LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION April 13, 2025 TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3794 by Darby (Relating to the licensing and regulation of advanced practice registered nurses and the payment of independent advanced practice registered nurses in certain government employee health plans.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB3794, As Introduced: a negative impact of ($122,625) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026($122,625)2027$02028$02029$02030$0All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund12026($122,625)2027$02028$02029$02030$0 Fiscal AnalysisThe bill would amend the Occupations Code to add an advanced practice registered nurse (APRN) to the list of practitioners who may write a prescription for controlled substances and dangerous drugs and are therefore exempt from the offense of delivery of a dangerous drug. The bill would take effect on September 1, 2025. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION April 13, 2025 TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3794 by Darby (Relating to the licensing and regulation of advanced practice registered nurses and the payment of independent advanced practice registered nurses in certain government employee health plans.), As Introduced TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3794 by Darby (Relating to the licensing and regulation of advanced practice registered nurses and the payment of independent advanced practice registered nurses in certain government employee health plans.), As Introduced Honorable Gary VanDeaver, Chair, House Committee on Public Health Honorable Gary VanDeaver, Chair, House Committee on Public Health Jerry McGinty, Director, Legislative Budget Board Jerry McGinty, Director, Legislative Budget Board HB3794 by Darby (Relating to the licensing and regulation of advanced practice registered nurses and the payment of independent advanced practice registered nurses in certain government employee health plans.), As Introduced HB3794 by Darby (Relating to the licensing and regulation of advanced practice registered nurses and the payment of independent advanced practice registered nurses in certain government employee health plans.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB3794, As Introduced: a negative impact of ($122,625) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. Estimated Two-year Net Impact to General Revenue Related Funds for HB3794, As Introduced: a negative impact of ($122,625) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: 2026 ($122,625) 2027 $0 2028 $0 2029 $0 2030 $0 All Funds, Five-Year Impact: 2026 ($122,625) 2027 $0 2028 $0 2029 $0 2030 $0 Fiscal Analysis The bill would amend the Occupations Code to add an advanced practice registered nurse (APRN) to the list of practitioners who may write a prescription for controlled substances and dangerous drugs and are therefore exempt from the offense of delivery of a dangerous drug. The bill would take effect on September 1, 2025. The bill would take effect on September 1, 2025. Methodology It is assumed that any impact on state correctional populations or on the demand for state correctional resources would not be significant. Technology Based on analysis by the Board of Pharmacy, the agency would require an estimated $122,625 in fiscal year 2026 to procure programming services to update the agency's Prescription Form Order Service. This is an online form used by prescribers to order Schedule II controlled substance prescription pads and is not currently configured to allow APRNs to order prescription pads without entering supervising physician information. Local Government Impact It is assumed that any fiscal impact to units of local government associated with enforcement, prosecution, supervision, or confinement would not be significant. Source Agencies: b > td > 212 Office of Court Administration, Texas Judicial Council, 304 Comptroller of Public Accounts, 323 Teacher Retirement System, 327 Employees Retirement System, 405 Department of Public Safety, 452 Department of Licensing and Regulation, 454 Department of Insurance, 503 Texas Medical Board, 507 Texas Board of Nursing, 515 Board of Pharmacy, 529 Health and Human Services Commission, 701 Texas Education Agency 212 Office of Court Administration, Texas Judicial Council, 304 Comptroller of Public Accounts, 323 Teacher Retirement System, 327 Employees Retirement System, 405 Department of Public Safety, 452 Department of Licensing and Regulation, 454 Department of Insurance, 503 Texas Medical Board, 507 Texas Board of Nursing, 515 Board of Pharmacy, 529 Health and Human Services Commission, 701 Texas Education Agency LBB Staff: b > td > JMc, NPe, GDZ, DPE JMc, NPe, GDZ, DPE