TITLE 22.EXAMINING BOARDS

Part 3. TEXAS BOARD OF CHIROPRACTIC EXAMINERS

Chapter 80. MISCELLANEOUS

22 TAC §80.3

The Texas Board of Chiropractic Examiners proposes to amend Chapter 80 relating to miscellaneous provisions to add a new §80.3. This new section was inadvertently omitted from the February 11, 2000, issue of the Texas Register .

The proposal transfers the current text of §76.3 of Title 22, relating to requests for information and records of practitioners to Chapter 80. No substantive changes are made to the section. This change is made in conjunction with the board's review of this chapter and Chapter 75 which relates to the board disciplinary procedures. Proposed revisions to the board's disciplinary procedures required additional provisions. Chapter 76 was repealed by separate rulemaking published in the February 11, 2000, issue of the Texas Register (25 TexReg 1025), and new sections relating to procedures at the State Office of Administrative Hearings were proposed for Chapter 76.

Cynthia Vaughn, D.C., Chair of the Rules Committee, has determined that for the first five-year period the proposed section is in effect, there will be no fiscal implications for state government or local government as a result of enforcing or administering Chapter 80 as amended.

Dr. Vaughn also has determined that for each year of the first five years, the proposed section is in effect, the public benefit anticipated as a result of enforcing the rule will be that the board's rules will be arranged in a more logical and orderly system, making it easier for the public, including those regulated by the board, to locate rules of interest. There will be no added adverse economic effect on micro or small businesses versus that on larger businesses or anticipated economic cost to persons who are required to comply with the rule.

Written comments may be submitted, no later than 30 days from the date of this publication, to Joyce Kershner, Rules Committee, Texas Board of Chiropractic Examiners, 333 Guadalupe, Tower III, Suite 825, Austin, Texas 78701.

The new section proposed under Occupations Code, §201.152, which the board interprets as authorizing it to adopt rules necessary for performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §210.405 which sets out statutory responsibilities and requirements for release of patient records, and which the board interprets as one of the provisions it is charged with enforcing.

The following are the statutes, articles, or codes affected by the proposed section: §80.3 -- Occupations Code, §§201.152, .405.

§80.3. Request for Information and Records from Licensees.

(a)

Request for chiropractic records. Upon request, a licensee shall furnish copies of chiropractic records or a summary or narrative of the records pursuant to a written consent for the release of the information or records. The requested information or record shall not be released if the licensee determines that access to the information would be harmful to the physical, mental, or emotional health of the patient. The licensee may delete from the requested records confidential information about another person who has not consented to release. For purposes of this subsection, "chiropractic records" means any records pertaining to the history, diagnosis, treatment or prognosis of the patient including records of other health care practitioners contained in the records of the licensee to whom a request for release of records has been made. "Patient" means any person who consults or is seen by a licensee for the purposes of receiving chiropractic care.

(b)

Written consent.

(1)

The written consent required by subsection (a) of this section shall be signed by:

(A)

the patient;

(B)

the patients' personal representative if the patient is deceased;

(C)

a parent or legal guardian if the patient is a minor;

(D)

a legal guardian if the patient has been adjudicated incompetent to manage his or her personal affairs; or

(E)

an attorney ad litem for the patient as authorized by law, including the Health and Safety Code, Title 7, Family Code, Chapter 11 or the Probate Code, Chapter 5.

(2)

The written consent shall contain the specific information or chiropractic records to be released under the consent; the reasons or purposes for the release; and the person to whom the information is to be released.

(3)

The patient, or other person authorized to consent, has the right to withdraw the consent to the release of any information. Withdrawal of consent does not affect any information disclosed prior to the written notice of the withdrawal. Any person who received information made confidential by the Chiropractic Act may disclose the information to others only to the extent consistent with the authorized purposes for which consent to release information was obtained.

(c)

Reasonable time. A copy of chiropractic records or a summary or narrative of the records requested under subsection (a) of this section shall be furnished by the licensee within reasonable time after the date of the request.

(d)

Denial of request. If the licensee denies the request under subsection (a) of this section for a copy of chiropractic records or a summary or narrative of the records, either in whole or in part, the licensee shall furnish the patient a written statement, signed and dated, stating the reason for the denial. Chiropractic records requested pursuant to subsection (a) of this section may not be withheld based on a past due account for care or treatment previously rendered to the patient.

(e)

Fee for records. The licensee may charge a reasonable fee for furnishing the information requested under subsection (a) of this section, which shall be paid by the patient or someone on the patient's behalf. A licensee may require payment in advance except from another licensee or other health care provider, including a chiropractor licensed by any other state, territory, or insular possession of the United States or any state or province of Canada, if requested for purposes of emergency or acute medical care. In the event payment is not received, within ten calendar days from notification of the charge, the licensee shall notify the requesting party in writing of the need for payment.

(f)

Subpoena not required. A subpoena shall not be required for the release of chiropractic records requested pursuant to subsection (a) of this section.

(g)

Renewal of licenses. A licensee shall furnish a written explanation of his or her answer to any question asked on the application for license renewal, if requested by the board. This explanation shall include all details as the board may request and shall be furnished within two weeks of the date of the board's request.

(h)

Impaired licensees.

(1)

The board shall require a licensee to submit to a mental and/or physical examination by the appropriate health care provider designated by the board if the board has probable cause to believe that the licensee is impaired. An impaired licensee is considered to be one who is unable to practice chiropractic with reasonable skill and safety to patients by reason of age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material; or as a result of any mental or physical condition.

(2)

Probable cause may include, but is not limited to, any one of the following listed in subparagraphs (A)-(F) of this paragraph:

(A)

sworn statements from two people, willing to testify before the board, that a certain licensee is impaired;

(B)

evidence that a licensee left a treatment program for alcohol or chemical dependency before completion of that program;

(C)

evidence that a licensee is guilty of intemperate use of drugs or alcohol;

(D)

evidence of repeated arrests of a licensee for intoxication;

(E)

evidence of recurring temporary commitments to a mental institution of a licensee; or

(F)

chiropractic records showing that licensee has an illness or condition which results in the inability to function properly in his or her practice.

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 February 16, 2000.

TRD-200001229

Gary K. Cain, Ed. D.

Executive Director

Texas Board of Chiropractic Examiners

Earliest possible date of adoption: April 2, 2000

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