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AN ACT
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relating to the authority of an advanced practice registered nurse |
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or physician assistant to sign a death certificate in limited |
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situations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 193.005, Health and Safety Code, is |
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amended by amending Subsections (a), (b), and (c) and adding |
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Subsection (a-1) to read as follows: |
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(a) A person required to file a death certificate or fetal |
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death certificate shall obtain the required medical certification |
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from the decedent's [an] attending physician, or, subject to |
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Subsection (a-1), a physician assistant or advanced practice |
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registered nurse of the decedent, if the death occurred under |
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[medical attendance for] the care of the person in connection with |
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the [and] treatment of the condition or disease process that |
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contributed to the death. |
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(a-1) A physician assistant or advanced practice registered |
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nurse may only complete the medical certification for a death |
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certificate or fetal death certificate under this section if: |
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(1) a patient who has executed a written certification |
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of a terminal illness has elected to receive hospice care and is |
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receiving hospice services, as defined under Chapter 142, from a |
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qualified hospice provider; or |
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(2) a patient is receiving palliative care. |
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(b) The attending physician, physician assistant, or |
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advanced practice registered nurse shall complete the medical |
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certification not later than five days after receiving the death |
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certificate. |
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(c) An associate physician, the chief medical officer of the |
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institution where the death occurred, or the physician who |
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performed an autopsy on the decedent may complete the medical |
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certification if: |
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(1) the attending physician, the physician assistant, |
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and the advanced practice registered nurse described by Subsection |
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(a) are [is] unavailable; |
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(2) the attending physician, the physician assistant, |
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or the advanced practice registered nurse described by Subsection |
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(a) approves; and |
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(3) the person completing the medical certification |
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has access to the medical history of the case and the death is due to |
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natural causes. |
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SECTION 2. Section 671.001(d), Health and Safety Code, is |
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amended to read as follows: |
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(d) A registered nurse, including an advanced practice |
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registered nurse, or physician assistant may determine and |
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pronounce a person dead in situations other than those described by |
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Subsection (b) if permitted by written policies of a licensed |
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health care facility, institution, or entity providing services to |
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that person. Those policies must include physician assistants who |
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are credentialed or otherwise permitted to practice at the |
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facility, institution, or entity. If the facility, institution, or |
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entity has an organized nursing staff and an organized medical |
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staff or medical consultant, the nursing staff and medical staff or |
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consultant shall jointly develop and approve those policies. The |
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executive commissioner of the Health and Human Services Commission |
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shall adopt rules to govern policies for facilities, institutions, |
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or entities that do not have organized nursing staffs and organized |
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medical staffs or medical consultants. |
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SECTION 3. Section 671.002(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) A physician who determines death in accordance with |
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Section 671.001(b) or a registered nurse, including an advanced |
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practice registered nurse, or physician assistant who determines |
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death in accordance with Section 671.001(d) is not liable for civil |
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damages or subject to criminal prosecution for the physician's, |
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registered nurse's, or physician assistant's actions or the actions |
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of others based on the determination of death. |
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SECTION 4. 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, 2017. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 919 passed the Senate on |
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May 4, 2017, by the following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 919 passed the House on |
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May 24, 2017, by the following vote: Yeas 144, Nays 2, two |
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present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |