1. (a) A LHR facility must have a written contract with a consulting physician. The LHR facility's contract with its consulting physician must provide the following:

   1. (1) The consulting physician must be available for emergency consultation with the facility as appropriate to the circumstances, including, if the physician considers it necessary, an emergency appointment with the client. This responsibility may be met through telemedicine in accordance with Texas Occupations Code, Chapter 111;
   2. (2) If the consulting physician is unavailable for an emergency consultation, the alternate consulting physician must be available for the consultation with the facility relating to care for the client;
   3. (3) The consulting physician and alternate consulting physician must have a non-residential primary practice site located within 75 miles of the LHR facility; and
   4. (4) The consulting physician must be responsible for reviewing all adverse events, serious injuries, and for determining whether such events are reportable in accordance with applicable laws.

2. (b) The protocols required in accordance with §118.10 are:

   1. (1) written instructions agreed upon and signed and dated by the consulting physician and the LHR facility operator;
   2. (2) maintained at the LHR facility; and
   3. (3) reviewed and signed by the consulting physician and LHR operator at least annually.

3. (c) The protocols required in accordance with §118.10, must include at least the following:

   1. (1) the level of licensure which is required for each LHR procedure;
   2. (2) the circumstances or conditions under which each procedure is to be performed;
   3. (3) specific instructions to be followed for individual LHR certification who are working under direct supervision or who are giving direct supervision;
   4. (4) conditions under which emergency consultation is required;
   5. (5) designated settings, in accordance with the manufacturer's instructions, at which the LHR device can be expected to safely remove hair; and
   6. (6) list of medications taken by the client that must be reported to the consulting physician before LHR services are provided or that, if taken by the client, preclude a LHR procedure from being performed.
4. (d) The requirements in this section do not relieve a consulting physician or another health care professional from complying with applicable regulations prescribed by a state or federal agency.

Source Note:The provisions of this §118.13 adopted to be effective October 1, 2025, 50 TexReg 6315.