Alcance de Práctica en Texas (FQHC)

Texas is a RESTRICTED-practice state (the inverse of CA's NP full-practice authority). Every APRN site needs a physician delegator + a maintained PAA with monthly QA meetings — a fixed physician-overhead cost and recruiting/credentialing constraint in Texas FQHC staffing models.

PAs are explicitly the physician's agent under delegated protocols — no independent practice. Same physician-delegator overhead and PAA credentialing as APRNs.

RNs are the supervising layer for LVNs/UAPs and anchor care-management / RN co-visit staffing models. 'Reduced' here flags only the absence of medical/prescriptive authority — nursing practice itself is not physician-supervised.

Every LVN needs a named supervisor on duty — a key staffing-ratio and supervision-coverage consideration for Texas FQHC clinic models.

No MA licensing board in Texas. MA duties (rooming, vitals, injections per order) must be covered by a physician's standing delegation orders with documented supervision.

The 180-hour DSHS training + mandatory certification for compensated CHWs is the key compliance gate for Texas FQHCs deploying outreach/Promotor(a) staff (contrast: California's CHW pathway runs through Medi-Cal + a different certification debate).

Behavioral-health therapists can deliver care independently at full licensure — a relative bright spot for Texas FQHC integrated-BH models — but medication management still needs a prescriber under physician delegation.

Texas FQHC dental programs operate under independent dentist authority; the dentist is the delegating/supervising authority for the dental team.

Because on-site dentist presence is not required for delegated acts (only an exam within 12 months), §262.002 enables FQHC mobile/school-based and 'alternate setting' dental programs under dentist supervision.