Source: http://www.sos.texas.gov/texreg/archive/May42018/Adopted%20Rules/22.EXAMINING%20BOARDS.html
Timestamp: 2018-07-20 14:23:55
Document Index: 261825152

Matched Legal Cases: ['§101', '§101', '§101', '§101', '§254', '§254', '§101', '§101', '§101', '§101', '§254', '§254', '§101', '§101', '§101', '§101', '§254', '§254', '§101', '§101', '§101', '§101', '§254', '§254', '§102', '§102', '§254', '§254', '§103', '§103', '§103', '§103', '§254', '§254', '§103', '§103', '§103', '§103', '§254', '§254', '§103', '§103', '§103', '§103', '§254', '§254', '§104', '§104', '§104', '§104', '§254', '§254', '§104', '§104', '§104', '§104', '§104', '§104', '§107', '§107', '§107', '§107', '§254', '§254', '§107', '§107', '§107', '§107', '§254', '§254', '§107', '§107', '§254', '§254', '§110', '§110', '§110', '§254', '§254', '§110', '§110', '§254', '§254', '§110', '§110', '§110', '§110', '§254', '§254', '§110', '§110', '§110', '§110', '§110', '§254', '§254', '§110', '§110', '§110', '§110', '§254', '§254', '§114', '§114', '§114', '§114', '§254', '§254', 'ART 11', '§214', '§214', '§301', '§214', '§214', '§301', '§217', '§217', '§301', '§217', '§217', '§301', 'ART 34', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§505', '§781', '§505', '§781', '§505', '§781', '§505', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781', '§781']

CHAPTER 101. DENTAL LICENSURE
22 TAC §101.1
The Texas State Board of Dental Examiners adopts amended rule §101.1, relating to general qualifications for dental licensure. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1364).
Amended rule §101.1 eliminates the requirement for good moral character and allows the board to deny an applicant if they are in violation of a board order at the time of application.
The Board received a comment from the Texas Dental Association, which supports the rule as written. The Board agrees with TDA's comments.
Rule §101.1 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety. No other statutes, articles, or codes are affected by the rule.
Filed with the Office of the Secretary of State on April 20, 2018.
TRD-201801743
Proposal publication date: March 9, 2018
For further information, please call: (512) 475-0977
22 TAC §101.2
The Texas State Board of Dental Examiners adopts amended rule §101.2, relating to licensure by examination. This rule is adopted without changes to the proposed text as published in the February 2, 2018, issue of the Texas Register (43 TexReg 529).
Amended rule §101.2 requires that all dental exam takers after January 1, 2019, must successfully complete the periodontics and prosthodontics sections of their chosen exam.
The Board received no comments.
Rule §101.2 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety. No other statutes, articles, or codes are affected by the rule.
TRD-201801744
Proposal publication date: February 2, 2018
22 TAC §101.5
The Texas State Board of Dental Examiners adopts amended rule §101.5, relating to staggered dental registrations. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1365).
Amended rule §101.5 changes the dental license renewal cycle to a two year period.
Rule §101.5 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
No other statutes, articles, or codes are affected by the rule.
TRD-201801748
22 TAC §101.13
The Texas State Board of Dental Examiners adopts new rule §101.13, relating to military limited volunteer licenses. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1366).
New rule §101.13 provides for a limited volunteer dental license for current and former military members.
Rule §101.13 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801752
The Texas State Board of Dental Examiners adopts amended rule §102.1 relating to fees. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1367).
This rule is being adopted to comply with statutory mandates to raise fees to pay for the Prescription Monitoring Program and other agency functions.
The Board received a comment from the Texas Dental Association, which appreciates our efforts to minimally raise fees but remains concerned about the negative impact of fee increases on licensees and registrants. TDA urges the board to implement reasonable fee increases that will not disrupt patient care or hinder dentists from operating their practices and employing Texans.
The Board’s appreciates TDA’s feedback and will take it into consideration. At this time, though, the Board feels the increases are reasonable.
Rule §102.1 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801761
CHAPTER 103. DENTAL HYGIENE LICENSURE
22 TAC §103.1
The Texas State Board of Dental Examiners adopts amended rule §103.1, relating to general qualifications for dental licensure. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1367).
Amended rule §103.1 eliminates the requirement for good moral character and allows the board to deny an applicant if they are in violation of a board order at the time of application.
Rule §103.1 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801745
22 TAC §103.5
The Texas State Board of Dental Examiners adopts amended rule §103.5, relating to staggered dental hygienist registrations. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1368).
Amended rule §103.5 changes the dental hygiene license renewal cycle to a two year period.
Rule §103.5 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801746
22 TAC §103.9
The Texas State Board of Dental Examiners adopts new rule §103.9, relating to military limited volunteer licenses for dental hygienists. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1369).
New rule §103.9 provides for a volunteer dental license for current and former military members.
The Board received a comment from the Texas Dental Association which supports the rule as written.
Rule §103.9 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801747
22 TAC §104.1
The Texas State Board of Dental Examiners adopts amended rule §104.1, relating to continuing education requirements. This rule is adopted with changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1370). Section (2)(C) of the proposed text incorrectly allowed for 12 hours of self-study, but the proposed rule approved by the Board provided for 8 hours of self-study. The Board is making this correction without re-proposing the rule because it believes it is a minor change that does not increase the overall amount of hours required.
Amended rule §104.1 changes the continuing education requirements of dentists and dental hygienists in light of the change to biennial license renewals. Most requirements have simply doubled, however 8 hours of self-study are allowed (previously 6) and the jurisprudence exam must be taken every 4 years (previously 3).
Rule §104.1 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety. No other statutes, articles, or codes are affected by the rule.
§104.1.Requirement.
As a prerequisite to the biennial renewal of a dental or dental hygiene license, proof of completion of 24 hours of acceptable continuing education is required.
(1) Each licensee shall select and participate in the continuing education courses endorsed by the providers identified in §104.2 of this title (relating to Providers). A licensee, other than a licensee who resides outside of the United States, who is unable to meet education course requirements may request that alternative courses or procedures be approved by the Licensing Committee.
(A) Such requests must be in writing and submitted to and approved by the Licensing Committee prior to the expiration of the biennial period for which the alternative is being requested.
(B) A licensee must provide supporting documentation detailing the reason why the continuing education requirements set forth in this section cannot be met and must submit a proposal for alternative education procedures.
(C) Acceptable causes may include unanticipated financial or medical hardships or other extraordinary circumstances that are documented.
(D) A licensee who resides outside of the United States may, without prior approval of the Licensing Committee, complete all required hours of coursework by self-study.
(i) These self-study hours must be provided by those entities cited in §104.2 of this title (relating to Providers). Examples of self-study courses include correspondence courses, video courses, audio courses, and reading courses.
(ii) Upon being audited for continuing education compliance, a licensee who submits self-study hours under this subsection must be able to demonstrate residence outside of the United States for all periods of time for which self-study hours were submitted.
(E) Should a request to the Licensing Committee be denied, the licensee must complete the requirements of this section.
(2) Effective September 1, 2018, the following conditions and restrictions shall apply to coursework submitted for renewal purposes:
(A) At least 16 hours of coursework must be either technical or scientific as related to clinical care. The terms “technical” and “scientific” as applied to continuing education shall mean that courses have significant intellectual or practical content and are designed to directly enhance the practitioner's knowledge and skill in providing clinical care to the individual patient.
(B) Up to 8 hours of coursework may be in risk-management courses. Acceptable “risk management” courses include courses in risk management, record-keeping, and ethics.
(C) Up to 8 hours of coursework may be self-study. These self-study hours must be provided by those entities cited in §104.2 of this title (relating to Providers). Examples of self-study courses include correspondence courses, video courses, audio courses, and reading courses.
(D) Hours of coursework in the standards of the Occupational Safety and Health Administration (OSHA) annual update course or in cardiopulmonary resuscitation (CPR) basic life support training may not be considered in the 24-hour requirement.
(E) Hours of coursework in practice finance may not be considered in the 24-hour requirement.
(3) Each licensee shall complete the jurisprudence assessment every four (4) years. This requirement is in addition to the twenty-four (24) hours of continuing education required biennially for the renewal of a license.
(4) A licensee may carry forward continuing education hours earned prior to a renewal period which are in excess of the 24-hour requirement and such excess hours may be applied to subsequent years' requirements. Excess hours to be carried forward must have been earned in a classroom setting and within the one year immediately preceding the renewal period. A maximum of 24 total excess credit hours may be carried forward.
(5) Examiners for the Western Regional Examining Board (WREB) and for Central Regional Dental Testing Services Inc. (CRDTS) will be allowed credit for no more than 12 hours biennially, obtained from calibration and standardization exercises associated with the examinations.
(6) Any individual or entity may petition one of the providers listed in §104.2 of this title to offer continuing education.
(7) Providers cited in §104.2 of this title will approve individual courses and/or instructors.
(8) A consultant for the SBDE who is also a licensee of the SBDE is eligible to receive up to 12 hours of continuing education credit biennially to apply towards the biennial renewal continuing education requirement under this section.
(A) Continuing education credit hours shall be awarded for the issuance of an expert opinion based upon the review of SBDE cases and for providing assistance to the SBDE in the investigation and prosecution of cases involving violations of the Dental Practice Act and/or the Rules of the SBDE.
(B) The amount of continuing education credit hours to be granted for each consultant task performed shall be determined by the Executive Director, Division Director or manager that authorizes the consultant task to be performed. The award of continuing education credit shall be confirmed in writing and based upon a reasonable assessment of the time required to complete the task.
TRD-201801749
CHAPTER 107. DENTAL BOARD PROCEDURES
SUBCHAPTER A. PROCEDURES GOVERNING GRIEVANCES, HEARINGS, AND APPEALS
22 TAC §107.52
The Texas State Board of Dental Examiners adopts amended rule §107.52 relating to oral and written arguments before the board. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1371).
Amended rule §107.52 provides that respondents addressing a proposal for decision before the Board may do so with either a 10 minute oral argument or a 10 page written response.
Rule §107.52 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801760
SUBCHAPTER B. COMPLAINTS AND INVESTIGATIONS
22 TAC §107.104
The Texas State Board of Dental Examiners adopts the repeal of rule §107.104, relating to the official investigation of a complaint. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1372).
This rule is being repealed to allow for the adoption of a new version of §107.104. The previous rule was improperly adopted.
Rule §107.104 is repealed under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801756
The Texas State Board of Dental Examiners adopts new rule §107.104 relating to the official investigation of a complaint. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1372).
This rule is being adopted to provide for classifications of investigations and the assigning of those classifications.
The Board received a comment from the Texas Dental Association, who requests that the rule give specific examples of kinds of cases that fall within each classification. Also, TDA requests that changes in classification be made by either the Dental Director or the Director of Investigations. The Board has decided not to change the rule from the proposed version because it believes that the rule as drafted provides us with more flexibility in handling complaints than we would have under a more specific rule.
Rule §107.104 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801757
22 TAC §110.7
The Texas State Board of Dental Examiners adopts repeal of rule §110.7 relating to portability. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1373).
This rule is being repealed because it was improperly adopted at the January 13, 2018 meeting. The repeal will allow for the proper adoption of a new rule.
Rule §110.7 is repealed under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801758
The Texas State Board of Dental Examiners adopts new rule §110.7 relating to portability. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1373).
This rule is being adopted to comply with Senate Bill 313 of the 85th Texas Legislature.
The Board received several comments to this rule:
The Texas Dental Association and the Texas Academy of General Dentistry both support the rule as drafted.
The Texas Society of Oral and Maxillofacial Surgeons requests that the rule include a requirement that portable dentists provide the addresses at which they administer sedation/anesthesia. TXSOMS believes that not having those addresses will prevent TSBDE from inspecting offices and efficiently investigating anesthesia mishaps. They believe the Board’s oversight of permit holders is weakened without the addresses, which in turn compromises patient safety.
Drs. Larry Stewart, James Bates, James Clark, Thomas Schlieve, Wendell Edgin, and Mark Ranschaert all submitted nearly identical comments expressing their concern that not having an address requirement in this rule is inadvertently compromising patient safety by weakening the board’s oversight of all permit holders. They believe we will be unable to conduct comprehensive office inspections and will be unable to quickly respond to incidents. Dr. Schlieve also adds that this rule does not improve access to care and does not improve dental care for Texans.
The Board’s response to these comments is that the statute requiring that this rule be created is very clear in requiring merely an attestation that one provides portable anesthesia and therefore does not give the Board the discretion to add any further requirements. Adding that requirement would open the Board up for a lawsuit.
Rule §110.7 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801759
22 TAC §110.13
The Texas State Board of Dental Examiners adopts new rule §110.13, relating to a required preoperative checklist for sedation and anesthesia. This rule is adopted with a minor change to the proposed text as published in the February 2, 2018, issue of the Texas Register (43 TexReg 530). The change will clarify that the checklist can be either a paper or electronic record. The board is not submitting this change for re-proposal because it does not affect the rule whatsoever, it merely clarifies it.
New rule §110.13 provides that licensees must complete a preoperative checklist prior to administering nitrous or levels 1, 2, 3, or 4 sedation/anesthesia to a patient. The checklist must contain at least the specified components in the rule and must be maintained in the patient's records.
The Board received comments from the Texas Dental Association and the Texas Academy of General Dentistry, both of which support the rule as drafted.
Rule §110.13 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
§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. The checklist may be paper or electronic.
(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. The checklist may be paper or electronic.
(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.
TRD-201801753
22 TAC §110.14
The Texas State Board of Dental Examiners adopts new rule §110.14, relating to emergency preparedness policies and procedures. This rule is adopted without changes to the proposed text as published in the February 2, 2018, issue of the Texas Register (43 TexReg 531).
New rule §110.14 requires all sedation/anesthesia permit holders (including nitrous) to develop written emergency preparedness policies and procedures specific to their practice setting and to annually review and update them.
Rule §110.14 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety. No other statutes, articles, or codes are affected by the rule.
TRD-201801754
22 TAC §110.15
The Texas State Board of Dental Examiners adopts new rule §110.15, relating to the prevention of and response to sedation and anesthesia emergencies. This rule is adopted without changes to the proposed text as published in the February 2, 2018, issue of the Texas Register (43 TexReg 532).
New rule §110.15 requires permit holders to have immediately available specific equipment and a supply of emergency drugs.
Rule §110.15 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety. No other statutes, articles, or codes are affected by the rule.
TRD-201801755
CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL--DENTAL ASSISTANTS
22 TAC §114.2
The Texas State Board of Dental Examiners adopts amended rule §114.2, relating to registration of dental assistants. This rule is adopted without changes to the proposed text as published in the March 9, 2018, issue of the Texas Register (43 TexReg 1377).
Amended rule §114.2 has several changes for registered dental assistants. Like dentists and hygienists, RDAs will now be on a two-year renewal cycle and will be ineligible for licensure if they are currently in violation of a board order. New applicants will be required to submit proof of the following: graduation from an accredited high school or high school equivalency, fingerprints for retrieval of criminal history, and successful completion of a hands on basic life support course.
The Board received a comment from the Texas Dental Association, which approves of the rule as drafted.
Rule §114.2 is adopted under Texas Occupations Code §254.001(a). The Board interprets §254.001(a) to give the Board authority to adopt rules necessary to perform its duties and ensure compliance with state law relating to the practice of dentistry to protect the public health and safety.
TRD-201801750
PART 11. TEXAS BOARD OF NURSING
CHAPTER 214. VOCATIONAL NURSING EDUCATION
22 TAC §214.9
The Texas Board of Nursing (Board) adopts amendments to §214.9(b), concerning Program of Study. The amendments are being adopted without changes to the proposed text published in the March 16, 2018, issue of the Texas Register (43 TexReg 1556).
The amendments are adopted under the authority of the Occupations Code §301.151 and are necessary to correct an inadvertent deletion of language from the text of the rule that occurred when this section was proposed for amendment and adopted in the February 23, 2018, edition of the Texas Register. The deletion of §214.9(b)(1) - (3) was unintended. The deletion of these provisions was not proposed by the Board in the proposal published in the December 8, 2017, edition of the Texas Register (42 TexReg 6884) and was not referenced in the Board's adoption order published in the February 23, 2018, edition of the Texas Register (43 TexReg 1095). The proposal published in the December 8, 2017, edition of the Texas Register (42 TexReg 6885) specifically stated that there should be no change to §214.9(b)(1) - (3), and the adoption order published in the February 23, 2018, edition of the Texas Register did not reference a change to this subsection. Thus, their deletion was wholesale in error. The amendments are necessary to correct the deletion of these paragraphs.
How the Section Will Function.
The adopted amendments add the prior version of paragraphs (1) - (3) back into to subsection (b).
Summary of Comments and Agency Response. The Board did not receive any comments on the proposal.
Statutory Authority. The amendments are adopted under the authority of the Occupations Code §301.151.
Section 301.151 addresses the Board's rulemaking authority. Section 301.151 authorizes the Board to adopt and enforce rules consistent with Chapter 301 and necessary to: (i) perform its duties and conduct proceedings before the Board; (ii) regulate the practice of professional nursing and vocational nursing; (iii) establish standards of professional conduct for license holders under Chapter 301; and (iv) determine whether an act constitutes the practice of professional nursing or vocational nursing.
Filed with the Office of the Secretary of State on April 18, 2018.
TRD-201801662
Jena Abel
Proposal publication date: March 16, 2018
For further information, please call: (512) 305-6822
CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE
22 TAC §217.2
The Texas Board of Nursing (Board) adopts an amendment to §217.2, concerning Licensure by Examination for Graduates of Nursing Education Programs Within the United States, its Territories, or Possessions. The amendment is being adopted without changes to the proposed text published in the March 16, 2018, issue of the Texas Register (43 TexReg 1557).
The amendment is adopted under the authority of the Occupations Code §301.151 and is necessary to correct the inadvertent deletion of the word "program" from the text of the rule that occurred when this section was proposed for amendment and adopted in the February 23, 2018, edition of the Texas Register. The deletion of the word "program" from §217.2(a)(4)(E)(ii) was unintended. The inclusion of this word was proposed by the Board in the proposal published in the December 8, 2017, edition of the Texas Register (42 TexReg 6888) and was not referenced as a change to the proposed text in the Board’s adoption order published in the February 23, 2018, edition of the Texas Register (43 TexReg 1096). Thus, the word’s deletion was wholesale in error. The amendment is necessary to correct the deletion of this word.
The adopted amendment adds the word "program" to §217.2(a)(4)(E)(ii).
Statutory Authority. The amendment is adopted under the authority of the Occupations Code §301.151.
TRD-201801663
PART 34. TEXAS STATE BOARD OF SOCIAL WORKER EXAMINERS
CHAPTER 781. SOCIAL WORKER LICENSURE
The Texas State Board of Social Worker Examiners (board) adopts amendments to §781.204 and §781.404, concerning the licensure and regulation of social workers, with changes to the proposed text as published in the October 27, 2017, issue of the Texas Register (42 TexReg 5981). The amendments to §§781.102, 781.203 and 781.316 and new §781.223 are adopted without changes to the proposed text as proposed and will not be republished.
The board has voted to withdraw the amendment to §781.603, concerning the licensure and regulation of social workers as published in the October 27, 2017, issue of the Texas Register (42 TexReg 5981).
The amendments to §781.102 and §781.316 eliminate the Advanced Practitioner specialty recognition to streamline the license structure and process. The amendments to §781.203 modifies what is required at the termination of the client relationship, and the amendments to §781.204(k) and §781.223 clarify the requirements for social workers engaging in electronic practice. The amendment to §781.404(b)(12)(A) clarifies the requirements for supervision towards licensure.
The amendments to §781.102 and §781.316 will remove existing language relating to the Advanced Practitioner specialty recognition.
The amendment to §781.203 details more specific guidelines when a service provider terminates the client relationship and facilitates the appropriate transfer of services.
The amendments to §781.204 detail more specific guidelines for social workers engaging in electronic practice, and the location of the client receiving services.
The amendment to §781.404 clarifies the requirements that board-approved supervisors must follow when providing supervision.
New §781.223 will implement guidelines regarding the use of technology when providing social work services.
The board received public comments regarding §§781.102(46), 781.203, 781.204, 781.223, 781.404, and 781.603. The board has reviewed and prepared responses to the comments received regarding the proposed rules during the comment period. The commenters were individuals, the National Association of Social Workers - Texas Chapter, the Association of Social Work Boards, the Texas Society for Clinical Social Work, and the Office of Senator Van Taylor. Commenters were generally in favor of the rules; however, some commenters raised questions or suggested changes that are discussed in the summary of comments.
Comment: A public comment was received from the Association of Social Work Boards regarding §781.102(46), requesting clarification about the Association of Social Work Boards offering the Advanced Generalist examination.
Response: The board responded that there is difficulty in validating only one version of the examination, and given the history of low volume of Advanced Practitioner licensees, the board voted to proceed with the rule amendment and eliminate the Advanced Practitioner recognition to streamline the license structure and process. No change to the proposed language was made as a result of this comment.
Comment: Public comment was received from the Texas Society for Clinical Social Work in support of the rule change regarding §781.203. Public comment received from individuals and the National Association of Social Workers- Texas Chapter cited potential limitations about the steps to facilitate transferring a client to other sources of service after termination, and wished to add the language "whenever possible."
Response: The board raised concern that the addition of "whenever possible" may release a licensee from an obligation to abide by the rule, and voted to proceed with the rule amendment as originally proposed and published. No change to the proposed language was made as a result of this comment.
Comment: Public comment was received from individuals, the National Association of Social Workers- Texas Chapter, and the Texas Society for Clinical Social Work regarding §781.204(k) about providing services to clients located in the State of Texas via electronic practice, and the mobility of clients and social workers.
Response: The board disagreed and has voted to proceed with the rule amendment as originally proposed and published. No change to the proposed language was made as a result of this comment.
Comment: Public comment was received from individuals, the National Association of Social Workers- Texas Chapter, and the Texas Society for Clinical Social Work regarding §781.204(n) about licensees or relatives of licensees borrowing or lending money to clients or relatives of clients, and the potential unawareness of relation of licensees or clients to the licensee or client, and the inability to police the behavior of relatives.
Response: The board agreed and voted to reword the amendment to subsection (n) to state "The licensee or relatives to the fourth degree of consanguinity or affinity of the licensee may not intentionally borrow or lend money or items of value to clients or relatives to the fourth degree of consanguinity or affinity of clients."
Comment: Public comment was received from the Texas Society for Clinical Social Work regarding §781.223 in favor of the rule addition. The Office of Senator Van Taylor inquired about providing social work services with the use of technology, and the potential limiting effect on suicide hotlines.
Response: The board responded that they had no concerns that the rule would have any effect on suicide hotlines, and voted to proceed with the new rule as originally proposed and published. No change to the proposed language was made as a result of this comment.
Comment: Public comment was received from the Texas Society for Clinical Social Work regarding §781.404(b)(3) about the supervisor training program, questioning the rationale for the change that the board was to become an accrediting body.
Response: The board agreed and has voted to withdraw the proposed rule amendment to §781.404(b)(3).
Comment: Public comment was received from the Texas Society for Clinical Social Work regarding §781.404(b)(12)(A) in support of the clarification. Public comment was received from an individual who requested consideration of not allowing group supervision as a stand-alone method of supervision.
Response: The board disagreed and responded that the addition of group supervision as a stand-alone method of supervision added flexibility to the supervision process and voted to proceed with the amendment as originally proposed and published. No change to the proposed language was made as a result of this comment.
Comment: Public comment was received from an individual, the National Association of Social Workers- Texas Chapter, and the Texas Society for Clinical Social Work regarding §781.603 about the processing of non-jurisdictional complaint cases, and questioned the necessity of presenting a case to the Ethics Committee for closure.
Response: The board agreed and has voted to withdraw the proposed rule amendment from this rulemaking.
22 TAC §781.102
The amendment is authorized by Texas Occupations Code, §505.201, which authorizes the board to adopt rules necessary for the performance of its duties.
Filed with the Office of the Secretary of State on April 23, 2018.
TRD-201801783
Proposal publication date: October 27, 2017
For further information, please call: (512) 776-6972
SUBCHAPTER B. CODE OF CONDUCT AND PROFESSIONAL STANDARDS OF PRACTICE
22 TAC §§781.203, 781.204, 781.223
The amendments and new rule are adopted under Texas Occupations Code, §505.201, which authorizes the board to adopt rules necessary for the performance of its duties.
§781.204.Relationships with Clients.
(a) A social worker shall inform in writing a prospective client about the nature of the professional relationship, which can include but is not limited to office procedures, after-hours coverage, services provided, fees, and arrangements for payment.
(b) The social worker shall not give or receive a commission, rebate, or any other form of remuneration for referring clients. A licensee shall not intentionally or knowingly offer to pay or agree to accept any remuneration directly or indirectly, overtly or covertly, in cash or in kind, to or from any person, firm, association of persons, partnership, corporation, or entity for securing or soliciting clients or patronage for or from any health care professional. In accordance with the provisions of the Act, §505.451, a licensee is subject to disciplinary action if the licensee directly or indirectly offers to pay or agrees to accept remuneration to or from any person for securing or soliciting a client or patronage. Payment of credentialing or other fees to insurance companies or other third party payers to be part of an approved provider list shall not be considered as a violation of this chapter.
(c) A social worker shall not enter into a business relationship with a client. This rule does not prohibit a professional social work relationship with a client, as described in this subchapter.
(d) A social worker shall not engage in activities that seek to primarily meet the social worker's personal needs or personal gain instead of the needs of the client.
(e) A social worker shall be responsible for setting and maintaining professional boundaries.
(f) A social worker shall keep accurate records of services to include, but not be limited to, dates of services, types of services, progress or case notes and billing information for a minimum of five years for an adult client and five years beyond the age of 18 years of age for a minor, or in compliance with applicable laws or professional standards. If the foregoing provision conflicts with the standards, requirements, or procedures for records generated in the course and scope of rendering services as a social worker, either directly or indirectly, for an educational institution, or a federal, state, or local governmental entity or political subdivision, the foregoing provision does not apply.
(g) A social worker shall bill clients or third parties for only those services actually rendered or as agreed to by mutual written understanding.
(h) A licensee shall not make any false, misleading, deceptive, fraudulent or exaggerated claim or statement about the effectiveness of the licensee's services; the licensee's qualifications, capabilities, background, training, experience, education, professional affiliations, fees, products, or publications; the type, effectiveness, qualifications, and products or services offered by an organization or agency; or the practice or field of social work.
(i) If the licensee learns that false, misleading, deceptive, fraudulent or exaggerated statements about the services, qualifications, or products have been made, the licensee shall take all available steps to correct the inappropriate claims, prevent their reoccurrence, and report the incident to the board.
(j) A licensee shall provide social work intervention only in the context of a professional relationship.
(k) Electronic practice may be used judiciously as part of the social work process and the supervision process. Social workers engaging in electronic practice, providing services to clients located in the State of Texas, must be licensed in Texas and adhere to provisions of this chapter.
(l) The licensee shall not provide social work services or intervention to previous or current family members; personal friends; educational or business associates; or individuals whose welfare might be jeopardized by a dual or multiple relationship.
(m) The licensee shall not accept from or give to a client any gift with a value in excess of $25. If the licensee's employer prohibits giving or receiving gifts, the licensee shall comply with the employer's policy.
(n) The licensee or relatives to the fourth degree of consanguinity or affinity of the licensee may not intentionally borrow or lend money or items of value to clients or relatives to the fourth degree of consanguinity or affinity of clients.
(o) The licensee shall take reasonable precautions to protect individuals from physical or emotional harm resulting from interaction within individual and group settings.
(p) A licensee shall not promote the licensee's personal or business activities that are unrelated to the current professional relationship.
(q) A licensee shall set and maintain professional boundaries, avoiding dual or multiple relationships with clients. If a dual or multiple relationship develops, the social worker is responsible for ensuring the client is safe.
TRD-201801784
SUBCHAPTER C. THE BOARD
22 TAC §781.316
The amendment is adopted under Texas Occupations Code, §505.201, which authorizes the board to adopt rules necessary for the performance of its duties.
TRD-201801785
SUBCHAPTER D. LICENSES AND LICENSING PROCESS
22 TAC §781.404
§781.404.Recognition as a Board-approved Supervisor and the Supervision Process.
(a) Types of supervision include:
(1) administrative or work-related supervision of an employee, contractor or volunteer that is not related to qualification for licensure, practice specialty recognition, a disciplinary order, or a condition of new or continued licensure;
(2) clinical supervision of a Licensed Master Social Worker in a setting in which the LMSW is providing clinical services; the supervision may be provided by a Licensed Professional Counselor, Licensed Psychologist, Licensed Marriage and Family Therapist, Licensed Clinical Social Worker or Psychiatrist. This supervision is not related to qualification for licensure, practice specialty recognition, a disciplinary order, or a condition of new or continued licensure;
(3) clinical supervision of a Licensed Master Social Worker, who is providing clinical services and is under a board-approved supervision plan to fulfill supervision requirements for achieving the LCSW; a Licensed Clinical Social Worker who is a board-approved supervisor delivers this supervision;
(4) non-clinical supervision of a Licensed Master Social Worker or Licensed Baccalaureate Social Worker who is providing non-clinical social work service toward qualifications for independent non-clinical practice recognition; this supervision is delivered by a board-approved supervisor;
(5) non-clinical supervision of a Licensed Master Social Worker who is providing non-clinical social work service toward qualifications for the LMSW-AP; this supervision is delivered by a board-approved supervisor;
(6) supervision of a probationary Licensed Master Social Worker or Licensed Baccalaureate Social Worker providing non-clinical services by a board-approved supervisor toward licensure under the AMEC program; or
(7) board-ordered supervision of a licensee by a board-approved supervisor pursuant to a disciplinary order or as a condition of new or continued licensure.
(b) A person who wishes to be a board-approved supervisor must file an application and pay the applicable fees as described in §781.316 of this chapter.
(1) A board-approved supervisor must be actively licensed in good standing by the board as an LBSW, an LMSW, an LCSW, or be recognized as an Advanced Practitioner (LMSW-AP), or hold the equivalent social work license in another jurisdiction. An individual whose licensure status is emeritus may not serve as a board-approved supervisor. The person applying for board-approved status must have practiced at his/her category of licensure for two years. The board-approved supervisor shall supervise only those supervisees who provide services that fall within the supervisor's own competency.
(2) The board-approved supervisor is responsible for the social work services provided within the supervisory plan.
(3) The board-approved supervisor must have completed a supervisor's training program acceptable to the board.
(4) The board-approved supervisor must complete three hours of continuing education every biennium in supervision theory, skills, strategies, and/or evaluation.
(5) The board-approved supervisor must designate at each license renewal that he/she wishes to continue board-approved supervisor status.
(6) The board-approved supervisor must submit required documentation and fees to the board as listed in §781.316 of this title (relating to Fees).
(7) When a licensee is designated a board-approved supervisor, he or she may perform the following supervisory functions.
(A) An LCSW may supervise clinical experience toward the LCSW license, non-clinical experience toward the Advanced Practitioner specialty recognition, non-clinical experience toward the Independent Practice Recognition (non-clinical), a licensee under probationary initial or continued licensure, board-ordered probated suspension, and probationary license holders under the AMEC program.
(B) An LMSW-AP may supervise non-clinical experience toward the Advanced Practitioner specialty recognition; non-clinical experience toward the non-clinical Independent Practice Recognition; a licensee under probationary initial or continued licensure; board-ordered probated suspension for non-clinical practitioners; and probationary license holders under the AMEC program.
(C) An LMSW with the Independent Practice Recognition (non-clinical) who is a board-approved supervisor may supervise an LBSW's or LMSW's non-clinical experience toward the non-clinical Independent Practice Recognition; an LBSW or LMSW under probationary initial or continued licensure; an LBSW or LMSW (non-clinical) under board-ordered probated suspension; and a probationary license holder under the AMEC program; however, an LMSW who does not hold the independent practice recognition may only supervise probationary license holders under the AMEC program in an employment setting.
(D) An LBSW with the non-clinical Independent Practice Recognition who is a board-approved supervisor may supervise: an LBSW's non-clinical experience toward the non-clinical Independent Practice Recognition; an LBSW under probationary initial or continued licensure; an LBSW under board-ordered probated suspension; and a probationary LBSW license holder under the AMEC program; however, an LBSW who does not hold the independent practice recognition may only supervise probationary license holders under the AMEC program in an employment setting.
(8) On receiving the licensee's application to be a board-approved supervisor, as well as fee and verification of qualifications, the board will issue a letter notifying the licensee that the licensee is a board-approved supervisor.
(9) The approved supervisor must renew the approved supervisor status in conjunction with the biennial license renewal. The approved supervisor may surrender supervisory status by documenting the choice on the appropriate board renewal form and subtracting the supervisory renewal fee from the renewal payment. If a licensee who has surrendered supervisory status desires to regain supervisory status, the licensee must reapply and meet the current requirements for approved supervisor status.
(10) A supervisor must maintain the qualifications described in this section while he or she is providing supervision.
(11) A board-approved supervisor who wishes to provide any form of board-approved or board-ordered supervision must comply with the following.
(A) The supervisor is obligated to keep legible, accurate, complete, signed supervision notes and must be able to produce such documentation for the board if requested. The notes shall document the content, duration, and date of each supervision session.
(B) A social worker may contract for supervision with written approval of the employing agency. A copy of the approval must accompany the supervisory plan submitted to the board.
(C) A board-approved supervisor may not charge or collect a fee or anything of value from his or her employee or contract employee for the supervision services provided to the employee or contract employee.
(D) Before entering into a supervisory agreement, the supervisor shall be aware of all conditions of exchange with the clients served by her or his supervisee. The supervisor shall not provide supervision if the supervisee is practicing outside the authorized scope of the license. If the supervisor believes that a social worker is practicing outside the scope of the license, the supervisor shall make a report to the board.
(E) A supervisor shall not be employed by or under the employment supervision of the person who he or she is supervising.
(F) A supervisor shall not be a family member of the person being supervised.
(G) A supervisee must have a clearly defined job description and responsibilities.
(H) A supervisee who provides client services for payment or reimbursement shall submit billing to the client or third-party payers which clearly indicates the services provided and who provided the services, and specifying the supervisee's licensure category and the fact that the licensee is under supervision.
(I) If either the supervisor or supervisee has an expired license or a license that is revoked or suspended during supervision, supervision hours accumulated during that time will be accepted only if the licensee appeals to and receives approval from the board.
(J) A licensee must be a current board-approved supervisor in order to provide professional development supervision toward licensure or specialty recognition, or to provide board-ordered supervision to a licensee. Providing supervision without having met all requirements for current, valid board-approved supervisor status may be grounds for disciplinary action against the supervisor.
(K) The supervisor shall ensure that the supervisee knows and adheres to the Code of Conduct and Professional Standards of Practice of this chapter.
(L) The supervisor and supervisee shall avoid forming any relationship with each other that impairs the objective, professional judgment and prudent, ethical behavior of either.
(M) Should a supervisor become subject to a board disciplinary order, that person is no longer a board-approved supervisor and must so inform all supervisees, helping them to find alternate supervision.
(N) The board may deny, revoke, or suspend board-approved supervisory status following a fair hearing for violation of the Act or rules, according to the department fair hearing rules. Continuing to supervise after the board has denied, revoked, or suspended board-approved supervisor status, or after the supervisor's supervisory status expires, may be grounds for disciplinary action against the supervisor.
(O) If a supervisor's board-approved status is expired, suspended, or revoked, the supervisor shall refund all supervisory fees the supervisee paid after the date the supervisor ceased to be board-approved.
(P) A supervisor is responsible for developing a well-conceptualized supervision plan with the supervisee, and for updating that plan whenever there is a change in agency of employment, job function, goals for supervision, or method by which supervision is provided.
(Q) All board-approved supervisors shall have taken a board-approved supervision training course by January 1, 2014 in order to renew board-approved supervisor status. The board recognizes that many licensees have had little, if any, formal education about supervision theories, strategies, problem-solving, and accountability, particularly LBSWs who may supervise licensees toward the IPR. Though some supervisors have functioned as employment supervisors for some time and have acquired practical knowledge, their practical supervision skills may be focused in one practice area, and may not include current skills in various supervision methods or familiarity with emerging supervisory theories, strategies, and regulations. Therefore, the board values high-quality, contemporary, multi-modality supervision training to ensure that all supervisors have refreshed their supervisory skills and knowledge in order to help supervisees practice safely and effectively.
(12) A board-approved supervisor who wishes to provide supervision towards licensure as an LCSW or towards specialty recognition in Independent Practice (IPR) or Advanced Practitioner (LMSW-AP), which is supervision for professional growth, must comply with the following.
(A) Supervision toward licensure or specialty recognition may occur in one-on-one sessions, in group sessions, or in a combination of one-on-one and group sessions. Session may transpire in the same geographic location, or via audio, web technology or other electronic supervision techniques that comply with HIPAA and Texas Health and Safety Code, Chapter 611, and/or other applicable state or federal statutes or rules.
(B) Supervision groups shall have no fewer than two members and no more than six.
(C) Supervision shall occur in proportion to the number of actual hours worked, with a base line of one hour of supervision for every 40 hours worked. If the supervisee works full-time, supervision shall occur on average at least twice a month and for no less than four hours per month; if the supervisee works part-time (at least 20 hours per week), supervision shall occur on average at least once a month and no less than two hours per month. Supervisory sessions shall last at least one hour and no more than two hours per session. No more than 10 hours of supervision may be counted in any one month, or 30-day period, as appropriate, towards satisfying minimum requirements for licensure or specialty recognition.
(D) The board considers supervision toward licensure or specialty recognition to be supervision which promotes professional growth. Therefore, all supervision formats must encourage clear, accurate communication between the supervisor and the supervisee, including case-based communication that meets standards for confidentiality. Though the board favors supervision formats in which the supervisor and supervisee are in the same geographical place for a substantial part of the supervision time, the board also recognizes that some current and future technology, such as using reliable, technologically-secure computer cameras and microphones, can allow personal face-to-face, though remote, interaction, and can support professional growth. Supervision formats must be clearly described in the supervision plan, explaining how the supervision strategies and methods of delivery meet the supervisee's professional growth needs and ensure that confidentiality is protected. The plan must be approved by the board.
(E) Supervision toward licensure or specialty recognition must extend over a full 3000 hours over a period of not less than 24 full months and a period of not more than 48 full months for LCSW or LMSW-AP or not more than 60 full months for Independent Practice Recognition (IPR). Even if the individual completes the minimum of 3000 hours of supervised experience and minimum of 100 hours of supervision prior to 24 months from the start date of supervision, supervision which meets the board's minimum requirements shall extend to a minimum of 24 full months. A month is a 30-day period or the length of the actual calendar month, whichever is longer.
(F) The supervisor and the supervisee bear professional responsibility for the supervisee's professional activities.
(G) If the supervisor determines that the supervisee lacks the professional skills and competence to practice social work under a regular license, the supervisor shall develop and implement a written remediation plan for the supervisee.
(H) Board-approved supervised professional experience towards licensure must comply with §781.401 of this title (relating to Qualifications for Licensure) and §781.402 of this title (relating to Clinical Supervision for LCSW and Non-Clinical Supervision for LMSW-AP and Independent Practice Recognition) of this title and all other applicable laws and rules.
(13) A board-approved supervisor who wishes to provide supervision required as a result of a board order must comply with relevant provisions of §781.413 of this title (relating to Alternate Method of Examining Competency (AMEC) Program), §781.610 of this title (relating to Due Process Following Violation of an Order) and §781.806 of this title (relating to Probation) of this title, all other applicable laws and rules, and/or the following.
(A) A licensee who is required to be supervised as a condition of initial licensure, continued licensure, or disciplinary action must:
(i) submit one supervisory plan for each practice location to the board for approval by the board or executive director/designee within 30 days of initiating supervision;
(ii) submit a current job description from the agency in which the social worker is employed with a verification of authenticity from the agency director or his or her designee on agency letterhead or submit a copy of the contract or appointment under which the licensee intends to work, along with a statement from the potential supervisor that the supervisor has reviewed the contract and is qualified to supervise the licensee in the setting;
(iii) ensure that the supervisor submits reports to the board on a schedule determined by the board. In each report, the supervisor must address the supervisee's performance, how closely the supervisee adheres to statutes and rules, any special circumstances that led to the imposition of supervision, and recommend whether the supervisee should continue licensure. If the supervisor does not recommend the supervisee for continued licensure, the supervisor must provide specific reasons for not recommending the supervisee. The board may consider the supervisor's reservations as it evaluates the supervision verification the supervisee submits; and
(iv) notify the board immediately if there is a disruption in the supervisory relationship or change in practice location and submit a new supervisory plan within 30 days of the break or change in practice location.
(B) The supervisor who agrees to provide board-ordered supervision of a licensee who is under board disciplinary action must understand the board order and follow the supervision stipulations outlined in the order. The supervisor must address with the licensee those professional behaviors that led to board discipline, and must help to remediate those concerns while assisting the licensee to develop strategies to avoid repeating illegal, substandard, or unethical behaviors.
(C) Board-ordered and mandated supervision timeframes are specified in the board order.
(c) A licensee who submits one of the following: a Clinical Supervision Plan, a Non-Clinical Supervision Plan, or a Board-Ordered Supervision Plan, to the board for approval, shall receive a written response from the board of either approval or deficiency related to the plan. If no written response is received by the licensee within four weeks of submission of the plan, it is the responsibility of the licensee who has submitted the plan to follow-up with the board office related to receipt and/or status of the plan within 60 days of submission. If written approval or deficiency is sent to the last known address of the licensee, a board response related to acceptance of the plan shall be considered to have been sent. Supervision and supervised experience hours are not acceptable to meet minimum requirements towards licensure or specialty recognition or to satisfy the terms of a board order if not accrued under a board-approved plan without explicit authorization from the board.
TRD-201801787