TITLE 22. EXAMINING BOARDS

PART 5. STATE BOARD OF DENTAL EXAMINERS

CHAPTER 101. DENTAL LICENSURE

22 TAC §101.2

The State Board of Dental Examiners (Board) proposes an amendment to rule §101.2, concerning Licensure by Examination. This amendment will require all dental applicants after January 1, 2019, to successfully complete the periodontics and prosthodontics sections of whichever national exam they take.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety to patients by ensuring dentists are adequately prepared to perform acts they are legally able to perform. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the following government growth effects apply: the rule does not create or eliminate a government program; implementation of the proposed rule does not require the creation or elimination of employee positions; the implementation of the proposed rule does not require an increase or decrease in future appropriations; the proposed rule does not require an increase or decrease in fees paid to the agency; the proposed rule creates a new regulation; the proposed rule expands an existing regulation; the proposed rule increases the number of individuals subject to it; the proposed rule does not adversely affect the state's economy.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 305-9364, tvance@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

This amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§101.2.Licensure by Examination.

(a) In addition to the general qualifications for licensure contained in §101.1 of this chapter (relating to General Qualifications for Licensure), an applicant for licensure by examination who is a graduate of an accredited school must present proof that the applicant:

(1) Has graduated and received either the "DDS" or "DMD" degree from a dental school accredited by the Commission on Dental Accreditation of the American Dental Association (CODA);

(2) Has taken and passed the examination for dentists given by the American Dental Association Joint Commission on National Dental Examinations; and

(3) Has taken and passed the appropriate general dentistry clinical examination administered by a regional examining board designated by the Board.

(b) In addition to the general qualifications for licensure contained in §101.1 of this chapter, an applicant for licensure by examination who is a graduate of a non-accredited school must present proof that the applicant:

(1) Has graduated from a dental school that is not CODA-accredited;

(2) Has successfully completed training in an American Dental Association-approved specialty in a CODA-accredited education program that consists of at least two years of training as specified by the Council on Dental Education;

(3) Has taken and passed the examination for dentists given by the American Dental Association Joint Commission on National Dental Examinations; and

(4) Has taken and passed the appropriate general dentistry clinical examination administered by a regional examining board designated by the Board. Many regional examining boards require prior written approval by the participating member state in order for graduates of non-accredited schools to be tested. Prior to submitting an application for regional examination, graduates of non-accredited schools must obtain such permission from the Board.

(c) Designated regional examining boards.

(1) The following regional examining boards have been designated as acceptable by the Board as of the effective dates shown:

(A) Western Regional Examining Board, January 1, 1994;

(B) Central Regional Dental Testing Service, January 1, 2002;

(C) Northeast Regional Board, January 1, 2005;

(D) Southern Regional Testing Agency, January 1, 2005; and

(E) Council of Interstate Testing Agencies (CITA), January 1, 2009.

(2) Examination results will be accepted for five years from the date of the examination.

(d) [(e)] Remediation.

(1) If an applicant for Texas dental licensure fails three general dentistry clinical examination attempts, the applicant must complete 80 hours of clinical remediation through a CODA-accredited dental school before approval will be issued to take another clinical examination.

(2) If an applicant fails four or more general dentistry clinical examination attempts, the applicant must complete one of the following before approval will be issued to take another clinical examination:

(A) the repetition of the final year of a graduate dental program from a CODA-accredited dental school; or

(B) a clinical remediation course offered by a CODA-accredited dental school, consisting of no less than 1,000 clinical hours.

(3) All programs of clinical remediation require prior approval by the Board. Applicants will be responsible for locating, identifying and obtaining approval from the Board prior to registration for any program.

(4) Re-examination must be accomplished within 18 months following the date the Board approves a remediation program for the applicant.

(e) An applicant who takes an examination after January 1, 2019, must also successfully complete the periodontics and prosthodontics sections of an exam approved under subsection (c)(1) of this section.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 18, 2018.

TRD-201800190

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 475-0977


CHAPTER 110. SEDATION AND ANESTHESIA

22 TAC §110.13

The State Board of Dental Examiners (Board) proposes new rule §110.13, concerning Sedation and Anesthesia checklist. This new rule will establish the requirements of a preoperative checklist for all levels of sedation/anesthesia as required by SB313.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety to patients receiving sedation/anesthesia. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the following government growth effects apply: the rule does not create or eliminate a government program; implementation of the proposed rule does not require the creation or elimination of employee positions; the implementation of the proposed rule does not require an increase or decrease in future appropriations; the proposed rule does not require an increase or decrease in fees paid to the agency; the proposed rule creates a new regulation; the proposed rule expands an existing regulation; the proposed rule increases the number of individuals subject to it; the proposed rule does not adversely affect the state's economy.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 305-9364, tvance@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

This new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposed rule.

§110.13.Required Preoperative Checklist for Administration of Nitrous Oxide and Levels 1, 2, 3, and 4 Sedation/Anesthesia.

(a) A dentist administering nitrous oxide or Level 1, 2, 3, or 4 sedation/anesthesia must create and maintain in the patient's dental records required by rule 108.8, a document titled "preoperative sedation/anesthesia checklist" that is completed by the dentist prior to commencing a procedure for which the dentist will administer nitrous oxide or Level 1, 2, 3, or 4 sedation/anesthesia.

(b) A dentist delegating the administration of sedation/anesthesia to another provider in accordance with Section 258.001(4) of the Act, must maintain in the patient's dental records required by rule 108.8, a document titled "preoperative sedation/anesthesia checklist" that is completed by the sedation/anesthesia provider prior to commencing a procedure for which the dentist has delegated another provider to administer the sedation/anesthesia.

(c) At a minimum, the preoperative checklist must include documentation of the following for each level of sedation/anesthesia:

(1) Medical history, including documentation of the following:

(A) review of patient medical history;

(B) review of patient allergies;

(C) review of patient surgical and/or anesthesia history;

(D) review of family surgical and/or anesthesia history; and

(E) review of patient medications and any modifications.

(2) Confirmation that written and verbal preoperative and post-operative instructions were delivered to the patient, parent, legal guardian, or care-giver;

(3) Medical consults, as needed;

(4) Physical examination, including documentation of the following:

(A) American Society of Anesthesiologists Physical Status Classification (ASA) classification;

(B) NPO status; and

(C) Preoperative vitals, including height, weight, blood pressure, pulse rate, and respiration rate;

(5) Anesthesia-specific physical examination including documentation of the following:

(A) Airway assessment, including Mallampati score and/or Brodsky score; and

(B) Auscultation;

(6) Confirmation of pre-procedure equipment readiness check;

(7) Confirmation of pre-procedure treatment review (correct patient and procedure);

(8) Special preoperative considerations as indicated for sedation/anesthesia administered to pediatric or high risk patients; and

(9) Documentation of reason for omission of any item required by subsection (c) of this section.

(d) The information required above may be gathered at any time, but the dentist administering the sedation/anesthesia must verify that the information is current and correct prior to the administration of sedation/anesthesia.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 18, 2018.

TRD-201800191

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 475-0977


22 TAC §110.14

The State Board of Dental Examiners (Board) proposes new rule §110.14, concerning Emergency Preparedness Policies and Procedures. This new rule will establish the requirements of emergency preparedness for all levels of sedation/anesthesia as required by SB 313.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety to patients receiving sedation/anesthesia. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the following government growth effects apply: the rule does not create or eliminate a government program; implementation of the proposed rule does not require the creation or elimination of employee positions; the implementation of the proposed rule does not require an increase or decrease in future appropriations; the proposed rule does not require an increase or decrease in fees paid to the agency; the proposed rule creates a new regulation; the proposed rule expands an existing regulation; the proposed rule increases the number of individuals subject to it; the proposed rule does not adversely affect the state's economy.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 305-9364, tvance@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

This new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposed rule.

§110.14.Emergency Preparedness Policies and Procedures.

(a) Pursuant to §258.1557 of the Act, all permit holders, including nitrous oxide, must develop written emergency preparedness policies and procedures specific to the permit holder's practice setting that establish a plan for the management of medical emergencies in each practice setting in which the dentist administers sedation/anesthesia.

(b) The emergency preparedness policies and procedures must include written protocols, policies, procedures, and training requirements specific to the permit holder's equipment and drugs for responding to emergency situations involving sedation/anesthesia, including information specific to respiratory emergencies.

(c) The permit holder must annually review the emergency preparedness policies and procedures to determine whether an update is necessary. The permit holder must maintain documentation of the dates of the emergency preparedness policies and procedures' creation, the most recent update, and the most recent annual review.

(d) Policies and procedures developed by all permit holders must include basic life support protocols, advanced cardiac life support rescue protocols, and/or pediatric advanced cardiac life support rescue protocols if treating pediatric patients, consistent with the requirements of §§110.3 - 110.6 of this chapter, as applied to the permit holder.

(e) Policies and procedures developed by all permit holders must include, at a minimum, the following documents:

(1) Specific protocols for response to a sedation/anesthesia emergency, including specific protocols for advanced airway management techniques;

(2) Staff training log, documenting staff training in emergency prevention, recognition, and response on at least an annual basis;

(3) Emergency drug log documenting annual reviews for assurance of unexpired supply;

(4) Equipment readiness log indicating annual reviews for assurance of function of the equipment required by §110.15 of this chapter; and

(5) Individual office staff roles and responsibilities in response to an emergency, including roles and responsibilities specific to a response to a respiratory emergency.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 18, 2018.

TRD-201800192

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 475-0977


22 TAC §110.15

The State Board of Dental Examiners (Board) proposes new rule §110.15, concerning Prevention of and Response to Sedation/Anesthesia Emergencies. This new rule will establish the requirements of emergency preparedness for all levels of sedation/anesthesia as required by SB313.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety to patients receiving sedation/anesthesia. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the following government growth effects apply: the rule does not create or eliminate a government program; implementation of the proposed rule does not require the creation or elimination of employee positions; the implementation of the proposed rule does not require an increase or decrease in future appropriations; the proposed rule does not require an increase or decrease in fees paid to the agency; the proposed rule creates a new regulation; the proposed rule expands an existing regulation; the proposed rule increases the number of individuals subject to it; the proposed rule does not adversely affect the state's economy.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 305-9364, tvance@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

This new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposed rule.

§110.15.Prevention of and Response to Sedation/Anesthesia Emergencies.

(a) Pursuant to Section 258.1556 of the Act, the Board establishes minimum emergency preparedness standards and requirements for the administration of sedation/anesthesia.

(b) At any time a permit holder administers sedation/anesthesia, the permit holder must have immediately available:

(1) an adequate and unexpired supply of drugs and anesthetic agents, including but not limited to pharmacologic antagonists and resuscitative drugs appropriate for the sedation/anesthesia drugs used.

(2) an automated external defibrillator, as defined by Section 779.001 of the Texas Health and Safety Code;

(3) a positive pressure ventilation device

(4) supplemental oxygen

(5) appropriate monitors and equipment, including but not limited to:

(A) stethoscope

(B) sphygmomanometer or automatic blood pressure monitor

(C) pulse oximeter

(D) an oxygen delivery system with adequate full face masks and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system

(E) suction equipment which permits aspiration of the oral and pharyngeal cavities and a backup suction device which will function in the event of a general power failure

(F) a lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure.

(G) precordial/pretracheal stethoscope, size-and-shape appropriate advanced airway device, intravenous fluid administration equipment, and /or electrocardiogram, consistent with the requirements of §§110.3, 110.4, 110.5. and 110.6, as applied to the permit holder.

(c) A permit holder who is administering sedation/anesthesia for which a Level 4 permit is required must use capnography during the administration of the sedation/anesthesia, as required by Section 258.1555 of the Act.

(d) Each permit holder must conduct an emergency drug inspection for assurance of unexpired supply at least annually. Documentation of emergency drug inspections must be maintained in the permit holder's emergency drug log, required by §110.14.

(e) Each permit holder must conduct an equipment inspection for assurance of function at least annually. Documentation of equipment inspections must be maintained in the permit holder's equipment readiness log, required by §110.14.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 18, 2018.

TRD-201800193

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 475-0977


PART 9. TEXAS MEDICAL BOARD

CHAPTER 185. PHYSICIAN ASSISTANTS

22 TAC §§185.4, 185.6, 185.8, 185.14, 185.17, 185.31, 185.32

The Texas Medical Board, on behalf of the Texas Physician Assistant Board (Board) proposes amendments to §§185.4, 185.6, 185.8, 185.14, 185.17, 185.31, and new §185.32, concerning Physician Assistants,.

The amendment to §185.4, concerning Procedural Rules for Licensure Applicants, eliminates the requirement for applicants to have good moral character and adds language requiring applicants to submit to a criminal background check. These changes are based on the passage of SB 1625 (85th Regular Session), which amended §204.153 and §204.1525 of the Physician Assistant Licensing Act. The proposed amendment also eliminates obsolete language referring to "surgeon assistants."

The amendment to §185.6, concerning Annual Renewal of License, changes registration of physician assistants to biennial instead of annual. The proposed change also adds language to require applicants to submit to a criminal background check. Finally, the proposed rule change includes new language providing that the Board may refuse to renew a license if the licensee is not in compliance with a Board Order. These changes are based on the passage of SB 1625 (85th Regular Session), which amended §§204.1525, 204.156 and 204.158 of the Physician Assistant Licensing Act.

The amendment to §185.8, concerning Inactive License, changes the reference to "annual" registration to "biennial" registration. This change is based on the passage of SB 1625(85th Regular Session), which amended §204.156 of the Physician Assistant Licensing Act.

The amendment to §185.14, concerning Physician Supervision, changes the reference to "annual" registration to "biennial" registration. This change is based on the passage of SB 1625 (85th Regular Session), which amended §204.156 of the Physician Assistant Licensing Act.

The amendment to §185.17, concerning Grounds for Denial of Licensure and for Disciplinary Action, adds language that provides the Board may refuse to renew a license if the licensee is not in compliance with a Board Order. This change is based on the passage of SB 1625 (85th Regular Session), which amended §204.158 of the Physician Assistant Licensing Act.

The amendment to §185.31, concerning Prescriptive Authority Agreements: Minimum Requirements, deletes language requiring face to face meetings as part of quality assurance and improvement plans. These changes are based on the passage of SB 1625 (85th Regular Session), which amended §157.0512 of the Medical Practice Act.

New §185.32, concerning Minimum Training and Registration Requirements for Physicians Assistant Performing Radiologic Procedures, creates a new rule requiring physician assistants, who perform radiologic procedures, to have successfully completed an accredited educational program. These changes are based on Texas Occupations Code 601.254.

Scott Freshour, General Counsel for the Board, has determined that for each year of the first five years the sections as proposed are in effect the public benefit anticipated as a result of enforcing this proposal will be to have rules that are consistent with statutes and to insure that physician assistants performing radiologic procedures have adequate training.

Mr. Freshour has also determined that for the first five-year period the sections are in effect there will be no fiscal impact or effect on government growth as a result of enforcing the sections as proposed. There will be no effect to individuals required to comply with the rules as proposed. There will be no effect on small or micro businesses or rural communities.

Pursuant to Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the proposed rules. For each year of the first five years the proposed amendments will be in effect, Mr. Freshour has determined the following:

(1) The proposed rules do not create or eliminate a government program.

(2) Implementation of the proposed rules does not require the creation of new employee positions or the elimination of existing employee positions.

(3) Implementation of the proposed rules does not require an increase or decrease in future legislative appropriations to the agency.

(4) The proposed rules do not require an increase or decrease in fees paid to the agency.

(5) The proposed rules do not create new regulations.

(6) The proposed rules do not expand existing regulations; however, the proposed rules do limit existing regulations as described above.

(7) The proposed rules do not increase or decrease the number of individuals subject to the rules' applicability.

(8) The proposed rules do not positively or adversely affect this state's economy.

Comments on the proposal may be submitted to Rita Chapin, P.O. Box 2018, Austin, Texas 78768-2018, or e-mail comments to: rules.development@tmb.state.tx.us. A public hearing will be held at a later date.

The amendments and new rule are proposed under the authority of the Texas Occupations Code Annotated, §204.101, which provides authority for the Board to recommend adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; enforce this subtitle; and establish rules related to licensure. The amendments are further proposed under the authority of Texas Occupations Code §601.254.

No other statutes, articles or codes are affected by this proposal.

§185.4.Procedural Rules for Licensure Applicants.

(a) Except as otherwise provided in this section, an individual shall be licensed by the board before the individual may function as a physician assistant. A license shall be granted to an applicant who:

(1) submits an application on forms approved by the board;

(2) pays the appropriate application fee as prescribed by the board;

(3) has successfully completed an educational program for physician assistants [or surgeon assistants] accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA), or by that committee's predecessor or successor entities, and holds a valid and current certificate issued by the National Commission on Certification of Physician Assistants ("NCCPA");

(4) certifies that the applicant is mentally and physically able to function safely as a physician assistant;

(5) does not have a license, certification, or registration as a physician assistant in this state or from any other licensing authority that is currently revoked or on suspension or the applicant is not subject to probation or other disciplinary action for cause resulting from the applicant's acts as a physician assistant, unless the board takes that fact into consideration in determining whether to issue the license;

[(6) is of good moral character;]

(6) [(7)] is of good professional character as defined under §185.2(8) of this title (relating to Definitions).

(7) [(8)] submits to the board any other information the board considers necessary to evaluate the applicant's qualifications;

(8) [(9)] meets any other requirement established by rules adopted by the board; and

(9) [(10)] must pass the national licensing examination required for NCCPA certification within no more than six attempts; and

(10) [(11)] must pass the jurisprudence examination ("JP exam"), which shall be conducted on the licensing requirements and other laws, rules, or regulations applicable to the physician assistant profession in this state. The jurisprudence examination shall be developed and administered as follows:

(A) The staff of the Medical Board shall prepare questions for the JP exam and provide a facility by which applicants can take the examination.

(B) Applicants must pass the JP exam with a score of 75 or better within three attempts.

(C) An examinee shall not be permitted to bring medical books, compends, notes, medical journals, calculators or other help into the examination room, nor be allowed to communicate by word or sign with another examinee while the examination is in progress without permission of the presiding examiner, nor be allowed to leave the examination room except when so permitted by the presiding examiner.

(D) Irregularities during an examination such as giving or obtaining unauthorized information or aid as evidenced by observation or subsequent statistical analysis of answer sheets, shall be sufficient cause to terminate an applicant's participation in an examination, invalidate the applicant's examination results, or take other appropriate action.

(E) An applicant who is unable to pass the JP exam within three attempts must appear before a committee of the board to address the applicant's inability to pass the examination and to re-evaluate the applicant's eligibility for licensure. It is at the discretion of the committee to allow an applicant additional attempts to take the JP exam.

(F) A person who has passed the JP Exam shall not be required to retake the Exam for relicensure, except as a specific requirement of the board as part of an agreed order.

(b) The following documentation shall be submitted as a part of the licensure process:

(1) Name Change. Any applicant who submits documentation showing a name other than the name under which the applicant has applied must present certified copies of marriage licenses, divorce decrees, or court orders stating the name change. In cases where the applicant's name has been changed by naturalization the applicant should send the original naturalization certificate by certified mail to the board for inspection.

(2) Certification. Each applicant for licensure must submit:

(A) a letter of verification of current NCCPA certification sent directly from NCCPA, and

(B) a certificate of successful completion of an educational program submitted directly from the program on a form provided by the board.

(3) Examination Scores. Each applicant for licensure must have a certified transcript of grades submitted directly from the appropriate testing service to the board for all examinations accepted by the board for licensure.

(4) Verification from other states. On request of board staff, an applicant must have any state, in which he or she has ever been licensed as any type of healthcare provider regardless of the current status of the license, submit to the board a letter verifying the status of the license and a description of any sanctions or pending disciplinary matters. The information must be sent directly from the state licensing entities.

(5) Arrest Records. If an applicant has ever been arrested, a copy of the arrest and arrest disposition needs to be requested from the arresting authority and that authority must submit copies directly to the board.

(6) Malpractice. If an applicant has ever been named in a malpractice claim filed with any liability carrier or if an applicant has ever been named in a malpractice suit, the applicant must:

(A) have each liability carrier complete a form furnished by this board regarding each claim filed against the applicant's insurance;

(B) for each claim that becomes a malpractice suit, have the attorney representing the applicant in each suit submit a letter directly to the board explaining the allegation, dates of the allegation, and current status of the suit. If the suit has been closed, the attorney must state the disposition of the suit, and if any money was paid, the amount of the settlement. The letter shall be accompanied by supporting documentation including court records if applicable. If such letter is not available, the applicant will be required to furnish a notarized affidavit explaining why this letter cannot be provided; and

(C) provide a statement, composed by the applicant, explaining the circumstances pertaining to patient care in defense of the allegations.

(7) provide a complete and legible set of fingerprints, on a form prescribed by the board, to the board or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation;

(8) [(7)] Additional Documentation. Additional documentation as is deemed necessary to facilitate the investigation of any application for licensure must be submitted.

(c) All physician assistant applicants shall provide sufficient documentation to the board that the applicant has, on a full-time basis, actively practiced as a physician assistant, has been a student at an acceptable approved physician assistant program, or has been on the active teaching faculty of an acceptable approved physician assistant program, within either of the last two years preceding receipt of an application for licensure. The term "full-time basis," for purposes of this section, shall mean at least 20 hours per week for 40 weeks duration during a given year. Applicants who are unable to demonstrate active practice on a full time basis may, in the discretion of the board, be eligible for an unrestricted license or a restricted license subject to one or more of the following conditions or restrictions as set forth in paragraphs (1) - (4) of this subsection:

(1) completion of specified continuing medical education hours approved for Category 1 credits by a CME sponsor approved by the American Academy of Physician Assistants;

(2) limitation and/or exclusion of the practice of the applicant to specified activities of the practice as a physician assistant;

(3) remedial education; and

(4) such other remedial or restrictive conditions or requirements which, in the discretion of the board are necessary to ensure protection of the public and minimal competency of the applicant to safely practice as a physician assistant.

(d) The executive director shall report to the board the names of all applicants determined to be ineligible for licensure, together with the reasons for each recommendation. An applicant deemed ineligible for licensure by the executive director may within 20 days of receipt of such notice request a review of the executive director's recommendation by a committee of the board, to be conducted in accordance with §187.13 of this title (relating to Informal Board Proceedings Relating to Licensure Eligibility), and the executive director may refer any application to said committee for a recommendation concerning eligibility. If the committee finds the applicant ineligible for licensure, such recommendation, together with the reasons therefore, shall be submitted to the board. The applicant shall be notified of the panel or committee's determination and given the option to appeal the determination of ineligibility to the State Office of Administrative Hearings (SOAH) or accept the determination of ineligibility. An applicant has 20 days from the date the applicant receives notice of the board's determination of ineligibility to submit a written response to the board indicating one of those two options. If the applicant does not within 20 days of receipt of such notice submit a response either accepting the determination of ineligibility or providing notice of his or her intent to appeal the determination of ineligibility, the lack of such response shall be deemed as the applicant's acceptance of the board's ineligibility determination. If the applicant timely notifies the board of his or her intent to appeal the board's ineligibility determination to SOAH, a contested case before SOAH will be initiated only in accordance with §187.24 of this title (relating to Pleadings). The applicant shall comply with all other provisions relating to formal proceedings as set out in this title Chapter 187 Subchapter C (relating to Formal Board Proceedings at SOAH). If the applicant does not timely comply with such provisions, or if prior to the initiation of a contested case at SOAH, the applicant withdraws his or her notice of intent to appeal the board's ineligibility determination to SOAH, the applicant's failure to take timely action or withdrawal shall be deemed acceptance of the board's ineligibility determination. The committee may refer any application for determination of eligibility to the full board. All reports received or gathered by the board on each applicant are confidential and are not subject to disclosure under the Public Information Act. The board may disclose such reports to appropriate licensing authorities in other states.

(e) Applicants for licensure:

(1) whose applications have been filed with the board in excess of one year will be considered expired. Any fee previously submitted with that application shall be forfeited unless otherwise provided by §175.5 of this title (relating to Payment of Fees or Penalties). Any further request for licensure will require submission of a new application and inclusion of the current licensure fee. An extension to an application may be granted under certain circumstances, including:

(A) Delay by board staff in processing an application;

(B) Application requires Licensure Committee review after completion of all other processing and will expire prior to the next scheduled meeting;

(C) Licensure Committee requires an applicant to meet specific additional requirements for licensure and the application will expire prior to deadline established by the Committee;

(D) Applicant requires a reasonable, limited additional period of time to obtain documentation after completing all other requirements and demonstrating diligence in attempting to provide the required documentation;

(E) Applicant is delayed due to unanticipated military assignments, medical reasons, or catastrophic events;

(2) who in any way falsify the application may be required to appear before the board;

(3) on whom adverse information is received by the board may be required to appear before the board;

(4) shall be required to comply with the board's rules and regulations which are in effect at the time the completed application form and fee are filed with the board;

(5) may be required to sit for additional oral or written examinations that, in the opinion of the board, are necessary to determine competency of the applicant;

(6) must have the application of licensure complete in every detail 20 days prior to the board meeting in which they are considered for licensure. Applicants may qualify for a Temporary License prior to being considered by the board for licensure, as required by §185.7 of this title (relating to Temporary License);

(7) who previously held a Texas health care provider license, certificate, permit, or registration may be required to complete additional forms as required.

(f) Alternative License Procedure for Military Service Members, Military Veterans, and Military Spouses.

(1) An applicant who is a military service member, military veteran, or military spouse may be eligible for alternative demonstrations of competency for certain licensure requirements. Unless specifically allowed in this subsection, an applicant must meet the requirements for licensure as specified in this chapter.

(2) To be eligible, an applicant must be a military service member, military veteran, or military spouse and meet one of the following requirements:

(A) holds an active unrestricted physician assistant license issued by another state that has licensing requirements that are substantially equivalent to the requirements for a Texas physician assistant license; or

(B) within the five years preceding the application date held a physician assistant license in this state.

(3) The executive director may waive any prerequisite to obtaining a license for an applicant described in this subsection after reviewing the applicant's credentials.

(4) Applications for licensure from applicants qualifying under paragraphs (1) and (2) of this subsection shall be expedited by the board's licensure division. Such applicants shall be notified, in writing or by electronic means, as soon as practicable, of the requirements and process for renewal of the license.

(5) Alternative Demonstrations of Competency Allowed. Applicants qualifying under paragraphs (1) and (2) of this subsection:

(A) in demonstrating compliance with subsection (d) of this section must only provide sufficient documentation to the board that the applicant has, on a full-time basis, actively practiced as a physician assistant, has been a student at an acceptable approved physician assistant program, or has been on the active teaching faculty of an acceptable approved physician assistant program, within one of the last three years preceding receipt of an Application for licensure;

(B) notwithstanding the one year expiration in subsection (e)(1) of this section, are allowed an additional 6 months to complete the application prior to it becoming inactive; and

(C) notwithstanding the 20 day deadline in subsection (e)(6) of this section, may be considered for permanent licensure up to 5 days prior to the board meeting.

(g) Applicants with Military Experience.

(1) For applications filed on or after March 1, 2014, the Board shall, with respect to an applicant who is a military service member or military veteran as defined in §185.2 of this title (relating to Definitions), credit verified military service, training, or education toward the licensing requirements, other than an examination requirement, for a license issued by the Board.

(2) This section does not apply to an applicant who:

(A) has had a physician assistant license suspended or revoked by another state or a Canadian province;

(B) holds a physician assistant license issued by another state or a Canadian province that is subject to a restriction, disciplinary order, or probationary order; or

(C) has an unacceptable criminal history.

(h) Re-Application for Licensure Prohibited. A person who has been determined ineligible for a license by the Licensure Committee may not reapply for a license prior to the expiration of one year from the date of the Board's ratification of the Licensure Committee's determination of ineligibility and denial of licensure.

§185.6.Biennial [Annual] Renewal of License.

(a) Physician assistants licensed under the Physician Assistant Licensing Act shall register biennially [annually ] and pay a fee. A physician assistant may, on notification from the board, renew an unexpired license by submitting the required form and documents and by paying the required renewal fee to the board on or before the expiration date of the permit. The fee shall accompany the required form which legibly sets forth the licensee's name, mailing address, business address, and other necessary information prescribed by the board.

(b) The following documentation shall be submitted as part of the renewal process:

(1) Continuing Medical Education. As a prerequisite to the biennial [annual] registration of a physician assistant's license, 40 hours of continuing medical education (CME) are required to be completed in the following categories:

(A) at least one-half of the hours are to be from formal courses:

(i) that are designated for Category I credit by a CME sponsor approved by the American Academy of Physician Assistants; or

(ii) approved by the board for course credit.

(B) The remaining hours may be from Category II composed of informal self-study, attendance at hospital lectures, grand rounds, case conferences, or by providing volunteer medical services at a site serving a medically underserved population, other than at a site that is the primary practice site of the license holder, and shall be recorded in a manner that can be easily transmitted to the board upon request.

(C) A physician assistant shall receive one credit of continuing medical education for each hour of time spent up to 6 hours per year, as required by subparagraph (A) of this paragraph based on participation in a program sponsored by the board and approved for CME credit for the evaluation of a physician assistant's competency or practice monitoring.

(2) A physician assistant must report on the biennial [annual] registration form if she or he has completed the required continuing medical education during the previous year. A licensee may carry forward CME credit hours earned prior to [annual ] registration which are in excess of the 40 hour biennial [annual] requirement and such excess hours may be applied to the following years' requirements. A maximum of 80 total excess credit hours may be carried forward and shall be reported according to whether the hours are Category I and/or Category II. Excess CME credit hours of any type may not be carried forward or applied to a [an annual] report of CME more than two years beyond the date of the biennial [annual] registration following the period during which the hours were earned.

(3) A physician assistant may request in writing an exemption for the following reasons:

(A) catastrophic illness;

(B) military service of longer than one year's duration outside the United States;

(C) residence of longer than one year's duration outside the United States; or

(D) good cause shown on written application of the licensee that gives satisfactory evidence to the board that the licensee is unable to comply with the requirement for continuing medical education.

(4) Exemptions are subject to the approval of the licensure committee of the board.

(5) A temporary exception under paragraph (4) [(3)] of this subsection may not exceed two years [one year] but may be renewed biennially [annually], subject to the approval of the board.

(6) This section does not prevent the board from taking disciplinary action with respect to a licensee or an applicant for a license by requiring additional hours of continuing medical education or of specific course subjects.

(7) The board may require written verification of both formal and informal credits from any licensee within 30 days of request. Failure to provide such verification may result in disciplinary action by the board.

(8) Unless exempted under the terms of this section, a physician assistant licensee's apparent failure to obtain and timely report the 40 hours of CME as required and provided for in this section shall result in nonrenewal of the license until such time as the physician assistant obtains and reports the required CME hours; however, the executive director of the board may issue to such a physician assistant a temporary license numbered so as to correspond to the nonrenewed license. Such a temporary license shall be issued at the direction of the executive director for a period of no longer than 90 days. A temporary license issued pursuant to this subsection may be issued to allow the physician assistant who has not obtained or timely reported the required number of hours an opportunity to correct any deficiency so as not to require termination of ongoing patient care.

(9) A physician assistant, who is a military service member, may request an extension of time, not to exceed two years, to complete any CME requirements.

(10) A physician assistant must provide a complete and legible set of fingerprints to the board, unless fingerprints were already submitted with their initial license application or a previous renewal request.

(c) Falsification of an affidavit or submission of false information to obtain renewal of a license shall subject a physician assistant to denial of the renewal and/or to discipline pursuant to the Act, §§204.301-.303.

(d) If the renewal fee and completed application form are not received on or before the expiration date of the permit, the fees set forth in Chapter 175 of this title (relating to Fees and Penalties) shall apply.

(e) The board shall not waive fees or penalties.

(f) The board shall stagger biennial [annual ] registration of physician assistants proportionally on a periodic basis.

(g) Practicing as a physician assistant as defined in the Act without a biennial [an annual] registration permit for the current year as provided for in the board rules has the same force and effect as and is subject to all penalties of practicing as a physician assistant without a license.

(h) Physician assistants shall inform the board of address changes within two weeks of the effective date of the address change.

(i) Expired Biennial [Annual] Registration Permits.

(1) If a physician assistant's registration permit has been expired for less than one year, the physician assistant may obtain a new permit by submitting to the board a completed permit application, the registration fee, as defined in §175.2(2) of this title (relating to Registration and Renewal Fees) and the penalty fee, as defined in §175.3(2) of this title (relating to Penalties).

(2) If a physician assistant's registration permit has been expired for one year or longer, the physician assistant's license is automatically canceled, unless an investigation is pending, and the physician assistant may not obtain a new permit.

(3) A person whose license has expired may not engage in activities that require a license until the licensed has been renewed. Practicing as a physician assistant after a physician assistant's permit has expired under subsection (a) of this section without obtaining a new registration permit for the current registration period has the same effect as, and is subject to all penalties of, practicing as a physician assistant without a license. The Board interprets §204.156 of the Act to provide the exclusive sanction that may be imposed by the board for practicing medicine after the expiration of the permit.

(j) A military service member who holds a physician assistant license in Texas is entitled to two years of additional time to complete any other requirement related to the renewal of the military service member's license.

(k) The physician assistant board may refuse to renew a license if the licensee is in violation of a physician assistant board order.

§185.8.Inactive License.

(a) A license holder may have the license holder's license placed on inactive status by applying to the board. A physician assistant with an inactive license is excused from paying renewal fees on the license and may not practice as a physician assistant in Texas.

(b) In order for a license holder to be placed on inactive status, the license holder must have a current [annual] registration permit and have a license in good standing.

(c) A license holder who practices as a physician assistant in Texas while on inactive status is considered to be practicing without a license.

(d) A physician assistant may return to active status by:

(1) applying to the board, paying an application fee equal to an application fee for a physician assistant license;

(2) complying with the requirements for license renewal under the Act;

(3) providing current verifications from each state in which the physician assistant holds a license;

(4) demonstrating current certification by NCCPA;

(5) completing a fingerprint card and returning the card to the board as part of the application;

(6) submitting a report from the National Practitioner Data Bank/Health Integrity and Protection Data Bank (NPDB-HIPDB) by contacting the NPDB-HIPDB and having a report of action submitted directly to the board on the applicant's behalf; and

(7) submitting professional evaluations from each employment held after the license was placed on inactive status, and complying with subsection (e) of this section.

(e) A physician assistant applicant applying to return to active status shall provide sufficient documentation to the board that the applicant has, on a full-time basis as defined in §185.4(d) of this title (relating to Procedural Rules for Licensure Applicants), actively practiced as a physician assistant or has been on the active teaching faculty of an acceptable approved physician assistant program, within either of the two years preceding receipt of an application for reactivation. Applicants who do not meet this requirement may, in the discretion of the board, be eligible for the reactivation of a license subject to one or more of the following conditions or restrictions as set forth in paragraphs (1) - (5) of this subsection:

(1) current certification by the National Commission on the Certification of Physician Assistants;

(2) completion of specified continuing medical education hours approved for Category 1 credits by a CME sponsor approved by the American Academy of Physician Assistants;

(3) limitation and/or exclusion of the practice of the applicant to specified activities of the practice as a physician assistant;

(4) remedial education; and/or

(5) such other remedial or restrictive conditions or requirements which, in the discretion of the board are necessary to ensure protection of the public and minimal competency of the applicant to safely practice as a physician assistant.

(f) After five years on inactive status, the license shall be canceled as if by request. The physician assistant may obtain a new license by complying with the requirements and procedures for obtaining an original license.

§185.14.Physician Supervision.

(a) Supervision shall be continuous, but shall not be construed as necessarily requiring the constant physical presence of the supervising physician at a place where physician assistant services are performed while the services are performed. Telecommunication shall always be available.

(b) It is the obligation of each physician and physician assistant to ensure that:

(1) the physician assistant's scope of practice is identified;

(2) delegation of medical tasks is appropriate to the physician assistant's level of competence;

(3) the methods of access to and communicating with the supervising physician is defined;

(4) a process for evaluation of the physician assistant's performance is established; and

(5) the physician assistant is licensed to practice and has a current [annual] registration permit. The physician assistant must immediately notify his or her supervising physician(s) of any change in licensure status, including, but not limited to: permit expiration, license cancellation, or entry of a disciplinary order.

(c) A physician assistant may have more than one supervising physician.

(d) Physician assistants must utilize mechanisms which provide medical authority when such mechanisms are indicated, including, but not limited to, prescriptive authority agreements, standing delegation orders, standing medical orders, protocols, or practice guidelines.

§185.17.Grounds for Denial of Licensure and for Disciplinary Action.

The board may refuse to issue a license to any person and may, following notice of hearing and a hearing as provided for in the APA, take disciplinary action against any physician assistant who:

(1) fraudulently or deceptively obtains or attempts to obtain a license;

(2) fraudulently or deceptively uses a license;

(3) violates the Act, or any rules relating to the practice of a physician assistant;

(4) is convicted of a felony, or has imposition of deferred adjudication or pre-trial diversion;

(5) habitually uses drugs or intoxicating liqueurs to the extent that, in the opinion of the board, the person cannot safely perform as a physician assistant;

(6) has been adjudicated as mentally incompetent or has a mental or physical condition that renders the person unable to safely perform as a physician assistant;

(7) has committed an act of moral turpitude. An act involving moral turpitude shall be defined as an act involving baseness, vileness, or depravity in the private and social duties one owes to others or to society in general, or an act committed with knowing disregard for justice, honesty, principles, or good morals;

(8) represents that the person is a physician;

(9) has acted in an unprofessional or dishonorable manner which is likely to deceive, defraud, or injure any member of the public;

(10) has failed to practice as a physician assistant in an acceptable manner consistent with public health and welfare;

(11) has committed any act that is in violation of the laws of the State of Texas if the act is connected with practice as a physician assistant; a complaint, indictment, or conviction of a law violation is not necessary for the enforcement of this provision; proof of the commission of the act while in practice as a physician assistant or under the guise of practice as a physician assistant is sufficient for action by the board under this section;

(12) has had the person's license or other authorization to practice as a physician assistant suspended, revoked, or restricted or who has had other disciplinary action taken by another state regarding practice as a physician assistant or had disciplinary action taken by the uniformed services of the United States. A certified copy of the record of the state or uniformed services of the United States taking the action is conclusive evidence of it;

(13) fails to keep complete and accurate records of purchases and disposal of drugs listed in Chapter 483, Health and Safety Code, as required by Chapter 483, Health and Safety Code, or any subsequent rules. A failure to keep the records for a reasonable time is grounds for disciplinary action against the license of a physician assistant. The board or its representative may enter and inspect a physician assistant's place of practice during reasonable business hours for the purpose of verifying the correctness of these records and of taking inventory of the drugs on hand;

(14) writes a false or fictitious prescription for a scheduled or a dangerous drug as defined by Chapters 481 and 483, Health and Safety Code;

(15) prescribes, dispenses, or administers a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is prescribed, dispensed, or administered;

(16) unlawfully advertises in a false, misleading, or deceptive manner. Advertisements shall be defined as false, misleading, or deceptive consistent with §101.201 of the Texas Occupations Code;

(17) alters, with fraudulent intent, any physician assistant license, certificate, or diploma;

(18) uses any physician assistant license, certificate, or diploma that has been fraudulently purchased, issued, or counterfeited or that has been materially altered;

(19) aids or abets, directly or indirectly, the practice as a physician assistant by any person not duly licensed to practice as a physician assistant by the board;

(20) is removed or suspended or has disciplinary action taken by his peers in any professional association or society, whether the association or society is local, regional, state, or national in scope, or is being disciplined by a licensed hospital or medical staff of a hospital, including removal, suspension, limitation of privileges, or other disciplinary action, if that action, in the opinion of the board, was based on unprofessional conduct or professional incompetence that was likely to harm the public. This action does not constitute state action on the part of the association, society, or hospital medical staff;

(21) has repeated or recurring meritorious health care liability claims that in the opinion of the board evidence professional incompetence likely to harm the public; [or]

(22) through his practice as a physician assistant sexually abuses or exploits another person; or[.]

(23) is in violation of an active board order.

§185.31.Prescriptive Authority Agreements: Minimum Requirements.

Prescriptive authority agreements must, at a minimum:

(1) be in writing and signed and dated by the parties to the agreement;

(2) state the name, address, and all professional license numbers of the parties to the agreement;

(3) state the nature of the practice, practice locations, or practice settings;

(4) identify the types or categories of drugs or devices that may be prescribed or the types or categories of drugs or devices that may not be prescribed;

(5) provide a general plan for addressing consultation and referral;

(6) provide a plan for addressing patient emergencies;

(7) state the general process for communication and the sharing of information between the physician and physician assistant to whom the physician has delegated prescriptive authority related to the care and treatment of patients;

(8) if alternate physician supervision is to be utilized, designate one or more alternate physicians who may:

(A) provide appropriate supervision on a temporary basis in accordance with the requirements established by the prescriptive authority agreement and the requirements of Chapter 157 of the Medical Practice Act and Chapter 193 of this title (relating to Standing Delegation Orders); and

(B) participate in the prescriptive authority quality assurance and improvement plan meetings required under this section; and

(9) describe a prescriptive authority quality assurance and improvement plan and specify methods for documenting the implementation of the plan that includes the following:

(A) chart review, with the number of charts to be reviewed determined by the physician and physician assistant; and

(B) periodic [face-to-face] meetings between the physician assistant and the physician at a location determined by the physician and the physician assistant.

(10) The periodic [face-to-face] meetings described by paragraph (9)(B) of this section must include:

(A) the sharing of information relating to patient treatment and care, needed changes in patient care plans, and issues relating to referrals;

(B) discussion of patient care improvement; and

(C) documentation of the periodic [face-to-face] meetings.

(11) The periodic [face-to-face] meetings shall take place at least once a month in a manner determined by the physician and physician assistant. [occur as follows:]

[(A) If during the seven years preceding the date the agreement is executed, the physician assistant was not in a practice that included the exercise of prescriptive authority with required physician supervision for at least five years:]

[(i) at least monthly until the third anniversary of the date the agreement is executed; and]

[(ii) at least quarterly after the third anniversary of the date the agreement is executed, with monthly meetings held between the quarterly meetings by means of a remote electronic communications system, including videoconferencing technology or the Internet; or]

[(B) if during five of the last seven years preceding the date the agreement is executed, the physician assistant was in a practice that included the exercise of prescriptive authority with required physician supervision, but the agreement is not being entered into with the same supervising physician who delegated and supervised during the five year period:]

[(i) at least monthly until the first anniversary of the date the agreement is executed; and]

[(ii) at least quarterly after the first anniversary of the date the agreement is executed, with monthly meetings held between the quarterly meetings by means of a remote electronic communications system, including videoconferencing technology or the Internet; or]

[(C) if during five of the last seven years preceding the date the agreement is executed, the physician assistant was in a practice that included the exercise of prescriptive authority with required physician supervision, and the agreement is being entered into with the same supervising physician who delegated and supervised during the five year period:]

[(i) at least quarterly; and]

[(ii) monthly meetings held between the quarterly meetings by means of a remote electronic communications system, including videoconferencing technology or the Internet.]

(12) The prescriptive authority agreement may include other provisions agreed to by the physician and the physician assistant.

(13) If the parties to the prescriptive authority agreement practice in a physician group practice, the physician may appoint one or more alternate supervising physicians designated, if any, to conduct and document the quality assurance meetings in accordance with the requirements of Chapter 157 of the Medical Practice Act and Chapter 193 of this title.

(14) The prescriptive authority agreement need not describe the exact steps that a physician assistant must take with respect to each specific condition, disease, or symptom.

(15) A physician or physician assistant who is a party to a prescriptive authority agreement must retain a copy of the agreement until the second anniversary of the date the agreement is terminated.

(16) A party to a prescriptive authority agreement may not by contract waive, void, or nullify any provision of this section or requirements for prescriptive authority agreements set forth by Chapter 157 of the Medical Practice Act and Chapter 193 of this title.

(17) In the event that a party to a prescriptive authority agreement is notified that the individual has become the subject of an investigation by the board or the Texas Medical Board, the individual shall immediately notify the other party to the prescriptive authority agreement.

(18) The prescriptive authority agreement and any amendments must be reviewed at least annually, dated, and signed by the parties to the agreement. The prescriptive authority agreement and any amendments must be made available to the board, the Texas Board of Nursing, or the Texas Medical Board not later than the third business day after the date of receipt of request, if any.

(19) The prescriptive authority agreement should promote the exercise of professional judgment by the physician assistant commensurate with the physician assistant's education and experience and the relationship between the physician assistant and the physician.

(20) This section shall be liberally construed to allow the use of prescriptive authority agreements to safely and effectively utilize the skills and services of physician assistants. §185.32.Minimum Training and Registration Requirements for Physicians Assistant Performing Radiologic Procedures.

In order to perform radiologic procedures a licensed physician assistant must have successfully completed an educational program for physician assistants accredited by the Committee on Allied Health Education and Accreditation or by that committee's predecessor or successor entities, and must be registered with the Texas Physician Assistant Board.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800220

Scott Freshour

Interim Executive Director

Texas Medical Board

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7016


PART 24. TEXAS BOARD OF VETERINARY MEDICAL EXAMINERS

CHAPTER 575. PRACTICE AND PROCEDURE

22 TAC §575.27

The Texas Board of Veterinary Medical Examiners (Board) proposes the repeal of §575.27, concerning Complaints--Receipt. This repeal is necessary because the Board is simultaneously proposing a new section for adoption that complies with recent legislative changes and streamlines the complaint process for more efficient and fair processing of complaints. The proposed repeal removes a provision that permitted the acceptance of anonymous complaints, which is now prohibited by the Occupations Code. The proposed repeal also removes procedural provisions which may be set by internal procedures to give staff greater flexibility. The proposed new §575.27 is being published elsewhere in this issue of the Texas Register.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the proposed repeal is in effect, there are no anticipated increases or reductions in costs to the state and local governments as a result of the proposed repeal.

Mr. Helenberg has also determined that for each year of the first five years that the proposed repeal is in effect, there is no anticipated impact in revenue to state government as a result of the proposed repeal.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the proposed repeal is in effect, the anticipated public benefit will be that the rule complies with recent legislative changes and streamlines the complaint process for more efficient and fair processing of complaints. There are no anticipated economic costs to persons required to comply with the proposed repeal.

Local Employment Impact Statement

Mr. Helenberg has determined that the proposed repeal will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the proposed repeal. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the repeal of the rule would be in effect, it is estimated that; the proposed repeal would not create or eliminate a government program; implementation of the proposed repeal would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed repeal would not require an increase or decrease in future legislative appropriations to the agency; the proposed repeal would not require an increase in the fees paid to the agency; the proposed repeal would not create a new regulation; the proposed repeal would not expand, limit, or repeal an existing regulation; the proposed repeal would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed repeal would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed repeal of the rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The repeal is proposed under the authority of the Veterinary Licensing Act, Texas Occupations Code, §801.151(a), which states that the Board may adopt rules necessary to administer the chapter.

No other statutes, articles, or codes are affected by the proposal.

§575.27.Complaints--Receipt.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800212

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573


22 TAC §575.27

The Texas Board of Veterinary Medical Examiners (Board) proposes new §575.27, concerning Complaints, simultaneously with the proposed repeal of current §575.27. The proposed repeal of current §575.27 is being published elsewhere in this issue of the Texas Register.

Overview

The purpose of the proposed new rule is to comply with recent legislative changes and streamline the complaint process for more efficient and fair processing of complaints. The proposed new rule sets out the method for filing a complaint and minimum required information, as mandated by §801.159, Occupations Code. The required information is necessary for Board staff to initiate an investigation. The proposed new rule also establishes a preliminary investigation procedure that may be used to determine whether the Board should proceed with an official investigation of a complaint. This process allows the Board to efficiently dispose of complaints over which it has no jurisdiction, or which have previously been resolved by the Board. The proposed new rule permits the agency to combine or divide complaints as needed for fair and efficient investigations. Finally, the proposed new rule permits a complainant to withdraw a complaint.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the rule is in effect, there are no anticipated increases or reductions in costs to the state and local governments as a result of enforcing or administering the rule.

Mr. Helenberg has also determined that for each year of the first five years that the rule is in effect, there is no anticipated impact in revenue to state government as a result of enforcing or administering the rule.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the rule is in effect, the anticipated public benefit will be that the rule complies with recent legislative changes and streamlines the complaint process for more efficient and fair processing of complaints. There are no anticipated economic costs to persons required to comply with the rule.

Local Employment Impact Statement

Mr. Helenberg has determined that the rule will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the rule. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the rule would be in effect, it is estimated that; the proposed rule would not create or eliminate a government program; implementation of the proposed rule would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed rule would not require an increase or decrease in future legislative appropriations to the agency; the proposed rule would not require an increase in the fees paid to the agency; the proposed rule would not create a new regulation; the proposed rule would not expand, limit, or repeal an existing regulation; the proposed rule would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed rule would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed new rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The new rule is proposed under the authority of §801.151(a), Occupations Code, which states that the Board may adopt rules necessary to administer the chapter, the authority of §801.204, Occupations Code, which states that the Board shall maintain a system to promptly and efficiently act on complaints filed with the Board, and the authority of §801.159, Occupations Code, which states that the Board by rule shall adopt a form to standardize information relating to complaints filed with the Board.

No other statutes, articles, or codes are affected by the proposal.

§575.27.Complaints.

(a) Initiation.

(1) Complaints submitted to the Board by the public shall be in writing on the complaint form provided by the Board. Complaints shall contain at least the following information:

(A) the complainant's name and contact information;

(B) the name of the person against whom the complaint is submitted;

(C) the date and place of the alleged violation; and

(D) a description of the facts or conduct alleged to violate the Act or Board rules.

(2) The Board may investigate violations on its own initiative.

(b) Preliminary Investigation.

(1) A preliminary investigation may be conducted to determine:

(A) whether the Board has jurisdiction over the complaint; and

(B) whether the matter has been resolved as part of a previous complaint.

(2) The Board has jurisdiction over a complaint if it alleges conduct that, if true, would constitute a violation of the Act or Board rules.

(3) The Board does not have jurisdiction over a complaint that is received after the fourth anniversary of the latest date:

(A) the alleged violation occurred; or

(B) the earlier of when the complainant discovered, or in the exercise of reasonable diligence should have discovered, the alleged violation.

(4) If the preliminary investigation shows that the Board does not have jurisdiction over the complaint, or that the matter has been resolved as part of a previous complaint, the Board may decline to initiate an official investigation. The complainant shall be notified of the reason that the Board declined to initiate an official investigation.

(c) If the Board receives multiple complaints regarding the same respondent and the same alleged violation, the Board may combine the complaints. If the Board receives a complaint with multiple alleged violations, the Board may divide the complaint as needed.

(d) A complainant may withdraw a complaint by submitting a written request to the Board.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800213

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573


22 TAC §575.28

The Texas Board of Veterinary Medical Examiners (Board) proposes the repeal of §575.28, concerning Complaints--Investigations. This repeal is necessary because the Board is simultaneously proposing a new section for adoption that streamlines the investigative process for more efficient and fair processing of complaints. The proposed repeal removes provisions that dictate Board policy regarding prioritization of complaints. The Board is already required by §801.509 to adopt a formal policy to focus enforcement efforts toward investigating complaints and required by §801.2051 to prioritize complaints to resolve the more serious complaints first. It is unnecessary to reiterate these requirements in Board rules. The proposed repeal also removes detailed procedural provisions that unnecessarily constrain investigations. This is necessary to allow staff greater flexibility and promote timely resolution of complaints.

The proposed new §575.28 is being published elsewhere in this issue of the Texas Register.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the proposed repeal is in effect, there are no anticipated increases in costs to the state and local governments as a result of the proposed repeal. There may be incidental reductions in postage-related costs to the agency.

Mr. Helenberg has also determined that for each year of the first five years that the proposed repeal is in effect, there is no anticipated impact in revenue to state government as a result of the proposed repeal.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the proposed repeal is in effect, the anticipated public benefit will be that the rule streamlines the investigative process for more efficient and fair processing of complaints. There are no anticipated economic costs to persons required to comply with the proposed repeal.

Local Employment Impact Statement

Mr. Helenberg has determined that the proposed repeal will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the proposed repeal. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the repeal of the rule would be in effect, it is estimated that; the proposed repeal would not create or eliminate a government program; implementation of the proposed repeal would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed repeal would not require an increase or decrease in future legislative appropriations to the agency; the proposed repeal would not require an increase in the fees paid to the agency; the proposed repeal would not create a new regulation; the proposed repeal would not expand, limit, or repeal an existing regulation; the proposed repeal would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed repeal would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed repeal of the rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The repeal is proposed under the authority of the Veterinary Licensing Act, Texas Occupations Code, §801.151(a), which states that the Board may adopt rules necessary to administer the chapter.

No other statutes, articles, or codes are affected by the proposal.

§575.28.Complaints--Investigations.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22 2018.

TRD-201800214

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573


22 TAC §575.28

The Texas Board of Veterinary Medical Examiners (Board) proposes new §575.28, concerning Investigations, simultaneously with the proposed repeal of current §575.28. The proposed repeal of current §575.28 is being published elsewhere in this issue of the Texas Register.

Overview

The purpose of the proposed new rule is to comply with statutory mandates and streamline the investigative process for more efficient and fair processing of complaints. The proposed new rule distinguishes between categories of complaints, as required by §801.205, Occupations Code. The rule also prescribes information to be provided to a complainant, as required by §801.159, Occupations Code, and requires that each party be notified of the projected time requirements of the complaint, as mandated by §801.206, Occupations Code. Finally, the proposed new rule prescribes guidelines concerning the use of private investigators, as mandated by §801.205(5), Occupations Code.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the rule is in effect, there are no anticipated increases or reductions in costs to the state and local governments as a result of enforcing or administering the rule.

Mr. Helenberg has also determined that for each year of the first five years that the rule is in effect, there is no anticipated impact in revenue to state government as a result of enforcing or administering the rule.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the rule is in effect, the anticipated public benefit will be that the rule complies with statutory mandates and streamlines the investigative process for more efficient and fair processing of complaints. There are no anticipated economic costs to persons required to comply with the rule.

Local Employment Impact Statement

Mr. Helenberg has determined that the rule will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the rule. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the rule would be in effect, it is estimated that; the proposed rule would not create or eliminate a government program; implementation of the proposed rule would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed rule would not require an increase or decrease in future legislative appropriations to the agency; the proposed rule would not require an increase in the fees paid to the agency; the proposed rule would not create a new regulation; the proposed rule would not expand, limit, or repeal an existing regulation; the proposed rule would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed rule would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed new rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The new rule is proposed under the authority of §801.151(a), Occupations Code, which states that the Board may adopt rules necessary to administer the chapter, the authority of §801.205(1), which states that the Board shall adopt rules to distinguish between categories of complaints, the authority of §801.159, which states that the Board shall adopt rules to prescribe information to be provided to a person when the person files a complaint with the Board, the authority of §801.206(b), which states that the Board shall notify each party to a complaint of the projected time requirements for the complaint, and §801.205(5) which states that the Board shall adopt rules to prescribe guidelines concerning the categories of complaints that require the use of a private investigator and the procedures for the Board to obtain the services of a private investigator.

No other statutes, articles, or codes are affected by the proposal.

§575.28.Investigations.

(a) Upon the initiation of an official investigation, complaints shall be classified into one or more of the following complaint categories:

(1) Complaints alleging acts or omissions that may constitute a continuing or imminent threat to the public welfare;

(2) Complaints that require medical expertise to review;

(3) Complaints that do not require medical expertise to review; or

(4) Complaints alleging the practice of veterinary medicine or equine dentistry without a license.

(b) The complainant and respondent shall be notified of the projected time requirements for the complaint, unless the notice would jeopardize an investigation.

(c) The executive director may approve the use of a private investigator to assist in the investigation of a complaint where the use of Board investigators is not feasible or economical or where private investigators could provide valuable assistance to the Board investigators.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800215

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573


22 TAC §575.29

The Texas Board of Veterinary Medical Examiners (Board) proposes the repeal of §575.29, concerning Informal Conferences. This repeal is necessary because the Board is simultaneously proposing a new section for adoption that complies with recent legislative changes and streamlines the informal conference process for more efficient and fair processing of complaints. The proposed repeal removes provisions that require all informal conferences to be conducted before a panel of Board members. Removing this provision is necessary because it has contributed to a backlog of complaints, and is more restrictive than the Occupations Code intends. The proposed repeal also removes detailed procedural provisions that unnecessarily constrain informal conferences. This is necessary to allow greater flexibility to conduct informal conferences.

The proposed new §575.29 is being published elsewhere in this issue of the Texas Register.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the proposed repeal is in effect, there are no anticipated increases in costs to the state and local governments as a result of the proposed repeal. The agency anticipates a reduction of costs associated with Board member travel.

Mr. Helenberg has also determined that for each year of the first five years that the proposed repeal is in effect, there is no anticipated impact in revenue to state government as a result of the proposed repeal.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the proposed repeal is in effect, the anticipated public benefit will be that the rule complies with recent legislative changes and streamlines the informal conference process for more efficient and fair processing of complaints. There are no anticipated economic costs to persons required to comply with the proposed repeal.

Local Employment Impact Statement

Mr. Helenberg has determined that the proposed repeal will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the proposed repeal. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the repeal of the rule would be in effect, it is estimated that; the proposed repeal would not create or eliminate a government program; implementation of the proposed repeal would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed repeal would not require an increase or decrease in future legislative appropriations to the agency; the proposed repeal would not require an increase in the fees paid to the agency; the proposed repeal would not create a new regulation; the proposed repeal would not expand, limit, or repeal an existing regulation; the proposed repeal would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed repeal would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed repeal of the rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The repeal is proposed under the authority of the Veterinary Licensing Act, Texas Occupations Code, §801.151(a), which states that the Board may adopt rules necessary to administer the chapter.

No other statutes, articles, or codes are affected by the proposal.

§575.29.Informal Conferences.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800216

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573


22 TAC §575.29

The Texas Board of Veterinary Medical Examiners (Board) proposes new §575.29, concerning Informal Conferences, simultaneously with the proposed repeal of current §575.29. The proposed repeal of current §575.29 is being published elsewhere in this issue of the Texas Register.

Overview

The purpose of the proposed new rule is to comply with recent legislative changes and streamline the informal conference process for more efficient and fair processing of complaints. The proposed new rule requires that parties to the complaint be given reasonable notice and an opportunity to be heard and represented by counsel at an informal conference. The proposed new rule requires that the general counsel or a representative of the attorney general be present during an informal conference, as mandated by §801.408(b)(2), Occupations Code. The proposed new rule would permit the agency to conduct informal conferences regarding complaints not requiring medical expertise before a panel comprised of Board staff, as authorized by §801.408, Occupations Code. This option allows for the faster processing of complaints and more flexible allocation of agency resources. Informal conferences regarding complaints will be conducted before a panel of Board members, as mandated by §801.408, Occupations Code.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the rule is in effect, there are no anticipated increases in costs to the state and local governments as a result of enforcing or administering the rule. The agency anticipates a reduction of costs associated with Board member travel.

Mr. Helenberg has also determined that for each year of the first five years that the rule is in effect, there is no anticipated impact in revenue to state government as a result of enforcing or administering the rule.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the rule is in effect, the anticipated public benefit will be that the rule complies with statutory mandates and streamlines the investigative process for more efficient and fair processing of complaints. There are no anticipated economic costs to persons required to comply with the rule.

Local Employment Impact Statement

Mr. Helenberg has determined that the rule will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the rule. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the rule would be in effect, it is estimated that; the proposed rule would not create or eliminate a government program; implementation of the proposed rule would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed rule would not require an increase or decrease in future legislative appropriations to the agency; the proposed rule would not require an increase in the fees paid to the agency; the proposed rule would not create a new regulation; the proposed rule would not expand, limit, or repeal an existing regulation; the proposed rule would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed rule would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed new rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The new rule is proposed under the authority of §801.151(a), Occupations Code, which states that the Board may adopt rules necessary to administer the chapter, and the authority of §801.408, which states that the board shall by rule adopt procedures governing informal proceedings.

No other statutes, articles, or codes are affected by the proposal.

§575.29.Informal Conferences.

(a) Reasonable written notice of the time, date, and location of an informal conference shall be provided to the respondent and complainant, if applicable. The notice shall include a statement of the alleged violation(s) to be considered by the informal conference panel.

(b) The respondent and complainant shall each be provided with an opportunity to be heard by the informal conference panel, and may be represented by counsel. Deliberations by the informal conference panel are confidential.

(c) The general counsel or a representative of the attorney general shall be present during an informal conference to advise the informal conference panel.

(d) Informal conferences regarding complaints requiring medical expertise shall be conducted by an informal conference panel comprised of two veterinarian Board members and one public Board member.

(e) Informal conferences regarding complaints not requiring medical expertise may be conducted by an informal conference panel comprised of Board staff. The Executive Director may designate the members of this panel.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800218

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573


22 TAC §575.40

The Texas Board of Veterinary Medical Examiners (Board) proposes the repeal of §575.40, concerning Cease and Desist Procedures. This purpose of this repeal is to eliminate provisions which merely duplicate procedures established elsewhere in Board rules and Chapter 801, Occupations Code. Cease and desist procedures do not differ substantially from procedures for complaints against licensees, thus separate rules governing those procedures are unnecessary.

Fiscal Note

John Helenberg, Executive Director, has determined that for each year of the first five years that the proposed repeal is in effect, there are no anticipated increases in costs to the state and local governments as a result of the proposed repeal. The agency anticipates a reduction costs associated with Board member travel.

Mr. Helenberg has also determined that for each year of the first five years that the proposed repeal is in effect, there is no anticipated impact in revenue to state government as a result of the proposed repeal.

Public Benefit and Cost Note

Mr. Helenberg has also determined that for each year of the first five years the proposed repeal is in effect, the anticipated public benefit will be that the Board rules do not contain unnecessary, repetitive provisions. There are no anticipated economic costs to persons required to comply with the proposed repeal.

Local Employment Impact Statement

Mr. Helenberg has determined that the proposed repeal will have no impact on local employment or a local economy. Thus, the board is not required to prepare a local employment impact statement pursuant to §2001.022, Government Code.

Economic Impact Statement and Regulatory Flexibility Analysis

Mr. Helenberg has determined that there are no anticipated adverse economic effects on small business or micro-businesses as a result of the proposed repeal. Thus, the Board is not required to prepare an economic impact statement or a regulatory flexibility analysis pursuant to §2006.002, Government Code.

Takings Impact Assessment

Mr. Helenberg has determined that there are no private real property interests affected by the proposed repeal. Thus, the board is not required to prepare a takings impact assessment pursuant to §2007.043, Government Code.

Government Growth Impact Statement

For the first five years that the repeal of the rule would be in effect, it is estimated that the proposed repeal would not create or eliminate a government program; implementation of the proposed repeal would not require the creation of new employee positions or the elimination of existing employee positions; implementation of the proposed repeal would not require an increase or decrease in future legislative appropriations to the agency; the proposed repeal would not require an increase in the fees paid to the agency; the proposed repeal would not create a new regulation; the proposed repeal would not expand, limit, or repeal an existing regulation; the proposed repeal would not increase or decrease the number of individuals subject to the rule's applicability; and the proposed repeal would not positively or adversely affect the state's economy.

Request for Public Comments

The Texas Board of Veterinary Medical Examiners invites comments on the proposed repeal of the rule from any interested persons, including any member of the public. A written statement should be mailed or delivered to Elaine Crease, Texas Board of Veterinary Medical Examiners, 333 Guadalupe, Ste. 3-810, Austin, Texas 78701-3942, by facsimile (FAX) to (512) 305-7574, or by e-mail to vet.board@tbvme.state.tx.us. Comments will be accepted for 30 days following publication in the Texas Register. Comments must be received within 30 days after publication of this proposal in order to be considered.

Statutory Authority

The repeal is proposed under the authority of the Veterinary Licensing Act, Texas Occupations Code, §801.151(a), which states that the Board may adopt rules necessary to administer the chapter.

No other statutes, articles, or codes are affected by the proposal.

§575.40.Cease and Desist Procedures.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 22, 2018.

TRD-201800217

Michelle Griffin

General Counsel

Texas Board of Veterinary Medical Examiners

Earliest possible date of adoption: March 4, 2018

For further information, please call: (512) 305-7573