Texas 2021 - 87th Regular

Texas House Bill HB1462 Compare Versions

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

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1	1	By: Goodwin H.B. No. 1462
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the prescriptive authority of certain psychologists;
7	7	authorizing a fee.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 501.002, Occupations Code, is amended by
10	10	adding Subdivision (2-a) to read as follows:
11	11	(2-a) "Prescription drug" and "prescription drug
12	12	order" have the meanings assigned by Section 551.003.
13	13	SECTION 2. Section 501.003(a)(1), Occupations Code, is
14	14	amended to read as follows:
15	15	(1) "Practice of psychology" means:
16	16	(A) the observation, description, diagnosis,
17	17	evaluation, assessment, interpretation, or treatment of and
18	18	intervention in human behavior by applying education, training,
19	19	methods, and procedures for the purpose of:
20	20	(i) preventing, predicting, treating,
21	21	remediating, or eliminating:
22	22	(a) symptomatic, maladaptive, or
23	23	undesired behavior;
24	24	(b) emotional, interpersonal,
25	25	learning, substance use, neuropsychological, cognitive, or
26	26	behavioral disorders or disabilities, including those that
27	27	accompany medical problems; or
28	28	(c) mental illness;
29	29	(ii) evaluating, assessing, or
30	30	facilitating, by a license holder or a person who represents the
31	31	person to the public by a title or description of services that
32	32	includes the word "psychological," "psychologist," or
33	33	"psychology," the enhancement of individual, group, or
34	34	organizational effectiveness, including evaluating, assessing, or
35	35	facilitating:
36	36	(a) personal effectiveness;
37	37	(b) adaptive behavior;
38	38	(c) interpersonal relationships;
39	39	(d) academic, vocational, and life
40	40	adjustment;
41	41	(e) health; or
42	42	(f) individual, group, or
43	43	organizational performance;
44	44	(iii) providing psychological,
45	45	neuropsychological, and psychoeducational evaluation, therapy, and
46	46	remediation as well as counseling, psychoanalysis, psychotherapy,
47	47	hypnosis, and biofeedback; or
48	48	(iv) consulting with others, including
49	49	other mental health professionals, physicians, school personnel,
50	50	or organizations within the scope of the provider's competency and
51	51	training with respect to services provided for a specific
52	52	individual; [or]
53	53	(B) action taken under the authority granted by a
54	54	prescriptive authority certificate issued under Section 501.353;
55	55	or
56	56	(C) the supervision of an activity or service
57	57	described by Paragraph (A) or (B).
58	58	SECTION 3. Section 501.051(b), Occupations Code, is amended
59	59	to read as follows:
60	60	(b) To ensure adequate representation on the board of the
61	61	diverse fields of psychology, the governor in making appointments
62	62	under Subsection (a)(1) shall appoint:
63	63	(1) at least two members who provide psychological
64	64	services, at least one of whom holds a prescriptive authority
65	65	certificate issued under Section 501.353;
66	66	(2) at least one member who conducts research in the
67	67	field of psychology; and
68	68	(3) at least one member who teaches as a member of the
69	69	faculty of a psychological training institution.
70	70	SECTION 4. Subchapter D, Chapter 501, Occupations Code, is
71	71	amended by adding Section 501.163 to read as follows:
72	72	Sec. 501.163. ADVISORY COMMITTEE ON PRESCRIPTIVE
73	73	AUTHORITY. (a) The board shall appoint an advisory committee on
74	74	prescriptive authority for psychologists.
75	75	(a-1) Effective September 1, 2021, the advisory committee
76	76	consists of six members as follows:
77	77	(1) three members who each hold a prescriptive
78	78	authority certificate issued under Section 501.353;
79	79	(2) one member who is a psychiatrist;
80	80	(3) one member who is a pediatrician; and
81	81	(4) one member who represents the public.
82	82	(a-2) This subsection and Subsection (a-1) expire September
83	83	1, 2022.
84	84	(b) Effective September 1, 2022, the advisory committee
85	85	consists of six members as follows:
86	86	(1) five members who each hold a prescriptive
87	87	authority certificate issued under Section 501.353; and
88	88	(2) one member who represents the public.
89	89	(c) The advisory committee shall make recommendations to
90	90	the board regarding the regulation of psychologists who hold
91	91	prescriptive authority certificates issued under Section 501.353,
92	92	including recommendations concerning board rules to establish:
93	93	(1) eligibility requirements; and
94	94	(2) standards of practice for certificate holders.
95	95	(d) Chapter 2110, Government Code, does not apply to the
96	96	composition or duration of the advisory committee.
97	97	SECTION 5. Section 507.157, Occupations Code, is amended by
98	98	adding Subsection (b) to read as follows:
99	99	(b) The rules adopted under Subsection (a) must require
100	100	that, of the minimum number of hours of continuing education
101	101	required to renew a license as a psychologist, half of that number
102	102	of hours or 10 hours, whichever is less, must be in the areas of
103	103	pharmacology and pathophysiology if the psychologist holds a
104	104	prescriptive authority certificate.
105	105	SECTION 6. Subchapter H, Chapter 501, Occupations Code, is
106	106	amended by adding Sections 501.353 and 501.354 to read as follows:
107	107	Sec. 501.353. PRESCRIPTIVE AUTHORITY CERTIFICATE. (a) The
108	108	board shall issue a prescriptive authority certificate to a
109	109	psychologist who:
110	110	(1) meets the eligibility requirements of Subsection
111	111	(b);
112	112	(2) submits an application on a form prescribed by the
113	113	board;
114	114	(3) has not, in the two-year period preceding the date
115	115	of the application, had a prescriptive authority certificate
116	116	revoked; and
117	117	(4) pays the fee set by the board.
118	118	(b) To be eligible for a prescriptive authority certificate
119	119	a psychologist must:
120	120	(1) have completed a training program in
121	121	psychopharmacology from an institution of higher education or a
122	122	provider of continuing education approved by the board that
123	123	includes instruction in:
124	124	(A) basic life sciences;
125	125	(B) neuroscience;
126	126	(C) clinical and research pharmacology and
127	127	psychopharmacology;
128	128	(D) clinical pathophysiology;
129	129	(E) physical assessments and laboratory
130	130	examinations;
131	131	(F) clinical pharmacotherapeutics; and
132	132	(G) ethical and legal issues relevant to
133	133	prescriptive authority and associated research;
134	134	(2) pass a nationally recognized examination approved
135	135	by the board in the area of prescriptive authority; and
136	136	(3) provide evidence of professional liability
137	137	coverage.
138	138	(c) A psychologist who holds a prescriptive authority
139	139	certificate is authorized to:
140	140	(1) issue a prescription drug order;
141	141	(2) administer or dispense a prescription drug;
142	142	(3) order tests commonly associated with monitoring
143	143	the use of prescription drugs; and
144	144	(4) represent that the psychologist holds a
145	145	prescriptive authority certificate.
146	146	(d) The authority of a psychologist to issue a prescription
147	147	drug order or administer or dispense a prescription drug under a
148	148	prescriptive authority certificate is limited to a drug or device
149	149	related to the diagnosis, treatment, or management of emotional,
150	150	interpersonal, learning, substance use, neuropsychological,
151	151	cognitive, or behavioral disorders or disabilities, or mental
152	152	illness. A prescriptive authority certificate does not authorize
153	153	the prescribing, administering, or dispensing of an opioid.
154	154	(e) A psychologist who holds a prescriptive authority
155	155	certificate may only practice under the supervision of a physician
156	156	or a psychologist who meets the requirements of Section 501.354
157	157	until the certificate holder satisfies the supervised experience
158	158	requirement of that section.
159	159	(f) The board shall adopt rules to protect the health of
160	160	patients by requiring a psychologist who holds a prescriptive
161	161	authority certificate to notify a patient's primary care physician
162	162	or provider, if any, before the psychologist:
163	163	(1) issues a prescription drug order for a drug or
164	164	otherwise changes the type or dosage of any drug prescribed for the
165	165	patient; or
166	166	(2) administers or dispenses a prescription drug to
167	167	the patient.
168	168	(g) A primary care provider is not liable for an act of a
169	169	psychologist acting under a prescriptive authority certificate
170	170	based solely on the provider receiving a notification under
171	171	Subsection (f).
172	172	Sec. 501.354. REQUIRED SUPERVISED EXPERIENCE FOR
173	173	PRESCRIPTIVE AUTHORITY CERTIFICATE HOLDER. (a) Not later than the
174	174	second anniversary of the date of issuance of a prescriptive
175	175	authority certificate, the psychologist who holds the certificate
176	176	must complete at least 2,000 hours of practice under the authority
177	177	of the certificate treating not less than 100 patients under the
178	178	supervision of a physician or a psychologist who has maintained a
179	179	prescriptive authority certificate for the three years preceding
180	180	the date the supervision began. The supervision must be under a
181	181	written agreement approved by the board that requires periodic
182	182	meetings between the psychologist and supervising provider.
183	183	(b) A physician or psychologist may not at any time
184	184	supervise under this section more than the full-time equivalent of
185	185	seven psychologists.
186	186	(c) Unless the supervising provider has reason to believe
187	187	the psychologist lacked the competency to perform the act, a
188	188	supervising provider is not liable for an act of a psychologist
189	189	solely because the provider entered into an agreement to supervise
190	190	the psychologist.
191	191	(d) The board shall revoke the prescriptive authority
192	192	certificate of a psychologist who does not complete the supervised
193	193	experience as required by Subsection (a).
194	194	SECTION 7. Section 481.002(39), Health and Safety Code, is
195	195	amended to read as follows:
196	196	(39) "Practitioner" means:
197	197	(A) a physician, dentist, veterinarian,
198	198	podiatrist, scientific investigator, psychologist, or other person
199	199	licensed, registered, or otherwise permitted to distribute,
200	200	dispense, analyze, conduct research with respect to, or administer
201	201	a controlled substance in the course of professional practice or
202	202	research in this state;
203	203	(B) a pharmacy, hospital, or other institution
204	204	licensed, registered, or otherwise permitted to distribute,
205	205	dispense, conduct research with respect to, or administer a
206	206	controlled substance in the course of professional practice or
207	207	research in this state;
208	208	(C) a person practicing in and licensed by
209	209	another state as a physician, dentist, veterinarian, psychologist,
210	210	or podiatrist, having a current Federal Drug Enforcement
211	211	Administration registration number, who may legally prescribe
212	212	Schedule II, III, IV, or V controlled substances in that state; or
213	213	(D) an advanced practice registered nurse or
214	214	physician assistant to whom a physician has delegated the authority
215	215	to prescribe or order a drug or device under Section 157.0511,
216	216	157.0512, or 157.054, Occupations Code.
217	217	SECTION 8. Section 481.073(a), Health and Safety Code, is
218	218	amended to read as follows:
219	219	(a) Only a practitioner defined by Section 481.002(39)(A)
220	220	and an agent designated in writing by the practitioner in
221	221	accordance with rules adopted by the board may communicate a
222	222	prescription by telephone. A pharmacy that receives a
223	223	telephonically communicated prescription shall promptly write the
224	224	prescription and file and retain the prescription in the manner
225	225	required by this subchapter. A practitioner who designates an
226	226	agent to communicate prescriptions shall maintain the written
227	227	designation of the agent in the practitioner's usual place of
228	228	business and shall make the designation available for inspection by
229	229	investigators for the Texas Medical Board, the State Board of
230	230	Dental Examiners, the State Board of Veterinary Medical Examiners,
231	231	the Texas State Board of Examiners of Psychologists, the board, and
232	232	the department. A practitioner who designates a different agent
233	233	shall designate that agent in writing and maintain the designation
234	234	in the same manner in which the practitioner initially designated
235	235	an agent under this section.
236	236	SECTION 9. Section 481.074(d), Health and Safety Code, is
237	237	amended to read as follows:
238	238	(d) Except as specified in Subsections (e) and (f), the
239	239	board, by rule and in consultation with the Texas Medical Board and
240	240	the Texas State Board of Examiners of Psychologists, shall
241	241	establish the period after the date on which the prescription is
242	242	issued that a person may fill a prescription for a controlled
243	243	substance listed in Schedule II. A person may not refill a
244	244	prescription for a substance listed in Schedule II.
245	245	SECTION 10. Sections 481.076(a) and (c), Health and Safety
246	246	Code, are amended to read as follows:
247	247	(a) The board may not permit any person to have access to
248	248	information submitted to the board under Section 481.074(q) or
249	249	481.075 except:
250	250	(1) the board, the Texas Medical Board, the Texas
251	251	Department of Licensing and Regulation [State Board of Podiatric
252	252	Medical Examiners], the State Board of Dental Examiners, the State
253	253	Board of Veterinary Medical Examiners, the Texas Board of Nursing,
254	254	[or] the Texas Optometry Board, or the Texas State Board of
255	255	Examiners of Psychologists for the purpose of:
256	256	(A) investigating a specific license holder; or
257	257	(B) monitoring for potentially harmful
258	258	prescribing or dispensing patterns or practices under Section
259	259	481.0762;
260	260	(2) an authorized officer or member of the department
261	261	or authorized employee of the board engaged in the administration,
262	262	investigation, or enforcement of this chapter or another law
263	263	governing illicit drugs in this state or another state;
264	264	(3) the department on behalf of a law enforcement or
265	265	prosecutorial official engaged in the administration,
266	266	investigation, or enforcement of this chapter or another law
267	267	governing illicit drugs in this state or another state;
268	268	(4) a medical examiner conducting an investigation;
269	269	(5) provided that accessing the information is
270	270	authorized under the Health Insurance Portability and
271	271	Accountability Act of 1996 (Pub. L. No. 104-191) and regulations
272	272	adopted under that Act:
273	273	(A) a pharmacist or a pharmacy technician, as
274	274	defined by Section 551.003, Occupations Code, acting at the
275	275	direction of a pharmacist; or
276	276	(B) a practitioner who:
277	277	(i) is a physician, dentist, veterinarian,
278	278	podiatrist, optometrist, psychologist, or advanced practice nurse
279	279	or is a physician assistant described by Section 481.002(39)(D) or
280	280	an employee or other agent of a practitioner acting at the direction
281	281	of a practitioner; and
282	282	(ii) is inquiring about a recent Schedule
283	283	II, III, IV, or V prescription history of a particular patient of
284	284	the practitioner;
285	285	(6) a pharmacist or practitioner who is inquiring
286	286	about the person's own dispensing or prescribing activity; or
287	287	(7) one or more states or an association of states with
288	288	which the board has an interoperability agreement, as provided by
289	289	Subsection (j).
290	290	(c) The board by rule shall design and implement a system
291	291	for submission of information to the board by electronic or other
292	292	means and for retrieval of information submitted to the board under
293	293	this section and Sections 481.074 and 481.075. The board shall use
294	294	automated information security techniques and devices to preclude
295	295	improper access to the information. The board shall submit the
296	296	system design to the director, [and] the Texas Medical Board, and
297	297	the Texas State Board of Examiners of Psychologists for review and
298	298	comment a reasonable time before implementation of the system and
299	299	shall comply with the comments of those agencies unless it is
300	300	unreasonable to do so.
301	301	SECTION 11. Section 483.001(12), Health and Safety Code, is
302	302	amended to read as follows:
303	303	(12) "Practitioner" means:
304	304	(A) a person:
305	305	(i) licensed or certified by the Texas
306	306	Medical Board, State Board of Dental Examiners, [Texas State Board
307	307	of Podiatric Medical Examiners,] Texas Optometry Board, Texas State
308	308	Board of Examiners of Psychologists, or State Board of Veterinary
309	309	Medical Examiners to prescribe and administer dangerous drugs; or
310	310	(ii) licensed by the Texas Department of
311	311	Licensing and Regulation, with respect to podiatry, to prescribe
312	312	and administer dangerous drugs;
313	313	(B) a person licensed by another state in a
314	314	health field in which, under the laws of this state, a licensee may
315	315	legally prescribe dangerous drugs;
316	316	(C) a person licensed in Canada or Mexico in a
317	317	health field in which, under the laws of this state, a licensee may
318	318	legally prescribe dangerous drugs; or
319	319	(D) an advanced practice registered nurse or
320	320	physician assistant to whom a physician has delegated the authority
321	321	to prescribe or order a drug or device under Section 157.0511,
322	322	157.0512, or 157.054, Occupations Code.
323	323	SECTION 12. Sections 576.025(b), (c), (e), and (f), Health
324	324	and Safety Code, are amended to read as follows:
325	325	(b) Consent to the administration of psychoactive
326	326	medication given by a patient or by a person authorized by law to
327	327	consent on behalf of the patient is valid only if:
328	328	(1) the consent is given voluntarily and without
329	329	coercive or undue influence;
330	330	(2) the treating physician, a treating psychologist
331	331	who holds a prescriptive authority certificate, or a person
332	332	designated by the physician or psychologist, provided the following
333	333	information, in a standard format approved by the department, to
334	334	the patient and, if applicable, to the patient's representative
335	335	authorized by law to consent on behalf of the patient:
336	336	(A) the specific condition to be treated;
337	337	(B) the beneficial effects on that condition
338	338	expected from the medication;
339	339	(C) the probable health and mental health
340	340	consequences of not consenting to the medication;
341	341	(D) the probable clinically significant side
342	342	effects and risks associated with the medication;
343	343	(E) the generally accepted alternatives to the
344	344	medication, if any, and why the physician or psychologist
345	345	recommends that they be rejected; and
346	346	(F) the proposed course of the medication;
347	347	(3) the patient and, if appropriate, the patient's
348	348	representative authorized by law to consent on behalf of the
349	349	patient is informed in writing that consent may be revoked; and
350	350	(4) the consent is evidenced in the patient's clinical
351	351	record by a signed form prescribed by the facility or by a statement
352	352	of the [treating] physician or psychologist described by
353	353	Subdivision (2), or a person designated by the physician or the
354	354	psychologist, that documents that consent was given by the
355	355	appropriate person and the circumstances under which the consent
356	356	was obtained.
357	357	(c) If the [treating] physician or psychologist described
358	358	by Subsection (b)(2) designates another person to provide the
359	359	information under Subsection (b), then, not later than two working
360	360	days after that person provides the information, excluding weekends
361	361	and legal holidays, the physician or psychologist shall meet with
362	362	the patient and, if appropriate, the patient's representative who
363	363	provided the consent, to review the information and answer any
364	364	questions.
365	365	(e) In prescribing psychoactive medication, a [treating]
366	366	physician or psychologist described by Subsection (b)(2) shall:
367	367	(1) prescribe, consistent with clinically appropriate
368	368	medical care, the medication that has the fewest side effects or the
369	369	least potential for adverse side effects, unless the class of
370	370	medication has been demonstrated or justified not to be effective
371	371	clinically; and
372	372	(2) administer the smallest therapeutically
373	373	acceptable dosages of medication for the patient's condition.
374	374	(f) If a physician or psychologist described by Subsection
375	375	(b)(2) issues an order to administer psychoactive medication to a
376	376	patient without the patient's consent because the patient is having
377	377	a medication-related emergency:
378	378	(1) the physician or psychologist shall document in
379	379	the patient's clinical record in specific medical or behavioral
380	380	terms the necessity of the order and that the physician or
381	381	psychologist has evaluated but rejected other generally accepted,
382	382	less intrusive forms of treatment, if any; and
383	383	(2) treatment of the patient with the psychoactive
384	384	medication shall be provided in the manner, consistent with
385	385	clinically appropriate medical care, least restrictive of the
386	386	patient's personal liberty.
387	387	SECTION 13. Section 301.002(2), Occupations Code, is
388	388	amended to read as follows:
389	389	(2) "Professional nursing" means the performance of an
390	390	act that requires substantial specialized judgment and skill, the
391	391	proper performance of which is based on knowledge and application
392	392	of the principles of biological, physical, and social science as
393	393	acquired by a completed course in an approved school of
394	394	professional nursing. The term does not include acts of medical
395	395	diagnosis or the prescription of therapeutic or corrective
396	396	measures. Professional nursing involves:
397	397	(A) the observation, assessment, intervention,
398	398	evaluation, rehabilitation, care and counsel, or health teachings
399	399	of a person who is ill, injured, infirm, or experiencing a change in
400	400	normal health processes;
401	401	(B) the maintenance of health or prevention of
402	402	illness;
403	403	(C) the administration of a medication or
404	404	treatment as ordered by a health care practitioner legally
405	405	authorized to prescribe the medication or treatment [physician,
406	406	podiatrist, or dentist];
407	407	(D) the supervision or teaching of nursing;
408	408	(E) the administration, supervision, and
409	409	evaluation of nursing practices, policies, and procedures;
410	410	(F) the requesting, receiving, signing for, and
411	411	distribution of prescription drug samples to patients at practices
412	412	at which an advanced practice registered nurse is authorized to
413	413	sign prescription drug orders as provided by Subchapter B, Chapter
414	414	157;
415	415	(G) the performance of an act delegated by a
416	416	physician under Section 157.0512, 157.054, 157.058, or 157.059; and
417	417	(H) the development of the nursing care plan.
418	418	SECTION 14. Section 551.003(34), Occupations Code, is
419	419	amended to read as follows:
420	420	(34) "Practitioner" means:
421	421	(A) a person licensed, certified, or registered
422	422	to prescribe, distribute, administer, or dispense a prescription
423	423	drug or device in the course of professional practice in this state,
424	424	including a physician, dentist, podiatrist, psychologist, or
425	425	veterinarian but excluding a person licensed under this subtitle;
426	426	(B) a person licensed by another state, Canada,
427	427	or the United Mexican States in a health field in which, under the
428	428	law of this state, a license or certificate holder in this state may
429	429	legally prescribe a dangerous drug;
430	430	(C) a person practicing in another state and
431	431	licensed by another state as a physician, dentist, veterinarian,
432	432	psychologist, or podiatrist, who has a current federal Drug
433	433	Enforcement Administration registration number and who may legally
434	434	prescribe a Schedule II, III, IV, or V controlled substance, as
435	435	specified under Chapter 481, Health and Safety Code, in that other
436	436	state; or
437	437	(D) an advanced practice registered nurse or
438	438	physician assistant to whom a physician has delegated the authority
439	439	to prescribe or order a drug or device under Section 157.0511,
440	440	157.0512, or 157.054.
441	441	SECTION 15. Section 501.051(b), Occupations Code, as
442	442	amended by this Act, does not affect the entitlement of a member
443	443	serving on the Texas State Board of Examiners of Psychologists
444	444	immediately before the effective date of this Act to continue to
445	445	serve for the remainder of the member's term. With the first
446	446	appointment of a member described by Section 501.051(a)(1),
447	447	Occupations Code, to be made by the governor on or after the
448	448	effective date of this Act, the governor shall appoint a member to
449	449	the board who has the qualifications required by Section
450	450	501.051(b), Occupations Code, as amended by this Act.
451	451	SECTION 16. (a) Not later than December 1, 2021, the Texas
452	452	State Board of Examiners of Psychologists shall appoint members of
453	453	the advisory committee in accordance with Section 501.163(a-1),
454	454	Occupations Code, as added by this Act.
455	455	(b) Not later than June 1, 2022, the advisory committee
456	456	shall make initial recommendations to the Texas State Board of
457	457	Examiners of Psychologists as described by Section 501.163(c),
458	458	Occupations Code, as added by this Act.
459	459	(c) Not later than December 1, 2024, the Texas State Board
460	460	of Examiners of Psychologists shall appoint members to the advisory
461	461	committee so that the composition of the committee complies with
462	462	Section 501.163(b), Occupations Code, as added by this Act.
463	463	SECTION 17. Not later than September 1, 2022, the Texas
464	464	State Board of Examiners of Psychologists shall adopt rules and
465	465	procedures necessary to implement Sections 501.353 and 501.354,
466	466	Occupations Code, as added by this Act.
467	467	SECTION 18. This Act takes effect September 1, 2021.