LBB Fiscal Note Summary. No significant fiscal implication to the State is anticipated.
Bill Summary. The bill addresses the prescribing and ordering of Schedule II controlled substances by certain advanced practice registered nurses and physician assistants. (House Public Health Committee, April 24th.)
Representative Coleman (for Representative Lucio) explained the bill. He stated that these bills have been heard before. The basis for this legislation is prescription restrictions for Physician Assistants and Advanced Practice Nurses related to Schedule II substances. The restrictions decrease access to care. This bill allows physicians to delegate the authority for prescribing Schedule II substances to PAs/APNs. Rep. Coleman stated that he has carried this bill before.
TESTIMONY.
Sharon Hillgartner, representing herself and Texas Nurse Practitioners testified in support of the bill. She stated that she works at the Texas Presbyterian Hospital where they provide joint and spine care. The inability of APNs to prescribe Schedule II drugs severely impacts the post-surgery care that patients receive. Patients are often in different locations, which can prevent physicians from being immediately present and able to address their needs. Medication needs can change and currently, physicians have to be present in order to prescribe. Patient care and discharge is being delayed because of the inability to access medication timely.
Dianne Lavin representing herself, Texas Nurse Practitioners, and others testified in support of the bill. She stated Texas law prohibits PAs/APNs from prescribing Schedule II substances, while 42 other states allow it. This has an adverse impact on care for people with behavioral health problems. There are 73 counties without a psychiatrist and many more counties have shortages in manpower. This Bill would help people with ADHD and other conditions.
Representative Frank asked about the length of time after an APN saw a child that they would prescribe ADHD medication. She replied that they would meet one to two times, but they also conduct very thorough evaluations and use input from the school districts.
Autumn Spencer, Ascension Seton and others testified in support of the bill. She clarified the difference between ordering a prescription and prescribing. Ordering medication occurs routinely by PAs/APNs in a facility. They cannot, however, prescribe the same medication for discharge and filling at a local pharmacy.
Representative Coleman closed on the bill. He stated that TMA is presently in support of the bill. Hospital teams understand where health care is going. Physician supervision is what makes this Bill work, moving forward. Patient discharge is a big issue for hospitals.
The bill was left pending on April 24th.
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