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INTRODUCED
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HOUSE COMMITTEE
SUBSTITUTE
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SECTION 1. The heading to
Subchapter B, Chapter 157, Occupations Code, is amended to read as follows:
SUBCHAPTER B. DELEGATION TO
ADVANCED PRACTICE REGISTERED NURSES, [AND] PHYSICIAN
ASSISTANTS, AND ANESTHESIOLOGIST ASSISTANTS
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No
equivalent provision.
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SECTION 2. Section 157.051,
Occupations Code, is amended by adding Subdivision (1-a) to read as
follows:
(1-a)
"Anesthesiologist assistant" means a person who holds a license
issued under Chapter 207.
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No
equivalent provision.
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SECTION 3. Subchapter B,
Chapter 157, Occupations Code, is amended by adding Section 157.061 to read
as follows:
Sec. 157.061. DELEGATION
TO ANESTHESIOLOGIST ASSISTANTS. (a) In a licensed hospital or ambulatory
surgical center, a board certified anesthesiologist may delegate to an
anesthesiologist assistant the ordering of drugs and devices necessary for
the anesthesiologist assistant to administer an anesthetic or an
anesthesia-related service.
(b) Under the
anesthesiologist's order and in accordance with facility policies or
medical staff bylaws, an anesthesiologist assistant may select, obtain, and
administer the drugs and apply the medical devices appropriate to
accomplish the anesthesiologist's order and maintain the patient within a
sound physiological status.
(c) This section shall be
liberally construed to permit the full use of safe and effective medication
orders to use the skills and services of anesthesiologist assistants.
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No
equivalent provision.
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SECTION 4. Subtitle C,
Title 3, Occupations Code, is amended by adding Chapter 207 to read as
follows:
CHAPTER 207.
ANESTHESIOLOGIST ASSISTANTS
SUBCHAPTER A. GENERAL
PROVISIONS
Sec. 207.001. SHORT
TITLE. This chapter may be cited as the Anesthesiologist Assistant
Licensing Act.
Sec. 207.002.
DEFINITIONS. In this chapter:
(1)
"Anesthesiologist" means a physician licensed by the Texas
Medical Board who specializes in anesthesiology.
(2) "Anesthesiologist
assistant" means a person who holds a license issued under this
chapter.
(3) "Anesthesiologist assistant board" means the Texas
Anesthesiologist Assistant Board.
(4) "Anesthesiologist assistant practice protocol" means
a written agreement of jointly agreed protocols or a standing order between
a supervising anesthesiologist and an anesthesiologist assistant that
provides for the delegation of health care services from a supervising
anesthesiologist to an anesthesiologist assistant and the review of those
services.
(5) "Anesthesiology" means the practice of medicine that
specializes in the relief of pain during and after surgical procedures and
childbirth, during certain chronic disease processes, and during the
resuscitation and critical care of patients in the operating room and
intensive care environments.
(6) "Direct supervision" means supervision by an
anesthesiologist who is present in the facility in which the
anesthesiologist assistant is performing anesthesia services and is immediately
available to provide assistance and direction while anesthesia services are
being performed.
(7) "Immediately available" means in the same physical
location or facility in which the services are provided.
(8) "Medical
board" means the Texas Medical Board.
(9) "Physician" means a person licensed by the Texas
Medical Board to practice medicine and surgery or osteopathic medicine and
surgery.
Sec. 207.003. APPLICATION
OF SUNSET ACT. The Texas Anesthesiologist Assistant Board is subject to
Chapter 325, Government Code (Texas Sunset Act). Unless continued in
existence as provided by that chapter, the board is abolished and this
chapter expires September 1, 2027.
Sec. 207.004.
APPLICABILITY OF CHAPTER. (a) A person is not required to hold a license
issued under this chapter to practice as:
(1) a technician,
assistant, or employee of a physician who performs delegated tasks but does
not act as an anesthesiologist assistant or represent that the person is an
anesthesiologist assistant; or
(2) any other licensed
health care worker acting within the scope of that person's license if the
person:
(A) does not use the
title "anesthesiologist assistant" or the initials
"A.A." or "A.A.-C"; or
(B) is not represented or
designated as an anesthesiologist assistant.
(b) This chapter does not
limit the employment arrangement of an anesthesiologist assistant.
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SECTION 1. Subtitle C, Title
3, Occupations Code, is amended by adding Chapter 207 to read as follows:
CHAPTER 207.
ANESTHESIOLOGIST ASSISTANTS
SUBCHAPTER A. GENERAL
PROVISIONS
No
equivalent provision.
Sec. 207.001.
DEFINITIONS. In this chapter:
(1)
"Anesthesiologist" means a physician licensed by the Texas
Medical Board who specializes in anesthesiology.
(2)
"Anesthesiologist assistant" means a person who holds a license
issued under this chapter.
(3) "Medical
board" means the Texas Medical Board.
No equivalent provision.
No equivalent provision.
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SUBCHAPTER B. TEXAS
ANESTHESIOLOGIST ASSISTANT BOARD
Sec. 207.051.
ANESTHESIOLOGIST ASSISTANT BOARD. (a) The Texas Anesthesiologist
Assistant Board is an advisory board to the medical board.
(b) The anesthesiologist
assistant board shall:
(1) guide, advise, and
make recommendations to the medical board; and
(2) assist the medical
board in carrying out this chapter.
(c) The medical board is
responsible for the ongoing examination of the scope of practice and
promoting the continuing role of anesthesiologist assistants in the
delivery of health care services.
Sec. 207.052. APPOINTMENT
OF BOARD. The anesthesiologist assistant board consists of six members
appointed by the governor with the advice and consent of the senate as
follows:
(1) one member who is a
physician;
(2) one anesthesiologist
assistant;
(3) two
anesthesiologists; and
(4) two members who
represent the public and are not licensed or trained in a health care
profession.
Sec. 207.053. PUBLIC
MEMBER ELIGIBILITY. A person is not eligible for appointment as a public
member of the anesthesiologist assistant board if the person or the
person's spouse:
(1) is registered,
certified, or licensed by an occupational regulatory agency in the field of
health care;
(2) is employed by or
participates in the management of a business entity or other organization
regulated by the medical board or receiving funds from the medical board or
anesthesiologist assistant board;
(3) owns or controls,
directly or indirectly, more than a 10 percent interest in a business
entity or other organization regulated by the medical board or
anesthesiologist assistant board or receiving funds from the medical board
or anesthesiologist assistant board; or
(4) uses or receives a
substantial amount of tangible goods, services, or money from the medical
board or anesthesiologist assistant board, other than compensation or
reimbursement authorized by law for anesthesiologist assistant board
membership, attendance, or expenses.
Sec. 207.054. MEMBERSHIP
AND EMPLOYEE RESTRICTIONS. (a) In this section, "Texas trade association"
means a cooperative and voluntarily joined association of business or
professional competitors in this state designed to assist its members and
its industry or profession in dealing with mutual business or professional
problems and in promoting their common interest.
(b) A person may not be a
member of the anesthesiologist assistant board or an employee of the
medical board employed in a "bona fide executive, administrative, or
professional capacity," as that phrase is used for purposes of
establishing an exemption to the overtime provisions of the federal Fair
Labor Standards Act of 1938 (29 U.S.C. Section 201 et seq.) if:
(1) the person is an
officer, employee, manager, or paid consultant of a Texas trade association
in the field of health care; or
(2) the person's spouse
is an officer, board member, employee, or paid consultant of a Texas trade
association in the field of health care.
(c) A person may not be a
member of the anesthesiologist assistant board if the person is required to
register as a lobbyist under Chapter 305, Government Code, because of the
person's activities for compensation on behalf of a profession related to
the operation of the medical board or anesthesiologist assistant board.
Sec. 207.055. MEMBERSHIP
REQUIREMENTS. Each member of the anesthesiologist assistant board must be
a citizen of the United States and a resident of this state. Each
physician member of the anesthesiologist assistant board must be licensed
to practice medicine in this state.
Sec. 207.056. TERMS; VACANCIES.
(a) Members of the anesthesiologist assistant board serve staggered
three-year terms. The terms of two members expire on January 31 each year.
(b) An anesthesiologist
assistant board member who is an anesthesiologist assistant or a physician
may not serve more than two consecutive terms.
(c) If a vacancy occurs
during a member's term, the governor shall appoint a new member to serve
the unexpired term.
Sec. 207.057. OFFICERS;
MEETINGS. (a) The anesthesiologist assistant board shall hold an open
annual meeting and elect a presiding officer and secretary from among its
members.
(b) The anesthesiologist
assistant board may hold additional meetings as necessary provided that
notice of each meeting is given to each member not less than 10 days before
the date of the meeting.
Sec. 207.058.
APPLICABILITY OF OTHER LAW. (a) Chapter 2110, Government Code, does not
apply to the anesthesiologist assistant board.
(b) Except as otherwise
provided by this chapter, the anesthesiologist assistant board is subject
to Chapters 551 and 2001, Government Code.
Sec. 207.059. GROUNDS FOR
REMOVAL. (a) It is a ground for removal from the anesthesiologist
assistant board that a member:
(1) does not have at the
time of taking office the qualifications required by Sections 207.052,
207.053, and 207.055;
(2) does not maintain
during service on the anesthesiologist assistant board the qualifications
required by Sections 207.052, 207.053, and 207.055;
(3) is ineligible for
membership under Section 207.054;
(4) cannot, because of
illness or disability, discharge the member's duties for a substantial part
of the member's term; or
(5) is absent from more
than half of the regularly scheduled anesthesiologist assistant board
meetings that the member is eligible to attend during a calendar year
without an excuse approved by a majority vote of the anesthesiologist
assistant board.
(b) The validity of an
action of the anesthesiologist assistant board is not affected by the fact
that it is taken when a ground for removal of an anesthesiologist assistant
board member exists.
(c) If the executive
director of the medical board has knowledge that a potential ground for
removal of an anesthesiologist assistant board member exists, the executive
director shall notify the presiding officer of the anesthesiologist
assistant board of the potential ground. The presiding officer shall then
notify the governor and the attorney general that a potential ground for
removal exists. If the potential ground for removal involves the presiding
officer, the executive director shall notify the next highest officer of
the anesthesiologist assistant board, who shall notify the governor and the
attorney general that a potential ground for removal exists.
Sec. 207.060. TRAINING.
(a) A person who is appointed to and qualifies for office as a member of
the anesthesiologist assistant board may not vote, deliberate, or be
counted as a member in attendance at a meeting of the anesthesiologist
assistant board until the person completes a training program that complies
with this section.
(b) The training program
must provide the person with information regarding:
(1) this chapter;
(2) the results of the
most recent formal audit of the anesthesiologist assistant board;
(3) the requirements of
laws relating to open meetings, public information, administrative
procedure, and conflicts of interest; and
(4) any applicable ethics
policies adopted by the medical board or the Texas Ethics Commission.
(c) A person appointed to
the anesthesiologist assistant board is entitled to reimbursement, as
provided by the General Appropriations Act, for travel expenses incurred in
attending the training program regardless of whether the attendance at the
program occurs before or after the person qualifies for office.
Sec. 207.061.
QUALIFICATIONS AND STANDARDS OF CONDUCT INFORMATION. The executive
director of the medical board or the executive director's designee shall
provide, as often as necessary, to members of the anesthesiologist
assistant board information regarding their:
(1) qualifications for
office under this chapter; and
(2) responsibilities
under applicable laws relating to standards of conduct for state officers.
Sec. 207.062.
COMPENSATION; REIMBURSEMENT. An anesthesiologist assistant board member
may not receive compensation for service on the anesthesiologist assistant
board but is entitled to receive reimbursement under the General
Appropriations Act for transportation and related expenses incurred while
conducting the anesthesiologist assistant board's business.
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No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
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SUBCHAPTER C. POWERS AND
DUTIES OF ANESTHESIOLOGIST
ASSISTANT BOARD AND
MEDICAL BOARD
Sec. 207.101. GENERAL
POWERS AND DUTIES OF ANESTHESIOLOGIST ASSISTANT BOARD. The
anesthesiologist assistant board shall:
(1) adopt rules that are
reasonable and necessary for the performance of the board's duties under
this chapter, as provided by Chapter 2001, Government Code, including rules
to establish:
(A) licensing and other
fees;
(B) license renewal
dates; and
(C) procedures for
disciplinary actions;
(2) review and approve or
reject each application for the issuance or renewal of a license;
(3) issue each license;
(4) deny, suspend, or
revoke a license or otherwise discipline a license holder; and
(5) take any action
necessary to carry out the functions and duties of the board under this
chapter.
Sec. 207.102. GUIDELINES
FOR EARLY INVOLVEMENT IN RULEMAKING PROCESS. (a) The anesthesiologist
assistant board shall adopt guidelines to establish procedures for receiving
input during the rulemaking process from individuals and groups that have
an interest in matters under the anesthesiologist assistant board's
jurisdiction. The guidelines must provide an opportunity for those
individuals and groups to provide input before the anesthesiologist
assistant board submits the rule to the medical board for approval.
(b) A rule adopted by the
medical board may not be challenged on the grounds that the
anesthesiologist assistant board did not comply with this section. If the
anesthesiologist assistant board was unable to solicit a significant amount
of input from the public or affected persons early in the rulemaking
process, the anesthesiologist assistant board shall state in writing the
reasons why the anesthesiologist assistant board was unable to do so.
Sec. 207.103. POWERS AND
DUTIES OF MEDICAL BOARD RELATING TO ANESTHESIOLOGIST ASSISTANTS.
No
equivalent provision.
(a) The medical board
shall adopt rules consistent with this
chapter to regulate anesthesiologist assistants and anesthesiologists who
supervise anesthesiologist assistants.
No equivalent provision.
(b) The medical board, by
a majority vote, shall approve or reject each rule adopted by the
anesthesiologist assistant board. If approved, the rule may take effect.
If the rule is rejected, the medical board shall return the rule to the
anesthesiologist assistant board for revision.
Sec. 207.104. RULES ON
CONSEQUENCES OF CRIMINAL CONVICTION. The anesthesiologist assistant board
shall adopt rules and guidelines as necessary to comply with Chapter 53,
except to the extent the requirements of this chapter are stricter than the
requirements of Chapter 53.
Sec. 207.105. ASSISTANCE
BY MEDICAL BOARD. (a) The medical board shall provide administrative and
clerical employees as necessary to enable the anesthesiologist assistant
board to administer this chapter.
(b) Subject to the advice
and approval of the medical board, the anesthesiologist assistant board shall
develop and implement policies that clearly separate the policy-making
responsibilities of the anesthesiologist assistant board and the management
responsibilities of the executive director and the staff of the medical
board.
Sec. 207.106. FEES.
No
equivalent provision.
Sec. 207.107. RULES
RESTRICTING ADVERTISING OR COMPETITIVE BIDDING. (a) The medical board may
not adopt rules under this chapter restricting advertising or competitive
bidding by a license holder except to prohibit false, misleading, or
deceptive practices.
(b) In its rules to
prohibit false, misleading, or deceptive practices, the medical board may
not include a rule that:
(1) restricts the use of
any medium for advertising;
(2) restricts the use of
a license holder's personal appearance or voice in an advertisement;
(3) relates to the size
or duration of an advertisement by the license holder; or
(4) restricts the license
holder's advertisement under a trade name.
Sec. 207.108. ANNUAL
REPORT. (a) The medical board shall prepare annually a complete and
detailed written report accounting for all funds received and disbursed by
the medical board or the anesthesiologist assistant board under this
chapter during the preceding fiscal year.
(b) The annual report
must meet the reporting requirements applicable to financial reporting
provided in the General Appropriations Act.
Sec. 207.109. TECHNOLOGY
POLICY. The medical board shall implement a policy requiring the
anesthesiologist assistant board to use appropriate technological solutions
to improve the anesthesiologist assistant board's ability to perform its
functions. The policy must ensure that the public is able to interact with
the anesthesiologist assistant board on the Internet.
Sec. 207.110. NEGOTIATED
RULEMAKING AND ALTERNATIVE DISPUTE RESOLUTION POLICY. The medical board
shall develop and implement a policy to encourage the use of:
(1) negotiated rulemaking
procedures under Chapter 2008, Government Code, for the adoption of medical
board rules for the anesthesiologist assistant board; and
(2) appropriate
alternative dispute resolution procedures under Chapter 2009, Government
Code, to assist in the resolution of internal and external disputes under
the anesthesiologist assistant board's jurisdiction.
Sec. 207.111. PUBLIC
INTEREST INFORMATION. (a) The anesthesiologist assistant board shall
prepare information of public interest describing the functions of the
anesthesiologist assistant board and the procedures by which complaints are
filed with and resolved by the anesthesiologist assistant board.
(b) The anesthesiologist
assistant board shall make the information available to the public and
appropriate state agencies.
Sec. 207.112. PUBLIC
PARTICIPATION. Subject to the advice and approval of the medical board,
the anesthesiologist assistant board shall develop and implement policies
that provide the public with a reasonable opportunity to appear before the
anesthesiologist assistant board and to speak on any issue under the
jurisdiction of the anesthesiologist assistant board.
Sec. 207.113. RECORDS OF
COMPLAINTS. (a) The anesthesiologist assistant board shall maintain a
system to promptly and efficiently act on complaints filed with the board.
The board shall maintain:
(1) information about the
parties to the complaint and the subject matter of the complaint;
(2) a summary of the
results of the review or investigation of the complaint; and
(3) information about the
disposition of the complaint.
(b) The anesthesiologist
assistant board shall make information available describing its procedures
for complaint investigation and resolution.
(c) The anesthesiologist
assistant board shall periodically notify the parties of the status of the
complaint until final disposition of the complaint, unless the notice would
jeopardize an active investigation.
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SUBCHAPTER B. POWERS AND
DUTIES OF MEDICAL BOARD
No
equivalent provision.
No
equivalent provision.
Sec. 207.051. POWERS AND
DUTIES OF MEDICAL BOARD RELATING TO ANESTHESIOLOGIST ASSISTANTS.
(a) The medical board
shall administer and enforce this chapter.
(b) The medical board:
(1) may establish
requirements to obtain an anesthesiologist assistant license, including
education and training requirements, in addition to the requirements under
Section 207.103;
(2) may establish
examination requirements for an anesthesiologist assistant license in
addition to the requirements under Section 207.103;
(3) shall prescribe
application requirements for a license to practice as an anesthesiologist
assistant; and
(4) shall develop an
approved program of mandatory continuing education and the manner by which
attendance at all approved courses, clinics, forums, lectures, programs, or
seminars is monitored and recorded.
Sec. 207.052. RULES.
(a) The medical board shall adopt rules necessary
to implement this chapter.
(b) The rules adopted by
the medical board must include requirements and limitations on the
provision of anesthesia services by an anesthesiologist assistant as
determined by the medical board to be in the best interests of patient
health and safety, including:
(1) a requirement that an
anesthesiologist assistant be supervised by an anesthesiologist who is
actively engaged in clinical practice and available on-site to provide
assistance to the anesthesiologist assistant;
(2) a limit on the number
of anesthesiologist assistants and student anesthesiologist assistants an
anesthesiologist may supervise, in accordance with any requirements of the
Centers for Medicare and Medicaid Services; and
(3) a requirement that an
anesthesiologist assistant shall maintain compliance with all continuing
education requirements adopted by the medical board and with
recertification requirements of the National Commission for Certification
of Anesthesiologist Assistants or its successor organization.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
Sec. 207.053. FEES.
Sec. 207.054.
APPLICABILITY OF OTHER LAW. Procedures under Subtitle B, Title 3, that
govern license or registration renewal, complaints, and disciplinary
actions apply to an anesthesiologist assistant in the same manner the
provisions apply to a physician.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
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SUBCHAPTER D. LICENSE
REQUIREMENTS; EXEMPTIONS; RENEWALS
Sec. 207.151. LICENSE
REQUIRED.
Sec. 207.152. ISSUANCE OF
LICENSE. (a) The anesthesiologist
assistant board shall issue a license to an applicant who:
(1) meets the eligibility
requirements of Section 207.153;
(2) submits an application
on a form prescribed by the board;
(3) pays the required
application fee;
(4) certifies that the applicant is mentally and physically able
to function safely as an anesthesiologist assistant; and
(5) submits to the board any other information the board considers
necessary to evaluate the applicant's qualifications.
(b) The anesthesiologist
assistant board may delegate authority to medical board employees to issue
licenses under this chapter to applicants who clearly meet all licensing
requirements. If the medical board employees determine that the applicant
does not clearly meet all licensing requirements, the application shall be
returned to the anesthesiologist assistant board. A license issued under
this subsection does not require formal anesthesiologist assistant board
approval.
Sec. 207.153. ELIGIBILITY
REQUIREMENTS. (a) To be eligible for a license under this chapter, an
applicant must:
(1) successfully complete an educational program accredited by the
Commission on Accreditation of Allied Health Education Programs or another national accrediting agency approved by
the medical board;
(2) pass the Certifying Examination for Anesthesiologist
Assistants as administered by the National Commission for
Certification of Anesthesiologist Assistants or another national testing service and examination approved by the
medical board;
(3) be of good moral
character; and
(4) meet any other
requirement established by anesthesiologist
assistant board rule.
(b) In addition to the requirements of Subsection (a), an
applicant is not eligible for a license, unless the anesthesiologist
assistant board takes into consideration in determining whether to issue
the license, if the applicant:
(1) has been issued a
license, certificate, or registration as an anesthesiologist assistant in
this state or from a licensing authority in another state that is revoked
or suspended; or
(2) is subject to
probation or other disciplinary action for cause in this state or another
state resulting from the applicant's acts as an anesthesiologist assistant.
Sec. 207.154. EXEMPTION
FROM LICENSING REQUIREMENT FOR CERTAIN ANESTHESIOLOGIST ASSISTANTS. A
person is not required to hold a license issued under this chapter to
practice as:
(1) an anesthesiologist
assistant student enrolled in an anesthesiologist assistant educational
program accredited by the Commission on Accreditation of Allied Health
Education Programs or another national accrediting agency approved by the
medical board; or
(2) an anesthesiologist
assistant employed in the service of the federal government while
performing duties related to that employment.
Sec. 207.155. TEMPORARY
LICENSE. (a) The anesthesiologist assistant board may issue a temporary
license to an applicant who:
(1) meets all the qualifications
for a license under this chapter but is waiting for the license to be
issued at the next scheduled meeting of the board;
(2) seeks to temporarily
substitute for a licensed anesthesiologist assistant during the license
holder's absence, if the applicant:
(A) is licensed or
registered in good standing in another state;
(B) submits an
application on a form prescribed by the board; and
(C) pays the appropriate
fee prescribed by the board; or
(3) has graduated from an
educational program for anesthesiologist assistants described by Section
207.153(a)(1) not later than six months before applying for a temporary
license and is waiting for examination results from the National Commission
for Certification of Anesthesiologist Assistants or another national
testing service approved by the medical board.
(b) A temporary license
may be valid for not more than one year after the date issued as determined
by anesthesiologist assistant board rule.
Sec. 207.156. LICENSE
RENEWAL. (a) On notification from the anesthesiologist assistant board, a
person who holds a license under this chapter may renew the license by:
(1) paying the required
renewal fee;
(2) submitting the
appropriate form; and
(3) meeting any other
requirement established by board rule.
(b) The anesthesiologist
assistant board by rule may adopt a system under which licenses expire on
various dates during the year.
(c) A person who is
otherwise eligible to renew a license may renew an unexpired license by
paying the required renewal fee to the anesthesiologist assistant board
before the expiration date of the license. A person whose license has
expired may not engage in activities that require a license until the
license has been renewed.
(d) A person whose
license has been expired for 90 days or less may renew the license by
paying to the anesthesiologist assistant board a fee that is equal to 1-1/2
times the renewal fee for the license.
(e) A person whose
license has been expired for more than 90 days but less than one year may
renew the license by paying to the anesthesiologist assistant board a fee
equal to two times the renewal fee for the license.
(f) A person who was
licensed in this state, moved to another state, and is currently licensed
and has been in practice in the other state for the two years preceding the
date of the application may obtain a new license by paying to the
anesthesiologist assistant board a fee that is equal to two times the
normally required renewal fee for the license.
Sec. 207.157. CONTINUING
EDUCATION REQUIREMENTS. The anesthesiologist assistant board by rule shall
establish continuing education requirements for an anesthesiologist
assistant licensed under this chapter. The rules may require a license
holder, as a condition for license renewal, to successfully complete the
continuing education required to maintain certification by the National
Commission for Certification of Anesthesiologist Assistants or another
national certification agency selected by the board.
Sec. 207.158. INACTIVE
STATUS. (a) A person licensed under this chapter may place the person's
license on inactive status by applying to the anesthesiologist assistant
board. A person whose license is on inactive status is not required to pay
renewal fees for the license.
(b) The holder of a
license on inactive status may not practice as an anesthesiologist
assistant. A violation of this subsection is considered to be practicing
without a license.
(c) A person whose
license is on inactive status under this section may return the person's
license to active status by:
(1) applying to the
anesthesiologist assistant board;
(2) paying the fee
established by the board for returning a license to active status; and
(3) satisfying any other
requirements established by the board.
(d) The anesthesiologist
assistant board by rule shall establish a limit on the length of time an
anesthesiologist assistant's license may remain on inactive status.
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SUBCHAPTER
C. LICENSE REQUIREMENTS
Sec.
207.101. LICENSE REQUIRED.
Sec. 207.102. ISSUANCE OF
LICENSE. The medical board shall
issue a license to an applicant who:
(1) meets the eligibility
requirements of Section 207.103;
(2) submits an
application on a form prescribed by the
medical board; and
(3) pays the required
application and licensing fees.
No
equivalent provision.
Sec. 207.103. ELIGIBILITY
REQUIREMENTS. To be eligible for a license under this chapter, an
applicant must:
(1) submit proof of completion of a graduate level training program accredited
by the Commission on Accreditation of Allied Health Education Programs or its successor organization;
(2) pass a certifying examination administered by
the National Commission for Certification of Anesthesiologist Assistants or
its successor organization not later than
12 months from the date of completion of the training program required
under Subdivision (1);
(3) submit proof of current certification from the National
Commission for Certification of Anesthesiologist Assistants or its
successor organization;
(4) be of good moral
character; and
(5) meet any additional
qualifications adopted by the medical board
by rule.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
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SUBCHAPTER E. PRACTICE BY
LICENSE HOLDER
Sec. 207.201. SCOPE OF
PRACTICE. (a) An anesthesiologist assistant may assist the supervising
anesthesiologist in developing and implementing an anesthesia care plan for
a patient.
In providing assistance to
the supervising anesthesiologist, an anesthesiologist assistant may:
(1) obtain from the
patient a comprehensive patient history, perform relevant elements of a
physical examination, and present the patient's history to the supervising
anesthesiologist;
(2) pretest and calibrate
anesthesia delivery systems and obtain and interpret information from the
systems and monitors, in consultation with an anesthesiologist;
(3) initiate
multiparameter monitoring before anesthesia or in other acute care settings
under anesthesiologist supervision, including American Society of
Anesthesiologists standard monitors and arterial and venous catheters, and
may use and interpret data from central venous, pulmonary artery, and
intracranial catheters and other monitors or devices that are indicated;
(4) establish basic and
advanced airway interventions, including intubation of the trachea and the
performance of ventilatory support;
(5) administer
intermittent vasoactive drugs and start and adjust vasoactive infusions;
(6) administer anesthetic
drugs, adjuvant drugs, and accessory drugs;
(7) assist and initiate
with the supervising anesthesiologist the performance of epidural
anesthetic procedures, spinal anesthetic procedures, and other regional
anesthetic techniques;
(8) administer blood,
blood products, and supportive fluids;
(9) provide initial
cardiopulmonary resuscitation in response to a life-threatening situation
as directed by a physician or protocol until the supervising
anesthesiologist arrives;
(10) participate in
administrative, research, and clinical teaching activities as authorized by
the supervising anesthesiologist; or
(11) perform other tasks
not prohibited by law that are delegated by a licensed anesthesiologist and
that the anesthesiologist assistant has been trained and is proficient to
perform.
(b) An anesthesiologist
shall at all times accept and be responsible for the oversight of the
health care services rendered by the anesthesiologist assistant.
(c) This chapter does not
prevent a third-party payor from reimbursing the employer of an
anesthesiologist assistant for covered services rendered by the
anesthesiologist assistant.
No
equivalent provision.
No
equivalent provision.
Sec. 207.202. CERTAIN
PROHIBITED PRACTICES. An anesthesiologist assistant may not:
(1) prescribe medication
or a controlled substance;
(2) administer any drug,
medicine, device, or therapy the supervising anesthesiologist is not
qualified or authorized to prescribe; or
(3) practice or attempt
to practice without the supervision of an anesthesiologist or in any
location where the supervising anesthesiologist is not immediately available
for consultation, assistance, and intervention.
No
equivalent provision. (But see Sec. 207.352, Occupations
Code, below).
Sec. 207.203. IDENTIFICATION REQUIREMENTS. (a) An
anesthesiologist assistant must be clearly identified as an anesthesiologist
assistant and may not use or permit to be used on the anesthesiologist
assistant's behalf the term:
(1) "doctor," "Dr.," or "doc," or
another term that identifies the person as a physician or surgeon; or
(2) "physician assistant" or "P.A." or another
term that may imply that the anesthesiologist assistant is a physician
assistant.
(b) An anesthesiologist assistant may not refer to a license as
"board-certified" or use any other terminology that may imply
that the anesthesiologist assistant is a physician or surgeon.
(c) A student in an
anesthesiologist assistant training program shall be identified as a
student anesthesiologist assistant or an anesthesiologist assistant
student. A student may not use or permit to be used on the student's behalf
the term "intern," "resident," or "fellow,"
or another term that identifies the student as a physician or surgeon.
Sec. 207.204. SUPERVISION
REQUIREMENTS. (a) An anesthesiologist assistant shall practice only under
the direct supervision of an anesthesiologist who is physically present or
immediately available. A supervising anesthesiologist may supervise not
more than four anesthesiologist assistants consistent with federal rules or
regulations for reimbursement for anesthesia services. An anesthesiologist
assistant may have more than one supervising anesthesiologist.
(b) Each anesthesiologist
who agrees to act as the supervising anesthesiologist of an
anesthesiologist assistant shall adopt a written practice protocol that
delineates the services the anesthesiologist assistant may provide and the
manner in which the anesthesiologist will supervise the anesthesiologist
assistant. The protocol must be based on relevant quality assurance
standards, including regular review by the supervising anesthesiologist of
the medical records of the patients cared for by the anesthesiologist
assistant.
(c) The supervising
anesthesiologist shall oversee the anesthesiologist assistant in accordance
with the terms of the protocol and rules adopted by the anesthesiologist
assistant board for the supervision of an anesthesiologist assistant. The
board may randomly audit or inspect any written practice protocol under
which an anesthesiologist assistant works.
Sec. 207.205.
REQUIREMENTS OF SUPERVISING ANESTHESIOLOGIST. (a) A supervising
anesthesiologist must:
(1) hold an unrestricted
and active license as a physician in this state;
(2) be engaged full-time
in the medical specialty of anesthesiology; and
(3) be certified by the
American Board of Medical Specialties, the Bureau of Osteopathic
Specialists in Anesthesiology, or another national certifying board
approved by the medical board.
(b) An individual who
does not meet the criteria under Subsection (a) may not supervise or
delegate any task to an anesthesiologist assistant.
Sec. 207.206. ASSUMPTION
OF PROFESSIONAL LIABILITY. (a) Each supervising anesthesiologist retains
legal responsibility for an anesthesiologist assistant's patient care
activities, including the provision of care and treatment to a patient in a
health care facility.
(b) If an
anesthesiologist assistant is employed by an entity, including a health
care facility, the entity shares the legal responsibility for the
anesthesiologist assistant's acts or omissions with the anesthesiologist
assistant's supervising anesthesiologist.
Sec. 207.207. FACILITY
LIMITATIONS OF FUNCTIONS. The governing body of each facility in which
anesthesiologist assistants practice may limit the functions and activities
that an anesthesiologist assistant may perform in the facility.
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SUBCHAPTER D. PRACTICE BY
LICENSE HOLDER
Sec. 207.151. SCOPE OF
PRACTICE. (a) An anesthesiologist assistant may assist the supervising
anesthesiologist in developing and implementing an anesthesia care plan for
a patient that is consistent with the rules
adopted under this chapter.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
(b) An anesthesiologist
assistant who assists an anesthesiologist is not considered to be engaged
in the practice of medicine.
(c) This chapter does not
limit or expand the scope of practice of a physician assistant.
No
equivalent provision.
Sec. 207.152. USE OF
TITLE. (a) A person may not use the title "anesthesiologist
assistant" or represent that the person is an anesthesiologist
assistant unless the person holds a license issued under this chapter. A
person who violates this subsection is subject to an administrative penalty
in an amount to be determined by the medical board.
(b) A student in an
anesthesiologist assistant training program shall be identified as a
student anesthesiologist assistant or an anesthesiologist assistant
student. A student may not use or permit to be used on the student's
behalf the term "intern," "resident," or
"fellow," or another term that identifies the student as a
physician or surgeon.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
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SUBCHAPTER F. COMPLAINTS
AND INVESTIGATIVE INFORMATION
Sec. 207.251. COMPLAINT
INFORMATION AND STATUS. (a) The anesthesiologist assistant board shall
keep information on file about each complaint filed with the board.
(b) If a written
complaint is filed with the anesthesiologist assistant board relating to a
person licensed by the board, the board, as often as quarterly and until
final determination of the action to be taken on the complaint, shall notify
the parties to the complaint of the status of the complaint unless the
notice would jeopardize an active investigation.
Sec. 207.252. CONDUCT OF
INVESTIGATION. (a) The anesthesiologist assistant board shall complete a
preliminary investigation of a complaint filed with the board not later
than the 30th day after the date of receiving the complaint.
(b) The anesthesiologist
assistant board shall first determine whether the anesthesiologist
assistant constitutes a continuing threat to the public welfare. On
completion of the preliminary investigation, the board shall determine
whether to officially proceed on the complaint.
(c) If the
anesthesiologist assistant board fails to complete the preliminary
investigation in the time required by this section, the board's official
investigation of the complaint is considered to commence on that date.
Sec. 207.253. LICENSE
HOLDER ACCESS TO COMPLAINT INFORMATION. (a) The anesthesiologist assistant
board shall provide a license holder who is the subject of a formal
complaint filed under this chapter with access to all information in its
possession that the board intends to offer into evidence in presenting its
case at the contested hearing on the complaint, subject to any other
privilege or restriction established by rule, statute, or legal precedent.
The board shall provide the information not later than the 30th day after
receipt of a written request from the license holder or the license
holder's counsel, unless good cause is shown for delay.
(b) Notwithstanding
Subsection (a), the anesthesiologist assistant board is not required to
provide:
(1) board investigative
reports;
(2) investigative
memoranda;
(3) the identity of a
nontestifying complainant;
(4) attorney-client
communications;
(5) attorney work
product; or
(6) other material
covered by a privilege recognized by the Texas Rules of Civil Procedure or
the Texas Rules of Evidence.
(c) The provision of
information does not constitute a waiver of privilege or confidentiality
under this chapter or other law.
Sec. 207.254. HEALTH CARE
ENTITY REQUEST FOR INFORMATION. On the written request of a health care
entity, the anesthesiologist assistant board shall provide to the entity:
(1) information about a
complaint filed against a license holder that was resolved after
investigation by:
(A) a disciplinary order
of the board; or
(B) an agreed
settlement; and
(2) the basis of and
current status of any complaint under active investigation.
Sec. 207.255.
CONFIDENTIALITY OF INVESTIGATIVE INFORMATION. A complaint, adverse report,
investigation file, other report, or other investigative information in the
possession of or received or gathered by the anesthesiologist assistant
board or a board employee or agent relating to a license holder, a license
application, or a criminal investigation or proceeding is privileged and
confidential and is not subject to discovery, subpoena, or other means of
legal compulsion for release to any person other than the board or a board
employee or agent involved in license holder discipline.
Sec. 207.256. PERMITTED
DISCLOSURE OF INVESTIGATIVE INFORMATION. (a) Investigative information in
the possession of an anesthesiologist assistant board employee or agent
that relates to the discipline of a license holder may be disclosed to:
(1) a licensing authority
in another state or country in which the license holder is licensed or has
applied for a license; or
(2) a peer review
committee reviewing:
(A) an application for
privileges; or
(B) the qualifications of
the license holder with respect to retaining privileges.
(b) If investigative
information in the possession of the anesthesiologist assistant board or a
board employee or agent indicates that a crime may have been committed, the
board shall report the information to the proper law enforcement agency.
The board shall cooperate with and assist each law enforcement agency
conducting a criminal investigation of a license holder by providing
information relevant to the investigation. Confidential information disclosed
by the board to a law enforcement agency under this subsection remains
confidential and may not be disclosed by the law enforcement agency except
as necessary to further the investigation.
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No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
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SUBCHAPTER G.
DISCIPLINARY PROCEEDINGS
Sec. 207.301. DISCIPLINE
AUTHORITY OF BOARD. (a) On a determination that an applicant or license
holder committed an act described in Section 207.302, the anesthesiologist
assistant board by order shall take any of the following actions:
(1) deny the person's
application for a license or license renewal or revoke the person's license
or other authorization;
(2) require the person to
submit to the care, counseling, or treatment of a health care practitioner
designated by the board;
(3) stay enforcement of
an order and place the person on probation;
(4) require the person to
complete additional training;
(5) suspend, limit, or
restrict the person's license, including:
(A) limiting the practice
of the person to, or excluding from the practice, one or more specified
activities of the practice as an anesthesiologist assistant; or
(B) stipulating periodic
board review;
(6) assess an
administrative penalty;
(7) order the person to
perform public service; or
(8) administer a public
reprimand.
(b) If the
anesthesiologist assistant board stays enforcement of an order and places a
person on probation, the board retains the right to vacate the probationary
stay and enforce the original order for noncompliance with the terms of
probation or impose any other remedial measure or sanction authorized by
this section.
(c) The anesthesiologist
assistant board may restore or reissue a license or remove any disciplinary
or corrective measure that the board has imposed.
Sec. 207.302. CONDUCT
INDICATING LACK OF FITNESS. The anesthesiologist assistant board may take
action under Section 207.301 against an applicant or license holder who:
(1) uses or unlawfully
possesses a controlled substance or alcoholic beverage to the extent that
the person cannot safely perform as an anesthesiologist assistant;
(2) has been finally
adjudicated and found guilty, or entered a plea of guilty or nolo
contendere, in a criminal prosecution under the laws of any state or of the
United States, for an offense reasonably related to the qualifications,
functions, or duties of an anesthesiologist assistant, for an offense for
which an essential element is fraud, dishonesty, or an act of violence, or
for an offense involving moral turpitude;
(3) has used fraud,
deception, misrepresentation, or bribery in:
(A) securing a
certificate of registration or authority issued under other law, a permit
issued under other law, or a license issued under this chapter; or
(B) obtaining permission
to take an examination given or required under this chapter;
(4) obtains or attempts
to obtain a fee, charge, tuition, or other compensation by fraud,
deception, or misrepresentation;
(5) has acted with
incompetence, misconduct, gross negligence, fraud, misrepresentation, or
dishonesty in the performance of the functions and duties of an
anesthesiologist assistant;
(6) has violated or has
assisted or enabled another person to violate any provision of this chapter
or a rule adopted under this chapter;
(7) has impersonated a
person holding a certificate of registration or authority, permit, or
license, or allowed a person to use a certificate of registration or
authority, permit, license, or diploma from any school;
(8) is subject to
disciplinary action relating to practice as an anesthesiologist assistant by
another state, territory, federal agency, or country on grounds for which
revocation or suspension is also authorized in this state;
(9) has been adjudicated
as mentally incompetent;
(10) assists or enables
another person to practice or offer to practice as an anesthesiologist
assistant if the person is not licensed and currently eligible to practice
under this chapter;
(11) is issued a
certificate of registration or authority under other law, a permit under
other law, or a license under this chapter based on a material mistake of
fact;
(12) violates a
professional trust or confidence; or
(13) violates any ethical
standard for an anesthesiologist assistant as defined by board rule.
Sec. 207.303. PHYSICAL OR
MENTAL EXAMINATION. (a) The anesthesiologist assistant board shall adopt
guidelines, in conjunction with persons interested in or affected by this
section, to enable the board to evaluate circumstances in which an
anesthesiologist assistant or applicant may be required to submit to an
examination for mental or physical health conditions, alcohol and substance
abuse, or professional behavior problems.
(b) The anesthesiologist
assistant board shall refer an anesthesiologist assistant or applicant with
a physical or mental health condition to the most appropriate medical
specialist for evaluation. The board may not require an anesthesiologist
assistant or applicant to submit to an examination by a physician having a
specialty specified by the board unless medically indicated. The board may
not require an anesthesiologist assistant or applicant to submit to an
examination to be conducted an unreasonable distance from the person's home
or place of business unless the anesthesiologist assistant or applicant
resides and works in an area in which there are a limited number of
appropriate medical specialists able to perform an appropriate examination.
(c) The guidelines
adopted under this section do not impair or remove the anesthesiologist
assistant board's power to make an independent licensing decision.
Sec. 207.304. PROTECTION
OF PATIENT IDENTITY. In a disciplinary investigation or proceeding
conducted under this chapter, the anesthesiologist assistant board shall
protect the identity of each patient whose medical records are examined and
used in a public proceeding, unless the patient:
(1) testifies in the
public proceeding; or
(2) submits a written
release with regard to the patient's records or identity.
Sec. 207.305. TEMPORARY
SUSPENSION. (a) The presiding officer of the anesthesiologist assistant
board, with board approval, shall appoint a three-member disciplinary panel
consisting of board members to determine whether a person's license to
practice as an anesthesiologist assistant should be temporarily suspended.
(b) If the disciplinary
panel determines from the evidence or information presented to the panel
that a person licensed to practice as an anesthesiologist assistant would,
by the person's continuation in practice, constitute a continuing threat to
the public welfare, the disciplinary panel shall temporarily suspend the
license of that person.
(c) A license may be
suspended under this section without notice or hearing on the complaint if:
(1) institution of
proceedings for a hearing before the anesthesiologist assistant board is
initiated simultaneously with the temporary suspension; and
(2) a hearing is held
under Chapter 2001, Government Code, and this chapter as soon as possible.
(d) Notwithstanding
Chapter 551, Government Code, the disciplinary panel may hold a meeting by
telephone conference call if immediate action is required and convening the
panel at one location is inconvenient for any member of the panel.
Sec. 207.306. SURRENDER
OF LICENSE. (a) The anesthesiologist assistant board may accept the
voluntary surrender of a license.
(b) A surrendered license
may not be returned to the license holder unless the anesthesiologist
assistant board determines, under board rules, that the former holder of
the license is competent to resume practice.
(c) The anesthesiologist
assistant board by rule shall establish guidelines for determining the
competency of a former license holder to return to practice.
|
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
No
equivalent provision.
|
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SUBCHAPTER H. PENALTIES
AND ENFORCEMENT PROVISIONS
Sec. 207.351.
ADMINISTRATIVE PENALTY. (a) The anesthesiologist assistant board by order
may impose an administrative penalty against a person licensed under this
chapter who violates this chapter or a rule or order adopted under this
chapter.
(b) The penalty may be in
an amount not to exceed $2,000. Each day a violation continues or occurs is
a separate violation for purposes of imposing a penalty.
(c) The anesthesiologist
assistant board shall base the amount of the penalty on:
(1) the severity of
patient harm;
(2) the severity of
economic harm to any person;
(3) the severity of any
environmental harm;
(4) increased potential
for harm to the public;
(5) any attempted
concealment of misconduct;
(6) any premeditated or
intentional misconduct;
(7) the motive for the
violation;
(8) prior misconduct of a
similar or related nature;
(9) the license holder's
disciplinary history;
(10) prior written
warnings or written admonishments from any government agency or official
regarding statutes or regulations relating to the misconduct;
(11) violation of a board
order;
(12) failure to implement
remedial measures to correct or mitigate harm from the misconduct;
(13) lack of
rehabilitative potential or likelihood of future misconduct of a similar
nature;
(14) relevant
circumstances increasing the seriousness of the misconduct; and
(15) any other matter
that justice may require.
(d) The anesthesiologist
assistant board by rule shall prescribe the procedure by which it may
impose an administrative penalty. A proceeding under this section is
subject to Chapter 2001, Government Code.
(e) If the
anesthesiologist assistant board by order determines that a violation has
occurred and imposes an administrative penalty, the board shall give notice
to the person of the board's order. The notice must include a statement of
the person's right to judicial review of the order.
Sec. 207.352. CRIMINAL
PENALTY. (a) A person commits an offense if, without holding a license
issued under this chapter, the person:
(1) represents that the
person is an anesthesiologist assistant;
(2) uses any combination
or abbreviation of the term "anesthesiologist assistant" to
indicate or imply that the person is an anesthesiologist assistant; or
(3) acts as an
anesthesiologist assistant.
(b) An offense under this
section is a felony of the third degree.
Sec. 207.353. CEASE AND
DESIST ORDER. (a) If it appears to the anesthesiologist assistant board
that a person who is not licensed under this chapter is violating this
chapter, a rule adopted under this chapter, or another state statute or
rule relating to anesthesiologist assistant practice, the board after
notice and opportunity for a hearing may issue a cease and desist order
prohibiting the person from engaging in the activity.
(b) A violation of an
order under this section constitutes grounds for imposing an administrative
penalty under this subchapter.
|
No
equivalent provision.
No
equivalent provision.
No
equivalent provision. (But see Sec. 207.152, Occupations Code,
above.)
No
equivalent provision.
|
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SECTION 5. As soon as
practicable after the effective date of this Act, the governor shall
appoint six members to the Texas Anesthesiologist Assistant Board in
accordance with Chapter 207, Occupations Code, as added by this Act. In
making the initial appointments, the governor shall designate two members
for terms expiring January 31, 2017, two members for terms expiring January
31, 2018, and two members for terms expiring January 31, 2019.
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No
equivalent provision.
|
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SECTION 6. Not later than
June 1, 2016, the Texas Medical Board with
the advice of the Texas Anesthesiologist Assistant Board shall adopt
the rules, procedures, and fees necessary to administer Chapter 207,
Occupations Code, as added by this Act.
|
SECTION 2. Not later than
June 1, 2016, the Texas Medical Board shall adopt the rules, procedures,
and fees necessary to administer Chapter 207, Occupations Code, as added by
this Act.
|
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SECTION 7. Notwithstanding
Chapter 207, Occupations Code, as added by this Act, an anesthesiologist
assistant is not required to hold a license under that chapter to practice
as an anesthesiologist assistant in this state before September 1, 2016.
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SECTION 3. Same as introduced
version.
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SECTION 8. (a) Except as
provided by Subsection (b) of this section, this Act takes effect September
1, 2015.
(b) Sections 207.151 and 207.352, Occupations Code, as added by
this Act, take effect September 1, 2016.
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SECTION 4. (a) Except as
provided by Subsection (b) of this section, this Act takes effect September
1, 2015.
(b) Sections 207.054, 207.101, and 207.152, Occupations Code, as added by
this Act, take effect September 1, 2016.
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