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A BILL TO BE ENTITLED
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AN ACT
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relating to the prescribing and ordering of Schedule II controlled |
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substances by certain advanced practice registered nurses and |
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physician assistants. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 157.0511, Occupations Code, is amended |
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by amending Subsections (b) and (b-1) and adding Subsections (b-3), |
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(b-4), and (d) to read as follows: |
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(b) Except as provided by Subsections [Subsection] (b-1) |
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and (b-3), a physician may delegate the prescribing or ordering of a |
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controlled substance only if: |
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(1) the prescription is for a controlled substance |
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listed in Schedule III, IV, or V as established by the commissioner |
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of state health services [the Department of State Health Services] |
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under Chapter 481, Health and Safety Code; |
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(2) the prescription, including refills [a refill] of |
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the prescription, is for a period not to exceed 90 days; |
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(3) with regard to the refill of a prescription, the |
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refill is authorized after consultation with the delegating |
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physician and the consultation is noted in the patient's chart; and |
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(4) with regard to a prescription for a child less than |
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two years of age, the prescription is made after consultation with |
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the delegating physician and the consultation is noted in the |
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patient's chart. |
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(b-1) A physician may delegate the prescribing or ordering |
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of a controlled substance listed in Schedule II as established by |
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the commissioner of state health services [the Department of State
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Health Services] under Chapter 481, Health and Safety Code, only: |
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(1) in a hospital facility-based practice under |
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Section 157.054, in accordance with policies approved by the |
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hospital's medical staff or a committee of the hospital's medical |
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staff as provided by the hospital bylaws to ensure patient safety, |
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and as part of the care, including discharge prescriptions, |
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provided to a patient who: |
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(A) has been admitted to the hospital for an |
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intended length of stay of 24 hours or greater; or |
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(B) is receiving services in the emergency |
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department of the hospital; [or] |
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(2) as part of the plan of care for the treatment of a |
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person who has executed a written certification of a terminal |
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illness, has elected to receive hospice care, and is receiving |
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hospice treatment from a qualified hospice provider; |
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(3) as part of the plan of care for the treatment of a |
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person receiving palliative care; or |
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(4) as part of the plan of care for the treatment of a |
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person with a disorder defined in the Diagnostic and Statistical |
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Manual of Mental Disorders, 5th Edition, or a subsequent edition, |
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to an advanced practice registered nurse authorized by the Texas |
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Board of Nursing to practice as a psychiatric mental health |
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advanced practice registered nurse or a physician assistant |
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recognized by the Texas Physician Assistant Board as specializing |
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in psychiatric or mental health care. |
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(b-3) A physician may delegate the prescribing or ordering |
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of a controlled substance listed in Schedule II as established by |
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the commissioner of state health services under Chapter 481, Health |
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and Safety Code, if the physician was able to delegate the |
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prescribing or ordering of that controlled substance on November 1, |
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2013, because on that date the controlled substance was listed in |
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Schedule III, IV, or V. |
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(b-4) A prescription or order issued by an advanced practice |
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registered nurse or a physician assistant under Subsection (b), |
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(b-1), or (b-3) may be filled by any pharmacy that may fill the |
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prescription or order if prescribed or ordered by the delegating |
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physician. |
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(d) For purposes of this section, "palliative care" means a |
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form of care that: |
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(1) is person-centered and family-focused; |
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(2) provides a patient with relief from the symptoms, |
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pain, and stress of a serious illness; |
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(3) ensures an additional layer of support to a |
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patient during the treatment of a serious illness; and |
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(4) is appropriate for a patient of any age and at any |
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stage of a serious illness. |
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SECTION 2. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2015. |