LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  April 16, 1997
         
         
      TO: Honorable Hugo Berlanga, Chair            IN RE:  House Bill No. 2846
          Committee on Public Health                              By: Berlanga
          House
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on HB2846 ( Relating 
to the practice of advanced practice nurses and physician assistants 
in collaborative practice with a physician.) this office has 
detemined the following:
         
         Biennial Net Impact to General Revenue Funds by HB2846-As Introduced
         
No significant fiscal implication to the State is anticipated. 
 
         
The bill relates to the practice of advanced practice nurses 
and physician assistants in collaborative practice with a physician. 
 The bill would change the on-site supervision requirements 
of a delegating physician and allow for a waiver of the requirements 
subject to approval by the Board of Medical Examiners (BME). 
 The increase in workload would be minimal and could be absorbed 
by BME staff.
         
 
          
No fiscal implication to units of local government is anticipated.
          
   Source:            Agencies:   503   Board of Medical Examiners
                                         507   Board of Nurse Examiners
                                         454   Department of Insurance
                                         
                      LBB Staff:   JK ,BB ,AC