(a) Referrals.

(1) The program shall accept a self-referral from a licensure applicant or licensee, or a referral from an individual, a physician health and rehabilitation committee, a physician assistant organization, a state physician health program, a state acupuncture program, a hospital or hospital system licensed in this state, a residency program, or the Agency.

(2) The Agency may publicly or privately refer an applicant or licensee to the Program.

(b) Eligible Program Participants. An individual who has or may have mental or physical impairment or substance use disorder is eligible to participate in the Program.

(c) Drug Testing.

(1) The Program's drug testing shall be provided under contract for services with the vendor approved by the Texas Medical Board.

(2) The Program shall adopt policies and protocols for drug-testing that are consistent with those of the Agency.

(3) The Agency may monitor the test results for all program participants, provided that the identities of the program participants are not disclosed to the agency.

(d) Reports to the Agency.

(1) If an individual who has been referred by the Agency and does not enter into an agreement for services or a program participant is found to have committed a substantive violation of an Agreement, the Governing Board shall report that individual to the Agency for possible disciplinary action.

(2) A positive drug screen that is not attributed to a therapeutic prescription by a treating physician, shall be determined to be substantive violation of an Agreement by the program participant.

(3) A committee of the Board shall review the report and may accept the individual or program participant for possible disciplinary action. The Agency has the option of referring the individual back to the Program.

(e) Fees.

(1) Program participants shall pay an annual fee of $1,200.00 for physicians and PAs and $1,000.00 for all other licensees. Half of the annual fee shall be due upon scheduling of the intake interview. This fee is in addition to costs owed by program participants for completion of monitoring associated with a program participant's Agreement.

(2) The Program may waive all or part of the annual fee for a program participant upon a showing of good cause. Good cause may include documented financial hardship. All fee waivers shall be reported on at the next scheduled meeting of the Governing Board.

(f) Process.

(1) Interview by Medical Director. (A) Upon receipt of a referral as described in subsection (a) of this section, the applicant or licensee shall meet with the TXPHP Medical Director or a member of the Advisory Committee designated by the Medical Director or Governing Board President for an interview to determine eligibility for the Program. (B) An interview may be waived if the Medical Director determines that good cause exists. (C) The performance of an intake interview may be delegated to another qualified medical professional as necessary.

(2) Review by Case Advisory Panel. (A) A case advisory panel shall include three members. These members shall be the President of the Governing Board, the Secretary of the Governing Board, another member of the Governing Board who shall serve for a four-month term on a rotating basis with the other members, and one member of the Advisory Board who shall serve for a three-month term on a rotating basis. In the event that the President and/or the Secretary is unavailable or must recuse themselves, additional members of the Governing Board may serve on the panel. (B) After an interview has occurred, a case advisory panel may be convened at the discretion of the Medical Director for the purpose of seeking advice and direction. (C) All cases reviewed by a case advisory panel shall be reported on at the next scheduled meeting of the Governing Board.

(3) After the requirements in paragraph (1) of this subsection have been completed, the applicant or licensee shall be offered an agreement, determined ineligible for the program, or discharged from TXPHP.

(4) Agreements are effective upon signature by the program participant.

(5) All agreements are subject to review by the Governing Board.

(g) Evaluations. The TXPHP may request that an applicant or licensee undergo a clinically appropriate evaluation after the person has been interviewed. The evaluation shall be considered a term of an agreement and the person will be considered a program participant at that time. If an individual refuses to undergo an evaluation, he or she may be referred to the Agency on an emergent basis or as described in subsection (d) of this section.

(h) Agreements. Agreements between program participants and the TXPHP may include, but are not limited to, the following terms and conditions:

(1) abstinence from prohibited substances and drug testing;

(2) agreement not to treat one's own family and friends or receive treatment from family or friends;

(3) agreement not to manage one's own medical care;

(4) participation in mutual help groups such as Alcoholics Anonymous;

(5) participation in support groups for recovering professionals;

(6) worksite monitor;

(7) worksite restrictions; and

(8) treatment by an appropriate health care provider.

Source Note: The provisions of this §180.4 adopted to be effective March 14, 2010, 35 TexReg 2004; amended to be effective September 19, 2010, 35 TexReg 8354; amended to be effective December 18, 2011, 36 TexReg 8378; amended to be effective December 23, 2012, 37 TexReg 9774; amended to be effective July 9, 2015, 40 TexReg 4353; amended to be effective July 5, 2020, 45 TexReg 4338; amended to be effective December 31, 2020, 45 TexReg 9522