84R8619 SCL-D
	By: Bell	H.B. No. 1473

	A BILL TO BE ENTITLED
	AN ACT
	relating to the authority of an advanced practice registered nurse
	and a physician assistant 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, an advanced practice registered nurse who is
	licensed to practice advanced nursing in this state, or a physician
	assistant licensed to practice under that license in this state, in
	which it is stated that, in the physician's, nurse's, or physician
	assistant'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, an advanced practice registered nurse who is
	licensed to practice advanced nursing in this state, or a physician
	assistant licensed to practice under that license in this state in
	which it is stated that, in the physician's, nurse's, or physician
	assistant'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, an advanced practice registered nurse who
	is licensed to practice advanced nursing in this state, or a
	physician assistant licensed to practice under that license in this
	state in which it is stated that, in the physician's, nurse's, or
	physician assistant'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, advanced practice registered nurse, or physician
	assistant. The affidavit and physician's, nurse's, or physician
	assistant'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, advanced
	practice registered nurse, or physician assistant 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 Subdivisions (1-a)
	and (7-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.
	(7-a)  "Physician assistant" means an individual who
	holds a license issued under Chapter 204, Occupations 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, an advanced practice registered
	nurse, or a physician assistant 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, an advanced
	practice registered nurse, or a physician assistant 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, an advanced practice
	registered nurse, or a physician assistant.
	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, an advanced
	practice registered nurse, or a physician assistant and the person
	provides to the governing body a certificate signed by the
	attending physician, nurse, or physician assistant 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,
	physician assistant, 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, physician assistant, 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, advanced practice registered nurse, or
	physician assistant 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, advanced practice registered
	nurse, or physician assistant 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, advanced practice
	registered nurse, or physician assistant is unavailable;
	(2)  the attending physician, advanced practice
	registered nurse, or physician assistant 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, an advanced practice registered
	nurse licensed to practice advanced nursing, or a physician
	assistant licensed to practice under that license in this state or
	in a state adjacent to this state or who is authorized by applicable
	law to practice medicine or advanced nursing or as a physician
	assistant, 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,
	an advanced practice registered nurse licensed to practice advanced
	nursing, or a physician assistant licensed to practice under that
	license in this state or a state adjacent to this state, or
	authorized by applicable law to practice medicine or advanced
	nursing or as a physician assistant, 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, advanced practice registered
	nurse's, or physician assistant'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,
	advanced practice registered nurse, or physician assistant
	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, advanced practice registered
	nurse, or physician assistant of the member's choice. The member
	shall pay any costs of or fees for obtaining the physician's,
	nurse's, or physician assistant'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, advanced practice
	registered nurse, or physician assistant; 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, advanced practice registered nurse, or physician
	assistant; 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.