Relating to the authority of a podiatrist to delegate certain podiatric medical acts to an advanced practice registered nurse.
SB 2669 would expand the ability of a podiatrist to delegate certain podiatric medical acts to an advanced practice registered nurse (APRN). It creates a new subchapter in the Occupations Code defining key terms such as “minor procedure” and “prescriptive authority agreement,” and authorizes a supervising podiatrist to delegate podiatric medical acts to a properly trained podiatric medical assistant or APRN when the podiatrist believes the act can be safely performed and is within sound medical judgment. The bill also specifies that the delegated person may not hold themselves out as authorized to practice podiatry, and that the delegating podiatrist remains responsible for the delegated act.
For APRNs specifically, the bill allows delegation of any podiatric medical act within the APRN’s scope of practice, subject to chapter requirements, commission or nursing board rules, and any written protocols. It directs the commission to adopt rules allowing APRNs, without the supervising podiatrist present, to conduct office visits, perform minor procedures, oversee clinic operations, and handle preoperative and postoperative assessments and medication management. It also requires rules for prescriptive authority agreements and allows registration of APRNs receiving delegated prescribing authority, with an electronic registration process permitted. The bill repeals Section 202.354 of the Occupations Code and takes effect September 1, 2025.
The bill would amend Texas occupational licensing and podiatry practice law by expressly authorizing broader delegation from podiatrists to APRNs and by requiring the relevant state agencies to adopt implementing rules. It also clarifies liability by stating that a podiatrist is not liable solely because of a prescriptive authority agreement, unless the podiatrist had reason to believe the APRN lacked competency. The practical effect would be to expand the role of APRNs in podiatric settings and to formalize delegation, protocol, and registration requirements for prescribing and other delegated acts.
The available legislative history shows little recorded debate or voting activity, so there is no strong evidence of broad support or opposition from the provided materials. The bill was referred to the House Health & Human Services committee, suggesting it was treated as a health-professions regulation measure. Based on the text, the likely general sentiment is permissive and modernization-oriented, aiming to increase flexibility in podiatric care delivery while preserving supervision and safety standards.
The main points of potential contention are the scope of delegation and the balance between access to care and professional oversight. Supporters would likely emphasize efficiency, expanded access, and better use of APRN training, while opponents or cautious stakeholders may focus on patient safety, whether APRNs should perform minor procedures or manage clinic operations without the podiatrist present, and how much liability should remain with the supervising podiatrist. The bill also leaves significant rulemaking to the commission and the Texas Board of Nursing, which could be a point of concern for groups seeking clearer statutory limits.
SB 2669 would add a new delegation framework to Chapter 202 of the Occupations Code, expressly authorizing podiatrists to delegate certain podiatric medical acts to advanced practice registered nurses and podiatric medical assistants under defined conditions. It would require agency rulemaking on protocols, prescriptive authority agreements, and delegation registration, while also repealing an existing section of law and clarifying liability standards for delegating podiatrists. The bill would primarily affect podiatrists, APRNs, the Texas Board of Nursing, and the state agency responsible for podiatry regulation.
The provided record suggests a generally favorable or at least noncontroversial posture toward the bill, with no recorded votes or committee testimony indicating organized opposition. The measure appears designed to expand practice flexibility and align podiatric delegation rules with existing health-profession delegation frameworks. Because there is no transcript or vote data, the sentiment can only be characterized as likely pragmatic and administrative rather than politically divisive.
The most likely contention centers on whether APRNs should be allowed to perform office visits, minor procedures, clinic oversight, and medication management in a podiatry setting without the supervising podiatrist physically present. Another possible issue is liability: the bill limits podiatrist liability absent reason to know the APRN lacked competency, which may concern those seeking stronger accountability standards. Stakeholders focused on scope of practice, patient safety, and professional boundaries would be the most likely sources of concern, while proponents would likely include podiatrists and APRN advocates seeking broader delegation authority.