S.B. No. 1302
AN ACT
1-1 relating to the regulation of physician assistants; providing a
1-2 criminal penalty.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. The Physician Assistant Licensing Act (Article
1-5 4495b-1, Vernon's Texas Civil Statutes), is amended to read as
1-6 follows:
1-7 Sec. 1. SHORT TITLE; LEGISLATIVE FINDINGS AND PURPOSE.
1-8 (a) This Act may be cited as the "Physician Assistant Licensing
1-9 Act."
1-10 (b) The legislature finds that the health, safety, and
1-11 welfare of the people of this state are best advanced by the
1-12 establishment of an orderly system for licensing physician
1-13 assistants. The creation of a licensing mechanism and
1-14 establishment of an entity dedicated to regulating physician
1-15 assistants provides a means to ensure the competency of physician
1-16 assistants without a financial burden to the people of this state.
1-17 Sec. 2. DEFINITIONS. In this Act:
1-18 (1) "Board" means the Texas State Board of Physician
1-19 Assistant <Medical> Examiners.
1-20 (2) "Medical Board" means the Texas State Board of
1-21 Medical Examiners. <"Council" means the Physician Assistant
1-22 Advisory Council.>
1-23 (3) "Physician assistant" means a person who has
2-1 graduated from a physician assistant or surgeon assistant training
2-2 program accredited by the American Medical Association's Committee
2-3 on Allied Health Education and Accreditation and <or> who has
2-4 passed the certifying examination administered by the National
2-5 Commission on Certification of Physician Assistants and who is
2-6 licensed as a physician assistant by the board.
2-7 (4) "Supervising physician" means a physician <medical
2-8 doctor or doctor of osteopathy> licensed by the medical board
2-9 either as a doctor of medicine or doctor of osteopathic medicine
2-10 who is assuming responsibility and legal liability for the services
2-11 rendered by the physician assistant and who has received approval
2-12 from the medical board to supervise <who supervises> a specific
2-13 physician assistant.
2-14 (5) "Alternate physician" means that physician
2-15 designated by the supervising physician to act in his or her stead.
2-16 (6) "Supervision" means overseeing the activities of,
2-17 and accepting responsibility for, the medical services rendered by
2-18 a physician assistant. Supervision does not require the constant
2-19 physical presence of a supervising physician <person providing
2-20 supervision> but includes a situation where a supervising physician
2-21 <person providing supervision> and the person being supervised are
2-22 or can easily be in contact with one another by radio, telephone,
2-23 or another telecommunication device.
2-24 (7) "State" means any state, territory, or insular
2-25 possession of the United States and the District of Columbia.
3-1 Sec. 3. LICENSE REQUIRED. A person may not practice as a
3-2 physician assistant unless the person is licensed under this Act.
3-3 Sec. 4. BOARD OF PHYSICIAN ASSISTANT EXAMINERS <ADVISORY
3-4 COUNCIL>. (a) The Texas State Board of Physician Assistant
3-5 Examiners <Advisory Council> is created as an advisory board to the
3-6 Texas State Board of Medical Examiners.
3-7 (b) The board <council> consists of nine members appointed
3-8 by the governor as follows:
3-9 (1) three members who are currently legally practicing
3-10 as physician assistants and who have at least five years of
3-11 clinical experience as practicing physician assistants;
3-12 (2) three members who are physicians licensed in this
3-13 state who currently supervise physician assistants; and
3-14 (3) three members who are members of the general
3-15 public who are not licensed either as physicians or physician
3-16 assistants.
3-17 (c) A person is not eligible for appointment as a public
3-18 member of the board <council> if the person or the person's spouse:
3-19 (1) is licensed by an occupational regulatory agency
3-20 in the field of health care; or
3-21 (2) is employed by or participates in the management
3-22 of a business entity or other organization that provides health
3-23 care services or that sells, manufactures, or distributes health
3-24 care supplies or equipment.
3-25 (d) Each member of the board <council> is entitled to a per
4-1 diem as set by legislative appropriation for each day that the
4-2 member engages in the business of the board <council>. If the
4-3 General Appropriations Act does not prescribe the amount of the per
4-4 diem, the per diem shall consist of actual expenses for meals,
4-5 lodging, and transportation plus $100. <A member may not receive
4-6 compensation for travel expenses, including expenses for meals and
4-7 lodging, other than transportation expenses. A member is entitled
4-8 to compensation for transportation expenses as provided by the
4-9 General Appropriations Act.>
4-10 (e) It is a ground for removal from the board <council> if a
4-11 member:
4-12 (1) does not have at the time of appointment the
4-13 qualifications required by this section for appointment to the
4-14 board <council>;
4-15 (2) does not maintain during the service on the board
4-16 <council> the qualifications required by this section for
4-17 appointment to the board <council>; or
4-18 (3) fails to attend at least one-half of the regularly
4-19 scheduled board <council> meetings held in a calendar year,
4-20 excluding meetings held while the person was not a board
4-21 <committee> member.
4-22 (f) A person who is required to register as a lobbyist under
4-23 Chapter 305, Government Code, and its subsequent amendments may not
4-24 serve as a member of the board <council>.
4-25 (g) The validity of an action of the board <council> is not
5-1 affected by the fact that it is taken when a ground for removal of
5-2 a member of the board <council> exists.
5-3 (h) The board <council> is subject to the open meetings law,
5-4 Chapter 551, Government Code <271, Acts of the 60th Legislature,
5-5 Regular Session, 1967 (Article 6252-17, Vernon's Texas Civil
5-6 Statutes)>, and its subsequent amendments, and Chapter 2001,
5-7 Government Code (<the> Administrative Procedure <and Texas
5-8 Register> Act), <(Article 6252-13a, Vernon's Texas Civil Statutes)>
5-9 and its subsequent amendments.
5-10 (i) Members of the board <council> hold office for staggered
5-11 terms of six years expiring February 1 of each odd-numbered year.
5-12 A member is ineligible to serve more than two consecutive full
5-13 terms and may not serve more than a total of three full terms.
5-14 (j) In the case of a vacancy on the board <council>, the
5-15 governor shall appoint a new member to complete an unexpired term.
5-16 (k) The board <council> is subject to Chapter 325,
5-17 Government Code (Texas Sunset Act), and its subsequent amendments.
5-18 Unless continued in existence as provided by that chapter, the
5-19 board <council> is abolished and this Act expires September 1,
5-20 2005.
5-21 (l) The board <council> shall select from its membership a
5-22 presiding officer and a secretary to serve for one-year terms.
5-23 (m) A majority of the <Five> members of the board <council>
5-24 constitute a quorum for the transaction of the business of the
5-25 board <council>.
6-1 Sec. 5. POWERS AND DUTIES OF THE BOARD <COUNCIL>. The board
6-2 <council> shall:
6-3 (1) adopt rules as provided by Section 23 <22> of this
6-4 Act;
6-5 (2) review and approve or reject applications for a
6-6 license;
6-7 (3) review and approve or reject applications for
6-8 renewal of a license;
6-9 (4) issue all licenses;
6-10 (5) deny, suspend, or revoke a license or otherwise
6-11 discipline a license holder;
6-12 (6) prescribe and collect fees authorized under this
6-13 Act; and
6-14 (7) take any action necessary to carry out the
6-15 functions and duties of the board <council> under this Act.
6-16 Sec. 6. FEES. (a) The board <council> shall establish fees
6-17 that are reasonable and necessary to defray the cost of
6-18 administering this Act.
6-19 (b) The board <council> may not maintain unnecessary fund
6-20 balances, and fee amounts shall be set in accordance with this
6-21 requirement.
6-22 Sec. 7. LICENSURE <LICENSE> QUALIFICATIONS. The board
6-23 <council> shall issue a license under this Act to an applicant who:
6-24 (1) submits an application on a form prescribed by the
6-25 board <council>;
7-1 (2) pays the application fee as prescribed by the
7-2 board <council>;
7-3 (3) has successfully completed an educational program
7-4 for physician assistants or surgeon assistants accredited by the
7-5 Committee on Allied Health Education and Accreditation or by that
7-6 committee's predecessor or successor entities and <or> has passed
7-7 the Physician Assistant National Certifying Examination
7-8 administered by the National Commission on Certification of
7-9 Physician Assistants;
7-10 (4) certifies that the applicant is mentally and
7-11 physically able to function safely as a physician assistant;
7-12 (5) does not have a license, certification, or
7-13 registration as a physician assistant in this state or from any
7-14 other licensing authority that is currently revoked or suspended or
7-15 the applicant is not subject to probation or other disciplinary
7-16 action for cause resulting from the applicant's acts as a physician
7-17 assistant, unless the board <council> takes that fact into
7-18 consideration in determining whether to issue the license;
7-19 (6) is of good moral character; <and>
7-20 (7) submits to the board <council> any other
7-21 information the board <council> considers necessary to evaluate the
7-22 applicant's qualifications; and
7-23 (8) meets any other requirement established by rules
7-24 adopted by the board.
7-25 Sec. 8. TEMPORARY LICENSE. (a) The board <council> may
8-1 issue a temporary license to an applicant who:
8-2 (1) meets all the qualifications for a license under
8-3 this Act but is waiting for the next scheduled meeting of the board
8-4 <council> for the license to be issued; <or>
8-5 (2) seeks to temporarily substitute for a licensed
8-6 physician assistant during the licensee's absence, if the
8-7 applicant:
8-8 (A) is licensed or registered in good standing
8-9 in another state, territory, or the District of Columbia;
8-10 (B) submits an application on a form prescribed
8-11 by the board <council>; and
8-12 (C) pays the appropriate fee prescribed by the
8-13 board; or
8-14 (3) has graduated from an educational program for
8-15 physician assistants or surgeon assistants accredited by the
8-16 Committee on Allied Health Education and Accreditation or by that
8-17 committee's predecessor or successor entities no later than six
8-18 months previous to the application for temporary licensure and is
8-19 waiting for examination results from the National Commission on
8-20 Certification of Physician Assistants <council>.
8-21 (b) A temporary license is valid for 100 <45> days from the
8-22 date issued and may be extended only for another 30 <45> days after
8-23 the date the initial temporary license expires.
8-24 Sec. 9. INACTIVE LICENSE. (a) A license holder may have
8-25 the license holder's license placed on inactive status by applying
9-1 to the board <council>. A physician assistant with an inactive
9-2 license is excused from paying renewal fees on the license and may
9-3 not practice as a physician assistant.
9-4 (b) A license holder who practices as a physician assistant
9-5 while on inactive status is considered to be practicing without a
9-6 license.
9-7 (c) A physician assistant may return to active status by
9-8 applying to the board <council>, paying the license renewal fee,
9-9 and complying with the requirements for license renewal under
9-10 Section 10 of this Act.
9-11 Sec. 10. RENEWAL. A person who holds a license under this
9-12 Act may, on notification from the board <council>, renew the
9-13 license by:
9-14 (1) paying the renewal fee prescribed by the board
9-15 <council>;
9-16 (2) submitting the appropriate form; and
9-17 (3) meeting any other requirement established by rules
9-18 adopted by the board <council>.
9-19 Sec. 11. EXEMPTION. This Act does not require a license
9-20 for:
9-21 (1) a physician assistant student enrolled in a
9-22 physician assistant or surgeon assistant educational program
9-23 accredited by the Committee on Allied Health Education and
9-24 Accreditation of the American Medical Association or, in the event
9-25 these entities go out of existence, successor entities as approved
10-1 and designated by the board through rulemaking;
10-2 (2) a physician assistant employed in the service of
10-3 the federal government while performing duties related to that
10-4 employment;
10-5 (3) a technician, assistant, or employee of a
10-6 physician who performs delegated tasks in the office of a physician
10-7 or elsewhere but who does not act as a physician assistant or
10-8 represent that the person is a physician assistant; or
10-9 (4) any other licensed health care worker acting
10-10 within the scope of that person's license if the person does not
10-11 use the title "physician assistant" or "P.A." or is not represented
10-12 or designated as a physician assistant.
10-13 Sec. 12. SCOPE OF PRACTICE. (a) The practice of a
10-14 physician assistant includes medical services within the education,
10-15 training, and experience of the physician assistant that are
10-16 delegated by the supervising physician.
10-17 (b) Medical services provided by a physician assistant may
10-18 include but are not limited to:
10-19 (1) obtaining patient histories and performing
10-20 physical examinations;
10-21 (2) ordering or performing diagnostic and therapeutic
10-22 procedures;
10-23 (3) formulating a working diagnosis;
10-24 (4) developing and implementing a treatment plan;
10-25 (5) monitoring the effectiveness of therapeutic
11-1 interventions;
11-2 (6) assisting at surgery;
11-3 (7) offering counseling and education to meet patient
11-4 needs <patients>;
11-5 (8) requesting, receiving, and signing for the receipt
11-6 of pharmaceutical sample prescription medications <professional
11-7 samples> and distributing the samples to patients in a specific
11-8 practice setting where the physician assistant is authorized to
11-9 prescribe pharmaceutical medications and sign prescription drug
11-10 orders at a site <serving medically underserved populations,> as
11-11 provided by Section 3.06(d)(5) and (6), Medical Practice Act
11-12 (Article 4495b, Vernon's Texas Civil Statutes), and its subsequent
11-13 amendments, or as otherwise authorized by this Act or board rule;
11-14 <and>
11-15 (9) the signing or completion of a prescription as
11-16 provided by Section 3.06(d)(5) or (6), Medical Practice Act
11-17 (Article 4495b, Vernon's Texas Civil Statutes); and
11-18 (10) making appropriate referrals.
11-19 (c) The activities listed in Subsection (b) of this section
11-20 may be performed in any place authorized by a supervising
11-21 physician, including but not limited to a clinic, hospital,
11-22 ambulatory surgical center, patient home, nursing home, or other
11-23 institutional setting.
11-24 Sec. 13. SUPERVISION REQUIREMENTS. (a) Supervision by a
11-25 supervising physician must be continuous but does not require the
12-1 physical presence of the supervising physician at the place where
12-2 physician assistant services are performed while the services are
12-3 performed.
12-4 (b) Each team of a physician and physician assistant must
12-5 ensure that:
12-6 (1) the physician assistant's scope of function is
12-7 identified;
12-8 (2) delegation of medical tasks is appropriate to the
12-9 physician assistant's level of competence;
12-10 (3) the relationship between the members of the team
12-11 and the access of the physician assistant to the supervising
12-12 physician is defined; and
12-13 (4) a process for evaluating the physician assistant's
12-14 performance is established.
12-15 (c) A physician assistant may have more than one supervising
12-16 physician.
12-17 Sec. 14. SUPERVISING PHYSICIAN. A supervising physician
12-18 must:
12-19 (1) be currently licensed as a physician in this state
12-20 by the medical board with a license that is unrestricted and
12-21 active;
12-22 (2) notify the board <council> of the physician's
12-23 intent to supervise a physician assistant; and
12-24 (3) submit a statement to the board <council> that the
12-25 physician will:
13-1 (A) supervise the physician assistant according
13-2 to rules adopted by the board <council>; and
13-3 (B) retain professional and legal responsibility
13-4 for the care rendered by the physician assistant.
13-5 Sec. 15. NOTIFICATION OF INTENT TO PRACTICE. (a) A
13-6 physician assistant licensed under this Act must, before beginning
13-7 practice, submit on a form prescribed by the board <council>
13-8 notification of the license holder's intent to begin practice.
13-9 Notification under this section must include:
13-10 (1) the name, business address, Texas license number,
13-11 and telephone number of the physician assistant's supervising
13-12 physician; and
13-13 (2) the name, business address, Texas license number,
13-14 and telephone number of the physician assistant.
13-15 (b) A physician assistant must notify the board <council> of
13-16 any changes in, or additions to, the person acting as a supervising
13-17 physician for the physician assistant not later than the 30th day
13-18 after the date the change or addition is made.
13-19 Sec. 16. EXCLUSION OF LIMITATION ON EMPLOYMENT. This Act
13-20 does not limit the employment arrangement of a physician assistant
13-21 licensed under this Act.
13-22 Sec. 17. ASSUMPTION OF PROFESSIONAL LIABILITY. (a) A
13-23 physician assistant employed by a physician or a group of
13-24 physicians must be supervised by and be the legal responsibility of
13-25 each supervising <employing> physician. The legal responsibility
14-1 for the physician assistant's patient care activities remains the
14-2 responsibility of the supervising <employing> physician, including
14-3 when the physician assistant provides care and treatment for a
14-4 patient in a health care facility.
14-5 (b) A physician assistant employed by a health care facility
14-6 or other entity shall be supervised by a licensed physician. A
14-7 health care facility or other entity that employs a physician
14-8 assistant shares the legal responsibility for the physician
14-9 assistant's acts or omissions with the physician assistant's
14-10 supervising physician.
14-11 Sec. 18. DISCIPLINARY PROCEEDINGS. The board <council> may
14-12 refuse to issue a license, publicly or privately reprimand a
14-13 license holder, or suspend, revoke, or place other restrictions on
14-14 a license of a person who:
14-15 (1) fraudulently or deceptively obtains or attempts to
14-16 obtain a license;
14-17 (2) fraudulently or deceptively uses a license;
14-18 (3) violates any provision of this Act or any rule
14-19 adopted under this Act;
14-20 (4) is convicted of a felony;
14-21 (5) is a habitual user of intoxicants or
14-22 nontherapeutic drugs to the extent that the person cannot safely
14-23 perform as a physician assistant;
14-24 (6) has been adjudicated as mentally incompetent or
14-25 has a mental or physical condition that renders the person unable
15-1 to safely perform as a physician assistant;
15-2 (7) has committed an act of moral turpitude; <or>
15-3 (8) represents that the person is a physician;
15-4 (9) has acted in an unprofessional or dishonorable
15-5 manner which is likely to deceive, defraud, or injure any member of
15-6 the public;
15-7 (10) has failed to practice as a physician assistant
15-8 in an acceptable manner consistent with public health and welfare;
15-9 (11) has committed any act that is in violation of the
15-10 laws of the State of Texas if the act is connected with practice as
15-11 a physician assistant; a complaint, indictment, or conviction of a
15-12 law violation is not necessary for the enforcement of this
15-13 provision; proof of the commission of the act while in practice as
15-14 a physician assistant or under the guise of practice as a physician
15-15 assistant is sufficient for action by the board under this section;
15-16 or
15-17 (12) has had the person's license suspended, revoked,
15-18 or restricted or who has had other disciplinary action taken by
15-19 another state regarding practice as a physician assistant or had
15-20 disciplinary action taken by the uniformed services of the United
15-21 States, based on acts by the licensee similar to acts described in
15-22 this section; a certified copy of the record of the state or
15-23 uniformed services of the United States taking the action is
15-24 conclusive evidence of it.
15-25 Sec. 19. ADDITIONAL DISCIPLINARY AUTHORITY. In addition to
16-1 the authority under Section 18 of this Act, the board <council>
16-2 may, on finding that a physician assistant has committed an offense
16-3 described in Section 18 of this Act:
16-4 (1) require a physician assistant to submit to the
16-5 care, counseling, or treatment of a health care practitioner
16-6 <physician> designated by the board <council>;
16-7 (2) stay enforcement of an order and place the
16-8 physician assistant on probation with the board <council> retaining
16-9 the right to vacate the probationary stay and enforce the original
16-10 order for noncompliance with the terms of probation or impose any
16-11 other remedial measures or sanctions authorized by this section;
16-12 (3) restore or reissue a license or remove any
16-13 disciplinary or corrective measure that the board <council> may
16-14 have imposed;
16-15 (4) order the physician assistant to perform public
16-16 service; or
16-17 (5) require the physician assistant to complete
16-18 additional training.
16-19 Sec. 20. REHABILITATION ORDER. (a) The board, through an
16-20 agreed order or after a contested proceeding, may impose a
16-21 nondisciplinary rehabilitation order on any licensee or, as a
16-22 prerequisite for issuing a license, on any licensure applicant
16-23 based on one or more of the following:
16-24 (1) intemperate use of drugs or alcohol directly
16-25 resulting from habituation or addiction caused by medical care or
17-1 treatment provided by a physician;
17-2 (2) self-reported intemperate use of drugs or alcohol
17-3 during the last five years immediately preceding the report which
17-4 could adversely affect the reporter's ability to safely practice as
17-5 a physician assistant, but only if the reporting individual has not
17-6 previously been the subject of a substance abuse related order of
17-7 the board;
17-8 (3) judgment by a court of competent jurisdiction that
17-9 the individual is of unsound mind; or
17-10 (4) results from a mental or physical examination, or
17-11 admissions by the individual, indicating that the licensee or
17-12 applicant suffers from a potentially dangerous limitation or an
17-13 inability to safely practice as a physician assistant with
17-14 reasonable skill and safety by reason of illness or as a result of
17-15 any physical or mental condition.
17-16 (b) A rehabilitation order entered pursuant to this section
17-17 shall be a nondisciplinary private order and shall contain findings
17-18 of fact and conclusions of law. A rehabilitation order, if entered
17-19 by agreement, shall be an agreed disposition or settlement
17-20 agreement for purposes of civil litigation and shall be exempt from
17-21 the open records law, Chapter 552, Government Code.
17-22 (c) A rehabilitation order entered pursuant to this section
17-23 may impose a revocation, cancellation, suspension, period of
17-24 probation or restriction, or any other terms and conditions
17-25 authorized under this Act or as otherwise agreed to by the board
18-1 and the individual subject to the order.
18-2 (d) Violation of a rehabilitation order entered pursuant to
18-3 this section may result in disciplinary action under the provisions
18-4 of this Act for contested matters or pursuant to the terms of the
18-5 agreed order. A violation of a rehabilitation order may be grounds
18-6 for disciplinary action based on unprofessional or dishonorable
18-7 conduct or on any of the provisions of this Act which may apply to
18-8 the misconduct which resulted in violation of the rehabilitation
18-9 order.
18-10 (e) The rehabilitation orders entered pursuant to this
18-11 section shall be kept in a confidential file which shall be subject
18-12 to an independent audit by state auditors or private auditors
18-13 contracted with by the board to perform such an audit. Audits may
18-14 be performed at any time at the direction of the board but shall be
18-15 performed at least once every three years. The audit results shall
18-16 be reported in a manner that maintains the confidentiality of all
18-17 licensees who are subject to rehabilitation orders and shall be a
18-18 public record. The audit shall be for the purposes of ensuring
18-19 that only qualified licensees are subject to rehabilitation orders.
18-20 Sec. 21. OFFENSE. (a) A person commits an offense if,
18-21 without holding a license under this Act, the person:
18-22 (1) holds the person out as a physician assistant;
18-23 (2) uses any combination or abbreviation of the term
18-24 "physician assistant" to indicate or imply that the person is a
18-25 physician assistant; or
19-1 (3) acts as a physician assistant without being
19-2 licensed by the board <council>.
19-3 (b) An offense under this section is a felony of the third
19-4 degree.
19-5 Sec. 22 <21>. IDENTIFICATION REQUIREMENTS. A physician
19-6 assistant licensed under this Act shall:
19-7 (1) keep the physician assistant's Texas license
19-8 available for inspection at the physician assistant's primary place
19-9 of business; and
19-10 (2) when engaged in the physician assistant's
19-11 professional activities, wear a name tag identifying the physician
19-12 assistant as a physician assistant.
19-13 Sec. 23 <22>. RULE-MAKING AUTHORITY. (a) The board
19-14 <council> shall adopt rules that are reasonable and necessary for
19-15 the performance of the board's <council's> duties under this Act,
19-16 as provided by Chapter 2001, Government Code (<the> Administrative
19-17 Procedure <and Texas Register> Act <(Article 6252-13a, Vernon's
19-18 Texas Civil Statutes>), and its subsequent amendments, including
19-19 rules:
19-20 (1) setting licensing and other fees;
19-21 (2) establishing renewal dates for licenses; and
19-22 (3) establishing rules and procedures for disciplinary
19-23 actions.
19-24 (b) Rules adopted by the board <council> must:
19-25 (1) be approved or rejected by a majority vote of the
20-1 medical board; and
20-2 (2) if rejected, be returned to the board <council>
20-3 for revision.
20-4 Sec. 24 <23>. RURAL PHYSICIAN ASSISTANT LOAN REIMBURSEMENT
20-5 PROGRAM. (a) The board <council> shall designate annually a
20-6 portion of the revenue generated under this Act from physician
20-7 assistant licensing fees to be set aside to provide student loan
20-8 reimbursement for graduates of physician assistant training
20-9 programs in this state who practice in rural health professional
20-10 shortage areas and medically underserved areas identified by the
20-11 Texas Department of Health.
20-12 (b) The Center for Rural Health Initiatives shall establish
20-13 policies for and adopt rules to administer the loan program under
20-14 this section.
20-15 (c) The board <council> shall authorize and the medical
20-16 board shall transfer annually the funds designated in Subsection
20-17 (a) of this section to the Center for Rural Health Initiatives to
20-18 administer the loan program under this section.
20-19 Sec. 25. CONFIDENTIALITY. (a) All complaints, adverse
20-20 reports, investigation files, other investigation reports, and
20-21 other investigative information in the possession of or received or
20-22 gathered by the board or its employees or agents relating to a
20-23 licensee, an application for license, or a criminal investigation
20-24 or proceeding are privileged and confidential and are not subject
20-25 to discovery, subpoena, or other means of legal compulsion for
21-1 their release to anyone other than the board or its employees or
21-2 agents involved in licensee discipline.
21-3 (b) Not later than 30 days after receiving a written request
21-4 from a licensee who is the subject of a formal complaint initiated
21-5 and filed under this Act or from the licensee's counsel of record
21-6 and subject to any other privileges or restrictions set forth by
21-7 rule, statute, or legal precedent, unless good cause is shown for
21-8 delay the board shall provide the licensee with access to all
21-9 information in its possession that the board intends to offer into
21-10 evidence in presenting its case in chief at the contested hearing
21-11 on the complaint. However, the board is not required to provide
21-12 board investigative reports or investigative memoranda, the
21-13 identity of a nontestifying complainant, attorney-client
21-14 communications, attorney work product, or other materials covered
21-15 by a privilege recognized by the Texas Rules of Civil Procedure or
21-16 the Texas Rules of Civil Evidence. The furnishing of information
21-17 shall not constitute a waiver of privilege or confidentiality under
21-18 this section, this Act, or other applicable law.
21-19 (c) Investigative information in the possession of the board
21-20 or its employees or agents which relates to licensee discipline may
21-21 be disclosed to the appropriate licensing authority in another
21-22 state or a territory or country in which the licensee is licensed
21-23 or has applied for a license or to a peer review committee
21-24 reviewing an application for privileges or the qualifications of
21-25 the licensee with respect to retaining privileges. If the
22-1 investigative information in the possession of the board or its
22-2 employees or agents indicates a crime may have been committed, the
22-3 information shall be reported to the proper law enforcement agency.
22-4 The board shall cooperate with and assist all law enforcement
22-5 agencies conducting criminal investigations of licensees by
22-6 providing information relevant to the criminal investigation to the
22-7 investigating agency. Any information disclosed by the board to an
22-8 investigative agency shall remain confidential and shall not be
22-9 disclosed by the investigating agency except as necessary to
22-10 further the investigation.
22-11 (d) The board shall provide information on the written
22-12 request of a health care entity about a complaint filed against a
22-13 licensee that was resolved after investigation by a disciplinary
22-14 order of the board or by an agreed settlement and shall provide the
22-15 basis of and current status of any complaint under active
22-16 investigation.
22-17 (e) The board shall keep information on file about each
22-18 complaint filed with the board, consistent with this Act. If a
22-19 written complaint is filed with the board relating to a person
22-20 licensed by the board, the board, at least as often as quarterly
22-21 and until final determination of the action to be taken relative to
22-22 the complaint, shall notify, in a manner consistent with this Act,
22-23 the parties to the complaint of the status of the complaint unless
22-24 the notice would jeopardize an active investigation.
22-25 Sec. 26. PATIENT IDENTITY. In any disciplinary
23-1 investigation or proceeding regarding a physician assistant
23-2 conducted under or pursuant to this Act, the board shall protect
23-3 the identity of any patient whose medical records are examined and
23-4 utilized in a public proceeding except for those patients who
23-5 testify in the public proceeding or who submit a written release in
23-6 regard to their records or identity.
23-7 Sec. 27. SUBPOENAS. (a) On behalf of the board, the
23-8 executive director or the secretary-treasurer of the medical board
23-9 may issue subpoenas and subpoenas duces tecum for purposes of
23-10 investigations or contested proceedings related to alleged
23-11 misconduct by physician assistants or alleged violations of this
23-12 Act or other laws related to practice as a physician assistant or
23-13 to the provision of health care under authority of this Act; for
23-14 purposes of issuing, suspending, restricting, revoking, or
23-15 cancelling any license, permit, or certification authorized by this
23-16 Act; and for purposes of denying or granting applications for such
23-17 licenses, permits, or certifications.
23-18 (b) Failure to timely comply with a subpoena issued pursuant
23-19 to this Act shall be grounds for disciplinary action by the board
23-20 or other licensing or regulatory agencies with jurisdiction over
23-21 the individual or entity subject to such a subpoena and grounds for
23-22 denial of an application for a license, permit, or certification.
23-23 Sec. 28. IMMUNITY. A person, health care entity, medical
23-24 peer review committee, or other entity that without malice
23-25 furnishes records, information, or assistance to the board is
24-1 immune from any civil liability arising from such act.
24-2 SECTION 2. The importance of this legislation and the
24-3 crowded condition of the calendars in both houses create an
24-4 emergency and an imperative public necessity that the
24-5 constitutional rule requiring bills to be read on three several
24-6 days in each house be suspended, and this rule is hereby suspended,
24-7 and that this Act take effect and be in force from and after its
24-8 passage, and it is so enacted.