85R5248 JG-F     By: Rodríguez S.B. No. 431       A BILL TO BE ENTITLED   AN ACT   relating to the authority of an advanced practice registered nurse   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 or an advanced practice registered nurse who is   licensed to practice advanced practice registered nursing in the   United States[,] in which it is stated that, in the physician's or   advanced practice registered nurse'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 or an advanced practice registered nurse who is   licensed to practice advanced practice registered nursing in the   United States in which it is stated that, in the physician's or   advanced practice registered nurse'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 or an advanced practice registered nurse   who is licensed to practice advanced practice registered nursing in   the United States in which it is stated that, in the physician's or   advanced practice registered nurse'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 or advanced practice registered nurse. The affidavit and   physician's or advanced practice registered nurse'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 or advanced   practice registered nurse 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 Subdivision (1-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.          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 rule, present to the governing body a certificate signed   by a physician or an advanced practice registered nurse that states   that:                (1)  the employee or volunteer has been tested for   tuberculosis infection in accordance with department 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 or an advanced   practice registered nurse 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 or an advanced practice   registered nurse.          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 or an advanced   practice registered nurse and the person provides to the governing   body a certificate signed by the attending physician or advanced   practice registered nurse 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,   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, 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 or advanced practice registered nurse   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 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 or advanced practice   registered nurse is unavailable;                (2)  the attending physician or advanced practice   registered nurse 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 408.025, Labor Code, is amended by   adding Subsection (a-1) to read as follows:          (a-1)  An advanced practice registered nurse who is licensed   to practice advanced practice registered nursing in this state may   complete and sign a report or record that is required to be filed or   provided under Subsection (a).          SECTION 11.  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 or an advanced practice registered   nurse licensed to practice advanced practice registered nursing in   this state or in a state adjacent to this state or who is authorized   by applicable law to practice medicine or advanced practice   registered nursing, 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 12.  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   or an advanced practice registered nurse licensed to practice   advanced practice registered nursing in this state or a state   adjacent to this state, or authorized by applicable law to practice   medicine or advanced practice registered nursing, 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 13.  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 or advanced practice   registered nurse's statement or prescription submitted as required   for a first application under Section 681.003(c).          SECTION 14.  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   or advanced practice registered nurse 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 15.  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 or advanced practice registered   nurse of the member's choice. The member shall pay any costs of or   fees for obtaining the physician's or advanced practice registered   nurse'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 16.  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 or an advanced practice   registered nurse; and                (2)  a statement of all employment activities pursued   in the preceding year.          SECTION 17.  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 or an advanced practice registered nurse; 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 18.  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.