Texas Board of Nursing Rules and Regulations, Study notes of Medical ethics

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TEXAS BOARD OF NURSING

RULES AND REGULATIONS

relating to

NURSE EDUCATION,

LICENSURE AND PRACTICE

Published: April 2022

333 Guadalupe, Suite 3-460, Austin, Texas 78701-

FOREWORD

This manual, based on statutory authority as provided for in Chapters

301, 303, and 304 of the Texas Occupations Code Annotated (Nursing

Practice Act), has been prepared by the Texas Board of Nursing. It sets

forth the rules and regulations established by the Board to regulate nursing

education and the practice of nursing in the state. Members of the Board

of Nursing have sought input from interested groups and individuals in

developing and revising these rules and regulations.

This compilation of the rules and regulations is being provided for conve-

nience and reference purposes only. Please refer to the rules and regula-

tions as published in Title 22, Part 11 of the Texas Administrative Code,

which is available on the Texas Secretary of State’s website at: https://

texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=2&ti=

i

PREFACE

During the 19th century, the public became aware of the value of nursing as an

indispensable ally of the medical arts and sciences and as an occupation predicated

upon formal education. The first nursing laws were enacted in the United States in

The original Nursing Practice Act of Texas was passed March 28, 1909. The passage

of this Act marked a milestone in the health care of the citizens of the State of Texas as

nursing was formally recognized as a vital service to society. The purpose of the Act

is to provide that the privilege and responsibility of practicing nursing be entrusted

only to those persons duly licensed and practicing under the provisions of the Act.

The Act provides for the creation of a Board of Nursing (Board) empowered with

the responsibility and legal authority for ensuring competent practitioners of nursing.

The Board fulfills this responsibility by licensing qualified practitioners, controlling

the practice of nursing in the interest of society by licensure, by investigation of

violations of the Act, by initiating appropriate legal action when necessary, and by

establishing minimum standards for educational programs in nursing. Without legal

regulation of nursing practices, the public has no assurance that the nurses who

provide nursing care as a part of the total health care plan are qualified to do so.

The Board meets regularly to execute its responsibilities for administering the law

governing nurse practice. Professional and nonprofessional personnel are employed

to carry out the provisions of the law, and the policies and regulations established

by the Board. Legal counsel is retained by the Board as provided by the law, to

represent it in matters pertaining to the implementation of the law.

It is the responsibility of the Board to establish standards for nursing education in

the State of Texas. The Board shall approve such nursing education programs that

meet its requirements, and shall deny or withdraw approval from schools of nursing

and educational programs which fail to meet the prescribed course of study or other

standards. The intent of the approval process is to improve the educational programs

and stimulate continuous self-study, evaluation, innovation, and appropriate changes

within the programs. The Board provides guidance to nursing programs so that a

high quality education for the preparation of practitioners is ensured. The preparation

of a practitioner competent to practice, however, is the responsibility of the school.

The services of the Board are available to the faculty of educational programs, to

staff of health agencies utilizing nursing services, and to practitioners of nursing as

the need may arise.

The Board conducts regularly scheduled meetings which are open to the public. The

notice of the meeting including agenda items, and the time and place of the meeting

is posted with the Secretary of State’s office approximately two weeks in advance.

Special meetings of the Board shall be called by the President acting upon the written

request of any two members.

ii

MISSION STATEMENT

The mission of the Texas Board of Nursing is to protect and promote the welfare of the

people of Texas by ensuring that each person holding a license as a nurse in the State

of Texas is competent to practice safely. The Board fulfills its mission through the

regulation of the practice of nursing and the approval of nursing education programs.

This mission, derived from the Nursing Practice Act, supersedes the interest of any

individual, the nursing profession, or any special interest group.

PHILOSOPHY

Acting in accordance with the highest standards of ethics, accountability, efficiency,

effectiveness, and openness, the Texas Board of Nursing approaches its mission

with a deep sense of purpose and responsibility and affirms that the regulation of

nursing is a public and private trust. The Board assumes a proactive leadership role

in regulating nursing practice and nursing education. The Board serves as a catalyst

for developing partnerships and promoting collaboration in addressing regulatory

issues. The public and nursing community alike can be assured of a balanced and

responsible approach to regulation.

iii

Table of Contents

FOREWORD......................................................................................................................................................i PREFACE..........................................................................................................................................................ii

• General Provisions - §§ 211.1 - 211.10........................................................................................................... 1- MISSION STATEMENT /PHILOSOPHY.......................................................................................................iii
• Introduction........................................................................................................................................................
• Purpose and Functions ......................................................................................................................................
• Organization and Structure ......................................................................................................................................
• Officers................................................................................................................................................................
• Meetings...........................................................................................................................................................................
• Committees of the Board ...........................................................................................................................................
• Executive Director.......................................................................................................................................................
• Conflict of Interest .....................................................................................................................................................
• General Considerations..................................................................................................................................................
• Training and Education Reimbursement.................................................................................................................
• Practice and Procedure - §§ 213.1 - 213.35.......................................................................................................... 9-
• Definitions....................................................................................................................................................................
• Construction................................................................................................................................................................
• Pleading.......................................................................................................................................................................
• Representation...........................................................................................................................................................
• Appearance................................................................................................................................................................
• Agreements in Writing.............................................................................................................................................
• Final Disposition........................................................................................................................................................
• Filing of Documents..................................................................................................................................................
• Computation of Time................................................................................................................................................
• Notice and Service......................................................................................................................................................
• Non-SOAH Motion for Continuance.......................................................................................................................
• Witness Fees and Expenses.......................................................................................................................................
• Complaint Investigation and Disposition................................................................................................................
• Preliminary Notice to Respondent in Disciplinary Matters..................................................................................
• Commencement of Disciplinary Proceedings.........................................................................................................
• Respondent’s Answer in a Disciplinary Matter......................................................................................................
• Discovery.....................................................................................................................................................................
• Depositions.................................................................................................................................................................
• Subpoenas..................................................................................................................................................................
• Informal Proceedings and Alternate Dispute Resolution (ADR)............................................................................
• Agreed Disposition....................................................................................................................................................
• Formal Proceedings..................................................................................................................................................
• Decision of the Board................................................................................................................................................
• Rescission of Probation..............................................................................................................................................
• Monitoring..................................................................................................................................................................
• Reissuance of a License...............................................................................................................................................
• Good Professional Character......................................................................................................................................
• Licensure of Individuals with Criminal History..................................................................................................22-
• Disciplinary Guidelines for Criminal Conduct.....................................................................................................22-
• Fitness to Practice......................................................................................................................................................
• Declaratory Order of Eligibility for Licensure......................................................................................................
• Cross-reference of Rights and Options Available to Licensees and Petitioners...................................................
• Corrective Action Proceedings and Schedule of Administrative Fine(s)................................................................
• Factors Considered for Imposition of Penalties/Sanctions....................................................................................
• Texas Board of Nursing Disciplinary Matrix....................................................................................................40-
• Deferred Discipline......................................................................................................................................................
• Targeted Assessment and Remediation Pilot Program..................................................................................................
• Vocational Nursing Education - §§ 214 .1 - 214.13............................................................................................. 57-
• General Requirements...............................................................................................................................................
• Definitions....................................................................................................................................................................
• Program Development, Expansion, and Closure..................................................................................................
• Approval......................................................................................................................................................................
• Philosophy/Mission and Objectives/Outcomes.......................................................................................................
• Administration and Organization...........................................................................................................................
• Faculty.......................................................................................................................................................................
• Students.......................................................................................................................................................................
• Program of Study......................................................................................................................................................
• Clinical Learning Experiences................................................................................................................................
• Facilities, Resources, and Services..........................................................................................................................
• Records and Reports.................................................................................................................................................
• Total Program Evaluation........................................................................................................................................
• Professional Nurse Education - §§ 215 .1 - 215.13................................................................................................. 77 -
• General Requirements.............................................................................................................................................
• Definitions...................................................................................................................................................................
• Program Development, Expansion, and Closure...................................................................................................
• Approval........................................................................................................................................................................
• Philosophy/Mission and Objectives/Outcomes......................................................................................................
• Administration and Organization..........................................................................................................................
• Faculty.......................................................................................................................................................................
• Students.....................................................................................................................................................................
• Program of Study.....................................................................................................................................................
• Clinical Learning Experiences..................................................................................................................................
• Facilities, Resources, and Services...........................................................................................................................
• Records and Reports.................................................................................................................................................
• Total Program Evaluation ......................................................................................................................................
• Continuing Competency - §§ 216.1 - 216.11....................................................................................................... 97-
• Definitions....................................................................................................................................................................
• Purpose........................................................................................................................................................................
• Continuing Competency Requirements.....................................................................................................................
• Criteria for Acceptable Continuing Education Offerings........................................................................................
• Additional Methods for Meeting Continuing Competency Requirements.................................................................
• Activities That are not Acceptable as Continuing Education ..................................................................................
• Responsibilities of Individual Licensee.................................................................................................................
• Relicensure Process..................................................................................................................................................
• Audit Process.............................................................................................................................................................
• Appeals.........................................................................................................................................................................
• Consequences of Non-Compliance...........................................................................................................................
• Licensure, Peer Assistance and Practice - §§ 217.1 - 217.24............................................................................... 105-
• Definitions....................................................................................................................................................................
• Within the United States, its Territories or Possessions......................................................................................... Licensure by Examination for Graduates of Nursing Education Programs
• Temporary Authorization to Practice/Temporary Permit....................................................................................
• Nursing Education Programs Outside of United States’ Jurisdictions................................................................. Requirements for Initial Licensure by Examination for Nurses Who Graduate from
• Temporary License and Endorsement...................................................................................................................
• Failure to Renew License..........................................................................................................................................
• Change of Name and/or Address.............................................................................................................................
• Inactive and Retired Status.......................................................................................................................................
• Restrictions to Use of Designations for Licensed Vocational or Registered Nurse.........................................................
• Standards of Nursing Practice......................................................................................................................................
• Unprofessional Conduct............................................................................................................................................
• Peer Assistance Program...........................................................................................................................................
• Registered Nurses Performing Radiologic Procedures...............................................................................................
• Registered Nurse/ Graduate Nurse/Advanced Practice Nurse.................................................................................... Copying the License/Permit/Permanent Certificate of a Licensed Vocational Nurse/
• Minor Incidents..........................................................................................................................................................
• Texas Nursing Jurisprudence Exam........................................................................................................................
• Assisting at Surgery...................................................................................................................................................
• Incident-Based Nursing Peer Review and Whistleblower Protections................................................................
• Safe Harbor Nursing Peer Review and Whistleblower Protections..............................................................................
• Remedial Education Course Providers and Remedial Education Courses.................................................
• Special Accommodations......................................................................................................................................
• Balance Billing Notice and Disclosure Requirements........................................................................................
• Telemedicine Medical Service Prescriptions.............................................................................................................
• Advanced Practice Nurse Education - §§ 219.1 - 219.13...................................................................................... 145-
• General Requirements and Purpose............................................................................................................................
• Definitions....................................................................................................................................................................
• Program Development, Closure, and Transfer of Administrative Control ............................................................
• Approval......................................................................................................................................................................
• Mission/Philosophy and Objectives/Outcomes.......................................................................................................
• Administration and Organization .............................................................................................................................
• Faculty Qualifications and Faculty Organization....................................................................................................
• Students......................................................................................................................................................................
• Program of Study.........................................................................................................................................................
• Management of Clinical Learning Experiences and Resources...................................................................................
• Facilities, Resources, and Services............................................................................................................................
• Records and Reports...................................................................................................................................................
• Total Program Evaluation........................................................................................................................................
• Nurse Licensure Compact - §§ 220.1
• Eligibility and Compliance........................................................................................................................................
• Advanced Practice Nurses - §§ 221.1 - 221.17...................................................................................................... 157-
• Definitions....................................................................................................................................................................
• APRN Titles and Abbreviations.............................................................................................................................
• APRN Education Requirements for Licensure............................................................................................................
• Licensure as an APRN............................................................................................................................................
• Acceptable Certification Examinations......................................................................................................................
• Interim Approval.....................................................................................................................................................
• Petitions for Waiver and Exemptions...................................................................................................................
• APRN Licensure Renewal.......................................................................................................................................
• Inactive Status...........................................................................................................................................................
• Reactivation or Reinstatement of APRN Licensure.....................................................................................................
• Scope of Practice........................................................................................................................................................
• Core Standards for Advanced Practice...................................................................................................................
• Nurse-Midwives Providing Controlled Substances................................................................................................
• or Ambulatory Surgical Centers................................................................................................................................ Provision of Anesthesia Services by Nurse Anesthetists in Licensed Hospitals
• Provision of Anesthesia Services by Nurse Anesthetists in Outpatient Settings............................................................
• Enforcement................................................................................................................................................................
• Advanced Practice Registered Nurses with Prescriptive Authority - §§ 222.1 - 222.10....................................... 173-
• Definitions...................................................................................................................................................................
• Approval for Prescriptive Authority.........................................................................................................................
• Renewal of Prescriptive Authority............................................................................................................................
• Minimum Standards for Prescribing or Ordering Drugs and Devices..........................................................................
• Prescriptive Authority Agreement.............................................................................................................................
• Prescribing at Facility-Based Practices....................................................................................................................
• Authority to Order and Prescribe Non-prescription Drugs, Dangerous Drugs, and Devices.......................................
• Authority to Order and Prescribe Controlled Substances......................................................................................
• Conditions for Obtaining and Distributing Drug Samples...........................................................................................
• Enforcement................................................................................................................................................................
• Fees - §§ 223.1 - 223.2..................................................................................................................................................
• Fees...............................................................................................................................................................................
• Charges for Public Records.......................................................................................................................................
• for Clients with Acute Conditions or in Acute Care Environments - §§ 224.1 - 224.11....................................... 183- Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel
• Application of Chapter..............................................................................................................................................
• Exclusions from Chapter..........................................................................................................................................
• Purpose........................................................................................................................................................................
• Definitions..................................................................................................................................................................
• RN Accountability for Delegated Tasks...................................................................................................................
• General Criteria for Delegation..............................................................................................................................
• Supervision................................................................................................................................................................
• Delegation of Tasks....................................................................................................................................................
• The Medication Aide Permit Holder.......................................................................................................................
• Supervising Unlicensed Personnel Performing Tasks Delegated by Non RN Practitioners.........................................
• Application of Other Laws and Regulations............................................................................................................
• Environments for Clients with Stable and Predictable Conditions - §§ 225.1 - 225.14....................................... 189- RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living
• Application of Chapter................................................................................................................................................
• Exclusions from Chapter............................................................................................................................................
• Purpose........................................................................................................................................................................
• Definitions....................................................................................................................................................................
• RN Accountability......................................................................................................................................................
• RN Assessment of the Client.....................................................................................................................................
• Activities of Daily Living Not Requiring Delegation...............................................................................................
• Health Maintenance Activities Not Requiring Delegation.....................................................................................
• Delegation Criteria.....................................................................................................................................................
• Tasks That May Be Delegated..................................................................................................................................
• Delegation of Administration of Medications From Pill Reminder Container......................................................
• Diabetes Mellitus .................................................................................................................................................... Delegation of Insulin or Other Injectable Medications Prescribed in the Treatment of
• Tasks Prohibited from Delegation .........................................................................................................................
• Supervising Unlicensed Personnel Performing Tasks Delegated by Other Practitioners............................................
• Application of Other Laws and Regulations.........................................................................................................
• Patient Safety Pilot Programs on Nurse Reporting Systems - §§ 226.1 - 226.7.................................................... 197-
• Patient Safety Pilot Programs on Nurse Reporting Systems.................................................................................
• Initiation of Application and Approval of Patient Safety Pilot Programs.............................................................
• General Selection Criteria........................................................................................................................................
• Limited Exception to Mandatory Reporting Requirements...................................................................................
• Application and Review Process...............................................................................................................................
• Monitoring and Evaluating Patient Safety Pilot Programs........................................................................................
• Contract Discussions.................................................................................................................................................
• Nursing Education - §§ 227.1 - 227.4............................................................................................... .................201- Pilot Programs for Innovative Applications to Vocational and Professional
• Purpose......................................................................................................................................................................
• Application and Approval........................................................................................................................................
• General Selection Criteria........................................................................................................................................
• Monitoring and Evaluation.......................................................................................................................................
• Pain Management - § 228.1 - 228.1................................................................................................................... 203-
• Standards of Practice.................................................................................................................................................

TITLE 22. EXAMINING BOARDS

PART 11. TEXAS BOARD OF NURSING

CHAPTER 211. GENERAL PROVISIONS

§211.1. Introduction.

(a) Name. The entity is the Board of Nurse Examiners for the State of Texas, hereafter referred to as the board. It is a decision-making board appointed by the Governor of the State of Texas in compliance with the Texas Occupations Code. (b) Location. The administrative offices shall be located in Austin, Texas. (c) Legal Authority. The board is established and functions under the authority of Chapters 301, 303 and 304 of the Texas Occupations Code. (d) Composition. The board shall be composed of those persons appointed by the Governor with the advice and consent of the Senate. (e) Fiscal year. For all fiscal and administrative purposes, the reporting year of the board shall be identical to that of the State of Texas. The provisions of this §211.1 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective May 17, 2004, 29 TexReg 4884.

§211.2. Purpose and Functions.

(a) Purpose. The purpose of the board is to protect and promote the welfare of the people of Texas. This purpose supersedes the interest of any individual, the nursing profession, or any special interest group. The board fulfills its mission through two principle areas of responsibility: (1) regulation of the practice of professional and vocational nursing, and (2) accreditation of schools of nursing. (b) Functions. The board shall perform the following functions as outlined in Texas Occupations Code chapters 301, 303, and 304. (1) Establish standards of nursing practice and regulate the practice of professional and vocational nursing. (2) Interpret the Nursing Practice Act and the Rules and Regulations Relating to Nurse Education, Licensure and Practice to nurses, employers, and the public to ensure informed professionals, allied health professionals, and consumers. (3) Receive complaints and investigate possible violations of the Nursing Practice Act and rules and regulations. (4) Discipline violators through appropriate legal action to enforce the Nursing Practice Act and rules and regulations. (5) Provide a mechanism for public comment with regard to the rules and regulations and the Nursing Practice Act and review and modify the rules and regulations when necessary and appropriate. (6) Examine and license qualified applicants to practice professional and vocational nursing and recognize qualified applicants to practice advanced practice nursing in the state of Texas in a manner that ensures that applicable standards are maintained and that practitioners are minimally competent. (7) Grant licensure by endorsement to vocational and registered nurses and grant recognition of advanced practice nurses from other states to ensure standards are maintained and applicable practices are consistent. (8) Recommend to legislature appropriate changes in the Nursing Practice Act to ensure that the act is current and applicable to changing needs and practices. (9) Establish standards for nursing education and accredit or deny accreditation to schools of nursing and educational programs which fail to meet or maintain the prescribed course of study or other applicable standards to ensure that high levels of education are achieved. (10) Monitor the examination results of licensure applicants to determine variances in the level of educational effectiveness. (11) Provide consultation and guidance to nurse education institutions to facilitate self-study, evaluation, and the development of effective nurse education programs. (12) Provide advice and counsel to the faculty of educational programs, to staff of health agencies utilizing nursing services, and to practitioners of nursing to continually improve professional service delivery. (13) Implement and manage all other programs and responsibilities as authorized and mandated from time to time by the Texas Legislature. The provisions of this §211.2 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective May 17, 2004, 29 TexReg 4884_._ 1

§211.3. Organization and Structure.

(a) General. In accordance with Texas Occupations Code §§301.051 through 301.059, the board shall consist of members appointed by the Governor with the advice and consent of the Senate. (b) Terms of office. The terms of board members shall be six years in length and shall be staggered so that the terms of as near to one-third of the members as possible shall expire on January 31 of each odd-numbered year. Upon completion of a term, a member may continue to serve until a successor has been appointed. A member may be reappointed to successive terms at the discretion of the Governor. (c) Eligibility. Board member eligibility is governed by the Texas Occupations Code §§301.052 and 301.053. (d) Compensation. Each member of the board shall receive per diem as provided by law for each day that the member engages in the business of the board and will be reimbursed for travel expenses incurred in accordance with the state of Texas and Board of Nurse Examiners’ travel policies. The provisions of this §211.3 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective May 17, 2004, 29 TexReg 4884.

§211.4. Officers.

(a) Selections and appointments. In accordance with the Texas Occupations Code §301.057, the Governor shall designate one of the members of the board as presiding officer. During the last meeting of the calendar year in even years, the board shall elect from among its membership a vice president. The term of the vice president shall be for two years. If the office of vice president becomes vacant during a two-year term, the members of the board shall elect a new vice president from among its membership to serve for the remainder of the term. All elections and any other issues requiring a vote of the board shall be decided by a simple majority of the members present and voting. (b) Duties of the officers. (1) The president shall: (A) preside at all meetings of the board; (B) represent the board in legislative matters and in meetings with related groups; (C) appoint standing, ad hoc, and advisory committees; (D) perform such other duties as pertain to the office of the president; and, (E) designate a member of the board to coordinate the annual performance reviews of the executive director and evaluation of the board. (2) The vice president shall function in the absence of the president and shall perform such other duties that are from time to time assigned by the board. If the office of president becomes vacant, the vice president will serve as president until another member is elected by the board or named by the Governor. The provisions of this §211.4 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective May 17, 2004, 29 TexReg 4884; amended to be effective July 10, 2013, 38 TexReg 4319.

§211.5. Meetings.

The board shall meet at least four times a year. It shall consider such matters as may be necessary. Special meetings shall be called by the president of the board or upon written request signed by three members of the board in accordance with Texas Occupations Code §301.058. (1) Agenda. An agenda shall be posted in accordance with the Texas Government Code chapter 551 and copies shall be sent to the board members. (2) Meetings of the board and of its committees are open to the public unless such meetings are conducted in executive session pursuant to state law. (3) Quorum. A majority of the members of the board, at least three of whom shall be nurses, shall constitute a quorum for the transaction of all business at any regular or special meeting. (4) Voting. The board may act only by majority vote of a quorum of members present and eligible to vote, with each eligible member entitled to one vote. A member is not eligible to vote if a conflict of interest exists as described in §211.8 of this title (relating to Conflict of Interest). No proxy vote shall be allowed. (5) Presiding officer. In the absence of the president and the vice president, a presiding officer shall be chosen by a majority of the board members present. (6) Meeting held by tele-conference call. A meeting by the Board of Nurse Examiners may be held by telephone conference call or video conference call only as authorized by Texas Government Code chapter 551. The provisions of this §211.5 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective May 17, 2004, 29 TexReg 4884. 2

§211.6. Committees of the Board.

(a) The following are standing and permanent committees of the board, as established by the board in accordance with the Nursing Practice Act. The responsibilities and authority of these committees include those duties and powers as set forth including other responsibilities and charges which the board may from time to time delegate to these committees. (b) Eligibility and Disciplinary Committee. (1) Members of the committee shall be appointed by the president and shall consist of one consumer member and two nurse members. The President shall have authority to substitute committee members when necessary to establish a quorum due to absences of standing members. (2) The chair shall be named by the president. (3) Duties and powers. (A) The Committee shall have the authority to determine all matters of eligibility for licensure and discipline of licenses, including temporary suspension of a license, administrative and civil penalties, and consideration and resolution of a default dismissal from the State Office of Administrative Hearings pursuant to Tex. Gov’t Code §2001.058(d-1). (B) The Committee shall have the authority to approve the adoption of rules on an emergency basis pursuant to Tex. Gov’t Code §2001.034. (4) Quorum. Two eligible voting members shall establish a quorum of the Committee of which at least one member is a nurse. (5) Tele-conference. A meeting by the Committee may be held by telephone conference call or video conference call as authorized by Texas Government Code chapter 551. (c) Education Liaison. The three board members representing nursing educational programs shall serve as advisory to the staff on matters pertaining to faculty waivers, proposed curriculum revisions and other issues that may arise between regular board meetings. The recommendations of the liaison members are presented to the board at the next regular meeting for consideration. (d) Advanced Practice Liaison. Three members shall be designated by the president to serve as advisory to the staff on matters pertaining to advanced practitioner waivers and other issues that may arise between regular board meetings. The recommendation of the liaison members are presented to the board at the next regular meeting for consideration. (e) Other standing or ad hoc committees. The board may designate other standing or ad hoc committees as deemed necessary. Such committees shall have and exercise such authority as may be granted by the board. (f) Advisory Committees. The president may appoint, with the authorization of the board, advisory committees for the performance of such activities as may be appropriate or required by law. (1) The board has established the following committees that advise the board on a continuous basis or as charged by the Board: (A) the Advanced Practice Nursing Advisory Committee (APNAC) advises the Board on practice issues and regulations that have or may have an impact on advanced practice nursing. The APNAC is comprised of representatives from the following: (i) Texas Association of Nurse Anesthetists (TANA); (ii) Coalition for Nurses in Advanced Practice (CNAP); (iii) Texas Nurse Practitioners (TNP); (iv) Consortium of Texas Certified Nurse-Midwives (CTCNM); (v) Texas Clinical Nurse Specialists (TXCNS); (vi) Texas Organization of Nurse Executives (TONE); (vii) Texas Nurses Association (TNA); (viii) CRNA Educator; (ix) CNS Education; (x) CNM Education; (xi) NP Educator; and (xii) other members approved by the Board. (B) the Advisory Committee on Education (ACE) advises the Board on education and practice issues that have or may have an impact on the regulation of nursing education in Texas. The ACE is comprised of representatives from the following: (i) Licensed Vocational Nurses Association of Texas (LVNAT); (ii) Texas Association of Vocational Nurse Educators (TAVNE); (iii) Texas Organization of Baccalaureate and Graduate Nursing Education (TOBGNE); (iv) Texas Organization of Associate Degree Nursing (TOADN); (v) Texas League for Vocational Nursing (TLVN); (vi) Texas Organization of Nurse Executives (TONE); 3

(vii) Texas Nurses Association (TNA); (viii) Texas Association of Deans and Directors Professional Nursing Programs (TADDPNS); (ix) various educators in Texas nursing programs; (x) interested state agencies; and (xi) other members approved by the Board. (C) the Nursing Practice Advisory Committee (NPAC) reviews and analyzes issues that affect the practice of nursing. The NPAC is comprised of representatives from the following: (i) Licensed Vocational Nurses Association of Texas (LVNAT); (ii) Texas Association of Vocational Nurse Educators (TAVNE); (iii) Texas League for Vocational Nursing (TLVN); (iv) Texas Organization of Nurse Executives (TONE); (v) Texas Nurses Association (TNA); (vi) Texas School Nurses Organization (TSNO); (vii) Texas Department of Aging and Disability Services (DADS); (viii) Texas Association for Home Care (TAHC); (ix) Texas Department of State Health Services (DSHS); (x) Texas Association of Homes and Services for the Aging (TAHSA); (xi) Texas Hospital Association (THA); and (xii) other members approved by the Board. (D) the Eligibility and Disciplinary Advisory Committee (EDAC) gives analysis and advises the Board regarding regulatory matters. The EDAC is comprised of representatives from the following: (i) Texas Association of Vocational Nurse Educators (TAVNE); (ii) Licensed Vocational Nurses Association of Texas (LVNAT); (iii) Texas League of Vocational Nurses (TLVN); (iv) Texas Organization of Associate Degree Nursing (TOADN); (v) Texas Organization of Baccalaureate and Graduate Nurse Educators (TOBGNE); (vi) Texas Nurses Association (TNA); (vii) Texas Organization of Nurse Executives (TONE); (viii) Coalition for Nurses in Advanced Practice; and (ix) other members approved by the Board. (2) Members shall be appointed by the Board. The Board may amend committee memberships as needed. (3) A board member or members appointed by the President of the board or the board may serve as a liaison(s) to a committee and report to the Board the recommendations of the committee for consideration by the Board. The role of a Board member liaison, however, is limited to clarifying the Board’s charge and intent to the advisory committee. (4) Each committee shall select from among its members a chairperson who shall report to the agency or Board as needed. (5) Each committee’s work and usefulness shall be evaluated periodically. (6) The committees will provide notice of meetings on the Secretary of State’s web site to allow the public an opportunity to participate. (7) The Executive Director shall appoint staff to support the committee. (8) Committees may identify topics and/or issues for development and communication to the Board for the consideration and/or issuance of a formal charge. (9) The majority of the members of a Committee must be present at a meeting in order to establish a quorum. Committee members will be expected to attend meetings. The chairperson has the discretion to recommend the dismissal of a member who does not regularly attend. The Board or Executive Director has the authority to approve the dismissal of a member. (10) Advisory committees chairs may invite individuals as expert resources to participate in committee discussions and deliberations. Invited experts serve as ad hoc members and do not have voting privileges. (11) The committees will meet as needed. Meeting times will be scheduled by the chairperson of each committee who shall determine whether a majority of the members will be in attendance to establish a quorum. (12) The decisions of the committee are advisory only. (13) Committee members may request and/or receive training as necessary to assist them in completing their work. The provisions of this §211.6 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective May 17, 2004, 29 TexReg 4884; amended to be effective March 14, 2007, 32 TexReg 1302; amended to be effective September 26, 2007, 32 TexReg 6519; amended to be effective January 4, 2009, 33 TexReg 10432; amended to be effective July 12, 2010, 35 TexReg 6072; amended to be effective April 19, 2016, 41 TexReg 2749; amended to be effective February 16, 2021, 46 TexReg 1057. 4

§211.7. Executive Director.

(a) The board shall determine qualifications for and retain an executive director who shall be the chief executive officer of the agency. (b) The executive director shall have the authority and responsibility for the operations and administration of the agency and such additional powers and duties as prescribed by the board. As chief executive of the board the executive director shall manage all aspects of the agency, including personnel, financial and other resources, in support of the NPA, rules and policies, the board’s mission and strategic plan. The executive director shall attend all meetings of the board and may offer recommendations to the board, but shall not vote on matters brought before the board. (c) The executive director shall have the authority to dismiss a complaint if an investigation demonstrates that a violation did not occur, or the subject of the complaint is outside the board’s jurisdiction. At each public meeting of the board, the executive director shall report to the board each complaint dismissed since the board’s last public meeting. (d) The Executive Director, or the Executive Director’s designee, is authorized to offer proposed disciplinary orders upon evaluation of the investigation findings. Such an offer may be made: (1) by mail at the conclusion of an investigation; or (2) in person following an informal conference. (e) The Executive Director is authorized to accept the voluntary surrender of a license. Board ratification is not required. The Executive Director will report summaries of dispositions to the Board at its regular meetings. (f) The Executive Director is authorized to accept the following orders on behalf of the Board and ratification by the Board is not necessary. The Executive Director will report summaries of dispositions to the Board at its regular meetings. (1) Orders issued under §213.32(2) and (5) of this title (relating to Corrective Action Proceedings and Schedule of Administrative Fines). (2) Orders requiring a licensee to comply with a peer assistance program. (3) Orders issued under subsection (i) of this section. (g) The Executive Director may grant any motion for rehearing if he/she is of the opinion that the motion has merit based on the criteria of §213.16(j) of this title (relating to Respondent’s Answer in a Disciplinary Matter). Otherwise, any motion considered untimely or without merit under the criteria of §213.16(j) of this title, would be scheduled without prejudice before the next practicable full Board or Eligibility and Disciplinary meeting for review and determination. (h) The Executive Director may grant a request for a limited license or negotiate an agreed order to return a limited licensee back to direct patient care. The Executive Director may negotiate an agreed resolution to a request for an exception to a stipulation contained in an existing order of the Board. The Executive Director shall not grant a request for exception under this subsection unless he/she is of the opinion that the requested relief falls within, and is consistent with, public safety and the parameters of §213.33(b), (g), and (h) of this title (relating to Factors Considered for Imposition of Penalties/Sanctions). Otherwise, a request for exception to an existing order of the Board may be scheduled without prejudice before the next practicable Eligibility and Disciplinary Committee meeting for review and determination. The Executive Director shall establish guidelines for review and approval of requests for exceptions to existing Board orders, including how often such requests may be made. The Executive Director shall report summaries of decisions related to requests for exceptions to existing Board orders to the Board at its regularly scheduled meetings. (i) Following the temporary suspension of an individual’s license pursuant to the Occupations Code §301. or §301.4551, the Executive Director may approve and accept on behalf of the Board an agreed order resolving the contested case if he/she is of the opinion that the agreed order falls within, and is consistent with, public safety and the parameters of §213.27 of this title (relating to Good Professional Character); §213.29 of this title (relating to Criteria and Procedure Regarding Intemperate Use and Lack of Fitness in Eligibility and Disciplinary Matters); and §213.33 of this title. The Executive Director shall report summaries of dispositions under this subsection to the Board at its regularly scheduled meetings. (j) The Executive Director is authorized to accept the voluntary closure of a vocational nursing education program or a professional nursing education program. Board ratification is not required. The Executive Director will report summaries of such closures to the Board at its regular meetings. The provisions of this §211.7 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective September 26, 2007, 32 TexReg 6519; amended to be effective October 19, 2008, 33 TexReg 8501; amended to be effective November 15, 2009, 34 TexReg 7810; amended to be effective April 17, 2013, 38 TexReg 2359; amended to be effective October 7, 2013, 38 TexReg 6917; amended to be effective January 31, 2017, 42 TexReg 310. 5

§211.8. Conflict of Interest.

When matters to be discussed by or before the board concern a school and/or agency with which the board member is affiliated, the board member shall not enter into the discussion unless questioned by a member of the board and shall not vote on the matter. The provisions of this §211.8 adopted to be effective March 31, 2002, 27 TexReg 2236.

§211.9. General Considerations.

(a) Parliamentary procedure. Board and committee meetings shall be conducted pursuant to the Board’s adopted Simplified Parliamentary Policy. (b) Minutes. Minutes of all board meetings will be prepared and transmitted to board members for their review prior to subsequent board meetings and shall be filed with the Legislative Reference Library and the Texas State Library. Proceedings of standing and ad hoc committee meetings and advisory committee meetings shall be recorded, distributed and filed in accordance with parliamentary procedure. (c) Video Tape. All or any part of the proceedings of a public board meeting may be recorded by any person in attendance by means of a tape recorder, video camera, or any other means of sonic or visual reproduction. (1) The executive director shall direct any individual wishing to record or videotape as to equipment location, placement, and the manner in which the recording is conducted. (2) The decision will be made so as not to disrupt the normal order and business of the board. (d) Executive Session. (1) The Board of Nurse Examiners may meet in executive session to consider the following items as provided by law: (A) involving the appointment, employment evaluation, reassignment, duties, discipline, or dismissal of a public officer or employee, unless such officer or employee requests a public hearing; (B) with respect to the purchase, exchange, lease, value of real property and negotiated contracts for prospective gift or donations to the state or the governmental body, when such discussion would have a detrimental effect on the negotiating position of the board as between the board and a third person, firm, or corporation; (C) regarding the deployment, or specific occasions for implementation of security personnel or devices; (D) in private consultation between a governmental body and its attorney, in instances in which the board seeks the attorney’s advice with respect to pending or contemplated litigation, settlement offer, and matters where the duty of board’s counsel to his client, pursuant to the Code of Professional Responsibility of the State Bar of Texas, clearly conflicts with applicable statutory provisions; or (E) any other matter as may relate to board business that is authorized by state law. (2) An executive session of the board shall not be held unless a quorum of the board has first been convened in open meeting. If during such open meeting, a motion is passed by the board to hold an executive session, the presiding officer shall publicly announce that an executive session will be held by stating the appropriate authority under which such executive session is being convened. (3) The presiding officer of the board shall announce the date and time at the beginning and end of the executive session. (4) The presiding officer of the board shall make a tape recording of the executive session which shall include the announcement made by the presiding officer at the beginning and end of the executive session. (5) In lieu of a tape recording, the presiding officer shall prepare an agenda of the executive session which shall be certified by the presiding officer as being a true and correct record of the proceedings. The certified agenda shall: (A) include an announcement of the date and time by the presiding officer at the beginning and end of the executive session; and (B) state the subject matter of each deliberation and include a record of any further action taken. (6) At the conclusion of the executive session, the presiding officer shall place the certified agenda or tape in an envelope, seal and date the envelope and deliver the envelope to the executive director. (7) The executive director or his or her designee will place the envelope containing the tape or agenda in the agency’s safe. (8) The certified agenda or tape shall be maintained at the board office for at least two years from the date of the executive session. If an action involving the executive session commences during such two year period, the certified agenda shall be maintained until the final disposition of such action. (9) The certified agenda or tape shall be available for inspection by the judge of a district court as specified in Government Code, §555.104, if litigation has been initiated involving a violation of this section. 6

(e) Contracts with Historically Underutilized Businesses (HUBS). (1) A Historically Underutilized Business (HUB) is a business that meets the definition of HUBs as defined in the rules of the Texas Building and Procurement Commission. (2) The Board shall make a good faith effort to utilize HUBs in contracts for construction, services, including professional and consulting services, and commodities purchases. (3) The board shall make a good faith effort to assist HUBs in receiving a portion of the total contract value of all contracts awarded by the board in accordance with the percentage goals established by the Texas Building and Procurement Commission. (f) Enhanced Contract and Performance Monitoring. (1) The following contracts require enhanced contract or performance monitoring: (A) A contract for the purchase of goods or services that has a value exceeding $1 million; and (B) A contract with a value of less than $1 million, if the Board’s contract manager determines enhanced contract or performance monitoring is appropriate. (2) For contracts identified under paragraph (1) of this subsection, the Board’s contract manager or designated staff member must submit the following information to the Board: (A) the general purpose of the contract; (B) the name of the vendor; (C) the legal authority under which the contract was entered; (D) the current cost of the contract; and (E) the total cost of the contract, including contract renewals. (3) The Executive Director shall be immediately notified of any serious issue or risk that is identified with respect to a contract monitored under this subsection. The provisions of this §211.9 adopted to be effective March 31, 2002, 27 TexReg 2236; amended to be effective July 14, 2016, 41 TexReg 5053; amended to be effective October 31, 2018, 43 TexReg 7318. 7

§211.10. Training and Education Reimbursement.

(a) The Board may use public funds to reimburse for the training and education for its employees. The training or education must be related to the duties or the prospective duties of the employee. (b) An employee may be eligible for education and training reimbursement if the employee is taking the course at the request of the agency or: (1) has been employed full-time at the Board for a period in excess of six (6) months; (2) is currently employed full-time; (3) has a performance evaluation of 3.0 or above; and (4) does not have a current employment disciplinary record. (c) If the course is completed at an accredited institution of higher education, the employee must achieve a grade of “C” or above for undergraduate work or a grade of “B” or above for graduate work to be eligible for reimbursement. (d) If the education or training is a pass/fail activity, the employee must pass the course to be eligible for reimbursement. (e) Permission to participate in any education or training program must be approved by the Executive Director and may be withdrawn if the Executive Director determines that participation would negatively impact the employee’s job duties or performance or that participation is no longer in the agency’s best interest. (f) If the employee does not remain employed at the agency for one (1) year following completion of the course or training, the employee will be required to refund all expenses reimbursed by the Board. (g) Before an employee of the agency may be reimbursed, the Executive Director must authorize the reimbursement. (h) For purposes of this rule, reimbursement only includes tuition, building fees, lab fees and student service fees. Tuition will be reimbursed up to half of the cost with a maximum of $1,000 per fiscal year contingent upon availability of agency resources. The provisions of this §211.10 adopted to be effective July 18, 2016, 41 TexReg 5174.

CHAPTER 213. PRACTICE AND PROCEDURE

§213.1. Definitions.

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise: (1) Act--The Nursing Practice Act or NPA, Texas Occupations Code Annotated §§301.001 - 301.607; 303.001 - 304.014. (2) Address of record--The address of each licensee as provided to the Board of Nursing (as required by Board rules relating to Change of Name and/or Address) and currently found in §217.7 of this title (relating to Change of Name and/or Address). (3) Administrative Law Judge or judge--An individual appointed by the chief administrative law judge of the State Office of Administrative Hearings to preside over administrative hearings pursuant to Texas Government Code Annotated, Chapter 2003, §2003.041. The term shall also include any temporary administrative law judge appointed by the chief administrative law judge pursuant to Texas Government Code Annotated §2003.043. (4) Adverse licensure action--Any action to fine, reprimand, warn, limit, probate, revoke, suspend, or otherwise discipline a license or multistate licensure privilege. The term includes an order accepting a voluntary surrender in lieu of disciplinary action. (5) Answer--A responsive pleading. (6) APA--Administrative Procedure Act, Texas Government Code Annotated Chapter 2001. (7) Attorney of record--A person licensed to practice law in Texas who has provided the staff with written notice of representation. (8) Board--The Board of Nursing appointed pursuant to Texas Occupations Code Annotated §301.051. For purposes of this section, “Board” also includes a three member standing committee designated by the Board to determine matters of eligibility for licensure and discipline of licensees. (9) Client--See Patient. (10) Complaint--Written accusations made by any person, or by the Board on its own initiative, alleging that a licensee’s conduct may have violated the NPA. (11) Contested case--A proceeding including, but not restricted to, rate making and licensing, in which the legal rights, duties or privileges of a party are to be determined by an agency after an opportunity for adjudicative hearing. (12) Conviction--The result of a criminal proceeding wherein an individual, based on a plea or verdict, is adjudged guilty of the offense charged, or has been placed on probation with or without an adjudication of guilt, or has received an order of deferred adjudication. (13) Declaratory order--An order, issued by the Board pursuant to Texas Occupations Code Annotated §301.257, determining the eligibility of an individual for initial licensure as a registered or vocational nurse and setting forth both the basis for potential ineligibility and the Board’s determination of the disclosed eligibility issues. (14) Default proceeding--The issuance of a proposal for decision or an order in which the factual allegations against the respondent in a contested case are deemed admitted as true upon the respondent’s failure to appear at a properly noticed hearing, or failure to file a response to the Formal Charges. (15) Eligibility and Disciplinary Committee--A three member committee organized in accordance with §211.6 of this title (relating to Agreements in Writing) and authorized by the Board to make a final disposition of licensure eligibility and disciplinary matters including temporary suspension. (16) Eligibility matter--A proceeding by which an individual requests licensure (such as by Petition for Declaratory Order, Application for Examination, Application for Endorsement), Reinstatement, Reissuance, or Renewal. (17) Executive director--The executive director of the Board of Nursing. (18) Formal charges--Pleading of the staff publicly alleging the reasons for disciplinary actions against a registered or vocational nurse created in accordance with Texas Occupations Code Annotated §301.458. (19) Hearing--A public adjudicative proceeding at the State Office of Administrative Hearings. 9

(20) Informal conference--A non-public settlement meeting conducted by the executive director or designee to resolve a disciplinary or eligibility matter pending before the Board. (21) Initial licensure--The original grant of permission to practice nursing in Texas, regardless of the method through which licensure was sought. (22) License--Includes the whole or part of any Board permit, certificate, approval, registration, or similar form of permission required by law to practice professional or vocational nursing in the State of Texas. For purposes of this subchapter, the term includes a multistate licensure privilege. (23) Licensee--A person who has met all the requirements to practice as a registered or vocational nurse pursuant to the Nursing Practice Act and the Rules and Regulations relating to Nurse Education, Licensure and Practice and has been issued a license to practice professional or vocational nursing in Texas. For purposes of this subchapter, the term includes a person who practices pursuant to a multistate licensure privilege. (24) Licensing--Includes the Board’s process with respect to the granting, denial, renewal, revocation, suspension, annulment, withdrawal, amendment of a license, or multistate licensure privilege. (25) Minor Incident--Conduct in violation of the Nursing Practice Act, which after a thorough evaluation of factors enumerated under §217.16 of this title (relating to Minor Incidents), indicates that the nurse’s continuing to practice professional or vocational nursing does not pose a risk of harm to a client or other person and, therefore, does not need to be reported to the Board or peer review committee. (26) Multistate Licensure Privilege--See Texas Occupations Code Annotated §304.001, article 1(h) (definition of Multistate Licensure Privilege). For purposes of this subchapter, the multistate licensure privilege means the privilege to practice as a professional or vocational nurse in the state of Texas based on the current, official authority to practice as a nurse in another state that has enacted the Nurse Licensure Compact, Texas Occupations Code Annotated Chapter 304. (27) Order--A written decision of the Board, regardless of form, signed by the Board or the executive director on its behalf. (28) Party--A person who holds a license issued by the Board of Nursing or multistate licensure privilege, a person who seeks to obtain, retain, modify his or her license, or a multistate licensure privilege, or the Board of Nursing. (29) Patient--An individual under the care and treatment of a health care professional either at a health care facility or in his/her own home. (30) Person--Any individual, representative, corporation, or other entity, including any public or non-profit corporation, or any agency or instrumentality of federal, state, or local government. (31) Petitioner--A party, including the staff, who brings a request or action and assumes the burden of going forward with an administrative proceeding, e.g., the staff in an action to discipline a licensee, the person who seeks reinstatement of a license, or the person who seeks a determination of eligibility for licensure. (32) Pleading--A written document submitted by a party, or a person seeking to participate in a case as a party, which requests procedural or substantive relief, makes claims, alleges facts, makes legal argument, or otherwise addresses matters involved in the case. (33) Reinstatement--The process of reissuing and restoring a license to active status that has been previously suspended, revoked, or voluntarily surrendered. (34) Respondent--A party, including the staff, to whom a request is made or against whom an action is brought, e.g., the licensee in a disciplinary action by the staff, the person who holds a multistate licensure privilege in a disciplinary action by the staff, the Board in a reinstatement action, or the Board in an action to determine eligibility for licensure. (35) Rule--Any agency statement of general applicability that implements, interprets, or prescribes law or policy, or describes the procedure or practice requirements of a state agency. The term includes the amendment or repeal of a prior rule, and does not include statements regarding only the internal management or organization of any agency and not affecting private rights or procedures. (36) SOAH--The State Office of Administrative Hearings. (37) Staff--The staff of the Board, not including the executive director. For purposes of these rules, the staff may act through the legal counsel. 10

(38) Technical error--A judge’s misinterpretation or misapplication of sound nursing principles or minimum nursing practice standards in a proposal for decision that must be corrected to sufficiently protect the public. The provisions of this §213.1 adopted to be effective August 15, 2002, 27 TexReg 7107; amended to be effective May 17, 2004, 29 TexReg 4884; amended to be effective February 15, 2021, 46 TexReg 1058.

§213.2. Construction.

(a) Unless otherwise expressly provided, the past, present or future tense shall each include the other; the masculine, feminine, or neuter gender shall each include the other; and the singular and plural number shall each include the other. (b) These rules apply to all contested cases within the Board’s jurisdiction and shall control practice and procedure before the Board and SOAH, unless pre-empted by rules promulgated by SOAH. (c) Words and phrases shall be read in context and construed according to the rules of grammar and common usage. Words and phrases that have acquired a technical or particular meaning, whether by legislative definition or otherwise, shall be construed otherwise. (d) A reference in statute revised by the Texas Occupations Code is considered to be a reference to the part of the Texas Occupations Code that revises that statute or part of statute. (e) A reference in a rule or part of a rule revised by this subchapter is considered to be a reference to the part of this subchapter that revises that rule or part of that rule. The provisions of this §213.2 adopted to be effective August 15, 2002, 27 TexReg 7107.

§213.3. Pleading.

(a) In licensure matters: (1) In actions by the staff as petitioner against a licensee, the staff’s pleading shall be styled “Formal Charges.” (2) Except in cases of temporary suspension and injunction, the Board may not take disciplinary action unless notice of the facts or conduct alleged to warrant the intended action has been sent to the licensee’s address of record and the licensee has an opportunity to show compliance with the law for retention of the license as provided in the APA, Texas Government Code §2001.054(c). Notice of hearing or amended notice of hearing constitutes institution of agency proceedings for purposes of §2001.054(c). (b) In eligibility matters: (1) In actions by the staff as petitioner, the staff’s pleading shall ordinarily be styled “Petition of the Board of Nursing.” (2) In actions by a person as petitioner, e.g., an individual seeking a determination of eligibility for licensure, examination or licensure applicant, or an individual petitioning to return to direct patient care or seeking reinstatement of a surrendered, revoked, or suspended license, the person’s pleading shall be styled “Petition of NAME.” The person shall have the burden of initiating the action, going forward with the administrative proceeding and proving the allegations contained in the pleading. The Board, at its discretion, may initiate proceedings before SOAH without relieving petitioner of the burden of proof as out-lined herein. If the Board has provided the petitioner with written notice of the basis of its refusal or denial of license, permit, application or petition, the Board may file an answer incorporating this notice and may rely on the notice as a responsive pleading. The provisions of this §213.3 adopted to be effective August 15, 2002, 27 TexReg 7107; amended to be effective October 7, 2013, 38 TexReg

§213.4. Representation.

(a) A person may represent himself/herself or be represented by an attorney licensed to practice law in Texas. (b) A party’s attorney of record shall remain the attorney of record in the absence of a formal request to withdraw and an order of the judge approving the request. (c) Notwithstanding the above, a party may expressly waive the right to assistance of counsel. The provisions of this §213.4 adopted to be effective August 15, 2002, 27 TexReg 7107.

§213.5. Appearance.

(a) Any person appearing before the Board in connection with a contested case shall prefile written testimony at least 21 days prior to the appearance. 11