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					             Texas State Perfusionist Licensing Program
     Title 25 (Health Services), Texas Administrative Code, Chapter 140

 Adopted effective April 18, 1995, 20TexReg 2527; amended to be effective June10, 2001, 26 TexReg 3932;
transfered effective September 1; 2005 as published in the Texas Register August 26, 2005, 30 TexReg 5007;
                          amended to be effective June 29, 2006, 31 TexReg 5126

                               Texas State Perfusionist Licensing Program
                                  Department of State Health Services
                                         1100 West 49th Street
                                        Austin, Texas 7856-3183
                                        512/834-6751 PHONE
                                           512/834-6677 FAX
                                         Table of Contents
Section   Title                                                    Page

140.1     Definitions                                              1

140.2     Fees                                                     2

140.3     Professional and Ethical Conduct                         2

140.4     Educational Requirements for Licensure                   4

140.5     Examination for Perfusionist Licensure                   4

140.6     Jurisprudence Examination                                5

140.7     Application Procedures                                   5

140.8     Determination of Eligibility                             6

140.9     Provisional Licensed Perfusionist                        7

140.10    Licensing After Examination                              8

140.11    Changes of Name or Address                               8

140.12    License Renewal                                          9

140.13    Minimum Continuing Education                             10

140.14    Licensing of Persons with Criminal Backgrounds to be a   11
          Perfusionist and Provisional Licensed Perfusionist

140.15    Violations, Complaints, and Subsequent Board Actions     12

140.16    Formal Hearings                                          13

140.17    Informal Disposition                                     14

140.18    Default Orders                                           15

140.19    Suspension of License for Failure to Pay Child Support   15

140.20    Relevant Factors                                         16

140.21    Severity Levels and Sanction Guide                       16

140.22    Texas State Perfusionist Advisory Committee              17
§140.1 Definitions                                                                     (15) Licensed perfusionist--A person
                                                                   licensed under the Act who practices perfusion.
The following words and terms, when used in this chapter,                              (16) Licensed physician--A physician
shall have the following meanings, unless the context              licensed under Texas Occupations Code, Chapter 155, by
clearly indicates otherwise:                                       the Texas State Board of Medical Examiners.
                    (1) Act--The Licensed Perfusionists Act,                           (17) Licensee--A person who holds a
Texas Occupations Code, Chapter 603.                               current license as a perfusionist or provisional licensed
                    (2) Administrative Law Judge--A judge          perfusionist issued by the department.
employed by the State Office of Administrative Hearings.                               (18) Perfusion--The function necessary
                    (3) APA--The Administrative Procedure          for the support, treatment, measurement, or
Act, Government Code.                                              supplementation of the cardiovascular, circulatory, or
                    (4) Committee--The Texas State                 respiratory system, or a combination of those activities,
Perfusionist Advisory Committee.                                   and to ensure the safe management of physiologic
                    (5) Cardiopulmonary Surgery--Surgery           functions by monitoring the parameters of the system
pertaining to the heart, great vessels, or lungs.                  under an order and under the supervision of a licensed
                    (6) Commissioner--The Commissioner             physician, including:
of the Department of State Health Services.                                                     (A) the use of extracorporeal
                    (7) Contested Case--A proceeding in            circulation, cardiopulmonary support techniques, and
accordance with APA and this chapter, including, but not           other therapeutic and diagnostic technologies;
restricted to, rule enforcement and licensing, in which the                                     (B) counterpulsation,
legal rights, duties, or privileges of a party are to be           ventricular assistance, or autotransfusion (including blood
determined by the Commissioner after an opportunity for            conservation techniques), administration of cardioplegia,
an adjudicative hearing.                                           and isolated limb perfusion;
                    (8) Delegated authority--As defined in                                      (C) the use of techniques
the Texas Medical Practice Act, Texas Occupations Code,            involving blood management, advanced life support, and
Chapter 157(d)(1), and the rules pertaining thereto                other related functions; and
adopted by the Texas State Board of Medical Examiners.                                          (D) in the performance of the
                    (9) Department--The Department of              acts described in this subsection:
State Health Services.                                                                                    (i) the administration
                    (10) Executive Commissioner--The               of:
Executive Commissioner of the Health and Human                                                                       (I)
Services Commission.                                               pharmacological and therapeutic agents; or
                    (11) Extracorporeal circulation--The                                                             (II) blood
diversion of a patient's blood through a heart-lung                products or anesthetic agents through the extracorporeal
machine or a similar device that assumes the functions of          circuit or through an intravenous line as ordered by a
the patient's heart, lungs, or both.                               physician;
                    (12) Formal hearing--A formal hearing or                                              (ii) the performance
proceeding in accordance with this chapter and includes a          and use of:
contested case.                                                                                                      (I)
                    (13) Formally trained--Completion of an        anticoagulation analysis;
organized educational activity which:                                                                                (II)
                               (A) includes supervised and         physiologic analysis;
directed instruction specific to the perfusion procedures to                                                         (III) blood
be performed by the individual;                                    gas and chemistry analysis;
                               (B) includes specific objectives,                                                     (IV)
activities and an evaluation of competency; and                    hematocrit analysis;
                               (C) is specifically supervised                                                        (V)
and directed by another individual qualified to provide the        hypothermia;
training and supervision.                                                                                            (VI)
                    14) Health care professional--A licensed       hyperthermia;
perfusionist, provisional licensed perfusionist, or any                                                              (VII)
person licensed, certified, or registered by the state in a        hemoconcentration; and
health-related profession.

25 Texas Administrative Code, Chapter 104                                                             Page 1
Perfusionist Licensing Program
                                                  (VIII)                                  (11) retired perfusionist license renewal
hemodilution; and                                                   issued for a two-year term (in accordance with §140.12(f)
                                         (iii) the observation of   of this title relating to License Renewal)--$175.
signs and symptoms related to perfusion services, the                           (b) An applicant whose check for the application
determination of whether the signs and symptoms exhibit             fee is not honored by the financial institution may reinstate
abnormal characteristics, and the implementation of                 the application by remitting to the department a money
appropriate reporting, perfusion protocols, or changes in           order or check for guaranteed funds within 30 days of the
or the initiation of emergency procedures.                          date of receipt of the department's notice. An application
                     (19) Perfusionist--An individual who           will be considered incomplete until the fee has been
practices perfusion.                                                received and cleared through the appropriate financial
                     (20) Perfusion protocols--Perfusion-           institution.
related policies and protocols developed or approved by a                       (c) A licensee whose check for the renewal fee is
licensed health facility or a physician through collaboration       not honored by the financial institution may remit to the
with administrators, licensed perfusionists, and other              department a money order or check for guaranteed funds
health professionals.                                               within 30 days of the date of receipt of the department's
                     (21) Pleading--Any written allegation          notice. Otherwise, the license shall not be renewed. If a
filed by a party concerning its claim or position.                  renewal card has already been issued, it shall be subject
                     (22) Presiding Officer--Presides over the      to revocation.
Committee and serves at the pleasure of the                                     (d) Fees paid to the department by applicants are
Commissioner.                                                       not refundable.
                     (23) Provisional licensed perfusionist--A                  (e) Any remittance submitted to the department
person provisionally licensed under the Act.                        in payment of a required fee must be in the form of a
                                                                    personal check, certified check, or money order.
§140.2 Fees                                                                     f) The department shall make periodic reviews of
                                                                    its fee schedule and make any adjustments necessary to
          (a) The schedule of fees for licensure as a               provide funds to meet its expenses without creating an
perfusionist or a provisional licensed perfusionist is as           unnecessary surplus. Such adjustments shall be through
follows:                                                            rule amendments.
                    (1) application and initial license fees--                  (g) For all applications and renewal applications,
$175;                                                               the department is authorized to collect subscription and
                    (2) license fee for upgrade of provisional      convenience fees, in amounts determined by the Texas
licensed perfusionist--$75;                                         Online Authority, to recover costs associated with
                    (3) a license renewal issued for a one-         application and renewal application processing through
year term--$175;                                                    Texas Online.
                    (4) a license renewal issued for a two-         h) For all applications and renewal applications, the
year term--$350;                                                    department is authorized to collect fees to fund the Office
                    (5) late renewal fee (prior to September        of Patient Protection, Health Professions Council, as
1, 2007)--$100;                                                     mandated by law.
                    (6) late renewal fee (on or after
September 1, 2007):                                                 §140.3 Professional and Ethical Conduct
                              (A) less than 90 days late--a
fee that is equal to 1/4 times the amount of the renewal                      (a) Code of ethics. These rules shall constitute a
fee due; or                                                         code of ethics as authorized by the Act, §603.151(6).
                              (B) more than 90 days and less                           (1) Professional representation and
than one year late--a fee that is equal to 1/2 times the            responsibilities.
amount of the renewal fee due;                                                                  (A) A licensee shall not
                    (7) license certificate and identification      misrepresent his or her professional qualifications or
card replacement fee--$10;                                          credentials.
                    (8) child support reinstatement fee--$40;                                   (B) A licensee shall not make
                    (9) student loan default reinstatement          any false or misleading claims pertaining to the indications
fee--$40;                                                           and efficacy of the practice of perfusion.
                    (10) verification fee--$10 per licensee;                                    (C) A licensee shall not permit
and                                                                 the use of his or her name for the purpose of certifying

25 Texas Administrative Code, Chapter 104                                                               Page 2
Perfusionist Licensing Program
that perfusion services have been rendered unless that            §140.9 of this title (relating to Provisional Licensed
licensee has provided those services.                             Perfusionists).
                              (D) A licensee shall not                                (2) Professional relationships.
promote or endorse products in a manner that is false or                                         (A) A licensee shall make
misleading.                                                       known to a prospective reimbursing entity the important
                              (E) A licensee shall disclose to    aspects of the professional relationship including fees and
the reimbursing entity any personal gain or profit from any       arrangements for payment which might affect the
supply, procedure or service.                                     reimbursing entity's decision to enter into the relationship.
                              (F) A licensee shall have the                                      (B) A licensee shall bill a
responsibility of reporting alleged misrepresentations or         reimbursing entity in the manner agreed to by the licensee
violations of department rules to the executive secretary.        and entity in accordance with 42 United States Code
                              (G) A licensee shall comply         §1395nn, relating to the anti-kickback statute and the
with any order relating to the licensee which is issued by        Health and Safety Code, §161.091, relating to illegal
the department.                                                   renumeration.
                              (H) A licensee shall not aid or                                    (C) A licensee shall not receive
abet the practice or misrepresentation of an unlicensed           or give a commission or rebate or any other form of
person when that person is required to have a license             renumeration for the referral of professional services.
under the Act.                                                                                   (D) A licensee shall disclose to
                              (I) A licensee shall not make       the reimbursing entity any interest in commercial
any false, misleading, or deceptive claims in any                 enterprises relating to the practice of perfusion which the
advertisement, announcement, or presentation relating to          licensee promotes for the purpose of personal gain or
the services of the licensee.                                     profit.
                              J) A licensee shall not interfere                                  (E) A licensee shall practice
with an investigation or disciplinary proceeding by willful       perfusion without discrimination based on race, creed,
misrepresentation of facts to the department or its               gender, religion, national origin, age, sexual orientation, or
authorized representative or by the use of threats or             genetic information.
harassment against any person associated with                                                    (F) A licensee shall not violate
investigation or disciplinary proceedings.                        any provision of any federal or state statute relating to
                              (K) The licensee who willfully      confidentiality of patient communications and records.
misstates fact during the application, examination, or                                           (G) A licensee shall not engage
recertification processes is guilty of unethical conduct.         in sexual contact with a patient. The term "sexual contact"
Likewise the willful misstatement of fact regarding the title     means any type of sexual behavior described in the Texas
or membership in a professional community is considered           Penal Code, Chapters 21, 22 or 43 and includes sexual
unethical conduct.                                                intercourse.
                              (L) The licensee who                                    (3) Billing information required;
consciously fails to promote both the safety and protection       prohibited practices.
of the public is guilty of unethical conduct.                                                    (A) On the written request of a
                              (M) The licensee who willfully      patient, a patient's guardian, a patient's parent if the
disregards the patient for monetary gain is guilty of             patient is a minor, or the billing entity, a licensee shall
unethical conduct. Examples of such conduct are                   provide, in plain language, a written explanation of the
unjustified reimbursement for services performed or               charges for acts of perfusion previously made on a bill or
prejudicial compensation.                                         statement for the patient. This requirement applies even if
                              (N) The licensee who shows          the charges are to be paid by a third party.
willful disregard for sound patient care by acts of omission                                     (B) A licensee may not
is guilty of unethical conduct.                                   overcharge or overtreat a patient.
                              (O) A licensee shall subscribe                          (4) Sanctions. A licensee shall be
to all other applicable ethical standards of the medical          subject to disciplinary action by the department if under
community.                                                        the Crime Victims Compensation Act, Texas Code of
                              (P) The licensee accepts the        Criminal Procedure, Article 56.31, the licensee is issued a
responsibility for subscribing to the preceding Code of           public letter of reprimand, is assessed a civil penalty by a
Ethics and for reporting unethical professional conduct.          court, or has an administrative penalty imposed by the
                              (Q) A licensee shall supervise      attorney general's office.
a provisional licensed perfusionist in accordance with

25 Texas Administrative Code, Chapter 104                                                            Page 3
Perfusionist Licensing Program
          (b) Disclosure. A licensee shall make a                program that has educational standards that are as
reasonable attempt to notify each patient of the name,           stringent as those established by the Accreditation
mailing address, and telephone number of the department          Committee for Perfusion Education (AC-PE) and approved
for the purpose of directing complaints to the department        by the Commission on Accreditation of Allied Health
by providing notification:                                       Education Programs (CAAHEP) or their successors.
                    (1) on each written contract for services                        (2) Degrees and course work received
of a licensee; or                                                in foreign countries shall be acceptable only if the degree
                    (2) on a sign prominently displayed in       or coursework has educational standards that are as
the primary place of business of each licensee; or               stringent as those established by the AC-PE and
                    (3) in a bill for service provided by a      approved by CAAHEP or their successors.
licensee to a patient or reimbursing entity.                                         (3) A foreign training program shall be
          (c) Unlawful false, misleading, or deceptive           acceptable only if it has educational standards as stringent
advertising. A licensee shall not use advertising that is        as those established by the AC-PE and approved by the
false, misleading, or deceptive or that is not readily subject   CAAHEP or their successors.
to verification. False, misleading, or deceptive advertising                         (4) In the event that an educational
or advertising that is not really subject to verification        deficiency is present, an applicant will have one year in
includes advertising that:                                       which to complete the additional course work acceptable
                    (1) makes a material misrepresentation       to the department before the application will be voided and
of fact or omits a fact necessary to make the statement as       the applicant will be required to reapply and to pay an
a whole not materially misleading;                               additional application fee.
                    (2) makes a representation likely to
create an unjustified expectation about the results of a         §140.5 Examination Procedures for Perfusionist
health care service or procedure;                                Licensure
                    (3) compares a health care
professional's services with another health care                           (a) Frequency. Examinations will be administered
professional's services unless the comparison can be             for the department at least once each year by a designee
factually substantiated;                                         of the department.
                    (4) contains a testimonial;                            (b) Requirements.
                    (5) causes confusion or                                         (1) The executive secretary shall notify
misunderstanding as to the credentials, education, or            an applicant when all requirements for licensure have
licensure of a perfusionist;                                     been met except the taking and passing of the required
                    (6) advertises or represents that health     examination. The department shall forward or cause to be
care insurance deductibles or copayments may be waived           forwarded an examination registration form to each
or are not applicable to health care services to be              approved applicant as soon as the application has been
provided if the deductibles or copayments are required;          approved.
                    (7) advertises or represents that the                           (2) An applicant who wishes to take a
benefits of a health benefit plan will be accepted as full       scheduled examination must complete the examination
payment when deductibles or copayments are required;             registration form which must be received by the
                    (8) makes a representation that is           department or designee by the deadline established by
designed to take advantage of the fears or emotions of a         the department. The fee shall be paid to the designee of
particularly susceptible type of patient; or                     the department.
                    (9) advertises or represents, in the use                        (3) The examination for licensure shall
of a professional name, a title or professional identification   be an examination approved by the department. A
that is expressly or commonly reserved to or used by             designee of the department shall administer and grade
another profession or professional.                              examinations and report to the department if the applicant
                                                                 has passed or failed the examination.
                                                                                    (4) If an applicant has already
§140.4 Educational Requirements for Licensure                    successfully completed the required examination or the
                                                                 examination administered by the American Board of
General.                                                         Cardiovascular Perfusion (ABCP), the applicant shall not
                                                                 be required to be reexamined, provided the applicant
                 (1) The department shall approve as             furnishes the department a copy of the test results
meeting licensure requirements a perfusion education             indicating that the applicant passed the examination and

25 Texas Administrative Code, Chapter 104                                                          Page 4
Perfusionist Licensing Program
proof that he or she has been certified by the ABCP for                                         (C) misrepresentation of
some time period within three years immediately                   perfusion services and the efficacy of perfusion services to
preceding date of application.                                    clients;
                   (5) An applicant who fails four                                              (D) use of misleading
examinations may not reapply as a provisional licensed            advertising or false advertising;
perfusionist.                                                                                   (E) violation of any provision of
                                                                  any federal or state statute relating to confidentiality of
§140.6 Jurisprudence Examination                                  client communication and records;
                                                                                                (F) abuse of alcohol or drugs or
          (a) The department shall develop and administer         the use of illegal drugs of any kind in any manner which
a jurisprudence examination to determine an applicant's           detrimentally affects the provision of perfusion services;
knowledge of the Act, this section, and any other                 and
applicable laws of this state affecting the practice of                                         (G) any misrepresentation in
perfusion.                                                        application or other materials submitted to the department.
          (b) The examination shall be administered in a                     (b) General Procedures.
web-based format through an examination contract, which                               (1) An applicant must submit a sworn
specifies that applicants for examination must be able to:        application and all required information and
                    (1) pay the examination fee online by         documentation of credentials on official department forms.
credit card; and                                                                      (2) The department will not consider an
                    (2) receive their examination results         application as officially submitted until the applicant pays
electronically immediately upon completion of the                 the application fee and submits all required written
examination.                                                      documentation. The application and initial license fee must
          (c) The department shall revise the jurisprudence       accompany the application form.
examination as needed.                                                                (3) The executive secretary will send a
          (d) All applicants for licensure must pass the          notice listing the additional materials required to an
jurisprudence examination prior to submitting an                  applicant who does not complete the application in a
application for licensure. The jurisprudence examination          timely manner. An application not completed within 30
must be taken and passed no more than two years prior to          days after the date of the department's notice shall be
the date of the application for licensure.                        void.
                                                                             (c) Required application materials.
§140.7 Application Procedures                                                         (1) The application form shall contain:
                                                                                                (A) specific information
           (a) Fitness of applicants for perfusion licensure.     regarding personal data, social security number, date of
                     (1) In determining the qualifications of     birth, place of employment, other state licenses and
applicants for licensure the department may request and           certifications held, misdemeanor and felony convictions,
consider any of the following:                                    educational and training background, and work
                               (A) evaluations of supervisors     experience;
or instructors;                                                                                 (B) a statement that the
                               (B) evaluations of employers or    applicant has read the Act and rules and agrees to abide
professional associations;                                        by them;
                               (C) transcripts or findings from                                 (C) the applicant's permission
official court, hearing or investigative proceedings; and         for the department to seek any information or references it
                               (D) any other information which    deems appropriate to determine the applicant's
the department considers pertinent to determining the             qualifications and fitness;
qualifications of an applicant.                                                                 (D) a statement that the
                     (2) The substantiation of any of the         applicant, if issued a license, shall return the license
following items related to an applicant may be, as the            certificate and license identification card to the department
department determines, the basis for the denial of                upon the revocation or suspension of the license;
licensure of the applicant:                                                                     (E) a statement that the
                               (A) lack of the necessary skills   applicant has been informed that fees submitted in the
and abilities to provide adequate perfusion services;             licensure process are nonrefundable;
                               (B) misrepresentation of                                         (F) a statement that the
professional qualifications, credentials or associations;         applicant has been informed that materials submitted in

25 Texas Administrative Code, Chapter 104                                                            Page 5
Perfusionist Licensing Program
the licensure process become the property of the                                         (1) not completed the requirements in
department and are nonreturnable; and                             §761.4 of this title (relating to Educational Requirements
                               (G) the signature of the           for Licensure).
applicant which has been dated and notarized.                                            (2) failed to pass the examination
                     (2) Applicants must submit official          prescribed by the department as set out in §140.5 of this
transcript(s) from a perfusion education program approved         title (relating to Examination Procedures for Perfusionist
by the department or from a program with requirements as          Licensure), if applicable;
stringent as those established by the Accreditation                                      (3) failed to remit any applicable fees
Committee for Perfusion Education (AC-PE) and approved            required in §140.2 of this title (relating to Fees);
by the Commission on Accreditation of Allied Health                                      (4) failed or refused to properly
Education Programs (CAAHEP) or their successors.                  complete or submit any application form(s) or
                     (3) If submitting an equivalent program,     endorsement(s), or presented false information on the
the burden is on an applicant to establish that program           application form, or any other form or document required
requirements are as stringent as those established by the         by the department to verify the applicant's qualifications
AC-PE and approved by the CAAHEP or their successors.             for licensure;
                     (4) Applicants must submit a full-face                              (5) been in violation of the Act, the Code
photo, a minimum in size of 1 1/2 inches by 1 1/2 inches,         of Ethics, or any other provision of this title;
signed on the reverse side with the applicant's signature                                (6) been convicted of a felony or
as it appears on the application. The photograph must             misdemeanor if the crime directly relates to the duties and
have been taken within the two-year period prior to               responsibilities of a licensee as set out in §140.14 of this
application.                                                      title (relating to Licensing of Persons with Criminal
                     (5) If an applicant is or has been           Backgrounds To Be a Licensed Perfusionist and
licensed, certified, or registered in another state, territory,   Provisional Licensed Perfusionist), and in Texas
or jurisdiction, the applicant must submit information            Occupations Code, Chapter 53.
required by the department concerning that license,                                      (7) had a license, registration,
certificate or registration on official department forms.         certificate, or certification to practice perfusion in another
                     (6) Curriculum vitae, resumes, and other     state or jurisdiction which has been suspended, revoked,
documentation of the applicant's credentials may be               or otherwise restricted by the licensing entity or American
submitted.                                                        Board of Cardiovascular Perfusion; or
                     (7) An applicant applying for licensing by                          (8) demonstrated lack of necessary
endorsement shall submit a copy of the license or                 skills and ability to provide adequate perfusion services.
certificate by which the reciprocal license is requested and                  (c) If after review, the department determines that
the name and address of the licensing or certifying               the application should not be approved, the executive
agency.                                                           secretary shall give the applicant written notice of the
                     (8) An applicant for provisional licensed    reason for the proposed decision and of the opportunity
perfusionist must have his or her supervising licensed            for a formal hearing and an informal settlement
perfusionist or an appropriately licensed physician sign the      conference. The notice and hearing shall be in
applicant form.                                                   accordance with §140.15 of this title (relating to Violations,
                                                                  Complaints, and Subsequent Department Actions).
§140.8 Determination of Eligibility                                           (d) An applicant whose application has been
                                                                  denied under subsection (b)(4), (5), (6), (7), or (8) of this
           (a) The department shall notify an applicant in        section shall be permitted to reapply after a period to be
writing of the receipt of the applicant's application and any     determined by the department. The applicant shall submit
other relevant evidence relating to qualifications                with the reapplication, proof satisfactory to the department
established by rule. The notice must state whether the            of compliance with all rules of the department and the
applicant has qualified for examination or licensure based        provisions of the Act in effect at the time of reapplication.
on the application and other submitted evidence. If the                       (e) Processing procedures are as follows.
applicant is not qualified, the notice must state the                                    (1) Time periods. The department shall
reasons for the applicant's failure to qualify.                   comply with the following procedures in processing
          (b) The department may deny the application if          application for licensure and renewal.
the person has:                                                                                    (A) The following periods of
                                                                  time shall apply from the date of receipt of an application
                                                                  until the date of issuance of a written notice that the

25 Texas Administrative Code, Chapter 104                                                              Page 6
Perfusionist Licensing Program
application is complete and accepted for filing or that the                                                (iii) any other
application is deficient and additional specific information        condition exists giving the department good cause for
is required. A written notice stating that the application has      exceeding the time period.
been approved may be sent in lieu of the notice of                                      (3) Appeal. If a request for
acceptance of a complete application. The time periods              reimbursement under paragraph (2) of this subsection is
are as follows:                                                     denied by the executive secretary, the applicant may
                                       (i) letter of acceptance     appeal in writing to the department. An appeal shall be
of application for licensure - 14 working days;                     decided in the applicant's favor if the applicable time
                                       (ii) letter of application   period was exceeded and good cause was not
deficiency - 14 working days; and                                   established. If the appeal is decided in favor of the
                                       (iii) issuance of            applicant, full reimbursement of all fees paid in that
license renewal after receipt of documentation of all               particular application process shall be made.
renewal requirements - 30 working days.                                                 (4) Contested cases. The time periods
                             (B) The following periods of           for contested cases related to the denial of licensure or
time shall apply from the receipt of the last item necessary        license renewals are not included within the time periods
to complete the application until the date of issuance of           stated in paragraph (1) of this subsection. The time period
written notice approving or denying the application. For            for conducting a contested case hearing runs from the
the purpose of this section, an application is not                  date the department receives a written request for a
considered complete until any required examination has              hearing and ends when the decision of the commissioner
been successfully completed by the applicant. The time              is final and appealable. A hearing may be completed
period for denial include notification of the proposed              within one to four months, but may extend for a longer
decision and of the opportunity, if required, to show               period of time depending on the particular circumstances
compliance with the law and of the opportunity for a formal         of the hearing.
hearing. The time periods are as follows:
                                       (i) letter of approval       §140.9 Provisional Licensed Perfusionists
examination - 20 working days;
                                       (ii) initial letter of                 (a) Supervision.
approval for licensure (exam waived) - 20 working days;                                 (1) To meet licensure and license
                                       (iii) letter of denial of    renewal requirements, a provisional licensed perfusionist
licensure - 20 working days;                                        shall be under the supervision and direction of a currently
                                       (iv) issuance of             licensed perfusionist who resides in Texas.
license renewal after receipt of documentation of all                                   (2) Supervision and direction shall be
renewal requirements - 30 working days.                             defined as procedural guidance provided by a licensed
                     (2) Reimbursement of fees.                     perfusionist and need not be on site.
                             (A) In the event an application                            (3) The supervising licensed perfusionist
is not processed in the time periods stated in paragraph            must sign the application for a provisional license and the
(1) of this subsection, the applicant has the right to              application for renewal of the provisional license.
request reimbursement of all fees paid in the particular                      (b) Termination. The supervising licensed
application process. Application for reimbursement shall            perfusionist must submit written notification of termination
be made to the executive secretary. If the executive                of supervision to the department and the supervisee within
secretary does not agree that the time period has been              14 days of when supervision has ceased. The provisional
violated or finds that good cause existed for exceeding the         licensed perfusionst shall make a good faith effort to
time period, the request will be denied.                            ensure that the supervising licensed perfusionist submits
                             (B) Good cause for exceeding           an appropriate notification.
the time period is considered to exist if:                                    (c) Changes. Any change in the supervision shall
                                       (i) the number of            be submitted in writing to the Executive Secretary. The
applications for licensure and licensure renewal exceeds            signature of the supervising licensed perfusionist shall be
by 15% or more the number of applications processed in              included in the written notice.
the same calendar quarter the preceding year; or                              (d) Required supervisor. A provisional licensed
                                       (ii) another public or       perfusionist must have a supervising licensed perfusionist
private entity relied upon by the department in the                 at all times whether or not the provisional licensed
application process caused the delay; or                            perfusionist is actively employed.

25 Texas Administrative Code, Chapter 104                                                             Page 7
Perfusionist Licensing Program
          (e) Time limits. A provisional license is valid for                         (3) Any certificate or identification card
one year from the date it is issued and may be renewed            issued by the department shall remain the property of the
annually for not more than three times by the procedures          department and must be surrendered to the department
set out at §140.12 of this title (relating to License             on demand.
Renewal).                                                                             (4) The license certificate must be
          (f) Variance. An applicant or provisional licensee      displayed in an appropriate and public manner as follows:
may request the department to approve that supervision                                           (A) The license certificate shall
and direction be performed by a licensed physician in lieu        be displayed in the primary office or place of employment
of a licensed perfusionist.                                       of the licensee.
                    (1) The request for a variance must be                                       (B) In the absence of a primary
in writing and must include the following:                        office or place of employment, or when the licensee is
                              (A) the individual's name and       employed at multiple locations, the licensee shall carry a
address;                                                          current identification card.
                              (B) the reason(s) why a                       (d) Upgrading a provisional license.
licensed perfusionist is not reasonably available to provide                          (1) The provisional licensed perfusionist
supervision and direction; and                                    shall submit to the department a photocopy of the
                              (C) the name, address, and          examination results from the American Board of
copies of the credentials for verification that the physician     Cardiovascular Perfusion and a written request to
is licensed by the Texas State Board of Medical                   upgrade.
Examiners and certified and/or eligible for certification by                          (2) The provisional licensed perfusionist
the American Board of Thoracic Surgeons, Inc., or                 who successfully completes the licensing examination
certified and/or eligible for certification in cardiovascular     shall surrender to the department the provisional license
surgery by the American Osteopathic Board of Surgery.             certificate and provisional license identification card, and
                    (2) The applicant will be notified of         submit the license fee for upgrade of provisional licensed
approval or denial of the request in writing.                     perfusionist to licensed perfusionist.
                                                                                      (3) If the provisional licensed
§140.10 Licensing After Examination                               perfusionist is not eligible for upgrade, the executive
                                                                  secretary shall notify the provisional licensed perfusionist
          (a) Issuance of licenses.                               in writing of the reasons for denial and the additional
                    (1) Upon request the department shall         documentation needed to meet the minimum requirements
send each applicant who has been approved and who has             for licensure as a licensed perfusionist.
passed the examinations, if applicable, a form to complete
and return with the upgrade fee, if applicable.                   §140.11 Changes of Name or Address
                    (2) Upon receiving an applicant's form
and fee, the department shall issue a license certificate                    (a) The licensee shall notify the department of
and license identification card containing a license              changes in name or preferred mailing address within 30
number.                                                           days of such change(s).
          (b) Replacement. The department shall replace a                    (b) Notification of address changes shall be
lost, damaged, or destroyed license certificate or                made in writing including the name, mailing address, and
identification card upon a written request from the licensee      zip codes, and be mailed to the executive secretary.
and payment of the license replacement fee. Requests                         (c) Before another license certificate and
shall include a statement detailing the loss or destruction       identification card will be issued by the department,
of the licensee's original license or identification card or be   notification of name changes must be mailed to the
accompanied by the damaged certificate or card.                   executive secretary and shall include a duly executed
          (c) License certificates.                               affidavit and a copy of a marriage certificate, court decree
                    (1) The department shall prepare and          evidencing such change, or a Social Security card
provide to each licensee a license certificate and                reflecting the new name. The licensee shall return any
identification card which contains the licensee's name,           previously issued license certificate and identification card
license number, and expiration date.                              and remit the appropriate replacement fee as set out in
                    (2) Official license certificates shall be    §140.2 of this title (relating to Fees).
signed by the executive secretary. Official identification
cards shall be signed by the executive secretary and the

25 Texas Administrative Code, Chapter 104                                                             Page 8
Perfusionist Licensing Program
§140.12 License Renewal                                           telephone number, and misdemeanor and felony
                                                                  convictions. The license renewal form for the provisional
           (a) General.                                           licensed perfusionist shall be signed by the supervising
                      (1) When issued, a license is valid until   licensed perfusionist or approved licensed physician and
the licensee's next birth month.                                  indicate whether the supervisor and supervisee have
                      (2) A licensee must renew the license       complied with this chapter.
annually or biannually, as determined by the department.                                (3) A licensee has renewed the license
                      (3) The renewal date of a license shall     when the licensee has mailed the renewal form and the
be the last day of the licensee's birth month.                    required renewal fee to the executive secretary prior to the
                      (4) Each licensee is responsible for        expiration date of the license. The postmark date shall be
renewing the license before the expiration date and shall         considered as the date of mailing.
not be excused from paying additional fees or penalties.                                (4) The department shall issue to a
Failure to receive notification from the executive secretary      licensee who has met all requirements for renewal a
prior to the expiration date of the license shall not excuse      license certificate and identification card.
failure to file for renewal or late renewal.                                  (c) Late renewal requirements.
                      (5) The department shall not renew the                            (1) The executive secretary shall inform
license of the licensee who is in violation of the Act or         a person who has not renewed a license after a period of
rules at the time of application for renewal.                     more than 90 days after the expiration of the license of the
                      (6) The department shall deny renewal       amount of the fee required for renewal and the date the
of the license of a licensee if renewal is prohibited by the      license expired.
Education Code, §57.491 relating to student loan default.                               (2) A person whose license has expired
                      (7) The department shall deny renewal       for not more than one year may renew the license by
of the license of a licensee for whom a contested case is         submitting the license renewal form and the appropriate
pending until resolution of the case, but such individual         renewal and late renewal fees to the executive secretary.
remains licensed pending resolution of the contested              The renewal is effective if it is mailed to the executive
case, if timely application for renewal is made.                  secretary within one year after the expiration date of the
                      (8) The department may refuse to renew      license. The postmark date shall be considered as the
the license of a person who fails to pay an administrative        date of mailing.
penalty imposed under the Act unless enforcement of the                                 (3) A person whose license has been
penalty is stayed or a court has ordered that the                 expired one year or more may not renew the license. The
administrative penalty is not owed.                               person may obtain a new license by complying with the
                      (9) A licensee who has been notified of     current requirements and procedures for obtaining an
a student loan default shall surrender their license until the    original license.
loan payment has been resolved to the satisfaction of the                     (d) Expiration of license.
National Student Loan Center.                                                           (1) A person whose license has expired
                      (10) A licensee shall pay a late renewal    may not use the title or represent or imply that he has the
fee as set out in §140.2 of this title (relating to Fees) prior   title of "licensed perfusionist" or "provisional licensed
to issuance of the license under this section.                    perfusionist" or use the letters "LP" or "PLP", and may not
           (b) License renewal requirements.                      use any facsimile of those titles in any manner.
                      (1) At least 30 days prior to the                                 (2) A person who fails to renew a
expiration date of a person's license, the executive              license after one year shall surrender the license
secretary shall send notice to the licensee at the address        certificate and license identification card to the
in the department's records of the expiration date of the         department.
license, the amount of the renewal fee due, and a license                     (e) Active duty. If a licensee fails to timely renew
renewal form which the licensee must complete and return          his or her license on or after August 1, 1990, and the
to the department with the required renewal fee. The              licensee is or was on active duty with the armed forces of
return of the completed renewal form in accordance with           the United States of America, the licensee may renew the
the requirements of paragraph (3) of this subsection shall        license in accordance with this subsection.
be considered confirmation of the receipt of renewal                                    (1) Renewal of the license may be
notification.                                                     requested by the licensee, the licensee's spouse, or an
                      2) The license renewal form for all         individual having power of attorney from the licensee. The
licensees shall require the provision of the preferred            renewal form shall include a current address and
mailing address, primary employment address and

25 Texas Administrative Code, Chapter 104                                                             Page 9
Perfusionist Licensing Program
telephone number for the individual requesting the                by submitting the professional activity report on the
renewal.                                                          approved form every third year. A minimum of 15 hours of
                     (2) Renewal may be requested before or       CEU must be earned in Category I. The activity period
after expiration of the license.                                  covered in the professional activity report is from the date
                     (3) A copy of the official orders or other   of licensure to the third licensure renewal date and every
official military documentation showing that the licensee is      subsequent third license renewal date.
or was on active duty shall be filed with the department                              (2) Document a minimum of 40 clinical
along with the renewal form.                                      perfusions in a one-year period by submitting the clinical
                     (4) A copy of the power of attorney from     activity report on the approved form upon annual license
the licensee shall be filed with the department along with        renewal. The first clinical activity report from a newly
the renewal form if the individual having the power of            licensed perfusionist is due on the second license renewal
attorney executes any of the documents required in this           date.
subsection.                                                                           (3) One CEU or contact hour activity is
                     (5) A licensee renewing under this           defined as 50 minutes spent in an organized, structured or
subsection shall pay the applicable renewal fee, but not          unstructured learning experience. Categories of CEU
the late renewal fee.                                             activities are:
            (f) Renewal for Retired Perfusionists Performing                                    (A) Category I--Perfusion
Voluntary Charity Care.                                           Meetings and Other Perfusion Related Activity--Perfusion
                     (1) A "retired perfusionist" is defined as   meetings are those programs and seminars in which a
a person who is:                                                  minimum of 75% of the contact hours consist of perfusion
                               (A) above the age of 55; and       related material. Only those meetings approved by the
                               (B) is not employed for            ABCP will qualify for Category 1 hours. Examples:
compensation in the practice of perfusion; and                                                            (i) International,
                               (C) has notified the department    national regional, and state perfusion meetings.
in writing of his or her intention to retire and provide only                                             (ii) Publication of
voluntary charity care.                                           perfusion related book chapter or paper in a professional
                     (2) "Voluntary charity care" for the         journal.
purposes of this subsection is defined as the practice of                                                 (iii) Presentation at an
perfusion by a retired perfusionist without compensation or       international, national, regional or state perfusion journal.
expectation of compensation.                                                                    (B) Category II--Non-
                     (3) A retired perfusionist providing only    Accredited Perfusion Meetings and Other Medical
voluntary charity care may renew his or her license by            Meetings--This category includes international, national,
submitting a renewal form; the retired perfusionist renewal       regional, and state meetings that have not been approved
fee required by §140.2 of this title (relating to Fees); and      by the ABCP, local perfusion meetings and all other
the continuing education hours required by §140.13 of this        medically related meetings. Examples:
title (related to Minimum Continuing Education                                                            (i) International,
Requirements).                                                    National, Regional, and State, perfusion meetings that
                                                                  have not been accredited by the ABCP.
§140.13 Minimum Continuing Education                                                                      (ii) Local perfusion
Requirements                                                      meetings (do not require ABCP accreditation). Any
                                                                  perfusion meeting NOT EQUALLY ACCESSIBLE to the
         (a) Completion of continuing education (CE)              general CCP community, this includes manufacturer-
requirements with current certification by the American           specific and company-sponsored educational activities.
Board of Cardiovascular Perfusion (ABCP) or its                                                           (iii) International,
successor agency. Completion of continuing education              National, Regional, or Local medically-related meetings.
requirements shall be documented by demonstrating                                               (C) Category III--Individual
current certification by the ABCP annual license renewal.         Education and Other Self-Study Activities Credit in this
         (b) Completion of CE requirements without                category is acquired on an hour for hour basis of the time
current certification by the ABCP. Licensed perfusionists         spent in these non-accredited or non-supervised activities.
without current certification by the ABCP at the time of          Examples:
license renewal must meet the following criteria.                 (i) Reading or viewing medical journals, audio-visual, or
                    (1) Document a minimum of 45                  other educational material.
continuing education credit (CEUs) in a three-year period

25 Texas Administrative Code, Chapter 104                                                            Page 10
Perfusionist Licensing Program
                                      (ii) Participation in                   (d) Licensees who are approved by the
electronic forums.                                                department for renewal in accordance with §140.12(f) of
                                      (iii) Participation in a    this title (relating to Retired Perfusionists Performing
Journal Club.                                                     Voluntary Charity Care) may complete reduced continuing
                                         (iv) Participation in    education requirements equal to two-thirds of the number
degree-oriented, professional-related course work.                of continuing education hours required for renewal for a
                                         (v) Presentation of      licensed perfusionist.
perfusion topic at a non-perfusion meeting.
                               (D) A minimum of 40 clinical       §140.14 Licensing of Persons with Criminal
perfusions per year are required of every licensed                Backgrounds To Be a Licensed Perfusionist and
perfusionist. A maximum of 15 activities may be                   Provisional Licensed Perfusionist
documented as intraoperative pump standbys.
                               (E) 40 cases are required each               (a) Criminal convictions which directly relate to
year as the Primary Perfusionist for Cardiopulmonary              the profession of perfusion.
bypass, ECMO, VAD, Isolated Limb Perfusion, or VENO-                                  (1) The department may suspend or
VENO bypass, or documented intraoperative pump                    revoke an existing license, disqualify a person from
standby. For each ECMO or VAD case, one case credit               receiving a license, refuse to renew a license, or deny to a
will be awarded for initiating and/or managing an eight-          person the opportunity to be examined for a license
hour shift.                                                       because of a person's conviction of a felony or
                     (4) Documentation of activities.             misdemeanor if the crime directly relates to the duties and
Licensed perfusionists are responsible for providing              responsibilities of a licensee.
documentation of their professional activities. This                                  (2) In considering whether a criminal
documentation must be submitted along with the                    conviction directly relates to the occupation of a licensed
professional activity report. Credit will not be granted for      perfusionist or provisional licensed perfusionist, the
activities that are not documented. The suitable                  department shall consider:
documentation is outlined as follows:                                                           (A) the nature and seriousness
                               (A) Category I--Perfusion          of the crime;
meetings--Approved perfusion meetings held before June                                          (B) the relationship of the crime
30, 1998, may be documented by copies of registration             to the purposes for licensure as a perfusionist or
receipts or official meeting name tags. For approved              provisional perfusionist. The following felonies and
perfusion meetings held after June 30, 1998, an official          misdemeanors listed in clauses (i) - (iv) of this
document from the meeting sponsor documenting                     subparagraph relate to the license of a perfusionist or
attendance and the number of hours received must be               provisional perfusionist because these criminal offenses
provided.                                                         indicate an inability or a tendency to be unable to perform
                                         (i) Perfusion            as a licensed perfusionist or a provisional licensed
Publications must have complete reference of book or              perfusionist:
article (authors, title, journal and date/volume of journal.                                              (i) the misdemeanor
                                         (ii) Perfusion           of knowingly or intentionally acting as a licensed
Presentations must have copy of program agenda.                   perfusionist or provisional licensed perfusionist without a
                               (B) Category II--International,    license under the Act, §15, Texas Occupations Code,
national, regional, and state perfusion meetings not              §603.452.
accredited by the ABCP, local perfusion meetings and all                                                  (ii) a misdemeanor or
other medical meetings--must provide an official document         a felony offense involving moral turpitude;
stating CEUs awarded and copy of the meeting program.                                                     (iii) a conviction
                               (C) Category III--All self-study   relating to health care fraud or individual excluded from
activities will require an official record of completion or       the Medicare or Medicare programs due to Medicare or
written summary of the activity.                                  Medicaid fraud;
           (c) Exceptions. Any deviation from the continuing                                              (iv) a misdemeanor or
education requirements will be reviewed on a case-by-             felony offense under the following titles of the Texas Penal
case basis by the department. A request for special               Code:
consideration shall be submitted in writing a minimum of                                                             (I) offenses
60 days prior to expiration of the license.                       against the person (Title 5);

25 Texas Administrative Code, Chapter 104                                                           Page 11
Perfusionist Licensing Program
                                                 (II) offenses     of "licensed perfusionist" or "provisional licensed
against property (Title 7);                                        perfusionist" or use the letters "LP" or "PLP" or any
                                                 (III) offenses    facsimile of those titles in any manner unless the person
against public order and decency (Title 9);                        holds an appropriate license issued under the Act.
                                                  (IV) offenses                         (2) A person may not intentionally or
against public health, safety, and morals (Title 10);              knowingly represent or imply that he or she has the title of
                                                  (V) offenses     "certified clinical perfusionist" or use the letters "CCP" or
of attempting or conspiring to commit any of the offenses          any facsimile of that title in any manner unless the person
in this subsection (Title 4); and                                  is certified as a certified clinical perfusionist by the
                                                  (VI)             American Board of Cardiovascular Perfusion.
insurance claim fraud under the Penal Code, §32.55; and                                 (3) A licensee may not issue an
                                                  (v) the          insufficient funds check and fail to redeem such
misdemeanors and felonies listed in clauses (i) - (iii) of this    instrument within 10 days after being given written notice
subparagraph are not inclusive in that the department may          by the department.
consider other particular crimes in special cases in order                              (4) A licensee may not violate any of the
to promote the intent of the Act and these sections;               provisions of the Act or any rules in this section.
                               (C) the extent to which a                      (b) Filing of complaints.
license might offer an opportunity to engage in further                                 (1) A person wishing to complain about
criminal activity of the same type as that in which the            a prohibited act or alleged violation a licensee or other
person previously had been involved; and                           person acting as a perfusionist shall notify the executive
                               (D) the relationship of the crime   secretary. The initial notification of a complaint may be in
to the ability or capacity required to perform the duties and      writing, by telephone, or by personal visit to the executive
discharge the responsibilities of a licensed perfusionist or       secretary's office.
provisional licensed perfusionist. In making this                                       (2) Upon receipt of a complaint, the
determination, the department will apply the criteria              executive secretary shall send to the complainant an
outlined in Texas Occupations Code, Chapter 53.                    acknowledgment letter and the department's complaint
          (b) Procedures for revoking, suspending, or              form, which the complainant will be requested to complete
denying a license to persons with criminal backgrounds.            and return to the executive secretary before further action
                    (1) The committee's executive secretary        can be taken. If the complaint is made by a visit to the
will give written notice to the person that the department         executive secretary's office, the form may be given to the
intends to deny, suspend, deny renewal of, or revoke the           complainant at that time; however, it must be completed
license in accordance with the provisions of the                   and returned to the executive secretary before further
Administrative Procedure Act and Texas Government                  action can be taken. Copies of the complaint form may be
Code, Chapter 2001, and the department's formal hearing            obtained from the department.
procedures, §140.15 of this title (relating to Violations,                              (3) Anonymous written complaints shall
Complaints, and Subsequent Department Actions) and                 be investigated by the executive secretary provided that
§140.16 of this title (relating to Formal Hearings).               the complainant provides sufficient information.
                    (2) If the department denies an                           (c) Investigation of complaints.
application or renewal application for a license, or                                    (1) The executive secretary on behalf of
suspends, or revokes a license under this section, the             the department is responsible for handling complaints.
executive secretary will give the person written notice:                                (2) If the executive secretary determines
                               (A) of the reasons for the          that the complaint does not come within the department's
decision; and                                                      jurisdiction, the executive secretary shall advise the
                    (B) that the person, after exhausting          complainant and, if possible, refer the complainant to the
administrative appeals, may appeal in a district court of          appropriate governmental agency for handling such
Travis County, Texas.                                              complaints.
                                                                              (d) Actions by executive secretary.
§140.15 Violations, Complaints, and Subsequent                                          (1) The department may take one or
Department Actions                                                 more of the following actions:
                                                                                                   (A) determine that an allegation
         (a) Types of violations and prohibited actions.           is groundless and dismiss the complaint; or
                   (1) A person may not knowingly or                                               (B) determine that a
intentionally represent or imply that he or she has the title      nonlicensed person has committed a prohibited action

25 Texas Administrative Code, Chapter 104                                                             Page 12
Perfusionist Licensing Program
under subsection (b) of this section. The department shall       executive secretary will notify the licensee that the license
consider the seriousness and the effects of the violation        has been received.
and shall initiate one of the following actions:                                     (2) When a licensee has offered the
                                        (i) attempt to resolve   surrender of his or her license after a complaint has been
the complaint by requesting the violator to stop the action      filed alleging violations of the Act or this chapter, and the
immediately. If the violator complies, the executive             executive secretary has accepted such a surrender, that
secretary may close the complaint file; or                       surrender is deemed to be the result of a formal
                                        (ii) ask the attorney    disciplinary action.
general, district attorney, or county attorney to take                               (3) A license which has been
appropriate legal action against the violator; or                surrendered may not be reinstated; however, that person
                               (C) determine that a licensee     may apply for a new license in accordance with the Act
has violated the Act or a rule in this section and propose       and this chapter.
denial of renewal, revocation, or suspension of the                         (g) Monitoring of licensees. The executive
license, reprimand, or probation of the license suspension.      secretary shall monitor each licensee against whom a
                    (2) Whenever the department dismisses        department order is issued to ascertain that the licensee
a complaint or closes a complaint file, the department will      performs the required acts.
give a summary report of the final action to the                            (h) Cease and Desist Order. If it appears to the
complainant, and the accused party.                              commissioner that a person who is not licensed under the
          (e) Final action by the department.                    Act is violating the Act, a rule adopted under the Act, or
                    (1) If the department suspends a             another state statute or rule relating to the practice of
license, the suspension remains in effect until the              perfusion, the commissioner after notice and an
department determines that the reasons for the                   opportunity for a hearing may issue a cease and desist
suspension no longer exist.                                      order prohibiting the person from engaging in the activity.
                    (2) During the time of suspension, the       A violation of an order under this subsection constitutes
former license holder shall return the license certificate       grounds for the imposition of an administrative penalty by
and license identification card to the department.               the department.
                    (3) Upon showing of good cause by the
former license holder, the department may probate the            §140.16 Formal Hearings
license suspension.
                    (4) If a suspension overlaps a license                 (a) General. This section covers the formal
renewal period, the former license holder must comply            hearing procedures and practices that will be used by the
with the normal renewal procedures in these rules;               department in handling suspensions, revocation of
however, the license will not be renewed until the               license, denial of licenses, probating a license suspension,
department determines that the reasons for suspension            reprimanding a licensee, or refusal to renew a license.
have been removed.                                               Such hearing will be conducted pursuant to the contested
                    (5) If the department revokes the            case provisions of the Administrative Procedure Act
license, the former license holder must reapply in order to      (APA), Texas Government Code, Chapter 2001, and will
obtain a new license. The department will not issue a new        be held by the State Office of Administrative Hearings.
license until the department determines that the reasons                   (b) Notice requirements.
for revocation have been removed. The department may                                 (1) Notice of the hearing shall be given
require an investigation and a recommendation from the           according to the notice requirements of APA.
executive secretary to assist the department in making its                           (2) If a party fails to appear or be
decision.                                                        represented at a hearing after receiving notice, the
                    (6) Upon revocation, the former license      administrative law judge may proceed with the hearing or
holder shall return the license certificate and license          take whatever action is fair and appropriate under the
identification card to the department.                           circumstances.
                    (7) The department may assess                                    (3) All parties shall timely notify the
administrative penalties for a violation of the Act or this      administrative law judge of any changes in their mailing
chapter in accordance with the procedures established in         addresses.
Occupations Code, §§603.501 - 603.511.                                     (c) Disposition of case. Unless precluded by law,
          (f) Surrender of license.                              informal disposition may be made of any contested case
                    (1) A licensee may offer his or her          by agreed settlement order or default order.
license for surrender to the department office. The

25 Texas Administrative Code, Chapter 104                                                         Page 13
Perfusionist Licensing Program
          (d) Agreements in writing. No stipulation or                                          (B) that the licensee may be
agreement between the parties with regard to any matter           represented by legal counsel;
involved in any proceeding shall be enforced unless it                                          (C) that the licensee or
shall have been reduced to writing and signed by the              applicant may offer the testimony of witnesses and
parties or their authorized representatives, dictated into        present other evidence as may be appropriate;
the record during the course of a hearing, or incorporated                                      (D) that the licensee's or
in an order bearing their written approval. This rule does        applicant's attendance and participation is voluntary;
not limit a party's ability to waive, modify, or stipulate away                                 (E) that the complainant may
any right or privilege afforded by these sections.                be present; and
          (e) Final orders or decisions.                                                        (F) that the informal conference
                    (1) The final order or decision will be       shall be canceled if the licensee or applicant notifies the
rendered by the department. The department is not                 executive secretary that he or she or his or her legal
required to adopt the recommendation of an administrative         counsel will not attend.
law judge and may take action as it deems appropriate                                  (2) A copy of this subsection concerning
and lawful.                                                       informal disposition shall be enclosed with the notice of
                    (2) All final orders or decisions shall be    the informal conference.
in writing and shall set forth the findings of fact and                     (e) The conference shall be informal and shall
conclusions required by law.                                      not follow the procedures established in this chapter for
                    (3) All final orders shall be signed by a     contested cases and formal hearings.
representative of the department.                                           (f) The licensee, the licensee's attorney, and
                    (4) A copy of all final orders and            department staff may question witnesses, make relevant
decisions shall be timely provided to all parties as required     statements, present statements of persons not in
by law.                                                           attendance, and present such other evidence as may be
§140.17 Informal Conference                                                 (g) The department's legal counsel will be
                                                                  requested to attend each informal conference. The
           (a) Informal disposition of any complaint or           complaint committee member or executive secretary may
contested case involving a licensee or an applicant for           call upon the department's attorney at any time for
licensure may be made through an informal conference              assistance in the informal conference.
held to determine whether an agreed order may be                            (h) The licensee shall be afforded the opportunity
approved.                                                         to make statements that are material and relevant.
           (b) If the department determines that the public                 (i) Access to the department's investigative file
interest might be served by attempting to resolve a               may be prohibited or limited in accordance with the APA,
complaint or contested case by an agreed order in lieu of         Texas Government Code, Chapter 552, and the Texas
a formal hearing, the provisions of this section shall apply.     Occupations Code, Chapter 603.
A licensee or applicant may request an informal                             (j) At the discretion of the department, a tape
conference; however, the decision to hold a conference            recording may be made of none or all of the informal
shall be made by the department.                                  conference.
           (c) An informal conference shall be voluntary. It                (k) The complainant shall not be considered a
shall not be a prerequisite to a formal hearing.                  party in the informal conference but shall be given the
           (d) The department shall decide upon the time,         opportunity to be heard if the complainant attends. Any
date, and place of the informal conference and provide            written statement submitted by the complainant shall be
written notice to the licensee or applicant of the same.          reviewed at the conference.
Notice shall be provided no less than ten days prior to the                 (l) At the conclusion of the informal conference,
date of the conference by certified mail, return receipt          the department may make recommendations for informal
requested to the last known address of the licensee or            disposition of the complaint or contested case. The
applicant or by personal delivery. The 10 days shall begin        recommendations may include any disciplinary action
on the date of mailing or personal delivery. The licensee         authorized by the Act. The department may also conclude
or applicant may waive the 10 day notice requirement.             that the department lacks jurisdiction, conclude that a
                      (1) The notice shall inform the licensee    violation of the Act or this chapter has not been
or applicant of the following:                                    established, or refer the matter for further investigation.
                               (A) the nature of the alleged                (m) At the time of the informal conference, the
violation;                                                        licensee or applicant may either accept or reject the

25 Texas Administrative Code, Chapter 104                                                           Page 14
Perfusionist Licensing Program
conference recommendations. If the recommendations are
accepted, an agreed order shall be prepared by the                §140.18 Default Orders
department or the department's legal counsel and
forwarded to the licensee or applicant. The order shall           If a right to a hearing is waived, the department shall enter
contain agreed finding of fact and conclusions of law. The        an order taking appropriate disciplinary action against the
licensee or applicant shall execute the order and return          licensee as described in the written notice to the licensee
the signed order to the department within ten days of his         or applicant.
or her receipt of the order. If the licensee or applicant fails
to return the signed order within the stated time period, the     §140.19 Suspension of License for Failure to Pay
inaction shall constitute rejection of the conference             Child Support or Compliance with Child Custody
recommendations.                                                  Order
          (n) If the licensee or applicant rejects the
proposed recommendations, the department shall take                         (a) On receipt of a final court order or attorney
appropriate action.                                               general's order suspending a license due to failure to pay
          (o) If the licensee or applicant signs and accepts      child support or failure to be in compliance with a court
the recommendations, the agreed order shall be submitted          order relating to child custody, the department shall
to the legal counsel for approval. The order shall contain        immediately determine if a license has been issued to the
agreed findings of fact and conclusions of law.                   obligator named on the order. If a license has been
          (p) After consultation with legal counsel, the          issued, the department shall:
department shall enter an agreed order approving the                                   (1) record the suspension of the license
accepted recommendations.                                         in the department's records;
          (q) If the department does not approve a                                     (2) report the suspension as
proposed agreed order, the licensee or applicant shall be         appropriate; and
so informed. The department shall take other appropriate                               (3) demand surrender of the suspended
action.                                                           license.
          (r) A licensee's opportunity for an informal                      (b) The department shall implement the terms of
conference under this section shall satisfy the requirement       a final court order or attorney general's order suspending
of the Texas Government Code, §2001.054(c).                       a license without additional review or hearing. The
                     (1) If the department determines that an     department will provide notice as appropriate to the
informal conference shall not be held, the department             licensee or to others concerned with the license.
shall give written notice to the licensee or applicant of the               (c) The department may not modify, remand,
facts or conduct alleged to warrant the intended                  reverse, vacate, or stay a court or attorney general's order
disciplinary action and the licensee or applicant shall be        suspending a license issued under the Family Code,
given the opportunity to show, in writing and as described        Chapter 232 as added by Acts 1995, 74th Legislature
in the notice, compliance with all requirements of the Act        Chapter 751, §85 (HB 433) and may not review, vacate, or
and this chapter.                                                 reconsider the terms of an order.
                     (2) The complainant shall be sent a                    (d) A licensee who is the subject of a final court
copy of the written notice described in paragraph (1) of          order or attorney general's order suspending his or her
this subsection. The complainant shall be informed that he        license is not entitled to a refund for any fee paid to the
or she may also submit a written statement to the                 department.
department.                                                                 (e) If a suspension overlaps a license renewal
          (s) Refund Order. The department may order a            period, an individual with a license suspended under this
license holder to pay a refund to a consumer as provided          section shall comply with the normal procedures in the Act
in an agreement resulting from an informal settlement             and this chapter; however, the license will not be renewed
conference instead of or in addition to imposing an               until subsection (g) and (h) of this section are met.
administrative penalty. The amount of a refund ordered as                   (f) An individual who continues to use the titles
provided in an agreement resulting from an informal               "licensed perfusionist", or "provisional licensed
settlement conference may not exceed the amount the               perfusionist" after the issuance of a court or attorney
consumer paid to the license holder for a service                 general's order suspending the license is liable for the
regulated by the Act and this section. The department may         same civil and criminal penalties provided for engaging in
not require payment of other damages or estimate harm in          the prohibited activity without a license or while a license
a refund order.                                                   is suspended as any other license holder of the

25 Texas Administrative Code, Chapter 104                                                          Page 15
Perfusionist Licensing Program
          (g) On receipt of a court order or attorney                                (3) Personal accountability. The
general's order vacating or staying an order suspending a        following factors are identified:
license, the department shall promptly issue the affected                                      (A) admission of wrong or
license to the individual if the individual is otherwise         error, and acceptance of responsibility;
qualified for the license.                                                                     (B) appropriate degree of
          (h) The individual must pay a reinstatement fee        remorse or concern;
set out at §140.2 of this title (relating to Fees) prior to                                    (C) efforts to ameliorate the
issuance of the license under subsection (g) of this             harm or make restitution;
section.                                                                                       (D) efforts to ensure future
                                                                 violations do not occur; and
§140.20 Relevant Factors                                                                       (E) cooperation with any
                                                                 investigation or request for information.
When a licensee has violated the Act or this chapter, three                          (4) Deterrence. The following factors are
general factors combine to determine the appropriate             identified:
sanction which include: the culpability of the licensee; the                                   (A) the sanction required to
harm caused or posed; and the requisite deterrence. It is        deter future similar violations by the licensee;
the responsibility of the licensee to bring exonerating                                        (B) sanctions necessary to
factors to the attention of the department or administrative     ensure compliance by the licensee of other provisions of
law judge. Specific factors are to be considered as set          the Act or this chapter; and
forth herein.                                                                                  (C) sanctions necessary to
                    (1) Seriousness of violation. The            deter other licensees from such violations.
following factors are identified:                                                    (5) Miscellaneous Factors. The following
                              (A) the nature of the harm         factors are identified:
caused, or the risk posed to the health, safety and welfare                                    (A) age and experience at time
of the public, such as emotional, physical or financial;         of violation;
                              (B) the extent of the harm                                       (B) presence or absence of
caused, or the risk posed, to the health, safety and welfare     prior or subsequent violations;
of the public; such as whether the harm is low, moderate                                       (C) conduct and work activity
or severe, and the number of persons harmed or exposed           prior to and following the violations;
to risk; and                                                                                   (D) character references; and
                              (C) the frequency and time-                                      (E) any other factors justice
periods covered by the violations, such as whether there         may require.
were multiple violations, or a single violation, and the
period of time over which the violations occurred.
                    (2) Nature of the violation. The following   §140.21 Severity Levels and Sanctions Guide
factors are identified:
                              (A) the relationship between       The following severity levels and sanctions guides are
the licensee and the person harmed, or exposed to harm;          based on the relevant factors in §140.20 of this title
                              (B) the vulnerability of the       (relating to Relevant Factors).
person harmed or exposed to harm;                                                    (1) Level One--Revocation of license.
                              (C) the moral culpability of the   These violations evidence intentional or gross misconduct
licensee, such as whether the violation was:                     on the part of the license, and/or cause or pose a high
                                        (i) intentional or       degree of harm to the public, and/or may require severe
premeditated;                                                    punishment as a deterrent to the licensee, or other
                                        (ii) due to blatant      licensees. The fact that a license is ordered revoked does
disregard or gross neglect; or                                   not necessarily mean the licensee can never again regain
                                        (iii) resulted from      licensure. In lieu of or in addition to revocation of license,
simple error or inadvertence; and                                the maximum administrative penalty of up to $5,000 per
                              (D) the extent to which the        day a violation continues or occurs may be assessed for
violation evidences a lack of character that could               these violations.
reasonably be assumed to affect the licensee's ability to                            (2) Level Two--Extended suspension of
safely or effectively engage in the practice of perfusion.       license. These violations involve less misconduct, harm,
                                                                 or need for deterrence than Level One violations, but may

25 Texas Administrative Code, Chapter 104                                                          Page 16
Perfusionist Licensing Program
require termination of licensure for a period of not less         conducted in accordance with the Open Meetings Act,
than one year. In lieu of or in addition to extended              Texas Government Code, Chapter 551, with the exception
suspension of license, a maximum administrative penalty           that the provisions allowing executive sessions shall not
of up to $3,000 per day a violation continues or occurs           apply.
may be assessed for these violations.                                        (c) Quorum. A simple majority of the committee
                    (3) Level Three--Moderate suspension          members is necessary to conduct official business.
of license. These violations are less serious than Level                     (d) Transaction of official business.
Two violations, but may require termination of licensure for                           (1) The committee may transact official
a period of time less than a year. In lieu of or in addition to   business only when in a legally constituted meeting with a
moderate suspension of license, a maximum                         quorum present.
administrative penalty of up to $1,000 per day a violation                             (2) Committee action shall require a
continues or occurs may be assessed for these violations.         majority vote of those members present and voting.
                    (4) Level Four--Probated suspension of                   (e) Policy against discrimination. The committee
licensure. These violations do not involve enough harm,           shall make no decision in the discharge of its statutory
misconduct, or need for deterrence to warrant termination         authority with regard to any person's race, color, disability,
of licensure, yet are severe enough to warrant monitoring         gender, religion, national origin, geographical distribution,
of the licensee to ensure future compliance. Probationary         age, physical condition, economic status, sexual
terms may be ordered as appropriate. In lieu of or in             orientation, or genetic information.
addition to probated suspension of license, a maximum                        (f) Conflict of interest. Any committee member
administrative penalty of up to $500 per day a violation          who has a conflict of interest regarding any matter before
continues or occurs may be assessed for these violations.         the committee, such as a matter pertaining to an
                    (5) Level Five--Reprimand. These              applicant's eligibility for licensure or a complaint against or
violations involve inadvertent or relatively minor                a violation by a licensee, shall so declare this and shall not
misconduct and/or rule violations not directly involving the      participate in any committee proceedings involving that
health, safety, and welfare of the public. In lieu of or in       individual or matter.
addition to the imposition of a reprimand, an administrative                 (g) Membership and employee restrictions.
penalty of not less than $50 and up to $250 per day a                                  (1) Texas trade association. A
violation continues or occurs may be assessed for these           cooperative and voluntarily joined statewide association of
violations.                                                       business or professional competitors in this state
                                                                  designated to assist its members and its industry or
§140.22 Texas State Perfusionist Advisory Committee               profession in dealing with mutual business or professional
                                                                  problems and in promoting their common interests.
          (a) Officers.                                                                (2) A person may not be a committee
                    (1) The Presiding Officer shall be            member and may not be a department employee
designated by the commissioner and serve at the pleasure          employed in a "bona fide executive, administrative, or
of the commissioner.                                              professional capacity," as that phrase is used for purposes
                    (2) The Assistant Presiding Officer shall     of establishing an exemption to the overtime provisions of
perform the duties of the presiding officer in case of the        the federal Fair Labor Standards Act of 1938 (U.S.C. §201
absence or disability of the chairman.                            et seq.) if:
                    (3) In case the presiding officer                                             (A) the person is an officer,
becomes vacant, the assistant presiding officer shall serve       employee, or paid consultant of a Texas trade association
until a successor is appointed by the commissioner.               in the field of health care; or
          (b) Meetings.                                                                           (B) the person's spouse is an
                    (1) The committee shall meet only to          officer, manager, or paid consultant of a Texas trade
conduct committee business.                                       association in the field of health care.
                    (2) Special meetings may be called by                              (3) A person may not be a member of
the commissioner at such times, dates, and places as              the committee or act as the general counsel to the
become necessary for the transaction of advisory                  committee or the department if the person is required to
committee business.                                               register as a lobbyist under Chapter 305, Government
                    (3) The committee is not a                    Code, because of the person's activities for compensation
"governmental body" as defined in the Open Meetings Act.          on behalf of a profession related to the operation of the
However, in order to promote public participation, each           department.
meeting of the committee shall be announced and                              (h) Attendance.

25 Texas Administrative Code, Chapter 104                                                           Page 17
Perfusionist Licensing Program
                    (1) Members shall attend regular          accordance with the Texas Open Meetings Act, Texas
committee meetings as scheduled.                              Government Code, Chapter 551.
                    (2) Upon request, the executive                      (l) Minutes.
secretary shall report to the commissioner, governor and                           (1) Drafts of the minutes of each
the Texas Sunset Advisory Commission the attendance           meeting shall be forwarded to each member of the
records of members.                                           committee for review and comments prior to approval by
                    (3) Except in case of emergency,          the committee.
committee members shall notify the presiding officer or                            (2) After approval by the committee, the
executive secretary at least 48 hours prior to the            minutes of any committee meeting are official only when
scheduled meeting if unable to be present.                    affixed with the original signatures of the presiding officer
                    (4) Except in case of emergency, the      and the executive secretary and official seal of the
executive secretary shall notify the presiding officer at     committee.
least 48 hours prior to the scheduled meeting if unable to                         (3) The official minutes of committee
be present.                                                   meetings shall be kept in the office of the executive
                    (5) It is grounds for removal from the    secretary and shall be available to any person desiring to
committee if a member is absent from more than half of        examine them during regular office hours.
the regularly scheduled committee meetings that the                      (m) Official records.
member is eligible to attend during a calendar year without                        (1) All official records of the committee
an excuse approved by a majority vote of the committee.       including application materials, except files containing
          (i) Reimbursement for expense. A member is          information considered confidential under the provisions of
entitled to reimbursement for expenses as provided by the     the Texas Open Records Act, Texas Government Code,
General Appropriations Act.                                   Chapter 552, shall be open for inspection during regular
                    (1) No compensatory per diem shall be     office hours.
paid to committee members unless required by law.                                  (2) Official records may not be taken
                    (2) A committee member who is an          from committee offices; however, persons may obtain
employee of a state agency, other than the department,        photocopies of files upon written request and by paying
may not receive reimbursement for expenses from the           the cost per page set by the department. Payment shall be
department.                                                   made prior to release of the records.
                    (3) A nonmember of the committee who                 (n) Official seal. The commissioner shall adopt an
is appointed to serve on a subcommittee may not receive       official seal for use in the course of official committee
reimbursement for expenses from the department.               business as authorized by the Act, §603.151(5).
                    (4) Each member who is to be                         (o) Registry.
reimbursed for expenses shall submit to staff the                                  (1) The department shall prepare a
member's receipts for expenses and any required official      registry of licensed perfusionists and provisionally licensed
forms no later than 14 days after each committee meeting.     perfusionists that is available to the public, license
                    (5) Requests for reimbursement of         holders, and appropriate state agencies.
expenses shall be made on official state travel vouchers                           (2) The registry shall include, but not be
prepared by department staff.                                 limited to, the names of current licensees.
          (j) Rules of order. The latest edition of Roberts                        (3) An original copy of the registry will
Rules of Order shall be the basis of parliamentary            be available for inspection by licensees and members of
decisions except where otherwise provided by these            the public in the office of the executive secretary.
committee rules.                                                         (p) Public interest information.
          (k) Agendas.                                                             (1) The department shall prepare
                    (1) The executive secretary shall         information of consumer interest describing the profession
prepare and submit to each member of the committee,           of perfusion, the regulatory functions of the department,
prior to each meeting, an agenda which includes items         and the procedures by which consumer complaints are
requested by members, items required by law, unfinished       filed with and resolved by the department.
business, and other matters of committee business which                            (2) The department shall make the
have been approved for discussion by the presiding            information available to the public and appropriate state
officer.                                                      agencies.
                    (2) The official agenda of a meeting                 (q) Executive secretary powers and duties. In
shall be filed with the Texas Secretary of State in           addition to performing other duties prescribed by this

25 Texas Administrative Code, Chapter 104                                                       Page 18
Perfusionist Licensing Program
section and by the department, the executive secretary
                   (1) administer licensing activity for the
                   (2) keep full and accurate minutes of the
committee's transactions and proceedings;
                   (3) serve as custodian of the
committee's files and other records;
                   (4) prepare and recommend to the
department plans and procedures necessary to implement
the objectives of this chapter, including rules and
proposals on administrative procedure;
                   (5) exercise general supervision over
persons employed by the department in the administration
of this chapter;
                   (6) investigate complaints and present
formal complaints;
                   (7) attend all committee meetings as a
nonvoting participant;
                   (8) handle the committee's
correspondence; and
                   (9) obtain, assemble, or prepare reports
and other information as directed or authorized by the

25 Texas Administrative Code, Chapter 104                      Page 19
Perfusionist Licensing Program

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