TITLE 25.HEALTH SERVICES

Part 1. TEXAS DEPARTMENT OF HEALTH

Chapter 13. HEALTH PLANNING AND RESOURCE DEVELOPMENT

Subchapter C. DESIGNATION OF SITES SERVING MEDICALLY UNDERSERVED POPULATIONS

25 TAC §§13.31 - 13.34

The Texas Department of Health (department) adopts amendments to §§13.31-13.34 regarding the designation of sites serving medically underserved populations. The sections are adopted without changes to the proposed text as published in the March 9, 2001, issue of the Texas Register (26 TexReg 1975), and therefore the sections will not be republished.

In accordance with the requirements of the Government Code, §2001.039 and the General Appropriations Act, 76th Legislature, Article IX, §9-10.13, the department has determined that reasons for adopting the sections continue to exist in that rules on this subject are needed; however the sections need revision as described in this preamble.

The department published a Notice of Intention to Review in the Texas Register on February 12, 1999 (24 TexReg 1001). No comments were received based on that notice.

Specifically, the Occupations Code, §157.052 requires the department to designate two types of sites serving medically underserved populations: (1) a site located in an area in which the department determines there is an insufficient number of physicians providing services to eligible clients of federal, state, or locally funded health care programs, and (2) a site that the department determines serves a disproportionate number of clients eligible to participate in federal, state, or locally funded health care programs.

The amended sections include purpose and scope, definitions, criteria for designating sites serving medically underserved populations, and application process. Amended §13.31 updates obsolete legal citations and corrects a reference. Amended §13.32 updates obsolete language regarding state funded health care programs and removes an obsolete legal citation. Amended §13.33 revises language to correspond with the definition of "eligible client population" as defined in §13.32. Amended §13.34 clarifies the information required in the application process and updates the mailing information for applications.

No comments were received concerning the proposed rules during the comment period.

The sections are adopted under the Occupations Code, §157.052 which authorizes the Board of Health (board) to adopt rules relating to the designation of sites serving medically underserved populations; and the Health and Safety Code, §12.001 which provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department and the Commissioner of Health.

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 21, 2001.

TRD-200102839

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: June 10, 2001

Proposal publication date: March 9, 2001

For further information, please call: (512) 458-7236


Subchapter D. ADMINISTRATION OF THE RESIDENT PHYSICIAN COMPENSATION PROGRAM

25 TAC §§13.41 - 13.44

The Texas Department of Health (department) adopts the repeal of §§13.41-13.44 concerning administration of the resident physician compensation program. The repeal of these sections is adopted without changes to the proposed text as published in the March 9, 2001, issue of the Texas Register (26 Tex Reg 1976), and therefore will not be republished.

Specifically, the sections cover purpose and scope; define terms used in the rules; define limits on reimbursement amounts; and describe methods of reimbursement. The repeal of these sections is necessary because the legislature transferred the responsibility for the program to the Texas Higher Education Coordinating Board on September 1, 1995.

In accordance with the requirements of the Government Code, §2001.039 and the General Appropriations Act, 76th Legislature, Article IX, §9-10.13, the sections have been reviewed and the department has determined that reasons for adopting the sections no longer exist.

The department published a Notice of Intention to Review in the Texas Register on February 12, 1999 (24 Tex Reg 1001). No comments were received based on that notice.

No comments were received on the proposal during the comment period.

The repeals are adopted under the Health and Safety Code, §12.001, which provides the Texas Board of Health (board) with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the Commissioner of Health.

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 21, 2001.

TRD-200102838

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: June 10, 2001

Proposal publication date: March 9, 2001

For further information, please call: (512) 458-7236


Chapter 129. OPTICIANS' REGISTRY

25 TAC §§129.1 - 129.4, 129.8, 129.9, 129.11 - 129.13

The Texas Department of Health (department) adopts amendments to §§129.1 - 129.4, 129.8, 129.9, and 129.11 - 129.13 concerning the voluntary registration and regulation of dispensing opticians. Section 129.9 is adopted with changes to the proposed text as published in the February 2, 2001, issue of the Texas Register (26 TexReg 1085). Sections 129.1 - 129.4, 129.8, and 129.11 - 129.13 are adopted without changes, and therefore the sections will not be republished.

The department published a Notice of Intention to Review the sections as required by the Government Code, §2001.039 in the Texas Register on May 5, 2000, (25 TexReg 4196). No comments were received in response to the notice.

The 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). Each section was reviewed and the department determined that the reasons for adopting the sections continue to exist. The sections were edited to improve draftsmanship and make the rules more accessible, understandable, and usable. Additionally, amendments are necessary to reflect changes in citations created by House Bill 3155, 76th Legislature, 1999, and to implement provisions of House Bill 2085, 76th Legislature, 1999.

Changes made to the proposed text resulted from comments received during the comment period. The details of the changes are described in the summary of comments that follow.

The following comment was received concerning the proposed rules. Following the comment is the department's response and any resulting change(s).

Comment: Concerning §129.9(b), one commenter suggested changing "classroom hours" to "contact hours" because using the term classroom hours does not distinguish between semester credit hours, continuing education units, or contact hours.

Response: The department agrees that the term "contact hours" more accurately describes the requirement and has modified the language.

The comment was received from an individual who was generally in favor of the rules and suggested recommendations for change as discussed in the summary of comment.

The amendments are adopted under Texas Occupations Code, Chapter 352, which provides the Board of Health (board) with the authority to adopt rules; and Health and Safety Code, §12.001, which provides the board with authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health.

§129.9.Requirements for Continuing Education.

(a)

Purpose. The purpose of this section is to establish the continuing education requirements a registrant shall meet annually to maintain registration. The requirements are intended to maintain and improve the quality of services provided to the public by registered spectacle dispensing opticians and registered contact lens dispensers. Continuing education credit includes programs beyond the basic preparation which are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of dispensing opticians, thus improving health care to the public. The Texas Department of Health (department) assumes dispensing opticians will maintain the high standards of the profession in selecting quality educational programs to fulfill the continuing education requirements.

(b)

Number of hours required. Proof of having earned five contact hours of continuing education credit in each area for which the registrant is renewing shall be required at the time of renewal for each registration. A contact hour is 50 minutes.

(1)

The hours must have been completed within 12 months prior to the date of expiration of the registration.

(2)

For a registered spectacle dispensing optician the hours must be offered or approved by the American Board of Opticianry. For a registered contact lens dispenser the hours must be offered or approved by the National Contact Lens Examiners.

(3)

If applying for dual registration renewal the applicant must have a total of 10 contact hours of continuing education. Five contact hours must be offered or approved by the American Board of Opticianry and five contact hours must be offered or approved by the National Contact Lens Examiners.

(c)

Records. The registrant shall be responsible for maintaining a record of his or her continuing education experiences. The certificates, diplomas, or other documentation verifying earning of the continuing education hours are not to be forwarded to the department at the time of renewal unless the registrant has been selected for audit by the department. Only the completed continuing education report form should accompany the renewal form and fee if the registrant has not been selected for audit.

(d)

Audit process.

(1)

The department shall select for audit a random sample of registrants for each renewal month. Audit forms shall be sent to the selected registrants at the time the renewal notice is mailed.

(2)

All registrants selected for audit will furnish documentation such as official transcripts, certificates, diplomas, receipts, agendas, programs, or an affidavit identifying the continuing education experience satisfactory to the department, to verify proof of having earned the continuing education hours listed on the continuing education report form. The documentation must be provided at the time the renewal form is returned to the department.

(3)

Failure to timely furnish this information or knowingly providing false information in the audit process or during the renewal process are grounds for suspension or revocation of the registration.

(e)

Accrual carryover. Earned continuing education hours exceeding the minimum requirements in a previous renewal period shall first be applied to the continuing education requirements for the current renewal period. A maximum of five additional clock hours may be accrued during a registration period to be applied to the next consecutive renewal period. A maximum of 10 additional clock hours may be accrued for dual registrants during a registration period to be applied to the next consecutive renewal period.

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 21, 2001.

TRD-200102840

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: June 10, 2001

Proposal publication date: February 2, 2001

For further information, please call: (512) 458-7236


Chapter 130. CODE ENFORCEMENT REGISTRY

25 TAC §130.2, §130.3

The Texas Department of Health (department) adopts the repeal of §130.19, amendment to §130.2 and new §130.3 concerning the Code Enforcement Officers' Advisory Committee. The sections are adopted without changes to the proposed text as published in the February 2, 2001, issue of the Texas Register (26 TexReg 1087), and therefore the sections will not be republished.

The sections cover definitions and the establishment, structure, and composition of a Code Enforcement Officers' Advisory Committee. The rules are necessary to separate the Sanitarian/Code Enforcement Officers' Advisory Committee into the Registered Sanitarian Advisory Committee in Chapter 265 of this title and the Code Enforcement Officers' Advisory Committee in this chapter.

The following comments were received concerning the proposed rules. Following each comment is the department's response and any resulting changes.

Comment: Seven commenters expressed support for the rules as proposed.

Response: No changes were made as a result of the comments.

Six individuals and one professional association, the Texas Environmental Health Association (TEHA), provided comments in favor of the rules as proposed.

The amendment and new section are adopted under the Texas Health and Safety Code, §11.016, which allows the Board of Health (board) to establish advisory committees; and Health and Safety Code, §12.001, which provides the board with authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health.

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 21, 2001.

TRD-200102837

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: June 10, 2001

Proposal publication date: February 2, 2001

For further information, please call: (512) 458-7236


25 TAC §130.19

The repeal is adopted under the Texas Health and Safety Code, §11.016, which allows the Board of Health (board) to establish advisory committees; and Health and Safety Code, §12.001, which provides the board with authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health.

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 21, 2001.

TRD-200102836

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: June 10, 2001

Proposal publication date: February 2, 2001

For further information, please call: (512) 458-7236


Chapter 265. GENERAL SANITATION

Subchapter J. ADVISORY COMMITTEE

25 TAC §265.131

The Texas Department of Health (department) adopts an amendment to §265.131 concerning the Registered Sanitarian Advisory Committee with changes to the proposed text as published in the February 2, 2001 issue of the Texas Register (26 TexReg 1094).

The amendment is necessary to separate the Sanitarian/Code Enforcement Officers' Advisory Committee into the Registered Sanitarian Advisory Committee in this chapter and the Code Enforcement Officers' Advisory Committee in Chapter 130 of this title.

The amendment to §265.131 covers the establishment, structure, and composition of a registered sanitarian advisory committee.

The following comments were received concerning the proposed rules. Following each comment is the department's response and any resulting change(s).

Comment: Concerning §265.131(f)(1), one commenter requested that the number of registered professional sanitarians on the advisory committee be increased from three to four in order to create a majority of sanitarians.

Response: The department disagrees. Ad hoc committees may be created at any time to draw on the experience of additional registrants. No change was made as a result of this comment.

Comment: Concerning §265.131(f)(2), three commenters requested that "one professional engineer" be replaced by "one individual who employs, contracts with, or otherwise receives services from registered sanitarians."

Response: The department disagrees that this broad language would provide the balance of expertise provided by a professional engineer. The inclusion of a professional engineer was recommended at a stakeholder meeting held November 29, 2000. No change was made as a result of this comment.

Comment: Concerning §265.131(f)(2), one commenter requested that "one professional engineer" be replaced by "an industry representative having specific occupational experience related to environmental and public health."

Response: The department disagrees that a clear definition of the required qualifications is provided by "specific occupational experience related to environmental or public health". The inclusion of a professional engineer was recommended at a stakeholder meeting held November 29, 2000. No change was made as a result of this comment.

Comment: Concerning §265.131(f)(2), One commenter requested that "one professional engineer" be replaced by "one on-site sewage facility professional as defined in Chapter 285 of the Texas Natural Resource Conservation Commission, On-Site Sewage Facilities Rules to include a professional engineer, a designated representative, an Installer I or an Installer II." The commenter stated that one major area of employment for professional sanitarians in Texas involves on-site sewage facilities. The commenter also stated that professional engineers have no direct relationship with professional sanitarians unless they are working under the provision of the on-site sewage facility rules.

Response: The department agrees that expertise in on-site sewage facility design, installation and maintenance is valuable and has amended §265.131(f)(2) accordingly to add "or one on-site sewage facility (OSSF) professional" with an additional restriction that the individual not be registered as a sanitarian.

Comment: Concerning §265.131(f)(2), two commenters requested that "one professional engineer" be replaced by "one professional engineer or designated representative involved in the design, inspection and maintenance of on-site sewage facilities (OSSF)."

Response: The department agrees and has amended §265.131(f)(2) with "or one on-site sewage facility (OSSF) professional who is not and has never been registered as a professional sanitarian in Texas".

Comment: Concerning §265.131(f)(3), four commenters requested that the definition of the two consumer positions on the advisory committee be changed from "two consumers, one of which must be a member of an industry or occupation which is regulated by the Texas Department of Health" to "two consumers, one of which must be a member of an industry or occupation which is regulated by a city or county environmental health unit or department or equivalent".

Response: The department agrees that the definition of one of the consumer members could be broadened to include an individual from an industry regulated by a city or county heath department, and has amended §265.131(f)(2) accordingly. The department does not, however, agree with narrowing the focus to environmental health. New language reads "...either by a city or by a county environmental health unit or department, or".

Comment: Concerning §265.131(f)(3), one commenter requested that the definition of the two consumer positions on the advisory committee be changed from "two consumers, one of which must be a member of an industry or occupation which is regulated by the Texas Department of Health" to "two members of the community regulated by the Texas Department of Health, one of which is associated with the food service industry".

Response: The department does not agree that the definition of consumer should be narrowed to this extent. No change was made as a result of this comment.

Seven individuals and one professional association, the Texas Environmental Health Association (TEHA), provided comments. The comments were neither for nor against the rules in their entirety; however, they raised questions and suggested modified language concerning specific provisions in the rules.

The amendment is adopted under the Texas Health and Safety Code, §11.016, which allows the Board of Health (board) to establish advisory committees; and Health and Safety Code, §12.001, which provides the board with authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health.

§265.131.Registered Sanitarian Advisory Committee

(a)

The committee. An advisory committee shall be appointed under and governed by this section.

(1)

The name of the committee shall be the Registered Sanitarian Advisory Committee (committee).

(2)

The committee is established under the Health and Safety Code, §11.016 which allows the Texas Board of Health (board) to establish advisory committees.

(b)

Applicable law. The committee is subject to the Government Code, Chapter 2110, concerning state agency advisory committees.

(c)

Purpose. The purpose of the committee is to provide advice to the board in the area of rules regarding registered professional sanitarians.

(d)

Tasks.

(1)

The committee shall advise the board concerning rules relating to registered professional sanitarians.

(2)

The committee shall advise the department in establishing regulations regarding the registration of professional sanitarians.

(3)

The committee shall carry out any other tasks given to the committee by the board.

(e)

Review and duration. By September 1, 2003, the board will initiate and complete a review of the committee to determine whether the committee should be continued, consolidated with another committee, or abolished. If the committee is not continued or consolidated, the committee shall be abolished on that date.

(f)

Composition. The committee shall be composed of seven members appointed by the board. The composition of the committee shall include:

(1)

three registered sanitarians;

(2)

one professional engineer, or one on-site sewage facility (OSSF) professional who is not and has never been registered as a professional sanitarian in Texas;

(3)

two consumers, one of which must be a member of an industry or occupation which is regulated either by a city or county environmental health unit or department or equivalent, or by the Texas Department of Health; and

(4)

one person involved in education in the field of public, consumer, or environmental health sciences.

(g)

Terms of office. The term of office of each member shall be six years. Members shall serve after expiration of their term until a replacement is appointed.

(1)

Members shall be appointed for staggered terms so that the terms of a substantial equivalent number of members will expire on December 31st of each odd-numbered year.

(2)

If a vacancy occurs, a person shall be appointed to serve the unexpired portion of that term

(h)

Officers. The chairman of the board shall appoint a presiding officer and an assistant presiding officer to begin serving on September 1 of each odd-numbered year.

(1)

Each officer shall serve until the next regular election of officers.

(2)

The presiding officer shall preside at all committee meetings at which he or she is in attendance, call meetings in accordance with this section, appoint subcommittees of the committee as necessary, and cause proper reports to be made to the board. The presiding officer may serve as an ex-officio member of any subcommittee of the committee.

(3)

The assistant presiding officer shall perform the duties of the presiding officer in case of the absence or disability of the presiding officer. In case the office of presiding officer becomes vacant, the assistant presiding officer will serve until a successor is appointed to complete the unexpired portion of the term of the office of presiding officer.

(4)

If the office of assistant presiding officer becomes vacant, it may be filled temporarily by vote of the committee until a successor is appointed by the chairman of the board.

(5)

A member shall serve no more than two consecutive terms as presiding officer and/or assistant presiding officer.

(6)

The committee may reference its officers by other terms, such as chairperson and vice-chairperson.

(i)

Meetings. The committee shall meet at least once each year to conduct committee business.

(1)

A meeting may be called by agreement of Texas Department of Health (department)staff and either the presiding officer or at least three members of the committee.

(2)

Meeting arrangements shall be made by department staff. Department staff shall contact committee members to determine availability for a meeting date and place.

(3)

The committee is not a "governmental body" as defined in the Open Meetings Act. However, in order to promote public participation, each meeting of the committee shall be announced and conducted in accordance with the Open Meetings Act, Texas Government Code, Chapter 551, with the exception that the provisions allowing executive sessions shall not apply.

(4)

Each member of the committee shall be informed of a committee meeting at least five working days before the meeting.

(5)

A simple majority of the members of the committee shall constitute a quorum for the purpose of transacting official business.

(6)

The committee is authorized to transact official business only when in a legally constituted meeting with quorum present.

(7)

The agenda for each committee meeting shall include an item entitled public comment under which any person will be allowed to address the committee on matters relating to committee business. The presiding officer may establish procedures for public comment, including a time limit on each comment.

(j)

Attendance. Members shall attend committee meetings as scheduled. Members shall attend meetings of subcommittees to which the member is assigned.

(1)

A member shall notify the presiding officer or appropriate department staff if he or she is unable to attend a scheduled meeting.

(2)

It is grounds for removal from the committee if a member cannot discharge the member's duties for a substantial part of the term for which the member is appointed because of illness or disability, is absent from more than half of the committee and subcommittee meetings during a calendar year, or is absent from at least three consecutive committee meetings.

(3)

The validity of an action of the committee is not affected by the fact that it is taken when a ground for removal of a member exists.

(k)

Staff. Staff support for the committee shall be provided by the department.

(l)

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

(1)

Any action taken by the committee must be approved by a majority vote of the members present once quorum is established.

(2)

Each member shall have one vote.

(3)

A member may not authorize another individual to represent the member by proxy.

(4)

The committee shall make decisions in the discharge of its duties without discrimination based on any person's race, creed, gender, religion, national origin, age, physical condition, or economic status.

(5)

Minutes of each committee meeting shall be taken by department staff.

(A)

A draft of the minutes approved by the presiding officer shall be provided to the board and each member of the committee within 30 days of each meeting.

(B)

After approval by the committee, the minutes shall be signed by the presiding officer.

(m)

Subcommittees. The committee may establish subcommittees as necessary to assist the committee in carrying out its duties.

(1)

The presiding officer shall appoint members of the committee to serve on subcommittees and to act as subcommittee chairpersons. The presiding officer may also appoint nonmembers of the committee to serve on subcommittees.

(2)

Subcommittees shall meet when called by the subcommittee chairperson or when so directed by the committee.

(3)

A subcommittee chairperson shall make regular reports to the advisory committee at each committee meeting or in interim written reports as needed. The reports shall include an executive summary or minutes of each subcommittee meeting.

(n)

Statement by members.

(1)

The board, the department, and the committee shall not be bound in any way by any statement or action on the part of any committee member except when a statement or action is in pursuit of specific instructions from the board, department, or committee.

(2)

The committee and its members may not participate in legislative activity in the name of the board, the department or the committee except with approval through the department's legislative process. Committee members are not prohibited from representing themselves or other entities in the legislative process.

(o)

Reports to board. The committee shall file an annual written report with the board.

(1)

The report shall list the meeting dates of the committee and any subcommittees, the attendance records of its members, a brief description of actions taken by the committee, a description of how the committee has accomplished the tasks given to the committee by the board, the status of any rules which were recommended by the committee to the board, and anticipated activities of the committee for the next year.

(2)

The report shall identify the costs related to the committee's existence, including the cost of department staff time spent in support of the committee's activities.

(3)

The report shall cover the meetings and activities in the preceding 12 months and shall be filed with the board each September. It shall be signed by the presiding officer and appropriate department staff.

(p)

Reimbursement for expenses. In accordance with the requirements set forth in the Government Code, Chapter 2110, a committee member may receive reimbursement for the member's expenses incurred for each day the member engages in official committee business if authorized by the General Appropriations Act or budget execution process.

(1)

No compensatory per diem shall be paid to committee members unless required by law.

(2)

A committee member who is an employee of a state agency, other than the department, may not receive reimbursement for expenses from the department.

(3)

A nonmember of the committee who is appointed to serve on a subcommittee may not receive reimbursement for expenses from the department.

(4)

Each member who is to be reimbursed for expenses shall submit to staff the member's receipts for expenses and any required official forms no later than 14 days after each committee meeting.

(5)

Requests for reimbursement of expenses shall be made on official state travel vouchers prepared by department staff.

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 21, 2001.

TRD-200102841

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: June 10, 2001

Proposal publication date: February 2, 2001

For further information, please call: (512) 458-7236