board
253	253	concerning continued proof of disability. The retirement board
254	254	shall adopt rules establishing the required supporting information
255	255	to accompany the reports, the content of the reports, and deadlines
256	256	for filing the reports. The report shall include:
257	257	(1) a current statement of the member's physical or
258	258	mental condition stating the existence of continued disability,
259	259	signed by the member's attending physician or an advanced practice
260	260	registered nurse; and
261	261	(2) a statement of all employment activities pursued
262	262	in the preceding year.
263	263	SECTION 17. Section 7.03(a)(1), Chapter 452 (S.B. 738),
264	264	Acts of the 72nd Legislature, Regular Session, 1991 (Article
265	265	6243n-1, Vernon's Texas Civil Statutes), is amended to read as
266	266	follows:
267	267	(1) A member receiving a disability retirement benefit
268	268	is required to file a report to the board concerning continued proof
269	269	of disability one year after the date on which the board originally
270	270	awarded the member disability retirement. The report shall
271	271	include:
272	272	(A) a current statement of the member's physical
273	273	or [and/or] mental condition, signed by the member's attending
274	274	physician or an advanced practice registered nurse; and
275	275	(B) a statement of all employment activities
276	276	pursued in the preceding one-year period and a copy of federal
277	277	income tax returns applicable to the one-year period.
278	278	SECTION 18. This Act takes effect immediately if it
279	279	receives a vote of two-thirds of all the members elected to each
280	280	house, as provided by Section 39, Article III, Texas Constitution.
281	281	If this Act does not receive the vote necessary for immediate
282	282	effect, this Act takes effect September 1, 2019.