TITLE 22. EXAMINING BOARDS

PART 14. TEXAS OPTOMETRY BOARD

CHAPTER 273. GENERAL RULES

22 TAC §273.17

The Texas Optometry Board (Board) adopts new §273.17, concerning Emergency Management. The adopted new rule requires CPR or BLS for initial licensure and for renewal licensure beginning January 1, 2023.

Rule 273.17 is adopted with one technical change to the proposed text published in the May 27, 2022 issue of the Texas Register (47 TexReg 3103). This rule will be republished.

SUMMARY OF TECHNICAL CHANGE(S):

Section §273.17(a)(2) - Change "Services" to "Support".

No public comments were received.

New Board Rule §273.17 is adopted under the Texas Optometry Act, Texas Occupations Code, §351.151. The Texas Optometry Board interprets §351.151 as authorizing the adoption of procedural and substantive rules for the regulation of the optometric profession.

§273.17.Emergency Management.

(a) Definitions.

(1) Cardiopulmonary resuscitation (CPR) is an emergency lifesaving procedure performed when the heart stops beating. A certification in CPR includes training and successful course completion in cardiopulmonary resuscitation, AED and obstructed airway procedures for all age groups according to recognized national standards.

(2) Basic Life Support (BLS) is a basic level of pre-hospital and inter-hospital emergency care and non-emergency medical services care. A certification in BLS includes training and successful course completion in airway management, cardiopulmonary resuscitation (CPR), control of shock and bleeding and splinting of fractures, according to recognized national standards.

(b) Requirement for Initial License. Commencing effective January 1, 2023, all applicants for initial licensure shall provide proof of successful completion of a CPR or BLS certification prior to receiving a license.

(c) Requirement for Renewal of License. Effective January 1, 2023, all active licensees shall provide proof of successful completion of a CPR or BLS certification for renewal of a license each renewal cycle. Licensees may be credited two general hours of continuing education for CPR certification and four general hours of continuing education for BLS certification.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 29, 2022.

TRD-202202848

Kelly Parker

Executive Director

Texas Optometry Board

Effective date: August 18, 2022

Proposal publication date: May 27, 2022

For further information, please call: (512) 305-8500


PART 24. TEXAS BOARD OF VETERINARY MEDICAL EXAMINERS

CHAPTER 573. RULES OF PROFESSIONAL CONDUCT

SUBCHAPTER F. RECORDS KEEPING

22 TAC §573.52

The Texas Board of Veterinary Medical Examiners adopts amendments to §573.52, concerning Veterinarian Patient Record Keeping. These amendments are adopted with changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3396). The rule will be republished.

The amendments are adopted, in part, to clarify what information is required for compliance. The amendments also update the rule in keeping with advances in the medical information modalities offered to the animal owning public and to increase the standards of veterinary medical practice. The changes reflect non-substantive variations from the proposed amendment. The changes affect no new persons, entities, or subjects other than those given notice, and the rule, as adopted, does not impose more stringent requirements that the proposed version.

The following entities furnished written comments on the proposed amendment: Texas Veterinary Medical Association (hereinafter "TVMA") and several other individual veterinarians.

TVMA and other individual veterinarians' comments essentially covered the same concerns contending the proposed rule, under subsection (a)(6) Examination Findings, requires the veterinarian to record medical data such as pulse and respiration rate, when the information often times is not useful and it would subject the veterinarian to disciplinary action for failing to record unnecessary information. The Board disagrees because under subsection (a)(6) the rule says, "if required for diagnosis or treatment and is not difficult to obtain," they would be required to record the listed medical information. The conditional language in the said subsection clearly allows the veterinarian latitude to practice medicine the way they see fit. Therefore, a veterinarian is not required to record the information they determine is not required for diagnosis or treatment or where it is difficult to obtain.

TVMA and other veterinarians commented against subsection (a)(12), regarding anesthesia monitoring. They contended it is too difficult to free up their aseptic hands to record real-time data or to recall every time they checked significant data. The Board disagrees that requiring basic information under subsections (a)(11) and (a) (12), such as the description of the procedure, the name of the surgeon, type of sedative and anesthetic agent used, route of administration, and dosage, is too much to ask of a medical professional. The requirement is very broad and a basic surgical report. For example, a horse castration would be sufficiently reported by documenting the horse's name, the owner's name, the doctor's name, name of sedative--Ketamine, Xylazine, and Valium--time of surgery, routine castration performed on right lateral accumbency, removed two testicles using an emasculator, and that the horse stood without complications at a time certain. This section in the rule gives large latitude to the practitioner to decide what they want to record.

The amendments are adopted under the authority of §§801.151(b) and 801.151(c) of the Texas Veterinary Licensing Act (Chapter 801, Texas Occupations Code). The Board interprets §801.151(c) as authorizing the agency to protect the public through adopting rules of professional conduct appropriate to establish and maintain a high standard of integrity, skills, and practice in the veterinary medicine profession.

§573.52.Veterinarian Patient Record Keeping.

(a) A veterinarian performing a physical examination, diagnosis, treatment or surgery on an animal or group of animals shall prepare a legible written record or computer record concerning the animals containing, at a minimum, the following information:

(1) name, address, and telephone number of the owner;

(2) identity of the species, animal, herd, or flock;

(3) except for herds or flocks, the age, sex, color, and breed;

(4) dates of examination, treatment and surgery;

(5) brief history of the condition of each animal, litter, herd, or flock;

(6) examination findings, if required for diagnosis or treatment and is not difficult to obtain:

(A) weight - actual or estimated;

(B) temperature;

(C) pulse;

(D) respiration; and

(E) any additional findings needed for diagnosis;

(7) laboratory and radiographic tests performed and reports;

(8) differential diagnosis; referrals/consultations; to/with specialists and the client’s response;

(9) procedures performed/treatment given and results;

(10) drugs (and their dosages) administered, dispensed, or prescribed;

(11) surgical procedures shall include a description of the procedure, the name of the surgeon, the type of sedative/anesthetic agent used, the route of administration and the dosage; and

(12) anesthesia monitoring performed during surgical procedures.

(b) Individual records must be maintained on each patient, except that records on livestock or litters of animals may be maintained on a per-client basis. Records pertaining to these animals may be kept in a daily log or billing records, provided that the treatment information is substantial enough to identify these animals and the medical care provided.

(c) Medical records and radiographs are the physical property of the hospital or the proprietor of the practice that prepared them. Records, including radiographs, must be maintained for a minimum of three years after the last visit.

(d) Medical records shall be released upon request from a treating veterinarian with a legitimate interest, and shall be returned to the originating practice within a reasonable time if requested. Copies of records must be made available upon request from the owner of an animal at a reasonable cost to the owner and within a reasonable time. A veterinarian may not withhold the release of veterinary medical records for nonpayment of a professional fee.

(e) All regulated substances shall be recorded as required by federal and/or state regulations.

(f) Any signed acknowledgement required by §§573.14 and 573.16 - 573.18 (relating to all complementary therapies).

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 27, 2022.

TRD-202202832

John Hargis

General Counsel

Texas Board of Veterinary Medical Examiners

Effective date: August 16, 2022

Proposal publication date: June 10, 2022

For further information, please call: (512) 693-4500x3