A physician may delegate certain controlled-substance administration or provision for obstetrical care to qualifying physician assistants or nurse midwives, subject to specified orders, monitoring, labeling, and scope limits.
Sec. 157.059. DELEGATION REGARDING CERTAIN OBSTETRICAL SERVICES. (a) In this section, "provide" means to supply, for a term not to exceed 48 hours, one or more unit doses of a controlled substance for the immediate needs of a patient. (b) A physician may delegate to a physician assistant offering obstetrical services and certified by the board as specializing in obstetrics or an advanced practice registered nurse recognized by the Texas Board of Nursing as a nurse midwife the act of administering or providing controlled substances to the physician assistant's or nurse midwife's clients during intrapartum and immediate postpartum care. (c) The physician may not delegate: (1) the use of a prescription sticker or the use or issuance of an official prescription form; or (2) the authority to issue an electronic prescription under Section 481.075, Health and Safety Code. (d) The delegation of authority to administer or provide controlled substances under Subsection (b) must be under a physician's order, medical order, standing delegation order, prescriptive authority agreement, or protocol that requires adequate and documented availability for access to medical care. (e) The physician's orders, medical orders, standing delegation orders, prescriptive authority agreements, or protocols must require the reporting of or monitoring of each client's progress, including complications of pregnancy and delivery and the administration and provision of controlled substances by the nurse midwife or physician assistant to the clients of the nurse midwife or physician assistant. (f) The authority of a physician to delegate under this section is limited to: (1) seven nurse midwives or physician assistants or their full-time equivalents; and (2) the designated facility at which the nurse midwife or physician assistant provides care. (g) The controlled substance must be supplied in a suitable container that is labeled in compliance with the applicable drug laws and must include: (1) the patient's name and address; (2) the drug to be provided; (3) the name, address, and telephone number of the physician; (4) the name, address, and telephone number of the nurse midwife or physician assistant; and (5) the date. (h) This section does not authorize a physician, physician assistant, or nurse midwife to operate a retail pharmacy as defined under Subtitle J. (i) This section authorizes a physician to delegate the act of administering or providing a controlled substance to a nurse midwife or physician assistant but does not require physician delegation of: (1) further acts to a nurse midwife; or (2) the administration of medications by a physician assistant or registered nurse other than as provided by this section. (j) This section does not limit the authority of a physician to delegate the prescribing or ordering of a controlled substance under this subchapter. Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2003, 78th Leg., ch. 88, Sec. 7, eff. May 20, 2003. Amended by: Acts 2007, 80th Leg., R.S., Ch. 889 (H.B. 2426), Sec. 33, eff. September 1, 2007. Acts 2009, 81st Leg., R.S., Ch. 746 (S.B. 532), Sec. 6, eff. September 1, 2009. Acts 2011, 82nd Leg., R.S., Ch. 1228 (S.B. 594), Sec. 7, eff. September 1, 2011. Acts 2013, 83rd Leg., R.S., Ch. 418 (S.B. 406), Sec. 8, eff. November 1, 2013.