Texas Administrative Code
Title 22 - EXAMINING BOARDS
Part 9 - TEXAS MEDICAL BOARD
Chapter 185 - PHYSICIAN ASSISTANTS
Section 185.22 - Impaired Physician Assistants
Universal Citation: 22 TX Admin Code ยง 185.22
Current through Reg. 49, No. 12; March 22, 2024
(a) Mental or physical examination requirement.
(1) The board may require a
licensee/applicant to submit to a mental and/or physical examination by a
physician or physicians designated by the board if the board has probable cause
to believe that the licensee/applicant is impaired. Impairment is present if
one appears to be unable to practice with reasonable skill and safety to
patients by reason of age, illness, drunkenness, excessive use of drugs,
narcotics, chemicals, or any other type of material; or as a result of any
mental or physical condition.
(2)
Probable cause may include, but is not limited to, any one of the following:
(A) sworn statements from two people, willing
to testify before the board, the medical board, or the State Office of
Administrative Hearings that a certain licensee/applicant is
impaired;
(B) a sworn statement
from an official representative of the Texas Academy of Physician Assistants
stating that the representative is willing to testify before the board that a
certain licensee /applicant is impaired;
(C) evidence that a licensee/applicant left a
treatment program for alcohol or chemical dependency before completion of that
program;
(D) evidence that a
licensee/applicant is guilty of intemperate use of drugs or alcohol;
(E) evidence of repeated arrests of a
licensee/applicant for intoxication;
(F) evidence of recurring temporary
commitments of a licensee/applicant to a mental institution;
(G) medical records indicating that a
licensee/applicant has an illness or condition which results in the inability
to function properly in his or her practice; or
(H) actions or statements by a
licensee/applicant at a hearing conducted by the Board that gives the Board
reason to believe that the licensee or applicant has an impairment.
(3) Upon presentation to the
Executive Director of probable cause, the Board authorizes the Executive
Director to write the licensee/applicant requesting that the licensee/applicant
submit to a physical or mental examination within 30 days of the receipt of the
letter from the Executive Director. The letter shall state the reasons for the
request for the mental or physical examination, the physician or physicians the
Executive Director has approved to conduct such examinations, and the date by
which the examination and the results are to be received by the
Board.
(4) If the
licensee/applicant to whom a letter requiring a mental or physical examination
is sent refuses to submit to the examination, the Board, through its Executive
Director, shall issue an order requiring the licensee/applicant to show cause
why the licensee/applicant should not be required to submit to the examination
and shall schedule a hearing on the order not later than the 30 days after the
date on which the notice of the hearing is provided to the licensee. The
licensee/applicant shall be notified by either personal service or certified
mail with return receipt requested.
(5) At the show cause hearing provided in for
in paragraph (4) of this subsection, a panel of the Board's representatives
shall determine whether the licensee/applicant shall submit to an evaluation or
that the matter shall be closed with no examination required.
(A) At the hearing, the licensee/applicant
and the licensee/applicant's attorney, if any, are entitled to present
testimony and other evidence showing that the licensee/applicant should not be
required to submit to the examination.
(B) If, after consideration of the evidence
presented at the show cause hearing, the panel determines that the
licensee/applicant shall submit to an examination, the Board's representatives
shall, through its Executive Director, issue an order requiring the examination
within 60 days after the date of the entry of the order requiring examination.
A licensee is entitled to cross-examine an expert who offers testimony at
hearing before the Board.
(C) If
the panel determines that no such examination is necessary, the panel will
withdraw the request for examination.
(D) The results of any Board-ordered mental
or physical examination are confidential shall be presented to the Board under
seal for it to take whatever action is deemed necessary and appropriate based
on the results of the mental or physical examination. A licensee shall be
provided the results of an examination and given the opportunity to provide a
response at least 30 days before the Board takes action.
(6) In fulfilling its obligations under
§ 204.3045 of the Act, the Board shall refer the licensee/applicant to the
most appropriate medical specialist for evaluation. The Board may not require a
licensee/applicant to submit to an examination by a physician having a
specialty specified by the Board unless medically indicated. The Board may not
require a licensee/applicant to submit to an examination to be conducted an
unreasonable distance from the person's home or place of business unless the
licensee/applicant resides and works in an area in which there are a limited
number of physicians able to perform an appropriate examination.
(7) The guidelines adopted under this
subsection do not impair or remove the Board's power to make an independent
licensing or disciplinary decision unless a temporary suspension is
convened.
(b) Chapter 180 of this title (relating to Texas Physician Health Program and Rehabilitation Orders) shall be applied to physician assistants who are believed to be impaired and eligible for the Texas Physician Health Program. Rehabilitation orders entered into on or before January 1, 2010 shall be governed by law as it existed immediately before that date.
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