3 Apr 2020

Texas Register April 3, 2020 Volume: 45 Number: 14

by | posted in: Governor, Texas Board of Nursing, Texas Health and Human Services Commission, Texas Medical Board, Texas State Board of Pharmacy |

Texas Register Table of Contents

Governor

 

Notices

Executive Order GA-08: Governor issues four orders relating to COVID-19 preparedness and mitigation

Executive Order GA-08: Relating to COVID-19 preparedness and mitigationOVERVIEWI, Greg Abbott, Governor of Texas, by virtue of the power and authority vested in me by the Constitution and laws of the State of Texas, do hereby order the following on a statewide basis effective 11:59 p.m. on March 20, 2020, and continuing until 11:59 p.m. on April 3, 2020, subject to extension thereafter based on the status of COVID-19 in Texas and the recommendations of the CDC:Order No. 1: In accordance with the Guidelines from the President and the CDC, every person in Texas shall avoid social gatherings in groups of more than 10 people.Order No. 2: In accordance with the Guidelines from the President and the CDC, people shall avoid eating or drinking at bars, restaurants, and food courts, or visiting gyms or massage parlors; provided, however, that the use of drive-thru, pickup, or delivery options is allowed and highly encouraged throughout the limited duration of this executive order.Order No. 3: In accordance with the Guidelines from the President and the CDC, people shall not visit nursing homes or retirement or long-term care facilities unless to provide critical assistance.Order No. 4: In accordance with the Guidelines from the President and the CDC, schools shall temporarily close.QUALIFICATIONSThis executive order does not prohibit people from visiting a variety of places, including grocery stores, gas stations, parks, and banks, so long as the necessary precautions are maintained to reduce the transmission of COVID-19. This executive order does not mandate sheltering in place. All critical infrastructure will remain operational, domestic travel will remain unrestricted, and government entities and businesses will continue providing essential services. For offices and workplaces that remain open, employees should practice good hygiene and, where feasible, work from home in order to achieve optimum isolation from COVID-19. The more that people reduce their public contact, the sooner COVID-19 will be contained and the sooner this executive order will expire.This executive order supersedes all previous orders on this matter that are in conflict or inconsistent with its terms, and this order shall remain in effect and in full force until 11:59 p.m. on April 3, 2020, subject to being extended, modified, amended, rescinded, or superseded by me or by a succeeding governor.BACKGROUND AND JUSTIFICATION WHEREAS, the novel coronavirus (COVID-19) has been recognized globally as a contagious respiratory virus; andWHEREAS, I, Greg Abbott, Governor of Texas, issued a disaster proclamation on March 13, 2020, certifying that COVID-19 poses an imminent threat of disaster for all counties in the state of Texas; andWHEREAS, COVID-19 continues to spread and to pose an increasing, imminent threat of disaster throughout Texas; andWHEREAS, the Centers for Disease Control and Prevention (CDC) has advised that person-to-person contact heightens the risk of COVID-19 transmission; andWHEREAS, the President’s Coronavirus Guidelines for America, as promulgated by President Donald J. Trump and the CDC on March 16, 2020, call upon Americans to slow the spread of COVID-19 by avoiding social gatherings in groups of more than 10 people, using drive-thru, pickup, or delivery options at restaurants and bars, and avoiding visitation at nursing homes, among other steps; andWHEREAS, the Texas Department of State Health Services has now determined that, as of March 19, 2020, COVID-19 represents a public health disaster within the meaning of Chapter 81 of the Texas Health and Safety Code; andWHEREAS, under the Texas Disaster Act of 1975, “[t]he governor is responsible for meeting… the dangers to the state and people presented by disasters” (Section 418.001 of the Texas Government Code), and the legislature has given the governor broad authority to fulfill that responsibility.

Governor

Notices

Executive Order GA-09: Governor issues order suspending non-urgent elective hospital procedures amid COVID-19 crisis

Executive Order GA-09: Relating to hospital capacity during the COVID-19 disasterOVERVIEWI, Greg Abbott, Governor of Texas, by virtue of the power and authority vested in me by the Constitution and laws of the State of Texas, do hereby order that, beginning now and continuing until 11:59 p.m. on April 21, 2020, all licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician.QUALIFICATIONSPROVIDED, however, that this prohibition shall not apply to any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID-19 disaster.At the request of the Texas Health and Human Services Commission, I hereby suspend the following provisions to the extent necessary to implement increased occupancy in the event of surge needs for hospital capacity due to COVID-19:25 TAC Sec. 133.162(d)(4)(A)(iii)(I);25 TAC Sec. 133.163(f)(l)(A)(i)(II)-(III);25 TAC Sec. 133.163(f)(l)(B)(i)(III)-(IV);25 TAC Sec. 133.163(m)(l)(B)(ii);25 TAC Sec. 133.163(t)(l)(B)(iii)-(iv);25 TAC Sec. 133.163(t)(l)(C);25 TAC Sec. 133.163(t)(5)(B)-(C); and any other pertinent regulations or statutes, upon written approval of the Office of the Governor.This executive order shall remain in effect and in full force until 11:59 p.m. on April 21, 2020, unless it is modified, amended, rescinded, or superseded by me or by a succeeding governor.BACKGROUND AND JUSTIFICATIONWHEREAS, I, Greg Abbott, Governor of Texas, issued a disaster proclamation on March 13, 2020, certifying under Section 418.014 of the Texas Government Code that the novel coronavirus (COVID-19) poses an imminent threat of disaster for all counties in the State of Texas; andWHEREAS, the Texas Department of State Health Services has determined that, as of March 19, 2020, COVID-19 represents a public health disaster within the meaning of Chapter 81 of the Texas Health and Safety Code; andWHEREAS, on March 19, 2020, I issued an executive order in accordance with the President’s Coronavirus Guidelines for America, as promulgated by President Donald J. Trump and the Centers for Disease Control and Prevention (CDC), and mandated certain obligations for Texans that are aimed at slowing the spread of COVID-19; andWHEREAS, a shortage of hospital capacity or personal protective equipment would hinder efforts to cope with the COVID-19 disaster; andWHEREAS, hospital capacity and personal protective equipment are being depleted by surgeries and procedures that are not medically necessary to correct a serious medical condition or to preserve the life of a patient, contrary to recommendations from the President’s Coronavirus Task Force, the CDC, the U.S. Surgeon General, and the Centers for Medicare and Medicaid Services; andWHEREAS, various hospital licensing requirements would stand in the way of implementing increased occupancy in the event of surge needs for hospital capacity due to COVID-19; andWHEREAS, the “governor is responsible for meeting… the dangers to the state and people presented by disasters” under Section 41″8.011 of the Texas Government Code, and the legislature has given the governor broad authority to fulfill that responsibility; andWHEREAS, under Section 418.012, the “governor may issue executive orders…hav[ing] the force and effect of law;” andWHEREAS, under Section 418.016(a), the “governor may suspend the provisions of any regulatory statute prescribing the procedures for conduct of state business or the orders or rules of a state agency if strict compliance with the provisions, orders, or rules would in any way prevent, hinder, or delay necessary action in coping with a disaster;” andWHEREAS, under Section 418.173, failure to comply with any executive order issued during the COVID-19 disaster is an offense punishable by a fine not to exceed $1,000, confinement in jail for a term not to exceed 180 days, or both fine and confinement.

Governor

Notices

Executive Order GA-10: Governor issues order requiring daily reports of hospital bed capacity and COVID-19 test results

Executive Order GA-10: Relating to daily reporting during the COVID-19 disasterOVERVIEWI, Greg Abbott, Governor of Texas, by virtue of the power and authority vested in me by the Constitution and laws of the State of Texas, do hereby order the following on a statewide basis effective 11:59 p.m. on March 24, 2020:All hospitals licensed under Chapter 241 of the Texas Health and Safety Code, and all Texas state-run hospitals, except for psychiatric hospitals, shall submit to DSHS daily reports of hospital bed capacity, in the manner prescribed by DSHS. DSHS shall promptly share this information with the CDC.Every public or private entity that is utilizing an FDA-approved test, including an emergency use authorization test, for human diagnostic purposes of COVID-19, shall submit to DSHS, as well as to the local health department, daily reports of all test results, both positive and negative. DSHS shall promptly share this information with the CDC.QUALIFICATIONSThis executive order shall remain in effect and in full force until modified, amended, rescinded, or superseded by me or by a succeeding governor.BACKGROUND AND JUSTIFICATIONWHEREAS, I, Greg Abbott, Governor of Texas, issued a disaster proclamation on March 13, 2020, certifying under Section 418.014 of the Texas Government Code that the novel coronavirus (COVID-19) poses an imminent threat of disaster for all counties in the State of Texas; andWHEREAS, the Texas Department of State Health Services (DSHS) has determined that, as of March 19, 2020, COVID-19 represents a public health disaster within the meaning of Chapter 81 of the Texas Health and Safety Code; andWHEREAS, I issued Executive Order GA-08 on March 19, 2020, and Executive Order GA-09 on March 22, 2020, in response to the COVID-19 disaster; andWHEREAS, timely information about COVID-19 testing and hospital bed capacity is crucial to efforts to cope with the COVID-19 disaster; andWHEREAS, Vice President Mike Pence, leader of the White House Coronavirus Task Force, has requested that every governor in the United States order daily reporting of these crucial pieces of information to the Centers for Disease Control and Prevention (CDC); andWHEREAS, the “governor is responsible for meeting… the dangers to the state and people presented by disasters” under Section 418.011 of the Texas Government Code, and the legislature has given the governor broad authority to fulfill that responsibility; andWHEREAS, under Section 418.012, the “governor may issue executive orders… hav[ing] the force and effect of law.”

Texas Medical Board

Emergency Rule

Amending 22 TAC §178.4, pursuant to Executive Order GA-09, to require that any physician who schedules or performs a non-urgent elective procedure be reported to the Board

CHAPTER 178. COMPLAINTS22 TAC §178.4OVERVIEWThe Texas Medical Board (Board) adopts on an emergency basis the emergency amendment to 22 TAC §178.4(d) for purposes of the COVID-19 disaster declaration. The amendment is being made pursuant to Executive Order GA 09 and amends certain reporting requirements under 22 TAC §178.4(d) for instances of physicians undertaking and performing non-urgent elective surgeries or procedures.BACKGROUND AND JUSTIFICATIONThe emergency rule amendment is adopted on an emergency basis due to the imminent peril to the public health, safety and welfare caused by unnecessary exposure of both patients and health care professionals in undertaking and performing non-urgent elective surgeries and procedures during the COVID-19 pandemic.The amended definitions are applicable only for purposes of the COVID-19 disaster declaration and shall only remain effective until the COVID-19 disaster declaration is terminated.SECTION SUMMARYThe following language has been added to §178.4(d):”Pursuant to Executive Order GA 09, and not withstanding any other statute, rule or provision concerning timing or when a report must be made to the Board, any peer review committee, licensee, and other group, entity, or person named in §§160.003, 204.208, 205.304, and 206.159 of the Act shall be immediately required to report any physician scheduling to perform, preparing to perform, performing, or who has performed a non-urgent elective surgery or procedure, as defined in §187.57(c) of this subtitle, while Executive Order GA 09 is in effect, immediately to the board. This duty to report is mandatory whether any type of proceeding, inquiry, investigation, or action of any kind is being considered, has been initiated, or is on-going at a hospital, ambulatory surgical center, or any other facility or medical setting. All reporting under this emergency rule is subject to confidentiality under §§160.004-160.008 of the Act; immunity for civil liability under §160.010 of the Act; and the prohibitions against discipline and discrimination under §160.012 of the Act.”

Texas State Board of Pharmacy

Emergency Rule

New 22 TAC §291.30, placing limitations on pharmacies’ dispensing of chloroquine, hydroxychloroquine, mefloquine, or azithromycin in response to the COVID-19 crisis

CHAPTER 291. PHARMACIESSUBCHAPTER A. ALL CLASSES OF PHARMACIES22 TAC §291.30OVERVIEWThe Texas State Board of Pharmacy adopts on an emergency basis new rule §291.30, concerning Medication Limitations, and finds that it is not practical to provide the usual 30 days’ prior notice and hearing. The Texas State Board of Pharmacy recognizes the extraordinary demand for chloroquine, hydroxychloroquine, mefloquine, or azithromycin as a result of COVID-19 (coronavirus).Emergency new rule §291.30 provides limitations on the dispensing of chloroquine, hydroxychloroquine, mefloquine, or azithromycin.BACKGROUND AND JUSTIFICATIONThe new rule is adopted on an emergency basis due to the imminent peril to public health, safety and welfare caused by shortages of medication for existing conditions due to COVID-19 (coronavirus).

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §500.1, allowing a licensed hospital to operate an off-site inpatient facility without obtaining a new license in response to the COVID-19 crisis

PART 1. HEALTH AND HUMAN SERVICES COMMISSIONCHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING26 TAC §500.1OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis new §500.1, Hospital Off-Site Facilities in Response to COVID-19, in Title 26, Texas Administrative Code, Chapter 500, concerning an emergency rule to allow hospitals to treat and house patients more effectively in response to COVID-19.New emergency rule 26 TAC §500.1 allows a currently licensed hospital to operate an off-site inpatient facility without obtaining a new license at: (1) another type of facility currently licensed or licensed within the past 36 months or a facility pending licensure that has passed its final architectural review inspection, such as an ambulatory surgical center, an assisted living facility, a freestanding emergency medical care facility, an inpatient hospice unit, a mental hospital, or a nursing facility; (2) an outpatient facility operated by the hospital; (3) a formerly licensed hospital that closed within the past 36 months or a hospital pending licensure that has passed its final architectural review inspection; (4) a hospital exempt from licensure; and (5) a mobile, transportable, or relocatable unit.BACKGROUND AND JUSTIFICATIONAs authorized by Government Code §2001.034, the Executive Commissioner may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the new emergency rule is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for hospital off-site facilities in response to COVID-19.

Texas Medical Board

Proposed Rules

Changing the title of 22 TAC, Chapter 170 from “Pain Management” to “Prescription of Controlled Substances”

CHAPTER 170. PRESCRIPTION OF CONTROLLED SUBSTANCES [PAIN MANAGEMENT]22 TAC §170.2, §170.3The Texas Medical Board (Board) proposes to amend the title of 22 TAC Chapter 170 from “Pain Management” to “Prescription of Controlled Substances.” 

Texas Medical Board

Adopted Rules

Amending 22 TAC §170.2 to frame the definitions of various pain classifications in terms of the length of time from initial opioid prescription

CHAPTER 170. PRESCRIPTION OF CONTROLLED SUBSTANCES [PAIN MANAGEMENT]22 TAC §170.2OVERVIEWThe Texas Medical Board (Board) proposes to amend §170.2, concerning Definitions. The amendments to §170.2 (Definitions) frame the definitions of “acute pain,” “chronic pain,” and “post-surgical, post-procedure, persistent non-chronic pain” in terms of the length of time from the initial opioid prescription. BACKGROUND AND JUSTIFICATIONThe amendments to §170.2 are proposed pursuant to HB 2174, 86th Texas Legislature, which set forth certain opioid prescription limits for the treatment of acute pain. All proposed language represents the input and consensus of the Opioid Workgroup, composed of physicians, patients, hospitals, medical schools, and other stakeholders.SECTION-BY-SECTION SUMMARYSection 170.2(2)’s definition for “acute pain” is proposed for amendment pursuant to HB 2174. The definition clarifies that acute pain is time limited to no more than 30 days from the date of initial prescription for opioids for treatment of the pain during a period of treatment for the acute condition or injury. This time limit defining acute pain is found in widely recognized literature and generally accepted throughout the medical community. This definition is fully endorsed and supported by the Opioid Workgroup.Section 170.2(4) proposes to amend the definition for chronic pain by clarifying that chronic pain is pain that exists for a period that has continued for no less than 91 days from the date of initial prescription for opioids for treatment of the condition or injury. This time limit is found in widely recognized literature and generally accepted throughout the medical community. This definition is fully endorsed and supported by Opioid Workgroup.Section 170.2(10) is added as a new definition for post-surgical, post-procedure, persistent non-chronic pain. The definition clarifies that there is pain that continues to exist in a period after the acute phase, but before becoming medically recognized as chronic pain. This period of pain exists for a period of more than 30 days but less than 91 days from the date of initial prescriptions for opioids during a period of treatment. This definition is found in widely recognized literature and generally accepted throughout the medical community. This proposed definition is fully endorsed and supported by Opioid Workgroup. This definition creates a period of time in which a physician will be allowed to prescribe opioids for more than a 10-day period for a condition, injury, or disease not already excepted under HB 2174, if the standard of care permits, and allow for an appropriate period for such treatment without the requirements related to chronic pain applying. Paragraphs (11) – (14) are re-numbered accordingly.

Texas Medical Board

Proposed Rules

Amending 22 TAC §170.3 to require a physician to review the Prescription Monitoring Program before issuing certain controlled substances

CHAPTER 170. PRESCRIPTION OF CONTROLLED SUBSTANCES [PAIN MANAGEMENT]22 TAC §170.3OVERVIEWThe Texas Medical Board (Board) proposes to amend 22 TAC §170.3, concerning Minimum Requirements for the Treatment of Chronic Pain.The amendments to §170.3 (Minimum Requirements for the Treatment of Chronic Pain) require healthcare providers to review the Prescription Monitoring Program prior to the issuance of a prescription for opioids, benzodiazepines, barbiturates, and carisoprodol. This PMP review is currently optional; the proposed amendment makes it mandatory.BACKGROUND AND JUSTIFICATIONSection 170.3 amendments are proposed pursuant to §481.0764 of the Texas Controlled Substances Act, which mandates a review of the PMP prior to the issuance of a prescription for opioids, benzodiazepines, barbiturates, and carisoprodol.SECTION BY SECTION SUMMARYSection 170.3(1)(C) is amended so that a review of the PMP is mandatory rather than optional. Remaining proposed amendments are changes made for readability and represent other non-substantive re-wording necessitated by the primary changes in text.Section 170.3(5)(E)(v) is amended so that language indicating an option of checking the PMP when conducting a periodic review of a patient’s compliance is deleted. A physician must continue to review the PMP prior to issuing each and every prescription for opioids, benzodiazepines, barbiturates, and carisoprodol. The proposed deletion is not intended to change a physician’s duty to review the PMP and represents a non-substantive re-wording of the section.Section 170.3(7) is amended to clarify that documentation of the PMP check must be maintained in the patient’s medical record.

Texas Medical Board

Proposed Rules

New 22 TAC §170.9, clarifying the circumstances under which a physician must check the Prescription Monitoring Program before issuing certain controlled substances

CHAPTER 170. PRESCRIPTION OF CONTROLLED SUBSTANCES [PAIN MANAGEMENT]22 TAC §170.9OVERVIEWThe Texas Medical Board (Board) proposes new §170.9, in new Subchapter C, titled Prescription Monitoring Program Check. The Texas Medical Board (Board) proposes adding to 22 TAC §170. et. seq., a new Subchapter C, Prescription Monitoring Program Check, in accordance with Sections 481.076, 481.0764, and 481.0765 of the Texas Controlled Substances Act. The purpose of the rule is to clarify when and under what circumstances a physician is required to check the PMP before issuing certain controlled substances. The new Subchapter C adds one new section, §170.9, which contains five interrelated parts. The proposed language reflects the input and consensus of stakeholders.SECTION BY SECTION SUMMARYNew §170.9(1) provides a description of the types of physician-patient interaction and medical settings that require a PMP check. This portion of the rule also specifies that the check is required prior to and each time a prescription is issued for opioids, benzodiazepines, barbiturates, or carisoprodol to the ultimate user.New §170.9(2) clarifies the types of physician-patient interaction and medical settings that do not require a PMP check.New §170.9(3) clarifies that documentation of the PMP check is required. The language also clarifies that it is permissible to place a copy of the patient’s PMP history in the patient’s medical record to demonstrate the check was conducted as required when a prescription is issued for opioids, benzodiazepines, barbiturates, or carisoprodol to the ultimate user. This portion of the rule is the result of physician and stakeholder inquiry concerning the permissibility of using a copy of the PMP as an acceptable method to comply with the statute. This documentation method is proposed as acceptable, in addition to other appropriate forms and methods of documentation.New §170.9(4) clarifies that physicians must perform the PMP check. This portion of the rule also specifies that physicians may allow certain other qualified individuals to check the PMP under Section 481.076(a)(5)(B) of the Health and Safety Code.New §170.9(5) provides exceptions to the required PMP check in accordance with Section 481.0765 of the Texas Controlled Substances Act.

Texas State Board of Pharmacy

Proposed Rules

New 22 TAC §281.35, outlining procedures for the temporary suspension or restriction of a license or registration

CHAPTER 281. ADMINISTRATIVE PRACTICE AND PROCEDURESSUBCHAPTER B. GENERAL PROCEDURES IN A CONTESTED CASE22 TAC §281.35The Texas State Board of Pharmacy proposes a new rule §281.35, concerning Temporary Suspension or Restriction. The new rule, if adopted, will detail procedures for the temporary suspension or restriction of a license or registration.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §283.2 to remove the definition of a pharmacist intern-trainee

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS22 TAC §283.2The Texas State Board of Pharmacy proposes amendments to §283.2, concerning Definitions. The amendments, if adopted, remove the definition of and references to a pharmacist intern-trainee.The intended purpose of the amendment is to provide a more streamlined approach to pharmacist internships and to allow pharmacy students to gain internship experience earlier in their educational career so that they will have more experience upon graduation. 

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §283.4 to remove references to a pharmacist intern-trainee with regard to pharmacist intern licensing requirements

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS22 TAC §283.4The Texas State Board of Pharmacy proposes amendments to §283.4, concerning Internship Requirements. The amendments, if adopted, remove references to a pharmacist intern-trainee and certain requirements for a pharmacist intern, and correct grammatical errors.The intended purpose of the amendments is to  to provide a more streamlined approach to pharmacist internships and to allow pharmacy students to gain internship experience earlier in their educational career so that they will have more experience upon graduation. 

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §283.6 to remove references to a pharmacist intern-trainee and clarify licensing requirements for a pharmacist preceptor

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS22 TAC §283.6The Texas State Board of Pharmacy proposes amendments to §283.6, concerning Preceptor Requirements and Ratio of Preceptors to Pharmacist-Interns. The amendments, if adopted, remove references to a pharmacist intern-trainee, clarify that a pharmacist preceptor must be certified by the board, and remove a fee for a duplicate or amended certificate.The intended purpose of the amendments is to  to provide a more streamlined approach to pharmacist internships and to allow pharmacy students to gain internship experience earlier in their educational career so that they will have more experience upon graduation and to provide clearer regulatory language that accurately reflects the current preceptor certification procedures.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §291.19 to update the administrative actions that may be taken after a pharmacy’s violation during a compliance inspection

CHAPTER 291. PHARMACIESSUBCHAPTER A. ALL CLASSES OF PHARMACIES22 TAC §291.19The Texas State Board of Pharmacy proposes amendments to §291.19, concerning Administrative Actions as a Result of a Compliance Inspection. The amendments, if adopted, update the actions that may be taken after violations are observed during a compliance inspection to reflect current procedures.The intended purpose of the amendments is to provide clearer regulatory language that accurately reflects current inspection procedures.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §291.93 to update drug and device labeling requirements for Clinic Pharmacy personnel

SUBCHAPTER E. CLINIC PHARMACY (CLASS D)22 TAC §291.93The Texas State Board of Pharmacy proposes amendments to §291.93, concerning Operational Standards. The amendments, if adopted, clarify the type of label supportive personnel may affix to a drug or device provided under the supervision of a physician according to standing delegation orders or standing medical orders.The intended purpose of the amendments is to provide clear regulations regarding labeling in clinic pharmacies.

Texas State Board of Pharmacy

Proposed Rules

Repealing 22 TAC §291.155, relating to Limited Prescription Delivery Pharmacies, a class of pharmacy which no longer exists

SUBCHAPTER H. OTHER CLASSES OF PHARMACY22 TAC §291.155The Texas State Board of Pharmacy proposes the repeal of §291.155, concerning Limited Prescription Delivery Pharmacy (Class H). The proposed repeal of §291.155 provides for a more organized subchapter by removing the rules for a class of pharmacy that no longer exists.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §295.1 to eliminate the name-change fee for pharmacists

CHAPTER 295. PHARMACISTS22 TAC §295.1The Texas State Board of Pharmacy proposes amendments to §295.1, concerning Change of Address and/or Name. The amendments, if adopted, remove the change of name fee for pharmacists to reflect the new procedure of no longer charging this fee.The intended purpose of the amendments is to provide clearer regulatory language that accurately reflects the current less costly process for pharmacists to notify the board of a change of name.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §295.8 to add a mental health awareness continuing education requirement for pharmacists during their initial license period

CHAPTER 295. PHARMACISTS22 TAC §295.8The Texas State Board of Pharmacy proposes amendments to §295.8, concerning Continuing Education Requirements. The amendments, if adopted, add a requirement for mental health awareness continuing education and clarify the continuing education requirements for pharmacists during their initial license period.The intended purpose of the amendments is to provide increased awareness and education in the pharmacist community regarding mental health.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §297.9 to eliminate the name-change fee for pharmacy technicians and pharmacy technician trainees

CHAPTER 297. PHARMACY TECHNICIANS AND PHARMACY TECHNICIAN TRAINEES22 TAC §297.9The Texas State Board of Pharmacy proposes amendments to §297.9, concerning Notifications. The amendments, if adopted, remove the change of name fee for pharmacy technicians and pharmacy technician trainees to reflect the new procedure of no longer charging this fee.The intended purpose of the amendments is to provide a less costly process for pharmacy technicians and pharmacy technician trainees to notify the board of a change of name.

Texas State Board of Pharmacy

Proposed Rules

Amending 22 TAC §283.5 to remove references to a pharmacist intern-trainee with regard to intern duties

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS22 TAC §283.5The Texas State Board of Pharmacy proposes amendments to §283.5, concerning Pharmacist-Intern Duties. The amendments, if adopted, remove references to a pharmacist intern-trainee.The intended purpose of the amendments is to  to provide a more streamlined approach to pharmacist internships and to allow pharmacy students to gain internship experience earlier in their educational career so that they will have more experience upon graduation. 

Texas Board of Nursing

In Addition

Board re-adopts 22 TAC §220.1, relating to nurse licensure compacts

Title 22, Part 11The Texas Board of Nursing (Board) has completed its review of the following rules contained in 22 TAC, Part 11: Chapter 220. Nurse Licensure Compact, §220.1.The Board readopts the rule in Chapters 220 without changes, pursuant to the Texas Government Code §2001.039 and Texas Occupations Code §301.151, which authorizes the Board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. This concludes the rule review of Chapter 220 under the 2019 rule review plan adopted by the Board.

Texas Board of Nursing

In Addition

Board re-adopts 22 TAC §223.1 and §223.2, relating to fees

Title 22, Part 11The Texas Board of Nursing (Board) has completed its review of the following rules contained in 22 TAC, Part 11: Chapter 223. Fees, §223.1 and §223.2The Board readopts the rule in Chapters 223 without changes, pursuant to the Texas Government Code §2001.039 and Texas Occupations Code §301.151, which authorizes the Board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. This concludes the rule review of Chapter 223 under the 2019 rule review plan adopted by the Board.

Texas Board of Nursing

In Addition

Board re-adopts 22 TAC §§224.1 – 224.11, relating to delegation of nursing tasks in an acute care environment

Title 22, Part 11The Texas Board of Nursing (Board) has completed its review of the following chapters contained in 22 TAC, Part 11:Chapter 224. Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments, §§224.1 – 224.11The Board readopts the rule in Chapters 224 without changes, pursuant to the Texas Government Code §2001.039 and Texas Occupations Code §301.151, which authorizes the Board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. This concludes the rule review of Chapter 224 under the 2019 rule review plan adopted by the Board.

Texas Board of Nursing

In Addition

Board re-adopts 22 TAC §§226.1 – 226.7, relating to Patient Safety Pilot Programs on nurse reporting systems

Title 22, Part 11The Texas Board of Nursing (Board) has completed its review of the following chapters contained in 22 TAC, Part 11:Chapter 226. Patient Safety Pilot Programs on Nurse Reporting Systems, §§226.1 – 226.7The Board readopts the rule in Chapters 226 without changes, pursuant to the Texas Government Code §2001.039 and Texas Occupations Code §301.151, which authorizes the Board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. This concludes the rule review of Chapter 226 under the 2019 rule review plan adopted by the Board.

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