(a) Course approval.      
        (1) To obtain initial approval as a basic midwifery education course, the course administrator must submit to the department a completed application, the fee required under §115.80, and the following supporting documentation:                  (A) course outline;                   (B) course curriculum with specific content references to:                      (i) MANA Core Competencies;                       (ii) NARM Written Test Specifications;                       (iii) NARM Skills Assessment Test Specifications;                       (iv) Texas Midwifery Basic Information and Instructor Manual; and                       (v) protocol writing, adaptation, and revision;                     (C) identification of didactic and preceptorship teaching sites;                   (D) a financial statement or balance sheet (within the last year) for the course administrator or course owner demonstrating the ability to provide refunds to any students who enroll; and                   (E) written policies to include:                      (i) entrance requirements;                       (ii) a tuition schedule and a list of all additional fees or charges;                       (iii) cancellation and refund policy, including the right of any prospective student to cancel an enrollment agreement within 72 hours after signing the agreement and receive a full refund of any money paid;                       (iv) student attendance, progress, and grievance policies;                       (v) rules of operation and conduct of course personnel;                       (vi) information on the requirements for state licensure, including the notice required by Occupations Code §53.152;                       (vii) disclosure of the approval status of the course; and                       (viii) maintenance of student files.           
        (2) Student files must be maintained for a minimum of three years after the student is no longer enrolled in the course and must include:                  (A) evidence that the entrance requirements have been met, including CPR certification;                   (B) documentation of progression and completion of didactic and clinical course work; and                   (C) copies of any financial agreements between the student and the course.         
        (3) If an application for initial approval meets all the requirements, a one-year provisional approval will be granted. The course administrator must then schedule with the department an on-site evaluation of the course to occur within the provisional year. The evaluation must be conducted by department staff and a licensed midwife within the provisional year. If the department is unable to conduct an on-site evaluation within the provisional year, the provisional approval will be extended until the department conducts an on-site evaluation and issues its approval or denial of the course. The on-site evaluation will include the following:                  (A) an inspection of the course's facilities;                   (B) a review of its teaching plan, protocols, and teaching materials;                   (C) a review of didactic and preceptorship instruction;                   (D) interviews with staff and students; and                   (E) a review of student, staff and preceptor files, to include coursework, protocols, and financial records.         
        (4) The fee required under §115.80 will be assessed for each on-site evaluation.       
        (5) The on-site evaluation written report will recommend to the department approval or denial of the course.       
        (6) The department will evaluate the application and all other pertinent information, including any complaints received and the on-site evaluation report.       
      (b) Course reciprocity. A course located in Texas which is currently accredited or pre-accredited by MEAC will be deemed approved as a basic midwifery education course, without an on-site evaluation, under this subsection upon submission to the department of evidence of such accreditation and the fee required under §115.80. An approval under this subsection is effective only for the period of time during which the course is accredited or pre-accredited by MEAC. A course approved under this subsection that later has its MEAC accreditation or pre-accreditation suspended or revoked must apply for department approval under subsection (a) within 10 days after the suspension or revocation.     
      (c) Duration of course approval.      
        (1) The department will approve basic midwifery education courses for a three year period. A course with reciprocity under subsection (b) will continue its reciprocity for as long as the course maintains MEAC accreditation or pre-accreditation.       
        (2) To obtain a new approval period for a current basic midwifery education course, the course administrator must, within six months before the expiration date of the current course approval:                  (A) submit to the department a completed application;                   (B) schedule with the department, and successfully pass, an on-site evaluation to occur before the expiration date of the current course approval; and                   (C) submit to the department the fee required under §115.80 for the on-site evaluation.         
      (d) Course changes. A substantive change to a basic midwifery course or its content must be approved by the department before the change is implemented.     
      (e) Transfer hours. A basic midwifery education course may accept:      
        (1) didactic and clinical transfer hours from another basic midwifery education course; and       
        (2) clinical hours earned under a NARM-certified preceptor.       
     Source Note:        The provisions of this §115.21 adopted to be effective October 1, 2016, 41 TexReg 4477; amended to be effective September 1, 2023, 48 TexReg 4660