Part 3.
TEXAS BOARD OF CHIROPRACTIC EXAMINERS
Chapter 73.
LICENSES AND RENEWALS
22 TAC §73.2
The Texas Board of Chiropractic Examiners proposes an amendment
to §73.2(a), relating to renewal of license. By separate rulemaking in
the May 25, 2001 issue of the
Texas Register
(26 TexReg 3686), the board proposed an amendment to §75.7, to accept
personal or company checks for payment of fees. At present, except for facility
licenses, it requires a money order or a cashier's or certified check. The
proposed amendment to §75.7 permits the use of a personal or company
check, money order, cashier or certified check. To discourage checks drawn
on insufficient funds, the board is also establishing a fee for a returned
check in the amount of $25. The proposed amendment also sets out procedures
and requirements for processing an application for which a check has been
returned. In conjunction with this rulemaking, the board proposed amendments
to §§73.2(a), 71.2(b), and 78.1, for consistency and conformity
with the proposed amendments to §75.7. By this rulemaking, the board
is deleting provisions in subsection (a) of §73.2 that will be covered
in the amended §75.7. See also the separate rulemakings published in
the May 25, 2001, issue of the
Texas Register
(26 TexReg 3683-3689).
Dr. Sergio Francois, D.C., Chair, Rules Committee, has determined that
for the first five-year period the section as amended is in effect, there
will be no fiscal implications for state or local government as a result of
enforcing or administering the section as amended. Dr. Francois has determined
that for each year of the first five years, the section as amended is in effect,
the public benefit anticipated as a result of enforcing and administering
the section, as amended, along with the changes being proposed in the other
related rulemaking, will be more timely compliance with the board license
and renewal requirements and collection of required fees. Submission of applications
will be simplified and expedited if applicants, licensees and registrants
no longer have to acquire money orders or certified checks before sending
in their applications. There are no probable economic costs to persons required
to comply with the section, as amended. There is no anticipated adverse economic
effect on small or micro-businesses.
Comments may be submitted, in writing, no later than 30 days after the
date of publication of this proposed rulemaking, to Jessica Harwell, Rules
Committee, Texas Board of Chiropractic Examiners, 333 Guadalupe, Tower III,
Suite 825, Austin, TX 78701.
The amendment is proposed 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, and §201.153, which the board interprets
as authorizing it to adopt necessary fees for administration of its programs.
The following are the statutes, articles, or codes affected by the amendment:
Chapter 73 -- Occupations Code, §201.152, §201.153.
§73.2.Renewal of License.
(a)
Annual renewal. Each year, on or before the first day of
a licensee's birth month, a licensee shall renew his or her license. A licensee
may also apply for inactive status in accordance with §73.4 of this title
(relating to Inactive Status). In order to renew a license, a licensee must
submit to the board the license renewal form provided by the board, the renewal
fee for an active license as provided in §75.7 of this title (relating
to Fees
and Charges for Public Information
), any late fees, if
applicable as provided in subsection (d) of this section, and verification
of continuing education attendance as required by §73.3 of this title
(relating to Continuing Education). An annual renewal certificate shall not
be issued until all information and fees required by this section
and §75.7
are provided to the board. [
(b)
Locum Tenens
Information.
A licensee who substitutes for another licensee (locum tenens) and temporarily
practices at the facility of the absent licensee shall provide the board with
a list of each facility that he or she has served as a
locum tenens
during the previous 12 months. The list shall include
the name, address, and facility registration of each facility. A
locum tenens
licensee shall have proof of licensure, such as a copy
of the license or the board-issued wallet size license, with them while practicing
and shall show it upon request.
(c)
Licensees in default of student loan or repayment agreement.
(1)
The board shall not renew a license of a licensee who is
in default of a loan guaranteed by the Texas Guaranteed Student Loan Corporation
or a repayment agreement with the corporation except as provided in paragraphs
(2) and (3) of this subsection.
(2)
For a licensee in default of a loan, the board shall renew
the license if:
(A)
the renewal is the first renewal following notice to the
board that the licensee is in default; or
(B)
the licensee presents to the board a certificate issued
by the corporation certifying that:
(i)
the licensee has entered into a repayment agreement on
the defaulted loan; or
(ii)
the licensee is not in default on a loan guaranteed by
the corporation.
(3)
For a licensee who is in default of a repayment agreement,
the board shall renew the license if the licensee presents to the board a
certificate issued by the corporation certifying that:
(A)
The licensee has entered into another repayment agreement
on the defaulted loan; or
(B)
the licensee is not in default on a loan guaranteed by
the corporation or on a repayment agreement.
(4)
This subsection does not prohibit the board from issuing
an initial license to a person who is in default of a loan or repayment agreement
but is otherwise qualified for licensure. However, the board shall not renew
the license of such a licensee, if at the time of renewal, the licensee is
in default of a loan or repayment agreement except as provided in paragraphs
(2)(B) or (3) of this subsection.
(5)
The board shall notify a licensee of the nonrenewal of
a license under this subsection and of the opportunity for a hearing under
paragraph (7) of this subsection prior to or at the time the annual renewal
application is sent.
(6)
A license which is not renewed under this subsection is
considered expired. The licensee cannot practice chiropractic until such time
that he or she complies with this subsection. Subsection (d) of this section
applies to licenses expired under this subsection.
(7)
Upon written request for a hearing by a licensee, the board
shall set the matter for hearing before the State Office of Administrative
Hearings in accordance with §75.9(d) of this title (relating to Complaint
Procedures). A licensee shall file a request for a hearing with the board
within 30 days from the date of receipt of the notice required by paragraph
(5) of this subsection.
(d)
Expired License.
(1)
If an active or inactive license is not renewed on or before
the first day of the licensee's birth month of each year, it becomes expired.
(2)
If a person's license has expired for 90 days or less,
the person may renew the license by paying to the board the required renewal
fee, as provided in §75.7 of this title (relating to Fees), and a late
fee of $62.
(3)
If a person's license has expired for longer than 90 days,
but less than one year, the person may renew the license by paying to the
board the required renewal fee, as provided in §75.7 of this title and
a late fee of $125.
(4)
If a person's license has expired for one year or longer,
the person may not renew the license but may obtain a new license by submitting
to reexamination and complying with the current requirements and procedures
for obtaining an initial license.
(5)
At the board's discretion, a person whose license has expired
for one year or longer may renew without complying with paragraph (4) of this
subsection if the person moved to another state and is currently licensed
and has been in practice in the other state for two years preceding application
for renewal. The person must also pay the board the required renewal fee,
as provided in §75.7 of this title and a late fee of $125.
(6)
The annual renewal application will be deemed to be the
written notice of the impending license expiration forwarded to the person
at the person's last known address according to the records of the board.
(e)
Practicing with an expired license. Practicing chiropractic
with an expired license constitutes practicing chiropractic without a license.
A licensee whose license expires shall not practice chiropractic until the
license is renewed or a new license is obtained as provided by subsection
(d) of this section.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on June 4, 2001.
TRD-200103065
Gary K. Cain, Ed.D.
Executive Director
Texas Board of Chiropractic Examiners
Earliest possible date of adoption: July 15, 2001
For further information, please call: (512) 305-6709
Chapter 219.
ADVANCED NURSE PRACTITIONER PROGRAM
22 TAC §§219.1 - 219.18
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Board of Nurse Examiners or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Board of Nurse Examiners for the State of Texas
proposes the repeal of current §§219.1 - 219.18 relating to Advanced
Nurse Practitioner Program.
House Bill 1, Section 167, Article IX, passed by the 75th Legislative Session
required that each rule adopted by an agency be reviewed within four years
of the date of its adoption to determine whether the reason for adopting the
rule continues to exist. Rules that were adopted prior to September 1, 1997
are required to be reviewed by August 31, 2001. The repeal of §§219.1
- 219.18 is the result of the Board's effort to implement the mandate of House
Bill 1.
The Board's Advanced Practice Nursing Advisory Committee has been working
since March 2000 to review the rules and recommend changes where necessary.
The committee is comprised of Advanced Practice Nurse Educators, Advanced
Practice Nurses in practice, and representatives from Advanced Practice Professional
Organizations, including Texas Nurses Association. Texas Nurse Practitioners,
Texas Association of Nurse Anesthetists, Consortium of Texas Certified Nurse
Midwives, and Texas Organization of Nurse Executives. Committee members shared
information regarding the current rules and how these rules have impacted
their advanced educational programs. They worked to make the rules easier
to use and understand. In addition, they tried to insure consistency between
all the rules, especially where terms have been defined. The Committee finished
discussion of Chapter 219 and made recommendations for the Board's consideration
on April 26, 2001. The Committee's recommendations are the basis of the proposed
rule changes.
The proposed rules and this concomitant proposed repeal were not intended
to make major substantive changes in the advanced practice nursing program
rules of the Board. Rather the proposal seeks to clarify the advanced practice
rules in order to make them better understood by Advanced Practice Nurse Educators,
Advanced Practice Nurses in Practice and applicants for Advanced practice
recognition. For example, many policies have been set by the Board over the
several years since the rules were last reviewed and have now been included
in the new rules for clarity and completeness (e.g. curricular requirements
adopted by the Board in collaboration with the Texas Higher Education Coordinating
Board). Many of these policies impact an advanced educational program's ability
to be approved by the Board.
Kathy Thomas, Executive Director, has determined that for the first five-year
period the repeal is effective there will be no fiscal implications for state
or local government as a result of enforcing or administering the repeal.
Ms. Thomas has determined that the public benefit of enforcing the repeal
is to clarify the process and procedures regarding advanced practice nursing
education. There will be no effect on small businesses. There will be no anticipated
costs to persons required to comply with the repeal as proposed.
Comments on the proposed repeal may be made in writing to Kathy Thomas,
Executive Director, Board of Nurse Examiners for the State of Texas, 333 Guadalupe,
Suite 3-460, Austin, Texas 78701. Comments will be accepted and considered
for 30 days following the publication of this proposal in the
Texas Register
.
The repeal is proposed under the authority of the Texas Occupations
Code, §301.151 and §301.152 that authorize the Board of Nurse Examiners
to adopt and enforce rules consistent with its legislative authority under
the Nurse Practice Act including rules relating to registered nurses approved,
or seeking approval, as an advanced practice nurse.
The repeal affects the Nursing Practice Act, Texas Occupations Code, §301.152
and §301.157 as they pertain to advanced practice nursing.
§219.1.Definitions.
§219.2.New Programs.
§219.3.Accreditation.
§219.4.Philosophy and Objectives.
§219.5.Administration and Organization.
§219.6.Faculty Qualifications.
§219.7.Change of Director.
§219.8.Faculty Policies.
§219.9.Faculty Development and Evaluation.
§219.10.Program of Study.
§219.11.Curriculum.
§219.12.Curriculum Change.
§219.13.Students.
§219.14.Educational Resources and Facilities.
§219.15.Clinical Resources.
§219.16.Records and Reports.
§219.17.Total Program Evaluation.
§219.18.Closing of a Program.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on June 4, 2001.
TRD-200103070
Katherine A. Thomas, MN, RN
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: July 15, 2001
For further information, please call: (512) 305-6811
22 TAC §§219.1 - 219.13
The Board of Nurse Examiners for the State of Texas proposes
new §§219.1 - 219.13 relating to Advanced Practice Nursing Programs.
House Bill 1, Section 167, Article IX, passed by the 75th Legislative Session
required that each rule adopted by an agency be reviewed within four years
of the date of its adoption to determine whether the reason for adopting the
rule continues to exist. Rules that were adopted prior to September 1, 1997
are required to be reviewed by August 31, 2001. The proposal for the adoption
of new §§219.1 - 219.13 is the result of the Board's effort to implement
the mandate of House Bill 1.
The Board's Advanced Practice Nursing Advisory Committee has been working
since March 2000 to review the rules and recommend changes where necessary.
The committee is comprised of Advanced Practice Nurse Educators, Advanced
Practice Nurses in practice, and representatives from Advanced Practice Professional
Organizations, including Texas Nurses Association. Texas Nurse Practitioners,
Texas Association of Nurse Anesthetists, Consortium of Texas Certified Nurse
Midwives, and Texas Organization of Nurse Executives. Committee members shared
information regarding the current rules and how these rules have impacted
their advanced educational programs. They worked to make the rules easier
to use and understand. In addition, they tried to insure consistency between
all the rules, especially where terms have been defined. The Committee finished
discussion of Chapter 219 and made recommendations for the Board's consideration
on April 26, 2001. The Committee's recommendations are the basis of the proposed
rule changes.
The proposed rules were not intended to make major substantive changes
in the advanced practice nursing program rules of the Board. Rather the proposal
seeks to clarify the advanced practice rules in order to make them better
understood by Advanced Practice Nurse Educators, Advanced Practice Nurses
in Practice and applicants for advanced practice recognition. For example,
many policies have been set by the Board over the several years since the
rules were last reviewed and have now been included in the new rules for clarity
and completeness (e.g., curricular requirements adopted by the Board in collaboration
with the Texas Higher Education Coordinating Board). Many of these policies
impact an advanced educational program's ability to obtain approval from the
Board. In addition, rule content was reordered for more logical flow.
Kathy Thomas, Executive Director, has determined that for the first five-year
period the proposed rules are effective there will be no fiscal implications
for state or local government as a result of enforcing or administering the
sections.
Ms. Thomas has determined that the public benefit of enforcing the rules
are to clarify the process and procedures regarding advanced practice nursing
education. There will be no effect on small businesses. There will be no anticipated
costs to persons required to comply with the sections as proposed.
Comments on the proposed rules may be made in writing to Kathy Thomas,
Executive Director, Board of Nurse Examiners for the State of Texas, 333 Guadalupe,
Suite 3-460, Austin, Texas 78701. Comments will be accepted and considered
for 30 days following the publication of this proposal in the
Texas Register
.
The new rules are proposed under the authority of the Texas Occupations
Code, §301.151 and §301.152 that authorize the Board of Nurse Examiners
to adopt and enforce rules consistent with its legislative authority under
the Nurse Practice Act including rules relating to registered nurses approved,
or seeking approval, as an advanced practice nurse.
The new rules affect the Nursing Practice Act, Texas Occupations Code, §301.152
and §301.157 as they pertain to advanced practice nursing.
§219.1.General Requirements.
(a)
General Requirements. Advanced educational programs in
the State of Texas shall be accredited by the Board or by a national accrediting
body recognized by the Board.
(1)
An educational institution located in Texas may apply for
Board accreditation for advanced educational programs that prepare either
nurse practitioners or clinical nurse specialists. Only that portion of the
program of study that qualifies registered nurses for authorization to practice
in an advanced role and specialty recognized by the Board is eligible for
accreditation.
(2)
To be eligible to apply for state accreditation, the advanced
educational program must be at a post-basic nursing education level.
(3)
All new advanced educational programs must be at the graduate
or post-graduate level.
(b)
These standards have been developed for use by nurse practitioner
and clinical nurse specialist programs accredited by or seeking accreditation
by the Board. The purpose of these standards is:
(1)
To promote safe and effective advanced nursing practice,
(2)
To serve as a guide for development of new advanced educational
programs that prepare nurse practitioners and clinical nurse specialists,
(3)
To provide criteria for the evaluation of new and established
advanced educational programs that prepare nurse practitioners and clinical
nurse specialists, and
(4)
To foster continued improvement of established advanced
educational programs.
§219.2.Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings unless the context clearly indicates otherwise:
(1)
Accredited program--A program that has been determined
to have met the standards set by the Board or by a national accrediting body
recognized by the Board.
(2)
Advanced educational program--A post-basic advanced practice
nurse program at the certificate or master's degree level. Beginning January
1, 2003, a minimum of a graduate degree in the advanced practice role and
specialty will be required for authorization as an advanced practice nurse.
(3)
Advanced practice nurse--A registered nurse approved by
the Board to practice as an advanced practice nurse based on completing an
advanced educational program acceptable to the Board. The term includes a
nurse practitioner, nurse-midwife, nurse anesthetist, and a clinical nurse
specialist. The advanced practice nurse is prepared to practice in an expanded
role to provide health care to individuals, families, and/or groups in a variety
of settings including, but not limited to homes, hospitals, institutions,
offices, industry, schools, community agencies, public and private clinics,
and private practice. The advanced practice nurse acts independently and/or
in collaboration with other health care professionals in the delivery of health
care services.
(4)
Affiliating agency--Agencies outside the institution that
are utilized in providing learning experiences for the students.
(5)
Board--The Board of Nurse Examiners for the State of Texas
(6)
Clinical learning experiences--Planned learning experiences
that involve direct contact with patients under guidance of faculty.
(7)
Diagnosis and management course--A course offering both
didactic and clinical content in clinical decision-making and aspects of medical
diagnosis and medical management of diseases and conditions. Supervised clinical
practice must include the opportunity to provide pharmacological and non-pharmacological
management of diseases and problems considered within the scope of practice
of the advanced practice nurse's specialty and role
(8)
Didactic learning experiences--Any planned learning activities
that take place in the classroom, learning resource center, skills laboratory,
or similar settings under the guidance of faculty.
(9)
Director--A registered nurse responsible for the administration
of the advanced educational program and who meets the requirements as stated
in §219.6(f) of this chapter (relating to Administration and Organization).
(10)
Distance education--Instruction delivered by an accredited
program by any means to any location(s) other than the main campus. Distance
education may range from offering a single course or multiple courses to offering
the entire program of study.
(11)
Governing institution--A college or university responsible
for the administration and operation of the program.
(12)
Party state--Any state that has entered into the Nurse
Licensure Compact.
(13)
Practicum--The practicum is that portion of the program
consisting of clinical experiences for the purpose of integrating theory with
practice. The term includes, but is not limited to, preceptorship, residency
and integration.
(14)
Qualified preceptor--An advanced practice nurse, physician
or other health care professional acceptable to the Board who meets the following
requirements:
(A)
Holds an active, unencumbered license (where licensure
is required),
(B)
Is in current practice in the advanced specialty area,
(C)
Is committed to the concept of the advanced practice nurse,
and
(D)
Functions as a supervisor and teacher and evaluates the
student's performance in the clinical setting.
(15)
Shall and must--Mandatory requirements.
(16)
Should--A recommendation
(17)
Unencumbered license--A professional license that does
not have stipulations against it.
§219.3.Program Development, Closure, and Transfer of Administrative Control.
(a)
New Programs.
(1)
Proposal to develop an advanced educational program
(A)
A college or university regionally accredited by a Board
recognized approval/accrediting body is eligible to submit a proposal to develop
an advanced educational program. Notice of intent to establish an advanced
educational program shall be submitted in writing well in advance of the anticipated
start of the program. This process may take 12 to 18 months to complete.
(B)
The proposal shall be completed under the direction/consultation
of a registered nurse who:
(i)
Holds a minimum of a master's degree in nursing or the
equivalent thereof as determined by the Board,
(ii)
Is authorized to practice as an advanced practice nurse
in an advanced role and specialty appropriate to the type of program being
proposed, and
(iii)
Has teaching and administrative experience related to
the type of program being proposed.
(C)
The proposal shall include information outlined in Board
guidelines.
(D)
The proposal shall include documentation of Texas Higher
Education Coordinating Board approval, as applicable.
(E)
The proposal will be considered by the Board following
a public hearing at a regularly scheduled meeting of the Board. The Board
may approve, defer action on, or deny the proposal.
(2)
Application for Initial Accreditation
(A)
Initial accreditation must be granted prior to admission
of students.
(B)
Following approval to develop an advanced educational program,
the director and faculty shall develop the application for initial accreditation.
(C)
The director and faculty shall plan the program of learning.
(D)
The application shall include information outlined in Board
guidelines.
(E)
The Board shall review the application and supporting evidence
at a regularly scheduled meeting. If the program is based upon educational
principles acceptable to the Board and is in compliance with the Board's requirements
as specified in this subsection, initial accreditation may be granted.
(F)
Survey visits shall be conducted, as necessary, by Board
staff until full accreditation is granted.
(b)
Transfer of Administrative Control by Governing Institutions
(1)
A governing institution of an advanced educational program
that has full accreditation status may request permission from the Board to
transfer administrative control of the program or any portion thereof.
(A)
A governing institution that proposes to transfer administrative
control of an advanced educational program or any portion thereof to another
governing institution accredited by a Board recognized approval/accrediting
body shall submit:
(i)
Notice of intent to transfer administrative control in
writing to the Board twelve months prior to the anticipated date of transfer,
and
(ii)
A written plan for closure of the nursing program as required
by subsection (c) of this section if the entire program is to be transferred.
(B)
The governing institution that will assume responsibility
for the program shall submit a Proposal to Assume Administrative Control to
the Board six months prior to a regularly scheduled Board meeting.
(i)
The proposal shall be completed under the direction/ consultation
of a registered nurse who holds a minimum of a master's degree in nursing,
is authorized to practice as an advanced practice nurse in a related advanced
role and specialty of the type of program being proposed, and who has teaching
and administrative experience related to the type of program being proposed.
(ii)
The proposal shall include information outlined in Board
approved guidelines.
(iii)
The proposal shall include documentation of Texas Higher
Education Coordinating Board approval, as applicable.
(iv)
The proposal will be considered by the Board at a regularly
scheduled meeting.
(v)
The Board may approve, may defer action, or may deny further
consideration of the proposal.
(2)
Accreditation Status of Transferred Program(s)
(A)
If the governing institution that is assuming administrative
control previously has been responsible for an accredited program and does
not intend to change the program of study, then the program shall maintain
its accreditation status.
(B)
If the governing institution that is assuming administrative
control previously has been responsible for an accredited program and intends
to alter the program of study, then that governing institution shall submit
a proposal to change the program of study in accordance with subsection §219.9
of this chapter.
(C)
If the governing institution that is assuming administrative
control has not previously been responsible for an accredited program, then
that governing institution shall submit an application for initial accreditation
in accordance with subsection (a)(2) of this section.
(c)
Closing a Program or Portion Thereof.
(1)
When the decision to close a program or portion thereof
has been made, the director must notify the Board and submit a written plan
for closure that includes the following:
(A)
Reason for closing the program or portion thereof;
(B)
Date of intended closing;
(C)
Academic provisions for students;
(D)
Provisions made for access to and safe storage of vital
school records, including transcripts of all graduates; and
(E)
Methods to be used to maintain requirements and standards
until the program or portion thereof closes.
(2)
The program or portion thereof shall continue within standards
until all classes that are enrolled at the time of the decision to close have
graduated. In the event this is not possible, a plan must be developed whereby
students may transfer to other accredited programs.
§219.4.Accreditation.
(a)
The progressive designation of accreditation status is
not implied by the order of the following listing. Accreditation status is
based upon each program's performance and demonstrated compliance to the Board's
requirements. Change from one status to another is based on annual reports
or survey visits. Types of accreditation include:
(1)
Initial accreditation. Initial accreditation is written
authorization to admit students and is granted if the program meets the requirements
of the Board.
(2)
Full accreditation. Full accreditation is granted to an
advanced educational program after one class has completed the program and
is based upon evidence that the program is continuing to meet the Board's
legal and educational requirements.
(3)
Accreditation (Initial or Full) With Warning
(A)
Issuance of warning. When the Board determines that a program
is not meeting the Board's legal and/or education requirements, the program
is issued a warning, is provided a list of the deficiencies, and is given
a specified time in which to correct the deficiencies.
(B)
Failure to correct deficiencies. If the program fails to
correct the deficiencies within the prescribed period, the Board may:
(i)
Restrict admissions or other program activities until the
deficiencies are corrected,
(ii)
Place the program on conditional accreditation, or
(iii)
Deny accreditation.
(4)
Conditional Accreditation. Conditional accreditation is
granted for a time specified by the Board in order to provide additional time
to correct the deficiencies.
(A)
The program shall not admit students while on conditional
accreditation.
(B)
The Board may establish specific criteria to be met in
order for the program's conditional accreditation status to be removed.
(C)
Depending upon the degree to which the Board's legal and
educational requirements are met, the Board may change the accreditation status
to full, warning, or deny accreditation.
(b)
Denial of Accreditation. A program that fails to meet legal
and educational requirements of the Board within the specified time shall
be removed from the list of state accredited nursing programs. Reasons for
denial of initial or continuing accreditation include but are not limited
to:
(1)
Failure to meet specific criteria set out by the Board
and
(2)
Continued lack of compliance with minimum requirements
as set out in this chapter.
(c)
Accreditation Procedures. The continuing accreditation
status of each program shall be determined annually by the Board based upon:
(1)
Review of annual report. Each Board-accredited advanced
educational program shall submit an annual report regarding its compliance
with the Board's legal and educational requirements. Accreditation status
is determined on the basis of the program's annual report and other pertinent
data when a program is not visited by staff.
(2)
Survey visit. Each nursing program will be visited at least
every six years after full accreditation has been granted. The Board may authorize
staff to conduct a survey visit at any time based upon established criteria.
(3)
A written report of the survey visit or annual report will
be reviewed by the Board at a regularly scheduled meeting.
(4)
Notice of a program's accreditation status will be sent
to the director, chief administrative officer of the governing institution,
and others as determined by the Board.
(d)
Voluntary Withdrawal from the Accreditation Process.
(1)
An advanced educational program accredited by the Board
may withdraw from the Board accreditation process by notifying the Board of
its intention to withdraw in writing
(2)
The advanced educational program shall be removed from
the list of Board accredited nursing programs.
(3)
Withdrawal of accreditation status will become effective
at the end of the yearly review period.
(4)
Programs may reapply for initial accreditation at any time.
§219.5.Mission and Goals (Philosophy and Outcomes).
(a)
The mission and goals (philosophy and outcomes) of the
advanced educational program shall be developed by the faculty.
(b)
The mission and goals (philosophy and outcomes) shall be
consistent with:
(1)
The mission of the governing institution;
(2)
The scope of practice of the advanced specialty and role;
(3)
The targeted population or setting for delivery of advanced
practice nursing care; and
(4)
Professional, educational, and ethical standards of nursing.
(c)
The program goals or outcomes shall be consistent with
the program's mission or philosophy and shall describe the capabilities of
the graduates of the program.
(d)
The written mission and goals (philosophy and outcomes)
shall be used as a basis for planning, organizing, implementing and evaluating
the program and shall be shared with the students.
(e)
The faculty shall periodically review the mission and goals
(philosophy and outcomes), consider student input as appropriate, and make
necessary revisions.
§219.6.Administration and Organization.
(a)
The advanced educational program shall operate within or
be affiliated with a college or university. New programs shall operate or
be affiliated with colleges or universities authorized to award graduate degrees.
(b)
The governing institution shall be accredited by a Board
recognized accrediting/ approval agency.
(c)
There shall be adequate financial support commensurate
with the financial resources of the institution and appropriate to the needs
of the program.
(d)
The structural relationship between the governing institution
and advanced educational program specifies lines of responsibility and authority
and channels of communication.
(e)
In colleges and universities, the program shall have comparable
status with other academic units and in areas affecting faculty such as salary,
rank, promotion, tenure, leave, benefits, academic rights, and professional
development.
(f)
Each advanced educational program shall be administered
by a qualified nurse faculty member who is accountable for the planning, implementation
and evaluation of the advanced educational program. The director shall:
(1)
Hold a current, valid, unencumbered license to practice
as a registered nurse in the State of Texas or reside in any party state and
hold a current, valid, unencumbered registered nurse license in that state;
(2)
Hold a minimum of a master's degree in nursing or the equivalent
thereof as determined by the Board;
(3)
Be authorized to practice as an advanced practice nurse
in a role and specialty appropriate to the type of program;
(4)
Have a minimum of three years teaching experience in a
program appropriately related to the type of program being administered; and
(5)
Have demonstrated knowledge, skills, and abilities in administration
within graduate level advanced educational programs.
(g)
When the director of the program changes, the director
shall submit to the Board written notification of the change indicating the
final date in the position.
(1)
A new director qualification form shall be submitted to
the Board office by the governing institution for approval prior to appointing
a new director for an existing program or a new advanced educational program.
(2)
A vitae and all official transcripts shall be submitted
with the new director qualification form.
(3)
In a fully accredited program, if the individual to be
appointed as director does not meet the requirements for director as specified
in subsection (f) of this section, the administration is permitted to petition
for a waiver of the Board's requirements prior to the appointment of said
individual.
(4)
An acting director may be appointed for a period of time
not to exceed one year.
§219.7.Faculty Qualifications and Faculty Organization.
(a)
Faculty Qualifications.
(1)
Documentation of faculty qualifications shall be included
in the official files of the program. Each nurse faculty member shall:
(A)
Hold a current, valid license to practice as a registered
nurse in the State of Texas or reside in any party state and hold a current,
valid registered nurse license in that state;
(B)
Hold a minimum of a master's degree in nursing or the equivalent
thereof as determined by the Board; and
(C)
Be qualified through academic preparation to teach the
subject assigned and shall meet the standards for faculty appointment by the
governing institution.
(2)
Faculty responsible for clinical management courses or
involved in clinical teaching and supervision shall also:
(A)
Be authorized to practice as advanced practice nurses in
the state in which they practice;
(B)
Have clinical practice experience at the advanced practice
nursing level of at least two years. If a faculty member has less than two
years advanced practice nursing experience, that faculty member must be responsible
to a qualified faculty member; and
(C)
Maintain clinical practice within the advanced role and
specialty.
(b)
An advanced educational program shall employ sufficient
faculty members with graduate preparation and expertise necessary to enable
students to meet the program goals. The number of faculty members shall:
(1)
Provide students with a level of instruction and supervision
that is compatible with safe practice and that includes educational experiences
necessary to meet students' learning needs; and
(2)
Be determined by such factors as:
(A)
The number and level of students enrolled;
(B)
The curriculum plan;
(C)
Activities and responsibilities required of faculty;
(D)
The number and geographic locations of preceptors, affiliate
agencies, and clinical practice settings; and
(E)
The complexity of care and acuity of patients
(c)
Faculty shall function under the same general policies
that affect other faculty members in the institution; however, variations
of these policies may be necessary because of the nature of the curriculum
for which the faculty must have authority and responsibility.
(1)
Policies concerning workload for faculty and the director
shall be in writing.
(2)
Time shall be provided faculty to accomplish those activities
related to the teaching-learning process as well as meet other institutional
duties such as scholarly activities, practice, or research.
(3)
The teaching load of the director shall not negatively
impact his/her ability to administer the program.
(d)
The faculty shall be organized with written policies and
procedures and/or bylaws to guide its activities. The policies, procedures,
and/or bylaws shall be consistent with the governing institution.
(1)
The faculty shall meet regularly and function in such a
manner that all members participate in planning, implementing, and evaluating
the program. Such participation includes, but is not limited to, the initiation
and/or change of academic policies, personnel policies, curriculum, utilization
of affiliate agencies, and program evaluation.
(2)
Minutes of faculty organization and/or committee meetings
shall document the reasons for actions and the decisions of the faculty and
shall be available for reference.
(e)
There shall be written plans for faculty orientation, development,
and evaluation.
(1)
Orientation of new faculty members shall be initiated at
the onset of employment.
(2)
A program of faculty development shall be offered to encourage
and assist faculty members to meet the program's needs as well as individual
faculty member's professional development needs.
(3)
A variety of means shall be used to evaluate faculty performance
such as self, student, peer and administrative evaluations as well as program
outcomes.
§219.8.Students.
(a)
Students should have a mechanism for input into the development
of academic policies and procedures, curriculum planning, and evaluation of
teaching effectiveness.
(b)
The number of students admitted to the program shall be
determined by the number of qualified faculty, adequate educational facilities
and resources, and the availability of appropriate clinical learning experiences
for students.
(c)
Written policies regarding admission and progression shall
be developed and implemented in accordance with the requirements that the
governing institution must meet to maintain accreditation. Student policies
that differ from those of the governing institution shall be in writing and
shall be made available to faculty and students.
(d)
Students shall hold a current, valid license or multi-state
privilege to practice as a registered nurse in the state(s) in which they
participate in any clinical learning experiences, including, but not limited
to, laboratory or observational experiences.
(e)
There shall be written policies for student grievance,
health, safety, and welfare.
(f)
Students shall have the opportunity to evaluate faculty,
courses, and learning resources and these evaluations shall be documented.
§219.9.Program of Study.
(a)
The program of study shall be:
(1)
At least the equivalent of one academic year;
(2)
Planned, implemented, and evaluated by the faculty;
(3)
Based on the mission and goals (philosophy and outcomes);
(4)
Organized logically and sequenced appropriately; and
(5)
Based on educational principles acceptable to the Board.
(b)
For clinical nurse specialist programs, the program of
study must also qualify the graduate for a master's degree in nursing.
(c)
The curriculum content shall include:
(1)
Didactic and clinical learning experiences necessary to
meet the goals or outcomes;
(2)
Concepts and principles critical to advanced practice nursing;
(3)
Professional and legal implications of the nurse in the
advanced role;
(4)
Knowledge and skills relevant to practice in the area of
specialty; and
(5)
Clinical nurse specialist and nurse practitioner course
requirements published by the Texas Higher Education Coordinating Board in
collaboration with the Board of Nurse Examiners that became effective in January
1997:
(A)
Separate courses in pharmacotherapeutics, advanced assessment,
and pathophysiology or psychopathology. These courses must be advanced level
academic courses with a minimum of 45 clock hours per course;
(B)
Evidence of theoretical and clinical role preparation;
(C)
Evidence of clinical major courses in the specialty area;
(D)
Evidence of a practicum/preceptorship/internship to integrate
essential content and the clinical major courses.
(d)
For clinical nurse specialist programs, the curriculum
must also contain a minimum of nine semester credit hours or the equivalent
in a specific clinical major. Clinical major courses must include didactic
content and offer clinical experiences in a specific clinical specialty/practice
area.
(e)
If a clinical nurse specialist program has as a goal or
outcome the preparation of graduates for approval for limited prescriptive
authority, then the program must also include at a minimum a separate course
in diagnosis and management of problems within the clinical specialty area.
This course(s) must be an advanced level academic course(s) with a minimum
of 45 clock hours.
(f)
The program of study shall include a minimum of 500 clinical
hours.
(g)
Post-master's preparation may be offered as graduate level
course work through certificate or master's level advanced educational programs
that include the desired role and specialty and otherwise meet the standards
in this chapter.
(1)
Post-master's students are required to complete a minimum
of 500 clinical hours and the equivalent of all of the role, clinical major,
and Texas Higher Education Coordinating Board curricular requirements. Courses
may be waived if an individual's transcript indicates that an equivalent course
has been successfully completed or if the student demonstrates proficiency,
validating program outcomes according to written program policies.
(2)
Only registered nurses who hold master's degrees in nursing
shall be eligible for post-master's preparation as clinical nurse specialists.
(h)
Board staff approval is required prior to implementation
of major curriculum changes. Proposed changes shall include information outlined
in Board guidelines and shall be reviewed using Board standards.
(1)
Changes that require approval include: should not exceed
one student per faculty during the clinical day.
(A)
Changes in program mission and goals (philosophy and outcomes)
that result in a reorganization or reconceptualization of the entire curriculum,
and/or
(B)
An increase or decrease in program length by more than
nine semester credit hours or 25%.
(2)
All other revisions such as editorial updates of mission
and goals or redistribution of course content or course hours shall be reported
to the Board in the Annual Report.
§219.10.Management of Clinical Learning Experiences and Resources.
(a)
Faculty shall be responsible and accountable for managing
clinical learning experiences of students.
(b)
Faculty shall develop criteria for the selection of affiliate
agencies or clinical practice settings that address the need for students
to observe and practice safe, effective health care.
(c)
Faculty shall select and evaluate affiliate agencies or
clinical practice settings that provide students with opportunities to achieve
the goals of the program.
(d)
Written agreements between the program and the affiliating
agencies shall specify the responsibility of the program to the agency and
the responsibility of the agency to the program. Such agreements shall be
developed jointly with the affiliating agency, reviewed periodically according
to the policies of the program and the affiliating agency, and include provisions
for adequate notice of termination.
(e)
When clinical preceptorships are used in an advanced educational
program, the following conditions shall be met:
(1)
Written agreements between the program, clinical preceptor
and the affiliating agency, when applicable, shall delineate the functions
and responsibilities of the parties involved.
(2)
Criteria for selecting clinical preceptors shall be developed
in writing. Competent clinicians can be considered qualified to be preceptors
if they are:
(A)
Authorized to practice as advanced practice nurses in the
state in which they practice, or
(B)
A currently licensed health care professional who can provide
supervision and teaching in clinical settings appropriate for advanced practice
nursing.
(3)
Written clinical objectives shall be specified and shared
with the clinical preceptor prior to the experience.
(4)
The designated faculty member shall be responsible for
the student's learning experiences and shall communicate regularly with the
clinical preceptor and student for the purpose of monitoring and evaluating
learning experiences. If site visits are not feasible, communication and evaluation
are managed by alternatives such as telephone, written communications, or
clinical simulations.
(f)
The maximum number of students that one advanced educational
program faculty member supervises in a clinical course should not exceed six
students.
(1)
If faculty are providing on-site clinical supervision of
students, the ratio should not exceed two students to one faculty member during
the clinical day.
(2)
If faculty are supervising students while managing their
own caseload of patients, the ratio should not exceed one student per faculty
during the clinical day.
§219.11.Facilities, Resources, and Services.
(a)
The physical facilities shall be adequate to meet the needs
of the program in relation to the size of the faculty and the student body.
(b)
The director shall have a private office.
(c)
Faculty offices shall be conveniently located and adequate
in number and size to provide faculty with the opportunity for uninterrupted
work and privacy for conferences with students.
(d)
Space for clerical staff, records, files, and equipment
shall be adequate.
(e)
Classrooms, laboratories, and conference rooms shall be
adequate in number, size, and type for the number of students and the educational
purposes for which the rooms are used.
(f)
The director and faculty shall have secretarial and clerical
assistance adequate in preparation and sufficient in numbers to meet the needs
of the program.
(g)
The learning resources, library, and program holdings shall
be current, use contemporary technology appropriate for the level of the curriculum,
and be sufficient for the size of the student body and the needs of the faculty.
(1)
Provisions shall be made for reasonable accessibility and
availability of information resources.
(2)
Facilities and policies shall promote effective use of
resources, e.g., environment, accessibility, and hours of operation.
§219.12.Records and Reports.
(a)
Accurate and appropriate records shall be maintained that
include, but are not limited to:
(1)
Current records of students;
(2)
Transcripts of graduates;
(3)
Faculty records;
(4)
Administrative records, including minutes of faculty meetings
for the past three years, annual reports of the program, and school bulletins;
(5)
The current curriculum, including mission and goals (philosophy
and outcomes) and course outlines;
(6)
Agreements with affiliating agencies; and
(7)
Master plan of evaluation with most recent data collection.
(b)
Records shall be safely stored to prevent loss, destruction,
or unauthorized use.
(c)
An annual report shall be submitted to the Board by the
director on forms provided.
§219.13.Total Program Evaluation.
There shall be a written plan for the systematic evaluation of the
total program. The plan shall include methodology, frequency of evaluation,
assignment of responsibility, evaluative criteria, and indicators of instructional
effectiveness and program outcomes. The following broad areas shall be periodically
evaluated:
(1)
Organization and administration of the program;
(2)
Mission and goals (philosophy and outcomes);
(3)
Program of study, curriculum, and instructional techniques;
(4)
Education facilities, resources, and services;
(5)
Clinical resources;
(6)
Student achievement, e.g., attrition rates, completion
rates, length of time for program completion;
(7)
Graduate outcomes, e.g., certification examination pass
rates, graduate surveys, employer surveys; and
(8)
Faculty's performance
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on June 4, 2001.
TRD-200103071
Katherine A. Thomas, MN, RN
Executive Director
Board of Nurse Examiners
Earliest possible date of adoption: July 15, 2001
For further information, please call: (512) 305-6811
Chapter 273.
GENERAL RULES
22 TAC §273.4
The Texas Optometry Board proposes amendments to §273.4
concerning Fees. The amendments raise the license renewal and corresponding
late fees by $25 in order to provide funding for the appropriations made by
the 77th Legislature. Part of this renewal fee ($10) will be for fees assessed
through various electronic licensing legislation.
Lois Ewald, Executive Director, has determined that for the first five-year
period the amendments are in effect there will be no fiscal implications for
local government as a result of enforcing or administering the amendments.
For state government, there will be increased revenue of $73,326 of the first
year of the biennium that the amended license fee amounts are in effect. $31,450
of this amount will be used for costs associated with electronic licensing
legislation. The same amounts are applicable for the next four years.
Lois Ewald also has determined that for the first five years the amendments
are in effect, the public benefit anticipated as a result of enforcing the
amendments will be the funding of those programs the 77th Legislature found
appropriate to fund.
The economic costs for persons who are required to comply with the amendments,
including small businesses, will be an additional license fee of $25 for each
license holder. No disparate effect is foreseen on small or micro-businesses
as the fee is imposed on individual professionals regardless of the size of
any business. Comments are solicited if a disparate cost of compliance can
be established.
Written comments on the proposal may be submitted in writing to Lois Ewald,
Texas Optometry Board, 333 Guadalupe, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
The amendments are proposed under the authority of the Texas
Optometry Act, Occupations Code, §351.152 which grants the Board the
authority to establish by rule reasonable and necessary fees to cover the
costs of administering the act.
The amendments affect the Texas Optometry Act, Occupations Code, §351.152,
which places limits on the Board's authority to set fees.
§273.4.Fees (Not Refundable).
(a)-(f)
(No change.)
(g)
License Renewal
$175.00
[
(h)-(i)
(No change.)
(j)
Late fees (for all renewals with delayed continuing education)
$175.00
[
(k)-(n)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on May 25, 2001.
TRD-200102998
Lois Ewald
Executive Director
Texas Optometry Board
Earliest possible date of adoption: July 15, 2001
For further information, please call: (512) 305-8500
The Texas Optometry Board proposes to reorganize a significant portion
of Chapter 279 in order to place matters concerning the same subject matter
in the same rule. The agency proposes to repeal §§279.1 - 279.7,
279.12, and 279.16. The agency proposes new §§279.1 - 279.5, 279.11,
and 279.12; and proposes amendments to §279.9 and §279.14 in order
to combine the text of the prior rules, update citations, amend titles, and
clarify some language.
The agency proposes to place the text of the repealed §§279.1
(contact lens prescription), 279.2 (fitting of contact lenses), 279.3 (dispensing
by optometrists), 279.4 (relationship of optician and optometrist), 279.5
(basic competence examination), 279.6 (separation of offices), 279.7 (contact
lens exam and follow-up visit), 279.12 (prescription requirements and duties
of opticians), and 279.16 (contact lens fitting fees) in the new and amended
rules proposed for this chapter.
Proposed new §279.1 contains sections from proposed repealed §§279.2,
279.5, 279.7, and 279.14, which were the prior rule sections relating to contact
lens examinations. In addition to the prior language, the new rule adds a
more specific title, updates citations to the Texas Occupations Code, and
clarifies from prior language both when a follow-up visit is required and
the method of notifying the patient.
Proposed new §279.2 contains sections from proposed repealed §§279.1,
279.12, and 279.16, which were the prior rule sections relating to contact
lens prescriptions. In addition to the prior language, the new rule adds a
more specific title, updates citations to the Texas Occupations Code, and
clarifies from prior language the minimum required prescription period. The
proposed new rule also adds language clarifying statutory requirements in
the Contact Lens Prescription Act regarding the mandatory two month prescription
extension and the manner in which information must be transmitted when a medical
condition prohibits the release of a prescription.
Proposed new §279.3 contains sections from proposed repealed §§279.5,
279.7, and 279.14, which were the prior rule sections relating to examinations
for which a spectacle prescription is written. In addition to the prior language,
the new rule adds a more specific title and updates citations to the Texas
Occupations Code.
Proposed new §279.4 contains sections from proposed repealed §§279.2,
279.5, 279.7, and 279.14, which were the prior rule sections relating to spectacle
prescriptions. In addition to the prior language, the new rule adds a more
specific title, and updates citations to the Texas Occupations Code.
Proposed amendment of §279.9 adds the text from the proposed repeal
of §280.6 to the current rule to group advertising issues together and
adds a more specific title.
Proposed new §279.11 contains the language of proposed repealed §279.6,
adds a more specific title and updates citations to the Texas Occupations
Code.
Proposed new §279.12 contains the language of proposed repealed §279.4,
adds a more specific title and updates citations to the Texas Occupations
Code.
Proposed amendment of §279.14 deletes subsections (b) - (e), which
text is now contained in proposed new §§279.1, 279.3, 279.5, and
279.9, and adds a more specific title.
Lois Ewald, Executive Director of the Texas Optometry Board, has determined
that for the first five-year period the new, amended and repealed rules are
in effect, there will be no fiscal implications for state and local governments
as a result of enforcing or administering the rules.
Lois Ewald also has determined that for each of the first five years the
proposed new, amended and repealed rules are in effect, the public benefits
anticipated as a result of enforcing the new, amended and repealed rules are
that it will be easier for the licensees and public to access and determine
all the requirements of the agency's rules in each subject area and it will
allow both licensees and the public to determine the requirements of the Contact
Lens Prescription Act. It has also been determined that the proposed new,
amended and repealed rules do not impose any additional costs on persons required
to comply with the rules which are substantially the same as current rules
except now arranged in a more logical order. Therefore the proposed new, amended
and repealed rules do not impose any new duties on small and micro businesses,
and no adverse economic effect on small or micro businesses is forecast.
Comments on the proposal may be submitted to Lois Ewald, Executive Director,
Texas Optometry Board, 333 Guadalupe Street, Suite 2-420, Austin, Texas 78701-3942.
The deadline for furnishing comments is 30 days after publication in the
22 TAC §§279.1 - 279.7, 279.12, 279.16
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Texas Optometry Board or in the Texas Register office, Room 245, James
Earl Rudder Building, 1019 Brazos Street, Austin.)
The repeal is proposed under the authority of the
Texas Optometry Act, Texas Occupations Code, §351.151. The Texas Optometry
Board interprets §351.151 as authorizing the adoption of procedural and
substantive rules for the regulation of the optometric profession.
The code that will be affected by this proposal is Chapter 351 of the Texas
Occupations Code.
§279.1.Board Interpretation Number One.
§279.2.Board Interpretation Number Two.
§279.3.Board Interpretation Number Three.
§279.4.Board Interpretation Number Four.
§279.5.Board Interpretation Number Five.
§279.6.Board Interpretation Number Six.
§279.7.Board Interpretation Number Seven.
§279.12.Board Interpretation Number Twelve.
§279.16.Board Interpretation Number Sixteen.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on May 25, 2001.
TRD-200102995
Lois Ewald
Executive Director
Texas Optometry Board
Earliest possible date of adoption: July 15, 2001
For further information, please call: (512) 305-8500
22 TAC §§279.1 - 279.5, 279.9, 279.11, 279.12, 279.14
The new sections and amendments are is proposed under the
Texas Optometry Act, Texas Occupations Code, §§351.005, 351.151,
351.353, 351.356, 351.357, and 351.501. The Texas Optometry Board interprets §351.151
as authorizing the adoption of procedural and substantive rules for the regulation
of the optometric profession, §351.353 as defining the steps required
in an examination, and §§351.005, 351.356 and 351.357 as defining
the limits of an ophthalmic dispenser's authority, and §351.501 as authorizing
the disciplining of licensees.
The new sections and amendments affect §§351.353, 351.357, and
351.501.
§279.1.Contact Lens Examination.
(a)
The optometrist or therapeutic optometrist shall, in the
initial examination of the patient for whom contact lenses are prescribed:
(1)
Personally make and record, if possible, the following
findings of the conditions of the patient as required by §351.353 of
the Act:
(A)
biomicroscopy examination (lids, cornea, sclera, etc.),
using a binocular microscope;
(B)
internal ophthalmoscopic examination (media, fundus, etc.),
using an ophthalmoscope or biomicroscope with fundus condensing lenses; videos
and photographs may be used only for documentation and consultation purposes
but do not fulfill the internal ophthalmoscopic examination requirement; and
(C)
subjective findings, far point and near point;
(2)
Either personally make and record or authorize an assistant
present in the same office with the optometrist or therapeutic optometrist
to make and record the following findings required by §351.353 of the
Act. The authorization for assistants to make and record the following findings
does not relieve the optometrist or therapeutic optometrist of professional
responsibility for the proper examination and recording of each finding required
by §351.353 of the Act:
(A)
case history (ocular, physical, occupational, and other
pertinent information);
(B)
visual acuity;
(C)
static retinoscopy O.D., O.S., or autorefractor;
(D)
assessment of binocular function;
(E)
amplitude or range of accommodation;
(F)
tonometry; and
(G)
angle of vision, to right and to left.
(3)
Personally notate in the patient's record the reasons why
it is not possible to make and record the findings required in subsection
(a) of this section;
(4)
When a follow-up visit is medically indicated, schedule
the follow-up visit within 30 days of the contact lens fitting, and inform
the patient on the initial visit regarding the necessity for the follow-up
care; and
(5)
Personally or authorize an assistant to instruct the patient
in the proper care of lenses.
(b)
The optometrist or therapeutic optometrist and assistants
shall observe proper hygiene in the handling and dispensing of the contact
lenses and in the conduct of the examination. Proper hygiene includes sanitary
office conditions, running water in the office where contact lenses are dispensed,
and proper sterilization of diagnostic lenses and instruments.
(c)
The fitting of contact lenses may be performed only by
a licensed physician, optometrist, or therapeutic optometrist. Ophthalmic
dispensers may make mechanical adjustments to contact lenses and dispense
contact lenses only after receipt of a fully written contact lens prescription
from a licensed optometrist, therapeutic optometrist, or a licensed physician.
An ophthalmic dispenser shall make no measurement of the eye or the cornea
or evaluate the physical fit of the contact lenses, by any means whatever,
subject solely and only to the exception contained in the §351.005 of
the Act.
(d)
The willful or repeated failure or refusal of an optometrist
or therapeutic optometrist to comply with any of the requirements in the Act, §351.353
and §351.359, shall be considered by the board to constitute prima facie
evidence that the licensee is unfit or incompetent by reason of negligence
within the meaning of the Act, §351.501(a)(2), and shall be sufficient
ground for the filing of charges to cancel, revoke, or suspend the license.
The charges shall state the specific instances in which it is alleged that
the rule was not complied with. After the board has produced evidence of the
omission of a finding required by §351.353, the burden shifts to the
licensee to establish that the making and recording of the findings was not
possible.
§279.2.Contact Lens Prescriptions.
(a)
A prescription for contact lenses is defined as a written
order signed by the examining optometrist, therapeutic optometrist or physician,
or a written order signed by an optometrist, therapeutic optometrist or physician
authorized by the examining doctor to issue the prescription. If the prescription
is signed by a doctor other than the examining optometrist, therapeutic optometrist
or physician, the prescription must contain:
(1)
the name of the examining doctor, and
(2)
the license number of both the examining doctor and the
doctor signing the prescription.
(b)
A contact lens prescription must comply with the requirements
of the Texas Optometry Act, §§351.005, 351.356, 351.357, 351.359
and 351.607, and the Contact Lens Prescription Act, §§353.152, 353.153
and 353.158.
(c)
A fully written contact lens prescription must contain
all information required to accurately dispense the contact lens, including:
(1)
patient's name;
(2)
date the prescription is issued;
(3)
an expiration date of not less than one year, unless a
shorter period is medically indicated;
(4)
examining optometrist's signature or authorized signature
(5)
name of the lens manufacturer, if required to accurately
dispense the lens;
(6)
lens brand name, including:
(A)
a statement that brand substitution is permitted if the
optometrist intends to authorize a contact lens dispenser to substitute the
brand name, and
(B)
a statement specifying a substitute brand name when the
prescribed brand name is not available to the optical industry as a whole,
unless the prescribing of a proprietary lens brand is medically indicated;
(7)
lens power;
(8)
lens diameter, unless set by the manufacturer;
(9)
base curve, unless set by the manufacturer; and
(10)
number of lenses and recommended replacement interval.
(d)
The Contact Lens Prescription Act requires the optometrist
or therapeutic optometrist to release a prescription upon request once the
parameters of the prescription are determined. An exception to this requirement
exists if the optometrist or therapeutic optometrist determines that because
of a medical indication further monitoring is required, and the optometrist
or therapeutic optometrist gives the patient a verbal explanation of the reason
the prescription is not released and documents in the patient's records a
written explanation of the reason.
(e)
Under the Contact Lens Prescription Act, if the optometrist
or therapeutic optometrist determines that the patient needs an emergency
refill of the contact lens prescription, the prescription may be telephoned
or faxed to a person authorized to fill the prescription.
(f)
The Contact Lens Prescription Act requires an optometrist
or therapeutic optometrist to authorize, upon request of the patient, a one
time, two month extension of the contact lens prescription. If the extension
request also constitutes a request for an emergency refill, the optometrist
or therapeutic optometrist may telephone or fax the prescription extension
to a person authorized to fill the prescription.
(g)
The prescribing optometrist or therapeutic optometrist
has the authority to specify any and all parameters of an optical prescription
for the therapeutic and visual health and welfare of a patient, but the prescription
shall not contain restrictions limiting the parameters to private labels not
available to the optical industry as a whole, unless the prescribing of a
proprietary lens brand is medically indicated. The specifications of the prescription
may not be altered without the consent of the prescribing doctor.
(h)
The Contact Lens Prescription Act (Act), prohibits an optometrist
or therapeutic optometrist from charging the patient a fee in addition to
the examination fee and the fitting fee as a condition for giving a contact
lens prescription to the patient. The Board does not interpret the Act to
prohibit charges in the fitting fee for lenses used to determine a final contact
lens prescription.
§279.3.Spectacle Examination.
(a)
The optometrist or therapeutic optometrist shall, in the
initial examination of the patient for whom ophthalmic lenses are prescribed:
(1)
Personally make and record, if possible, the following
findings of the conditions of the patient as required by §351.353 of
the Act:
(A)
biomicroscopy examination (lids, cornea, sclera, etc.),
using a binocular microscope;
(B)
internal ophthalmoscopic examination (media, fundus, etc.),
using an ophthalmoscope or biomicroscope with fundus condensing lenses; videos
and photographs may be used only for documentation and consultation purposes
but do not fulfill the internal ophthalmoscopic examination requirement; and
(C)
subjective findings, far point and near point.
(2)
Either personally make and record or authorize an assistant
present in the same office with the optometrist or therapeutic optometrist
to make and record the following findings required by §351.353 of the
Act. The authorization for assistants to make and record the following findings
does not relieve the optometrist or therapeutic optometrist of professional
responsibility for the proper examination and recording of each finding required
by §351.353 of the Act:
(A)
case history (ocular, physical, occupational, and other
pertinent information);
(B)
visual acuity;
(C)
static retinoscopy O.D., O.S., or autorefractor;
(D)
assessment of binocular function;
(E)
amplitude or range of accommodation;
(F)
tonometry;
(G)
angle of vision, to right and to left.
(3)
Personally notate in the patient's record the reasons why
it is not possible to make and record the findings required in this subsection.
(b)
The willful or repeated failure or refusal of an optometrist
or therapeutic optometrist to comply with any of the requirements in the Act, §351.353
and §351.359, shall be considered by the board to constitute prima facie
evidence that the licensee is unfit or incompetent by reason of negligence
within the meaning of the Act, §351.501(a)(2), and shall be sufficient
ground for the filing of charges to cancel, revoke, or suspend the license.
The charges shall state the specific instances in which it is alleged that
the rule was not complied with. After the board has produced evidence of the
omission of a finding required by §351.353, the burden shifts to the
licensee to establish that the making and recording of the findings was not
possible.
§279.4.Spectacle and Ophthalmic Devices Prescriptions.
(a)
A prescription for spectacles or ophthalmic devices is
defined as a written order signed by the examining optometrist, therapeutic
optometrist or physician, or a written order signed by an optometrist, therapeutic
optometrist or physician authorized by the examining doctor to issue the prescription.
A facsimile (FAX) prescription is not considered a valid prescription. If
the prescription is signed by a doctor other than the examining optometrist,
therapeutic optometrist or physician, the prescription must contain:
(1)
the name of the examining doctor, and
(2)
the license number of both the examining doctor and the
doctor signing the prescription.
(b)
The prescribing optometrist or therapeutic optometrist
has the authority to specify any and all parameters of an optical prescription
for the therapeutic and visual health and welfare of a patient, but the prescription
shall not contain restrictions limiting the parameters to private labels not
available to the optical industry as a whole, unless the prescribing of a
proprietary lens brand is medically indicated. The specifications of the prescription
may not be altered without the consent of the prescribing doctor.
§279.5.Dispensing Ophthalmic Materials.
(a)
The dispensing of medications, spectacles, contact lenses,
or ophthalmic devices without a valid prescription constitutes the unlawful
practice of optometry, subject to penalties under the Texas Optometry Act, §§351.251,
351.406, 351.602, 351.603, 351.606 and 351.607.
(b)
The Texas Optometry Act, §351.453, relates to prescribing
without examination. Nothing in this section prohibits a licensed optometrist
or therapeutic optometrist from:
(1)
duplicating a patient's spectacle lenses;
(2)
filling or having filled a prescription that has been signed
by an authorized practitioner;
(3)
dispensing or having dispensed lenses from a patient's
optometric record located within the same optometric office; or
(4)
replacing or repairing frames or parts thereof.
(c)
Under the Texas Optometry Act, §§351.005, 351.356
and 351.357, the practice of optometry and therapeutic optometry includes
prescribing lenses or prisms, and an ophthalmic dispenser is charged to fill
such prescription in accordance with the specific directions of a prescription
of a licensed physician, optometrist, or therapeutic optometrist.
Advertising
[
(a)
All advertising must be in compliance
with the Texas Optometry Act, §351.155 and §351.403. Any advertising
regarding services to be provided by an optometrist must not be false, deceptive,
or misleading.
(b)
The term "board certified" or any similar
word or phrase denoting certification or specialization may be used by an
optometrist if the advertising includes the name of the organization that
has conferred the certification or specialization. The Texas Optometry Board
does not confer certifications or specializations.
(c)
Any advertisement of price of contact lens shall
affirmatively disclose the number of lenses included for the price specified.
§279.11.Relationship with Dispensing Optician--Books and Records.
(a)
Texas Optometry Act, §351.364, relating to relationships
with dispensing opticians, states: The purpose of this section is to insure
that the practice of optometry shall be carried out in such a manner that
it is completely and totally separated from the business of any dispensing
optician, with no control of one by the other and no solicitation for one
by the other.
(b)
It is therefore the interpretation of this board that an
optometrist practicing under his own name and dispensing, repairing, or duplicating
lenses and/or frames in his own office as part of his optometric practice
would not be required to keep separate records or books by virtue of the fact
that it is all part of his practice of optometry and not a separate dispensing
business.
§279.12.Relationship with Dispensing Optician--Separation of Offices.
(a)
The Texas Optometry Act, §351.364(a), requires that
the space occupied by the optometrist or therapeutic optometrist shall be
separated from the space occupied by the dispensing optician by solid partitions
or walls from floor to ceiling. The intent of the legislature in passing §351.364
is specifically spelled out in §351.364(d) and is to insure that the
practices of optometry and therapeutic optometry shall be carried out in such
a manner that they are completely and totally separated from the business
of any dispensing optician.
(b)
In light of the overriding legislative intent in passing §351.364
that the practices of optometry and therapeutic optometry be completely and
totally separate from the business of any dispensing optician, it is the interpretation
of the board that §351.364(a), set forth in subsection (a) of this section
prohibits the space occupied by an optometrist or therapeutic optometrist
and space occupied by a dispensing optician from being joined by a wall in
which there is a door, either locked or unlocked.
Patient Files
[
[
Patient's optometric records are defined as
the patient chart, historical record, or working document during the course
of examination and patient care between the doctor and patient. The patient's
records may contain information regarding spectacle prescription findings
and contact lens prescription findings but do not include a prescription for
spectacles or contact lenses.
[(b)
A prescription for spectacles, contact
lenses, or ophthalmic devices is defined as a written order signed by the
examining optometrist, therapeutic optometrist or physician, or a written
order signed by an optometrist, therapeutic optometrist or physician authorized
by the examining doctor to issue the prescription. If the prescription is
signed by a doctor other than the examining optometrist, therapeutic optometrist
or physician, the prescription must contain:]
[(1)
the name of the examining doctor, and]
[(2)
the license number of both the examining doctor and the
doctor signing the prescription.]
[(c)
A facsimile (FAX) prescription is not
considered a valid prescription. Under the Contact Lens Prescription Act,
if the optometrist or therapeutic optometrist determines that the patient
needs an emergency refill of the contact lens prescription, the prescription
may be telephoned or faxed to a person authorized to fill the prescription.]
[(d)
A prescription for medications may be
verbal or written.]
[(e)
The dispensing of medications, spectacles,
contact lenses, or ophthalmic devices without a valid prescription constitutes
the unlawful practice of optometry, subject to penalties under the Texas Optometry
Act, §§351.251, 351.406, 351.602, 351.603, 351.606 and 351.607.]
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed
with the Office of the Secretary of State, on May 25, 2001.
TRD-200102996
Lois Ewald
Executive Director
Texas Optometry Board
Earliest possible date of adoption: July 15, 2001
For further information, please call: (512) 305-8500
The license renewal fee and any late
fees shall be paid by cashier's check or money order made payable to the Texas
Board of Chiropractic Examiners.
]
Part 11.
BOARD OF NURSE EXAMINERS
Part 14.
TEXAS OPTOMETRY BOARD
$150.00
]
$150.00
]
Chapter 279.
INTERPRETATIONS
Board Interpretation
Number Nine
].
Board Interpretation
Number Fourteen
].
(a)
]
Chapter 280.
THERAPEUTIC OPTOMETRY