PART 5. STATE BOARD OF DENTAL EXAMINERS
CHAPTER 102. FEES
The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §102.1, concerning Fees, without changes to the proposal as published in the October 4, 2024, issue of the Texas Register (49 TexReg 8014) and will not be republished.
The adopted amendment fixes a clerical error made by staff to the total fee amounts for the dentist renewal fee, dentist renewal late - 1 to 90 days fee, and dentist renewal late - 91 to 364 days fee. An extra $15 charge was mistakenly imposed, and therefore the adopted amendment updates the fees to remove the extra charge.
In addition, the adopted amendment includes late fees for the dentist and dental hygienist temporary license by credentials renewal application. The late fees are imposed in accordance with Section 257.002(c)-(c-1) of the Texas Occupations Code by requiring licensees whose license is expired for 90 days or less to pay a renewal fee that is equal to 1 ½ times the normally required renewal fee, and whose license is expired for more than 90 days but less than one year to pay a renewal fee that is equal to two times the normally required renewal fee.
No comments were received regarding adoption of this rule.
This rule is adopted under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety, and Texas Occupations Code §254.004, which directs the Board to establish reasonable and necessary fees sufficient to cover the cost of administering the Board's duties.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on November 8, 2024.
TRD-202405467
Lauren Studdard
General Counsel
State Board of Dental Examiners
Effective date: November 28, 2024
Proposal publication date: October 4, 2024
For further information, please call: (512) 305-8910
CHAPTER 211. GENERAL PROVISIONS
Introduction. The Texas Board of Nursing (Board) adopts amendments to 22 Texas Administrative Code §211.7, relating to Executive Director, without changes to the proposed text published in the September 20, 2024, issue of the Texas Register (49 TexReg 7570). The rule will not be republished.
Reasoned Justification. The Board has established an agreed order to inactivate a nurse's license if it is found that their education is not substantially equivalent to a Texas approved nursing program's requirements. Traditionally, such orders have been ratified during a regular Board Meeting or a meeting of the Board's Eligibility and Disciplinary Committee. However, certain agreed orders are currently accepted on behalf of the Board by the Executive Director. The adopted amendments aim to include inactivation orders, based on educational deficiencies, among those that the Executive Director can accept. This delegation of authority is intended to reduce the time between a nurse's agreement to inactivate their license and their removal from practice. The Executive Director will provide summaries of these actions at regular Board meetings. Additionally, the amendments clarify the Executive Director's authority to accept orders for nurses facing temporary suspension under the Occupations Code §§301.455 & 301.4551. These changes aim to improve regulatory efficiency by processing monitoring or suspension orders signed by Respondents without waiting for a temporary suspension hearing or other Board meeting.
Section by Section Overview. The adopted amendments include the addition of §211.7(f)(4) to the categories of orders the Executive Director is authorized to accept on the Board's behalf. The Executive Director must report summaries of these orders to the Board during its regular meetings. Additionally, the amendments eliminate language from §211.7(i) that previously stated the Executive Director could only enter an order for a nurse following a temporary suspension hearing. The revised language broadens this authority, allowing the Executive Director to enter an order when a licensee is subject to temporary suspension or after the licensee has already been temporarily suspended.
Public Comment. The Board received no comments on the adoption of these amendments.
Statutory Authority. These amendments are adopted under the authority of Texas Occupations Code §§301.151 & 301.101. Texas Occupations Code § 301.151 addresses the general rulemaking authority of the Board to adopt and enforce rules consistent with Chapter 301 to perform its duties and conduct proceedings before the Board, regulate the practice of professional nursing and vocational nursing, establish standards of professional conduct for license holders under Chapter 301, and determine whether an act constitutes the act of professional nursing or vocational nursing. Texas Occupations Code §301.101 authorizes the Board to designate duties of the Executive Director.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on November 13, 2024.
TRD-202405510
James W. Johnston
General Counsel
Texas Board of Nursing
Effective date: December 3, 2024
Proposal publication date: September 20, 2024
For further information, please call: (512) 305-6879
Introduction. The Texas Board of Nursing (Board) adopts amendments to 1§213.33, relating to Factors Considered for Imposition of Penalties/Sanctions, without changes to the proposed text as published in the September 20, 2024, issue of the Texas Register (49 TexReg 7571). The rule will not be republished.
Reasoned Justification. On January 25, 2023, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and law enforcement partners executed a coordinated, multi-state operation to apprehend individuals involved in selling fraudulent nursing degree diplomas and transcripts. The scheme allegedly involved the sale of fake nursing diplomas and transcripts from accredited Florida-based nursing schools to Registered Nurse (RN) and Licensed Practical/Vocational Nurse (LPN/VN) candidates. Those who obtained these fraudulent credentials used them to qualify for the national nursing board exam. Upon passing the exam, these individuals were eligible to obtain licensure in various states, including Texas, to practice as RNs or LVNs.
The Board has begun disciplinary actions to revoke or deny the renewal of licenses and to deny initial licenses to individuals implicated in the scheme. Additionally, the Board has begun to deny licensure or take action against other individuals who obtained legally insufficient education. According to Tex. Occ. Code §301.451, it is illegal to practice nursing with a diploma, license, or record obtained unlawfully or fraudulently. Tex. Occ. Code §301.452(b)(1) authorizes the Board to act on violations of Chapter 301 or any related rule, regulation, or order. The adopted amendments bridge the gap between a violation of Tex. Occ. Code §301.451 and the concurrent violation of Tex. Occ. Code §301.452(b)(1).
The adopted amendments aim to clarify the Board's stance on these violations, informing licensees and the public about the likely sanctions for such violations based on the Disciplinary Matrix's Tier and Sanction Level analysis. The amendments also specify disciplinary actions for applicants who falsely certify that they meet Texas's licensure qualifications. A number of applicants for renewal and licensure have inaccurately claimed to meet educational requirements, leading to the licensure of nurses who have not completed the necessary clinical or didactic education, posing a significant public health risk. The amendments seek to ensure applicants understand the Board's position on this behavior and to maintain consistency in applying the Board's disciplinary matrix.
Additionally, the adopted amendments distinguish between technical and substantive requirements of a Board order. Current language misclassifies remedial education, typically required in Board disciplinary orders, as technical, non-remedial requirements. The amendments remove this language to align with the Board's current view of these violations.
Section by Section Overview. The adopted amendments introduce several changes to the Board's Disciplinary Matrix, found in §213.33(b), particularly concerning §301.452(b)(1). The amendments clarify the Board's stance on non-compliance with remedial education requirements in disciplinary orders, removing language that previously classified these requirements as technical and non-remedial. The Board now views non-compliance with remedial education requirements as substantive violations.
The adopted amendments in the Third Tier of §301.452(b)(1) articulate two violations that the Board views as Third Tier offenses. The first offense involves practicing nursing with unlawfully or fraudulently obtained credentials, or credentials issued under false representation. The second offense pertains to inaccurately certifying on initial or renewal licensure applications that an applicant meets Texas's legal and regulatory qualifications. Adopted changes to Sanction Level I in the Third Tier include the denial of initial licensure or licensure renewal, aligning with Board precedent in similar cases. These adopted additional sanctions support the Board's authority under §301.453, which includes the denial of applications for licensure, renewal, or temporary permits. Additionally, a new aggravating factor related to evidence of fraud, misrepresentation, or falsity will guide the Board in determining the appropriate sanction level that will apply when undertaking a matrix analysis for the above stated violations.
Public Comment. The Board received no comments on the adoption of these amendments.
Statutory Authority. These amendments are adopted under the authority of Texas Occupations Code §301.151. Texas Occupations Code §301.151 addresses the general rulemaking authority of the Board to adopt and enforce rules consistent with Chapter 301 to perform its duties and conduct proceedings before the Board, regulate the practice of professional nursing and vocational nursing, establish standards of professional conduct for license holders under Chapter 301, and determine whether an act constitutes the act of professional nursing or vocational nursing.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on November 13, 2024.
TRD-202405511
James W. Johnston
General Counsel
Texas Board of Nursing
Effective date: December 3, 2024
Proposal publication date: September 20, 2024
For further information, please call: (512) 305-6879