Limitations & Qualifications
The bill amends §681.003, Texas Transportation Code, permitting APNs and PAs to verify a person is legally blind or has a mobility problem. However, the bill includes significant limitations.
1) The authority for APNs and PAs to sign verifications must be delegated and supervised by a physician under Subchapter B, Chapter 157, Occupations Code (the portion of the Medical Practice Act that permits physicians to delegate prescriptive authority. Therefore the authority for an APN to sign a prescription for a disabled parking placard must be included in the APN’s Practice Agreement Protocol (Prescriptive Authority Protocol).
2) APNs and PAs may only sign verifications accompanying initial applications for a temporary parking placard. If the patient needs a permit for longer than six months, then a physician must sign the prescription for the subsequent verification. A physician must also sign the medical verification for patients with permanent disabilities to obtain a permanent handicapped license plate.
3) APNs and PAs may only sign these verifications if the individual lives in a county with a population of 125,000 or less. To find that information, go to http://www.tsl.state.tx.us/ref/abouttx/popcnty42008.html.  That link to the “About Texas” Website lists the estimated 2008 population of Texas counties from largest to smallest. The first 30 counties on the list have populations greater than 125,000, and therefore APNs will only qualify to sign medical verifications for individuals living in the remaining 224 counties, and only for the first application for a temporary placard.  As stated above, if a patient has a permanent disability, then the APN needs to ask the delegating physician to sign a prescription for a handicapped license plate and permanent placard. 

 

Before signing a prescriptive for a disabled parking placard, APNs also must also know the list of qualifying conditions. The Transportation Code identifies the following impairments that qualify a person for a disabled parking placard:
     (1)  cannot walk 200 feet without stopping to rest;
     (2)  cannot walk without the use of an assistance device, including a brace, cane, crutch, another person, or a prosthetic device;
     (3)  cannot ambulate without a wheelchair or similar device;
     (4)  is restricted by lung disease to the extent that the person's forced respiratory expiratory volume for one second, measured by spirometry, is less than one liter, or the arterial oxygen tension is less than 60 millimeters of mercury on room air at rest;
     (5)  uses portable oxygen;
     (6)  has a cardiac condition to the extent that the person's functional limitations are classified in severity as Class III or Class IV according to standards set by the American Heart Association;
     (7)  is severely limited in the ability to walk because of an arthritic, neurological, or orthopedic condition; or
     (8)  has another debilitating condition that limits or impairs the person's ability to walk.

 

Click the link to read the full text of SB 1984, authored by Sen. Carlos Uresti (D-San Antonio, SD #19) & Sen. Glenn Hegar (R-Katy, SD #18) and sponsored by Rep. Tracy O. King (R-Weatherford, HD #61). While this bill grants APNs only limited authority to sign medical verifications for disabled parking placards, APNs should realize it is the first time that legislators have expanded authority to sign these verifications since 1999. In that year, podiatrists won the right to sign medical verifications for persons with a disability of the foot. In addition to the expanded authority for APNs and PA signed into law in 2009, optometrists were also granted authority to sign verifications for persons with a visual disability.

 

2009 Legislation Increases Consequences for People Who Misuse Disabled Parking Placards.
SB 52, by Sen. Judith Zaffirini (D-Laredo, SD #21) and sponsored by Rep. Garnet Coleman (D-Houston, HD # 146), and HB 3095 by Rep. Patricia Harless (R-Spring, HD #126) and sponsored by Sen. Kirk Watson (D-Austin, SD #14), are similar bills. HB 3095 designates blue placards will be reserved for persons with permanent disabilities while those with red shields will designate a person whose placard expires within 6 months of the date of issuance.  Both SB 52 and HB 3095 increase the fines and punishments that may be imposed if a peace officer sees a driver using a disabled parking placard whose identification does not match the placard or is not transporting a person whose identification matches the placard.

 

In addition to allowing the peace officer to seize the disabled parking placard immediately, the following are the new consequences offenders will face on or after September 1, 2009.
• First offense - $250 - $500 (same as current law)
• Second offense – a fine of not less than $500 or more than $800 and 10 hours of community service
• Third offense – a fine of not less than $550 or more than $800 and 20 hours of community service
• Fourth offense- a fine of not less than $800 or more than $1,100 and 30 hours of community service
• Fifth offense – a fine of $1,250 and 50 hours of community service.

 

Advice APNs Should Give Patients
Because of these new laws, APNs prescribing a disabled parking placard should advise patients that they need to carry their driver’s license whenever they are in a car using their parking placard, even if they are not driving the car.  APNs should also advise patients that local county tax assessor-collectors’ offices may not yet be advised of the change in the law allowing APNs to sign the medical verifications. If that is the case, it may help your patient to know the bill number, SB 1984. It is likely that the language in the section of the Transportation Code, Chapter 681, will not be updated to include the language allowing APNs to sign verifications until late 2009. However, when it is updated, your patient can refer the staff person in the county tax assessor-collector’s office to §681.003.