TITLE 25.HEALTH SERVICES

Part 1. DEPARTMENT OF STATE HEALTH SERVICES

Chapter 97. COMMUNICABLE DISEASES

Subchapter I. IMMUNIZATION REQUIREMENTS FOR RESIDENTS OF TEXAS NURSING HOMES

25 TAC §97.201, §97.202

The Executive Commissioner of the Health and Human Services Commission (commission), on behalf of the Department of State Health Services (department), adopts amendments to §97.201 and §97.202, concerning the immunizations nursing homes are required to offer in accordance with the most recent recommendations of the Advisory Committee on Immunization Practices (ACIP) and the requirement to document the receipt or refusal of the vaccinations, without changes to the proposed text as published in the March 3, 2006, issue of the Texas Register (31 TexReg 1409) and, therefore, the sections will not be republished.

BACKGROUND AND PURPOSE

The amendments provide the ACIP recommendations as an immunization reference for nursing homes, clarify language, and expand the mandatory time to provide influenza vaccine for employees hired or residents admitted after November 30 of each year from "through February of each year" to "through March of each year". This change will make these rules consistent with proposed Centers for Medicare and Medicaid Services (CMS) nursing homes regulations and is also in accordance with the most recent recommendation of the ACIP.

The department consulted with the Department of Aging and Disability Services, CMS, Department of State Health Services Division for Regulatory Services, ARC of Texas, Texas Association of Residential Care Communities, Texas Health Care Association, Texas Organization of Residential Care Homes, Texas Advocates for Nursing Homes, and the Texas Association of Area Agencies on Aging during the rule process.

Government Code, §2001.039, requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 97.201 and 97.202 have been reviewed and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed.

SECTION-BY-SECTION SUMMARY

A grammatical change was made to the amendment to §97.201, replacing "which serve" with "serving". The amendment to §97.202 provides the ACIP recommendations as an immunization reference for nursing homes, and expands the mandatory time to provide influenza vaccine for employees hired or residents admitted after November 30 of each year from "through February of each year" to "through March of each year".

COMMENTS

The department, on behalf of the commission, did not receive any comments regarding the proposed rules during the comment period.

LEGAL CERTIFICATION

The Department of State Health Services General Counsel, Cathy Campbell, certifies that the rules, as adopted, have been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.

STATUTORY AUTHORITY

The amendments are authorized under Health and Safety Code, §81.021, which requires the department to develop immunization requirements; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.

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 May 30, 2006.

TRD-200602940

Cathy Campbell

General Counsel

Department of State Health Services

Effective date: June 19, 2006

Proposal publication date: March 3, 2006

For further information, please call: (512) 458-7111 x6972


Chapter 230. SPECIFIC ADDITIONAL REQUIREMENTS FOR DRUGS

Subchapter B. LIMITATIONS ON SALES OF PRODUCTS CONTAINING EPHEDRINE, PSEUDOEPHEDRINE, AND NORPSEUDOEPHEDRINE

25 TAC §§230.11 - 230.16

The Executive Commissioner of the Health and Human Services Commission (commission), on behalf of the Department of State Health Services (department), adopts new §§230.11 - 230.16, concerning limitations on sales of products containing ephedrine, pseudoephedrine, and norpseudoephedrine. New §230.11 and §230.15 are adopted with changes to the proposed text as published in the February 24, 2006, issue of the Texas Register (31 TexReg 1170). New §§230.12 - 230.14, and 230.16 are adopted without changes to the proposed text and, therefore, will not be republished.

BACKGROUND AND PURPOSE

The new sections are necessary to comply with Health and Safety Code (HSC), Chapter 486, relating to the over-the-counter sales of ephedrine, pseudoephedrine, and norpseudoephedrine. The new chapter requires the department to adopt rules to implement and enforce the chapter. Under the chapter, any business establishment (other than a pharmacy licensed by the Board of Pharmacy) that wishes to engage in over-the-counter sales of products containing any quantity of ephedrine, pseudoephedrine, or norpseudoephedrine must have a certificate of authority (COA) from the department. In order to obtain a COA, a business must file an application with the department; pay the required fee; and agree to comply with the restrictions to access and record keeping requirements of these sections. Compliance with these sections will be verified through audits and inspections.

SECTION-BY-SECTION SUMMARY

The name of Title 25, Texas Administrative Code, Chapter 230, was amended to reflect the addition of new Subchapter B concerning the limitations on sales of products containing ephedrine, pseudoephedrine, and norpseudoephedrine. New §§230.11 - 230.16 set out the rules that limit the over-the-counter sales of these regulated products. Section 230.11 defines the purpose and definitions used in the rules. Section 230.12 sets out exemptions from obtaining a certificate of authority (COA). Sections 230.13 and 230.14 explain the requirements for a COA to engage in over-the-counter sales of these products, and provide the minimum standards required to obtain and maintain the COA. Section 230.15 identifies the records that must be maintained for each transaction involving the sale of these regulated products. Section 230.16 establishes the enforcement actions that can be taken to ensure compliance with the rules.

COMMENTS

The department, on behalf of the commission, has reviewed and prepared responses to the comments received regarding the proposed new rules during the comment period, which the commission has reviewed and accepts. The department's responses to the comments are discussed in the summary of comments.

Concerning proposed new §230.15(a)(2), a comment was submitted by the National Association of Chain Drug Stores. The commenter was generally in favor of the new rules but expressed concerns and made recommendations.

Comment: Concerning proposed new §230.15(a)(2), the commenter expressed concern that requiring sales associates to record the Universal Product Code (UPC) or Store Keeping Unit (SKU) would be an unnecessary and burdensome recordkeeping requirement and alternatively suggested that sales associates should be required to record the name of the product.

Response: The commission agrees with the comment and has revised the language in §230.15(a)(2) and (3) accordingly.

The department staff on behalf of the commission provided comments and the commission has reviewed and agrees to the following changes that will result in clarification regarding any federal requirements that may apply to persons selling pseudoephedrine, ephedrine, and phenylpropanolamine products. In addition, the changes will result in clarification of the acceptable forms of personal identification required to purchase these products.

Change: Concerning proposed new §230.11, relating to General Provisions, clarifying language was added in new subsection (c) to reflect that persons who sell or distribute ephedrine, pseudoephedrine, norpseudoephedrine or phenylpropanolamine may be subject to additional federal statutes and regulations.

Change: Concerning proposed new §230.15(a)(1)(A), relating to Records, a reference to "government" identification was removed in order to clarify that other acceptable forms of personal identification are allowed for under Health and Safety Code, Chapter 486.

LEGAL CERTIFICATION

The Department of State Health Services General Counsel, Cathy Campbell, certifies that the rules, as adopted, have been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.

STATUTORY AUTHORITY

The adopted new sections are authorized by Health and Safety Code, §12.0111, which requires the department to charge fees for issuing or renewing a license; §12.0112, which requires the term of each license issued to be two years; Health and Safety Code, §486.003, which authorizes adoption of rules necessary for the implementation and enforcement of Chapter 486; and Health and Safety Code, §486.004, which requires that the department collect fees pertaining to the application and issuance of the certificate of authority and enforcement of Chapter 486, and the rules adopted under that chapter; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorizes the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.

§230.11.General Provisions.

(a) Purpose and applicability. The purpose of these sections is to implement the duties of the Department of State Health Services (department) under the Health and Safety Code (HSC), Chapter 486, relating to over-the-counter sales of ephedrine, pseudoephedrine, and norpseudoephedrine.

(b) Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. Unless otherwise specified, the terms have the meaning assigned by HSC, Chapters 481 and 486, or their common use meaning.

(1) Business establishment--A retail distributor such as a grocery store; general merchandise store; drug store; or other entity or person, other than a licensed pharmacy, that engages in direct sales to end-user consumers. A distributor who engages in greater than 5% of gross annual sales of regulated products to other than end-user consumers must obtain a license as a wholesaler under HSC, Chapter 431, Subchapter I or Subchapter N.

(2) Department--The Department of State Health Services.

(3) Certificate of authority (COA)--A grant of authority to engage in over-the-counter sales of regulated products, issued by the department to a person under this subchapter.

(4) Certificate of authority holder (COA holder)--A person that has been issued a certificate of authority by the department to engage in over-the-counter sales of regulated products.

(5) Pharmacy--A person holding a current license to operate a pharmacy issued by the Texas State Board of Pharmacy (Board of Pharmacy) under Occupations Code, Chapter 560.

(6) Record of sale--The paper or electronic documentation prepared and maintained in compliance with §230.15 of this title (relating to Records).

(7) Regulated products--Any compound, mixture, or preparation containing any detectable amount of ephedrine, pseudoephedrine, or norpseudoephedrine, including its salts, optical isomers, and salts of optical isomers. The term does not include any compound, mixture, or preparation that is in liquid, liquid capsule, or liquid gel capsule form. A list of regulated products, by name and universal product code (UPC) or stock-keeping unit (SKU) identifiers, may be obtained from the Department of State Health Services, 1100 West 49th, Austin, Texas 78756.

(8) Over-the-counter sale--The sale of not more than two packages or six grams of regulated products, in a single transaction to an individual.

(c) Persons who sell or distribute ephedrine, pseudoephedrine, norpseudoephedrine or phenylpropanolamine may be subject to additional federal statutes and regulations adopted thereunder.

§230.15.Records.

(a) Before completing a sale of a regulated product, an employee with authority to access regulated products must:

(1) require the person making the purchase to:

(A) display a driver's license or other form of identification containing the person's photograph and indicating that the person is 16 years of age or older; and

(B) sign for the purchase;

(2) make a record of the sale, using a format approved or provided by the department for this purpose, that includes the name of the person making the purchase, the date of the purchase, the product name for the item purchased, and the number of grams purchased; and

(3) take reasonable measures to limit single sales transactions to:

(A) two packages of a regulated product; or

(B) no more than 6 grams of ephedrine, pseudoephedrine, or norpseuodoephedrine base.

(b) The COA holder must maintain these records at the business establishment for a minimum of two years from the date the record is made.

(c) The COA holder must make the records available to the agent(s) of the Department of State Health Services or the Department of Public Safety upon request.

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 May 30, 2006.

TRD-200602939

Cathy Campbell

General Counsel

Department of State Health Services

Effective date: June 19, 2006

Proposal publication date: February 24, 2006

For further information, please call: (512) 458-7111 x6972


Part 12. TEXAS COUNCIL ON ALZHEIMER'S DISEASE AND RELATED DISORDERS

Chapter 801. PROCEDURES AND BYLAWS

The Texas Council on Alzheimer's Disease and Related Disorders (council) adopts the repeal of §§801.1 - 801.4 and new §801.1, concerning the conduct of its meetings. New §801.1 is adopted with changes to the proposed text as published in the March 3, 2006, issue of the Texas Register (31 TexReg 1415). The repealed §§801.1 - 801.4 are adopted without changes and, therefore, the sections will not be republished.

BACKGROUND AND PURPOSE

The repeals and new section are necessary to comply with the Health and Safety Code, Chapter 101, §101.006, which requires the council to adopt rules for the conduct of its meetings.

Government Code, §2001.039, requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 801.1 - 801.4 have been reviewed and the council has determined that reasons for adopting the sections continue to exist because rules on this subject are needed, and the restructuring of the rules better defines the Council's organization.

SECTION-BY-SECTION SUMMARY

In accordance with Health and Safety Code, Chapter 101, the repeal of §§801.1 - 801.4 and new §801.1 documents in the rules previously defined "procedures" as "by-laws". The reorganization of the rules provides improved clarity in redefining the council's officers and their duties, meetings, quorums, and its voting membership.

COMMENTS

The council did not receive any comments regarding the proposed rules during the comment period, but due to staff comments is making the following changes.

Change: Concerning §801.1(a), the phrase "by the" was added following Chapter 101 for further clarification.

Change: Concerning §801.1(c)(6), the phrase "appointed by the Governor, Lieutenant Governor and Speaker of the House" was added to the second sentence in the paragraph concerning member appointment.

25 TAC §§801.1 - 801.4

STATUTORY AUTHORITY

The repeals are authorized by Health and Safety Code, Chapter 101, §101.006, which requires the council to adopt rules for the conduct of its meetings. Review of the sections implements Government Code, §2001.039.

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 June 5, 2006.

TRD-200603036

Debbie Hanna

Chair

Texas Council on Alzheimer's Disease and Related Disorders

Effective date: June 25, 2006

Proposal publication date: March 3, 2006

For further information, please call: (512) 458-7111, x6972


Chapter 801. PROCEDURES

25 TAC §801.1

STATUTORY AUTHORITY

The new section is authorized by Health and Safety Code, Chapter 101, §101.006, which requires the council to adopt rules for the conduct of its meetings. Review of the sections implements Government Code, §2001.039.

§801.1.Conduct of Meetings.

(a) Applicable law. The Texas Council on Alzheimer's Disease and Related Disorders is created by the Health and Safety Code, Subtitle E., Chapter 101 by the 70th Legislature, Regular Session, 1987.

(b) Officers and their duties.

(1) The governor shall designate a member of the council who is not an agency representative as the chairman of the council to serve in that capacity at the will of the governor.

(2) The chairman shall preside at all council meetings at which he or she is in attendance, call meetings in accordance with this section, assist in the preparation of the agenda, appoint committees, task forces or workgroups of the council with council consensus, cause proper reports to be made to the governor, lieutenant governor and speaker of the house and serve as spokesperson for the council. The chairman may serve as an ex-officio member of any subcommittee or workgroup of the council. The chairman may invite guests or speakers.

(3) The members of the council shall elect a vice-chairman each year.

(4) The vice-chairman shall perform the duties of the chairman in the absence or disability of the chairman. Should the office of the chairman become vacant, the vice-chairman shall serve until a successor is appointed.

(c) Meetings.

(1) The council shall meet at least two times in each calendar year and may meet at other times, as the chairman deems necessary.

(2) Each meeting of the council shall be announced and conducted in accordance with the Open Meetings Act, Texas Government Code, Chapter 551.

(3) A simple majority of the members of the council shall constitute a quorum for the purpose of transacting official business.

(4) The council is authorized to transact official business only when in a legally constituted meeting with a quorum present.

(5) Roberts Rules of Order, Newly Revised, shall be the basis of parliamentary decisions except where otherwise provided by law or rule.

(6) Any action taken by the council must be approved by a majority of the voting members present once a quorum is established. Each member appointed by the Governor, Lieutenant Governor and Speaker of the House shall have one vote. A member may not authorize another individual to represent the member by proxy.

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 June 5, 2006.

TRD-200603035

Debbie Hanna

Chair

Texas Council on Alzheimer's Disease and Related Disorders

Effective date: June 25, 2006

Proposal publication date: March 3, 2006

For further information, please call: (512) 458-7111, x6972