By Farabee H.B. No. 2209
77R8109 GJH-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the delegation of prescription drug orders to physician
1-3 assistants and advanced practice nurses who provide health care
1-4 services at certain alternate practice sites.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 157.053, Occupations Code, is amended by
1-7 amending Subsections (a), (b), and (e) and adding Subsections (g)
1-8 and (h) to read as follows:
1-9 (a) In this section:[,]
1-10 (1) "Alternate practice site" means a practice
1-11 location of a physician that is located within 60 miles of the
1-12 physician's primary practice site and at which medical services
1-13 similar to those provided at the primary practice site are offered.
1-14 (2) "Primary ["primary] practice site" means:
1-15 (A) [(1)] the practice location of a physician
1-16 at which the physician spends the majority of the physician's time;
1-17 (B) [(2)] a licensed hospital, a licensed
1-18 long-term care facility, or a licensed adult care center where both
1-19 the physician and the physician assistant or advanced practice
1-20 nurse are authorized to practice;
1-21 (C) [(3)] a clinic operated by or for the
1-22 benefit of a public school district to provide care to the students
1-23 of that district and the siblings of those students, if consent to
1-24 treatment at that clinic is obtained in a manner that complies with
2-1 Chapter 32, Family Code;
2-2 (D) [(4)] the residence of an established
2-3 patient; or
2-4 (E) [(5)] another location at which the
2-5 physician is physically present with the physician assistant or
2-6 advanced practice nurse.
2-7 (b) At a physician's primary practice site or a qualified
2-8 alternate practice site, a physician licensed by the board may
2-9 delegate to a physician assistant or an advanced practice nurse
2-10 acting under adequate physician supervision the act of
2-11 administering, providing, or carrying out or signing a prescription
2-12 drug order as authorized through a physician's order, a standing
2-13 medical order, a standing delegation order, or another order or
2-14 protocol as defined by the board. Providing a drug and carrying out
2-15 or signing a prescription drug order under this section is limited
2-16 to dangerous drugs.
2-17 (e) A physician's authority to delegate the carrying out or
2-18 signing of a prescription drug order at the physician's primary
2-19 practice site under this section is limited to:
2-20 (1) three physician assistants or advanced practice
2-21 nurses or their full-time equivalents practicing at the physician's
2-22 primary practice site or qualified alternate practice site; and
2-23 (2) the patients with whom the physician has
2-24 established or will establish a physician-patient relationship.
2-25 (g) A physician may establish not more than one qualified
2-26 alternate practice site by filing with the board an application
2-27 prescribed by the board.
3-1 (h) To maintain an alternate practice site's qualification,
3-2 the delegating physician must:
3-3 (1) review at least 10 percent of the charts or
3-4 records of patients treated at the alternate practice site;
3-5 (2) be present at the alternate practice site with a
3-6 physician assistant or advanced practice nurse at least 20 percent
3-7 of the time the alternate practice site is open;
3-8 (3) when not present at the alternate practice site,
3-9 be available by voice communication at any time a physician
3-10 assistant or advanced practice nurse is providing health care at
3-11 the alternate practice site; and
3-12 (4) complete any reports required by the board.
3-13 SECTION 2. This Act takes effect September 1, 2001.