TITLE 22.EXAMINING BOARDS

Part 3. TEXAS BOARD OF CHIROPRACTIC EXAMINERS

Chapter 71. APPLICATIONS AND APPLICANTS

22 TAC §71.12

The Texas Board of Chiropractic Examiners adopts an amendment to Chapter 71, by adding a new §71.12, relating to temporary licenses, with changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10482).

The Chiropractic Act, Occupations Code, §201.308, authorizes the board to adopt rules relating to the issuance of a temporary license of limited duration. The board at times has received inquiries about obtaining board permission to provide chiropractic services at events, such as sports competitions, in Texas each year. Without a rule in place, the board has not been able to grant temporary permission for chiropractors who are licensed in other states to work at such events. Chiropractors licensed in other states who are associated with the sponsors of such events or who have been invited to provide services to the participants at the events are not able to provide services without board authorization. The board's annual regular license or provisional license do not meet the needs of these chiropractors. The application process for these licenses is more detailed and approval takes too long. Neither do these chiropractors desire an annual or provisional license, because they do not intend to provide chiropractic services to the general public in Texas. Their practice is limited in time and scope. A temporary license will enable chiropractors qualified to practice in their licensed state to participate in events held in Texas.

Section 71.12 sets out the procedures, restrictions and eligibility requirements for a temporary license not to exceed 30 days in a calendar year. The section only applies to out-of-state licensed chiropractors who desire to practice at special events in Texas. To minimize the risk to the citizens of Texas, §71.12 restricts a chiropractor with a temporary license to providing services only to participants of an event and may not provide services to the general public. Because of the limited time in which these chiropractors will be providing services and the limited scope of practice allowed by the proposed section, the board is adopting minimal eligibility requirements as set out in subsections (a) and (b). A chiropractic must be licensed in another state and be in good standing. The chiropractor must also be either associated with the sponsor of an event or invited by the sponsor to provide services. The rule will enable sponsors of events held in Texas to have chiropractors who they have invited and who are licensed in other states, in good standing, to provide chiropractic services to a limited group of persons at meetings, sports events, or other functions. The section will allow these groups to utilize their regular doctors of chiropractic, who may be most familiar with the needs of the participants, or renown doctors of chiropractic, who frequently are on the programs of functions, to provide limited chiropractic services in Texas.

No comments were received concerning the proposed section.

The new section is adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §201.308, which the board interprets as authorizing it to adopt rules providing for temporary licensure.

The following are the statutes, articles, or codes affected by the section: §71.12 -- Occupations Code, §§201.152, 201.308.

§71.12.Temporary License.

(a)

A person licensed as a chiropractor in good standing in another state, the District of Columbia, or a territory of the United States may practice chiropractic as defined by the Occupations Code, §201.002 and provide chiropractic services to individuals, groups, or organizations within the State of Texas for a period of time not to exceed 30 days within a calendar year as provided by this section. A person applying for temporary privileges shall apply in writing, to the board, on a form prescribed by the board, at least 14 days prior to the expected working days in Texas. The executive director of the board, at his or her discretion, may accept an application within a lesser time period if the applicant has submitted a full and complete application. The application must include a description of the chiropractic services to be performed and the event, meeting, or function at which the services are to be performed, identification of the persons to be treated, the specific dates the services are to be performed, and documentation of eligibility as provided in subsection (b) of this section.

(b)

An applicant for a temporary license must have a current, active, and unrestricted license, without any pending disciplinary proceedings, as a chiropractor in another state, the District of Columbia, or a territory of the United States. An applicant must submit with the application:

(1)

a statement which has a notary seal or a state seal from the appropriate chiropractic licensing agency in another jurisdiction confirming that the applicant has an active license and is in good standing with that jurisdiction, with no pending disciplinary orders or proceedings against the applicant; and

(2)

a letter of invitation or other document from the sponsoring entity showing that the applicant is invited or authorized to participate and to provide chiropractic services at a scheduled event, meeting, or other function in Texas.

(c)

A person granted temporary privileges under this section shall abide by the rules of the board during the period the privileges are in effect. The granting of a temporary license constitutes limited authority to practice chiropractic in Texas only within the scope of services and in connection with the persons to be treated as described in the application and approved by the executive director. A person granted temporary privileges may not provide chiropractic services to the general public at an event, meeting, or other function, or at any other location in Texas. Violations of the Chiropractic Act, board rules, or the temporary license will subject the temporary licensee to disciplinary action by the board.

(d)

This section does not apply to those persons who reside or who are in the process of establishing residence in Texas or who provide or intend to provide chiropractic services primarily in Texas. This section cannot be used as an entry to licensure in Texas.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000669

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


Chapter 73. LICENSES AND RENEWALS

22 TAC §73.3, §73.7

The Texas Board of Chiropractic Examiners adopts amendments to §73.3(1), relating to Continuing Education, and §73.7, relating to Approved Continuing Education Courses, without changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10483). The text of the rules as amended will not be republished.

The board currently requires 16 hours annually of continuing education. A licensee may choose the courses to fulfill this requirement from the board's list of approved courses. However, if the board presents a course, a licensee is required to attend that course as part of the 16 hour requirement. The amendments explain that the required board course is one for which its subject, content and presenter has been approved by the board and will generally be on a topic of timely and educational interest to the chiropractic profession. The amendments also provide that the board will give advance notice of the course in its newsletter and on its website. A TBCE Required Course will be labeled as such as by a seminar sponsor only after receiving written notice of board approval. The amendments also provide notice, in §73.3, that a list of approved courses is available on the board's website and upon request. Other changes have been made for format and to delete redundant language; specifically, references to the criteria for approved courses has been revised to reflect that these courses are those approved pursuant to §73.7.

The rules as amended provide better notice of continuing education requirements and information on required board courses.

No comments were received concerning the proposed amendments.

The amendments are adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §201.356, which the board interprets as requiring it to adopt rules establishing a mandatory continuing education program and an approval process for courses.

The following are the statutes, articles, or codes affected by the amendments: §§73.3(1), 73.7 -- Occupations Code, §§201.152, .356.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000670

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


Chapter 75. RULES OF PRACTICE

22 TAC §75.3

The Texas Board of Chiropractic Examiners adopts new §75.3, relating to persons with criminal convictions, with changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10486). The text of the rule will be republished.

The only change made to this rule since publication was to correct and incorrect citation to §75.9(d) in subsection (i); the correct title of this section is "Complaint and Disciplinary Procedures," as proposed in amendments to this section by separate rulemaking. The reference has been changed accordingly. In conjunction with this rulemaking, the board is repealing §76.7, the board's current rule on this subject as published in this same issue of the Texas Register . See also the November 26, 1999, issue of the Texas Register (24 TexReg 10488). With the adoption of §75.3, §76.7 is no longer be needed. Chapter 53 of the Occupations Code requires licensing authorities to make certain determinations relating to applicants for licensure or current license holders who have criminal convictions. The chapter also requires the board to adopt guidelines relating to its policies and procedures under the chapter, including a provision that states the reasons a particular crime is considered to relate to a particular license and any other criteria that the board considers in making a decision under the chapter. Rule 75.3 contains the guidelines required by Chapter 53. Subsection (k) of §75.3 lists the crimes the board has determined are directly related to a chiropractic license and its reasons for this determination. As part of the drafting of this rule, legal counsel for the board reviewed similar rules of other licensing agencies, including the Texas Department of Health (25 TAC §133.113), State Board of Examiners for Speech-Language pathology and Audiology (22 TAC §741.195, State Board of Medical Examiners (22 TAC §168.1); Texas Board of Physical Therapy Examiners (22 TAC §343.9), and the Texas State Board of Examiners of Psychologists (22 TAC §461.23). Rule 75.3, including subsection (k), was modeled after these rules as well as Chapter 53 itself. Chapter 53 requires the board to consider criminal conduct of those persons regulated by it. In order to carrying out this responsibility, the board must have sufficient information. Accordingly, Rule 75.3 requires an affected person to notify timely the board of any conviction and to provide certain information required by Chapter 53 and gives a person the opportunity to submit any other relevant information he or she may choose. Subsection (h) provides examples of documentation that may be submitted to establish some of the factors set out in that subsection and which the board must consider in its determinations. The section as a whole gives notice to licensees and the public of board procedures relating to the licensure and registration of persons with criminal backgrounds. The section gives advance notice of the statutory factors which the board must consider in each case; however, Chapter 53 and §75.3 give the board broad discretion to determine in each case whether or not a person with a criminal conviction should be licensed, giving full consideration of the board's policy and the person's particular situation.

No comments were received concerning the proposed section.

The new section is adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §53.025, which the board interprets as requiring it to adopt guidelines relating to the practice of the board under Occupations Code, Chapter 53, and which guidelines must state the reasons a particular crime is considered by the board to relate to a particular license and any other criterion that affects the decisions of the board.

The following are the statutes, articles, or codes affected by §75.3: Occupations Code, §201.152, §53.025.

§75.3.Individuals With Criminal Convictions.

(a)

This section establishes guidelines and criteria on the eligibility of persons with criminal backgrounds, including each person who owns a 10% or more interest in a chiropractic facility, to obtain licenses or registrations as chiropractors or chiropractic radiologic technologists (CRTs) or facility registrations.

(b)

The board may suspend or revoke a current license or registration, disqualify a person from receiving a license or registration, or deny to a person the opportunity to be examined for a license because of an person's conviction of a felony or misdemeanor that directly relates to the duties and responsibilities of a licensed chiropractor, registered CRT, or registered facility. This subsection applies to persons who are not imprisoned at the time the board considers the conviction.

(c)

The board shall revoke a license or registration on the license or registration holder's imprisonment following a felony conviction, felony community supervision revocation, revocation of parole, or revocation of mandatory supervision. A person in prison is not eligible for a license or registration.

(d)

In considering whether a criminal conviction directly relates to the occupation of chiropractic, chiropractic radiology, or facility operation, the board shall consider:

(1)

the nature and seriousness of the crime;

(2)

the relationship of the crime to the purposes for requiring a license or registration to engage in chiropractic, chiropractic radiology, or facility operation;

(3)

the extent to which a license or registration might afford an opportunity to repeat the criminal activity in which the person had been involved; and

(4)

the relationship of the crime to the ability, capacity, or fitness required to perform the duties and discharge the responsibilities of a licensed chiropractor, registered CRT, or registered facility.

(e)

In reaching a decision required by this section, the board shall also determine the person's fitness to perform the duties and discharge the responsibilities of a licensed chiropractor, registered CRT, or registered facility. In making this determination, the board shall consider the following factors listed in paragraphs (1)-(6) of this subsection:

(1)

the extent and nature of the person's past criminal activity;

(2)

the age of the person at the time of the commission of the crime;

(3)

the amount of time that has elapsed since the person's last criminal activity;

(4)

the conduct and work activity of the person prior to and following the criminal activity;

(5)

evidence of the person's rehabilitation or rehabilitative effort while incarcerated or following release; and

(6)

other evidence of the person's present fitness, including letters of recommendation from:

(A)

prosecution, law enforcement, and correctional officers who prosecuted, arrested, or had custodial responsibility for the person;

(B)

the sheriff and chief of police in the community where the person resides; and

(C)

any other persons in contact with the convicted person.

(f)

An applicant for a license or registration from the board or a current licensee or registrant shall disclose to the board any conviction against him or her at the time of application or, if a current licensee or registrant, at the time of renewal or no later than 30 days after judgment in the trial court, whichever date is earlier.

(g)

Upon notification of a conviction, the board shall provide a copy of this section to the person and request that the person respond, in writing, to the board as to why the board should not deny the application or take disciplinary action against the person, if already licensed or registered.

(h)

A person with a felony conviction shall provide a response in writing to the board and may submit any information that he or she believes is relevant to the determinations required by this section. If the person fails to respond, the matter will be referred to the Enforcement Committee or the Licensure/Educational Standards Committee as provided in subsection (i) of this section. The person shall also:

(1)

to the extent possible, secure and provide to the board the recommendations of the prosecution, law enforcement, and correctional authorities specified in subsection (e)(6) of this section;

(2)

cooperate with the board by providing the information required by subsection (e) of this section, including proof, in the form indicated in subparagraphs (A)-(D) of this paragraph, that he or she has:

(A)

maintained a record of steady employment, as evidenced by salary stubs, income tax records or other employment records for the time since the conviction and/or release from imprisonment;

(B)

supported his or her dependents, as evidenced by salary stubs, income tax records or other employment records for the time since the conviction and/or release from imprisonment, and a letter from the spouse or other parent;

(C)

maintained a record of good conduct as evidenced by letters of recommendation, absence of other criminal activity or documentation of community service since conviction; and

(D)

paid all outstanding court costs, supervision fees, fines, and restitution as may have been ordered in all criminal cases in which he or she has been convicted, as evidenced by certified copies of a court release or other documentation from the court system that all monies have been paid.

(i)

Determinations under this section will be considered enforcement matters and made in accordance with this chapter, except that the executive director will review the application for licensure or registration of a person with a criminal conviction and refer it to the Licensure/Educational Standards Committee (LESC), upon receipt of all information required by this section. The LESC shall determine whether the applicant may sit for examination or be granted a certificate of registration. Upon a recommendation to deny an application by the LESC, the matter will be referred to the Executive Director for informal settlement or, if necessary, a hearing as provided by §75.9(d) of this title (relating to Complaint and Disciplinary Procedures).

(j)

The board shall notify the affected person in its order that denies, suspends, or revokes a license or registration under this section, or otherwise in writing, after hearing, of:

(1)

the reason for the suspension, revocation, denial, or disqualification;

(2)

the review procedure provided by Occupations Code, §53.052; and

(3)

the earliest date the person may appeal the action of the licensing authority.

(k)

The Chiropractic Act, Occupations Code, §201.302, requires that an applicant for licensure be of good moral character. Section 201.502 further authorizes the board to revoke or impose other sanctions for violations of certain specified conduct, including deception and fraud in the practice of chiropractic, conviction of a felony or a misdemeanor of moral turpitude, grossly unprofessional conduct, habitual conduct that is harmful to patients, and lack of diligence in the chiropractic profession. Chiropractors and the healthcare profession generally are held to high standards of professional conduct. To protect the public and patients, the board has a duty to ensure that licensees and registrants are persons who possess integrity, honesty and a high standard of conduct as well the skill, education, and training to perform their duties and responsibilities. The crimes listed in paragraphs (1)-(6) of this subsection relate to the license and registrations issued by the board. These crimes generally indicate an inability or a tendency for the person to be unable to perform or to be unfit for licensure or registration because violation of such crimes indicates a lack of integrity and respect for one's fellow human being and the community at large. The direct relationship to a board issued license or registration is obvious when the crime occurs in connection with the practice of chiropractic:

(1)

practicing chiropractic without a license and other violations of the Chiropractic Act;

(2)

deceptive business practices;

(3)

medicare or medicaid fraud;

(4)

a misdemeanor or felony offense involving:

(A)

murder;

(B)

assault;

(C)

burglary;

(D)

robbery;

(E)

theft;

(F)

sexual assault;

(G)

injury to a child;

(H)

injury to an elderly person;

(I)

child abuse or neglect;

(J)

tampering with a governmental record;

(K)

forgery;

(L)

perjury;

(M)

failure to report abuse;

(N)

bribery;

(O)

harassment;

(P)

insurance claim fraud under the Penal Code, § 32.55; or

(Q)

solicitation under the Penal Code, §38.12(d) or Occupations Code, Chapter 102;

(5)

delivery, possession, manufacture, or use of or the dispensing or prescribing a controlled substance, dangerous drug, or narcotic; or

(6)

other misdemeanors or felonies, including violations of the Penal Code, Titles 4, 5, 7, 9, and 10, which indicate an inability or tendency for the person to be unable to perform as a licensee or registrant or to be unfit for licensure or registration if action by the board will promote the intent of the Chiropractic Act, board rules including this chapter, and Occupations Code, Chapter 53.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000671

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


22 TAC §75.7

The Texas Board of Chiropractic Examiners adopts an amendment to §75.7(a), relating to board fees, without changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10488). The text of the rule as amended will not be republished.

The board earlier this year adopted changes to §§78.1, 78.2 and 75.7, providing for biennial registration of CRTs, which were published in the July 30, 1999, issue of the Texas Register (24 TexReg 5870). This change in the registration and continuing education reporting periods was to begin with the January 1, 2000 registration period. By separate rulemaking published in this issue of the Texas Register , the board, for administrative reasons, has adopted amendments to Chapter 78 which maintain an annual renewal cycle. See rulemaking adopting amendments to §78.1 and §78.2, published in this issue of the Texas Register , and proposed published in the November 26, 1999, issue of the Texas Register (24 TexReg 10489). As a result, the fee change made in July to the registration fee for CRT needed to be revised to reflect an annual fee, which this rulemaking does. These changes overall will result in more timely compliance with the board registration requirements with no additional administrative costs to the state attributable to an annual registration program.

No comments were received concerning the proposed amendment.

The amendment is adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Act, §201.153, which the board interprets as authorizing it to adopt necessary fees for administration of its programs, and §201.452 and §601.252, which the board interprets as authorizing it to adopt rules to establish a registration and continuing education program for CRTs in the use of x-ray in conformity with state law and TDH rules, and to implement state law relating to radiologic training for employees of a chiropractor, including fees to administer the program..

The following are the statutes, articles, or codes affected by the amendment: §§75.7 -- Occupations Code, §§201.152, .153, .452; 601.252.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000672

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


Chapter 76. INVESTIGATION

22 TAC §76.7

The Texas Board of Chiropractic Examiners adopts the repeal §76.7, relating to criminal convictions, without changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10488).

In conjunction with this repeal, the board is adopting a new §75.3 relating to this same subject as published in this same issue of the Texas Register . See also the November 26, 1999, issue of the Texas Register (24 TexReg 10486). With the adoption of §75.3, §76.7 will no longer be needed. Chapter 53 of the Occupations Code requires licensing authorities to make certain determinations relating to applicants for licensure or current license holders who have criminal convictions. The chapter also requires the board to adopt guidelines relating to its policies and procedures under the chapter, including a provision that states the reasons a particular crime is considered to relate to a particular license and any other criteria that the board considers in making a decision under the chapter. Section 75.3 contains the guidelines required by Chapter 53.

No comments were received concerning the proposed repeal.

The repeal is adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §53.025, which the board interprets as requiring it to adopt guidelines relating to the practice of the board under Occupations Code, Chapter 53.

The following are the statutes, articles, or codes affected by the repeal: §76.7 -- Occupations Code, §§201.152, 53.025.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000673

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


Chapter 78. CHIROPRACTIC RADIOLOGIC TECHNOLOGISTS

22 TAC §78.1, §78.2

The Texas Board of Chiropractic Examiners adopts amendments to §78.1 and §78.2, regarding Registration of Chiropractic Radiologic Technologists (CRTs), without changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10489). The text of the rules as amended will not be republished.

Earlier this year, the board adopted changes to §§78.1, 78.2 and 75.7, providing for biennial registration, which were published in the July 30, 1999, issue of the Texas Register (24 TexReg 5870). This change in the registration and continuing education reporting periods was to begin with the January 1, 2000 registration period. The purpose of the change was to promote uniformity and consistency with the Texas Department of Health's (TDH) registration and continuing education program for radiological technicians. With the same deadlines and reporting periods as TDH, it was anticipated that CRTs would be provided a greater choice of seminars and greater training opportunities. However, after the amendments were adopted it was determined that the change from annual to biennial would have an adverse administrative impact on the agency. Current budget accounts are established based on an annual revenue flow. The change to biennial would require revision to the accounting system which would affect not only the TBCE but the comptroller's office as well. After weighing the increased administrative burden which would be created by the change with the purposes for the rule, the board has decided to maintain the current annual registration by the adoption of these amendments to §78.1 and §78.2, and in a separate rulemaking to §75.7, relating to fees, published in this issue of the Texas Register . See also the November 26, 1999, issue of the Texas Register (24 TexReg 10488).

The board is also adopting a fee of $25 for late renewal by amendment to §78.1. The board continues to have a problem with late renewals by those persons it regulates even though it sends out each year to licensees and registrants 30 days prior notice of the renewal deadline, along with a renewal form. The establishment of a late fee for CRT renewal is intended to act as an incentive to renew on time. The amendments also provide notice that if a CRT fails to renew, he or she may also be subject to an administrative penalty, for failing to renew and performing radiologic procedures without registering, as provided in §75.11 of the board's rules.

A person with a CRT registration may perform radiologic procedures only if the underlying authorization from TDH is valid. To make this intent clear, the board has added a new subsection (g) to §78.1 that expressly states that a CRT may not perform radiologic procedures if he or she is no longer authorized by the TDH, for instance, if the CRT is no longer on TDH's registry or the hardship exemption for that CRT has been revoked or has expired. A CRT will be required to submit, within five days, a copy of a new hardship exemption if the exemption is issued prior to the next renewal deadline. A corresponding change is made for subsection (j), to be re-lettered as (n), which prohibits a licensed chiropractor from authorizing a person without the proper TDH authority to perform such procedures. Lastly, the amendments change the references to the Chiropractic Act and the Medical Radiologic Technologist Certification Act to the Occupations Code chapters where they have been codified and make other non-substantive format changes.

No comments were received concerning the proposed amendments.

The amendments are adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the act, §201.153, which the board interprets as authorizing it to adopt necessary fees for administration of its programs, and §201.452 and §601.252, which the board interprets as authorizing it to adopt rules to establish a registration and continuing education program for CRTs in the use of x-ray in conformity with state law and TDH rules, and to implement state law relating to radiologic training for employees of a chiropractor, including fees to administer the program.

The following are the statutes, articles, or codes affected by the amendments: §§78.1, 78.2 -- Occupations Code, §§201.152, .153, .452; 601.252.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000674

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


Chapter 80. MISCELLANEOUS

22 TAC §80.1

The Texas Board of Chiropractic Examiners adopts an amendment to §80.1 relating to delegation of authority, with changes to the proposed text as published in the November 26, 1999, issue of the Texas Register (24 TexReg 10491).

Non-substantive grammatical revisions are made to paragraphs (6) and (7) of subsection (c), inserting the word "a" before "patient," and inserting the word "demonstrating" before "uses," respectively. Subsection (c)(2) has been clarified to include the taking as well as the recording of vital signs as a delegated task. The text of the rule will be republished. Section 80.1 implements Occupations Code, § 201.301's prohibition against practicing chiropractic without a license by prohibiting licensees from delegating chiropractic treatment to non-licensees, except for students enrolled in a chiropractic college, and §201.451's requirement that the board establish guidelines on the tasks and procedures that a chiropractor may properly delegate to a chiropractic assistant. Section 80.1(d) has been amended to clarify that §201.301's prohibition applies to licensees whose licenses have been suspended or revoked. The amendments also clarify that this prohibition does not prohibit a licensee from using non-licensed persons, who are otherwise qualified and trained, to perform tasks or procedures that do not require chiropractic training in order to perform the task or procedure under the supervision of a licensee. Those tasks and procedures that may be delegated are set out in subsection (c). Certain tasks and procedures may only be performed by a trained, licensed chiropractor, as required by the Chiropractic Act, Occupations Code, §201.002, §.301, in order to ensure the safety and health of patients.

The amendments to subsection (a) set out those tasks and procedures that may not be delegated to a non-licensed person. The section, as amended, provides greater assurance that patients are properly treated in a clinical setting that utilizes chiropractic students and staff other than chiropractors, and gives chiropractors and their staff better notice that the failure to adhere to specific restrictions or conditions may subject them to enforcement action. At the same time, the rule, as amended, will enable licensees to structure their services in such a manner that enhances time utilization, for the benefit of themselves, their staff and their patients.

No comments were received concerning the proposed amendment.

The amendment is adopted under the Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §201.451, which the board interprets as requiring it to adopt guidelines relating to the tasks and procedures that a chiropractor may delegate to an assistant. The following are the statutes, articles, or codes affected by the amendment: §80.1 -- Occupations Code, §§201.152, 201.451.

§80.1.Delegation of Authority.

(a)

Except as provided in this section, a licensee shall not allow or direct a person who is not licensed by the board to perform procedures or tasks that are within the scope of chiropractic, including:

(1)

rendering a diagnosis and prescribing a treatment plan; or

(2)

performing a chiropractic adjustment or manipulation.

(b)

A licensee may allow or direct a student enrolled in an accredited chiropractic college to perform chiropractic adjustments or manipulations, provided that:

(1)

the chiropractic adjustment or manipulation is performed as part of a regular curriculum; and

(2)

the chiropractic adjustment or manipulation is performed under the supervision of a licensee who is physically present in the treating room at the time of the adjustment.

(c)

"Qualified and properly trained" as used in this subsection means that the person, in addition to the requisite training and skill, has any license or certification required by law in order to perform a specific task or procedure. A licensee may allow or direct a qualified and properly trained person, who is acting under the licensee's supervision, to perform a task or procedure that assists the chiropractor in making a diagnosis, prescribing a treatment plan or treating a patient if the performance of the task or procedure does not require the training of a chiropractor in order to protect the health or safety of a patient, such as:

(1)

taking the patient's medical history;

(2)

taking or recording vital signs;

(3)

performing radiologic procedures;

(4)

taking or recording range of motion measurements;

(5)

performing prescribed physical therapy modalities;

(6)

demonstrating prescribed exercises or stretches for a patient; or

(7)

demonstrating proper uses of dispensed supports and devices.

(d)

A licensee shall not allow or direct a person whose chiropractic license has been suspended or revoked to practice chiropractic in connection with the treatment of a patient of the licensee during the effective period of the suspension or upon revocation.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 31, 2000.

TRD-200000675

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 20, 2000

Proposal publication date: November 26, 1999

For further information, please call: (512) 305-6709


Part 12. BOARD OF VOCATIONAL NURSE EXAMINERS

Chapter 236. NURSE LICENSURE COMPACT

Subchapter A. DEFINITIONS

22 TAC §236.1

The Board of Vocational Nurse Examiners adopts new Chapter 236 relative to Nurse Licensure Compact and new §236.1 relative to definitions without changes to the proposed text published in the December 24, 1999, issue of the Texas Register (24 TexReg 11685).

The Chapter and rule are adopted to comply with Article 4528B, Nurse Licensure Compact. The law gives authority to the licensing Boards Compact Administrators to adopt uniform rules to facilitate and coordinate compact implementation of the party states. Uniform rules are to be adopted by the compact party states under Article 6(a)(4) and Article 9(c) of Article 4528B, Nurse Licensure Compact.

The rule will define the meanings of terms when used in relation to the Compact.

No comments were received relative to the adoption of this Chapter or rule.

The Chapter and rule are adopted under Texas Civil Statutes, Chapter 302 Occupations Code, Subchapter D, §302.151 (b), which provides the Board of Vocational Nurse Examiners with the authority to make such rules and regulations as may be necessary to carry in effect the purposes of the law.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 24, 2000.

TRD-200000453

Mary M. Strange, RN, BSN, CNA

Executive Director

Board of Vocational Nurse Examiners

Effective date: February 13, 2000

Proposal publication date: December 24, 1999

For further information, please call: (512) 305-7653


Subchapter B. ISSUANCE OF A LICENSE BY A COMPACT PARTY STATE

22 TAC §§236.11-236.13

The Board of Vocational Nurse Examiners adopts new Chapter 236 relative to Nurse Licensure Compact and new §236.11 and §236.12 without changes and §236.13 with changes to the proposed text published in the December 24, 1999 issue of the Texas Register (24 TexReg 11686). In the proposed text of §236.12(a)(3) the word "have" was left out between the words shall and access.

The Chapter and rules are adopted to comply with Article 4528B, Nurse Licensure Compact. The law gives authority to the licensing Boards Compact Administrators to adopt uniform rules to facilitate and coordinate compact implementation of the party states. Uniform rules are to be adopted by the compact party states under Article 6(a)(4) and Article 9(c) of Article 4528B, Nurse Licensure Compact.

The rules will define the meanings of terms when used in relation to the Compact.

No comments were received relative to the adoption of these rules.

The Chapter and rules are adopted under Texas Civil Statutes, Chapter 302 Occupations Code, Subchapter D, §302.151 (b), which provides the Board of Vocational Nurse Examiners with the authority to make such rules and regulations as may be necessary to carry in effect the purposes of the law.

§236.13.Information System.

(a)

Levels of Access

(1)

The public shall have access to nurse licensure information limited to:

(A)

the nurse's name

(B)

jurisdiction(s) of licensure

(C)

license expiration date(s)

(D)

licensure classification(s) and status(es)

(E)

public emergency and final disciplinary actions, as defined by contributing state authority, and

(F)

the status of multistate licensure privileges.

(2)

Non-party state Boards shall have access to Information System data except current significant investigative information and other information as limited by contributing party state authority.

(3)

party State Boards shall have access to all Information System data contributed by the party states and other information as limited by contributing non-party state authority.

(b)

The licensee may request in writing to the home state Board to review the data relating to the licensee in the Information System. In the event a licensee asserts that any data relating to him or her is inaccurate, the burden of proof shall be upon the licensee to provide evidence that substantiates such claim. The Board shall verify and within ten business days correct inaccurate data to the Information System.

(c)

The Board shall report to the Information System within ten business days:

(1)

disciplinary action, agreement or order requiring participation in alternative programs or which limit practice or require monitoring (except agreements and orders relating to participation in alternative programs required to remain nonpublic by contributing state authority);

(2)

dismissal of complaint; and

(3)

changes in status of disciplinary action, or licensure encumbrances.

(d)

Current significant investigative information shall be deleted from the Information System within ten business days upon report of disciplinary action, agreement or order requiring participation in alternative programs or agreements which limit practice or require monitoring or dismissal of a complaint.

(e)

Changes to licensure information in the Information System shall be completed within ten business days upon notification by a Board.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 24, 2000.

TRD-200000454

Mary M. Strange, RN, BSN, CNA

Executive Director

Board of Vocational Nurse Examiners

Effective date: February 13, 2000

Proposal publication date: December 24, 1999

For further information, please call: (512) 305-7653