74R9609 CAG-D
By Van de Putte H.B. No. 1508
Substitute the following for H.B. No. 1508:
By Berlanga C.S.H.B. No. 1508
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the ability of a pharmacist to perform a specific act
1-3 delegated to the pharmacist by a written protocol.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 5, Texas Pharmacy Act (Article 4542a-1,
1-6 Vernon's Texas Civil Statutes), is amended by amending Subdivision
1-7 (38) and adding Subdivision (50) to read as follows:
1-8 (38) "Practice of pharmacy" means:
1-9 (A) provision of those acts or services
1-10 necessary to provide pharmaceutical care;
1-11 (B) interpretation and evaluation of
1-12 prescription drug orders or medication orders;
1-13 (C) participation in drug and device selection
1-14 as authorized by law, drug administration, drug regimen review, or
1-15 drug or drug-related research;
1-16 (D) provision of patient counseling; <and>
1-17 (E) responsibility for:
1-18 (i) dispensing of prescription drug orders
1-19 or distribution of medication orders;
1-20 (ii) compounding and labeling of drugs and
1-21 devices, except labeling by a manufacturer, repackager, or
1-22 distributor of nonprescription drugs and commercially packaged
1-23 prescription drugs and devices;
1-24 (iii) proper and safe storage of drugs and
2-1 devices; or
2-2 (iv) maintenance of proper records for
2-3 drugs and devices; and
2-4 (F) performance of a specific act of drug
2-5 therapy management for a patient delegated to a pharmacist by a
2-6 written protocol from a physician licensed in this state in
2-7 compliance with the Medical Practice Act (Article 4495b, Vernon's
2-8 Texas Civil Statutes).
2-9 (50) "Written protocol" means a physician's order,
2-10 standing medical order, standing delegation order, or other order
2-11 or protocol as defined by rule of the Texas State Board of Medical
2-12 Examiners under the Medical Practice Act (Article 4495b, Vernon's
2-13 Texas Civil Statutes).
2-14 SECTION 2. Section 17, Texas Pharmacy Act (Article 4542a-1,
2-15 Vernon's Texas Civil Statutes), is amended by adding Subsection (x)
2-16 to read as follows:
2-17 (x) The board shall adopt rules regarding records to be
2-18 maintained by a pharmacist performing a specific act under a
2-19 written protocol.
2-20 SECTION 3. Subchapter C, Medical Practice Act (Article
2-21 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
2-22 3.061 to read as follows:
2-23 Sec. 3.061. DELEGATION OF CERTAIN FUNCTIONS. (a) A person
2-24 licensed to practice medicine may delegate to a properly qualified
2-25 and trained pharmacist acting under adequate physician supervision
2-26 the performance of specific acts of drug therapy management
2-27 authorized by the physician through the physician's order, standing
3-1 medical order, standing delegation order, or other order or
3-2 protocol as defined by board rule.
3-3 (b) The management of drug therapy permitted under this
3-4 section must comply with other applicable law, including Section
3-5 17(a)(5), Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
3-6 Statutes).
3-7 (c) Physician supervision is considered to be adequate for
3-8 the purposes of this section if a delegating physician:
3-9 (1) is responsible for the formulation or approval of
3-10 the physician's order, standing medical order, standing delegation
3-11 order, or other order or protocol and periodically reviews the
3-12 order or protocol and the services provided to a patient under the
3-13 order or protocol;
3-14 (2) has established a physician-patient relationship
3-15 with each patient provided drug therapy management by a delegated
3-16 pharmacist;
3-17 (3) is geographically located so as to be able to be
3-18 physically present daily to provide medical care and supervision;
3-19 (4) receives, as appropriate, a periodic status report
3-20 on the patient, including any problem or complication encountered;
3-21 and
3-22 (5) is available through direct telecommunication for
3-23 consultation, assistance, and direction.
3-24 (d) This section does not restrict the use of a
3-25 preestablished program of health care or restrict a physician from
3-26 authorizing the provision of patient care by use of a
3-27 preestablished health care program if the patient is
4-1 institutionalized and the care is to be delivered in a licensed
4-2 hospital with an organized medical staff that has authorized
4-3 standing delegation orders, standing medical orders, or protocols.
4-4 (e) This section may not be construed to limit, expand, or
4-5 change any provision of law concerning or relating to therapeutic
4-6 drug substitution or administration of medication, including
4-7 Section 17(a)(5), Texas Pharmacy Act (Article 4542a-1, Vernon's
4-8 Texas Civil Statutes).
4-9 (f) The board by rule shall establish the minimum content of
4-10 a written order or protocol. The order or protocol may not permit
4-11 the delegation of medical diagnosis.
4-12 (g) In this section, "pharmacist" has the meaning assigned
4-13 by the Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
4-14 Statutes).
4-15 SECTION 4. This Act takes effect September 1, 1995.
4-16 SECTION 5. The importance of this legislation and the
4-17 crowded condition of the calendars in both houses create an
4-18 emergency and an imperative public necessity that the
4-19 constitutional rule requiring bills to be read on three several
4-20 days in each house be suspended, and this rule is hereby suspended.