LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 18, 2001
TO: Honorable Mike Moncrief, Chair, Senate Committee on
Health & Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB1166 by Madla (Relating to the authority of certain
advanced practice nurses and physician assistants to
prescribe drugs.), As Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB1166, As Introduced: an impact of $0 through the biennium *
* ending August 31, 2003. *
* *
* The bill would make no appropriation but could provide the legal *
* basis for an appropriation of funds to implement the provisions of *
* the bill. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $0 *
* 2003 0 *
* 2004 0 *
* 2005 0 *
* 2006 0 *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable Revenue Change in Number of *
* Year Savings/(Cost) from Gain/(Loss) from State Employees from *
* General Revenue Fund General Revenue Fund FY 2001 *
* 0001 0001 *
* 2002 $(46,652) $46,652 1.0 *
* 2003 (23,052) 23,052 1.0 *
* 2004 (23,052) 23,052 1.0 *
* 2005 (23,052) 23,052 1.0 *
* 2006 (23,052) 23,052 1.0 *
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Technology Impact
The agency estimates consultant costs of $13,600 in the first year.
Fiscal Analysis
The bill would amend the Occupations Code to provide that a physician's
authority to delegate the carrying out or signing of a prescription drug
order is limited to a certain number of physician assistants or advanced
practice nurses or their full-time equivalents at the physician's primary
practice site or at an alternate practice site. The bill would provide
authorization, conditions, and limitations for a physician to delegate
the carrying out or signing of prescription drug orders. The bill would
require the Board of Medical Examiners (BME) to establish procedures for
granting waivers of delegation requirements and to waive delegation
requirements under certain conditions. The bill would establish the
duties and responsibilities of a waiver advisory committee and would
require the BME to make committee appointments. The advisory committee
and the BME's requirement to waive certain delegation requirements would
expire as of September 1, 2005, under the provisions of the bill.
The bill would take effect immediately upon receiving the necessary
two-thirds vote in both chambers. Otherwise, the bill would take effect
September 1, 2001.
Methodology
The BME estimates $13,600 would be required to upgrade and expand a
database for tracking, monitoring, and verifying specific information
relating to the delegation of carrying out or signing prescription drug
orders to physician assistants or advanced practice nurses by physicians.
The BME reports processing approximately 10,000 delegation authority
transactions each year with three FTEs and estimates that 3,000 new
transactions would be realized in implementing the provisions of the
bill. It is estimated that one additional FTE would be required to
verify, process, and enter the additional delegation transaction
information into the database.
It is assumed the BME would adjust fees to offset any cost associated
with the implementation of the bill.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 503 Texas State Board of Medical Examiners, 507
Board of Nurse Examiners
LBB Staff: JK, HD, MW