GOVERNOR ABBOTT EXTENDS STATE DISASTER DECLARATION FOR COVID-19

AUSTIN, TX, August 8, 2020 – Governor Greg Abbott today extended his Disaster Declaration for all Texas counties in response to COVID-19. Originally issued on March 13th, the Disaster Declaration provides the state a variety of resources to effectively serve Texans as the Lone Star State continues to mitigate the spread of COVID-19.

"Renewing this Disaster Declaration will provide communities with the resources they need to respond to COVID-19," said Governor Abbott. "I urge Texans to remain vigilant in our fight against this virus. Everyone must do their part to slow the spread of COVID-19 by wearing a mask, practicing social distancing, and washing your hands frequently and thoroughly. We will overcome this challenge by working together." View the Governor's proclamation.

View the Governor's proclamation
  

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GOVERNOR ABBOTT WAIVERS HELPS MAKE TEXAS PAS MORE NIMBLE
Governor Abbott issues a waiver of restrictive supervising requirements during COVID-19 

AUSTIN, TX, April 6, 2020 – Yesterday, Governor Abbott responded to a request submitted by the Texas Academy of Physician Assistants (TAPA) requesting the temporary waiver of specific statutory regulations which prohibit Texas PAs from being nimble and able to serve at the top of their license. Furthermore, TAPA called on the Governor to allow a temporary Physician Assistant (PA) license to be granted to a PA who has graduated from an accredited program and is awaiting the results of their NCCPA certification test.  

The newly issued changes issue a waiver of restrictive supervising requirements during COVID-19 pandemic; furthermore, it addresses the PA student testing issue and the durable medical equipment and home health issue. In an announcement today by the Governor regarding the waiver of restrictive supervising requirements during COVID-19:

  1. PAs will not have to formally designate to the Texas Medical Board whom their Supervising Physician (SP) is/will be; rather, it will be a verbal agreement and can be any physician in good standing. PAs to practice in any areas medicine where they are needed during this crisis. (The Medical Director of a Hospital could be SP for the PAs going into these facilities to help during the crisis); 
  1. There will be no limit as to how many PAs or Nurse Practitioners (NP) a SP can supervise (prior to this order, the total was 7 in Texas)
  2. There will not be a requirement for written delegation of prescriptive authority (standard of care should still be met)
  3. Students that only lack the PANCE as the final step of licensure will be granted temporary licenses

Since Governor Abbott issued the Declaration of Disaster on March 13, 2020, the following changes have been implemented: 

  • PAs in Texas have been able to volunteer without a Supervising Physician.  
  • PAs in Texas can perform all telemedicine including phone only visits 
  • Retired PAs in Texas can have license reinstated immediately.

“TAPA has been busy preparing for the peak of this pandemic to hit Texas. We want to protect the PAs in Texas and allow them to serve in any capacity if needed,” said TAPA President, Eric Martinez, PA-C. “This will be a big step in the right direction for Texas PAs. to care for the citizens (or patients) of Texas.” 

TAPA continues to monitor this situation closely as things evolve and will be in direct contact with the Governor’s office if there continue to be statutes and regulations that do not allow PAs to be at the forefront of this fight. 

TAPA would like to thank the Governor, the Texas Medical Board, the Texas PA Board, as well as all of our allies in the legislature for their unwavering support and acting in the best interest of Texans in their crisis. Together, we all understand that PAs are a part of the solution during these unprecedented times of the COVID-19 crisis. 

The Texas Academy of Physician Assistants is a 501(c)6 not-for-profit organization leading PA organization in Texas that serves the profession through professional development, education, representation, legislative advocacy and a commitment to team-based care for the 10,000 Physician Assistants who serve as a vital resource to the medical community across the state of Texas.

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If you would like more information about this topic, please contact Kent Prickett at 800.280.7655 or email at exec@tapa.org. 

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Hello fellow Texas PAs:

While we are amid the COVID-19 pandemic, TAPA leadership has been working conscientiously with government leaders and health leaders to ensure that the PAs in Texas will be protected and allowed to practice at the top of our licenses.  

The Declaration of Disaster by Governor Abbott on March 13, 2020 allows for 60 days of unrestricted telemedicine visits including telephone only. This declaration may be extended for another 60 days by the Governor depending on the activity of the virus.  See the link from Texas Department of Insurance.

PAs can also volunteer during the COVID-19 Declaration of Disaster without a supervising physician.

TAPA is aware that this pandemic is affecting the PA programs and PA students across the state. We are also aware that PAs in certain specialties are at risk of being furloughed or losing their jobs. Furthermore, we know that PAs on the frontlines in Emergency Medicine, Urgent Care, Family Medicine and many other areas will be pushed to the limit while providing care to patients affected by COVID-19.

TAPA has been communicating with key legislators, the Lieutenant Governor, and the Governor to ensure that there are no barriers to prevent PAs from practicing during the COVID-19 pandemic. We understand that some of the laws and statutes regarding supervision and limitations are a hinderance to our ability to care for our patients currently. (Click here to see our letter to Governor Abbott.)

We want to reassure all PAs in Texas that TAPA is supporting you as we all maneuver through this difficult time. We know that PAs are equipped to be a part of the solution during this pandemic and are and essential part of the healthcare workforce. While you are on the frontlines of this crisis, know that TAPA is working diligently to ensure PAs are protected. 

Visit the TAPA website for the latest updates regarding COVID-19.

 

Sincerely,

 

TAPA BOD

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§291.30. Medication Limitations

Effective: March 20, 2020

  No prescription or medication order for chloroquine, hydroxychloroquine, mefloquine, or azithromycin may be dispensed or distributed unless all the following apply:

(1) the prescription or medication order bears a written diagnosis from the prescriber consistent with the evidence for its use;

(2) the prescription or medication order is limited to no more than a fourteen (14) day supply, unless the patient was previously established on the medication prior to the effective date of this rule; and no refills may be permitted unless a new prescription or medication order is furnished.

Source: Texas State Board of Pharmacy


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TMB Waiver for Chronic Pain Patients Granted by Governor Abbott

Effective: March 19, 2020

Governor Abbott approved TMB’s request to temporarily suspend Title 22, Chapter 174.5 (e) (2)(A) of the Texas Administrative Code. The Texas Medical Board asserts that strict compliance with these laws could prevent, hinder, or delay timely delivery of necessary medical services in relation to efforts to cope with the declared disaster.

This waiver allows telephone refill(s) of a valid prescription for treatment of chronic pain by a physician with an established chronic pain patient. Due to the seriousness of the opioid crisis and the need to ensure there is proper oversight of chronic pain management, this suspension is only in effect until April 10, 2020.

Additionally, this waiver enables health care providers to provide necessary continuity of care for their chronic pain patients, while at the same time better preventing the risk of unnecessary exposure of the physician or their delegates to COVID-19.

The physician(s) remains responsible for meeting the standard of care and all other laws and rules related to the practice of medicine. The standard of care must still be maintained related to the treatment of chronic pain patients.

This waiver follows the Drug Enforcement Agency (DEA) announcement that healthcare professionals can prescribe controlled substances, including opioids, via telemedicine during the current coronavirus public health emergency.

Source:Texas State Board of Pharmacy


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Governor Abbott Waives Certain Regulations For Telemedicine Care In Texas

Effective: March 17, 2020

Governor Greg Abbott waived certain regulations and directed that the Texas Department of Insurance (TDI) issue an emergency rule, all relating to telemedicine care for patients with state-regulated insurance plans to help doctors across Texas continue to treat their patients while mitigating the spread of COVID-19. The suspensions and emergency rule will work together to allow telemedicine visits for patients with state-regulated plans to be paid the same as in-office visits for insurance purposes. These actions build upon waivers the Governor issued previously of portions in the Occupations Code to expand provider flexibility in providing medical services over the phone.

“As the State of Texas responds to COVID-19, we continue to work to maintain regular health care services and operations throughout the state, and telemedicine is one of the most valuable tools we have to ensure Texans continue to receive the health services they need,” said Governor Abbott. “Expanding telemedicine options will help protect the health of patients and health care professionals, and help Texas mitigate the spread of COVID-19.”

Doctors will be eligible for payment from insurance plans regulated by TDI for medical visits they conduct over the phone instead of in-person at the same rate they would receive for in-person visits. 

As a reminder, Texans covered by CHIP or Medicaid will not be charged copays for test or telemedicine consults. Individuals covered by Medicare or large employer plans should check with their health plan administrator to determine their specific benefits. 

Source: Office of the Texas Governor


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§35.1. Telemedicine Medical and Telehealth Services

Effective: March 17, 2020

(a) This section applies as follows:

(1) This section applies to health benefit plans as specified in Insurance Code  §1455.002 and §1455.003.
(2) The requirements of this section apply only to a health care service or procedure delivered on or after the effective date of this section.

(b) Words and terms defined in Insurance Code §1455.001*+ have the same meaning when used in this section. The term "health professional" includes a mental health professional providing services under 22 TAC §174.9. 

(c) A health benefit plan must provide coverage for a covered health care service or procedure delivered by a preferred or contracted health professional to a covered patient as a telemedicine medical service or telehealth service on the same basis and to the same extent that the plan provides coverage for the service or procedure in an in- person setting. 

(d) A health benefit plan must reimburse a preferred or contracted health professional for providing a covered health care service or procedure to a covered patient as a telemedicine medical service or telehealth service on the same basis and at least at the same rate that the plan is responsible for reimbursement to that health professional for the same service or procedure in an in-person setting. 

(e) Notwithstanding subsection (d) of this section, a health benefit plan is not required to pay more than the billed charge on a claim. 

(f) Except as provided by Insurance Code §1455.004(c), to the extent §1455.004(c) is not suspended, a health benefit plan may not limit, deny, or reduce coverage for a covered health care service or procedure delivered as a telemedicine medical service or telehealth service based on the health professional's choice of platform for delivering the service or procedure. 

(g) For purposes of processing payment of a claim, a health benefit plan may not require a health professional to provide documentation of a health care service or procedure delivered as a telemedicine medical service or telehealth service beyond what is required for the same service or procedure in an in-person setting. 

(h) The provisions of this section may not be waived, voided, or nullified by contract. 

Source: Texas Department of Insurance

*+The definitions of Health Provide under Sec 1455.001 are

(A) a physician;

(B) an individual who is:

      (i)licensed or certified in this state to perform health care services; and

      (II) authorized to assist a physician in providing telemedicine medical services that are delegated and supervised by the physician; or

(C) a licensed or certified health professional acting within the scope of the license or certification who does not perform a telemedicine medical service.


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A Message from NCCPA’s President/CEO Regarding the Reopening of Test Centers

Greetings to PANCE and PANRE Candidates:

The NCCPA staff and I know that this is a challenging time for everyone, and we appreciate your patience. 

We are pleased to announce that test delivery is now available for essential medical service providers, such as the PAs, at a subset of Pearson VUE test centers across the United States. Not all test centers will be immediately open due to factors such as local government guidance, business operations, staff availability, and the supply of cleaning and disinfectant materials. Your health and safety are paramount for both NCCPA and Pearson VUE alike and more test centers will be available as soon as feasible based on the factors above.

Pearson VUE’s test centers are following government guidelines for social distancing and limiting the number of individuals, including staff, in the test center at any time. As a result of these measures, appointment availability will be extremely limited. Also, because the situation rapidly changes as this pandemic impacts different areas of our country, the list of open test centers may be revised as additional centers are added or as others close. Please continue to check for appointment availability often as Pearson VUE works to increase availability as quickly as possible.

In addition to social distancing, Pearson VUE has advised that they are cleaning and disinfecting the open test centers, including all objects candidates interact with, such as scanners, keyboards, and locker fobs, with increased frequency and between each test taker. You will be allowed to bring a face mask and/or protective gloves to wear during your exam appointment if you wish to do so. Please note: you will be asked to briefly remove the mask during the check-in process to verify your identity and take your photo. 

If you have applied for PANCE or PANRE and have received your exam acknowledgement notice, please visit Pearson VUE’s web site at PearsonVUE.com to schedule (or reschedule, if your exam date was previously canceled) your exam online. If you need to contact Pearson VUE by phone, please be patient, as they are experiencing longer wait times than usual due to the level of support needed during this time. As always, the NCCPA is standing by to answer any questions you may have, as well.  Please feel free to reach out to us at nccpa@nccpa.net.

Thank you for your patience as NCCPA and Pearson VUE work through these unprecedented times. We want you to know that we are doing all we can to support you in your important role as health care providers — especially during this time of critical need. 

Best regards,

Dawn Morton-Rias, EdD, PA-C

NCCPA President/CEO


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Governor Abbott Waives Certain Pharmacy Regulations To Increase Workforce Capabilities

AUSTIN - Governor Greg Abbott has temporarily waived certain regulatory requirements to increase the job capacities of pharmacy technicians and pharmacy interns. Under the Governor's waiver, pharmacy technicians can now accept prescription drug orders over the phone — a responsibility typically reserved for pharmacists. The Governor's waiver also allows pharmacy technicians to transfer or receive a transfer of original prescription information on behalf of patients. These two waivers can be utilized at the discretion of pharmacists. Additionally, Governor Abbott has waived certain regulations allowing pharmacy interns to assist pharmacists without the designation of preceptor.

"By expanding the duties of pharmacy technicians and the additional availability of interns to all pharmacists, we are ensuring members of the pharmacy workforce can efficiently serve their fellow Texans throughout the COVID-19 response," said Governor Abbott. "These waivers provide flexibility to our pharmacists and those that assist them to ensure they can continue to perform their important duties."


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Huizenga Introduces HEROES Act in Support of First Responders and Medical Professionals Amid Coronavirus Outbreak

Today, Congressman Bill Huizenga (MI-02) introduced the Helping Emergency Responders Overcome Emergency Situations (HEROES) Act of 2020. The HEROES Act will provide a four month federal income tax holiday for medical professionals and first responders, in counties with at least one positive COVID-19 patient, including: law enforcement officers, corrections officers, firefighters, EMT’s, paramedics, pharmacists, nurses, nurse practitioners, physician assistants, doctors, hospital and licensed medical facility support staff, and senior care facility staff during the coronavirus outbreak.

“Medical professionals and first responders across America are serving on the front lines in the fight against the coronavirus.” said Congressman Bill Huizenga. “The HEROES Act provides a way for the federal government to say thank you for the courage, dedication, and care given by these individuals in the face of the unprecedented threat posed by the coronavirus.”

The HEROES Act is modeled after how members of the military serving in combat zones designated by the Department of Defense are exempted from having to pay federal tax on their income. The legislation also provides the Secretary of the Treasury with the ability to extend the tax holiday for up to an additional three months.

The text of the HEROES Act is available to view here .

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Guidance for Licensed Pharmacists, COVID-19 Testing, and Immunity under the PREP Act 

On January 31, 2020, the Secretary of Health and Human Services declared that the 2019 novel coronavirus (COVID-19) is a public-health emergency for the United States. The United States Department of Health and Human Services (HHS) is the lead agency for the federal government’s response to the COVID-19 pandemic. 

A key component of that response is rapidly expanding COVID-19 testing across America. Within HHS, the Office of the Assistant Secretary for Health leads federal efforts to support that expansion. 

Pharmacists, in partnership with other healthcare providers, are well positioned to aid COVID-19 testing expansion. Pharmacists are trusted healthcare professionals with established relationships with their patients. The vast majority of Americans live close to a retail or independent community- based pharmacy. That proximity reduces travel to testing locations, which is an important mitigation measure. Pharmacists also have strong relationships with medical providers and hospitals to appropriately refer patients when necessary. 

Therefore, as an Authority Having Jurisdiction under the Secretary’s March 10, 2020 declaration 

under the Public Readiness and Emergency Preparedness Act (PREP Act), OASH issues this 

guidance authorizing licensed pharmacists to order and administer COVID-19 tests, including 

serology tests, that the Food and Drug Administration (FDA) has authorized. See 85 Fed. Reg. 

15,198, 15,202 (March 17, 2020); see also Pub. L. No. 109-148, Public Health Service Act § 319F-3,

42U.S.C.§247d-6dand42U.S.C.§247d-6e. By doing so, such pharmacists will qualify as “covered persons” under the PREP Act. And they may receive immunity under the PREP Act with respect to all claims for loss caused by, arising out of, relating to, or resulting from, the administration or use of FDA-authorized COVID-19 tests. 42 U.S.C. § 247d-6d(a)(1). 


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Governor Abbott Issues Executive Order Establishing Strike Force To Open Texas

 Directs Select Services To Reopen, Closes Schools For Remainder Of Academic Year

 

AUSTIN, April 17, 2020  - Governor Greg Abbott today held a press conference where he issued three new Executive Orders to begin the process of reopening the state of Texas while revising hospital capacity and certain social distancing guidelines. Within the orders, select activities and services that pose minimal to no threat of spreading COVID-19 are allowed to reopen using a "Retail-To-Go" model, certain restrictions on surgeries have been loosened, and schools will remain closed for the remainder of the 2019-2020 academic year. 

Within these orders, the Governor has established the Strike Force to Open Texas—a team of nationally recognized medical experts and private and public leaders who will advise the Governor on safely and strategically reopening the state of Texas.

"Texans are battling a colossal challenge—an invisible enemy that has tested our lives and our livelihoods—but overcoming challenges is part of who we are as Texans," said Governor Abbott. "We have shown that Texas can continue our efforts to contain COVID-19 while also adopting safe standards that will allow us to begin the process of reopening Texas. The Strike Force to Open Texas brings together nationally recognized medical experts with public and private sector leaders to achieve this mission. By coming together, we can get Texans back to work, practice safe standards that will prevent the spread of COVID-19, and we can overcome this pandemic."

James Huffines will lead the advisory strike force and Mike Toomey will serve as Chief Operating Officer. Lieutenant Governor Dan Patrick, House Speaker Dennis Bonnen, Attorney General Ken Paxton, and Comptroller Glenn Hegar will serve as consulting members.

In addition, Governor Abbott has appointed Texas Department of State Health Services (DSHS) Commissioner John Hellerstedt, MD, as Chief Medical Officer of the strike force. Dr. Hellerstedt will be supported by three Chief Medical Advisors: 

  • John Zerwas, MD, Executive Vice-Chancellor for Health Affairs at the University of Texas System
  • Mark McClellan, MD, PhD, Former Food and Drug Administration Commissioner and U.S. Medicaid and Medicare Administrator
  • Parker Hudson, MD, MPH, Assistant Professor of Internal Medicine and Infectious Diseases at Dell Medical School and program director for the Internal Medicine Residency

These health experts will develop a medical architecture to comprehensively test and trace COVID-19 that will enable Texans to gradually and safely begin the process of returning to work and other activities.

The medical team will work alongside a Special Advisory Council who will share innovative ideas to help businesses strategically reopen while containing the spread of COVID-19. The council consists of 39 business leaders representing the state's regions and industries. The advisory council will collaborate with working groups to devise strategies, statewide standards, and appropriate time frames to reopen the Lone Star State while prioritizing the health and safety of all Texans.

The strike force will immediately begin providing input on potential additional openings of activities and services in Texas consistent with guidelines provided by the Centers for Disease Control and Prevention (CDC). The Governor will announce a revised plan for the state based on these initial recommendations on April 27.  

Special Advisory Council members include:

  • Arcilia Acosta: President and CEO, CARCON Industries & Construction
  • Paul Andrews, Jr.: Founder and CEO, TTI Inc.
  • Mark Bivins: Rancher, partner in Corsino Cattle Company
  • Kathy Britton: CEO and Owner, Perry Homes
  • Brad Brookshire: Chairman and CEO, Brookshire Grocery Co.
  • J. Bruce Bugg, Jr.: Chairman, Texas Transportation Commission 
  • Alonzo Cantu: President & CEO of Cantu Construction
  • Bobby Cox: Owner and operator, Bobby Cox Companies, Inc.
  • Adriana Cruz: Executive Director, Economic Development & Tourism Division, Office of the Governor
  • Michael Dell: Chairman and CEO, Dell Technologies
  • Scott Dueser: Chairman, President & CEO, First Financial Bank
  • Don Evans: Chairman of the President George W. Bush Foundation, Chairman of Permian Strategic Partnership
  • Tilman Fertitta: Chairman, CEO, and sole owner, Landry's, Inc.
  • Richard Fisher: Senior Advisor, Barclays and Former President & CEO, the Federal Reserve Bank of Dallas
  • Rick Francis: Chairman of the Board, WestStar Bank Holding Company, Inc.
  • Printice Gary: Founding Partner/Principal and CEO, Carleton Companies
  • Brad Heffington: Owner of Heffington Farms, Inc. and Triple T Irrigation, Inc.
  • Jeffery D. Hildebrand: Executive Chairman and Founder, Hilcorp Energy Company
  • Nancy Kinder: President & CEO, Kinder Foundation
  • Tom Luce: Founder and Chairman, Texas 2036
  • Marc McDougal: CEO, McDougal Companies
  • Jim "Mattress Mack" McIngvale: Owner, Gallery Furniture
  • Drayton McLane: Chairman, McLane Group
  • Elaine Mendoza: Founder, President & CEO of Conceptual MindWorks, Inc
  • Balous Miller: Owner, Bill Miller Bar-B-Q Restaurants
  • Carla Moran: Ramar Communications
  • Dennis Nixon: CEO and Chairman of International Bank of Commerce
  • David Oliveira: Partner at Roerig, Oliveira & Fisher, L.L.P.
  • Ross Perot, Jr.: Chairman, The Perot Group
  • Kevin D. Roberts, Ph.D.: Executive Director, Texas Public Policy Foundation
  • Robert B. Rowling: Owner and Chairman, TRT Holdings, Inc.
  • Kendra Scott: Founder and CEO, Kendra Scott
  • Robert F. Smith: Founder, Chairman & CEO, Vista Equity Partners
  • Sam L. Susser: Chairman of BancAffiliated, Inc.
  • Massey Villarreal: CEO and President, Precision Task Group, Inc.
  • Kirk Watson: Founding Dean of the University of Houston Hobby School of Public Affairs
  • Marc Watts: President, The Friedkin Group
  • Graham Weston: Former Chairman of Rackspace Hosting Inc.
  • Sanjiv Yajnik: President of the Financial Services Division, Capital One

For more information about the Governor's Strike Force to Open Texas, visit the strike force webpage. 

The Governor’s second Executive Order (GA-16) relates to the safe, strategic reopening of select services and activities in Texas. This order establishes a temporary "Retail-To-Go" model that will allow retail outlets in Texas to reopen beginning Friday, April 24. Under this model, reopened establishments are required to deliver items to customer's cars, homes, or other locations to minimize contact.

Under this Executive Order, schools—including public, private, and higher education institutions—will remain closed for the 2019-2020 school year. Teachers may go into the classroom for video instruction, to perform administrative duties, and to clean out their classrooms.

The Governor’s third Executive Order (GA-15) relates to hospital capacity and personal protective equipment (PPE) needed for the COVID-19 response. The order loosens restrictions on surgeries put in place by Governor Abbott in March. Beginning at 11:59pm on April 21 through 11:59pm on May 8, all licensed health care professionals and all licensed health care facilities must continue to postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death as determined by a patient's physician. Exceptions now include:

  • Any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the PPE needed to cope with COVID-19, or
  • Any surgery or procedure performed in a licensed health care facility that has certified in writing to Texas HHSC both (1) that it will reserve at least 25% of its hospital capacity for treatment of COVID-19 patients, accounting for the range of clinical severity of COVID-19 patients, and (2) that it will not request any PPE from any public source—whether federal, state, or local—for the duration of the COVID-19 disaster. 

The Governor today also directed state parks to reopen on Monday, April 20 with strict guidelines to reduce transmission of COVID-19—including requiring visitors to wear face coverings, maintain a six-foot distance from individuals outside of their party, and prohibiting the gathering of groups larger than five.

TMB Adopts Emergency Rule to Enforce Gov. Abbott's Executive Order GA-15

Following Governor Greg Abbott's issuance of Executive Order GA-15, the Texas Medical Board's Executive Committee today adopted rules on an emergency basis to enforce the Governor's Executive Order which continues the postponement of certain surgeries and procedures as outlined in the order.
The adopted rule amends 22 TAC Chapter 190.8 Violation Guidelines, and adds to the definition of "Unprofessional and Dishonorable Conduct" under 22 TAC §190.8(2)(U). The adopted emergency rule goes into effect later today at 11:59 p.m. when GA-15 goes into effect.
 
The rule adds to the definition to include the following:
 
(U) a violation of Texas Executive Order GA-15, issued April 17, 2020, which states: "All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient's physician; provided, however, that this prohibition shall not apply to either of the following:
 
(i) any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID-19 disaster; or
 
(ii) any surgery or procedure performed in a licensed health care facility that has certified in writing to the Texas Health and Human Services Commission both: 
 
(1) that it will reserve at least 25% of its hospital capacity for treatment of COVID-19 patients, accounting for the range of clinical severity of COVID-l9 patients; and 
 
(2) that it will not request any personal protective equipment from any public source, whether federal, state, or local, for the duration of the COVID-19 disaster."
 
The Executive Committee also withdrew emergency rules related to Executive Order GA-09 effective today at 11:59 p.m.
 
The Board has published updated FAQs on the TMB website atwww.tmb.state.tx.us/page/coronavirus.
 
For the latest COVID-19 information for health providers and the public, visit the Department of State Health Services (DSHS) COVID-19 web page atdshs.texas.gov/coronavirus/.


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Governor Abbott, TDEM Announce Extension Of Federally-Supported Community-Based Testing Sites In Texas

AUSTIN - Governor Greg Abbott and the Texas Division of Emergency Management (TDEM) today announced that the federal government has extended seven community-based testing sites in Texas through June 30, 2020. These federally-supported, state-managed, and locally-executed sites include El Paso (1), Dallas (2), Houston (2), and Harris County (2).

"Our federal partners play a crucial role in rapidly expanding COVID-19 testing in Texas," said Governor Abbott. "I thank our federal partners for extending the operations of these community-based testing sites and remain committed to our ongoing collaboration as we mitigate the spread of COVID-19 in our communities."

Waiver for Chronic Pain Patients Extended by Governor Abbott


Governor Greg Abbott today approved the Texas Medical Board's request to extend the previously issued waiver which temporarily suspends Title 22, Chapter 174.5 (e) (2)(A) of the Texas Administrative Code , as the measure is still necessary to protect public health by providing patients access to ensure on-going treatment of chronic pain and curbing the spread of COVID-19. The suspension is in effect until June 6, 2020.

The extended waiver continues to allow for telephone refill(s) of a valid prescription for treatment of chronic pain by a physician with an established chronic pain patient. The physician(s) remains responsible for meeting the standard of care and all other laws and rules related to the practice of medicine. The standard of care must still be maintained related to the treatment of chronic pain patients.

For further guidance, please review the TMB's telemedicine FAQs on its COVID-19 website , as well as the Drug Enforcement Administration's COVID-19 website for federal requirements.

TMB will continue to provide any updates on COVID-19 issues on the TMB website at www.tmb.state.tx.us/page/coronavirus.

For the latest COVID-19 information for health providers and the public, visit the Department of State Health Services (DSHS) COVID-19 web page at dshs.texas.gov/coronavirus/.

TMB Adopts Emergency Rule Related to Gov. Abbott's Executive Order GA-19

Following Governor Greg Abbott's issuance of Executive Order GA-19, the Texas Medical Board's Executive Committee today adopted rules on an emergency basis.

The adopted rule amends 22 TAC Chapter 190.8 Violation Guidelines, and adds to the definition of "Unprofessional and Dishonorable Conduct" under 22 TAC §190.8(2)(U).

The adopted emergency rule goes into effect May 1, 2020 at 12:00 a.m.

The rule adds the following required minimum standards for safe practice related to COVID-19, and certain posting notice of those minimum standards:

(U) Notice and Compliance Requirements Concerning COVID-19 Minimum Standards of Safe Practice
(i) All physicians providing patient care or engaging in an in-person patient encounter, must implement the following minimum COVID-19 standards of safe practice.
(I) a mask must be worn by both the patient and physician or the physician's delegate when in proximity of the patient (meaning less than a 6-foot distance between the patient and the physician or the physician's delegate);
(II) follow policies the physician, medical and healthcare practice, or facility has in place regarding COVID-19 screening and testing and/or screening patients;
(III) that, before any encounter, patients must be screened for potential symptoms of COVID-19 or verified previously screened within last 20 days; and
(IV) that prior to care involving a medical procedure or surgery on the mucous membranes, including the respiratory tract, with a high risk of aerosol transmission, the minimum safety equipment used by a physician or physician's delegate should include N95 masks, or an equivalent protection from aerosolized particles, and face shields.
(ii) All physicians providing patient care or engaging in an in-person patient encounter in medical and healthcare practices, offices, and facilities, other than hospitals as defined under Chapter 241 of the Texas Health & Safety Code, shall post a COVID-19 Minimum Standards of Safe Practice Notice (COVID-19 Notice), delineating the minimum standards of safe practice described in this subsection, in each public area and treatment room or area of the office, practice, or facility.

The Executive Committee also withdrew emergency rules related to Executive Order GA-15 effective May 1, 2020 at 12:00 a.m.

The Board will publish guidance related to Executive Order GA-19 on the TMB website at www.tmb.state.tx.us/page/coronavirus.

For the latest COVID-19 information for health providers and the public, visit the Department of State Health Services (DSHS) COVID-19 web page atdshs.texas.gov/coronavirus/.