September 19, 1989 

Louise Waddill, R.N., Ph.D. Opinion No. JM-1096 

Executive Secretary 

Board of Nurse Examiners Re: Whether a nursing student 

9101 Burnet Road may administer medications 

Suite 104 under certain conditions and 

Austin, Texas 78758 related questions (RQ-1782) 

Dear Ms. Waddill: 

You refer to the provisions of what is now subchapter F 

of chapter 242 of the Health and Safety Code, relating to 

convalescent and nursing homes and related institutions.1 

Section 242.151 provides as follows: 

PERMITS TO ADMINISTER MEDICATION. A 

person may not administer medication to a 

resident unless the person: 

(1) holds a.license under state law 

that authorizes the person to administer 

medication; or 

1. You refer in your request to section 7B of article 

4442c, V.T.C.S. Effective September 1, 1989, article 4442~ 

is repealed and its provisions recodified without 

substantive change as part of the Health and Safety Code. 

Acts 1989, 71st Leg., ch. 678, 5 1, at 2230; see id. 

58 13, at 3165 (repealer), 1, at 2236 (no substantive change 

intended), 1, at 2476 (codification of provisions of section 

7B of article 4442~). We will refer in this opinion to the 

provisions in question as they are found in chapter 242, 

subchapter F (sections 242.151 thru 242.158) of the Health 

and Safety Code. Also, two different acts of the 68th 

Legislature added a section 7B to article 4442~. You refer, 

and in the following discussion we will be referring to, the 

provisions of the section 7B added by House Bill No. 1753, 

Acts 1983, 68th Leg., ch. 940 at 5170. 

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Louise Waddill, R.N., Ph.D. - Page 2 (JM-1096) 

(2) holds a permit issued under 

Section 242.154 and acts under the 

authority of a person who holds a license 

under state law that authorizes the person 

to administer medication. 

You say that institutions covered by chapter 242 have 

in the past provided settings for clinical training of 

nursing students 

medication aides.2 

and persons undergoing training as 

You ask whether the provisions of 

chapter 242, subchapter F, prevent such a person from 

administering medications under supervision to residents of 

these institutions as part of his training unless he holds 

the license or permit referred to in subsections (1) and (2) 

of section 242.151. 

You argue that by the addition of the provisions of 

what is now subchapter F the legislature intended to provide 

for ongoing oversight of unlicensed persons administering 

medications in chapter 242 ‘institutions, in view of problems 

and abuses encountered with respect to administration of 

medications in such facilities by unlicensed persons. See 

Bill Analysis, H.B. 1753, 68th Leg. (1983). You say that it 

is your agency's position that the legislature never 

intended, with the enactment of the provisions of what is 

now subchapter F, to limit the administration of medications 

by nursing students under supervision to residents of 

chapter 242 institutions as part of the clinical training 

component of the students' curriculum. You also argue that 

medication aide trainees should not be prevented by subchapter F from administering medications to such institutions' residents as part of the trainees' instruction. 

Despite your contentions, we decline to go beyond the 

plain language of section 242.151 of subchapter F to create 

exceptions to the clear requirements of those provisions: 

that a person may not administer medication to a resident of 

a chapter 242 institution unless he holds a license or 

permit as provided for in the section. We do not think that 

such general provisions as those of article 449533, section 

3.06(d), that a physician may delegate medical acts, 

administration of drugs r etc., to "any qualified and 

2. The term winstitutionll as used in chapter 242 is 

defined in some detail in section 242.002(6); u 

section 242.003 (exemptions). 

p. 5743 
Louise Waddill, R.N., Ph.D. - Page 3 (JM-1096) 

properly trained person," provide exceptions to the 

requirements of subchapter F specifically applicable to 

chapter 242 institutions, i.e., that a person may not 

administer medications to such institutions' residents 

without the license or permit provided for by that 

subchapter. Whether the person in question be a nursing 

student, a medication aide trainee, or otherwise, we find no 

exception in chapter 242 or elsewhere in Texas law to the 

requirement of section 242.151 that a person have the 

necessary license or permit in order to administer 

medications in a chapter 242 institution.3 

3. We would also note, in respect to your question 

whether the provisions of what is now subchapter F, chapter 

242, Health and Safety Code, prohibit the administration of 

medication in chapter 242 institutions without a license or 

permit as provided there, that prior to its codification in 

chapter 242, article 4442c, section 7(a)(8) also provided 

that "all nersonneb administering medications must have 

completed a state-approved training program in medication 

administration." (Emphasis added.) These provisions were 

added in 1977. Acts 1977, 65th Leg., 1st C.S., ch. 2, § 1, 

at 49. With the addition of the more detailed permit 

requirements of section 7B of article 4442~ in 1983, the 

quoted provisions of section 7(a)(8) became redundant and 

accordingly are merged in the 1989 Health and Safety Code, 

with the recodified provisions of section 7B of article 

4442c, in subchapter F of the code. Acts 1989, 71st Leg., 

ch. 678, § 1, at 2477 (section 7(a)(8) indicated as part of 

source law for provision of section 242.154 that the 

Department of Health shall issue a permit to persons who 

meet requirements adopted under subchapter F). 

It would appear that, since 1977, with the addition of 

the section 7(a)(8) provisions, nursing students, medication 

aides and other persons would have been subject to the 

requirement that they must have completed a state approved 

training program in medication administration in order to 

administer medications in the nursing and convalescent homes 

and other institutions now covered by chapter 242 of the 

code. The bill analysis for House Bill No. 1753, the 1983 

act adding section 7B to article 4442~ (now subchapter F of 

chapter 242 of the code), indicates that current law in 1983 

already empowered "the Texas Department of Health to 

for . . . the administration of certain medications 

all;; 

(Footnote Continued) 

p. 5744 
Louise Waddill, R.N., Ph.D. - Page 4 (JM-1096) 

We do note that the provisions of subchapter F allow 

the Board of Health and Department of Health some flexibility in establishing the requirements for obtaining a 

permit under the section. 4 Section 242.152 provides, inter 

alia, that the board shall adopt rules establishing 

requirements for issuance, renewal, etc., of a permit: 

curricula to train persons to administer medications to 

institution residents: and standards for approval of 

training programs. Section 242.154(b) requires the 

department to prepare and conduct examinations for permit 

applicants. Section 242.155 requires the board to set a fee 

in connection with permit applications. 

Currently, board rules promulgated under subchapter F 

require, inter ahaa 

program consisting oi 

completion of an approved training 

100 classroom hours and 40 hours of 

clinical experience in order to obtain a permit. 25 T.A.C. 

5 145.256 (1983). Notably, the rules currently exempt 

unlicensed or unregistered nursing school graduates from the 

training component of the permit requirements. Id. 

5 145.252. It would appear that the board would also have 

authority under subchapter F to adopt rules under which, for 

example, completion of certain portions of a nursing school 

curriculum would fulfill the training requirements. 

SUMMARY 

Nursing students and medication aide 

trainees are subject to the requirement of 

chapter 242, subchapter F, section 242.151 

that a person must hold a license authorizing 

(Footnote Continued) 

unlicensed personnel [in the subject institutions]. These 

individuals receive formal training through state-approved 

medication administrative training courses . . . and are 

issued an acknowledgment card as a credential of their 

training." Bill Analysis, H.B. 1753, 68th Leg. (1983). 

See [Health 

(prov4dinfihat the te:i 

Safety Code] 5 242.002(l), (2) 

"boardl* and "department" as used 

in chapter 242 refer respectively to the Board of Health and 

Department of Health). Acts 1989, 71st Leg., ch. 678, § 1, 

at 2462. Section 11.013 of the code provides: "The board 

shall adopt policies and rules and shall govern the department." L at 2239. 

p. 5745 
Louise Waddill, R.N., Ph.D. - Page 5 (JM-1096) 

. 

the person to administer medication, or a 

permit issued by the Department of Health 

under subchapter F, in order to administer 

medications to residents of convalescent and 

nursing homes and related institutions subject to chapter 242, Health and Safety Code. 

a.ti 

MATTOX 

Attorney General of Texas 

MARY KELLER 

First Assistant Attorney General 

LOU MCCREARY 

Executive Assistant Attorney General 

JUDGE ZOLLIE STEAKLEY 

Special Assistant Attorney General 

RICK GILPIN 

Chairman, Opinion Committee 

Prepared by William Walker 

Assistant Attorney General 

P. 5746