Bill Text: TX HB1185 | 2015-2016 | 84th Legislature | Introduced

---

Bill Title: Relating to the authority of an advanced practice registered nurse to sign or issue certain documents.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2015-03-03 - Referred to Public Health [HB1185 Detail]

Download: Texas-2015-HB1185-Introduced.html

---

84R5930 SCL-D
By: Bell H.B. No. 1185

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 nursing in the United States, in
which it is stated that, in the physician's or 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 nursing in the United States in which
it is stated that, in the physician's or 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 nursing within the United
States in which it is stated that, in the physician's or 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 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 [board] 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 [board]
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 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 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. Sections 193.005(a), (b), and (c), Health and
Safety Code, are amended to read as follows:
(a) A person required to file a death certificate or fetal
death certificate shall obtain the required medical certification
from an attending physician or advanced practice registered nurse
if the death occurred under medical attendance for the care and
treatment of the condition or disease process that contributed to
the death.
(b) The attending physician 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 or advanced practice
registered nurse is unavailable;
(2) the attending physician or advanced practice
registered nurse 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 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 nursing in this state or in a
state adjacent to this state or who is authorized by applicable law
to practice medicine or advanced 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 nursing in this state or a state adjacent to this state, or
authorized by applicable law to practice medicine or advanced
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. 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 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 15. 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 advanced practice
registered nurse; and
(2) a statement of all employment activities pursued
in the preceding year.
SECTION 16. 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 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 17. 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, 2015.