89R12406 AND-F     By: Hinojosa of Hidalgo S.B. No. 2669       A BILL TO BE ENTITLED   AN ACT   relating to the authority of a podiatrist to delegate certain   podiatric medical acts to an advanced practice registered nurse.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Chapter 202, Occupations Code, is amended by   adding Subchapter H-1 to read as follows:   SUBCHAPTER H-1. DELEGATION OF CERTAIN PODIATRIC MEDICAL ACTS          Sec. 202.371.  DEFINITIONS. In this subchapter:                (1)  "Advanced practice registered nurse" has the   meaning assigned by Section 301.152.                (2)  "Minor procedure" means a procedure typically   performed in an office setting and not requiring the use of   medication or treatment other than local anesthesia.                (3)  "Nursing board" means the Texas Board of Nursing.                (4)  "Prescriptive authority agreement" means an   agreement entered into by a podiatrist and an advanced practice   registered nurse through which the podiatrist delegates to the   advanced practice registered nurse the act of prescribing or   ordering a drug or device.          Sec. 202.372.  DELEGATION OF CERTAIN PODIATRIC MEDICAL ACTS.   (a) A supervising podiatrist may delegate to a qualified and   properly trained podiatric medical assistant or advanced practice   registered nurse any podiatric medical act that a reasonable and   prudent podiatrist would find within the scope of sound medical   judgment to delegate if:                (1)  in the opinion of the delegating podiatrist, the   act:                      (A)  can be properly and safely performed by the   podiatric medical assistant or advanced practice registered nurse   to whom the act is delegated; and                      (B)  is performed in a customary manner and not in   violation of any other statute; and                (2)  the podiatric medical assistant or advanced   practice registered nurse to whom the act is delegated does not   represent to the public that the person is authorized to practice   podiatry.          (b)  A delegating podiatrist is responsible for a podiatric   medical act performed by the podiatric medical assistant or   advanced practice registered nurse to whom the podiatrist delegates   the act.          (c)  The department may determine whether:                (1)  an act constitutes the practice of podiatric   medicine; and                (2)  a podiatric medical act may be properly or safely   delegated by podiatrists.          Sec. 202.373.  DELEGATIONS TO ADVANCED PRACTICE REGISTERED   NURSE. (a) A podiatrist may delegate to an advanced practice   registered nurse the performance of any podiatric medical act   within the scope of practice of the advanced practice registered   nurse.  The performance of a delegated act must be consistent with   this chapter, rules adopted by the commission or nursing board, and   any written protocol adopted by the podiatrist consistent with   commission or nursing board rules.          (b)  The commission shall adopt rules providing that an   advanced practice registered nurse may, without the presence of a   supervising podiatrist:                (1)  conduct office visits with patients, including the   performance of minor procedures;                (2)  oversee clinic operations; and                (3)  conduct preoperative and postoperative   assessments and medication management.          (c)  A podiatrist delegating to an advanced practice   registered nurse shall, consistent with nursing board rules,   cooperate with the advanced practice registered nurse in the   development and review of written protocols for the provision of   podiatric medical care.          Sec. 202.374.  PRESCRIPTIVE AUTHORITY AGREEMENTS. (a) The   commission shall adopt rules establishing requirements for a   prescriptive authority agreement.  The rules may require a   podiatrist who delegates the prescribing or ordering of a drug or   device to register with the department the name and license number   of any advanced practice registered nurse to whom the delegation is   made.  The department may develop and use an electronic online   delegation registration process for registration under this   subsection.          (b)  The rules adopted under Subsection (a) must be at least   as stringent as the requirements for a delegation by a physician   under Chapter 157.          Sec. 202.375.  LIABILITY FOR DELEGATED ACTS. Unless the   podiatrist has reason to believe the advanced practice registered   nurse lacked the competency to perform the act, a podiatrist is not   liable for an act of an advanced practice registered nurse solely   because the podiatrist entered into a prescriptive authority   agreement authorizing the advanced practice registered nurse to   administer, provide, prescribe, or order a drug or device.          SECTION 2.  Section 202.354, Occupations Code, is repealed.          SECTION 3.  This Act takes effect September 1, 2025.