Texas Register May 19, 2023 Volume: 48 Number: 20

Texas Register Table of Contents

Governor

Appointments Re:

The Governor reappointed one person to the Correctional Managed Health Care Committee on May 3, 2023.

Appointed to the Correctional Managed Health Care Committee for a term to expire February 1, 2027, Kristen S. “Kris” Coons of San Antonio, Texas.


Texas Health and Human Services Commission

Emergency Rules Re:

Renewing 26 TAC § 600.1 for a 60-day period, which permits qualified rural hospitals to apply for licensure as a limited service rural hospital.

CHAPTER 600. LIMITED SERVICES RURAL HOSPITALS
26 TAC §600.1

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §600.1 for a 60-day period. The text of the emergency rule was originally published in the January 27, 2023, issue of the Texas Register (48 TexReg 265).


Texas State Board of Dental Examiners

Adopted Rules Re:

Amending 22 TAC §104.2 to reflect the merger of the regional examining board CDCA-WREB-CITA.

CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.2

OVERVIEW

The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §104.2, concerning continuing education providers. This rule is adopted with minor non-substantive changes to the proposed text published in the March 31, 2023, issue of the Texas Register (48 TexReg 1698), and will be republished. The adopted amendment reflects the merger of the regional examining board CDCA-WREB-CITA. The adopted amendment includes the States Resources for Testing and Assessments (SRTA), Central Regional Dental Testing Services Inc. (CRDTS), and the American Association of Dental Boards – Accredited Continuing Education Program (AADB-ACE) as board approved continuing education providers. The adopted amendment removes Dental Quality Assurance and Dentist Secure Labs as continuing education providers.


Review of Agency Rules Re:

Reviewing Title 22, Part 5, concerning dental licensure and fees.

The Texas State Board of Dental Examiners (Board) filed a Notice of Intent to Review to consider for readoption, revision, or repeal the rule chapters listed below, in their entirety, under Title 22, Part 5, of the Texas Administrative Code (TAC). This review was conducted in accordance with Texas Government Code §2001.039.

Rule Chapters Under Review

The Board reviewed the following rule chapters:

Chapter 100, General Provisions

Chapter 101, Dental Licensure

Chapter 102, Fees


Texas Optometry Board

Adopted 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 (Board) adopts amendments to 22 TAC Chapter 280, §280.1 – Application for Therapeutic Certification. The Board adopts this rule without changes to the proposed text as published in the February 10, 2023, issue of the Texas Register (48 TexReg 610). The amended rule will not be republished.

BACKGROUND AND JUSTIFICATION

The rules in Chapter 280 were reviewed as a result of the Board’s general rule review under Texas Government Code Section 2001.039. The rule clarifies a therapeutic optometrist can prescribe both oral and topical over-the-counter medications. It updates the title of the rule to clearly reflect that the agency only issues Therapeutic Optometrist licenses, eliminates 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, deletes the requirement the application be notarized, and makes non-substantive capitalization and grammar changes to ensure consistency across the Board’s rules. Finally, it eliminates 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 eliminate 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 (Board) adopts 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 Board adopts §280.2- Required Education; §280.3- Certified Therapeutic Optometrist Examination; and §280.6- Procedures Authorized for Therapeutic Optometrists without changes to the proposed text as published in the February 10, 2023, issue of the Texas Register (48 TexReg 611). These rules will not be republished.

The Board adopts §280.8 – Optometric Glaucoma Specialist: Required Education, Examination and Clinical Skills Evaluation; and §280.9- Application for Licensure as Optometric Glaucoma Specialist with changes to the proposed text as published in the February 10, 2023, issue of the Texas Register (48 TexReg 611). These amended rules will be republished.

BACKGROUND AND JUSTIFICATION

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.

As adopted, the amendment now eliminates an outdated requirement from 1991 from §280.2, updates 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, eliminates the requirement optometric glaucoma applications be notarized, updates statutory references, makes non-substantive capitalization and grammar changes to ensure consistency across the Board’s rules, and eliminates 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 (Board) adopts amendments to 22 TAC Chapter 280, §280.5 Prescription and Diagnostic Drugs for Therapeutic Optometry. The Board adopts this rule without changes to the proposed text as published in the February 10, 2023, issue of the Texas Register (48 TexReg 613). The amended rule will not be republished.

BACKGROUND AND JUSTIFICATION

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.

The rule updates statutory references to reflect legislative changes to statute; deletes the requirement the Board provide a list of appropriate pharmaceuticals to the Texas State Board of Pharmacy; authorizes the use of both oral and topical prescriptions by a therapeutic optometrist; deletes 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; states the authority of an optometric glaucoma specialist to prescribe antiglaucoma drugs is defined by Section 351.3581 of the Texas Optometry Act; and deletes the requirement a therapeutic optometrist obtain a registration number from DPS.


Amending 22 TAC §280.10, to provide an updated list of authorized prescriptions and treatment plans for therapeutic optometry.

CHAPTER 280. THERAPEUTIC OPTOMETRY
22 TAC §280.10

OVERVIEW

The Texas Optometry Board (Board) adopts amendments to 22 TAC Chapter 280, §280.10 Optometric Glaucoma Specialist: Administration and Prescribing of Oral Medications and Anti-Glaucoma Drugs. The Board adopts this rule without changes to the proposed text as published in the February 10, 2023, issue of the Texas Register (48 TexReg 616). The amended rule will not be republished.

BACKGROUND AND JUSTIFICATION

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.

The rule deletes the requirement the Board provide a list of appropriate pharmaceuticals to the Texas State Board of Pharmacy; authorizes the use of both oral and topical prescriptions, but deletes the specific classifications and supply limitations; authorizes the use of appropriate medications pursuant to §351.3581 of the Texas Optometry Act; authorizes an optometric glaucoma specialist to independently administer oral carbonic anhydrase inhibitors for emergency purposes and immediately refer the patient to an ophthalmologist; eliminates the specific language calling for a periodic check of the Prescription Monitoring Program; and eliminates outdated effective date. It also makes non-substantive grammar changes to ensure consistency across the Board’s rules.


Texas State Board of Pharmacy

Adopted Rules Re:

Amending 22 TAC §283.2, to clarify definitions concerning accreditation requirements for residency programs.

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS
22 TAC §283.2

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §283.2, concerning Definitions. These amendments are adopted without changes to the proposed text as published in the March 17, 2023, issue of the Texas Register (48 TexReg 1487). The rule will not be republished.


Amending 22 TAC §283.4 to adjust the licensing requirements for a residency program and to specify what prompts a pharmacist-intern registration to expire.

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS
22 TAC §283.4

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §283.4, concerning Internship Requirements. These amendments are adopted without changes to the proposed text as published in the March 17, 2023, issue of the Texas Register (48 TexReg 1488). The rule will not be republished.

The amendments remove the requirement that a residency program be accredited by the American Society of Health System Pharmacists for a resident to be eligible for designation as an extended-intern and specify that a pharmacist-intern registration expires due to failing the NAPLEX or Texas Pharmacy Jurisprudence Examination only if the intern fails either exam more than once.


Amending 22 TAC §291.121 to allow remote pharmacy services to be provided using an automated pharmacy system under certain conditions.

CHAPTER 291. PHARMACIES
SUBCHAPTER G. SERVICES PROVIDED BY PHARMACIES
22 TAC §291.121

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.121, concerning Remote Pharmacy Services. These amendments are adopted without changes to the proposed text as published in the March 17, 2023, issue of the Texas Register (48 TexReg 1491). The rule will not be republished.

The amendments allow remote pharmacy services to be provided using an automated pharmacy system to be provided at healthcare facilities regulated under Chapters 464 and 577, Health and Safety Code.


Amending 22 TAC §295.8, clarifying continuing education requirements.

CHAPTER 295. PHARMACISTS
22 TAC §295.8

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §295.8, concerning Continuing Education Requirements. These amendments are adopted without changes to the proposed text as published in the March 17, 2023, issue of the Texas Register (48 TexReg 1503). The rule will not be republished. Due to an error by the Texas Register, the text of the proposed amendments was published incorrectly. A Correction of Error is published contemporaneously in this issue.


In Addition Re:

Correction of Error concerning a section name.

The Texas State Board of Pharmacy proposed amendments to 22 TAC §295.8 in the March 17, 2023, issue of the Texas Register (48 TexReg 1503). Due to an error by the Texas Register, the name of the section was published incorrectly. The correct name of the section is:

§295.8. Continuing Education Requirements


Texas Medical Disclosure Panel

Adopted Rules Re:

Amending 25 TAC §601.5 and §601.9, to replace the English and Spanish disclosure and consent forms for radiation therapy and anesthesia and/or perioperative pain management.

CHAPTER 601. INFORMED CONSENT
25 TAC §601.5, §601.9

The Texas Medical Disclosure Panel (Panel) adopts amendments to §601.5, concerning Disclosure and Consent Form for Radiation Therapy; and §601.9, concerning Disclosure and Consent Form for Anesthesia and/or Perioperative Pain Management (Analgesia). Sections 601.5 and 601.9 are adopted with changes to the proposed text as published in the November 4, 2022, issue of the Texas Register (47 TexReg 7389). The rules will be republished.

BACKGROUND AND JUSTIFICATION

These amendments are adopted in accordance with Texas Civil Practice and Remedies Code §74.103, which requires the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure. Section 601.5 contains the Disclosure and Consent Form for Radiation Therapy. Section 601.9 contains the Disclosure and Consent Form for Anesthesia and/or Perioperative Pain Management (Analgesia).

SECTION-BY-SECTION SUMMARY

  • Amendments to §601.5 replace the English and Spanish forms in Figure 25 TAC §601.5(1) and Figure 25 TAC §601.5(2) respectively and specify an effective date of September 1, 2023, for these forms.
  • Amendments to §601.9 replace the English and Spanish forms in Figure 25 TAC §601.9(1) and Figure 25 TAC §601.9(2) respectively and specify an effective date of September 1, 2023, for these forms.