86R12993 JG-F
 
  By: Stickland H.B. No. 4418
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the authority of an advanced practice registered nurse
  to sign or issue certain documents.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 38.001(c), Education Code, is amended to
  read as follows:
         (c)  Immunization is not required for a person's admission to
  any elementary or secondary school if the person applying for
  admission:
               (1)  submits to the admitting official:
                     (A)  an affidavit or a certificate signed by a
  physician who is duly registered and licensed to practice medicine
  in the United States or an advanced practice registered nurse who is
  licensed to practice advanced practice registered nursing in the
  United States[,] in which it is stated that, in the physician's or
  advanced practice registered nurse's opinion, the immunization
  required poses a significant risk to the health and well-being of
  the applicant or any member of the applicant's family or household;
  or
                     (B)  an affidavit signed by the applicant or, if a
  minor, by the applicant's parent or guardian stating that the
  applicant declines immunization for reasons of conscience,
  including a religious belief; or
               (2)  is a member of the armed forces of the United
  States and is on active duty.
         SECTION 2.  Section 51.9192(d), Education Code, is amended
  to read as follows:
         (d)  A student to whom this section applies or a parent or
  guardian of the student is not required to comply with Subsection
  (c) if the student or a parent or guardian of the student submits to
  the institution:
               (1)  an affidavit or a certificate signed by a
  physician who is duly registered and licensed to practice medicine
  in the United States or an advanced practice registered nurse who is
  licensed to practice advanced practice registered nursing in the
  United States in which it is stated that, in the physician's or
  advanced practice registered nurse's opinion, the vaccination
  required would be injurious to the health and well-being of the
  student; or
               (2)  an affidavit signed by the student stating that
  the student declines the vaccination for bacterial meningitis for
  reasons of conscience, including a religious belief, or
  confirmation that the student has completed the Internet-based
  process described by Subsection (d-3) for declining the vaccination
  on that basis, if applicable to the student.
         SECTION 3.  Section 51.933(d), Education Code, is amended to
  read as follows:
         (d)  No form of immunization is required for a person's
  admission to an institution of higher education if the person
  applying for admission:
               (1)  submits to the admitting official:
                     (A)  an affidavit or a certificate signed by a
  physician who is duly registered and licensed to practice medicine
  within the United States or an advanced practice registered nurse
  who is licensed to practice advanced practice registered nursing in
  the United States in which it is stated that, in the physician's or
  advanced practice registered nurse's opinion, the immunization
  required poses a significant risk to the health and well-being of
  the applicant or any member of the applicant's family or household;
  or
                     (B)  an affidavit signed by the applicant or, if a
  minor, by the applicant's parent or guardian stating that the
  applicant declines immunization for reasons of conscience,
  including a religious belief; or
               (2)  is a member of the armed forces of the United
  States and is on active duty.
         SECTION 4.  Sections 62.109(b) and (f), Government Code, are
  amended to read as follows:
         (b)  A person requesting an exemption under this section must
  submit to the court an affidavit stating the person's name and
  address and the reason for and the duration of the requested
  exemption. A person requesting an exemption due to a physical or
  mental impairment must attach to the affidavit a statement from a
  physician or advanced practice registered nurse. The affidavit and
  physician's or advanced practice registered nurse's statement may
  be submitted to the court at the time the person is summoned for
  jury service or at any other time.
         (f)  An affidavit accompanying a request for an exemption
  from jury service because of a physical or mental impairment may be
  presented by the affiant or by a friend or relative of the affiant.
  The affidavit must state:
               (1)  the name and address of the physician or advanced
  practice registered nurse whose statement accompanies the
  affidavit;
               (2)  whether the request is for a permanent or
  temporary exemption;
               (3)  the period of time for which a temporary exemption
  is requested; and
               (4)  that as a direct result of the physical or mental
  impairment it is impossible or very difficult for the affiant to
  serve on a jury.
         SECTION 5.  Section 89.001, Health and Safety Code, is
  amended by amending Subdivision (1) and adding Subdivision (1-a) to
  read as follows:
               (1)  "Advanced practice registered nurse" has the
  meaning assigned by Section 301.152, Occupations Code.
               (1-a)  "Community corrections facility" means a
  facility established under Chapter 509, Government Code.
         SECTION 6.  Sections 89.011(a), (b), and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The governing body of a jail or community corrections
  facility, through the community supervision and corrections
  department, shall require that each employee or volunteer working
  or providing services in a jail or a community corrections
  facility, who meets the screening guidelines prescribed by
  department rule, present to the governing body a certificate signed
  by a physician or an advanced practice registered nurse that states
  that:
               (1)  the employee or volunteer has been tested for
  tuberculosis infection in accordance with department rules; and
               (2)  the results of the test indicate that the person
  does not have tuberculosis.
         (b)  In lieu of a screening test, an employee or volunteer
  with a history of a positive screening test may provide:
               (1)  documentation of that positive test result and of
  any diagnostic and therapeutic follow-up; and
               (2)  a certificate signed by a physician or an advanced
  practice registered nurse that states that the person does not have
  tuberculosis.
         (d)  An employee or volunteer is exempt from the screening
  test required by this section if:
               (1)  the screening test conflicts with the tenets of an
  organized religion to which the individual belongs; or
               (2)  the screening test is medically contraindicated
  based on an examination by a physician or an advanced practice
  registered nurse.
         SECTION 7.  Section 89.012(b), Health and Safety Code, is
  amended to read as follows:
         (b)  If the employee or volunteer has tuberculosis, the
  governing body may not permit the person to begin or continue the
  person's employment duties or volunteer services unless the person
  is under treatment for the disease by a physician or an advanced
  practice registered nurse and the person provides to the governing
  body a certificate signed by the attending physician or advanced
  practice registered nurse stating that the patient is
  noninfectious.
         SECTION 8.  Sections 192.003(a) and (c), Health and Safety
  Code, are amended to read as follows:
         (a)  The physician, advanced practice registered nurse,
  midwife, or person acting as a midwife in attendance at a birth
  shall file the birth certificate with the local registrar of the
  registration district in which the birth occurs.
         (c)  If there is no physician, advanced practice registered
  nurse, midwife, or person acting as a midwife in attendance at a
  birth and if the birth does not occur in a hospital or birthing
  center, the following in the order listed shall report the birth to
  the local registrar:
               (1)  the father or mother of the child; or
               (2)  the owner or householder of the premises where the
  birth occurs.
         SECTION 9.  Section 408.025, Labor Code, is amended by
  adding Subsection (a-2) to read as follows:
         (a-2)  An advanced practice registered nurse who is licensed
  to practice advanced practice registered nursing in this state may
  complete and sign a report or record that is required to be filed or
  provided under Subsection (a).
         SECTION 10.  Section 504.201(d), Transportation Code, is
  amended to read as follows:
         (d)  Except as provided by Subsection (d-1), the initial
  application for specialty license plates under this section must be
  accompanied by a written statement from a physician [who is]
  licensed to practice medicine or an advanced practice registered
  nurse licensed to practice advanced practice registered nursing in
  this state or in a state adjacent to this state or who is authorized
  by applicable law to practice medicine or advanced practice
  registered nursing, as applicable, in a hospital or other health
  facility of the Department of Veterans Affairs.  If the applicant
  has a mobility problem caused by a disorder of the foot, the written
  statement may be issued by a person licensed to practice podiatry in
  this state or a state adjacent to this state.  In this subsection,
  "podiatry" has the meaning assigned by Section 681.001.  The
  statement must certify that the person making the application or on
  whose behalf the application is made is legally blind or has a
  mobility problem that substantially impairs the person's ability to
  ambulate.  The statement must also certify whether a mobility
  problem is temporary or permanent.  A written statement is not
  required as acceptable medical proof if:
               (1)  the person with a disability:
                     (A)  has had a limb, hand, or foot amputated; or
                     (B)  must use a wheelchair; and
               (2)  the applicant executes a statement attesting to
  the person's disability before the county assessor-collector.
         SECTION 11.  Section 681.003(c), Transportation Code, is
  amended to read as follows:
         (c)  Subject to Subsections (e) and (f), the first
  application must be accompanied by a notarized written statement or
  written prescription of a physician licensed to practice medicine
  or an advanced practice registered nurse licensed to practice
  advanced practice registered nursing in this state or a state
  adjacent to this state, or authorized by applicable law to practice
  medicine or advanced practice registered nursing, as applicable, in
  a hospital or other health facility of the United States Department
  of Veterans Affairs, certifying and providing evidence acceptable
  to the department that the person making the application or on whose
  behalf the application is made is legally blind or has a mobility
  problem that substantially impairs the person's ability to
  ambulate.  The statement or prescription must include a
  certification of whether the disability is temporary or permanent
  and information acceptable to the department to determine the type
  of disabled parking placard for which the applicant is
  eligible.  The department shall determine a person's eligibility
  based on evidence provided by the applicant establishing legal
  blindness or mobility impairment.
         SECTION 12.  Section 681.004(d), Transportation Code, is
  amended to read as follows:
         (d)  A disabled parking placard issued to a person with a
  temporary disability expires after the period set by the department
  and may be renewed at the end of that period if the disability
  remains as evidenced by a physician's or advanced practice
  registered nurse's statement or prescription submitted as required
  for a first application under Section 681.003(c).
         SECTION 13.  Section 14(b), Texas Local Fire Fighters
  Retirement Act (Article 6243e, Vernon's Texas Civil Statutes), is
  amended to read as follows:
         (b)  An application for disability retirement must be filed
  with the board of trustees of the retirement system of which the
  applicant is a member. The application must contain a sworn
  statement of the member's medical condition, signed by a physician
  or advanced practice registered nurse attending the member, and a
  sworn statement of the circumstances under which the disability
  arose, signed by the member or another person who has reason to know
  those circumstances. The application also may contain other
  pertinent information to enable the board to determine whether the
  member is eligible for disability retirement.
         SECTION 14.  The heading to Section 6.06, Chapter 183 (S.B.
  598), Acts of the 64th Legislature, Regular Session, 1975 (Article
  6243e.1, Vernon's Texas Civil Statutes), is amended to read as
  follows:
         Sec. 6.06.  APPLICATION; [PHYSICIAN'S] STATEMENT; MEDICAL
  BOARD ACTION.
         SECTION 15.  Section 6.06(a), Chapter 183 (S.B. 598), Acts
  of the 64th Legislature, Regular Session, 1975 (Article 6243e.1,
  Vernon's Texas Civil Statutes), is amended to read as follows:
         (a)  An application for disability retirement must be
  accompanied by a written statement, on a form approved by the board
  of trustees, signed by a physician or advanced practice registered
  nurse of the member's choice. The member shall pay any costs of or
  fees for obtaining the physician's or advanced practice registered
  nurse's statement and shall file the application and statement with
  the fund. As soon as possible after the application is filed, the
  medical board shall evaluate the medical and other pertinent
  information concerning the member's application.
         SECTION 16.  Section 8(f), Chapter 451 (S.B. 737), Acts of
  the 72nd Legislature, Regular Session, 1991 (Article 6243n,
  Vernon's Texas Civil Statutes), is amended to read as follows:
         (f)  A member receiving a disability retirement allowance
  shall periodically file a report with the retirement board
  concerning continued proof of disability. The retirement board
  shall adopt rules establishing the required supporting information
  to accompany the reports, the content of the reports, and deadlines
  for filing the reports. The report shall include:
               (1)  a current statement of the member's physical or
  mental condition stating the existence of continued disability,
  signed by the member's attending physician or an advanced practice
  registered nurse; and
               (2)  a statement of all employment activities pursued
  in the preceding year.
         SECTION 17.  Section 7.03(a)(1), Chapter 452 (S.B. 738),
  Acts of the 72nd Legislature, Regular Session, 1991 (Article
  6243n-1, Vernon's Texas Civil Statutes), is amended to read as
  follows:
               (1)  A member receiving a disability retirement benefit
  is required to file a report to the board concerning continued proof
  of disability one year after the date on which the board originally
  awarded the member disability retirement. The report shall
  include:
                     (A)  a current statement of the member's physical
  or [and/or] mental condition, signed by the member's attending
  physician or an advanced practice registered nurse; and
                     (B)  a statement of all employment activities
  pursued in the preceding one-year period and a copy of federal
  income tax returns applicable to the one-year period.
         SECTION 18.  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, 2019.