89R12406 AND-F
By: Hinojosa of Hidalgo S.B. No. 2669
A BILL TO BE ENTITLED
AN ACT
relating to the authority of a podiatrist to delegate certain
podiatric medical acts to an advanced practice registered nurse.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 202, Occupations Code, is amended by
adding Subchapter H-1 to read as follows:
SUBCHAPTER H-1. DELEGATION OF CERTAIN PODIATRIC MEDICAL ACTS
Sec. 202.371. DEFINITIONS. In this subchapter:
(1) "Advanced practice registered nurse" has the
meaning assigned by Section 301.152.
(2) "Minor procedure" means a procedure typically
performed in an office setting and not requiring the use of
medication or treatment other than local anesthesia.
(3) "Nursing board" means the Texas Board of Nursing.
(4) "Prescriptive authority agreement" means an
agreement entered into by a podiatrist and an advanced practice
registered nurse through which the podiatrist delegates to the
advanced practice registered nurse the act of prescribing or
ordering a drug or device.
Sec. 202.372. DELEGATION OF CERTAIN PODIATRIC MEDICAL ACTS.
(a) A supervising podiatrist may delegate to a qualified and
properly trained podiatric medical assistant or advanced practice
registered nurse any podiatric medical act that a reasonable and
prudent podiatrist would find within the scope of sound medical
judgment to delegate if:
(1) in the opinion of the delegating podiatrist, the
act:
(A) can be properly and safely performed by the
podiatric medical assistant or advanced practice registered nurse
to whom the act is delegated; and
(B) is performed in a customary manner and not in
violation of any other statute; and
(2) the podiatric medical assistant or advanced
practice registered nurse to whom the act is delegated does not
represent to the public that the person is authorized to practice
podiatry.
(b) A delegating podiatrist is responsible for a podiatric
medical act performed by the podiatric medical assistant or
advanced practice registered nurse to whom the podiatrist delegates
the act.
(c) The department may determine whether:
(1) an act constitutes the practice of podiatric
medicine; and
(2) a podiatric medical act may be properly or safely
delegated by podiatrists.
Sec. 202.373. DELEGATIONS TO ADVANCED PRACTICE REGISTERED
NURSE. (a) A podiatrist may delegate to an advanced practice
registered nurse the performance of any podiatric medical act
within the scope of practice of the advanced practice registered
nurse. The performance of a delegated act must be consistent with
this chapter, rules adopted by the commission or nursing board, and
any written protocol adopted by the podiatrist consistent with
commission or nursing board rules.
(b) The commission shall adopt rules providing that an
advanced practice registered nurse may, without the presence of a
supervising podiatrist:
(1) conduct office visits with patients, including the
performance of minor procedures;
(2) oversee clinic operations; and
(3) conduct preoperative and postoperative
assessments and medication management.
(c) A podiatrist delegating to an advanced practice
registered nurse shall, consistent with nursing board rules,
cooperate with the advanced practice registered nurse in the
development and review of written protocols for the provision of
podiatric medical care.
Sec. 202.374. PRESCRIPTIVE AUTHORITY AGREEMENTS. (a) The
commission shall adopt rules establishing requirements for a
prescriptive authority agreement. The rules may require a
podiatrist who delegates the prescribing or ordering of a drug or
device to register with the department the name and license number
of any advanced practice registered nurse to whom the delegation is
made. The department may develop and use an electronic online
delegation registration process for registration under this
subsection.
(b) The rules adopted under Subsection (a) must be at least
as stringent as the requirements for a delegation by a physician
under Chapter 157.
Sec. 202.375. LIABILITY FOR DELEGATED ACTS. Unless the
podiatrist has reason to believe the advanced practice registered
nurse lacked the competency to perform the act, a podiatrist is not
liable for an act of an advanced practice registered nurse solely
because the podiatrist entered into a prescriptive authority
agreement authorizing the advanced practice registered nurse to
administer, provide, prescribe, or order a drug or device.
SECTION 2. Section 202.354, Occupations Code, is repealed.
SECTION 3. This Act takes effect September 1, 2025.