Texas Register, Volume 34, Number 25, Pages 4057-4230, June 19, 2009 Page: 4,125
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The Texas Medical Board (Board) adopts amendments to
Chapter 190, 190.8, concerning Violation Guidelines, without
changes to the proposed text as published in the March 27,
2009, issue of the Texas Register (34 TexReg 2671) and will
not be republished.
Elsewhere in this issue of the Texas Register, the Board contem-
poraneously withdraws the emergency amendment to 190.8,
which was published in the March 27, 2009, issue of the Texas
Register (34 TexReg 2071). The withdrawal becomes effective
June 24, 2009, which is the same date this amendment becomes
The Board sought stakeholder input through Stakeholder
Groups, which made comments on the suggested changes to
the rule at a meeting held on October 29, 2008. The comments
were incorporated into the proposed rule.
The amendment to 190.8 adds an exception to the requirement
in paragraph (1)(L) that a physician may only prescribe drugs to
a person with whom a proper professional relationship has been
established, for the prescription of drugs for a partner of a patient
who may have a sexually transmitted disease.
The Board has determined that the amendment to the rule ad-
dresses a serious public health issue and is intended to allow
physicians to treat persons with sexually transmitted diseases
as early as possible or prevent such persons from contracting
sexually transmitted diseases from their partners.
The Board received public written comments; however, no one
appeared to testify at the public hearing held on May 29, 2009.
The Board received a written comment from one individual with
the Corpus Christi Nueces Public Health District. The comment
was that nurses would be the actual persons prescribing the
medication to the partners of patients with sexually transmitted
diseases and therefore be held liable if the persons had ad-
verse side effects to the medications. The Board determined
that the prescribing by midlevel practitioners under the amend-
ment would occur through a physician-delegated act under writ-
ten standing delegation orders so that a physician will retain lia-
bility if the protocols are followed.
The amendment is adopted under the authority of the Texas Oc-
cupations Code Annotated, 153.001 and 154.006, which pro-
vide authority for the Board to adopt rules and bylaws as neces-
sary to govern its own proceedings, perform its duties, regulate
the practice of medicine in this state, enforce this subtitle, and
establish rules related to licensure.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's
Filed with the Office of the Secretary of State on June 4, 2009.
Mari Robinson, J.D.
Interim Executive Director
Texas Medical Board
Effective date: June 24, 2009
Proposal publication date: March 27, 2009
For further information, please call: (512) 305-7016
TITLE 25. HEALTH SERVICES
DEPARTMENT OF STATE
CHAPTER 139. ABORTION FACILITY
REPORTING AND LICENSING
The Executive Commissioner of the Health and Human Services
Commission (commission) on behalf of the Department of State
Health Services (department) adopts the repeal of 139.1 -
139.8, 139.21 - 139.25, 139.31 - 139.33, and 139.41 - 139.60
and new 139.1 - 139.8, 139.21 - 139.25, 139.31 - 139.33, and
139.41 - 139.60, concerning the regulation of abortion facilities.
New 139.2, 139.6, 139.8, 139.23, 139.46 - 139.49, 139.51,
139.53, 139.54, 139.57, and 139.59 are adopted with changes
to the proposed text as published in the December 19, 2008,
issue of the Texas Register (33 TexReg 10269). The repeal of
139.1 - 139.8, 139.21 - 139.25, 139.31 - 139.33, and 139.41 -
139.60 and new 139.1, 139.3 - 139.5, 139.7, 139.21, 139.22,
139.24, 139.25, 139.31 - 139.33, 139.41 - 139.45, 139.50,
139.52, 139.55, 139.56, 139.58 and 139.60 are adopted without
changes and, therefore, the sections will not be republished.
BACKGROUND AND PURPOSE
The repeals and new sections are necessary to update and
clarify the rules. Government Code, 2001.039, requires that
each state agency review and consider for readoption each
rule adopted by that agency pursuant to the Government Code,
Chapter 2001 (Administrative Procedure Act). Sections 139.1 -
139.8, 139.21 - 139.25, 139.31 - 139.33, and 139.41 - 139.60
have been reviewed and the department has determined that
reasons for adopting the sections continue to exist because
rules on this subject are needed.
New 139.1 - 139.8, 139.21 - 139.25, 139.31 - 139.33, and
139.41 - 139.60 provide clarification to the rules and update ref-
erences to statutes and rules, the names and contact information
of boards, the department and its programs. The new 139.2
deletes definitions not used in the rules, adds the definitions of
advanced practice nurse, fetus, medical abortion, physician as-
sistant, and surgical abortion, and revises the definitions of cer-
tified registered nurse anesthetist, director, licensed vocational
nurse, physician, and registered nurse. The new 139.21 -
139.23 delete references to certain dates. The new 139.49 clar-
ifies the use of steam sterilizers. The new 139.50 and 139.52
clarify that disclosure, patient education and information services
are to be provided to a woman on whom the abortion is to be
performed. The new 139.54 deletes language concerning the
scope of practice for licensed vocational nurses and changes
nursing services to licensed health care professionals. The new
139.55 requires a preanesthesia evaluation by personnel ap-
proved to provide anesthesia services. The new 139.59 re-
vises anesthesia services using language similar to the ambula-
tory surgical center rules for consistency.
The department, on behalf of the commission, has reviewed and
prepared responses to the comments received regarding the
proposed rules during the comment period, which the commis-
sion has reviewed and accepts. The commenters were individ-
uals, associations, and/or groups, including the following: Texas
Association of Nurse Anesthetists, Texas Society of Anesthe-
siologists, Whole Woman's Health, LLC, Society of Diagnostic
Medical Sonography, Texas Association of Planned Parenthood
June 19, 2009 34 TexReg 4125
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Texas. Secretary of State. Texas Register, Volume 34, Number 25, Pages 4057-4230, June 19, 2009, periodical, June 19, 2009; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth90857/m1/65/: accessed December 7, 2019), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.