81R3306 BEF-F By: Eissler H.B. No. 461 A BILL TO BE ENTITLED AN ACT relating to the regulation of dyslexia practitioners and therapists; providing penalties. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subtitle G, Title 3, Occupations Code, is amended by adding Chapter 403 to read as follows: CHAPTER 403. LICENSED DYSLEXIA PRACTITIONERS AND LICENSED DYSLEXIA THERAPISTS SUBCHAPTER A. GENERAL PROVISIONS Sec. 403.001. DEFINITIONS. In this chapter: (1) "Commissioner" means the commissioner of state health services. (2) "Department" means the Department of State Health Services. (3) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission. (4) "License holder" means a person who holds a license issued under this chapter. (5) "Multisensory structured language education" means a program described by the International Multisensory Structured Language Education Council for the treatment of individuals with dyslexia and related disorders that provides instruction in the skills of reading, writing, and spelling: (A) through program content that includes: (i) phonology and phonological awareness; (ii) sound and symbol association; (iii) syllables; (iv) morphology; (v) syntax; and (vi) semantics; and (B) following principles of instruction that include: (i) simultaneous multisensory instruction, including visual-auditory-kinesthetic-tactile instruction; (ii) systematic and cumulative instruction; (iii) explicit instruction; (iv) diagnostic teaching to automaticity; and (v) synthetic and analytic instruction. (6) "Qualified instructor" means a person described by Section 403.113. Sec. 403.002. ADMINISTRATION BY DEPARTMENT OF STATE HEALTH SERVICES. The department shall administer this chapter. Sec. 403.003. APPLICABILITY. This chapter does not: (1) require a school district to employ a person licensed under this chapter; or (2) authorize a person who is not licensed under Chapter 401 to practice audiology or speech-language pathology. [Sections 403.004-403.050 reserved for expansion] SUBCHAPTER B. POWERS AND DUTIES Sec. 403.051. ADVISORY COMMITTEE. The department shall appoint an advisory committee to advise the department in administering this chapter. Sec. 403.052. RULES. The executive commissioner shall adopt rules necessary to administer and enforce this chapter, including rules that establish standards of ethical practice. [Sections 403.053-403.100 reserved for expansion] SUBCHAPTER C. LICENSE REQUIREMENTS Sec. 403.101. LICENSE REQUIRED. A person may not use the title "licensed dyslexia practitioner," "dyslexia practitioner," "licensed dyslexia therapist," or "dyslexia therapist" in this state unless the person holds the appropriate license under this chapter. Sec. 403.102. ISSUANCE OF LICENSE. The department shall issue a licensed dyslexia practitioner or licensed dyslexia therapist license to an applicant who meets the requirements of this chapter. Sec. 403.103. LICENSE APPLICATION. (a) A license applicant must apply to the department on a form and in the manner the department prescribes. (b) The application must be accompanied by a nonrefundable application fee. Sec. 403.104. ELIGIBILITY FOR LICENSED DYSLEXIA PRACTITIONER LICENSE. (a) To be eligible for a licensed dyslexia practitioner license, an applicant must have: (1) earned a bachelor's degree from an accredited public or private institution of higher education; (2) successfully completed at least 45 hours of course work in multisensory structured language education from a training program that meets the requirements of Section 403.106; (3) completed at least 60 hours of supervised clinical experience in multisensory structured language education; (4) completed at least five demonstration lessons of the practice of multisensory structured language education, each observed by an instructor from a training program that meets the requirements of Section 403.106 and followed by a conference with and a written report by the instructor; and (5) successfully completed a national multisensory structured language education competency examination approved by the department and administered by a national certifying professional organization. (b) Clinical experience required under Subsection (a)(3) must be obtained under: (1) the supervision of a qualified instructor or an instructor from an accredited training program that meets the requirements of Section 403.106; and (2) guidelines approved by the department. Sec. 403.105. ELIGIBILITY FOR LICENSED DYSLEXIA THERAPIST LICENSE. (a) To be eligible for a licensed dyslexia therapist license, an applicant must have: (1) earned at least a master's degree from an accredited public or private institution of higher education; (2) successfully completed at least 200 hours of course work in multisensory structured language education from a training program that meets the requirements of Section 403.106; (3) completed at least 700 hours of supervised clinical experience in multisensory structured language education; (4) completed at least 10 demonstration lessons of the practice of multisensory structured language education, each observed by an instructor from a training program that meets the requirements of Section 403.106 and followed by a conference with and a written report by the instructor; and (5) successfully completed a national multisensory structured language education competency examination approved by the department and administered by a national certifying professional organization. (b) Clinical experience required under Subsection (a)(3) must be obtained under: (1) the supervision of a qualified instructor or an instructor from an accredited training program that meets the requirements of Section 403.106; and (2) guidelines approved by the department. Sec. 403.106. REQUIREMENTS FOR TRAINING PROGRAMS. (a) For purposes of determining whether an applicant satisfies the training requirements for a license under this chapter, a multisensory structured language education training program completed by the applicant must: (1) be accredited by a nationally recognized accrediting organization; (2) have in writing defined goals and objectives, areas of authority, and policies and procedures; (3) have the appropriate financial and management resources to operate the training program, including a knowledgeable administrator and standard accounting and reporting procedures; (4) have a physical site, equipment, materials, supplies, and environment suitable for the training program; (5) have a sufficient number of instructional personnel who have completed the requirements for certification in multisensory structured language education; (6) have been reviewed by multisensory structured language education professionals who are not affiliated with the training program; (7) have developed and followed procedures to maintain and improve the quality of training provided by the program; (8) have provided direct instruction in the principles and in each element of multisensory structured language education for a minimum of: (A) 200 contact hours of coursework for training program participants who seek a licensed dyslexia therapist license; and (B) 45 contact hours of coursework for training program participants who seek a licensed dyslexia practitioner license; (9) have required training program participants to complete a program of supervised clinical experience in which the participants provided multisensory structured language education to students either individually or in small groups for a minimum of: (A) 700 hours for training program participants who seek a licensed dyslexia therapist license; and (B) 60 hours for training program participants who seek a licensed dyslexia practitioner license; (10) have required training program participants to demonstrate the application of multisensory structured language education principles of instruction by completing demonstration lessons observed by an instructor and followed by a conference with and a written report by the instructor; and (11) have provided instruction based on the Texas Education Agency publication "The Dyslexia Handbook: Procedures Concerning Dyslexia and Related Disorders (2007)," or a revised version of that publication approved by the department. (b) A training program must require a training program participant who seeks a licensed dyslexia practitioner license to have completed at least five demonstration lessons described by Subsection (a)(10) and a participant who seeks a licensed dyslexia therapist license to have completed at least 10 demonstration lessons. (c) The department, in consultation with the advisory committee, shall determine whether a training program meets the requirements of this section. Sec. 403.107. EXAMINATION; RULES. (a) To obtain a license, an applicant must: (1) pass a written examination approved by the department under Subsection (b); and (2) pay fees set by the executive commissioner. (b) The department shall, in consultation with the advisory committee: (1) approve a competency examination that is related to multisensory structured language education and that will be administered at least twice each year by a professional organization that issues national certifications; and (2) maintain a record of all examinations for at least two years after the date of examination. Sec. 403.108. REEXAMINATION. (a) A person who fails the examination may take a later examination on payment of a nonrefundable fee for the examination. (b) An applicant who fails two examinations may not be reexamined until the person: (1) submits a new application accompanied by a nonrefundable application fee; and (2) presents evidence acceptable to the department of additional study in the area for which a license is sought. Sec. 403.109. WAIVER OF EXAMINATION REQUIREMENT. The department, in consultation with the advisory committee, may waive the examination requirement and issue a license to an applicant who holds an appropriate certificate or other accreditation from a nationally accredited multisensory structured language education organization recognized by the department. Sec. 403.110. PROVISIONAL LICENSE. (a) The department, in consultation with the advisory committee, may issue a provisional license to an applicant currently licensed in another jurisdiction who seeks a license in this state and who: (1) has been certified in good standing as a multisensory structured language education professional for at least two of the last five years in another jurisdiction, including a foreign country, that has certification requirements substantially equivalent to the license requirements of this chapter; (2) has passed a national multisensory structured language education certification examination or an equivalent examination recognized by the department; and (3) is sponsored by a person licensed by the department under this chapter with whom the provisional license holder will practice during the time the person holds a provisional license. (b) The department may waive the requirement of Subsection (a)(3) for an applicant if the department determines that compliance with that subsection would be a hardship to the applicant. (c) A provisional license is valid until the date the department approves or denies the provisional license holder's application for a license. (d) The department shall issue a license under this chapter to the provisional license holder if: (1) the provisional license holder demonstrates knowledge and understanding of the laws and rules relating to the practice of multisensory structured language education in this state; (2) the department verifies that the provisional license holder meets the academic and experience requirements for a license under this chapter; and (3) the provisional license holder satisfies any other licensing requirements under this chapter. (e) The department must approve or deny a provisional license holder's application for a license not later than the 180th day after the date the provisional license is issued. The department may extend the 180-day period if the results of an examination have not been received by the department before the end of that period. Sec. 403.111. TEMPORARY LICENSE; RULES. The executive commissioner by rule may provide for the issuance of a temporary license. Sec. 403.112. INACTIVE STATUS; RULES. (a) The executive commissioner by rule may provide for a license holder to be placed on inactive status. (b) Rules adopted under this section must include a time limit for a license holder to remain on inactive status. Sec. 403.113. QUALIFIED INSTRUCTOR. To be considered a qualified instructor under this chapter, a person must: (1) be a licensed dyslexia therapist; (2) have at least 1,400 hours of clinical teaching experience; and (3) have completed a two-year course of study dedicated to the administration and supervision of multisensory structured language education programs taught by a nationally accredited training program that meets the requirements of Section 403.106. [Sections 403.114-403.150 reserved for expansion] SUBCHAPTER D. PRACTICE BY LICENSE HOLDER Sec. 403.151. PRACTICE SETTING. (a) A licensed dyslexia practitioner may practice only in an educational setting, including a school, learning center, or clinic. (b) A licensed dyslexia therapist may practice in a school, learning center, clinic, or private practice setting. Sec. 403.152. CONTINUING EDUCATION. (a) A license holder may not renew the person's license unless the person meets the continuing education requirements established by the executive commissioner. (b) The executive commissioner, in consultation with the advisory committee, shall establish the continuing education requirements in a manner that allows a license holder to comply without an extended absence from the license holder's county of residence. (c) The department shall: (1) provide to a license applicant, with the application form on which the person is to apply for a license, information describing the continuing education requirements; and (2) notify each license holder of any change in the continuing education requirements at least one year before the date the change takes effect. [Sections 403.153-403.200 reserved for expansion] SUBCHAPTER E. LICENSE DENIAL; COMPLAINT AND DISCIPLINARY PROCEDURES Sec. 403.201. COMPLAINTS. Any person may file a complaint with the department alleging a violation of this chapter or a rule adopted under this chapter. Sec. 403.202. PROHIBITED ACTIONS. A license holder may not: (1) obtain a license by means of fraud, misrepresentation, or concealment of a material fact; (2) sell, barter, or offer to sell or barter a license; or (3) engage in unprofessional conduct that endangers or is likely to endanger the health, welfare, or safety of the public as defined by executive commissioner rule. Sec. 403.203. GROUNDS FOR DISCIPLINARY ACTION. If a license holder violates this chapter or a rule or code of ethics adopted by the executive commissioner, the department shall: (1) revoke or suspend the license; (2) place on probation the person if the person's license has been suspended; (3) reprimand the license holder; or (4) refuse to renew the license. Sec. 403.204. LICENSE DENIAL, REVOCATION, OR SUSPENSION FOR CRIMINAL CONVICTION. (a) The department may deny a license or may suspend or revoke a license if the applicant or license holder has been convicted of a misdemeanor involving moral turpitude or a felony. The department may take action authorized by this section when: (1) the time for appeal of the person's conviction has elapsed; (2) the judgment or conviction has been affirmed on appeal; or (3) an order granting probation is made suspending the imposition of the person's sentence, without regard to whether a subsequent order: (A) allows withdrawal of a plea of guilty; (B) sets aside a verdict of guilty; or (C) dismisses an information or indictment. (b) A plea or verdict of guilty or a conviction following a plea of nolo contendere is a conviction for purposes of this section. Sec. 403.205. HEARING. (a) If the department proposes to revoke, suspend, or refuse to renew a person's license, the person is entitled to a hearing before a hearings officer appointed by the State Office of Administrative Hearings. (b) The executive commissioner shall prescribe procedures for appealing to the commissioner a decision to revoke, suspend, or refuse to renew a license. Sec. 403.206. ADMINISTRATIVE PROCEDURE. A proceeding under this subchapter to suspend, revoke, or refuse to renew a license is governed by Chapter 2001, Government Code. Sec. 403.207. SANCTIONS. (a) The executive commissioner, in consultation with the advisory committee, by rule shall adopt a broad schedule of sanctions for a violation of this chapter. (b) The State Office of Administrative Hearings shall use the schedule of sanctions for a sanction imposed as the result of a hearing conducted by that office. Sec. 403.208. PROBATION. The department may require a license holder whose license suspension is probated to: (1) report regularly to the department on matters that are the basis of the probation; (2) limit practice to areas prescribed by the department; or (3) continue the license holder's professional education until the license holder attains a degree of skill satisfactory to the department in those areas that are the basis of the probation. Sec. 403.209. MONITORING OF LICENSE HOLDER. (a) The executive commissioner by rule shall develop a system for monitoring a license holder's compliance with the requirements of this chapter. (b) Rules adopted under this section must include procedures to: (1) monitor for compliance a license holder who is ordered by the department to perform certain acts; and (2) identify and monitor license holders who represent a risk to the public. Sec. 403.210. INFORMAL PROCEDURES. (a) The executive commissioner by rule shall adopt procedures governing: (1) informal disposition of a contested case under Section 2001.056, Government Code; and (2) an informal proceeding held in compliance with Section 2001.054, Government Code. (b) Rules adopted under Subsection (a) must: (1) provide the complainant and the license holder an opportunity to be heard; and (2) require the presence of a representative of the attorney general or the department's legal counsel to advise the department or the department's employees. Sec. 403.211. REFUND. (a) Subject to Subsection (b), the department may order a license holder to pay a refund to a consumer as provided in an agreement resulting from an informal settlement conference instead of or in addition to imposing an administrative penalty under this chapter. (b) The amount of a refund ordered as provided in an agreement resulting from an informal settlement conference may not exceed the amount the consumer paid to the license holder for a service regulated by this chapter. The department may not require payment of other damages or estimate harm in a refund order. Sec. 403.212. REINSTATEMENT. (a) A person may apply for reinstatement of a revoked license on or after the first anniversary of the date of revocation. (b) The department may: (1) accept or reject the application; and (2) require an examination as a condition for reinstatement of the license. Sec. 403.213. REPRIMAND; CONTINUING EDUCATION. (a) In addition to other disciplinary action authorized by this subchapter, the department may: (1) issue a written reprimand to a license holder who violates this chapter; or (2) require that a license holder who violates this chapter attend continuing education programs. (b) The department, in consultation with the advisory committee, may specify the number of hours of continuing education that must be completed by a license holder to fulfill the requirement of Subsection (a)(2). Sec. 403.214. EMERGENCY SUSPENSION. (a) The department shall temporarily suspend the license of a license holder if the department determines from the evidence or information presented to it that continued practice by the license holder would constitute a continuing and imminent threat to the public welfare. (b) A license may be suspended under this section without notice or hearing on the complaint if: (1) action is taken to initiate proceedings for a hearing before the State Office of Administrative Hearings simultaneously with the temporary suspension; and (2) a hearing is held as soon as practicable under this chapter and Chapter 2001, Government Code. (c) The State Office of Administrative Hearings shall hold a preliminary hearing not later than the 14th day after the date of the temporary suspension to determine if there is probable cause to believe that a continuing and imminent threat to the public welfare still exists. A final hearing on the matter shall be held not later than the 61st day after the date of the temporary suspension. [Sections 403.215-403.250 reserved for expansion] SUBCHAPTER F. ADMINISTRATIVE PENALTY Sec. 403.251. IMPOSITION OF ADMINISTRATIVE PENALTY. The department may impose an administrative penalty on a person licensed under this chapter who violates this chapter or a rule or order adopted under this chapter. Sec. 403.252. AMOUNT OF ADMINISTRATIVE PENALTY. (a) The amount of the administrative penalty may not be more than $5,000 for each violation. Each day a violation continues or occurs is a separate violation for the purpose of imposing a penalty. (b) The amount shall be based on: (1) the seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation; (2) the economic harm caused by the violation; (3) the history of previous violations; (4) the amount necessary to deter a future violation; (5) efforts to correct the violation; and (6) any other matter that justice may require. (c) The executive commissioner by rule shall adopt an administrative penalty schedule based on the criteria listed in Subsection (b) for violations of this chapter or applicable rules to ensure that the amounts of penalties imposed are appropriate to the violation. The executive commissioner shall provide the administrative penalty schedule to the public on request. Sec. 403.253. REPORT AND NOTICE OF VIOLATION AND PENALTY. (a) If the commissioner or the commissioner's designee determines that a violation occurred, the commissioner or the designee may issue to the department a report stating: (1) the facts on which the determination is based; and (2) the commissioner's or the designee's recommendation on the imposition of an administrative penalty, including a recommendation on the amount of the penalty. (b) Within 14 days after the date the report is issued, the commissioner or the commissioner's designee shall give written notice of the report to the license holder. The notice must: (1) include a brief summary of the alleged violation; (2) state the amount of the recommended administrative penalty; and (3) inform the license holder of the license holder's right to a hearing on the occurrence of the violation, the amount of the penalty, or both. Sec. 403.254. PENALTY TO BE PAID OR HEARING REQUESTED. (a) Within 10 days after the date the license holder receives the notice, the license holder in writing may: (1) accept the determination and recommended administrative penalty of the commissioner or the commissioner's designee; or (2) make a request for a hearing on the occurrence of the violation, the amount of the penalty, or both. (b) If the license holder accepts the determination and recommended penalty of the commissioner or the commissioner's designee, the commissioner by order shall approve the determination and impose the recommended penalty. Sec. 403.255. HEARING. (a) If the license holder requests a hearing or fails to respond in a timely manner to the notice, the commissioner or the commissioner's designee shall set a hearing and give written notice of the hearing to the license holder. (b) An administrative law judge of the State Office of Administrative Hearings shall hold the hearing. (c) The administrative law judge shall make findings of fact and conclusions of law and promptly issue to the commissioner a proposal for a decision about the occurrence of the violation and the amount of a proposed administrative penalty. Sec. 403.256. DECISION BY COMMISSIONER. (a) Based on the findings of fact, conclusions of law, and proposal for decision, the commissioner by order may determine that: (1) a violation occurred and impose an administrative penalty; or (2) a violation did not occur. (b) The notice of the commissioner's order given to the license holder must include a statement of the right of the license holder to judicial review of the order. Sec. 403.257. OPTIONS FOLLOWING DECISION: PAY OR APPEAL. (a) Within 30 days after the date the commissioner's order becomes final, the license holder shall: (1) pay the administrative penalty; or (2) file a petition for judicial review contesting the occurrence of the violation, the amount of the penalty, or both. (b) Within the 30-day period prescribed by Subsection (a), a license holder who files a petition for judicial review may: (1) stay enforcement of the penalty by: (A) paying the penalty to the court for placement in an escrow account; or (B) giving the court a supersedeas bond approved by the court that: (i) is for the amount of the penalty; and (ii) is effective until all judicial review of the commissioner's order is final; or (2) request the court to stay enforcement of the penalty by: (A) filing with the court a sworn affidavit of the license holder stating that the license holder is financially unable to pay the penalty and is financially unable to give the supersedeas bond; and (B) giving a copy of the affidavit to the commissioner or the commissioner's designee by certified mail. (c) If the commissioner or the commissioner's designee receives a copy of an affidavit under Subsection (b)(2), the commissioner or the designee may file with the court, within five days after the date the copy is received, a contest to the affidavit. (d) The court shall hold a hearing on the facts alleged in the affidavit as soon as practicable and shall stay the enforcement of the penalty on finding that the alleged facts are true. The license holder who files an affidavit has the burden of proving that the license holder is financially unable to pay the penalty and to give a supersedeas bond. Sec. 403.258. COLLECTION OF PENALTY. (a) If the license holder does not pay the administrative penalty and the enforcement of the penalty is not stayed, the penalty may be collected. (b) The attorney general may sue to collect the penalty. Sec. 403.259. DETERMINATION BY COURT. (a) If the court sustains the determination that a violation occurred, the court may uphold or reduce the amount of the administrative penalty and order the license holder to pay the full or reduced amount of the penalty. (b) If the court does not sustain the finding that a violation occurred, the court shall order that a penalty is not owed. Sec. 403.260. REMITTANCE OF PENALTY AND INTEREST. (a) If the license holder paid the administrative penalty and if the amount of the penalty is reduced or the penalty is not upheld by the court, the court shall order, when the court's judgment becomes final, that the appropriate amount plus accrued interest be remitted to the license holder. (b) The interest accrues at the rate charged on loans to depository institutions by the New York Federal Reserve Bank. (c) The interest shall be paid for the period beginning on the date the penalty is paid and ending on the date the penalty is remitted. (d) If the license holder gave a supersedeas bond and the penalty is not upheld by the court, the court shall order, when the court's judgment becomes final, the release of the bond. (e) If the license holder gave a supersedeas bond and the amount of the penalty is reduced, the court shall order the release of the bond after the license holder pays the reduced amount. Sec. 403.261. ADMINISTRATIVE PROCEDURE. A proceeding under this subchapter is a contested case under Chapter 2001, Government Code. [Sections 403.262-403.300 reserved for expansion] SUBCHAPTER G. PENALTIES AND OTHER ENFORCEMENT PROCEDURES Sec. 403.301. INJUNCTION. (a) The department may request the attorney general or the appropriate county or district attorney to commence an action to enjoin a violation of this chapter. (b) The remedy provided by this section is in addition to any other action authorized by law. Sec. 403.302. CIVIL PENALTY. (a) A person who violates this chapter, a rule adopted by the executive commissioner, or an order adopted by the commissioner under this chapter is liable for a civil penalty not to exceed $5,000 a day. (b) At the request of the department, the attorney general shall bring an action to recover a civil penalty authorized under this section. Sec. 403.303. CRIMINAL PENALTY. (a) A person commits an offense if the person violates Section 403.101. (b) An offense under this section is a Class B misdemeanor. Sec. 403.304. CEASE AND DESIST ORDER. (a) If it appears to the commissioner that a person who is not licensed under this chapter is violating this chapter or a rule adopted under this chapter, the commissioner after notice and an opportunity for a hearing may issue a cease and desist order prohibiting the person from engaging in the activity. (b) A violation of an order under this section constitutes grounds for imposing an administrative penalty under this chapter. SECTION 2. The heading to Subtitle G, Title 3, Occupations Code, is amended to read as follows: SUBTITLE G. PROFESSIONS RELATED TO HEARING, [AND] SPEECH, AND DYSLEXIA SECTION 3. Not later than November 1, 2009, the commissioner of the Department of State Health Services shall appoint the initial members of the advisory committee under Section 403.051, Occupations Code, as added by this Act. SECTION 4. Not later than June 1, 2010, the executive commissioner of the Health and Human Services Commission shall adopt final rules under Section 403.052, Occupations Code, as added by this Act. SECTION 5. The Department of State Health Services shall issue a licensed dyslexia therapist license to an applicant under this section who: (1) applies for a license under this section not later than December 31, 2012; (2) not later than November 30, 2012, meets the requirements of Sections 403.105(a)(2)-(5), Occupations Code, as added by this Act; (3) submits any other information required by the department by rule; and (4) pays the application fee. SECTION 6. (a) Except as required by Subsection (b) of this section, this Act takes effect September 1, 2009. (b) Section 403.101 and Subchapters E, F, and G, Chapter 403, Occupations Code, as added by this Act, take effect September 1, 2010.