S.B. No. 919

	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.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I hereby certify that S.B. No. 919 passed the Senate on
	May 4, 2017, by the following vote:  Yeas 31, Nays 0.
	______________________________
	Secretary of the Senate
	I hereby certify that S.B. No. 919 passed the House on
	May 24, 2017, by the following vote:  Yeas 144, Nays 2, two
	present not voting.
	______________________________
	Chief Clerk of the House
	Approved:
	______________________________
	Date
	______________________________
	Governor