Texas Register June 14, 2019 Volume: 44 Number: 24

Texas Board of Nursing

 

Proposed Rules

Fees

22 TAC §223.1Introduction. The Texas Board of Nursing (Board) proposes amendments to §223.1, concerning Fees. The amendments are proposed under the authority of the Texas Occupations Code §301.151 and §301.155, Texas Health and Safety Code §481.0756(e), and HB 1, enacted by the 86th Texas Legislature, effective September 1, 2019.In its budget request for the 2020-2021 biennium, the Texas Legislature approved the Board’s request for $777,236 in exceptional items, in addition to its base budget of $28,271,031. As such, the Board will be required to raise enough revenue to cover the Board’s base budget (which includes obligatory payments for employee health and retirement benefits), exceptional items (which includes temporary staffing costs, nurse salary adjustments, and the executive director salary increase), and additional costs associated with the implementation of House Bill (HB) 2174, which was passed during the legislative session, and becomes effective September 1, 2019.HB 2174 relates, in part, to the issuance of electronic prescriptions for controlled substances. The bill requires licensing agencies to develop a waiver process for practitioners who are unable to issue electronic prescriptions for statutorily defined reasons. There are currently 25,410 advanced practice registered nurses with prescriptive authorization in Texas that may be affected by the bill’s new requirements. Further, the Board experiences an approximate 6.6% to 20.7% increase in the number of new prescriptive authorizations issued each year. Based upon the potential volume of waivers the Board may receive as a result of the requirements of HB 2174, the Board anticipates that it will need to employ one additional staff member, full time, to review and respond to the waiver requests. The Board estimates the cost associated with an additional staff member to be approximately $59,629.50 each fiscal year.In order to meet the revenue requirements approved by the legislature, the Board has determined that it will be necessary to increase its current licensure renewal fees. The Board’s current renewal fee for licensed vocational nurses is $42 each biennium; $65 for registered nurses each biennium; and $50 each biennium for advanced practice registered nurses. The Board anticipates that it will need to raise licensed vocational nurse renewal fees by $3, making the new renewal fee $45 each biennium; registered nurse renewal fees by $3, making the new renewal fee $68 each biennium; and advanced practice registered nurse renewal fees by $4, making the new renewal fee $54 each biennium.The proposed amendments also clarify that more than one fee may apply, depending on an individual’s particular situation. For example, an advanced practice registered nurse wishing to renew his/her advanced practice registered nurse license must also renew his/her Texas registered nurse license at the same time. This would result in the advanced practice registered nurse license renewal fee and the registered nurse license renewal fee applying to that individuals’ biennial renewal. The proposed amendments do not alter the Board’s current requirements in this regard, but instead, clarify how the Board’s current fee structure functions.

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Texas Board of Physical Therapy Examiners

Proposed Rules

Proposed amendment to §322.4 – Practicing in a Manner Detrimental to the Public Health and Welfare

22 TAC §322.4The Texas Board of Physical Therapy Examiners proposes amending §322.4. Practicing in a Manner Detrimental to the Public Health and Welfare pursuant to the amendment of the PT Practice Act, Occupations Code Chapter 453 pertaining to the repeal of physical therapy facility registration and annual renewal in SB 317 during the 85th Legislative Session.The amendment is proposed in order to eliminate failure to register or renew a facility registration and practicing in an unregistered facility from the list of practices considered detrimental to the public health and welfare.

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Texas Board of Physical Therapy Examiners

Proposed Rules

Facility registration and annual renewal

22 TAC §344.1The Board proposes amending §344.1, Administrative Fines and Penalties pursuant to the amendment of the PT Practice Act, Occupations Code Chapter 453 pertaining to the repeal of physical therapy facility registration and annual renewal in SB 317 during the 85th Legislative Session.The amendment is proposed in order to establish a process for expungement of facility-related administrative violations from a licensee’s record.

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Executive Council of Physical and Occupational Therapy Examiners

Proposed Rules

Proposed discontinuation of fees associated with the application, renewal, and associated fees for physical and occupational therapy facilities

22 TAC §§651.1 – 651.3The Executive Council of Physical Therapy and Occupational Therapy Examiners proposes amending Chapter 651, concerning Fees, pursuant to the amendment of the Executive Council of Physical Therapy and Occupational Therapy Examiners Act, Title 3, Subtitle H, Chapter 452 of the Occupations Code, pertaining to the repeal of physical therapy and occupational therapy facility registration and annual renewal in SB 317, 85th Legislative Session.The amendments in Chapter 651 are proposed to discontinue the fees associated with the application, renewal, and associated fees for physical and occupational therapy facilities.

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Texas Board of Occupational Therapy Examiners

Proposed Rules

Proposed amendment to revise the definition of “Investigation Committee”

40 TAC §362.1The Texas Board of Occupational Therapy Examiners proposes an amendment to §362.1, concerning Definitions, pursuant to changes to the OT Practice Act, Occupations Code, Chapter 454, made by SB 317 from the 85th Regular Legislative Session, pertaining to the repeal of occupational therapy facility registration.The amendment is proposed to revise the definition of “Investigation Committee” to remove the facilities reference therein in accordance with changes in statute to the OT Practice Act pursuant to SB 317, which repeals requirements concerning the registration of occupational therapy facilities.Other proposed rule changes regarding facility registration have been submitted to the Texas Register for publication, including the proposed repeal of Chapter 376, concerning registration of facilities; and proposed amendments to §374.1, concerning disciplinary actions, and §374.2, concerning detrimental practice.

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Texas Board of Occupational Therapy Examiners

Proposed Rules

Continuing education

40 TAC §§367.1 – 367.3The Texas Board of Occupational Therapy Examiners proposes amendments to §367.1, concerning continuing education, §367.2, concerning categories of education, and §367.3, concerning continuing education audit.

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Texas Board of Occupational Therapy Examiners

Proposed Rules

Proposed amendments concerning disciplinary actions and detrimental practice

40 TAC §374.1, §374.2The Texas Board of Occupational Therapy Examiners proposes amendments to §374.1, concerning disciplinary actions, and §374.2, concerning detrimental practice, pursuant to changes to the OT Practice Act, Occupations Code, Chapter 454, made by SB 317 from the 85th Regular Legislative Session, including pertaining to the repeal of occupational therapy facility registration.The amendments, required to enact statutory changes to the OT Practice Act pursuant to SB 317, are proposed to remove from the chapter facilities related language concerning disciplinary actions and detrimental practice and to add language regarding the expunction of facility related violations.Changes to §374.1 would remove from the section references to facilities in a provision concerning understanding and complying with the OT Practice Act and the OT Rules and a provision concerning the publishing of final disciplinary actions taken by the Board. In addition, the proposal would add to §374.1 that “The board may expunge any record of disciplinary action taken against a license holder before September 1, 2019, for practicing in a facility that failed to meet the registration requirements of §454.215 of the Act (relating to Occupational Therapy Facility Registration), as that section existed on January 1, 2019. The board may not expunge a record under this subsection after September 1, 2021.” The provision is being proposed pursuant to SB 317 and the addition to the OT Practice Act of §454.307, concerning record of disciplinary action and expungement.The changes would also eliminate failure to register or renew a facility registration and practicing in an unregistered facility from the list of practices considered detrimental to the public health and welfare in §374.2 and from a schedule of sanctions in §374.1.Other proposed rule changes regarding facility registration have also been submitted to the Texas Register for publication, including the proposed repeal of Chapter 376, concerning registration of facilities, and a proposed amendment to §362.1, concerning definitions.

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Texas Board of Occupational Therapy Examiners

Proposed Rules

Repeal of provisions concerning registration of OT facilities

40 TAC §§376.1 – 376.10The Texas Board of Occupational Therapy Examiners proposes the repeal of Chapter 376, concerning registration of occupational therapy facilities, pursuant to changes to the OT Practice Act, Occupations Code, Chapter 454, made by SB 317 from the 85th Regular Legislative Session, pertaining to the repeal of occupational therapy facility registration.The repeal is proposed in order to discontinue the registration of occupational therapy facilities as mandated by changes to the OT Practice Act pursuant to SB 317 in the 85th Regular Legislative Session. The repeal would remove from the OT Rules requirements to register an occupational therapy facility with the Board and renew the registration annually and the requirement that occupational therapy practitioners may only practice in an occupational facility if that facility is registered or exempt from the registration requirement.Other proposed amendments regarding facility registration have also been submitted to the Texas Register for publication, including proposed amendments to §362.1, concerning definitions, §374.1, concerning disciplinary actions, and §374.2, concerning detrimental practice.

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Texas State Board of Examiners of Psychologists

Withdrawn Rule

Withdrawing proposed rules re: general rulings and fees

CHAPTER 461. GENERAL RULINGS22 TAC §461.7The Texas State Board of Examiners of Psychologists withdraws the proposed amended §461.7 which appeared in the March 8, 2019, issue of the Texas Register (44 TexReg 1232).CHAPTER 473. FEES22 TAC §473.1The Texas State Board of Examiners of Psychologists withdraws the proposed amended §473.1 which appeared in the March 8, 2019, issue of the Texas Register (44 TexReg 1241).22 TAC §473.4The Texas State Board of Examiners of Psychologists withdraws the proposed amended §473.4 which appeared in the March 8, 2019, issue of the Texas Register (44 TexReg 1243).

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Texas State Board of Pharmacy

Adopted Rules

Adopting amendments to §281.7, concerning Grounds for Discipline for a Pharmacist License

The amendments update the grounds for disciplinary action against a pharmacist license after receipt of a warning notice from the board to reflect current board policies and procedures, and correct grammatical errors.These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1642) and will not be republished.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Internship Requirements

The Texas State Board of Pharmacy adopts amendments to §283.4, concerning Internship Requirements. The amendments update the pharmacist-intern requirements to reflect the board’s new procedure of issuing electronic pharmacist-intern documentation.These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1645) and will not be republished.No comments were received.

Texas State Board of Pharmacy

Adopted Rules

Preceptor Requirements and Ratio of Preceptors to Pharmacist-Interns

CHAPTER 461. GENERAL RULINGS22 TAC §461.7The Texas State Board of Examiners of Psychologists withdraws the proposed amended §461.7 which appeared in the March 8, 2019, issue of the Texas Register (44 TexReg 1232).CHAPTER 473. FEES22 TAC §473.1The Texas State Board of Examiners of Psychologists withdraws the proposed amended §473.1 which appeared in the March 8, 2019, issue of the Texas Register (44 TexReg 1241).22 TAC §473.4The Texas State Board of Examiners of Psychologists withdraws the proposed amended §473.4 which appeared in the March 8, 2019, issue of the Texas Register (44 TexReg 1243).

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Texas State Board of Pharmacy

Adopted Rules

Inventory requirements

CHAPTER 291. PHARMACIESSUBCHAPTER A. ALL CLASSES OF PHARMACIES22 TAC §291.17The Texas State Board of Pharmacy adopts amendments to §291.17, concerning Inventory Requirements. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1649).The amendments clarify that the annual inventory of a Class C and Class C-S pharmacy shall include a physical count of all controlled substances located in the pharmacy and all controlled substances located in other departments of the institution.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Pharmacy technicians and pharmacy technician trainees

SUBCHAPTER B. COMMUNITY PHARMACY (CLASS A)22 TAC §291.32The Texas State Board of Pharmacy adopts amendments to §291.32, concerning Personnel. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1651).The amendments allow pharmacy technicians and pharmacy technician trainees to perform data entry remotely in Class A pharmacies.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Miscellaneous updates and corrections to § 291.34 – Records

The Texas State Board of Pharmacy adopts amendments to §291.34, concerning Records. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1653) and will not be republished.The amendments remove an outdated reference to the Department of Public Safety as one of the agencies to which reports of theft or loss of controlled substances are made, remove an outdated reference to a Schedule V nonprescription register book, and correct grammatical errors.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Miscellaneous updates and corrections to ¶ 291.55 – records

SUBCHAPTER C. NUCLEAR PHARMACY (CLASS B)22 TAC §291.55The Texas State Board of Pharmacy adopts amendments to §291.55, concerning Records. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1654). The rule will not be republished.The amendments remove an outdated reference to the Department of Public Safety as one of the agencies to which reports of theft or loss of controlled substances are made and correct grammatical errors.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Updates and corrections to § 291.75 – Records

SUBCHAPTER D. INSTITUTIONAL PHARMACY (CLASS C)22 TAC §291.75The Texas State Board of Pharmacy adopts amendments to §291.75, concerning Records. These amendments are adopted with change to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1657). The amended rule will be republished.The amendments remove an outdated reference to the Department of Public Safety as one of the agencies to which reports of theft or loss of controlled substances are made and correct grammatical errors.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Updates and corrections to § 291.76 – Class C Pharmacies Located in a Freestanding Ambulatory Surgical Center

22 TAC §291.76The Texas State Board of Pharmacy adopts amendments to §291.76, concerning Class C Pharmacies Located in a Freestanding Ambulatory Surgical Center. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1661); therefore, the rules will not be republished.The amendments remove an outdated reference to the Department of Public Safety as one of the agencies to which reports of theft or loss of controlled substances are made and correct grammatical errors.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Pharmacy technician trainees in a Class A, Class C, or Class E pharmacy

SUBCHAPTER G. SERVICES PROVIDED BY PHARMACIES22 TAC §291.123The Texas State Board of Pharmacy adopts amendments to §291.123, concerning Central Prescription Drug or Medication Order Processing. These amendments are adopted with changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1670). The Board made changes to include pharmacy technician trainees in those allowed to perform certain duties remotely.The amendments allow a pharmacy technician employee or a pharmacy technician trainee employee who is licensed in Texas to remotely access a Class A, Class C, or Class E pharmacy engaged in centralized prescription drug or medication order processing’s data base in order to process prescription or medication drug orders.

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Texas State Board of Pharmacy

Adopted Rules

Updates and corrections to § 291.151 – Pharmacies Located in a Freestanding Emergency Medical Care Facility (Class F

SUBCHAPTER H. OTHER CLASSES OF PHARMACY22 TAC §291.151The Texas State Board of Pharmacy adopts amendments to §291.151, concerning Pharmacies Located in a Freestanding Emergency Medical Care Facility (Class F). These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1671). The amended rule will not be republished.The amendments remove an outdated reference to the Department of Public Safety as one of the agencies to which reports of theft or loss of controlled substances are made and correct grammatical errors.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Amends § 291.153, concerning Central Prescription Drug or Medication Order Processing Pharmacy (Class G)

22 TAC §291.153The Texas State Board of Pharmacy adopts amendments to §291.153, concerning Central Prescription Drug or Medication Order Processing Pharmacy (Class G). These amendments are adopted with changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1680). The Board made changes to include pharmacy technician trainees in those allowed to perform certain duties remotely. The rule will be republished.The amendments allow a pharmacy technician employee or a pharmacy technician trainee employee who is licensed in Texas to remotely access a Class G pharmacy’s data base in order to process prescription or medication drug orders.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Amending §295.1 – Pharmacists – concerning Change of Address and/or Name

CHAPTER 295. PHARMACISTS22 TAC §295.1The Texas State Board of Pharmacy adopts amendments to §295.1, concerning Change of Address and/or Name. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1682).The amendments update the change of address or name requirements for pharmacists to reflect the board’s new procedure of issuing electronic renewal certificates.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Pharmacist License or Renewal Fees

22 TAC §295.5The Texas State Board of Pharmacy adopts amendments to §295.5, concerning Pharmacist License or Renewal Fees. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1683). The rule will not be republished.The amendments remove the fees for duplicate or amended renewal certificates to reflect the board’s new procedure of issuing electronic renewal certificates and correct a subsection reference.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Pharmacy technicians and Pharmacy technician trainees – 22 TAC § 297.4 – Fees

CHAPTER 297. PHARMACY TECHNICIANS AND PHARMACY TECHNICIAN TRAINEES22 TAC §297.4The Texas State Board of Pharmacy adopts amendments to §297.4, concerning Fees. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1684).The amendments remove the fees for duplicate or amended certificates to reflect the board’s new procedure of issuing electronic renewal certificates.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Amending §315.2 concerning Official Prescription Form

CHAPTER 315. CONTROLLED SUBSTANCES22 TAC §315.2The Texas State Board of Pharmacy adopts amendments to §315.2, concerning Official Prescription Form. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44 TexReg 1685).The amendments remove the effective date from the short title and remove language pertaining to the validity of official prescription forms previously issued by the Texas Department of Public Safety.No comments were received.

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Texas State Board of Pharmacy

Adopted Rules

Clarifying which pharmacist is responsible for the review of the Texas Prescription Monitoring Program database

22 TAC §315.15The Texas State Board of Pharmacy adopts amendments to §315.15, concerning Access Requirements. These amendments are adopted without changes to the proposed text as published in the April 5, 2019, issue of the Texas Register (44TexReg 1685).The amendments clarify which pharmacist is responsible for the review of the Texas Prescription Monitoring Program database prior to dispensing an opioid, benzodiazepine, barbiturate, or carisoprodol.No comments were received.