Texas HB80

[Hope2PA]

https://legiscan.com/TX/bill/HB80/2019

i understand there is currently not much push or support for doctorate level PA, however, why be left out as a profession when a state is looking into helping financially with programs to increase educated professionals. The NPs are right on top of this bill that includes most, if not all medically related professionals that currently have MS or have moved to doctorate.......that's all except PA"s. I started to put this on Texas site, but some of you out there may know members of Texas PA associations. Even if not in agreement with doctorate, why leave out those that may want to pursue advanced degree????

 

[wdtpac]

Interesting... I’d be lying if I told you my blood isn’t boiling that we are not on the list. 

“If you’re not at the table, you’re on the menu.”

[sas5814]

*sigh* TAPA is aware of it but I haven't heard any comments about it.

[Joelseff]

*sigh* TAPA is aware of it but I haven't heard any comments about it.

How is TAPA doing from a PA advocacy standpoint?

From what I read here and have been told by PA colleagues from Texas, they are pretty passive.

Sent from my SAMSUNG-SM-G891A using Tapatalk

[Cideous]

25 minutes ago, Joelseff said:

How is TAPA doing from a PA advocacy standpoint?

From what I read here and have been told by PA colleagues from Texas, they are pretty passive.

Sent from my SAMSUNG-SM-G891A using Tapatalk
 

Passive?  More like complicit.  I sometimes wonder if they are on the payroll of the TMA.....

[sas5814]

They have historically been very cozy and, in my opinion afraid of, the physicians. They have occasionally done some things that were just stupid. I am hopeful they are starting to assert themselves some but it will be a process un-doing 20+ years of subserviance to the physicians.

I had some good talks with their leadership at the recent TAPA conference but I'm waiting to see some movement. I remain cautiously optomistic.

[Guest Paula]

TAPA should oppose and get TMA to oppose unless PAs are included.  

[fishbum]

Apparently the people who have the power to affect change do buy in to the idea that the doctoral degree matters. This, in spite of how useless, redundant, awkward-sounding, or extortive it might sound to those of us in a position to really know.  

There might be a lesson there.

[Cideous]

Yes, I want to be a Doctor of Physician Assistant....... LOL.  Errr no.

[Hope2PA]

Doctor of Physician Assistant studies sounds almost worse than Physician Assistant for the profession. However the point is being left out,  yet again! 

It may sound or seam stupid now, may not be so in future. Just like NP independence leaving PAs in dust, it’s harder to jump on a speeding train than one stopped at the station calling for all aboard.

 

[NeoTrion]

TAPA has put these bill forward for consideration.  

HB 2250 (Lucio III)- Schedule II bill (Senate companion- SB 1308 by Buckingham)
HB 3970 (Sheffield)- Mental Health recognition
HB 3128 (Price)- Concussion forms (Senate companion is forthcoming from Perry)
HB 4066 (Beckley)- PA Practice Management
HB 2907 (Darby)- Delegation of radiology interpretation and diagnosis (PAs will be included in committee substitute)

TAPA is also supporting SB919 and companion bill HB1592.  

Feel free to take a look at these bills on the Texas web site.

I know SAS has run for office, but it is easy to complain about things when your not part of the solution.  Run for office or ask for placement on a  committee and make your voice heard.  I think why there isn't much support for HB80 is because a large amount of PAs do not want to support what they see as degree creep.  We have our share just on this board.

 

[Hope2PA]

5 hours ago, NeoTrion said:

TAPA has put these bill forward for consideration.  

HB 2250 (Lucio III)- Schedule II bill (Senate companion- SB 1308 by Buckingham)
HB 3970 (Sheffield)- Mental Health recognition
HB 3128 (Price)- Concussion forms (Senate companion is forthcoming from Perry)
HB 4066 (Beckley)- PA Practice Management
HB 2907 (Darby)- Delegation of radiology interpretation and diagnosis (PAs will be included in committee substitute)

TAPA is also supporting SB919 and companion bill HB1592.  

Feel free to take a look at these bills on the Texas web site.

I know SAS has run for office, but it is easy to complain about things when your not part of the solution.  Run for office or ask for placement on a  committee and make your voice heard.  I think why there isn't much support for HB80 is because a large amount of PAs do not want to support what they see as degree creep.  We have our share just on this board.

 

Agree, don't complain if you don't want to take action. I have assisted with state  working group. Called, emailed, written letters or met with more than 50 state and federal legislative members. I am not in Texas and don't really know anyone from there. I am  not really complaining,  just providing info on something I read and would be contacting people if it were my state.

PA's may not "like" the idea of degree creep, few professions have. Yet, there is not one(that I'm aware of), previously Master degree program in a health related field, that has not or is not moving toward doctorate. I'd say SLP slowest because so many working in public schools. Meanwhile PA Master degree requirements are pretty close to equal most of those doctorates.

How many PA's didn't "like" the idea of more independence and wanted to stay closely bound to physicians while NP's pushed forward? We can see where that has gotten the profession, scrambling to catch up! 

 

[Cideous]

^^^ Lord retirement please come soon!, LOL

[fireguy]

On 3/17/2019 at 1:51 PM, NeoTrion said:

TAPA has put these bill forward for consideration.  

HB 2250 (Lucio III)- Schedule II bill (Senate companion- SB 1308 by Buckingham)
HB 3970 (Sheffield)- Mental Health recognition
HB 3128 (Price)- Concussion forms (Senate companion is forthcoming from Perry)
HB 4066 (Beckley)- PA Practice Management
HB 2907 (Darby)- Delegation of radiology interpretation and diagnosis (PAs will be included in committee substitute)

TAPA is also supporting SB919 and companion bill HB1592.  

Feel free to take a look at these bills on the Texas web site.

I know SAS has run for office, but it is easy to complain about things when your not part of the solution.  Run for office or ask for placement on a  committee and make your voice heard.  I think why there isn't much support for HB80 is because a large amount of PAs do not want to support what they see as degree creep.  We have our share just on this board.

 

If TAPA put forth HB2907 then someone is seriously dropping the ball...

 

"

BILL TO BE ENTITLED
	AN ACT
	relating to a physician's order or protocol delegating certain
	radiologic procedures to certain health care providers.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Subchapter B, Chapter 157, Occupations Code, is
	amended by adding Section 157.0551 to read as follows:
	Sec. 157.0551.  ORDERS AND PROTOCOLS: CERTAIN RADIOLOGIC
	PROCEDURES. Notwithstanding any other law, a physician may
	delegate by an order, medical order, standing delegation order, or
	another order or protocol authority for an advanced practice
	registered nurse to:
	(1)  read and interpret radiological studies; and
	(2)  render diagnoses based on radiological studies.
	SECTION 2.  This Act takes effect September 1, 2019."

[Hope2PA]

I do not believe legislatures really understand what is included in many bills they pass, but why the hell would TAPA support  HB2907! Should be fighting to get PA’s included! Are they planning on waiting, like has been done with independence, thinking they can add it on in the future? Good luck Texas PA’s, with support for bills like this, will there be much of a future? Hopefully, it is an oversight that will be amended before continuing to proceed.

[Rondaben]

A little background on HB2907.

At the end of Jan/First of March the TMB put forth a proposed rule that would prevent PAs from reading, interpreting, or making a diagnosis on the basis of radiological studies.  Effectively you could order the study but had to wait on a physician to provide a read before you could legally act on the study.   Rediculous, yes.  There was no clear determination of who was behind the rule proposal and the TMB essentially shelved it due to pushback.
 

Rep Darby was informed of this and submitted HB2907.  TAPA was NOT involved with this particular piece of legislation but does support it.  It restores the current language allowing PAs to interpret and make a diagnosis based on radiological studies.  Why it is important is that if it is set forth in legislation--like this--it preempts regulatory rule making by the TMB.  It protects the current scope of practice and prevents arbitrarily taking away something PAs have been doing for more than 50 years.   

The proposed TMB rule was 193.5.  The relevant section of the TMB proposal is below--and you will be able to see what HB2907 does in context:
 

(c) Any physician authorizing standing delegation orders or standing medical orders which authorize the exercise of independent medical judgment or treatment shall be subject to having his or her license to practice medicine in the State of Texas revoked or suspended under §§164.001, 164.052, and 164.053 of the Act. §193.21.Delegation Related to Radiological Services.

(a) A physician may delegate the performance of radiological procedures to properly trained midlevel providers, certified radiological technologists (MRT and LMRT), or non-certified radiological technologists (NCT).

(b) The delegation under this section must be under a physician's order, medical order, standing delegation order, prescriptive authority agreement, or protocol.

(c) The administering or providing of radiological services under this section shall comply with other applicable laws.

(d) The following acts have been determined to be the practice of medicine under the authority of the Act, §157.001(b)(1), and cannot be delegated to a midlevel provider, certified radiological technologist (MRT and LMRT), or non-certified radiological technologist (NCT):

(1) the reading and interpretation of the radiological studies; and

(2) rendering a diagnosis based on the radiological studies.

[Guest Paula]

So you are saying the parts in BOLD are deleted and the non bolded areas will be the legislation? 

It's good for Texas PAs to maintain their ability to read and interpret and act on radiological studies.

Texas still needs full force OTP as it looks like PAs are still considered mid-level providers and TMB looks like they are pretty old-school. 

I think Texas should go for independence practice like North Dakota just achieved in their OTP bill.

 

 

[Rondaben]

193.5 was a proposed regulation.  The problematic parts of the proposal are in bold.   Essentially they made it impossible to delegate the reading, interpretation and rendering of diagnosis something that could NOT be delegated--thereby taking away PAs ability to use those tests in practice.  

Darby's HB 2907 essentially reiterates the EXISTING language allowing us to do those things.  Because it would be passed as a law, it would prevent the TMB from putting forth a regulation that contradicted it.  This would protect the current ability of PAs to use radiological procedures as we do currently.

Texas is at a crossroads in many respects.  There is a huge battle every legislative session between the NPs and the TMA.  Right now the TMA has the upper hand but they are lashing out against the NPs.  I suspect 193.5 was one of those attempts.  The problem is that due to the language in the Occupations Code that governs our scope of practice there is no distinction between NPs and PAs.  

[Cideous]

It's true.  Texas sees us in an identical light as NP's.  Anything coming their way bad will hit us.

[Hope2PA]

14 hours ago, Rondaben said:

193.5 was a proposed regulation.  The problematic parts of the proposal are in bold.   Essentially they made it impossible to delegate the reading, interpretation and rendering of diagnosis something that could NOT be delegated--thereby taking away PAs ability to use those tests in practice.  

Darby's HB 2907 essentially reiterates the EXISTING language allowing us to do those things.  Because it would be passed as a law, it would prevent the TMB from putting forth a regulation that contradicted it.  This would protect the current ability of PAs to use radiological procedures as we do currently.

Texas is at a crossroads in many respects.  There is a huge battle every legislative session between the NPs and the TMA.  Right now the TMA has the upper hand but they are lashing out against the NPs.  I suspect 193.5 was one of those attempts.  The problem is that due to the language in the Occupations Code that governs our scope of practice there is no distinction between NPs and PAs.  

If there is no distinction, why does Darby’s proposal list NP instead of APP or NP/PA. I’m or was skeptical when it specifically stated one and not other. 

[sas5814]

Interestingly when the NPs try something that is good for them they make sure they are the only ones included in the language. There could be some valid reasons for that including not presuming to include another profession in things they are proposing. Mostly I think they are just looking out for themselves. It would be nice if we could work together on something OTP-like but they are after independence so collaboration seems unlikely.

A session or 2 ago they tried to make a simple change. They wanted to amend the practice act we share to remove all mention of supervision only as it applies to NPs. It was clever and simple. You read the proposed amendment and it just drew red lines through every mention of NPs. It was kinda funny...but bold.

 

[Hope2PA]

I still do not understand!, what am I missing?, HB 2907 does NOT mention PA, only NP.  Rondoben said there is no distinction in Tx. between NP and PA, yet sas5818 stated that NP tried to strike themselves from supervision,  Which suggests there is a difference. So why are PA’s not listed in Darby’s HB2907? Looks like it will only help NP.  

[sas5814]

The striking from supervision was an unsuccessful attempt a few years back. We are in the same practice act and anything that effects one of us applies to both of us. 

They have tried for many years to make different moves for independence but so far without any luck. For now we are joined at the hip.

[Rondaben]

Sorry Hope2PA, just got online.  Darby's original bill text did only include NPs.  PAs were included in the committee substitute version of the bill that is not available until it is voted out of committee.   The bill under consideration in the committee includes both NP and PAs.

I should have included that.  Apologies.

[KpsPac]

On 3/11/2019 at 9:13 PM, Paula said:

TAPA should oppose and get TMA to oppose unless PAs are included.  

Would be nice.  Fingers crossed that will actually happen ( with TAPA I mean) .......