bill lets podiatrists delegate foot care to advanced practice nurses

The text as introduced · 687 words

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.