Legislative Hotline: Safety for First Responders, and Preventing Chiropractors From Practicing Neurology
By Jennifer Perkins



A pair of bills that would help first responders during disasters began their journey through the Senate today with hearings in the Senate Health and Human Services Committee. The bills were written by Rep. Dade Phelan (R-Beaumont), whose district was hit particularly hard by Hurricane Harvey in 2017.

House Bill 1256 would grant first responders and their employers access to first responders’ vaccination records on the statewide immunization registry during a disaster. House Bill 1418 would provide first responders and emergency services personnel with their immunization status when they seek certification or recertification.

Thomas Kaspar, MD, an infectious disease specialist from Victoria and the incoming chair of the Texas Medical Association’s Committee on Infectious Diseases, testified on behalf of both bills, reminding lawmakers that if they’re not up to date on their immunizations, “first responders risk exposure to and infection by potentially serious or even deadly diseases.”

TMA supports both of these bills.

Senate Bill 1867 by Sen. Juan “Chuy” Hinojosa (D-McAllen), which also was heard in the Senate Health and Human Services Committee today, would add “neuro” to chiropractors’ current statutory scope of practice, which is limited to the musculoskeletal system.

Testifying in opposition to SB 1867 was Sara Austin, MD, an Austin-based neurologist, who informed lawmakers that adding neuro is not merely the addition of the nerves that may connect muscle tissue or bones. “It is the addition of the entire neurological system that includes the brain, spinal cord, and the regulation of many bodily functions beyond chiropractors’ education and training.” TMA strongly opposes this bill.

TMA yesterday issued a legislative alert for all Texas physicians to register their opposition to this bill by calling the committee members.

“The chiropractors are trying to convince the Texas Legislature that they are qualified to diagnose and treat disorders of the nervous system,” said TMA President Doug Curran, MD. “You and I know that’s an absurd idea. We know that such a drastic expansion of chiropractors’ scope of practice is unsupported by their education and training. We know it would be a danger to patient safety.”


TMA is monitoring 1,952 of the 7,771 bills filed this session. Bills must be voted out of committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. House bills must be out of House committee by Monday, May 6 – the day before our last First Tuesdays of this session – to be considered this session.

As debate shifts from committees to chamber floors, the debate calendars will lengthen as hundreds of bills will be set for consideration each day. Committee meetings will bookend floor sessions and will start to run late into the night. Bills that haven’t yet moved out of committee may be proposed as amendments to legislation that is moving.

TMA is watching each bill, committee substitute, and amendment for any changes. It is not uncommon for revised legislation to prompt a revised position from TMA, particularly when bad bills become better bills through rewriting or amendments. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT.

Below are a few TMA-tracked bills that continue to move through the legislative process:

  • House Bill 1504 by Rep. Chris Paddie (R-Marshall), the Texas Medical Board (TMB) Sunset bill that would extend the TMB for another 12 years, was heard in the Senate Health and Human Services Committee without much debate. HB 1504 sponsor Sen. Robert Nichols (R-Jacksonville) pledged to keep the bill “clean” as it moves through the Senate, meaning he will consider the original version of the bill as written by Representative Paddie and will not be accepting amendments. TMA testified in support of HB 1504 last month and continues to closely monitor this bill.
  • Senate Bill 732 by Sen. Bryan Hughes (R-Mineola), which would allow patients to have direct access to physical therapists without a referral by a physician, was heard today in the Senate Business and Commerce Committee. The companion bill, House Bill 29 by Rep. Ina Minjarez (D-San Antonio), has been amended to limit the allowable number of direct access visits and now requires patient acknowledgement that they are not receiving a medical diagnosis, nor is the treatment likely to be covered by insurance. HB 29 was voted out of the House Public Health Committee last week. TMA continues to closely monitor these bills.
  • House Bill 1532 by Rep. Morgan Meyer (R-Dallas), which would protect employed physicians’ clinical autonomy and independent medical judgment from hospital administrators’ interference – was set for debate on the House floor today. As of press time, the bill had not yet come up for debate. TMA strongly supports this bill.
  • House Bill 3345 by Rep. Four Price (R-Amarillo), which would allow physicians to choose the best platform to use for providing telemedicine services to their patients, rather than having health plans dictate the platform, is set for debate on the House floor tomorrow. TMA strongly supports HB 3345.


Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador.


Just as you’d like more direct face-to-face time with your patients, lawmakers find face-to-face time with constituents valuable. But they, too, have limitations. When you schedule an in-person meeting with your legislators, 15 minutes (possibly 20) is a realistic expectation for your meeting. But be aware that chances are good you’ll have to wait when you arrive at your legislator’s office – even for a meeting with a staff member. Build the prospect of delay into your schedule; don’t take it personally. Use the time to relax or chat with a staff member who offers conversation. On the other hand, don’t interrupt a busy staff person or an overworked receptionist trying to cope with ringing telephones. Get more tips in our Grassroots Advocacy Guide.


Today’s physician of the day is Linda Porter-Tucci, MD, of Houston. Dr. Porter-Tucci graduated from the Baylor College of Medicine and is a member of both TMA and the Harris County Medical Society.


Pain & Profit: Bills to fix Texas’ broken Medicaid system gain momentum despite pushback from insurers –The Dallas Morning News

Here’s why more young people in Texas are considering suicide – Fort Worth Star-Telegram

Austin rally tackles child mental health and suicide prevention – KXAN-TV

San Antonio ‘at the heart’ of burgeoning kidney disease crisis – San Antonio Express-News

New development aims to boost medical innovation in Austin – KVUE-TV

Stop selling tobacco to Texans 21 and younger [Opinion] Galveston Daily News

Keep Texas at the forefront of the fight against cancer [Opinion] – Austin American-Statesman


Last Updated On

April 30, 2019

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Jennifer Perkins

Advocacy Communication Manager

(512) 370-1469
Jennifer Perkins

Jennifer Perkins, a native Texan and University of Texas Longhorn, has worked in politics, public affairs, and advocacy for more than two decades, covering a litany of subject areas and a number of states, using a marketing-oriented communications style as informed by her MBA. Jennifer has two dogs, is a college football fanatic, loves to entertain, and prefers to be outdoors..

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