Delegated Prescriptive Authority for Scheduled/Controlled Substances
During the 2003 Texas Legislature House Bill 1095 was passed and signed by Governor Perry. This bill provided an important practice option for the Physician-PA team. The bill allows the supervising physician the option to delegate prescriptive authority of scheduled/controlled medications to the PA. The essentials of the bill included:
The supervising physician may:
1. Delegate prescriptive authority to a Physician Assistant for Schedule/Controlled III-V medications;
2. The prescription may be for no more than 30 days;
3. Refills of a scheduled/controlled medication requires consultation with the supervising physician and documentation in the patient’s chart of such consultation;
4. A prescription for a Schedule/Controlled medication to a child less than two years of age requires consultation with the supervising physician and documentation in the patient’s chart of such consultation.
5. The complete text of the bill can be found at the Texas Legislature Online at http://www.capitol.state.tx.us
/. Under “Legislature” click on “Bill Number”. In the search box enter “hb 1095” and select “78th Regular Session – 2003”. You should select the enrolled version of the bill.
Even though the law went into effect with the Governor’s signature in May, the rule making process is still underway at the Texas Medical Board (TMB)/Texas Physician Assistant Board (TPAB). The rules are expected to be posted in the near future and can be accessed at the web site of the TPAB at http://www.tmb.state.tx.us
. Delegation of this authority should not occur until the rules have been approved by the TMB, you have registered with the Texas Department of Safety (DPS), and registered with the Drug Enforcement Administration (DEA).
The process for pursuing delegated prescriptive authority of Scheduled/Controlled substances are as follows:
1. There should be mutual consensus between you and your supervising physician on the delegation of this authority.
2. Your protocol, collaborative practice agreement, etc. should be updated to reflect this new delegation authority.
3. The process first requires that you have prescriptive authority from your supervising physician registered with the TMB/TPAB. The form and instructions for registering supervision and prescriptive delegation are available on the Board web site at www.tmb.state.tx.us
. If you have registered already, you do not need to register again.
4. Next you must obtain an application from the DPS for a Controlled Substance Registration Certificate
. (The DEA will not process your application until the DPS has approved your registration). You can request an application by calling the Austin DPS office at 512-424-2188
or send an e-mail request for an application to email@example.com
. Your request must include your full name, your professional title, mailing address, and a telephone number. The application fee is $25.00. There is no on-line application and the original application and fee must be mailed to the DPS.
This application will require the signature of every supervising physician who will be delegating you prescriptive authority for scheduled/controlled substances. DPS will require you to designate one supervising physician as your primary physician. If you have more than one supervising physician you must decide who will be listed as your primary physician on the certificate.
The application process will require checking the credentials of the PA and each delegating, supervising physician. Be sure the supervising physicians who will be delegating are registered at the TMB as delegating to you prescriptive authority. You can check this by going to the TMB web site for information on health professionals at http://tmb.state.tx.us/page/renewal-useful-informatio
n. DPS is currently reprogramming its application process and the approval of your application may take up to two months at this time. It is anticipated though the process length will be shorter as they perfect the programming.
** Update as of 2014
- You can register for a DPS Controlled Substance Registration Certificate online. https://www.txdps.state.tx.us/rsd/controlledSubstances/index.htm
5. Once you have received your Controlled Substance Registration Certificate by the DPS you will next need to register with the DEA. At this writing the DEA is not processing any applications from Texas PAs and are awaiting guidance and clearance from their main office in Washington. Notification by the DEA of when it will start accepting applications can be found by accessing the DEA web site at www.deadiversion.usdoj.gov/
and clicking on “Hot Items”.
Once the DEA has started accepting applications you can copy an application from the same web site at www.deadiversion.usdoj.gov/
or you can call the Dallas office at 888-336-4704 or Houston office 800-743-0595. The application fee will cost $731.00/3 years (as of 2012) and both the application original and fee must be mailed in. It is anticipated the application process may also take up to 2 months to complete but hopefully less.
If you currently have a DEA number you will not have to apply for a new number. You still must register with DPS for a Controlled Substance Registration Certificate. At this writing it is advised not to start writing prescriptions for scheduled medications until all the above processes have been accomplished and the DEA has approved clearance for Texas PAs to register. Doing so before all the above mechanisms are in place could result in penalties.
6. The important message at this point is to please be patient while this new law and regulatory processes are worked out.
To check on the status of the TMB rule-making process and for contact information you can check the TSBME web site at http://www.tmb.state.tx.us/
This document and any updates will be posted on the TAPA web site at http://www.tapa.org/
. This notice is provided as a service by the Texas Academy of Physician Assistants.