On April 5, Gov. Abbott announced more temporary waivers of regulations on health-related professional licenses to support Texas’ response to the ongoing COVID-19 pandemic.
Emergency licenses. The most recent waiver allows physician assistant (PA), medical physicist, perfusionist, and respiratory care license candidates to obtain emergency medical licenses to work under supervision before passing their final licensing examinations. The waiver also allows name-based background checks, rather than fingerprint checks, for emergency licensees. After the state of disaster declared by the governor on March 13 ends or the emergency license is terminated by the appropriate authority, pending license applicants will return to applicant status.
To support the rapid deployment of health workers in response to COVID-19, the governor’s April 5 order also allows physicians to establish oral, rather than written, prescriptive agreements with the PAs and advanced practice registered nurses (APRNs) they supervise and lifts the requirement to register such agreements with the Texas Medical Board (TMB). A prescriptive authority agreement allows PAs and APRNs to prescribe or order a drug or medical device under physician supervision.
On April 7, Gov. Abbott issued a temporary waiver allowing pharmacy technicians, rather than only pharmacists, to receive oral prescription drug orders and transfer or receive a transfer of original prescription information on behalf of a patient.
License extensions. TMB announced it will automatically extend the expiration dates of licenses and permits and waive continuing education requirements for certain physicians, PAs, surgical assistants, medical physicists, medical radiologic technologists, perfusionists, respiratory care practitioners, and individuals on the Non-Certified Radiologic Technician Registry. These extensions are in place until August 31, 2020.
Retired health professionals. TMB also has expanded on its earlier call for recently retired physicians to come out of retirement to assist the state’s response to COVID-19 by encouraging retired medical radiologic technologists, respiratory care practitioners, and PAs whose licenses have been on official retired status for less than four years to apply for a return to active status.
Previous waivers. In the past month, the governor ordered TMB and the Texas Board of Nursing (TBN) to expedite temporary emergency medical licenses for out-of-state physicians, PAs, and other relevant medical personnel. Previous waivers also granted a six-month grace period for nurses with expired licenses, allowed TBN to issue temporary permits to practice for graduate nurses and graduate vocational nurses who have yet to take the licensing exams, and allowed APRNs with expired licenses to reactivate their licenses without paying fees or completing continuing education or current practice requirements. Additional waivers announced on March 20 and April 2 granted extensions for certain pharmacy licenses and allowed certain EMS personnel who are qualified but lack formal certification to provide critical emergency services.
UPDATE: On April 9, Gov. Abbott and the Health and Human Services Commission (HHSC) announced an emergency rule that temporarily allows nursing facilities to hire nurse aides without requiring them to complete a full certification program in the first four months of employment. The waiver aims to help nursing facilities address potential worker shortages during the COVID-19 pandemic.
On April 11, with the goal of increasing Texas’ health care capacity, the governor issued a waiver temporarily allowing Texas hospitals and medical facilities associated with graduate medical education programs to use holders of physician-in-training permits in areas outside of their relevant training programs.
On April 22, the governor announced a waiver to allow new advanced practiced registered nurse graduates who have applied for licensure with the Texas Board of Nursing and have met all license requirements except passing the test for national certification to practice under the direct supervision of a physician. The waiver does not grant new APRN graduates prescriptive authority.
By Andrew McNair