Texas Register October 25, 2024 Volume: 49 Number: 43

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Department of State Health Services
3 Department of Assistive and Rehabilitative Services
- - 3.0.1 Proposed Rules Re:

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §354.1430, §354.1434, to add federally qualified health centers (FQHCs) and rural health clinics (RHCs) as Medicaid providers of home telemonitoring services, require the establishment of a plan of care and define terms used in the newly-added paragraphs.

CHAPTER 354. MEDICAID HEALTH SERVICES
SUBCHAPTER A. PURCHASED HEALTH SERVICES
DIVISION 33. ADVANCED TELECOMMUNICATIONS SERVICES
1 TAC §354.1430, §354.1434

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §354.1430, concerning Definitions, and §354.1434, concerning Home Telemonitoring Benefits and Limitations.

BACKGROUND AND PURPOSE

The purpose of the proposal is to implement Texas Government Code §531.001(4-a) and §531.02164, amended by House Bill (H.B.) 2727, 88th Legislature, Regular Session, 2023.

Texas Government Code §531.02164 adds federally qualified health centers (FQHCs) and rural health clinics (RHCs) as Medicaid providers of home telemonitoring services. Texas Government Code §531.001(4-a) clarifies the term “home telemonitoring services” is synonymous with “remote patient monitoring”. Texas Government Code §531.02164(c)(5) requires home telemonitoring providers to establish a plan of care with outcome measures for each recipient, and to share the plan and outcome measures with the recipient’s physician. Texas Government Code §531.02164(2)(B) also reduces the eligibility criteria for the service from two or more risk factors to at least one risk factor.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §354.1430, Definitions, adds a new definition for the term “Federally qualified health center” in paragraph (4), “Home telemonitoring service” in paragraph (5), “hospital” in paragraph (6), and “Rural health clinic” in paragraph (10). As part of the “Home telemonitoring service” definition in paragraph (4), the proposed language clarifies that the term is synonymous with “remote patient monitoring”. The proposed amendment renumbers the paragraphs because of the addition of the new terms.

The proposed amendment to §354.1434, Home Telemonitoring Benefits and Limitations, in subsection (b), adds a FQHC and RHC as providers of home telemonitoring services. The proposed amendment adds a new paragraph (4) in subsection (c) to require home telemonitoring providers to establish a plan of care with outcome measures for each recipient and, in new paragraph (5), to share the plan of care with the recipient’s physician. The proposed amendment in subsection (d)(1), in the eligibility criteria for recipients, replaces “feasible” with” clinically effective”. This change is needed to be consistent with the language used in Texas Government Code §531.02164(c)(1). The proposed amendment in subsection (d)(2) replaces “two or more” with “at least one.” This change to reduce the home telemonitoring services eligibility criteria for recipients from two or more risk factors to at least one risk factor implements the requirement in Texas Government Code §531.02164(c)(2)(B). The proposed amendment in subsection (d)(2)(D) changes a risk factor to “a documented risk of falls” by removing “in the prior six month period; and removes the risk factor in (d)(2)(E) of “limited or absent informal support systems” and in (d)(2)(F) of “living alone or being home alone for extended periods of time”. These changes are needed to implement the requirements in Texas Government Code §531.02164(c)(2)(B). The proposed amendment removes subsection (e) relating to reimbursement and replaces it with a new subsection (g). This change is made to better organize the rule within the section and to improve the readability of the rule. The proposed amendment adds a new subsection (f) to set forth that HHSC may discontinue home telemonitoring services for a condition, if after implementation, HHSC determines the provision and reimbursement of services are not cost-effective and clinically effective for that condition. The proposed amendment makes a minor editing change in subsection (c), changing “service” to “services;” changes “patient’s” to “recipient’s” and “clients” to “recipients” as needed; updates the numbering of the paragraphs within subsections (c) and (d); removes “only” from subsection (d); and renumbers subsection (f) as subsection (e).

Amending 1 TAC §§363.203, 363.205, 363.207, 363.209, 363.211 – 363.213, 363.215, to establish minimum standards when transporting participants to a Prescribed Pediatric Extended Care Center (PPECCs), update eligibility guidelines for certain services, including private duty nursing (PDN) services and PPECC services, and establish documentation requirements for admission to a PPECC and for non-transportation PPECC services for reimbursement eligibility.

CHAPTER 363. TEXAS HEALTH STEPS COMPREHENSIVE CARE PROGRAM
SUBCHAPTER B. PRESCRIBED PEDIATRIC EXTENDED CARE CENTER SERVICES
1 TAC §§363.203, 363.205, 363.207, 363.209, 363.211 – 363.213, 363.215

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §363.203, concerning Definitions; §363.205, concerning Provider Participation Requirements; §363.207, concerning Participant Eligibility Criteria; §363.209, concerning Benefits and Limitations; §363.211, concerning Service Authorization; §363.213, concerning Ordering Physician Responsibilities; §363.215, concerning Termination, Reduction, or Denial of Authorization for Prescribed Pediatric Extended Care Center Services; and new §363.212, concerning Documentation Requirements for Services Other than Transportation Services.

BACKGROUND AND PURPOSE

The purpose of the proposal is to implement Texas Health and Safety Code, §248A.1015, §248A.158, and §248A.159, and Texas Human Resources Code, §32.0287, added or amended by House Bill (H.B.) 3550, 88th Legislature, Regular Session, 2023. H.B. 3550 requires rules establishing minimum standards for transportation services for individuals served by Prescribed Pediatric Extended Care Centers (PPECCs). H.B. 3550 also requires rules for the reimbursement of services provided by PPECCs under Medicaid to clearly identify the documentation that PPECCs must obtain and maintain for reimbursement.

The proposed rules establish minimum standards for transportation services when transporting participants to a PPECC by requiring a center to coordinate the schedule of transportation services with the participant’s responsible adult, as defined in the rules; determining what type of provider needs to be present during transportation; and allowing the participant’s responsible adult to decline a center’s transportation services entirely or on a specific date.

The proposed rules remove the requirement that the plan of care and the physician’s order document a participant’s need for transportation services as nursing services in a participant’s plan of care.

The proposed rules update guidelines allowing participants who are eligible to receive authorized continuous skilled nursing service hours for private duty nursing (PDN) services, PPECC services, or a combination of both services with certain limitations. The proposed rules clarify that PPECC services must be a replacement of other skilled nursing services provided in a setting other than a PPECC unless additional nursing services are medically necessary.

The proposed rules establish and outline documentation requirements for admission to a PPECC and for non-transportation PPECC services for reimbursement eligibility. The proposed rules require a PPECC to include the documentation of PPECC services provided to a participant in the participant’s medical record.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §363.203 adds a definition for “direct care staff” and amends the definitions of “Licensed Vocational Nurse (LVN)”, “Registered Nurse (RN)”, and “stable”. The proposed amendment also revises certain definitions to correct spelling, allow use of an acronym for a term, and make other minor corrections.

The proposed amendment to §363.205 corrects the use of acronyms and updates the reference to the current Texas Administrative Code (TAC) to the Licensing Standards for Prescribed Pediatric Extended Care Centers.

The proposed amendment to §363.207 provides for a participant’s ordering physician to waive the in-person examination of the participant required in subsection (a)(6) of the rule as long as the conditions described in the proposed rule are met. The proposed amendment replaces the criteria for a participant to be “stable and eligible for outpatient medical services” with “the participant meets the criteria in 26 TAC §550.601”, the admission criteria in the licensing standards. The proposed amendment revises the participant eligibility criteria to improve the readability, makes minor edits, and renumbers subsections of the rule.

The proposed amendment to §363.209 updates provisions and transportation requirements for transporting a participant to a PPECC; clarifies staffing determinations on the transport vehicle; and outlines documentation requirements regarding transportation services. The proposed amendment adds that a participant who is eligible to receive PDN services may also receive PPECC services. The proposed amendment adds that a participant may choose to receive all authorized continuous skilled nursing services through PPECC only, PDN only, or a combination of both PPECC and PDN services with certain limitations. The proposed amendment adds that PDN, home health skilled nursing, home health aide services, and personal care services may be billed on the same day as PPECC services but may not be billed simultaneously with PPECC services.

The proposed amendment to §363.211 makes editorial changes to clarify the service authorization process for PPECC services; clarifies in subsection (d) of the rule that “days” means “calendar days;” spells out “managed care organization;” makes a correction in subsection (l) of the rule by adding “termination;” clarifies a comprehensive nursing assessment is required no later than the day the participant is admitted to the center; and clarifies a revised nursing assessment is required when there are changes in the participant’s medical condition that impact the amount or duration of services.

Proposed new §363.212 outlines the documentation requirements a PPECC must obtain and maintain in the participant’s medical record to be eligible for reimbursement of non-transportation PPECC services. The proposed rule includes that HHSC may request documentation from the PPECC to substantiate the provision of services and may recoup payment if services are not substantiated as outlined in the rule.

The proposed amendment to §363.213 adds responsibilities and flexibilities for the ordering physician including examination of the participant when prescribing PPECC services and written requirements to ensure safe transport.

The proposed amendment to §363.215 makes editorial changes to adhere to HHS rulemaking guidelines; makes corrections in subsection (b) of the rule to add “terminate” or “termination” where needed; and clarifies in subsection (b)(3) of the rule that “days” means “calendar days.”

Amending 26 TAC §745.117, to update the requirements for an exemption to require a program to be located in a county with a municipality with a population of 500,000 and update language and references in the figure.

CHAPTER 745. LICENSING
SUBCHAPTER C. OPERATIONS THAT ARE EXEMPT FROM REGULATION
DIVISION 2. EXEMPTIONS FROM REGULATION
26 TAC §745.117

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §745.117, concerning Which programs of limited duration are exempt from Licensing regulation.

BACKGROUND AND PURPOSE

The purpose of this proposal is to implement Section 115 of House Bill (H.B.) 4559, 88th Legislature, Regular Session, 2023. This section of H.B. 4559 amended a requirement in Texas Human Resources Code (HRC) §42.041, which identifies certain programs that meet the definition of “child-care facility” in HRC §42.002(3) that are exempt from requiring a license under HRC Chapter 42. HRC §42.041(b)(3) includes an exemption for a program that provides short-term child care that meets certain requirements in connection with a shopping center, business or other activity. In turn, HRC §42.041(g) limits the number of hours a week that a certain type of program that meets this exemption language may operate. H.B. 4559 amended the requirements in HRC Section 42.041(g). Prior to the effective date of H.B. 4559, HRC Section 42.041(g) limited a program exempt under HRC Section 42.041(b)(3) to providing a maximum of 15 hours per week of childcare to an individual child if the program (1) provides child-care so that a person may attend an educational class provided by a nonprofit entity and (2) is located in a county that has a population of 800,000 and on an international border. H.B. 4559 amended the population requirement so that the limits in Subsection (g) apply if the program is located in a county with a municipality with a population of at least 500,000. Accordingly, HHSC Child Care Regulation (CCR) is proposing to update §745.117 to reflect the amended statutory language.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §745.117 in (1)(D)(ii) in Figure: 26 TAC §745.117, updates the criteria for exemption to reflect that the program must be located in a county with a municipality with a population of 500,000; (2) replaces “regulation” with “oversight”; (3) replaces “Licensing” and “our” with Child Care Regulation (CCR); and (4) updates a reference in the figure.

Adopted Rules Re:

Adopting 26 TAC §506.40, to require a facility to complete and submit the Ethics or Medical Committee Reporting Form to HHSC after the facility provides the written notice.

CHAPTER 506. SPECIAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §506.40

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new §506.40, concerning Advance Directives Reporting Requirements.

BACKGROUND AND PURPOSE

The adoption is necessary to implement House Bill (H.B.) 3162, 88th Legislature, Regular Session, 2023. H.B. 3162 amended Texas Health and Safety Code (HSC) Chapter 166, Subchapters B and E, and HSC Chapter 313.

HSC §166.046, as amended by H.B. 3162, in part, requires a facility’s ethics or medical committee to review a physician’s refusal to honor an advance directive or health care or treatment decision made by or on behalf of a patient determined to be incompetent or otherwise mentally or physically incapable of communication. Amended HSC §166.046 also requires the facility to provide a written notice to the person responsible for the patient’s health care decisions that the facility’s ethics or medical committee will meet at least seven days later to review the physician’s refusal to honor the patient’s advanced directive or health care treatment decision.

HSC §166.054, as added by H.B. 3162, requires health care facilities to report certain information to HHSC within 180 days after the health care facility provides the written notice required under HSC §166.046. New HSC §166.054 also requires HHSC to adopt rules for reporting, protecting, and aggregating this information.

In Addition Re:

Notice of Public Hearing on Proposed Updates to Medicaid Payment Rates for the Special Review of Medical Transportation Program

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 12, 2024, at 9:00 a.m., to receive public comments on proposed updates to Medicaid payment rates for the Medical Transportation Program (MTP).

Public Notice – Texas State Plan for Medical Assistance Amendments

The Texas Health and Human Services Commission (HHSC) announces its intent to submit amendments to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendments are effective November 1, 2024.

Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §33.70, to set forth guidelines for teledentistry dental services, establish reimbursement requirements, and add teledentistry dental services as a service provided under Medicaid in the Texas Health Steps Program.

CHAPTER 33. EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT
SUBCHAPTER F. DENTAL SERVICES
25 TAC §33.70

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §33.70, concerning Dental Preventive and Treatment Services.

BACKGROUND AND PURPOSE

The Texas Health and Human Services Commission (HHSC) proposes to amend §33.70, concerning Dental Preventative and Treatment Services, to implement House Bill (H.B.) 2056, 87th Legislature, Regular Session, 2021.

H.B. 2056 added a requirement for providers to be reimbursed for teledentistry dental services by amending Texas Government Code §§531.0216 and 531.02162(b) and (c), and adding Texas Government Code §531.02172. The purpose of the proposal is to amend §33.70 to implement teledentistry dental services under Medicaid in the Texas Health Steps Program.

Before proposing the amendment HHSC waited until after the Texas State Board of Dental Examiners adopted rules in 2022 to regulate the practice of teledentistry. HHSC also needed time to decide which dental services and treatments available through the Texas Health Steps Program could safely and effectively be provided as a teledentistry dental service to clients enrolled in the program.

The proposed amendment to §33.70 adds a new subsection (c) to require dental providers to perform dental services as described in the Texas Medicaid Provider Procedures Manual. The proposed amendment adds new subsection (d) to allow dental providers to conduct an oral evaluation as a teledentistry dental service, as defined in Texas Occupations Code §111.001, for established clients, using synchronous audiovisual technologies.

The proposed amendment allows flexibility for an established client and the dentist to use synchronous audiovisual technologies to conduct an oral evaluation, and thereby, makes oral evaluations more easily available to and prevents unnecessary travel for clients in the Texas Health Steps Program.

Amending 25 TAC §37.401, to rename the rule to Maternal Mortality and Morbidity Review Committee (MMMRC), increase the number of voting members appointed by the DSHS Commissioner, change the MMMRC membership terms, add training requirements, and change the abolishment and expiration date of the MMMRC to September 1, 2027.

CHAPTER 37. MATERNAL AND INFANT HEALTH SERVICES
SUBCHAPTER R. ADVISORY COMMITTEES
25 TAC §37.401

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes an amendment to §37.401, concerning Maternal Mortality and Morbidity Task Force.

BACKGROUND AND PURPOSE

The Texas Maternal Mortality and Morbidity Review Committee (MMMRC) studies and reviews cases of pregnancy-related deaths and severe maternal morbidity to identify trends, rates, and disparities.

The purpose of the proposal is to implement House Bill (H.B.) 852, 88th Legislature, Regular Session, 2023, which amended Texas Health and Safety Code, Chapter 34. H.B. 852 added six new MMMRC members and amended the current community advocate MMMRC member position. New positions include physicians specializing in emergency care, cardiology, anesthesiology, oncology, and a representative of a managed care organization. Additionally, the former community advocate position was changed to two community members with experience in a relevant health care field involving the analysis of health care data. One of the community members must represent an urban area of this state, and another must represent a rural area.

H.B. 852 also staggered MMMRC membership terms, making one-third of the terms expire on every odd-numbered year.

This amendment will include changing the title of §37.401 from Maternal Mortality and Morbidity Task Force to Maternal Mortality and Morbidity Review Committee.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §37.401 changes the name of the rule from Maternal Mortality and Morbidity Task Force (committee) to Maternal Mortality and Morbidity Review Committee (MMMRC); adds the task of adopting bylaws to guide MMMRC operations; increases the number of voting members appointed by the DSHS Commissioner from 15 to 21; changes the number of members staggered for six-year terms from four or five members to one-third, or as near as possible to one-third, of the members’ terms expiring February 1 of each odd-numbered year; adds training requirements for MMMRC members; adds reference to the current General Appropriations Act for MMMRC participation payment and travel reimbursement; and changes the abolishment and expiration date of the MMMRC from September 1, 2023, to September 1, 2027, to align with Texas Government Code Chapter 325 (Texas Sunset Act).

Amending 25 TAC §157.11, to revise language for clarity, consistency, and style; update reference to current laws; and clarify participation in the Regional Advisory Council to align with current practices in the United States.

CHAPTER 157. EMERGENCY MEDICAL CARE
SUBCHAPTER B. EMERGENCY MEDICAL SERVICES PROVIDER LICENSES
25 TAC §157.11

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendment to §157.11, concerning Requirements for an EMS Provider License.

BACKGROUND AND PURPOSE

The purpose of the proposal is to comply with Senate Bill (S.B.) 2133, 88th Legislature, Regular Session, 2023, that amended Texas Health and Safety Code (HSC) §773.050 by adding subsection (j). The new subsection requires emergency medical services (EMS) providers to have a plan for transporting dialysis patients directly to and from an outpatient end stage renal disease facility during a declared disaster, if the patient’s normal and alternative modes of transportation cannot be used. Texas HSC §773.050(j) permits the EMS provider’s plan to prioritize transporting a patient suffering from an acute emergency condition over transporting a dialysis patient. The proposed amendment to 25 TAC §157.11 aligns with the changes in Texas HSC §773.050.

Additionally, House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to Texas Government Code that becomes effective on April 1, 2025.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §157.11 revises language for clarity, consistency, plain language, and style throughout the rule; updates reference to current laws; and clarifies participation in the Regional Advisory Council triage plan to align with current practice throughout Texas and the nation. The proposed amendment adds language that an EMS provider must have a plan for providing transport for a dialysis patient who places an emergency 9-1-1 telephone call during a declared disaster and adds language that permits the EMS provider’s plan to prioritize transporting a patient suffering from an acute emergency condition over transporting a dialysis patient. The proposed amendment also adds language that the liability of a unit of local government under this chapter is limited to money damages in a maximum amount of $100,000 for each person and $300,000 for each single occurrence for bodily injury or death and $100,000 for each single occurrence for injury to or destruction of property, as described in Texas Civil Practice and Remedies Code Section 101.023(d).

Adopted Rules Re:

Adopting 25 TAC §133.41, §133.49, to require a health care facility’s ethics or medical committee to review a physician’s refusal to honor an advance directive or health care or treatment decision made by or on behalf of a patient determined to be incompetent or otherwise mentally or physically incapable of communication.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
25 TAC §133.41, §133.49

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §133.41, concerning Hospital Functions and Services, and §133.49, concerning Reporting Requirements.

BACKGROUND AND PURPOSE

Adopting 25 TAC §181.22, to clarify, delete, renumber, or add fees for different services regarding the fee for a copy or research copy of a birth, death, or fetal death record.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER B. VITAL RECORDS
25 TAC §181.22

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts an amendment to §181.22, concerning Fees Charged for Vital Records Services; and the repeal of §181.35, concerning Parental Consent of Underage Applicants to Marriage.

The amendment to §181.22 and repeal of §181.35 are adopted without changes to the proposed text as published in the August 2, 2024, issue of the Texas Register (49 TexReg 5683). These rules will not be republished.

BACKGROUND AND PURPOSE

The amendment is necessary to clarify and enhance the transparency of Vital Statistics fees in rule and the repeal is necessary to remove outdated rules identified during the rule review process.

The amendment to §181.22 consolidates fees charged for vital records services to clearly state each fee amount. There is no fee increase with this consolidation.

The expedited service fee, which shortens processing time, is available if the applicant chooses to pay the extra sum. The expedited service fee increased from $5 to $25 per application. This expedited service fee has not increased in 33 years and does not cover the costs for the service. The public does not need to pay this fee to obtain a vital record.

The amendment includes longstanding services being provided but not listed in rule.

Section 181.35 is repealed to comply with Senate Bill 1705, 85th Legislature, Regular Session, 2017, that repealed the statutory authority in Texas Family Code §2.102.

Adopting 25 TAC §181.35, to delete the rule as the rule is no longer necessary.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER B. VITAL RECORDS
25 TAC §181.35

OVERVIEW

BACKGROUND AND PURPOSE

The amendment is necessary to clarify and enhance the transparency of Vital Statistics fees in rule and the repeal is necessary to remove outdated rules identified during the rule review process.

The amendment to §181.22 consolidates fees charged for vital records services to clearly state each fee amount. There is no fee increase with this consolidation.

The amendment includes longstanding services being provided but not listed in rule.

Section 181.35 is repealed to comply with Senate Bill 1705, 85th Legislature, Regular Session, 2017, that repealed the statutory authority in Texas Family Code §2.102.

Adopting 25 TAC §289.252, to update the NRC information used to determine the categorization of radionuclides and provide an update to the 21 Code of Federal Regulations (CFR) reference used when evaluating applications for specific licenses for the manufacture, preparation, or transfer of radioactive drugs for commercial distribution.

CHAPTER 289. RADIATION CONTROL
SUBCHAPTER F. LICENSE REGULATIONS
25 TAC §289.252

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts an amendment to §289.252, concerning Licensing of Radioactive Material.

BACKGROUND AND PURPOSE

The amendment is necessary for Texas (an Agreement State) to comply with United States Nuclear Regulatory Commission (NRC) requirements, as identified in the Review Summary Sheets for Regulation Amendments (RATS Identification). The amendment updates NRC information, including the sum of ratios equation, used for determining whether aggregate quantities of radionuclides exceed the category 1 or category 2 radioactive material thresholds. An additional RATS Identification prescribes an update to the 21 Code of Federal Regulations (CFR) reference used when evaluating applications for specific licenses to manufacture, prepare, or transfer for commercial distribution, radioactive drugs containing radioactive material.

The amendment clarifies Radiation Safety Officer training requirements; updates licensee responsibility for providing documentation to support nuclear pharmacist designation; specifies cut-off dates for nuclear pharmacy practice experience as they relate to authority to designate nuclear pharmacists; corrects the reference for reporting and notifying DSHS when radiopharmaceutical generator eluates exceed permissible concentrations; and simplifies the “Form of records” requirements for category 1 and category 2 protection standards by removing references to obsolete storage media. The amendment ensures compatibility with NRC requirements not specifically mentioned in the RATS Identification.

The amendment updates, corrects, improves, and clarifies the rule language and incorporates plain language where appropriate.

Proposed Rule Reviews Re:

Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal of the chapter concerning Information Practices.

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 85, Local Public Health

Department of Assistive and Rehabilitative Services

Proposed Rules Re:

Amending 40 TAC §§106.201, 106.203, 106.205, to repeal the chapters concerning the Purpose, Legal Authority, and Definitions under the Division for Blind Services.

CHAPTER 106. DIVISION FOR BLIND SERVICES
SUBCHAPTER B. VOCATIONAL REHABILITATION PROGRAM
DIVISION 1. PROGRAM AND SUBCHAPTER PURPOSE
40 TAC §§106.201, 106.203, 106.205

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Chapter 106 in Texas Administrative Code Title 40, Part 2, concerning Division for Blind Services. The chapter consists of §§106.201, concerning, Purpose; 106.203, concerning Legal Authority; 106.205, concerning Definitions; 106.307, concerning Application; 106.309, concerning Eligibility; 106.311, concerning Prohibited Factors; 106.313, concerning Eligibility Determination Time Frame; 106.315, concerning Determination of Ineligibility; 106.317, concerning Case Closure; 106.407, concerning Provision of Services; 106.409, concerning Assessment for Determining Eligibility, Vocational Rehabilitation Needs, and Rehabilitation Technology Needs; 106.411, concerning Physical and Mental Restoration Services; 106.413, concerning Vocational and Other Training Services; 106.415, concerning Maintenance; 106.417, concerning Transportation; 106.419, concerning Services to Family Members; 106.421, concerning Interpreter Services and Note-Taking Services for Consumers Who Are Deaf and Tactile Interpreting for Consumers Who Are Deafblind; 106.423, concerning Reader Services and Rehabilitation Teaching Services; 106.425, concerning Employment Assistance; 106.427, concerning Post-Employment Services; 106.429, concerning Occupational Licenses, Tools, Equipment, and Initial Stocks and Supplies; 106.431, concerning Assistive Technology Devices; 106.433, concerning Individualized Plan for Employment (IPE); §106.501, concerning Purpose of Consumer Participation; 106.507, concerning Scope of Consumer Participation; 106.509, concerning Refusal to Disclose Economic Resources; 106.607, concerning Comparable Services and Benefits; 106.707, concerning Application of an Order of Selection; 106.801, concerning Purpose; 106.803, concerning Legal Authority; 106.805, concerning Definitions; 106.807, concerning Eligibility; and 106.809, concerning Certificate of Blindness for Tuition Waiver.

BACKGROUND AND PURPOSE

Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, transferred the functions of the Department of Assistive and Rehabilitative Services (DARS) to HHSC. S.B. 208, 84th Legislature, Regular Session, 2015, transferred the Vocational Rehabilitation (VR) Program from DARS to the Texas Workforce Commission (TWC). HHSC is repealing the rules in 40 TAC Chapter 106, Division for Blind Services, because HHSC no longer oversees that program. The Texas Workforce Commission has adopted rules for the VR Program in Title 40, Part 20, Chapter 856, so there will be no disruption to the VR Program or to Texans receiving services.

SECTION-BY-SECTION SUMMARY