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Texas Occupations Code - Section 157.052. Prescribing At Sites Serving Certain Medically Underserved Populations

Legal Research Home > Texas Lawyer > Occupations Code > Texas Occupations Code - Section 157.052. Prescribing At Sites Serving Certain Medically Underserved Populations

§ 157.052. PRESCRIBING AT SITES SERVING CERTAIN MEDICALLY 
UNDERSERVED POPULATIONS.  (a) In this section:
		(1)  "Health manpower shortage area" means:                                   
			(A)  an urban or rural area of this state that:                              
				(i)  is not required to conform to the 
geographic boundaries of a political subdivision but is a rational 
area for the delivery of health service;
				(ii)  the secretary of health and human 
services determines has a health manpower shortage;  and
				(iii)  is not reasonably accessible to an 
adequately served area;         
			(B)  a population group that the secretary of 
health and human services determines has a health manpower 
shortage;  or
			(C)  a public or nonprofit private medical 
facility or other facility that the secretary of health and human 
services determines has a health manpower shortage, as described by 
42 U.S.C. Section 254e(a)(1).
		(2)  "Medically underserved area" means:                                      
			(A)  an area in this state with a medically 
underserved population;        
			(B)  an urban or rural area designated by the 
secretary of health and human services as an area in this state with 
a shortage of personal health services or a population group 
designated by the secretary as having a shortage of those services, 
as described by 42 U.S.C. Section 300e-1(7);  or
			(C)  an area defined as medically underserved by 
rules adopted by the Texas Board of Health based on:
				(i)  demographics specific to this state;                                   
				(ii)  geographic factors that affect access 
to health care;  and          
				(iii)  environmental health factors.                                        
		(3)  "Registered nurse" means a registered nurse 
recognized by the Board of Nurse Examiners as having the 
specialized education and training required under Section 301.152.
		(4)  "Site serving a medically underserved population" 
means:               
			(A)  a site located in a medically underserved 
area;                       
			(B)  a site located in a health manpower shortage 
area;                    
			(C)  a clinic designated as a rural health clinic 
under 42 U.S.C. Section 1395x(aa);
			(D)  a public health clinic or a family planning 
clinic under contract with the Texas Department of Human Services 
or the Texas Department of Health;
			(E)  a site located in an area in which the Texas 
Department of Health determines there is an insufficient number of 
physicians providing services to eligible clients of federal, 
state, or locally funded health care programs;  or
			(F)  a site that the Texas Department of Health 
determines serves a disproportionate number of clients eligible to 
participate in federal, state, or locally funded health care 
programs.
	(b)  After making a determination under this section that a 
site serves a medically underserved population, the Texas 
Department of Health shall publish notice of its determination in 
the Texas Register and provide an opportunity for public comment in 
the manner provided for a proposed rule under Chapter 2001, 
Government Code.
	(c)  At a site serving a medically underserved population, a 
physician licensed by the board may delegate to a registered nurse 
or physician assistant acting under adequate physician supervision 
the act of administering, providing, or carrying out or signing a 
prescription drug order, as authorized by the physician through a 
physician's order, a standing medical order, a standing delegation 
order, or another order or protocol as defined by the board.
	(d)  An advertisement for a site serving a medically 
underserved population must include the name and business address 
of the supervising physician for the site.
	(e)  Physician supervision is adequate for the purposes of 
this section if a delegating physician:
		(1)  is responsible for the formulation or approval of 
the physician's order, standing medical order, standing delegation 
order, or other order or protocol, and periodically reviews the 
order and the services provided patients under the order;
		(2)  is on-site to provide medical direction and 
consultation at least once every 10 business days during which the 
advanced practice nurse or physician assistant is on-site providing 
care;
		(3)  receives a daily status report from the advanced 
practice nurse or physician assistant on any problem or 
complication encountered;  and
		(4)  is available through direct telecommunication for 
consultation, patient referral, or assistance with a medical 
emergency.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 88, § 3, eff. May 20, 2003.

Last modified: August 10, 2007