Amend CSSB 532 as follows:                                                   
	(1)  Strike the recital to Section 1 of the bill (page 1, 
lines 5 and 6), and substitute:
	SECTION 1.  Section 157.0511, Occupations Code, is amended 
by amending Subsections (b) and (b-1) and adding Subsection (b-2) 
to read as follows:
	(2)  In Section 1 of the bill, immediately following amended 
Subsection (b-1), Section 157.0511, Occupations Code (page 2, 
between lines 6 and 7), insert:
	(b-2)  Physician supervision of the carrying out and signing 
of prescription drug orders must conform to what a reasonable and 
prudent physician would find consistent with sound medical judgment 
but may vary with the education and experience of the particular 
advanced practice nurse or physician assistant. A physician shall 
provide continuous supervision, but the constant physical presence 
of the physician is not required.  Board rules regarding 
supervision shall promote the ability of physicians to:
		(1)  exercise medical judgment in supervising the 
carrying out and signing of prescription drug orders; and
		(2)  promote the full use of health information 
technology, including telemedicine, telehealth, and electronic 
medical records.
	(3)  In Section 3 of the bill, strike amended Section 
157.0541(c), Occupations Code (page 3, line 18, through page 4, 
line 12), and substitute the following:
	(c)  The delegating physician may not be prohibited by 
contract from seeing, diagnosing, or treating a patient for 
services provided or to be provided by the physician assistant or 
advanced practice nurse under delegated prescriptive authority
[Physician supervision is adequate for the purposes of this section 
if the delegating physician:
		(1)  is on-site with the advanced practice nurse or 
physician assistant at least 20 percent of the time;
		(2)  reviews at least 10 percent of the medical charts 
at the site;  and
		(3)  is available through direct telecommunication for 
consultation, patient referral, or assistance with a medical 
emergency].
	(4)  In Section 4 of the bill, in the recital (page 4, line 
21), strike "by adding" and substitute "by amending Subsection (b) 
and adding".
	(5)  In Section 4 of the bill, between the recital and added 
Section 157.0542(b-1), Occupations Code (page 4, between lines 21 
and 22), insert the following:
	(b)  The board may grant a waiver under Subsection (a) if the 
board determines that:
		(1)  the practice site where the physician is seeking 
to delegate prescriptive authority is unable to meet the 
requirements of this chapter or board rules or compliance would 
cause an undue burden without a corresponding benefit to patient 
care; and
		(2)  safeguards exist for patient care and for 
fostering a collaborative practice between the physician and the 
advanced practice nurses and physician assistants[;  and
		(3)  if the requirement for which the waiver is sought 
is the amount of time the physician is on-site, the frequency and 
duration of time the physician is on-site when the advanced 
practice nurse or physician assistant is present is sufficient for 
collaboration to occur, taking into consideration the other ways 
the physician collaborates with the advanced practice nurse or 
physician assistant, including at other sites].
	(6)  In Section 4 of the bill, in proposed Subdivision (1), 
Subsection (b-1), Section 157.0542, Occupations Code (page 5, line 
5), following "equivalents;" add "or".
	(7)  In Section 4 of the bill, in proposed Subdivision (2), 
Subsection (b-1), Section 157.0542, Occupations Code (page 5, line 
6), strike "; or" and substitute an underscored period.
	(8)  In Section 4 of the bill (page 5, lines 7-9), strike 
proposed Subdivision (3), Subsection (b-1), Section 157.0542, 
Occupations Code.
	(9)  Add the following sections to the bill, numbered 
appropriately, and renumber any subsequent sections of the bill 
accordingly:
	SECTION ____.  Section 671.001(b), Government Code, is 
amended to read as follows:
	(b)  The pilot program must provide for the following:                         
		(1)  a licensed advanced practice nurse as defined by 
Section 301.152, Occupations Code, or a licensed physician 
assistant as described by Chapter 204, Occupations Code, who is 
employed by the state or whose services are acquired by contract, 
who will be located at a state office complex;
		[(2)  a licensed physician, who is employed by a state 
governmental entity for purposes other than the pilot program or 
whose services are acquired by contract, who will perform all 
supervisory functions described by Section 157.052(e), Occupations 
Code;]
		(2)[(3)]  appropriate office space and equipment for 
the advanced practice nurse or physician assistant to provide basic 
medical care to employees at the state office complex where the 
nurse or physician assistant is located; and
		(3)[(4)]  professional liability insurance covering 
services provided by the advanced practice nurse or the physician 
assistant.
	SECTION ____.  Sections 157.052(e), 157.053(c), and 
157.054(c), Occupations Code, are repealed.