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Texas Senate Bill SB2128

Texas 2025 - 89th Regular

Texas Senate Bill SB2128 Compare Versions

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11 89R971 JTZ-F
22 By: Campbell S.B. No. 2128
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77 A BILL TO BE ENTITLED
88 AN ACT
99 relating to the licensing and regulation of anesthesiologist
1010 assistants; requiring an occupational license; providing an
1111 administrative penalty; authorizing fees.
1212 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1313 SECTION 1. Subtitle C, Title 3, Occupations Code, is
1414 amended by adding Chapter 207 to read as follows:
1515 CHAPTER 207. ANESTHESIOLOGIST ASSISTANTS
1616 SUBCHAPTER A. GENERAL PROVISIONS
1717 Sec. 207.001. SHORT TITLE. This chapter may be cited as the
1818 Anesthesiologist Assistant Licensing Act.
1919 Sec. 207.002. DEFINITIONS. In this chapter:
2020 (1) "Anesthesiologist" means a physician who:
2121 (A) holds a license in good standing issued by
2222 the medical board under Subtitle B;
2323 (B) is certified in anesthesiology by:
2424 (i) the American Board of Physician
2525 Specialties;
2626 (ii) the American Osteopathic Board of
2727 Anesthesiology; or
2828 (iii) a certifying board recognized by the
2929 medical board; and
3030 (C) has a medical practice in which the physician
3131 regularly practices anesthesiology.
3232 (2) "Anesthesiologist assistant" means a person who
3333 holds a license issued under this chapter.
3434 (3) "Anesthesiologist assistant board" means the
3535 Texas Anesthesiologist Assistant Board.
3636 (4) "Medical board" means the Texas Medical Board.
3737 (5) "Practice as an anesthesiologist assistant" means
3838 personally performing a medical task delegated to the person by a
3939 supervising anesthesiologist.
4040 Sec. 207.003. APPLICABILITY. (a) A person is not required
4141 to hold a license issued under this chapter to practice as:
4242 (1) a technician, assistant, or employee of a
4343 physician who performs delegated tasks but does not act as an
4444 anesthesiologist assistant or represent that the person is an
4545 anesthesiologist assistant; or
4646 (2) any other licensed health care worker acting
4747 within the scope of that person's license if the person:
4848 (A) does not use the title "anesthesiologist
4949 assistant" or the initials "C.A.A." or "A.A."; or
5050 (B) is not represented or designated as an
5151 anesthesiologist assistant.
5252 (b) This chapter does not limit the employment arrangement
5353 of an anesthesiologist assistant licensed under this chapter.
5454 SUBCHAPTER B. TEXAS ANESTHESIOLOGIST ASSISTANT BOARD
5555 Sec. 207.051. ANESTHESIOLOGIST ASSISTANT BOARD. (a) The
5656 Texas Anesthesiologist Assistant Board is an advisory board to the
5757 medical board.
5858 (b) Chapter 2110, Government Code, does not apply to the
5959 anesthesiologist assistant board.
6060 Sec. 207.052. APPOINTMENT OF BOARD. (a) The
6161 anesthesiologist assistant board consists of five members
6262 appointed by the president of the medical board as follows:
6363 (1) two anesthesiologist assistants;
6464 (2) two anesthesiologists; and
6565 (3) one member who represents the public and is not
6666 licensed or trained in a health care profession.
6767 (b) Appointments to the anesthesiologist assistant board
6868 shall be made without regard to the race, color, disability, sex,
6969 religion, age, or national origin of the appointee.
7070 Sec. 207.053. TERMS; VACANCIES. (a) Members of the
7171 anesthesiologist assistant board are appointed for staggered
7272 six-year terms. The terms of one or two members, as appropriate,
7373 expire on February 1 of each odd-numbered year.
7474 (b) A member may not serve more than:
7575 (1) two consecutive full terms; or
7676 (2) a total of three full terms.
7777 (c) If a vacancy occurs during a member's term, the
7878 president of the medical board shall appoint a new member to serve
7979 the unexpired term.
8080 Sec. 207.054. OFFICERS. The president of the medical board
8181 shall designate an anesthesiologist assistant member of the
8282 anesthesiologist assistant board as the presiding officer of the
8383 board to serve in that capacity at the will of the president. The
8484 anesthesiologist assistant board shall select from its membership a
8585 secretary to serve a one-year term.
8686 Sec. 207.055. GROUNDS FOR REMOVAL. (a) It is a ground for
8787 removal from the anesthesiologist assistant board that a member:
8888 (1) does not have at the time of taking office the
8989 qualifications required by Section 207.052;
9090 (2) does not maintain during service on the
9191 anesthesiologist assistant board the qualifications required by
9292 Section 207.052;
9393 (3) cannot, because of illness or disability,
9494 discharge the member's duties for a substantial part of the member's
9595 term; or
9696 (4) is absent from more than half of the regularly
9797 scheduled anesthesiologist assistant board meetings that the
9898 member is eligible to attend during a calendar year without an
9999 excuse approved by a majority vote of the board.
100100 (b) The validity of an action of the anesthesiologist
101101 assistant board is not affected by the fact that it is taken when a
102102 ground for removal of a board member exists.
103103 (c) If the executive director of the medical board has
104104 knowledge that a potential ground for removal exists, the executive
105105 director shall notify the presiding officer of the anesthesiologist
106106 assistant board of the potential ground. If the potential ground
107107 for removal involves the presiding officer, the executive director
108108 shall notify the next highest ranking officer of the
109109 anesthesiologist assistant board, who shall then notify the
110110 president of the medical board that a potential ground for removal
111111 exists.
112112 Sec. 207.056. COMPENSATION; REIMBURSEMENT OF EXPENSES. A
113113 member of the anesthesiologist assistant board may not receive
114114 compensation but is entitled to reimbursement for actual and
115115 necessary expenses incurred in performing the functions of the
116116 board, subject to the General Appropriations Act.
117117 Sec. 207.057. OPEN MEETINGS; ADMINISTRATIVE PROCEDURE LAW.
118118 Except as otherwise provided by this chapter, the anesthesiologist
119119 assistant board is subject to Chapters 551 and 2001, Government
120120 Code.
121121 Sec. 207.058. TRAINING. (a) A person who is appointed to
122122 and qualifies for office as a member of the anesthesiologist
123123 assistant board may not vote, deliberate, or be counted as a member
124124 in attendance at a meeting of the board until the person completes a
125125 training program that complies with this section.
126126 (b) The training program must provide the person with
127127 information regarding:
128128 (1) the law governing anesthesiologist assistant
129129 board operations;
130130 (2) the programs, functions, rules, and budget of the
131131 anesthesiologist assistant board;
132132 (3) the scope of and limitations on the rulemaking
133133 authority of the anesthesiologist assistant board;
134134 (4) the results of the most recent formal audit of the
135135 anesthesiologist assistant board;
136136 (5) the requirements of:
137137 (A) laws relating to open meetings, public
138138 information, administrative procedure, and disclosing conflicts of
139139 interest; and
140140 (B) other laws applicable to members of the
141141 anesthesiologist assistant board in performing their duties; and
142142 (6) any applicable ethics policies adopted by the
143143 anesthesiologist assistant board or the Texas Ethics Commission.
144144 (c) A person appointed to the anesthesiologist assistant
145145 board is entitled to reimbursement, as provided by the General
146146 Appropriations Act, for the travel expenses incurred in attending
147147 the training program regardless of whether the attendance at the
148148 program occurs before or after the person qualifies for office.
149149 (d) The executive director of the medical board shall create
150150 a training manual that includes the information required by
151151 Subsection (b). The executive director shall distribute a copy of
152152 the training manual annually to each anesthesiologist assistant
153153 board member. On receipt of the training manual, each board member
154154 shall sign and submit to the executive director a statement
155155 acknowledging receipt of the training manual.
156156 SUBCHAPTER C. POWERS AND DUTIES OF ANESTHESIOLOGIST ASSISTANT BOARD
157157 AND MEDICAL BOARD
158158 Sec. 207.101. GENERAL POWERS AND DUTIES OF ANESTHESIOLOGIST
159159 ASSISTANT BOARD; MEDICAL BOARD APPROVAL. (a) The anesthesiologist
160160 assistant board shall adopt rules that are reasonable and necessary
161161 for the performance of the anesthesiologist assistant board's
162162 duties under this chapter, as provided by Chapter 2001, Government
163163 Code, including rules to establish:
164164 (1) licensing, renewal, and other fees;
165165 (2) license renewal dates; and
166166 (3) procedures for disciplinary actions.
167167 (b) The medical board, by a majority vote, shall approve or
168168 reject each rule adopted by the anesthesiologist assistant board.
169169 If approved, the rule may take effect. If the rule is rejected, the
170170 medical board shall return the rule to the anesthesiologist
171171 assistant board for revision.
172172 Sec. 207.102. GUIDELINES FOR EARLY INVOLVEMENT IN
173173 RULEMAKING PROCESS. (a) The anesthesiologist assistant board
174174 shall adopt guidelines to establish procedures for receiving input
175175 during the rulemaking process from individuals and groups that have
176176 an interest in matters under the anesthesiologist assistant board's
177177 jurisdiction. The guidelines must provide an opportunity for those
178178 individuals and groups to provide input before the anesthesiologist
179179 assistant board submits the rule to the medical board for approval.
180180 (b) A rule adopted or approved by the medical board may not
181181 be challenged on the grounds that the anesthesiologist assistant
182182 board did not comply with this section. If the anesthesiologist
183183 assistant board was unable to solicit a significant amount of input
184184 from the public or affected persons early in the rulemaking
185185 process, the anesthesiologist assistant board shall state in
186186 writing the reasons why the anesthesiologist assistant board was
187187 unable to do so.
188188 Sec. 207.103. POWERS AND DUTIES OF MEDICAL BOARD RELATING
189189 TO ANESTHESIOLOGIST ASSISTANTS. (a) The medical board shall
190190 administer and enforce this chapter.
191191 (b) The medical board shall adopt rules consistent with this
192192 chapter to regulate anesthesiologist assistants and
193193 anesthesiologists who supervise anesthesiologist assistants.
194194 (c) The rules adopted by the medical board must include a
195195 requirement that:
196196 (1) an anesthesiologist assistant assist only an
197197 anesthesiologist who is:
198198 (A) physically present in the facility where the
199199 anesthesiologist assistant is performing a medical task delegated
200200 by the anesthesiologist; and
201201 (B) able to respond to a medically emergent issue
202202 arising from the delegated medical task;
203203 (2) a supervising anesthesiologist supervise an
204204 anesthesiologist assistant in a manner consistent with the
205205 requirements for reimbursement of anesthesia services under
206206 Medicaid and Medicare, as applicable; and
207207 (3) an anesthesiologist assistant shall maintain
208208 compliance with all continuing medical education requirements
209209 adopted under Section 207.157 and the recertification requirements
210210 of the National Commission for Certification of Anesthesiologist
211211 Assistants or its successor organization.
212212 Sec. 207.104. FEES. The anesthesiologist assistant board
213213 shall set fees in amounts that are reasonable and necessary to cover
214214 the costs of administering and enforcing this chapter without the
215215 use of any other funds generated by the medical board.
216216 Sec. 207.105. RULES ON CONSEQUENCES OF CRIMINAL CONVICTION.
217217 The anesthesiologist assistant board shall adopt rules and
218218 guidelines as necessary to comply with Chapter 53, except to the
219219 extent the requirements of this chapter are stricter than the
220220 requirements of Chapter 53.
221221 Sec. 207.106. COMPLAINTS. The medical board shall maintain
222222 a system to promptly and efficiently act on complaints filed with
223223 the medical board regarding anesthesiologist assistants. The
224224 medical board shall maintain:
225225 (1) information about the parties to the complaint and
226226 the subject matter of the complaint;
227227 (2) a summary of the results of the review or
228228 investigation of the complaint; and
229229 (3) information about the disposition of the
230230 complaint.
231231 SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL
232232 Sec. 207.151. LICENSE REQUIRED. (a) A person may not
233233 practice as an anesthesiologist assistant in this state unless the
234234 person holds an anesthesiologist assistant license issued under
235235 this chapter.
236236 (b) A person may not use the title "anesthesiologist
237237 assistant" or "certified anesthesiologist assistant" or the
238238 initials "C.A.A." or "A.A." or represent that the person is an
239239 anesthesiologist assistant unless the person holds a license issued
240240 under this chapter.
241241 Sec. 207.152. ISSUANCE OF LICENSE. The medical board shall
242242 issue a license to an applicant who:
243243 (1) meets the eligibility requirements of Section
244244 207.153;
245245 (2) submits an application on a form prescribed by the
246246 board;
247247 (3) pays the required application and licensing fees;
248248 and
249249 (4) submits to the board any other information the
250250 board considers necessary to evaluate the applicant's
251251 qualifications.
252252 Sec. 207.153. ELIGIBILITY REQUIREMENTS. To be eligible for
253253 a license under this chapter, an applicant must:
254254 (1) submit proof of completion of a graduate level
255255 training program accredited by the Commission on Accreditation of
256256 Allied Health Education Programs or its successor organization;
257257 (2) pass a certifying examination administered by the
258258 National Commission for Certification of Anesthesiologist
259259 Assistants or its successor organization not later than the first
260260 anniversary of the date of completion of the training program
261261 required under Subdivision (1);
262262 (3) submit proof of current certification from the
263263 National Commission for Certification of Anesthesiologist
264264 Assistants or its successor organization; and
265265 (4) meet any additional qualifications adopted by rule
266266 by the anesthesiologist assistant board.
267267 Sec. 207.154. CRIMINAL HISTORY RECORD INFORMATION
268268 REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall
269269 require that an applicant for a license submit a complete and
270270 legible set of fingerprints, on a form prescribed by the medical
271271 board, to the medical board or to the Department of Public Safety
272272 for the purpose of obtaining criminal history record information
273273 from the Department of Public Safety and the Federal Bureau of
274274 Investigation.
275275 (b) The medical board may not issue a license to a person who
276276 does not comply with the requirement of Subsection (a).
277277 (c) The medical board shall conduct a criminal history
278278 record information check of each applicant for a license using
279279 information:
280280 (1) provided by the individual under this section; and
281281 (2) made available to the medical board by the
282282 Department of Public Safety, the Federal Bureau of Investigation,
283283 and any other criminal justice agency under Chapter 411, Government
284284 Code.
285285 (d) The medical board may:
286286 (1) enter into an agreement with the Department of
287287 Public Safety to administer a criminal history record information
288288 check required under this section; and
289289 (2) authorize the Department of Public Safety to
290290 collect from each applicant the costs incurred by the Department of
291291 Public Safety in conducting the criminal history record information
292292 check.
293293 Sec. 207.155. EXEMPTIONS FROM LICENSING REQUIREMENT FOR
294294 CERTAIN ANESTHESIOLOGIST ASSISTANTS. A person is not required to
295295 hold a license issued under this chapter to practice as an
296296 anesthesiologist assistant student enrolled in an anesthesiologist
297297 assistant educational program accredited by the Commission on
298298 Accreditation of Allied Health Education Programs or its successor
299299 organization.
300300 Sec. 207.156. LICENSE RENEWAL. (a) A license issued under
301301 this chapter is valid for a term of two or more years, as determined
302302 by anesthesiologist assistant board rule.
303303 (b) On notification from the medical board, a person who
304304 holds a license under this chapter may renew the license by:
305305 (1) paying the required renewal fee;
306306 (2) submitting the appropriate form; and
307307 (3) meeting any other requirement established by
308308 anesthesiologist assistant board rule.
309309 (c) The anesthesiologist assistant board by rule may adopt a
310310 system under which licenses expire on various dates during the
311311 year.
312312 (d) A person who is otherwise eligible to renew a license
313313 may renew an unexpired license by paying the required renewal fee to
314314 the medical board before the expiration date of the license. A
315315 person whose license has expired may not engage in activities that
316316 require a license until the license has been renewed.
317317 (e) A person whose license is expired may renew the license
318318 by paying to the medical board a fee that is equal to 1-1/2 times the
319319 renewal fee for the license.
320320 Sec. 207.157. CONTINUING MEDICAL EDUCATION REQUIREMENTS.
321321 The medical board by rule shall adopt, monitor, and enforce a
322322 reporting program for the continuing medical education of
323323 anesthesiologist assistants. The medical board shall adopt and
324324 administer rules that:
325325 (1) establish the number of hours of continuing
326326 medical education the medical board determines appropriate as a
327327 prerequisite to the renewal of a license under this chapter;
328328 (2) require at least one-half of the hours of
329329 continuing medical education established under Subdivision (1) to
330330 be approved by the medical board; and
331331 (3) adopt a process to assess an anesthesiologist
332332 assistant's participation in continuing medical education courses.
333333 Sec. 207.158. REFUSAL FOR VIOLATION OF BOARD ORDER. The
334334 medical board may refuse to renew a license issued under this
335335 chapter if the license holder is in violation of a medical board
336336 order.
337337 SUBCHAPTER E. PRACTICE BY LICENSE HOLDER
338338 Sec. 207.201. NOTICE OF INTENT TO PRACTICE. Before
339339 beginning practice, each anesthesiologist assistant licensed under
340340 this chapter must submit on a form prescribed by the
341341 anesthesiologist assistant board notice of the license holder's
342342 intent to practice. The notice must include the name, business
343343 address, license number, and telephone number of the
344344 anesthesiologist assistant.
345345 Sec. 207.202. SCOPE OF PRACTICE. (a) An anesthesiologist
346346 assistant may assist the supervising anesthesiologist and perform
347347 duties delegated by the supervising anesthesiologist, including
348348 the development and implementation of a patient's anesthesia care
349349 plan that is consistent with the rules adopted under this chapter.
350350 (b) An anesthesiologist assistant who assists an
351351 anesthesiologist is not considered to be engaged in the practice of
352352 medicine.
353353 (c) This chapter does not limit or expand the scope of
354354 practice of a physician assistant.
355355 Sec. 207.203. NAME TAG. A person acting within the scope of
356356 a license issued under this chapter shall wear a name tag
357357 identifying the person as an anesthesiologist assistant.
358358 Sec. 207.204. IDENTIFICATION OF STUDENT. A student in an
359359 anesthesiologist assistant training program shall be identified as
360360 a student anesthesiologist assistant or an anesthesiologist
361361 assistant student. A student may not use or permit to be used on the
362362 student's behalf the term "intern," "resident," or "fellow," or
363363 another term that identifies the student as a physician or surgeon.
364364 SUBCHAPTER F. ENFORCEMENT
365365 Sec. 207.251. ADMINISTRATIVE PENALTY. (a) The medical
366366 board by order may impose an administrative penalty against a
367367 person who violates this chapter or a rule or order adopted under
368368 this chapter.
369369 (b) The medical board shall impose the penalty in the same
370370 manner and using the same procedures as Subchapter A, Chapter 165.
371371 SECTION 2. Section 411.12510(a), Government Code, is
372372 amended to read as follows:
373373 (a) The Texas Medical Board is entitled to obtain criminal
374374 history record information as provided by Subsection (b) that
375375 relates to a person who is:
376376 (1) an applicant for or holder of a license to practice
377377 medicine;
378378 (2) an applicant for or holder of a license to practice
379379 as a physician assistant;
380380 (3) an applicant for or holder of a license to practice
381381 as an acupuncturist;
382382 (4) an applicant for or holder of a certificate to
383383 practice as an acudetox specialist;
384384 (5) an applicant for or holder of a license to practice
385385 as a surgical assistant;
386386 (6) an applicant for or holder of a general
387387 certificate to perform radiologic procedures, limited certificate
388388 to perform radiologic procedures only on specific parts of the
389389 body, or radiologist assistant certificate;
390390 (7) an applicant for or holder of a placement on the
391391 registry of noncertified technicians;
392392 (8) an employee of an applicant for a hardship
393393 exemption;
394394 (9) an applicant for or holder of a license to practice
395395 as a medical physicist;
396396 (10) an applicant for or holder of a license to
397397 practice as a perfusionist;
398398 (11) an applicant for or holder of a license to
399399 practice as a respiratory care practitioner; [and]
400400 (12) an applicant for or holder of a pain management
401401 clinic certificate; and
402402 (13) an applicant for or holder of a license to
403403 practice as an anesthesiologist assistant.
404404 SECTION 3. (a) As soon as practicable after the effective
405405 date of this Act, the president of the Texas Medical Board shall
406406 appoint five members to the Texas Anesthesiologist Assistant Board
407407 in accordance with Chapter 207, Occupations Code, as added by this
408408 Act. In making the initial appointments, the president of the Texas
409409 Medical Board shall designate two members for terms expiring
410410 January 31, 2027, two members for terms expiring January 31, 2029,
411411 and one member for a term expiring January 31, 2031.
412412 (b) Notwithstanding Section 207.052(a), Occupations Code,
413413 as added by this Act, a person practicing as an anesthesiologist
414414 assistant is eligible for appointment as an initial member of the
415415 Texas Anesthesiologist Assistant Board regardless of whether the
416416 person holds an anesthesiologist assistant license issued under
417417 Chapter 207, Occupations Code, as added by this Act.
418418 SECTION 4. Not later than June 1, 2026, the Texas Medical
419419 Board with the advice of the Texas Anesthesiologist Assistant Board
420420 shall adopt the rules, procedures, and fees necessary to administer
421421 Chapter 207, Occupations Code, as added by this Act.
422422 SECTION 5. Notwithstanding Chapter 207, Occupations Code,
423423 as added by this Act, an anesthesiologist assistant is not required
424424 to hold a license under that chapter to practice as an
425425 anesthesiologist assistant in this state before September 1, 2026.
426426 SECTION 6. (a) Except as provided by Subsection (b) of this
427427 section, this Act takes effect September 1, 2025.
428428 (b) Section 207.151 and Subchapter F, Chapter 207,
429429 Occupations Code, as added by this Act, take effect September 1,
430430 2026.