TDLR Health Monitor

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TDLR Health Monitor

The Medical & Health Professions Newsletter 

from the Texas Department of Licensing & Regulation 

Fall 2017

Welcome to the TDLR Health Monitor

Brian Francis color

A Message From the Executive Director

The Texas Department of Licensing and Regulation (TDLR) is a small agency with big responsibilities. This week, our responsibilities grew just a bit as we welcomed to the TDLR family six licensing programs from the Department of State Health Services (DSHS), joining our existing roster of 32 professional and business licensing programs.

I want our new licensees to know that at TDLR, you can expect quick, efficient licensing, exceptional customer service, and responsible regulatory oversight of your licensing program – and all at the lowest possible cost to you.

Since summer 2015, staff from TDLR and DSHS have worked together to consolidate the first phase of seven DSHS programs at TDLR (finalized in October 2016) and continued working together as we completed the second phase on November 1. Our focus has been to ensure there is no disruption of services. For our "phase two" licensees, we are ready to go and eager to serve each of you.

The TDLR Health Monitor is just one of the ways we are reaching out to share information with you about the services we provide for our medical and health programs, and give you some insight in to TDLR. I encourage you to visit the TDLR web pages for your program, where you will find everything you need to know about laws, rules, forms, advisory board meetings, FAQs, and the latest program information. Of course, if you haven’t already done so, make sure to sign up for email updates from TDLR so you can get alerts about important news relating to your program and other agency activities. 

Whether you came to TDLR this week or last October, I’d like to welcome you to our family. Please know that your voice matters to TDLR, and I always want to hear directly from our licensees about ways we can improve the work we do. Feel free to email me at with your insights and suggestions.                                                     

Yours in Service,

Brian Francis

TDLR Executive Director

Six Programs Transferred to TDLR from DSHS November 1, 2017

Phase Two cover

TDLR is excited to complete the second and final phase of Senate Bill 202 implementation. This important bill was enacted by the Texas Legislature during the 84th Regular Session (2015). The bill utilized a phased-in approach to the transfer of thirteen licensing programs to TDLR from DSHS.

On November 1, 2017, the second phase of the transition transferred six programs to TDLR: Code Enforcement Officers, Laser Hair Removal, Massage Therapy, Mold Assessors and Remediators, Offender Education Programs, and Sanitarians. Three of these programs - Code Enforcement Officers, Massage Therapy, and Sanitarians – will have a new advisory board at TDLR, with board member training planned for November, and board meetings beginning in December. 

TDLR invites you to attend the open public meetings of TDLR’s Advisory Boards and the Texas Commission of Licensing & Regulation, the agency's governing body. You may also watch all public meetings online at your convenience, in either our live streaming format, or after the meeting is complete through the TDLR YouTube channel. You may also be interested in following our TDLR Medical and Health Professions programs on Facebook and Twitter.

As with the seven programs which transferred from DSHS to TDLR in October 2016, most of the existing DSHS rules for the six new programs have been adopted by the Commission with minimal changes, apart from some fee reductions and formatting. The new rules took effect November 1, 2017, and are available to view on the TDLR website.

Here are some of the changes for the new programs at TDLR:

Mold Assessors & Remediators: New online functionality for the mold assessors and remediators program. Online mold project notifications will replace the previous DSHS paper forms. Mold remediation workers will receive a temporary license immediately upon completing the online application.  This will enable them to work while their full license applications, including TDLR’s criminal history checks, are being processed.

Code Enforcement Officers and Sanitarians: The examination process for code enforcement officers and sanitarians is changing to facilitate exam administration by TDLR’s exam contractor, PSI. A new candidate information bulletin (CIB) with information and instructions for each exam was posted on the TDLR website November 1.

Laser Hair Removal: Although licensing and renewals for laser hair removal individuals, facilities, and training programs has been transferred to TDLR, the regulation of laser devices remains with the DSHS Radiation Control Program.

Massage Therapists: Massage therapy establishment inspections will be conducted regularly by our Field Operations regional inspectors. Massage school and offender education program inspections will be performed by TDLR’s Education and Examination staff.

Complaints and Enforcement: TDLR Enforcement staff will begin receiving and processing new complaints on November 1. Complainants, respondents, and witnesses to open complaints which are being transferred from DSHS will be contacted by TDLR Enforcement staff once those complaints have been reviewed.

Staff from all functional areas at TDLR (Licensing, Customer Service, Compliance, Education & Examinations, and more) are actively involved in task forces and work groups to ensure that the program transfers from DSHS are seamless and successful.

For more information on the transfer, please visit our new programs webpage.  

First Anniversary of SB 202 Phase One Transfers

health professions


As mentioned above, the Texas Legislature passed Senate Bill 202 in 2015, transferring 13 health-related licensing programs from DSHS to TDLR. The first phase transferred seven programs to TDLR in October 2016.

As part of our mission to deliver improved service to Texans at a lower cost, TDLR reduced and eliminated numerous fees for many of the programs. Thanks to these reductions, Texas health professionals kept thousands of dollars in their pockets in their first year at TDLR.

In addition, TDLR reduced the word count in each program’s administrative rules to make them clear, concise, and easier to read--without impacting their effectiveness. For example, the program rules for athletic trainers went from 12,860 words to 5,255 words, for a 59% reduction.

At TDLR, one of our core values is open and free communication. Interested parties that are subscribed to the various program email distribution lists were the beneficiaries of this core value. For example, during this first year, 2,575 email subscribers for the Dietitians program were contacted 13 times (38,625 total emails delivered), with information about meetings, rule changes, licensing, and more. In addition, all interested parties were invited to four public meetings of the Dietitians Advisory Board.

TDLR is delivering on our promise to promote transparency and accountability, protect the health and safety of all Texans, and eliminate unnecessary barriers to doing business. You can find the one-year updates for each program on their respective webpages.

Athletic Trainers -

Dietitians -

Dyslexia Therapists & Practitioners -

Hearing Instrument Fitters & Dispensers -

Midwives -

Orthotists & Prosthetists -

Speech-Language Pathologists & Audiologists -

Podiatrist Licensing Program Transfers to TDLR

podiatry foot

In May, the Texas Legislature--acting on recommendations of the Sunset Advisory Commission--passed House Bill 3078, transferring the licensing and regulation of podiatrists to TDLR. HB 3078 was signed by Governor Greg Abbott on May 29, 2017, and TDLR began issuing licenses and performing all regulatory duties associated with the podiatry program on September 1, 2017.

In preparation for the transfer of the podiatry program, TDLR reached out to professional associations and license holders to raise awareness of the move, let them know what to expect with TDLR, and ask the professional experts how to improve the program. 

Texas has regulated podiatrists since 1923. Over the last several decades, podiatric medicine has evolved into a complex profession, requiring significant expertise. Podiatrists perform surgery, admit patients to hospitals, and have prescriptive authority. Some podiatrists complete three-year residencies to become certified to perform complex reconstructive surgeries, others are joining medical practices to work alongside orthopedic medical doctors, and many are recognized in the treatment of diabetic wound care. These services could have serious consequences to patients if performed incorrectly, which is why Texas licenses and regulates podiatrists. 

Licensing ensures a podiatrist has completed 90 hours of undergraduate coursework, four years at an approved podiatry school, and at least a one-year residency. A podiatrist also must pass both a three-part national podiatry exam and a state jurisprudence exam. To maintain the license, the podiatrist must have received 50 hours of continuing medical education every two years.

The practice of podiatry, as defined by Texas law, means the treatment of or offer to treat any disease, disorder, physical injury, deformity, or ailment of the human foot by any system or method.  Texans seek the services of podiatrists for a number of conditions including plantar fasciitis, neuromas, bunions, and problems related to diabetes.

TDLR’s mission is to protect public health and safety by ensuring podiatrists and their podiatric medical radiological technicians are qualified, competent, and in compliance with appropriate professional standards. Currently, there are approximately 1,109 podiatrists licensed and 478 podiatric medical radiological technicians registered with TDLR.

To learn more about the transition of the podiatry program and to sign-up to receive important email updates, visit TDLR's podiatry webpage.  To contact Customer Service, call 512-463-6599 or toll-free in Texas at 1-800-803-9202, or by email at

Athletic Trainers Begin Busy Fall Season

athletic trainer

As we head into the fall season, we also head into the heart of football season. For Texas licensed athletic trainers, it is their busiest time of the year. These skilled health professionals are a vital component of any football team, from the smallest high school playing six-man (now referenced as 1A) football to the state’s numerous college football programs, to our two NFL organizations, the Dallas Cowboys and Houston Texans. 

Athletic trainers’ dedication and commitment is evident whenever you see them on a sideline, from stabilizing a wide receiver’s ankle to evaluating a defensive back for possible concussion symptoms. The efforts of an athletic trainer can sometimes mean the difference between a player having to give up the sport and being able to continue playing and pursuing their dream.

When the 62nd Texas Legislature passed House Bill 602 in May 1971, Texas became the first state to license and regulate the practice of athletic training. Texas has been a leader in the regulation of athletic training across the United States. Since the program’s transfer from DSHS one year ago, TDLR has been proud to carry on the legacy of athletic trainer regulation in the state of Texas. The agency is also proud of the relationships it has cultivated with our stakeholders.

If you would like to learn more about athletic trainer licensing, you can visit the program’s webpage at

FAQ Spotlight: Speech-Language Pathology & Audiology


Each TDLR licensing program has its own homepage, accessible from From the program homepage, you can find valuable information on continuing education, forms, rules, frequently asked questions (FAQs), and other subjects. The FAQs for each program are categorized, which allows users to quickly find answers to their questions. 

The FAQs have been developed based on questions received by our customer service representatives and questions we receive while conducting outreach activities. FAQs are updated on a regular basis to reflect current questions and to give updated information on existing questions. 

Each edition of the Health Monitor will highlight a FAQ, which may also be found on the program’s FAQ page. This edition’s FAQ comes from the Speech-Language Pathology and Audiology program:

What are the supervision requirements for an assistant in speech-language pathology?

A supervisor of an assistant in speech-language pathology must provide a total of 8 hours of supervision per month. Four hours must be direct supervision, and up to four hours may be indirect supervision.

Indirect supervision would include monitoring activities, such as telephone conferences with the licensed assistant, evaluating the licensed assistant's records and correspondence, reviewing videotapes of the licensed assistant's therapy, and discussing the licensed assistant's performance with professional colleagues. Telepractice/telehealth may be used for in-direct supervision. For instance, a supervisor may wish to video conference with an assistant to discuss areas for improvement.

Two hours of the direct supervision must occur on-site, in-person. This means the supervisor must be physically present where the therapy is occurring. The supervisor must be directly observing the assistant in speech-language pathology providing client services. The supervisor may not be doing something else at the same time as the supervision. For the remaining two hours, the supervisor may directly supervise the direct client contact via telepractice/telehealth. If a supervisor is not using telepractice/telehealth, all four of the direct supervision hours must be in-person and onsite where the assistant is providing therapy.

For more information on the Speech-Language Pathology and Audiology program, please visit the program’s webpage.

TDLR at TPMA Foot & Ankle Conference

brian at tpma

In September, TDLR staff Dede McEachernMary WinstonHeather MuehrHemant Makan, and Colleen Tran welcomed visitors to the TDLR exhibit booth at the 2017 Texas Podiatric Medical Association (TPMA) Southwest Foot and Ankle Conference held in Frisco, TX. 

The Conference provided podiatrists and podiatric assistants with continuing medical education hours and hosted an exhibit hall that showcased the latest information on technology, innovations, and resources available today for the practice of podiatry. TDLR staff were on hand to answer questions regarding the transfer of the Podiatry Program, Renewals, Resident Applications, and the Jurisprudence Exam.

The team met with past board members and many association members. It was educational and beneficial for both conference attendees and TDLR staff. According to Hemant, "TDLR was well-received at the TPMA conference. Overall, the doctors were supportive of the change/consolidation and look forward to program improvements at TDLR."

On the last day of the Conference, Executive Director Brian Francis presented the Ethics portion of the continuing medical education with an informational overview of TDLR, the transition, and what to expect moving forward. Many of the attendees thanked the TDLR staff for being there to answer questions.  

L-R) Health Professions Program Specialist Hemant Makan, Paul Kinberg, DPM, David Bastawros, DPM, and Executive Director Brian Francis at the 2017 TPMA Foot & Ankle Conference.

Texans Helping Texans: Hurricane Harvey Recovery

house hands

In late August, the Texas Coastal Bend and Houston areas were devastated by Hurricane Harvey, the first major hurricane to make landfall in the United States in 12 years. The storm brought with it catastrophic flooding and destructive winds after making landfall near Rockport.

As Texans responded to the ongoing disaster caused by Hurricane Harvey, TDLR reached out to help those in the affected areas. During this difficult time, we streamlined procedures to help our licensees and small businesses recover as quickly as possible.

In coordination with Governor Greg Abbott's proclamation, TDLR implemented fast-track licensing procedures for all eligible TDLR licensees in the affected counties to help them recover and return to work as quickly as possible.  Those procedures include waiving late fees and license replacement fees, waiving continuing education (CE) requirements, and extending certain license expiration dates for 60 days. TDLR is also continuing to offer the same mold remediation waiver requests available from DSHS prior to the November 1 program transfer.

On October 20, 2017, Gov. Abbott extended the disaster declaration for an additional 30 days. Stay updated on any future extensions and find out more about TDLR’s response to Hurricane Harvey by visiting our website at

New Advisory Board & Committee Appointments


On October 20, 2017, the Texas Commission of Licensing and Regulation made appointments to the following medical & health-related advisory boards and committees: 

TDLR welcomes all our new board and committee members. We look forward to working together!

Upcoming Advisory Board Meetings


Unless otherwise noted, TDLR Commission meetings and all Advisory Board meetings will be held in the Department's North Campus, 1106 Clayton Lane in Austin. Full details and directions