Texas Medical Board could set the state’s first rules for ketamine clinics Friday

The Texas Medical Board meets Friday with a rule on its desk that would regulate ketamine clinics for the first time. Comment on it ran for thirty days from July 10, and the notice says a public hearing will be held at a later date.

The proposed rule would make any clinic offering ketamine for psychiatric use register with the board, two years at a time, name a medical director and limit who may give the drug to practitioners and registered nurses. Staff would have to watch no more than four patients at once, keep emergency drugs and equipment on hand, log every adverse event, and report a death or an emergency transport to the board in writing within 24 hours. Another section would bar giving ketamine outside a registered clinic and bar prescribing it for use at home. Most of it would take effect after 180 days; the reporting duty would start at once.

The board has been through two drafts in two months. It proposed one version on May 15, withdrew it on June 29, and published the current one on July 10 with two sections fewer. Friday’s notice lists a ketamine update under the executive director’s report and one rule item with no chapter named, so whether the board finishes the job this week is not stated on the agenda.

Two other changes carry out laws the Legislature passed in 2025. Physicians renewing a license would owe two hours of continuing education on collecting forensic evidence and caring for sexual assault survivors, plus one hour on nutrition; physician assistants would owe the same. The board also takes up adoptions covering acupuncturists, radiologic technicians and respiratory therapists. Separately, the state’s new regulatory efficiency office has recommended trimming the board’s rulebook, and the board’s informal feedback window on those recommendations closes Friday.

The rest is enforcement: agreed orders, consent orders, cease-and-desist orders, remedial plans and defaults, plus one administrative law judge’s recommendation in a case involving Steve Frank Montoya Jr., M.D. That recommendation is not public, no public document found describes what is alleged, and the board has made no findings. Public comment comes at 9:30 a.m. or later; the board publishes no sign-up procedure, so call ahead.

Meeting at a glance

Board members

• Sherif Z. Zaafran, M.D., Houston — president; anesthesiologist.
• Kandace B. Farmer, D.O., Highland Village — vice president.
• Michael E. Cokinos, Houston — secretary-treasurer; public member.
• Sharon J. Barnes, Rosharon — public member.
• Devinder S. Bhatia, M.D., Houston — thoracic and cardiovascular surgeon.
• Garry D. Crain, San Marcos — public member.
• George L. De Loach, D.O., Livingston — orthopedic surgeon.
• Luisa del Rosal, Dallas — public member.
• James “J.D.” Distefano, D.O., College Station — sports medicine.
• Mary “Kelly” Green, M.D., Marble Falls — ophthalmologist.
• Tomeka Moses Herod, Allen — public member.
• Zachary S. “Zach” Jones, M.D., Frisco — anesthesiologist.
• Robert D. Martinez, M.D., Mission — internist; chief medical officer, DHR Health.
• LuAnn Morgan, Midland — public member.
• Jayaram B. Naidu, M.D., Odessa — internist.
• Manuel “Manny” Quiñones Jr., M.D., San Antonio — family physician.
• Jason K. Tibbels, M.D., Bridgeport — family physician.
• Linda Troncoso, El Paso — public member.
• David G. Vanderweide, M.D., League City — orthopedic surgeon.

The roster is taken from the board’s own boards and committees page and its most recent published full board agenda. The 12-to-7 split between physicians and public members, and the requirement that three physician members be doctors of osteopathic medicine, are set by Occupations Code §152.002; §152.005 sets the staggered six-year terms. Staff contact for this meeting: Alicia Freeman, (512) 971-7205.