Amend CSSB 532 (house committee printing) as follows:
(1) In SECTION 2 of the bill, in amended Section
157.053(e)(1), Occupations Code (page 3, line 4), strike "three"
and substitute "four [three]".
(2) In SECTION 3 of the bill, in amended Section
157.0541(e), Occupations Code (page 4, lines 17 and 18), strike
"three" both times the word appears in Subsection (e) and
substitute "four [three]".
(3) In the recital to SECTION 4 of the bill (page 4, line 21)
between "by" and "adding", insert "amending Subsection (a) and".
(4) In SECTION 4 of the bill, immediately before proposed
Section 157.0542(b-1), Occupations Code (page 4, between lines 21
and 22), insert the following:
(a) On determining that the conditions of Subsection (b)
have been met, the board may waive or modify any of the site or
supervision requirements for a physician to delegate the carrying
out or signing of prescription drug orders to an advanced practice
nurse or physician assistant under Sections 157.052, 157.053,
157.054, and 157.0541, or under board rules. The board may not
waive the limitation on the number of primary or alternate practice
sites at which a physician may delegate the carrying out or signing
of prescription drug orders or the number of advanced practice
nurses or physician assistants to whom a physician may delegate the
carrying out or signing of prescription drug orders, except as
provided by Subsection (b-1)(1).
(5) Add the following appropriately numbered SECTIONS to
the bill and renumber the SECTIONS of the bill accordingly:
SECTION ____. Section 157.054(b), Occupations Code, is
amended to read as follows:
(b) A physician's authority to delegate under Subsection
(a) is limited as follows:
(1) the delegation must be made under a physician's
order, standing medical order, standing delegation order, or
another order or protocol developed in accordance with policies
approved by the facility's medical staff or a committee of the
facility's medical staff as provided by the facility bylaws;
(2) the delegation must occur in the facility in which
the physician is the medical director, the chief of medical staff,
the chair of the credentialing committee, or a department chair;
(3) the delegation may not permit the carrying out or
signing of prescription drug orders for the care or treatment of the
patients of any other physician without the prior consent of that
physician;
(4) delegation in a long-term care facility must be by
the medical director and is limited to the carrying out and signing
of prescription drug orders to not more than four [three] advanced
practice nurses or physician assistants or their full-time
equivalents; and
(5) a physician may not delegate at more than one
licensed hospital or more than two long-term care facilities unless
approved by the board.
SECTION ____. Section 157.059(f), Occupations Code, is
amended to read as follows:
(f) The authority of a physician to delegate under this
section is limited to:
(1) four [three] nurse midwives or physician
assistants or their full-time equivalents; and
(2) the designated facility at which the nurse midwife
or physician assistant provides care.