89R971 JTZ-F     By: Cunningham H.B. No. 5274       A BILL TO BE ENTITLED   AN ACT   relating to the licensing and regulation of anesthesiologist   assistants; requiring an occupational license; providing an   administrative penalty; authorizing fees.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subtitle C, Title 3, Occupations Code, is   amended by adding Chapter 207 to read as follows:   CHAPTER 207. ANESTHESIOLOGIST ASSISTANTS   SUBCHAPTER A. GENERAL PROVISIONS          Sec. 207.001.  SHORT TITLE. This chapter may be cited as the   Anesthesiologist Assistant Licensing Act.          Sec. 207.002.  DEFINITIONS. In this chapter:                (1)  "Anesthesiologist" means a physician who:                      (A)  holds a license in good standing issued by   the medical board under Subtitle B;                      (B)  is certified in anesthesiology by:                            (i)  the American Board of Physician   Specialties;                            (ii)  the American Osteopathic Board of   Anesthesiology; or                            (iii)  a certifying board recognized by the   medical board; and                      (C)  has a medical practice in which the physician   regularly practices anesthesiology.                (2)  "Anesthesiologist assistant" means a person who   holds a license issued under this chapter.                (3)  "Anesthesiologist assistant board" means the   Texas Anesthesiologist Assistant Board.                (4)  "Medical board" means the Texas Medical Board.                (5)  "Practice as an anesthesiologist assistant" means   personally performing a medical task delegated to the person by a   supervising anesthesiologist.          Sec. 207.003.  APPLICABILITY. (a) A person is not required   to hold a license issued under this chapter to practice as:                (1)  a technician, assistant, or employee of a   physician who performs delegated tasks but does not act as an   anesthesiologist assistant or represent that the person is an   anesthesiologist assistant; or                (2)  any other licensed health care worker acting   within the scope of that person's license if the person:                      (A)  does not use the title "anesthesiologist   assistant" or the initials "C.A.A." or "A.A."; or                      (B)  is not represented or designated as an   anesthesiologist assistant.          (b)  This chapter does not limit the employment arrangement   of an anesthesiologist assistant licensed under this chapter.   SUBCHAPTER B. TEXAS ANESTHESIOLOGIST ASSISTANT BOARD          Sec. 207.051.  ANESTHESIOLOGIST ASSISTANT BOARD. (a) The   Texas Anesthesiologist Assistant Board is an advisory board to the   medical board.          (b)  Chapter 2110, Government Code, does not apply to the   anesthesiologist assistant board.          Sec. 207.052.  APPOINTMENT OF BOARD. (a)  The   anesthesiologist assistant board consists of five members   appointed by the president of the medical board as follows:                (1)  two anesthesiologist assistants;                (2)  two anesthesiologists;  and                (3)  one member who represents the public and is not   licensed or trained in a health care profession.          (b)  Appointments to the anesthesiologist assistant board   shall be made without regard to the race, color, disability, sex,   religion, age, or national origin of the appointee.          Sec. 207.053.  TERMS; VACANCIES. (a)  Members of the   anesthesiologist assistant board are appointed for staggered   six-year terms.  The terms of one or two members, as appropriate,   expire on February 1 of each odd-numbered year.          (b)  A member may not serve more than:                (1)  two consecutive full terms; or                (2)  a total of three full terms.          (c)  If a vacancy occurs during a member's term, the   president of the medical board shall appoint a new member to serve   the unexpired term.          Sec. 207.054.  OFFICERS.  The president of the medical board   shall designate an anesthesiologist assistant member of the   anesthesiologist assistant board as the presiding officer of the   board to serve in that capacity at the will of the president.  The   anesthesiologist assistant board shall select from its membership a   secretary to serve a one-year term.          Sec. 207.055.  GROUNDS FOR REMOVAL. (a) It is a ground for   removal from the anesthesiologist assistant board that a member:                (1)  does not have at the time of taking office the   qualifications required by Section 207.052;                (2)  does not maintain during service on the   anesthesiologist assistant board the qualifications required by   Section 207.052;                (3)  cannot, because of illness or disability,   discharge the member's duties for a substantial part of the member's   term; or                (4)  is absent from more than half of the regularly   scheduled anesthesiologist assistant board meetings that the   member is eligible to attend during a calendar year without an   excuse approved by a majority vote of the board.          (b)  The validity of an action of the anesthesiologist   assistant board is not affected by the fact that it is taken when a   ground for removal of a board member exists.          (c)  If the executive director of the medical board has   knowledge that a potential ground for removal exists, the executive   director shall notify the presiding officer of the anesthesiologist   assistant board of the potential ground.  If the potential ground   for removal involves the presiding officer, the executive director   shall notify the next highest ranking officer of the   anesthesiologist assistant board, who shall then notify the   president of the medical board that a potential ground for removal   exists.          Sec. 207.056.  COMPENSATION; REIMBURSEMENT OF EXPENSES.  A   member of the anesthesiologist assistant board may not receive   compensation but is entitled to reimbursement for actual and   necessary expenses incurred in performing the functions of the   board, subject to the General Appropriations Act.          Sec. 207.057.  OPEN MEETINGS; ADMINISTRATIVE PROCEDURE LAW.   Except as otherwise provided by this chapter, the anesthesiologist   assistant board is subject to Chapters 551 and 2001, Government   Code.          Sec. 207.058.  TRAINING. (a) A person who is appointed to   and qualifies for office as a member of the anesthesiologist   assistant board may not vote, deliberate, or be counted as a member   in attendance at a meeting of the board until the person completes a   training program that complies with this section.          (b)  The training program must provide the person with   information regarding:                (1)  the law governing anesthesiologist assistant   board operations;                (2)  the programs, functions, rules, and budget of the   anesthesiologist assistant board;                (3)  the scope of and limitations on the rulemaking   authority of the anesthesiologist assistant board;                (4)  the results of the most recent formal audit of the   anesthesiologist assistant board;                (5)  the requirements of:                      (A)  laws relating to open meetings, public   information, administrative procedure, and disclosing conflicts of   interest; and                      (B)  other laws applicable to members of the   anesthesiologist assistant board in performing their duties; and                (6)  any applicable ethics policies adopted by the   anesthesiologist assistant board or the Texas Ethics Commission.          (c)  A person appointed to the anesthesiologist assistant   board is entitled to reimbursement, as provided by the General   Appropriations Act, for the travel expenses incurred in attending   the training program regardless of whether the attendance at the   program occurs before or after the person qualifies for office.          (d)  The executive director of the medical board shall create   a training manual that includes the information required by   Subsection (b).  The executive director shall distribute a copy of   the training manual annually to each anesthesiologist assistant   board member.  On receipt of the training manual, each board member   shall sign and submit to the executive director a statement   acknowledging receipt of the training manual.   SUBCHAPTER C. POWERS AND DUTIES OF ANESTHESIOLOGIST ASSISTANT BOARD   AND MEDICAL BOARD          Sec. 207.101.  GENERAL POWERS AND DUTIES OF ANESTHESIOLOGIST   ASSISTANT BOARD; MEDICAL BOARD APPROVAL. (a)  The anesthesiologist   assistant board shall adopt rules that are reasonable and necessary   for the performance of the anesthesiologist assistant board's   duties under this chapter, as provided by Chapter 2001, Government   Code, including rules to establish:                (1)  licensing, renewal, and other fees;                (2)  license renewal dates; and                (3)  procedures for disciplinary actions.          (b)  The medical board, by a majority vote, shall approve or   reject each rule adopted by the anesthesiologist assistant board.   If approved, the rule may take effect. If the rule is rejected, the   medical board shall return the rule to the anesthesiologist   assistant board for revision.          Sec. 207.102.  GUIDELINES FOR EARLY INVOLVEMENT IN   RULEMAKING PROCESS. (a) The anesthesiologist assistant board   shall adopt guidelines to establish procedures for receiving input   during the rulemaking process from individuals and groups that have   an interest in matters under the anesthesiologist assistant board's   jurisdiction. The guidelines must provide an opportunity for those   individuals and groups to provide input before the anesthesiologist   assistant board submits the rule to the medical board for approval.          (b)  A rule adopted or approved by the medical board may not   be challenged on the grounds that the anesthesiologist assistant   board did not comply with this section. If the anesthesiologist   assistant board was unable to solicit a significant amount of input   from the public or affected persons early in the rulemaking   process, the anesthesiologist assistant board shall state in   writing the reasons why the anesthesiologist assistant board was   unable to do so.          Sec. 207.103.  POWERS AND DUTIES OF MEDICAL BOARD RELATING   TO ANESTHESIOLOGIST ASSISTANTS. (a) The medical board shall   administer and enforce this chapter.          (b)  The medical board shall adopt rules consistent with this   chapter to regulate anesthesiologist assistants and   anesthesiologists who supervise anesthesiologist assistants.          (c)  The rules adopted by the medical board must include a   requirement that:                (1)  an anesthesiologist assistant assist only an   anesthesiologist who is:                      (A)  physically present in the facility where the   anesthesiologist assistant is performing a medical task delegated   by the anesthesiologist; and                      (B)  able to respond to a medically emergent issue   arising from the delegated medical task;                (2)  a supervising anesthesiologist supervise an   anesthesiologist assistant in a manner consistent with the   requirements for reimbursement of anesthesia services under   Medicaid and Medicare, as applicable; and                (3)  an anesthesiologist assistant shall maintain   compliance with all continuing medical education requirements   adopted under Section 207.157 and the recertification requirements   of the National Commission for Certification of Anesthesiologist   Assistants or its successor organization.          Sec. 207.104.  FEES. The anesthesiologist assistant board   shall set fees in amounts that are reasonable and necessary to cover   the costs of administering and enforcing this chapter without the   use of any other funds generated by the medical board.          Sec. 207.105.  RULES ON CONSEQUENCES OF CRIMINAL CONVICTION.   The anesthesiologist assistant board shall adopt rules and   guidelines as necessary to comply with Chapter 53, except to the   extent the requirements of this chapter are stricter than the   requirements of Chapter 53.          Sec. 207.106.  COMPLAINTS. The medical board shall maintain   a system to promptly and efficiently act on complaints filed with   the medical board regarding anesthesiologist assistants.  The   medical board shall maintain:                (1)  information about the parties to the complaint and   the subject matter of the complaint;                (2)  a summary of the results of the review or   investigation of the complaint; and                (3)  information about the disposition of the   complaint.   SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL          Sec. 207.151.  LICENSE REQUIRED. (a)  A person may not   practice as an anesthesiologist assistant in this state unless the   person holds an anesthesiologist assistant license issued under   this chapter.          (b)  A person may not use the title "anesthesiologist   assistant" or "certified anesthesiologist assistant" or the   initials "C.A.A." or "A.A." or represent that the person is an   anesthesiologist assistant unless the person holds a license issued   under this chapter.          Sec. 207.152.  ISSUANCE OF LICENSE. The medical board shall   issue a license to an applicant who:                (1)  meets the eligibility requirements of Section   207.153;                (2)  submits an application on a form prescribed by the   board;                (3)  pays the required application and licensing fees;   and                (4)  submits to the board any other information the   board considers necessary to evaluate the applicant's   qualifications.          Sec. 207.153.  ELIGIBILITY REQUIREMENTS. To be eligible for   a license under this chapter, an applicant must:                (1)  submit proof of completion of a graduate level   training program accredited by the Commission on Accreditation of   Allied Health Education Programs or its successor organization;                (2)  pass a certifying examination administered by the   National Commission for Certification of Anesthesiologist   Assistants or its successor organization not later than the first   anniversary of the date of completion of the training program   required under Subdivision (1);                (3)  submit proof of current certification from the   National Commission for Certification of Anesthesiologist   Assistants or its successor organization; and                (4)  meet any additional qualifications adopted by rule   by the anesthesiologist assistant board.          Sec. 207.154.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall   require that an applicant for a license submit a complete and   legible set of fingerprints, on a form prescribed by the medical   board, to the medical board or to the Department of Public Safety   for the purpose of obtaining criminal history record information   from the Department of Public Safety and the Federal Bureau of   Investigation.          (b)  The medical board may not issue a license to a person who   does not comply with the requirement of Subsection (a).          (c)  The medical board shall conduct a criminal history   record information check of each applicant for a license using   information:                (1)  provided by the individual under this section; and                (2)  made available to the medical board by the   Department of Public Safety, the Federal Bureau of Investigation,   and any other criminal justice agency under Chapter 411, Government   Code.          (d)  The medical board may:                (1)  enter into an agreement with the Department of   Public Safety to administer a criminal history record information   check required under this section; and                (2)  authorize the Department of Public Safety to   collect from each applicant the costs incurred by the Department of   Public Safety in conducting the criminal history record information   check.          Sec. 207.155.  EXEMPTIONS FROM LICENSING REQUIREMENT FOR   CERTAIN ANESTHESIOLOGIST ASSISTANTS. A person is not required to   hold a license issued under this chapter to practice as an   anesthesiologist assistant student enrolled in an anesthesiologist   assistant educational program accredited by the Commission on   Accreditation of Allied Health Education Programs or its successor   organization.          Sec. 207.156.  LICENSE RENEWAL. (a) A license issued under   this chapter is valid for a term of two or more years, as determined   by anesthesiologist assistant board rule.          (b)  On notification from the medical board, a person who   holds a license under this chapter may renew the license by:                (1)  paying the required renewal fee;                (2)  submitting the appropriate form; and                (3)  meeting any other requirement established by   anesthesiologist assistant board rule.          (c)  The anesthesiologist assistant board by rule may adopt a   system under which licenses expire on various dates during the   year.          (d)  A person who is otherwise eligible to renew a license   may renew an unexpired license by paying the required renewal fee to   the medical board before the expiration date of the license.  A   person whose license has expired may not engage in activities that   require a license until the license has been renewed.          (e)  A person whose license is expired may renew the license   by paying to the medical board a fee that is equal to 1-1/2 times the   renewal fee for the license.          Sec. 207.157.  CONTINUING MEDICAL EDUCATION REQUIREMENTS.   The medical board by rule shall adopt, monitor, and enforce a   reporting program for the continuing medical education of   anesthesiologist assistants.  The medical board shall adopt and   administer rules that:                (1)  establish the number of hours of continuing   medical education the medical board determines appropriate as a   prerequisite to the renewal of a license under this chapter;                (2)  require at least one-half of the hours of   continuing medical education established under Subdivision (1) to   be approved by the medical board; and                (3)  adopt a process to assess an anesthesiologist   assistant's participation in continuing medical education courses.          Sec. 207.158.  REFUSAL FOR VIOLATION OF BOARD ORDER.  The   medical board may refuse to renew a license issued under this   chapter if the license holder is in violation of a medical board   order.   SUBCHAPTER E. PRACTICE BY LICENSE HOLDER          Sec. 207.201.  NOTICE OF INTENT TO PRACTICE. Before   beginning practice, each anesthesiologist assistant licensed under   this chapter must submit on a form prescribed by the   anesthesiologist assistant board notice of the license holder's   intent to practice. The notice must include the name, business   address, license number, and telephone number of the   anesthesiologist assistant.          Sec. 207.202.  SCOPE OF PRACTICE. (a)  An anesthesiologist   assistant may assist the supervising anesthesiologist and perform   duties delegated by the supervising anesthesiologist, including   the development and implementation of a patient's anesthesia care   plan that is consistent with the rules adopted under this chapter.          (b)  An anesthesiologist assistant who assists an   anesthesiologist is not considered to be engaged in the practice of   medicine.          (c)  This chapter does not limit or expand the scope of   practice of a physician assistant.          Sec. 207.203.  NAME TAG. A person acting within the scope of   a license issued under this chapter shall wear a name tag   identifying the person as an anesthesiologist assistant.          Sec. 207.204.  IDENTIFICATION OF STUDENT. A student in an   anesthesiologist assistant training program shall be identified as   a student anesthesiologist assistant or an anesthesiologist   assistant student. A student may not use or permit to be used on the   student's behalf the term "intern," "resident," or "fellow," or   another term that identifies the student as a physician or surgeon.   SUBCHAPTER F. ENFORCEMENT          Sec. 207.251.  ADMINISTRATIVE PENALTY. (a) The medical   board by order may impose an administrative penalty against a   person who violates this chapter or a rule or order adopted under   this chapter.          (b)  The medical board shall impose the penalty in the same   manner and using the same procedures as Subchapter A, Chapter 165.          SECTION 2.  Section 411.12510(a), Government Code, is   amended to read as follows:          (a)  The Texas Medical Board is entitled to obtain criminal   history record information as provided by Subsection (b) that   relates to a person who is:                (1)  an applicant for or holder of a license to practice   medicine;                (2)  an applicant for or holder of a license to practice   as a physician assistant;                (3)  an applicant for or holder of a license to practice   as an acupuncturist;                (4)  an applicant for or holder of a certificate to   practice as an acudetox specialist;                (5)  an applicant for or holder of a license to practice   as a surgical assistant;                (6)  an applicant for or holder of a general   certificate to perform radiologic procedures, limited certificate   to perform radiologic procedures only on specific parts of the   body, or radiologist assistant certificate;                (7)  an applicant for or holder of a placement on the   registry of noncertified technicians;                (8)  an employee of an applicant for a hardship   exemption;                (9)  an applicant for or holder of a license to practice   as a medical physicist;                (10)  an applicant for or holder of a license to   practice as a perfusionist;                (11)  an applicant for or holder of a license to   practice as a respiratory care practitioner; [and]                (12)  an applicant for or holder of a pain management   clinic certificate; and                (13)  an applicant for or holder of a license to   practice as an anesthesiologist assistant.          SECTION 3.  (a)  As soon as practicable after the effective   date of this Act, the president of the Texas Medical Board shall   appoint five members to the Texas Anesthesiologist Assistant Board   in accordance with Chapter 207, Occupations Code, as added by this   Act. In making the initial appointments, the president of the Texas   Medical Board shall designate two members for terms expiring   January 31, 2027, two members for terms expiring January 31, 2029,   and one member for a term expiring January 31, 2031.          (b)  Notwithstanding Section 207.052(a), Occupations Code,   as added by this Act, a person practicing as an anesthesiologist   assistant is eligible for appointment as an initial member of the   Texas Anesthesiologist Assistant Board regardless of whether the   person holds an anesthesiologist assistant license issued under   Chapter 207, Occupations Code, as added by this Act.          SECTION 4.  Not later than June 1, 2026, the Texas Medical   Board with the advice of the Texas Anesthesiologist Assistant Board   shall adopt the rules, procedures, and fees necessary to administer   Chapter 207, Occupations Code, as added by this Act.          SECTION 5.  Notwithstanding Chapter 207, Occupations Code,   as added by this Act, an anesthesiologist assistant is not required   to hold a license under that chapter to practice as an   anesthesiologist assistant in this state before September 1, 2026.          SECTION 6.  (a)  Except as provided by Subsection (b) of this   section, this Act takes effect September 1, 2025.          (b)  Section 207.151 and Subchapter F, Chapter 207,   Occupations Code, as added by this Act, take effect September 1,   2026.