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Seal of the Senate of the State of Texas
Welcome to the official website for the
Texas Senate
Senator Jane Nelson: District 12
Senator Jane Nelson
P.O. Box 12068, State Capitol
Austin, Texas 78711
Tel. (512) 463-0112
News Release
February 6, 2013
Contact: Megan Hanson
Chris Steinbach

AUSTIN — Texas State Senator Jane Nelson, R- Flower Mound, and Representative Lois Kolkhorst, R-Brenham, today filed legislation to improve access to health care by making it easier for physicians, advanced practice nurses, and physician assistants to work together to deliver services. The legislation was filed after weeks of discussions led to an agreement between Texas nurses, physicians and physician assistants.

"One of my goals this session is to increase access to health care, and to do that we must take a three-pronged approach. First, we must increase the number of primary care physicians in Texas. Second, we must ensure we adequately fund residency slots. Third, we need to allow our most highly trained nurses and physician assistants to deliver care that can be responsibly and safely delegated to them by our physicians. Our success in expanding access to care this session depends on the success of all three objectives," said Senator Nelson, Chairman of the Senate Committee on Health and Human Services.

"Texas is famous for solving tough challenges in its own way, and this is a great example. Members of the House and Senate sat down with stakeholders at all levels to find a workable solution. Hopefully we'll see a policy shift that expands care to more Texans in a way that's both safe and sensible," said Rep. Kolkhorst, Chair of the House Committee on Public Health.

SB 406 expands access to health care by:

  • Eliminating current site-based supervision requirements and creating a standardized "prescriptive authority agreement" through which a physician may delegate the authority to prescribe and order a drug or device to an advanced practice registered nurse (APRN) or a physician assistant (PA);
  • Increasing the number of APRNs and PAs a physician may delegate to from four to seven;
  • Ensuring patient safety by improving communication and coordination between the Medical Board, Board of Nursing, and Physician Assistant Board regarding physicians, APRNs and PAs who have entered into prescriptive authority agreements; and
  • Allowing physicians to delegate prescriptive authority for Schedule II controlled substances to APRNs and PAs in hospitals and hospice.

"Through their efforts, Texas patients will have better access to more efficient, high-quality, team-based medical care, which will ensure patients get the right care, at the right time, in the right place, and from the right health care provider," said Texas Medical Association President Michael E. Speer, MD. "Their bills establish a more collaborative, delegated practice that allows members of the health care team to practice to their level of education and training. Physicians, nurse practitioners, and physician assistants are natural partners in the delivery of appropriate and compassionate patient care. These bills strengthen that partnership."

"Given our changing demographics, projected physician shortages, and the rapid increase in people becoming eligible for health care, Senator Nelson's and Representative Kolkhorst's proposed legislation will allow APRNs to help fill the need for quality health care practitioners," said Melanie Dossey, RN, CNM, Chair of the Coalition for Nurses in Advanced Practice. "The Coalition for Nurses in Advanced Practice, Texas Nurses Association, Texas Nurse Practitioners, and Texas Association of Nurse Anesthetists commend these efforts."

"The Texas Academy of Physician Assistants is eager to continue team- based medicine under the newly revised laws outlined in this bill as health care changes across the nation. Revisions to current law, like this bill, will impact patient care and access for all," said TAPA President Lauren Dobbs PA-C.