UPDATED TDLR Health Monitor - August 2021

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Vol. 14 |  August 2021

Message from the Executive Director

Brian Francis color

Welcome to the 15th edition of the TDLR Health Monitor, our quarterly newsletter for TDLR’s medical and health professionals. This edition marks our sixth newsletter produced during the COVID-19 pandemic. As of this writing, the Delta variant is threatening to slow down the hard-won progress made in recent months. I want to thank each of you for continuing to do your best to protect yourselves, your families, and your clients during these trying times.

Here at TDLR, we are hard at work implementing the bills passed by the 87th Texas Legislature during the regular session. We have 28 bill teams – some large, some small – tasked with ensuring that every bill is closely examined to determine its impact on our licensees and on how we regulate. You can read about more about this process and how these bills will affect licensees in the Legislative Update below.

Rulemaking plays a huge role in this process, and our advisory boards will be the first stop for all upcoming rule proposals. I encourage each of you to attend advisory board meetings by video conference.

Ways to offer input include submitting public comments through the rulemaking process and at advisory board and Commission meetings. Comments may be submitted in writing. You may also attend the Commission meetings by videoconference. We always welcome your feedback. Please keep an eye out for TDLR’s email notices of upcoming meetings and rule proposals, and be sure to bookmark the TDLR Meetings webpage. You can find not just the date and time of the upcoming meetings, but also links to agendas and information on how to participate.

Be sure to check our 87th Legislature webpage where you can see the final list of all the bills passed by the Legislature that relate to TDLR and its programs. Just click on the bill number and you can see the history and text of each bill at Texas Legislature Online.

Once again, I want to thank each of you for the essential care you have provided and continue to provide to Texans, and for your continued patience over the past few months as we have experienced delays in our application processing. I hope you, your loved ones, and your clients continue to stay safe and healthy as we work together to finally put COVID-19 behind us once and for all.

Yours in Service,

Brian Francis, TDLR Executive Director

Legislative Update

texas capitol 3

Several new state laws affecting TDLR Health Professions licensees will go into effect September 1, 2021. Some laws will take effect later. The laws were passed during the 87th Regular Session of the Texas Legislature.

In order to administer these changes, in some cases, the agency must first develop rules for implementation. Some bills include specific direction to TDLR on the rules the agency must adopt and the deadline for adoption. The rulemaking process gives the public an opportunity to provide comment and feedback at TDLR advisory board meetings.

The public can also participate in the process when proposed rules are published in the Texas Register and at meetings of the Texas Commission of Licensing and Regulation when the rules are discussed and brought up for a vote. The rulemaking process can take several months to complete.

To keep abreast of proposed rule changes, TDLR urges interested parties to sign up for email updates tailored to specific licensing programs: https://public.govdelivery.com/accounts/TXDLR/subscriber/new. Select "important notices" for the programs of interest.

The following is a selection of new laws affecting TDLR licensees. For a full list, please see the TDLR website: https://www.tdlr.texas.gov/legislation.htm.

  • HB 1560, TDLR’s Sunset bill: Extends TDLR for another 12 years. The Texas Sunset Commission will next evaluate TDLR and whether it should remain an agency in 2033.

Health Professions (Athletic Trainers, Behavior Analysts, Dietitians, Dyslexia Therapy, Hearing Instrument Fitters and Dispensers, Massage Therapy, Midwives, Podiatrists, Speech-Language Pathologists and Audiologists)

  • SB 40 authorizes the Commission to adopt rules to ensure standards of care are met while providing services by telehealth and removes impediments to the use of telehealth in some health professions programs that TDLR administers.

 Massage Therapy:

  • HB 3721 requires massage establishments to post human trafficking awareness signs that include information on how to contact the Texas Department of Public Safety to report suspicious activity.
  • HB 1540 includes new criminal penalties for allowing prostitution in a massage establishment.
  • SB 1130 allows massage therapy schools to provide distance education in certain circumstances.


  • SB 1941directs the Texas Health and Human Services Commission to create a strategic plan for improving the diagnosis and treatment of hyperemesis gravidarum, a disorder that occurs during pregnancy and can cause extreme, persistent nausea and vomiting that leads to dehydration, weight loss or electrolyte imbalance.


  • HB 2509 includes nationally accredited post-doctor of podiatric medicine programs (DPM) in the definition of graduate medical education programs, which will allow podiatric programs to receive funding through the Texas Higher Education Coordinating Board.
  • SB 768 increases the criminal penalties for manufacture or delivery of fentanyl and related substances.

Commissioner Spotlight: Chairman Rick Figueroa

Rick Figueroa 2

The Texas Commission of Licensing and Regulation (Commission) is the governing board and policymaking body that oversees the Texas Department of Licensing and Regulation (TDLR). The Commission has seven members who are appointed by the Governor and serve staggered six-year terms.

We’re spotlighting Commissioners in the TDLR Health Monitor so you can learn more about them. Please meet Rick Figueroa, who was appointed to the Commission in 2016 and was appointed Chair in 2019.

A life of public service doesn’t just happen. Chairman Figueroa’s considerable experience and achievement has been the result of hard work and underlying it all is adherence to the seven rules his mom taught him to embody. A few of those rules include ‘get up and get to work,’ ‘look for ways to help others,’ ‘keep to your faith’ and ’call your mother.' These basic tenets have clearly worked well for his success.  

Mr. Figueroa is the youngest of eight children who were born into a modest but happy home. Everybody in the home had a job to do. The family’s strong work ethic was instilled in him from a young age. Mr. Figueroa obtained his B.A. in Accounting and M.S. in Land Economics from Texas A&M University. After graduating, he worked in South America for firms such as Arthur Andersen and Halliburton, where he gained extensive organizational and financial experience and an appreciation for the unique challenges people face in their profession. Mr. Figueroa also worked for such financial powerhouses such as Merrill Lynch and UBS. Most recently, he has become a managing partner at Patron Partners, LLC, a financial management firm.   

Chairman Figueroa lives in Brenham with his wife Laura. They have four children and love to travel and entertain family and friends. In addition to his new financial management firm, the chairman is also a member of multiple boards including the Memorial Hospital System, Young Life Hispanic National Committee, Houston/Gulf Coast Chapter of the American Leadership Forum, and the American Judicial Council. This broad involvement benefits TDLR in having a chairman who clearly understands the complexity of the many professions TDLR regulates and looks to lift people through good work.  

Commission Adopts Rule Amendments at Recent Meetings

Stack of Books

The Texas Commission of Licensing and Regulation has adopted the following rule amendments:

Behavior Analysts

Adopted amendments and new rule establish standards and responsibilities for delivering behavior analysis services by license holders who choose to provide their services using telehealth. 

The adoption justification was published in the May 28, 2021, issue of the Texas Register (46 TexReg 3389). These amendments went into effect on June 1, 2021. You can find information about the new rules on the Behavior Analysts program webpage.

Dyslexia Therapy

Adopted amendments reduce documentation required of license applicants certified by ALTA, designate approved examinations, allow continuing education credit for human trafficking prevention training courses, and allow telehealth services without an initial in-person meeting.

The adoption justification was published in the May 28, 2021, issue of the Texas Register (46 TexReg 3385). These amendments went into effect on June 1, 2021. You can find information about the new rules on the Dyslexia Therapy program webpage.

Hearing Instrument Fitters and Dispensers 

Emergency rulemaking was necessary to ensure that services to clients may continue to be provided through telehealth as was allowed under the waivers that were granted by the Governor during the COVID-19 pandemic. This emergency rulemaking also reflects the change in the statutory authority regarding telehealth.

More information regarding the new rules will be posted soon to the Hearing Instrument Fitters and Dispensers program webpage.

Speech-Language Pathologists and Audiologists 

Emergency rulemaking was necessary to ensure that services to clients and supervision of certain licensees may continue to be provided through telehealth as was allowed under the waivers that were granted by the Governor during the COVID-19 pandemic. This emergency rulemaking also reflects the change in the statutory authority regarding telehealth.

More information regarding the new rules will be posted soon to the Speech-Language Pathologists and Audiologists program webpage.

Department Continuing Education and Procedural Rules

The Commission readopted existing rules at 16 Texas Administrative Code, Chapter 59, regarding Continuing Education Requirements, and Chapter 60, regarding Procedural Rules of the Commission and the Department as a result of the four-year rule review. These readoptions went into effect on July 15, 2021.

The Commission adopted amendments to 16 Texas Administrative Code, Chapter 60, Subchapter D, §60.42, that reduced the fee amount charged for the Criminal History Evaluation Letter (CHEL) from $25 to $10. The amendment went into effect June 15, 2021.

The Commission adopted amendments to 16 Texas Administrative Code, Chapter 60, Subchapter B, §60.22, that enable the executive director to issue emergency licenses to license holders whose licenses expire during a state disaster declared by the governor. These amendments will go into effect September 1, 2021.

Information on these adoptions and links to the adoption justifications can be found on the TDLR webpage.

first AT license

The first Athletic Trainer license issued in Texas.

Athletic Trainers Mark Fifty Years of Texas Licensure

50 years

On September 1, 1971, through the passage of House Bill 602 by the 62nd Texas Legislature, Texas became the first state in the U.S. to license and regulate athletic trainers. The bill also created the Texas Board of Athletic Trainers, which we now know as the Advisory Board of Athletic Trainers.

When licensure was first established, the application fee was $25, and the renewal fee was $10. Since then, Texas athletic trainers have been on the forefront of the treatment and care of athletes, both in Texas and around the world. 

As we celebrate this monumental anniversary, we must say how grateful we are to the individuals, like Logan Wood, Frank Medina, and Allan Eggert, who were instrumental in establishing licensure in our great state. We also recognize every board member, executive secretary, executive director, staff member and others who have filled a role in athletic training regulation since then.

TDLR salutes 50 years of athletic trainer licensure in Texas, and we look forward to the next 50 years!

UPDATED Advisory Board Appointments

The “Advisory Board Appointment” article has been updated to reflect a recent appointment and two reappointments to the Podiatric Medical Examiners Advisory Board.

advisory board

On August 10, 2021, the Texas Commission of Licensing and Regulation approved the following reappointments for three medical and health professions advisory boards:

Dietitians Advisory Board

  • Janet Hall: term expires 9/1/2027

Massage Therapy Advisory Board

  • Susan Sparks: term expires 9/1/2027
  • Carol Willess: term expires 9/1/2027

Speech Language Pathologists and Audiologists Advisory Board

  • Sherry Sancibrian: term expires 9/1/2027

On June 7, 2021, Governor Greg Abbott announced the following appointment and reappointments to the Podiatric Medical Examiners Advisory Board:

  • Leslie Campbell, D.P.M., reappointed: term expires 2/1/2027
  • Amanda Nobles, new appointment: term expires 2/1/2027
  • Renee Pietzsch, D.P.M., reappointed: term expires 2/1/2027

Congratulations to all new and reappointed members.

To learn more about specific advisory boards and committees, visit the program’s webpage and select Advisory Board or Advisory Committee from the menu on the right-hand side of the page

Revised Massage Therapy Sample Consultation Document Available

massage consultation document

TDLR recently released a revised Massage Therapy Sample Consultation Document that massage therapists may use as a guide in developing their consultation document.

The revised document even provides a handy checklist so you can ensure that your current consultation document meets the minimum requirements established by rule.

Texas Massage Therapy rules require all massage therapists to provide an initial consultation document to each client before the first massage therapy session. An updated document must be provided if the client’s reason for seeking massage therapy changes and:

  • the type of massage therapy services or techniques the licensee anticipates using during the massage therapy session changes; or
  • the parts of the client’s body that will be massaged or the areas of the client’s body that will be avoided during the session, including indications and contraindications, changes.

Additionally, the rules require licensees to obtain a new written consent before each session in which breast massage of a female client will be performed. This may be accomplished on a new consultation document or in a separate document.

You may use the link above to go directly to the sample document or you can find it on the Massage Therapy webpage under Forms and Publications.

Virtual Midwives Educational Summit

midwives summit

Mark your calendars! TDLR will host the next Midwives Educational Summit virtually on Friday, December 10, 2021.

The TDLR Midwives Educational Summit is a one-day educational conference hosted by TDLR for the purpose of discussing emerging topics and best practices in midwifery.

We have an exciting line up of topics planned for you. A few of the confirmed presentations include:

  • Special Families, Special Births: Supporting clients in Non-Traditional Families and LGBTQ Identities;
  • Effects of COVID on Pregnancy, Labor, Birth and Postpartum; and
  • How to Start Your Midwifery Journey in Order to Avoid Burnout.

Breakout sessions have been added to the agenda to allow participant interaction.

Keep an eye on the Midwives Educational Summit webpage, as the full agenda and information on how to join the virtual summit will be posted in the coming weeks.

Participation in the virtual summit is free and attendance will be tracked for licensed midwives wishing to earn continuing education credits. We look forward to hosting this virtual event and hope to "see" you there.

Reminder: How To File A Complaint

complaint button

You can file a complaint online for most TDLR programs. 

You will be asked to choose whether you are filing a complaint against a licensed or an unlicensed person or business. If you are unsure about whether the person or business holds a TDLR license, use the unlicensed link.

Some medical or health-related programs require you to submit a complaint form by fax or mail, due to the risk of electronically transmitting confidential health information. The online system will direct you to print out a complaint form in .pdf format if one is required.

If your complaint does not allege a violation of the law or rules or does not include sufficient information for TDLR to investigate the allegations, TDLR will not open a complaint.

Read more about TDLR's complaint investigation and resolution process.

Meet TDLR at Upcoming Conferences

pod conf june 21

Over the past year, due to Covid concerns, TDLR Medical and Health Professions staff have only been available to attend conferences virtually. However, we are pleased to announce that TDLR staff will now be available to also meet you in person at the below conferences. We hope to see you at one of these upcoming events!

TDLR is available to provide informational presentations and/or staff booths, either virtually or in person, at your next conference or meeting. If you would like a TDLR representative at your next conference or meeting, please contact us

Upcoming Advisory Board Meetings

meeting mics

Until further notice, Commission meetings and all advisory board meetings will be held via videoconference. You can view live broadcasts or archived meetings on TDLR's YouTube channel. Meeting notices, agendas and staff reports are posted on the TDLR Meetings page.

Let's Get Social!

lets get social

TDLR has an active social media presence that provides useful information about our agency and its programs on Facebook, Twitter and Instagram. These accounts are great resources for everyone, providing the latest TDLR news and information 

We even have a YouTube channel that carries Commission and advisory board meetings, important licensing information and useful tips for everyday life.

If you're not already following us, please take a moment to follow us on: