Texas HSC Chapter 331
Chapter 331: The Physician & Security Committee Seats
Texas HSC Chapter 331 requires a direct-care physician on every WVP committee, with one exemption for HCSSAs, and a security-services employee if any and if practicable. How each seat works and how to document it.
Texas HSC Chapter 331 requires one physician licensed in Texas who provides direct care to the facility's patients on every workplace violence prevention committee, with a single exemption for home and community support services agencies. It requires one facility employee who provides security services only "if any and if practicable." The third seat, a registered nurse providing direct care, is required of every covered facility.
We are stating this plainly because an earlier version of this article described both seats as conditional on employment, and said a facility that works only with contracted or independent physicians could leave the physician seat empty. That was wrong. The physician seat has no employment qualifier, and this version follows the text of Section 331.002. If you relied on the earlier reading, re-check your roster against the rule below.
For the full committee picture, see who must serve on a Chapter 331 WVP committee and our hub, Texas SB 240 & HSC Chapter 331 compliance.
#What the statute says
Section 331.002(b) says a committee "must include at least":
- one registered nurse who provides direct care to patients of the facility;
- except as provided by Subsection (c), one physician licensed to practice medicine in this state who provides direct care to patients of the facility; and
- one facility employee who provides security services for the facility if any and if practicable.
Subsection (c) is the only exemption: if a home and community support services agency does not have on staff at least one physician who fits that description, the agency is not required to include a physician on the committee.
| Member category | Required? | The deciding condition |
|---|---|---|
| Registered nurse providing direct patient care | Mandatory | Every covered facility must seat one. |
| Physician providing direct patient care | Mandatory | Every covered facility must seat one. Only exemption: an HCSSA with no such physician on staff (§331.002(c)). |
| Security-services employee | Conditional | Required only if a facility employee provides security services, and only if practicable. |
(Source: Texas Health & Safety Code §331.002; SB 240, 88th Leg., 2023. The hospital rule, 26 TAC §505.55(b), repeats the same three seats.)
The RN seat is covered in depth in our direct-care RN seat article. This piece is about the other two.
#The physician seat: required, with one exemption
The statute describes the physician member by licensure and function: licensed to practice medicine in Texas, and providing direct care to the facility's patients. It says nothing about who signs the physician's paycheck.
That matters because many hospitals, surgical centers, and freestanding emergency centers work almost entirely with independent or contracted physicians. Those arrangements do not remove the seat. A hospitalist group physician, an emergency physician under a staffing contract, a surgeon with privileges, or a nursing facility's attending physician or medical director who sees residents can each fill it, because each provides direct care to the facility's patients.
What the seat is not:
- Not conditional on employment. "We do not employ physicians" is not a reason to leave the seat empty at a hospital, mental hospital, ambulatory surgical center, freestanding emergency medical care facility, nursing facility, ICF/IID, or state supported living center.
- Not satisfied by a title alone. A physician executive who no longer provides direct care to the facility's patients does not fit the description.
The HCSSA exemption. Section 331.002(c) exempts a home and community support services agency that has no direct-care physician on staff. HHSC's Provider Letter PL 2024-10 words the seat the same way for agencies: a physician who provides direct care "if applicable." An agency relying on the exemption should say so in its charter.
A note for ICF/IIDs. Intermediate care facilities became covered through SB 463 and get no statutory exemption. HHSC's Provider Letter PL 2026-13, as revised August 10, 2026, applies a hold-harmless period to the physician seat from September 1, 2026 to August 31, 2027; every other requirement applies in full. HHSC's proposed ICF/IID rule (26 TAC §551.51, published September 25, 2026 and not yet adopted) requires the physician seat as proposed.
#The security-services seat: "if any and if practicable"
This seat is the conditional one, and the condition has two parts.
- "If any." The seat belongs to a facility employee who provides security services for the facility. If the facility has no such employee, because security is contracted to a vendor or the facility has no security function at all, there is no one who fits the description and the seat does not have to be filled.
- "If practicable." Even where such an employee exists, the statute qualifies the seat with practicability.
This is the one place "security" appears in Chapter 331's committee rule, and it is strictly a committee-membership matter. It does not turn a workplace violence prevention program into a guarding or patrol operation, and it does not obligate a facility to add security staffing. A compliant program is a documentation and preparedness program; the seat exists to bring an environment-of-care security perspective to the table.
Whichever applies, document the arrangement. A note that the facility contracts its security function and employs no security-services personnel is the record that supports leaving the seat unfilled.
#Where committees go wrong at survey
A surveyor's job is to confirm the committee meets the statutory composition. Three failure patterns stand out:
- A physician seat left empty on an employment theory. The roster has no physician because the facility's physicians are contracted or independent. Outside the HCSSA exemption, that is a missing required member.
- A physician member who does not provide direct care. The seat is filled by title, not by function.
- An unexplained empty security seat. There is no security member and no record of why. A surveyor cannot tell whether the seat was missed or correctly left open.
All three are fixable on paper, which is good news.
#How to settle the two seats correctly
- Seat a direct-care physician. Identify a Texas-licensed physician who provides direct care to your patients, whatever the employment arrangement, and issue an appointment letter that states the direct-care role.
- If you are an HCSSA with no direct-care physician on staff, document the exemption. One sentence in the charter citing §331.002(c) is enough.
- Answer the security question with a fact. Does a facility employee provide security services? If yes, seat one where practicable. If no, record that the function is contracted or absent.
- Re-check on workforce changes. Bringing security in-house, or an agency adding a direct-care physician, changes the answer. Treat committee composition as a monitored status.
A surveyor verifying composition will open the committee charter, the membership roster mapping each seat to a person, the appointment letters, and any attestation explaining a seat left open.
Facilities that want the charter and Chapter 331-compliant appointment letters drafted turnkey use our policy and plan development service, or stand up the whole committee (including the seat analysis and minutes) through the workplace violence prevention program. To self-audit first, the Chapter 331 compliance checklist includes the committee-composition line items.
The two seats are simple once you anchor on the statute's own words: the physician seat turns on direct care, not employment, and the security seat turns on whether a facility employee provides security services and whether seating one is practicable.
Sources: Texas Health & Safety Code §331.002 (SB 240, 88th Leg., 2023, as amended by SB 463, 89th Leg., 2025); 26 TAC §505.55(b); HHSC Provider Letters PL 2024-10 and PL 2026-13. This article is general compliance information, not legal advice.
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