Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 9 - TEXAS MEDICAL BOARD › Chapter 185 - PHYSICIAN ASSISTANTS › Section 185.22 - Impaired Physician Assistants

Current through Reg. 49, No. 28; July 12, 2024
(a)
				Mental or physical examination requirement.
(1) The board may require a
				licensee/applicant to submit to a mental and/or physical examination by a
				physician or physicians designated by the board if the board has probable cause
				to believe that the licensee/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 board, the medical board, or the State Office of
				Administrative Hearings that a certain licensee/applicant is
				impaired;
(B) a sworn statement
				from an official representative of the Texas Academy of Physician Assistants
				stating that the representative is willing to testify before the board that a
				certain licensee /applicant is impaired;
(C) evidence that a licensee/applicant left a
				treatment program for alcohol or chemical dependency before completion of that
				program;
(D) evidence that a
				licensee/applicant is guilty of intemperate use of drugs or alcohol;
(E) evidence of repeated arrests of a
				licensee/applicant for intoxication;
(F) evidence of recurring temporary
				commitments of a licensee/applicant to a mental institution;
(G) medical records indicating that a
				licensee/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
				licensee/applicant at a hearing conducted by the Board that gives the Board
				reason to believe that the licensee or applicant has an impairment.
(3) Upon presentation to the
				Executive Director of probable cause, the Board authorizes the Executive
				Director to write the licensee/applicant requesting that the licensee/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
				Board.
(4) If the
				licensee/applicant to whom a letter requiring a mental or physical examination
				is sent refuses to submit to the examination, the Board, through its Executive
				Director, shall issue an order requiring the licensee/applicant to show cause
				why the licensee/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 licensee. The
				licensee/applicant shall be notified by either personal service or certified
				mail with return receipt requested.
(5) At the show cause hearing provided in for
				in paragraph (4) of this subsection, a panel of the Board's representatives
				shall determine whether the licensee/applicant shall submit to an evaluation or
				that the matter shall be closed with no examination required.
(A) At the hearing, the licensee/applicant
				and the licensee/applicant's attorney, if any, are entitled to present
				testimony and other evidence showing that the licensee/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
				licensee/applicant shall submit to an examination, the 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 licensee is entitled to cross-examine an expert who offers testimony at
				hearing before the 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 Board-ordered mental
				or physical examination are confidential shall be presented to the 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 licensee shall be
				provided the results of an examination and given the opportunity to provide a
				response at least 30 days before the Board takes action.
(6) In fulfilling its obligations under
				§ 204.3045 of the Act, the Board shall refer the licensee/applicant to the
				most appropriate medical specialist for evaluation. The Board may not require a
				licensee/applicant to submit to an examination by a physician having a
				specialty specified by the Board unless medically indicated. The Board may not
				require a licensee/applicant to submit to an examination to be conducted an
				unreasonable distance from the person's home or place of business unless the
				licensee/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 Board's power to make an independent
				licensing or disciplinary decision unless a temporary suspension is
				convened.