Bill Text: TX HB2525 | 2017-2018 | 85th Legislature | Comm Sub


Bill Title: Relating to the regulation of physician assistants and anesthesiologist assistants.

Spectrum: Partisan Bill (Republican 3-0)

Status: (Introduced) 2017-05-02 - Committee report sent to Calendars [HB2525 Detail]

Download: Texas-2017-HB2525-Comm_Sub.html
  85R21304 JCG-D
 
  By: Zerwas, Oliverson, Parker H.B. No. 2525
 
  Substitute the following for H.B. No. 2525:
 
  By:  Hernandez C.S.H.B. No. 2525
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the regulation of physician assistants and
  anesthesiologist assistants.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 204, Occupations Code, is
  amended by adding Section 204.060 to read as follows:
         Sec. 204.060.  ANESTHESIOLOGIST ASSISTANT ADVISORY
  COMMITTEE. (a)  The anesthesiologist assistant advisory committee
  consists of seven members appointed by the presiding officer of the
  physician assistant board.
         (b)  The committee consists of:
               (1)  four anesthesiologist assistants; and
               (2)  three physician anesthesiologists.
         (c)  The committee members serve:
               (1)  at the will of the presiding officer of the
  physician assistant board; and
               (2)  without compensation or reimbursement for
  expenses incurred in the performance of duties as a committee
  member.
         (d)  The committee shall:
               (1)  meet at the call of the presiding officer of the
  physician assistant board; and
               (2)  provide recommendations to the physician
  assistant board on matters related to the regulation of
  anesthesiologist assistants as requested by the presiding officer
  of the physician assistant board.
         SECTION 2.  The heading to Section 204.102, Occupations
  Code, is amended to read as follows:
         Sec. 204.102.  POWERS AND DUTIES OF MEDICAL BOARD RELATING
  TO PHYSICIAN ASSISTANTS AND ANESTHESIOLOGIST ASSISTANTS.
         SECTION 3.  Section 204.102(a), Occupations Code, is amended
  to read as follows:
         (a)  The medical board shall adopt rules consistent with this
  chapter to regulate:
               (1)  physician assistants;
               (2)  [and] physicians who supervise physician
  assistants;
               (3)  anesthesiologist assistants; and
               (4)  physician anesthesiologists who supervise
  anesthesiologist assistants.
         SECTION 4.  Section 204.151, Occupations Code, is amended to
  read as follows:
         Sec. 204.151.  LICENSE REQUIRED; EXCEPTION. (a) A person
  may not practice as a physician assistant in this state unless the
  person holds a physician assistant license issued under this
  chapter.
         (b)  An anesthesiologist assistant is not required to obtain
  a license under this chapter and may practice as an
  anesthesiologist assistant under the delegated authority of a
  licensed physician. 
         SECTION 5.  Section 204.152(a), Occupations Code, is amended
  to read as follows:
         (a)  The physician assistant board shall issue a physician
  assistant or anesthesiologist assistant license to an applicant
  who:
               (1)  meets the eligibility requirements of Section
  204.153 or 204.1535, as applicable;
               (2)  submits an application on a form prescribed by the
  board;
               (3)  pays the required application fee;
               (4)  certifies that the applicant is mentally and
  physically able to function safely as a physician assistant; and
               (5)  submits to the board any other information the
  board considers necessary to evaluate the applicant's
  qualifications.
         SECTION 6.  The heading to Section 204.153, Occupations
  Code, is amended to read as follows:
         Sec. 204.153.  ELIGIBILITY REQUIREMENTS FOR PHYSICIAN
  ASSISTANT LICENSE.
         SECTION 7.  Section 204.153(a), Occupations Code, is amended
  to read as follows:
         (a)  To be eligible for a physician assistant license under
  this chapter, an applicant must:
               (1)  successfully complete an educational program for
  physician assistants or surgeon assistants accredited by the
  Accreditation Review Commission on Education for the Physician
  Assistant [Committee on Allied Health Education and Accreditation]
  or by that commission's [committee's] predecessor or successor
  entities;
               (2)  pass the Physician Assistant National Certifying
  Examination administered by the National Commission on
  Certification of Physician Assistants or the commission's
  successor entity;
               (3)  hold a certificate issued by the National
  Commission on Certification of Physician Assistants or the
  commission's successor entity;
               (4)  be of good moral character;
               (5)  meet any other requirement established by
  physician assistant board rule; and
               (6)  pass a jurisprudence examination approved by the
  physician assistant board as provided by Subsection (a-1).
         SECTION 8.  Subchapter D, Chapter 204, Occupations Code, is
  amended by adding Section 204.1535 to read as follows:
         Sec. 204.1535.  ELIGIBILITY REQUIREMENTS FOR
  ANESTHESIOLOGIST ASSISTANT LICENSE. To be eligible for an
  anesthesiologist assistant license under this chapter, an
  applicant must:
               (1)  successfully complete an educational program for
  anesthesiologist assistants accredited by the Commission on
  Accreditation of Allied Health Education Programs or by that
  commission's predecessor or successor entities;
               (2)  pass the Certifying Examination for
  Anesthesiologist Assistants administered by the National
  Commission for Certification of Anesthesiologist Assistants or the
  commission's successor entity;
               (3)  hold a certificate issued by the National
  Commission for Certification of Anesthesiologist Assistants or the
  commission's successor entity;
               (4)  be of good moral character;
               (5)  meet any other requirement established by
  physician assistant board rule; and
               (6)  pass a jurisprudence examination approved by the
  physician assistant board that is comparable to the examination
  under Section 204.153(a-1).
         SECTION 9.  Section 204.201, Occupations Code, is amended to
  read as follows:
         Sec. 204.201.  NOTICE OF INTENT TO PRACTICE. (a) Before
  beginning practice, each person [physician assistant] licensed
  under this chapter shall submit on a form prescribed by the
  physician assistant board notice of the license holder's intent to
  practice. The notice must include:
               (1)  the name, business address, license number, and
  telephone number of the license holder [physician assistant]; and
               (2)  the name, business address, Texas license number,
  and telephone number of the license holder's [physician
  assistant's] supervising physician or supervising physician
  anesthesiologist, as applicable.
         (b)  A license holder [physician assistant] shall notify the
  physician assistant board of any change in, or addition to, the
  person acting as a supervising physician or supervising physician
  anesthesiologist, as applicable, [for the physician assistant] not
  later than the 30th day after the date the change or addition
  occurs.
         SECTION 10.  The heading to Section 204.202, Occupations
  Code, is amended to read as follows:
         Sec. 204.202.  SCOPE OF PRACTICE FOR PHYSICIAN ASSISTANT.
         SECTION 11.  Subchapter E, Chapter 204, Occupations Code, is
  amended by adding Section 204.2025 to read as follows:
         Sec. 204.2025.  SCOPE OF PRACTICE FOR ANESTHESIOLOGIST
  ASSISTANT. (a) The practice of an anesthesiologist assistant
  includes providing medical services delegated by a supervising
  physician anesthesiologist that are within the education,
  training, and experience of the anesthesiologist assistant.
         (b)  Medical services provided by an anesthesiologist
  assistant may include:
               (1)  obtaining an appropriate and accurate
  pre-anesthetic health history; 
               (2)  performing an appropriate physical examination
  and recording pertinent information in an organized and legible
  manner;
               (3)  performing diagnostic laboratory and related
  studies as appropriate, including drawing arterial and venous blood
  samples;
               (4)  performing the insertion of invasive monitoring
  modalities, including transesophageal echocardiography probes,
  arterial lines, pulmonary artery catheters, and central venous
  lines, as delegated by the supervising physician anesthesiologist;
               (5)  administering anesthetic agents and controlled
  substances, including administering induction agents, maintaining
  and altering anesthesia levels, administering adjunctive
  treatments, and providing continuity of anesthetic care into and
  during the post-operative recovery period;
               (6)  establishing airway interventions and performing
  ventilation support;
               (7)  applying, performing, and interpreting advanced
  monitoring techniques;
               (8)  using advanced life support techniques, including
  high frequency ventilation and intra-arterial cardiovascular
  assist devices;
               (9)  monitoring patients after the administration of
  anesthesia by recording patient progress notes, compiling and
  recording case summaries, and transcribing standing and specific
  orders;
               (10)  evaluating and treating life-threatening
  situations, including performing cardiopulmonary resuscitation, on
  the basis of established protocols, including basic life support,
  advanced cardiac life support, and pediatric advanced life support
  protocols; and
               (11)  performing duties in intensive care units, pain
  clinics, and other settings, as delegated by the supervising
  physician anesthesiologist. 
         SECTION 12.  Section 204.204, Occupations Code, is amended
  by adding Subsection (d) to read as follows:
         (d)  An anesthesiologist assistant must be supervised by a
  supervising physician anesthesiologist in the same manner that a
  physician assistant is supervised by a supervising physician under
  Subsections (a), (b), and (c), except that during the provision of
  any anesthesia service by an anesthesiologist assistant, the
  supervising physician anesthesiologist shall maintain a physical
  proximity that enables the supervising physician anesthesiologist
  to be immediately available if needed.
         SECTION 13.  As soon as practicable after the effective date
  of this Act, the presiding officer of the Texas Physician Assistant
  Board shall appoint seven members to the anesthesiologist assistant
  advisory committee in accordance with Section 204.060, Occupations
  Code, as added by this Act.
         SECTION 14.  (a) Sections 204.152 and 204.153, Occupations
  Code, as amended by this Act, and Section 204.1535, Occupations
  Code, as added by this Act, apply only to an application for a
  license submitted to the Texas Physician Assistant Board on or
  after the effective date of this Act.  An application submitted
  before the effective date of this Act is governed by the law in
  effect on the date the application was submitted, and the former law
  is continued in effect for that purpose.
         (b)  As soon as practicable after the effective date of this
  Act, the Texas Physician Assistant Board or Texas Medical Board, as
  appropriate, shall adopt rules necessary to implement the changes
  in law made by this Act to Chapter 204, Occupations Code.
         SECTION 15.  This Act takes effect September 1, 2017.
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