Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 9 - TEXAS MEDICAL BOARD › Chapter 186 - RESPIRATORY CARE PRACTITIONERS › Section 186.22 - Impaired Respiratory Care Practitioners

Current through Reg. 49, No. 28; July 12, 2024
(a) Mental or physical examination
				requirement.
(1) The advisory board may
				require a practitioner/applicant to submit to a mental and/or physical
				examination by a physician or physicians designated by the advisory board if
				the advisory board has probable cause to believe that the
				practitioner/applicant is impaired. Impairment is present if one appears to be
				unable to practice with reasonable skill and safety to patients by reason of
				age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any
				other type of material; or as a result of any mental or physical condition.
(2) Probable cause may include,
				but is not limited to, any one of the following:
(A) sworn statements from two people, willing
				to testify before the advisory board, the Medical Board, committees of those
				boards, or the State Office of Administrative Hearings that a certain
				practitioner/applicant is impaired;
(B) a sworn statement from an official
				representative of the Texas Society for Respiratory Care stating that the
				representative is willing to testify before the advisory board that a certain
				practitioner/applicant is impaired;
(C) evidence that a practitioner/applicant
				left a treatment program for alcohol or chemical dependency before completion
				of that program;
(D) evidence that
				a practitioner/applicant is guilty of intemperate use of drugs or alcohol;
(E) evidence of repeated arrests
				of a practitioner/applicant for intoxication;
(F) evidence of recurring temporary
				commitments of a practitioner/applicant to a mental institution;
(G) medical records indicating that a
				practitioner/applicant has an illness or condition which results in the
				inability to function properly in his or her practice; or
(H) actions or statements by a
				practitioner/applicant at a hearing conducted by the advisory board or the
				Medical Board that gives the advisory board or the Medical Board reason to
				believe that the practitioner or applicant has an impairment.
(3) Upon presentation to the
				Executive Director of probable cause, the advisory board authorizes the
				Executive Director to write the practitioner/applicant requesting that the
				practitioner/applicant submit to a physical or mental examination within 30
				days of the receipt of the letter from the Executive Director. The letter shall
				state the reasons for the request for the mental or physical examination, the
				physician or physicians the Executive Director has approved to conduct such
				examinations, and the date by which the examination and the results are to be
				received by the advisory board.
(4) If the practitioner/applicant to whom a
				letter requiring a mental or physical examination is sent refuses to submit to
				the examination, the advisory board, through its Executive Director, shall
				issue an order requiring the practitioner/applicant to show cause why the
				practitioner/applicant should not be required to submit to the examination and
				shall schedule a hearing on the order not later than the 30 days after the date
				on which the notice of the hearing is provided to the practitioner. The
				practitioner/applicant shall be notified by either personal service or
				certified mail with return receipt requested.
(5) At the show cause hearing provided for in
				paragraph (4) of this subsection, a panel of the advisory board's
				representatives shall determine whether the practitioner/applicant shall submit
				to an evaluation or that the matter shall be closed with no examination
				required.
(A) At the hearing, the
				practitioner/applicant and the practitioner/applicant's attorney, if any, are
				entitled to present testimony and other evidence showing that the
				practitioner/applicant should not be required to submit to the examination.
(B) If, after consideration of the
				evidence presented at the show cause hearing, the panel determines that the
				practitioner/applicant shall submit to an examination, the advisory board's
				representatives shall, through its Executive Director, issue an order requiring
				the examination within 60 days after the date of the entry of the order
				requiring examination. A practitioner/applicant is entitled to cross-examine an
				expert who offers testimony at hearing before the advisory board.
(C) If the panel determines that no such
				examination is necessary, the panel will withdraw the request for examination.
(D) The results of any advisory
				board-ordered mental or physical examination are confidential shall be
				presented to the advisory board under seal for it to take whatever action is
				deemed necessary and appropriate based on the results of the mental or physical
				examination. A practitioner/applicant shall be provided the results of an
				examination and given the opportunity to provide a response at least 30 days
				before the advisory board takes action.
(6) In fulfilling its obligations under
				§604.052(1)(H) of the
				Act, the advisory board shall refer the practitioner /applicant to the most
				appropriate medical specialist for evaluation. The advisory board may not
				require a practitioner /applicant to submit to an examination by a physician
				having a specialty specified by the advisory board unless medically indicated.
				The advisory board may not require a practitioner /applicant to submit to an
				examination to be conducted an unreasonable distance from the person's home or
				place of business unless the practitioner /applicant resides and works in an
				area in which there are a limited number of physicians able to perform an
				appropriate examination.
(7) The
				guidelines adopted under this subsection do not impair or remove the advisory
				board's power to make an independent licensing or disciplinary decision unless
				a temporary suspension is convened.