Texas Register, Volume 30, Number 44, Pages 7095-7310, November 4, 2005 Page: 7,137
7095-7310 p. ; 28 cm.View a full description of this periodical.
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Comments on the proposal may be submitted to Sally Durocher,
P.O. Box 2018, Austin, Texas 78768-2018. A public hearing will
be held at a later date.
The amendment is proposed under the authority of the Texas Oc-
cupations Code Annotated, 153.001 which provides the Texas
Medical Board to adopt rules and bylaws as necessary to: gov-
ern its own proceedings; perform its duties; regulate the practice
of medicine in this state; enforce this subtitle; and establish rules
related to licensure.
The following statutes, articles or codes are affected by this pro-
posal: 164.202, Texas Occupations Code.
180.1. Rehabilitation Orders.
(a) Purpose of chapter. The purpose of this chapter is to estab-
lish the process for the board's review and proposal of a nondisciplinary
private rehabilitation order ("rehabilitation order") to a licensee or li-
censure applicant ("applicant") pursuant to the Medical Practice Act
("Act"), Tex. Occ. Code Ann. 164.202-.204.
(b) Purposes of rehabilitation orders.
(1) To provide an incentive to a licensee or applicant to
seek early assistance with drug or alcohol related problems or mental
or physical conditions that present a potentially dangerous limitation
or inability to practice medicine with reasonable skill and safety.
(2) To protect the public by requiring the impaired licensee
or applicant to obtain treatment and/or limit or refrain from the practice
of medicine while suffering from an impairment.
(c) Eligibility for rehabilitation order. The board may issue
a rehabilitation order for a licensee or applicant, as a prerequisite for
issuing a license, for the following reasons:
(1) intemperate use of drugs or alcohol directly resulting
from habituation or addiction caused by medical care or treatment pro-
vided by a physician [the licensee or applicant suffers from an addiction
caused by treatment];
(2) the licensee or applicant self-reported intemperate use
of drugs or alcohol as set out in subsection (f) of this chapter, and has
not previously been the subject of a substance abuse-related order of
the board;
(3) a court has determined that the licensee or applicant is
of unsound mind;
(4) the licensee or applicant has an impairment as deter-
mined by a mental or physical examination; or
(5) an admission by the licensee or applicant of an illness
or a physical or mental condition that limits or prevents the person's
practice of medicine with reasonable skill and safety.
(d) Factors for board consideration in proposing a rehabilita-
tion order.
(1) General. In determining whether to recommend a reha-
bilitation order to an otherwise eligible licensee or applicant, the board
shall consider all relevant factors.
(2) Federal and state drug and alcohol laws. Absent a
showing of good cause by the licensee or applicant, the board may not
grant a rehabilitation order if any of the following factors exist:
(A) the licensee or applicant has been found guilty, pled
guilty, or received deferred adjudication of any felony or misdemeanor
related to the intemperate use of drugs or alcohol at issue;
(B) the licensee or applicant was required to or volun-
tarily surrendered his/her drug license(s) or certification(s) issued bythe Federal Drug Enforcement Administration (DEA), Texas Depart-
ment of Public Safety (DPS) or comparable authority of another state
in connection with a criminal investigation related to the intemperate
use of drugs or alcohol at issue; and
(C) the licensee's or applicant's intemperate use of
drugs or alcohol led to a violation of Sections 481 and 483 of the
Texas Health and Safety Code or a violation of the Comprehensive
Drug Abuse Prevention and Control Act of 1970 (21 U.S.C. Section
801 et seq.).
(3) The licensee or applicant and board staff may present
information to the Board's representatives relevant to whether any vio-
lation of the standard of care is a result of the intemperate use of drugs
or alcohol. The Board's representatives may not recommend a con-
fidential rehabilitation order if they determine that a violation of the
standard of care was a result of the intemperate use of drugs or alcohol.
The board shall have complete discretion to determine whether any vi-
olation of the standard of care was a result of the intemperate use of
drugs or alcohol.
(4) [(3)]Additional factors to be established by a licensee
or applicant. Licensees or applicants otherwise eligible for a rehabil-
itation order should provide evidence of the following factors to be
considered by the board prior to the board proposing a rehabilitation
order:
(A) steps taken to prevent potential future harm to the
public that may include a treatment and monitoring plan;
(B) existence of rehabilitative potential;
(C) a clinical diagnosis of a physical or mental condi-
tion and supporting medical records; [and]
(D) that the licensee or applicant cooperated with board
staff during the course of the investigation; and
(E) applicability of any other mitigating factors set forth
in Section 190.15(b) of this title (relating to Aggravating and Mitigat-
ing Factors).
(5) [(4)] Additional factors to be established by board staff.
If applicable, board staff shall present evidence of the following factors
to be considered by the board prior to the board proposing a rehabili-
tation order:
(A) intemperate use of drugs or alcohol by the licensee
or applicant in a manner affecting the standard of care [caused patient
harm];
(B) a complaint alleging intemperate use of drugs or al-
cohol by the licensee or applicant in a manner affecting the standard of
care has been received by the board, and the status of the investigation
of the complaint;
(C) [(B)] licensee or applicant caused [economic] harm
to any individual or entity;
(D) [(-)] licensee or applicant has a disciplinary his-
tory, including criminal convictions, disciplinary orders with board or
other state medical boards, disciplinary actions by other state or federal
regulatory agencies, and peer review actions by hospitals or medical
societies;
(E) [(9)] licensee or applicant inappropriately
self-treated or self-prescribed; [and]
(F) [(E)] licensee or applicant violated provisions of the
Act other than 164.051(a)(4), (a)(5) and 164.052(a)(5)PROPOSED RULES November 4, 2005 30 TexReg 7137
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Texas. Secretary of State. Texas Register, Volume 30, Number 44, Pages 7095-7310, November 4, 2005, periodical, November 4, 2005; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth97317/m1/43/: accessed May 5, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.