Sites Serving Medically Underserved Populations (Site-MUPs) & Limited Prescriptive Authority

Legislative history of Limited Prescriptive Authority (LPA) for advanced practice nurses and physician assistants:

The Omnibus Health Care Rescue Act (Texas House Bill 18, 71st Legislature) authorized limited prescriptive authority for advanced practice nurses (APNs) and physician assistants (PAs) practicing in certain worksites. APNs and PAs may sign prescription drug orders only after meeting criteria defined by the Texas Board of Nurse Examiners (for APNs), and the Texas Medical Board (for PAs). See the Texas Administrative Code* for legislative details.

NOTE: A site must be open a minimum of 30 days before submitting an application.

1. APN and PA Practice Sites that DO NOT need the Health Professions Resource Center's special designation as a Site-MUP:

• Provider-based sites which the physician designates as his (or her) Primary Practice Site, i.e., where they practice medicine for more than 50% of their practice time. A primary practice site does not require HPRC to designate it as a Site-MUP since the physician supervises his staff the majority of the time.
• Facility-based sites, such as hospitals, where a medical director authorizes limited prescriptive authority for the APN and PA staff practicing in the facility. 
• Clinics in Health Professional Shortage Areas (HPSAs)
• Clinics in Medically Underserved Areas (MUAs) or serving Medically Underserved Populations (MUPs)
• Rural Health Clinics
• Clinics funded by Texas Department of State Health Services or Texas Health and Human Services Commission: 
  • Public Health Clinics, Title 5, 10, 19 and 20
  • COPC clinics
  • AIDS clinics
  • Family Planning Clinics 
• School Based Clinics. In the 1997, the law was expanded to include School-based Clinics established by public school systems.

2. Practice Sites that DO require a Health Professions Resource Center Designation:

Category A: Site-MUP - a site located in an area with an insufficient number of physicians providing services to patients eligible for federal, state or locally funded health care programs. Category B: Site-MUP - a site that serves a disproportionate number of clients eligible for federal, state or locally funded health care programs.

3. Download Site-MUP Application Form

Determining if your practice site is designated as a Site-MUP: HPRC maintains a list of designated sites, as does the Board of Nurse Examiners and the Board of Medical Examiners. A practitioner should first contact their licensing board to see if a site is already approved. Since practice sites in HPSAs or MUAs do not have to be designated as Site-MUPs, you may need to know in which census tract your site is located - since some partial county HPSA and MUA designations are census tract specific.

Convert your site's street address to a census tract*.

*External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services. These sites may also not be accessible to people with disabilities.