By: Rodríguez S.B. No. 919
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the authority of an advanced practice registered nurse
  or physician assistant to sign a death certificate in limited
  situations.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 193.005, Health and Safety Code, is
  amended by amending Subsections (a), (b), and (c) and adding
  Subsection (a-1) to read as follows:
         (a)  A person required to file a death certificate or fetal
  death certificate shall obtain the required medical certification
  from the decedent's [an] attending physician, or, subject to
  Subsection (a-1), a physician assistant or advanced practice
  registered nurse of the decedent, if the death occurred under
  [medical attendance for] the care of the person in connection with
  the [and] treatment of the condition or disease process that
  contributed to the death.
         (a-1)  A physician assistant or advanced practice registered
  nurse may only complete the medical certification for a death
  certificate or fetal death certificate under this section if:
               (1)  a patient who has executed a written certification
  of a terminal illness has elected to receive hospice care and is
  receiving hospice services, as defined under Chapter 142, from a
  qualified hospice provider; or
               (2)  a patient is receiving palliative care.
         (b)  The attending physician, physician assistant, or
  advanced practice registered nurse shall complete the medical
  certification not later than five days after receiving the death
  certificate.
         (c)  An associate physician, the chief medical officer of the
  institution where the death occurred, or the physician who
  performed an autopsy on the decedent may complete the medical
  certification if:
               (1)  the attending physician, the physician assistant,
  and the advanced practice registered nurse described by Subsection
  (a) are [is] unavailable;
               (2)  the attending physician, the physician assistant,
  or the advanced practice registered nurse described by Subsection
  (a) approves; and
               (3)  the person completing the medical certification
  has access to the medical history of the case and the death is due to
  natural causes.
         SECTION 2.  Section 671.001(d), Health and Safety Code, is
  amended to read as follows:
         (d)  A registered nurse, including an advanced practice
  registered nurse, or physician assistant may determine and
  pronounce a person dead in situations other than those described by
  Subsection (b) if permitted by written policies of a licensed
  health care facility, institution, or entity providing services to
  that person.  Those policies must include physician assistants who
  are credentialed or otherwise permitted to practice at the
  facility, institution, or entity.  If the facility, institution, or
  entity has an organized nursing staff and an organized medical
  staff or medical consultant, the nursing staff and medical staff or
  consultant shall jointly develop and approve those policies.  The
  executive commissioner of the Health and Human Services Commission
  shall adopt rules to govern policies for facilities, institutions,
  or entities that do not have organized nursing staffs and organized
  medical staffs or medical consultants.
         SECTION 3.  Section 671.002(a), Health and Safety Code, is
  amended to read as follows:
         (a)  A physician who determines death in accordance with
  Section 671.001(b) or a registered nurse, including an advanced
  practice registered nurse, or physician assistant who determines
  death in accordance with Section 671.001(d) is not liable for civil
  damages or subject to criminal prosecution for the physician's,
  registered nurse's, or physician assistant's actions or the actions
  of others based on the determination of death.
         SECTION 4.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2017.