Texas Register Table of Contents
- 1 Texas Optometry Board
- 1.0.1 Proposed Rules Re:
- 1.0.1.1 Amending 22 TAC §280.1, to clarify that a therapeutic optometrist can prescribe both oral and topical over-the-counter medications.
- 1.0.1.2 Amending 22 TAC §§280.2, 280.3, 280.6, 280.8, 280.9, to update outdated requirements and references.
- 1.0.1.3 Amending 22 TAC §280.5, to update treatment and prescription requirements for therapeutic optometry.
- 1.0.1.4 Amending 22 TAC §280.10, to provide an updated list of authorized prescriptions and treatment plans for therapeutic optometry.
- 1.0.2 Adopted Rules Re:
- 1.0.2.1 Amending 22 TAC §277.1, to update the complaint and investigation procedures related to the treatment of glaucoma.
- 1.0.2.2 Amending 22 TAC §277.2, to specify the notice language required when entering into a default judgement under the rule.
- 1.0.2.3 Amending 22 TAC §§277.3 – 277.6, 277.10 – 277.12, which changes the capitalization in the rule to be consistent with the rest of the chapter.
- 1.0.2.4 Amending 22 TAC §279.2, to eliminate the word “manually” when describing the signature requirements for contact lens prescriptions.
- 1.0.2.5 Amending 22 TAC §279.4, to update signature formatting on spectacle and ophthalmic device prescriptions.
- 1.0.2.6 Amending 22 TAC §279.11 and §279.12, to add “or therapeutic optometry” when describing the “practice of optometry.”
- 1.0.2.7 Amending 22 TAC §279.13 to update statutory references and allow follow-up care to be accomplished via telehealth services.
- 1.0.2.8 Amending 22 TAC §279.15, to update the title to better reflect the rule’s purpose of prohibiting practice when the licensee is knowingly suffering from a contagious or infectious disease.
- 1.0.3 Review of Agency Rules Re:
- 1.0.1 Proposed Rules Re:
- 2 Texas Board of Nursing
- 3 Texas Health and Human Services Commission
- 4 Texas Department of State Health Services
Texas Optometry Board
Proposed Rules Re:
Amending 22 TAC §280.1, to clarify that a therapeutic optometrist can prescribe both oral and topical over-the-counter medications.
CHAPTER 280. THERAPEUTIC OPTOMETRY
22 TAC §280.1
OVERVIEW
The Texas Optometry Board proposes amendments to 22 TAC Chapter 280, §280.1 – Application for Certification.
The rules in Chapter 280 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. Notice of the review was published in the August 12, 2022, issue of the Texas Register (47 TexReg 4859). No comments were received regarding the Board’s notice of review.
BACKGROUND AND JUSTIFICATION
The Board has determined that there continues to be a need for the rules in Chapter 280. The Board has also determined that changes to §280.1 as currently in effect are necessary.
The amendment would clarify a therapeutic optometrist can prescribe both oral and topical over-the-counter medications. It would: update the title of the rule to clearly reflect that the agency only issues Therapeutic Optometrist licenses, eliminate the requirement that the therapeutic certificate must be displayed along with the initial license in a conspicuous place in the principal office where the optometrist practices as all licenses issued currently are therapeutic licenses, delete the requirement the application be notarized, and make non-substantive capitalization and grammar changes to ensure consistency across the Board’s rules. Finally, it would eliminate the specific fees outlined by the rule because all authorized fees are outlined under §273.4 – Fees (Not Refundable).
Amending 22 TAC §§280.2, 280.3, 280.6, 280.8, 280.9, to update outdated requirements and references.
CHAPTER 280. THERAPEUTIC OPTOMETRY
22 TAC §§280.2, 280.3, 280.6, 280.8, 280.9
OVERVIEW
The Texas Optometry Board proposes amendments to 22 TAC Chapter 280, §280.2, Required Education; §280.3, Certified Therapeutic Optometrist Examination; §280.6, Procedures Authorized for Therapeutic Optometrists; §280.8, Optometric Glaucoma Specialist: Required Education, Examination and Clinical Skills Evaluation; and §280.9, Application for Licensure as Optometric Glaucoma Specialist.
The rules in the Chapter 280 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. Notice of the review was published in the August 12, 2022, issue of the Texas Register (47 TexReg 4859). No comments were received regarding the Board’s notice of review.
BACKGROUND AND JUSTIFICATION
The Board has determined that there continues to be a need for the rules in Chapter 280. The Board has also determined that changes to §280.2, §280.3, §280.6, §280.8, and §280.9 as currently in effect are necessary. The changes outlined below are needed to update outdated references and provide clarity across the Board’s rules.
The amendment would eliminate an outdated requirement from 1991 from §280.2, update the reference to the organization that currently administers the exam on behalf of the agency to the Association of Regulatory Boards of Optometry in §280.3, eliminate the requirement optometric glaucoma applications be notarized, update statutory references, make non-substantive capitalization and grammar changes to ensure consistency across the Board’s rules, and eliminate the specific fees outlined by the rule because all fees currently are outlined under §273.4 – Fees (Not Refundable).
Amending 22 TAC §280.5, to update treatment and prescription requirements for therapeutic optometry.
CHAPTER 280. THERAPEUTIC OPTOMETRY
22 TAC §280.5
OVERVIEW
The Texas Optometry Board proposes amendments to 22 TAC Chapter 280, §280.5 Prescription and Diagnostic Drugs for Therapeutic Optometry.
The rules in Chapter 280 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. Notice of the review was published in the August 12, 2022, issue of the Texas Register (47 TexReg 4859). No comments were received regarding the Board’s notice of review.
BACKGROUND AND JUSTIFICATION
The Board has determined that there continues to be a need for the rules in Chapter 280. The Board has also determined that changes to §280.5 as currently in effect are necessary.
The amendment would update statutory references to reflect legislative changes to statute; delete the requirement the Board provide a list of appropriate pharmaceuticals to the Texas State Board of Pharmacy; authorize the use of both oral and topical prescriptions by a therapeutic optometrist; delete the specific classifications and limitations on medications, including list of medications that could not be used for the treatment of glaucoma if not permitted by law on August 31, 1991; state the authority of an optometric glaucoma specialist to prescribe antiglaucoma drugs is defined by Section 351.3581 of the Texas Optometry Act; and delete the requirement a therapeutic optometrist obtain a registration number from DPS.
CHAPTER 280. THERAPEUTIC OPTOMETRY
22 TAC §280.10
OVERVIEW
The Texas Optometry Board proposes amendments to 22 TAC Chapter 280, §280.10, Optometric Glaucoma Specialist: Administration and Prescribing of Oral Medications and Anti-Glaucoma Drugs.
The rules in the Chapter 280 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. Notice of the review was published in the August 12, 2022, issue of the Texas Register (47 TexReg 4859). No comments were received regarding the Board’s notice of review.
BACKGROUND AND JUSTIFICATION
The Board has determined that there continues to be a need for the rules in Chapter 280. The Board has also determined that changes to §280.10 as currently in effect are necessary.
The amendment would delete the requirement the Board provide a list of appropriate pharmaceuticals to the Texas State Board of Pharmacy; would authorize the use of both oral and topical prescriptions, but delete the specific classifications and supply limitations; would authorize the use of appropriate medications pursuant to §351.3581 of the Texas Optometry Act; would authorize an optometric glaucoma specialist to independently administer oral carbonic anhydrase inhibitors for emergency purposes and immediately refer the patient to an ophthalmologist; eliminate the specific language calling for a periodic check of the Prescription Monitoring Program; and eliminate outdated effective date. It would also make non-substantive grammar changes to ensure consistency across the Board’s rules.
Adopted Rules Re:
CHAPTER 277. PRACTICE AND PROCEDURE
22 TAC §277.1
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 277, §277.1 – Complaint Procedures. The Board adopts this rule with changes to the proposed text as published in the November 18, 2022, issue of the Texas Register (47 TexReg 7641). The amended rule will be republished.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 277 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. The main focus of the amendments were to update the agency’s complaint process to make it more efficient and effective for both the complainant and the respondent.
The final amended rule: 1. Requires the Board to consider §279.1 – Contact Lens Examination and §279.3 – Spectacle Examination when determining basic competency, 2. Specifies that if the optometrist or therapeutic optometrist fails to complete all the of required findings in an initial examination at which a prescription for corrective lenses is written, the completed report of investigation shall be classified as a complaint, 3. Outlines the purpose of the rule, 4. Clarifies complaints that must be received on the Board’s official complaint form and information that must be included in a complaint – adding a provision to specify if the service was related to an in-person or telehealth visit, 5. Clarifies how jurisdictional complaints are handled by Board staff including specifying glaucoma complaints will be handled as outlined in §277.13 and §277.14, 6. Clarifies the creation the Investigation-Enforcement Committee including deleting the geographic regions, 7. Clarifies the duties of the Investigation-Enforcement Committee on determining whether or not a violation has occurred, and 8. Makes non-substantive capitalization changes to ensure consistency across the Board’s rules.
Amending 22 TAC §277.2, to specify the notice language required when entering into a default judgement under the rule.
CHAPTER 277. PRACTICE AND PROCEDURE
22 TAC §277.2
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 277, §277.2, Disciplinary Proceedings. The Board adopts this rule with one minor editing change to the proposed text as published in the November 18, 2022, issue of the Texas Register (47 TexReg 7644). The amended rule will be republished.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 277 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. The final amended rule: 1. outlines the specific language that must be included on the notice when entering a default judgment under the rule “FAILURE TO RESPOND TO THE ALLEGATIONS, BY EITHER PERSONAL APPEARANCE AT THE INFORMAL CONFERENCE OR IN WRITING, WILL RESULT IN THE ALLEGATIONS BEING ADMITTED AS TRUE AND THE RECOMMENDED SANCTION MADE AT THE INFORMAL CONFERENCE BEING GRANTED BY DEFAULT” and 2. makes non-substantive capitalization changes to ensure consistency across the Board’s rules.
Amending 22 TAC §§277.3 – 277.6, 277.10 – 277.12, which changes the capitalization in the rule to be consistent with the rest of the chapter.
CHAPTER 277. PRACTICE AND PROCEDURE
22 TAC §§277.3 – 277.6, 277.10 – 277.12
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 277, Practice and Procedure. The Board adopts these amendments with no changes to the proposed text as published in the November 18, 2022, issue of the Texas Register (47 TexReg 7646). The rules will not be republished.
The specific rules being adopted with amendments include: §277.3 – Probation, §277.4 – Reinstatement, §277.5 – Convictions, §277.6 – Administrative Fines and Penalties, §277.10 – Remedial Plans, §277.11 – Submission to Mental or Physical Examination, and §277.12 – Denial of License and Disciplinary Action by Board.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 277 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. The rules being adopted are non-substantive as follows: 1. change capitalization in order for the language across the entirety of Chapter 277 to be consistent; 2. in Rule 277.12, adds “or therapeutic optometry” in subsection (a)(1) when describing the “practice of optometry”; and 3. in §277.10(d) adds the word “the” to provide clarity.
Amending 22 TAC §279.2, to eliminate the word “manually” when describing the signature requirements for contact lens prescriptions.
CHAPTER 279. INTERPRETATIONS
22 TAC §279.2
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 279, §279.2 – Contact Lens Prescriptions. The Board adopts these amendments without changes to the proposed text as published in the November 25, 2022, issue of the Texas Register (47 TexReg 7845). The rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039.
The rule deletes the word “manually” when describing the signature on a prescription as many prescriptions are digitally written or transmitted. It deletes the section related to faxing prescriptions. It prohibits an optometrist or therapeutic optometrist from signing or causing to be signed an ophthalmic lens prescription without first personally examining the eyes for whom the prescription is made pursuant to Section 351.435 of the Optometry Act. It specifies that an optometrist or therapeutic optometrist is responsible for the prescriptions signed under the practitioner’s name even if they are produced by non-clinical staff. And it requires a licensee to report to the Board within seven business days if the licensee discovers a prescription for lenses was issued without his knowledge or permission. Finally, it makes non-substantive capitalization changes to ensure consistency across the Board’s rules.
Amending 22 TAC §279.4, to update signature formatting on spectacle and ophthalmic device prescriptions.
CHAPTER 279. INTERPRETATIONS
22 TAC §279.4
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 279, §279.4, Spectacle and Ophthalmic Devices Prescriptions. The Board adopts this rule without changes to the proposed text as published in the November 25, 2022, issue of the Texas Register (47 TexReg 7848). The amended rule will not be republished.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. The rule deletes the word “manually” when describing the signature on a prescription as many prescriptions are digitally written or transmitted. It deletes instructions related to faxing prescriptions.
Amending 22 TAC §279.11 and §279.12, to add “or therapeutic optometry” when describing the “practice of optometry.”
CHAPTER 279. INTERPRETATIONS
22 TAC §279.11, §279.12
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 279, Interpretations. The Board adopts these rules with no changes to the proposed text as published in the November 25, 2022, issue of the Texas Register (47 TexReg 7849). The amended rules will not be republished.
The specific rules being adopted with amendments include: §279.11 – Relationship with Dispensing Optician – Books and Records and §279.12 – Relationship with Dispensing Optician – Separation of Offices.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. The adoption is non-substantive as follows: 1. changing the reference from “legislature” to “Texas Legislature” and “board” to “Board” and 2. §279.11 adds “or therapeutic optometry” in subsections (a) and (b) when describing the “practice of optometry.”
Amending 22 TAC §279.13 to update statutory references and allow follow-up care to be accomplished via telehealth services.
CHAPTER 279. INTERPRETATIONS
22 TAC §279.13
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 279, §279.13, Professional Responsibility for Off-Site Examinations: Improper Solicitation of Patients. The Board adopts this rule without changes to the proposed text as published in the November 25, 2022, issue of the Texas Register (47 TexReg 7850). The amended rule will not be republished.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039.
Section 279.13 references §5.04(5) of Vernon’s Civil Statutes – which was codified as §351.455 of the Texas Occupations Code in 1999. The Board has interpreted the statute to prohibit licensees from unsolicited house-to-house business and continues to support that prohibition. This rule updates the statutory reference and allows that follow-up care can be accomplished through telehealth services. Additionally, the rule title is updated to provide better clarity of the rule’s content.
Amending 22 TAC §279.15, to update the title to better reflect the rule’s purpose of prohibiting practice when the licensee is knowingly suffering from a contagious or infectious disease.
CHAPTER 279. INTERPRETATIONS
22 TAC §279.15
OVERVIEW
The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 279, §279.15, Practice with Contagious or Infectious Disease. The Board adopts this rule without changes to the proposed text as published in the November 25, 2022, issue of the Texas Register (47 TexReg 7851). The amended rule will not be republished.
BACKGROUND AND JUSTIFICATION
The rules in the Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039.
Section 279.15 references §5.08(a) of Vernon’s Civil Statutes – which was codified as §351.454 of the Texas Occupations Code in 1999. The adoption updates the title to better reflect the rule’s purpose of prohibiting practice when the licensee knowingly suffering from a contagious or infectious disease and it updates the reference to the current statutory authority.
Review of Agency Rules Re:
Reviewing Title 22, Part 14, concerning reasons and justifications for adopting the rules in Chapter 280.
OVERVIEW
The Texas Optometry Board (Board) has concluded the statutory review of Texas Administrative Code Chapter 280 – Therapeutic Optometry conducted in accordance with Government Code §2001.039. The Board’s intent to review Chapter 280 was published in the August 12, 2022, issue of the Texas Register (47 TexReg 4859). No comments were received regarding the Board’s notice of review.
The Board’s review assessed and determined that the original reasons and justifications for adopting each rule in Chapter 280 continue to exist, reflect current legal and policy considerations, and the rules are within the agency’s legal authority as certified by legal counsel.
Texas Board of Nursing
Adopted Rules Re:
Amending 22 TAC §221.12 to update the scope of Advanced Practice Nurses (APRN) training and practice.
CHAPTER 221. ADVANCED PRACTICE NURSES
22 TAC §221.12
OVERVIEW
The Board adopts amendments to §221.12, relating to Scope of Practice, with changes to the proposed text published in the August 19, 2022, edition of the Texas Register (47 TexReg 4936). The rule will be republished.
BACKGROUND AND JUSTIFICATION
The Board received two written comments on the proposal. The comments were considered by the Board at its January 2023 meeting. In response to the written comments on the published proposal, the Board has made changes to subsections (b) and (c) of the rule text as adopted. These changes, however, do not materially alter issues raised in the proposal, introduce new subject matter, or affect persons other than those previously on notice. Further, the changes are intended to address the written comments received.
At its regularly scheduled October 2021 Board meeting, the Board charged the Advanced Practice Nursing Advisory Committee (APNAC) with reviewing and making recommendations for amendments to §221.12, regarding the scope of practice of advanced practice registered nurses (APRNs). The Board issued this charge to the Committee based upon an increased number of questions and complaints from the public regarding certain procedures and patient care activities being performed by APRNs.
Texas Health and Human Services Commission
In Addition Re:
Home and Community Based Services Waiver Renewal Effective September 1, 2023
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to renew the Home and Community-based Services (HCS) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the HCS waiver application through August 31, 2023. The proposed effective date for the renewal is September 1, 2023.
The HCS waiver program provides services and supports to individuals with intellectual disabilities who live in their own homes, in the home of a family member, or another community setting such as a three-person or four-person residence operated by an HCS program provider. Services and supports are intended to enhance quality of life, functional independence, and health and well-being in continued community-based living and to supplement, rather than replace, existing informal or formal supports and resources. Services in the HCS waiver program include respite, supported employment, adaptive aids, audiology, occupational therapy, physical therapy, prescribed drugs, speech and language pathology, financial management services, support consultation, behavioral support, cognitive rehabilitation therapy, dental treatment, dietary services, employment assistance, individualized skills and socialization, minor home modifications, nursing, residential assistance, social work, supporting home living, and transition assistance services.
Texas Department of State Health Services
In Addition Re:
Designation of a Practice Serving a Medically Underserved Population
The Texas Department of State Health Services (Department) is required under Texas Occupations Code §157.051 to designate practices serving a medically underserved population. In addition, the Department is required to publish notice of such designations in the Texas Register and to provide an opportunity for public comment on the designations.
Accordingly, the Department has proposed designating the following as practices serving medically underserved populations:
MD Kids Pediatrics, 2110 West Slaughter Lane, Suite 185, Austin, Texas 78748;
MD Kids Pediatrics, 4130 South New Braunfels Avenue, Suite 110, San Antonio, Texas 78233;
MD Kids Pediatrics, 8535 Blanco Road, Suite 103, San Antonio, Texas 78216; and
MD Kids Pediatrics, 17026 Bulverde Road, Suite 105, San Antonio, Texas 78247.