Texas Register June 11, 2021 Volume: 46 Number: 24

Texas Board Of Nursing

June 11, 2021: Proposed Rules Amending 22 TAC §221.14 to update requirements for nurse-midwives’ provision of controlled substances

CHAPTER 221. ADVANCED PRACTICE NURSES

22 TAC §221.14

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to 22 Texas Administrative Code §221.14, relating to Nurse-Midwives Providing Controlled Substances. 

BACKGROUND AND JUSTIFICATION

As required by Tex. Gov’t. Code §2001.039, the Board filed its notice of intention to review and consider for readoption, readoption with amendments, or repeal, 22 Texas Administrative Code Chapters 213, 216, and 221, pursuant to the 2019 rule review plan adopted by the Board at its July 2018 meeting. The notice was posted in the December 11, 2020, issue of the Texas Register (45 TexReg 8885). As a result of the rule review, the Board is now proposing substantive amendments to §221.14 for consistency with Tex. Occ. Code §157.059, which governs Delegation of Certain Obstetrical Services.

Pursuant to SB 406, a physician may delegate to a physician assistant or a nurse-midwife the act of administering or providing controlled substances to the patients of the physician assistant or nurse-midwife during intrapartum and immediate postpartum care. This delegation is limited to seven nurse-midwives or physician assistants or their full-time equivalents and the designated facility at which the nurse-midwife or physician assistant provides care. Additionally, SB 406 authorized the use of a prescriptive authority agreement as an additional method for physician delegation under Tex. Occ. Code §157.059. It also updated the terminology throughout the bill to refer to advanced practice registered nurses. The Board’s proposed amendments are necessary for consistency with these statutory changes.

46 TexReg 3601
June 11, 2021: Adopted Rules Board will conduct official rule review for 22 TAC Chapters 214 (Vocational Nursing Education), 215 (Professional Nursing Education), and 222 (Advanced Practice Registered Nurses with Prescriptive Authority)

OVERVIEW

Title 22, Part 11

In accordance with Government Code §2001.039, the Texas Board of Nursing (Board) files this notice of intention to review and consider for readoption, readoption with amendments, or repeal, the following chapters contained in Title 22, Part 11, of the Texas Administrative Code, pursuant to the 2019 rule review plan adopted by the Board at its July 2018 meeting.

• Chapter 214. Vocational Nursing Education, §§214.1 – 214.13

• Chapter 215. Professional Nursing Education, §§215.1-215.13

• Chapter 222. Advanced Practice Registered Nurses with Prescriptive Authority, §§222.1 – 222.10

BACKGROUND AND JUSTIFICATION

In conducting its review, the Board will assess whether the reasons for originally adopting these chapters continue to exist. Each section of these chapters will be reviewed to determine whether it is obsolete, whether it reflects current legal and policy considerations and current procedures and practices of the Board, and whether it is in compliance with Chapter 2001 of the Government Code (Administrative Procedure Act).

PUBLIC COMMENT 

The public has thirty (30) days from the publication of this rule review in the Texas Register to comment and submit any response or suggestions. Written comments may be submitted to John Vanderford, Assistant General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, by email to john.vanderford@bon.texas.gov or by fax to John Vanderford at (512) 305-8101. Any proposed changes to these chapters as a result of this review will be published separately in the Proposed Rules section of the Texas Register and will be open for an additional comment period prior to the final adoption or repeal by the Board.

Texas Council for Development Disabilities

June 11, 2021: Adopted Rules Council will conduct official rule review for 40 TAC Chapter 876 (Grant Provisions) and Chapter 877 (Grant Awards)

OVERVIEW

In accordance with Texas Government Code §2001.039, the Texas Council for Developmental Disabilities (TCDD) submits notice of its intention to review its rules. These rules appear under Texas Administrative Code Title 40, Part 21. TCDD will consider, among other things, whether the reasons for readoption of these rules continue to exist and following the assessment will readopt, readopt with amendments, or repeal the rules: 

• Chapter 876. General Provisions
• Chapter 877. Grant Awards

PUBLIC COMMENT

Comments will be accepted from any interested persons or groups.

All comments and/or questions should be directed to Koren Vogel, Council Business Manager, Texas Council for Developmental Disabilities, 6201 E. Oltorf, Suite 600, Austin, Texas 78741; or email koren.vogel@tcdd.texas.gov. Comments must be received in the office no later than Monday, July 12, 2021, at 5:00 p.m.

Texas Department of State Health Services

June 11, 2021: In Addition DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the first half of April 2021

OVERVIEW

During the first half of April 2021, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials as listed in the tables (in alphabetical order by location). The subheading “Location” indicates the city in which the radioactive material may be possessed and/or used. The location listing “Throughout TX [Texas]” indicates that the radioactive material may be used on a temporary basis at locations throughout the state. In issuing new licenses and amending and renewing existing licenses, the Department’s Business Filing and Verification Section has determined that the applicant has complied with the licensing requirements in Title 25 Texas Administrative Code (TAC), Chapter 289, for the noted action. 

BACKGROUND AND JUSTIFICATION

In granting termination of licenses, the Department has determined that the licensee has complied with the applicable decommissioning requirements of 25 TAC, Chapter 289. In granting exemptions to the licensing requirements of Chapter 289, the Department has determined that the exemption is not prohibited by law and will not result in a significant risk to public health and safety and the environment.

In granting termination of licenses, the Department has determined that the licensee has complied with the applicable decommissioning requirements of 25 TAC, Chapter 289. In granting exemptions to the licensing requirements of Chapter 289, the Department has determined that the exemption is not prohibited by law and will not result in a significant risk to public health and safety and the environment.

AFFECTED PERSONS’ RIGHT TO HEARING

A person affected by the actions published in this notice may request a hearing within 30 days of the publication date. A “person affected” is defined as a person who demonstrates that the person has suffered or will suffer actual injury or economic damage and, if the person is not a local government, is (a) a resident of a county, or a county adjacent to the county, in which radioactive material is or will be located, or (b) doing business or has a legal interest in land in the county or adjacent county. 25 TAC §289.205(b)(15); Health and Safety Code §401.003(15). Requests must be made in writing and should contain the words “hearing request,” the name and address of the person affected by the agency action, the name and license number of the entity that is the subject of the hearing request, a brief statement of how the person is affected by the action what the requestor seeks as the outcome of the hearing, and the name and address of the attorney if the requestor is represented by an attorney. Send hearing requests by mail to: Hearing Request, Radiation Material Licensing, MC 2835, PO Box 149347, Austin, Texas 78714-9347, or by fax to: 512-834-6690, or by e-mail to: RAMlicensing@dshs.texas.gov.

Texas Department on Aging and Disability Services

June 11, 2021: Transferred Rule Transferring oversight of transition assistance services from DADS to HHSC

OVERVIEW

The former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 62, Transition Assistance Services, are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 272, Transition Assistance Services.

The rules will be transferred in the Texas Administrative Code effective July 1, 2021.

BACKGROUND AND JUSTIFICATION

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. 

A chart outlining the specific rules to be transferred is included in this week’s edition of the Texas Register (46 Tex Reg 3619).46 TexReg 3619
June 11, 2021: Transferred Rule Transferring oversight of contracting to provide emergency response services from DADS to HHSC

OVERVIEW

The former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 52, Contracting to Provide Emergency Response Services, are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 279, Contracting to Provide Emergency Response Services.

The rules will be transferred in the Texas Administrative Code effective July 1, 2021.

BACKGROUND AND JUSTIFICATION

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011.

A chart outlining the specific rules to be transferred is included in this week’s edition of the Texas Register (46 Tex Reg 24).

Texas Health and Human Services Commission

46 TexReg 3769
June 11, 2021: Emergency Rule New 26 TAC §554.2802, requiring nursing facilities to take certain actions to reduce the risk of spreading COVID-19

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

SUBCHAPTER CC. COVID-19 EMERGENCY RULE

26 TAC §554.2802

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 554, Nursing Facility Requirements for Licensure and Medicaid Certification, new §554.2802. This emergency rule is adopted in response to COVID-19 and requires nursing facilities to take certain actions to reduce the risk of spreading COVID-19. The emergency rule also permits nursing facilities to request temporary increases in capacity and Medicaid bed allocations to aid in preventing the transmission of COVID-19 or caring for residents with COVID-19. 

HHSC is adopting this emergency rule to mitigate and contain COVID-19 and to permit a nursing facility to request a temporary increase in capacity or Medicaid bed allocation as part of the facility’s response to COVID-19. The purpose of the new rule is to describe the requirements nursing facility providers must immediately put into place to mitigate and contain COVID-19 and the procedures and criteria for requesting a temporary capacity increase or a temporary Medicaid bed allocation increase.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Nursing Facility Response to COVID-19.

46 TexReg 3593
June 11, 2021: Emergency Rule New 26 TAC §554.2803, describing requirements for limited indoor and outdoor visitation in a nursing facility

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

SUBCHAPTER CC. COVID-19 EMERGENCY RULE

26 TAC §554.2803

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 554, Nursing Facility Requirements for Licensure and Medicaid Certification, new §554.2803, concerning an emergency rule in response to COVID-19 describing requirements for limited indoor and outdoor visitation in a facility. 

HHSC is adopting this new emergency rule to allow limited indoor and outdoor visitation in a nursing facility. The purpose of the new rule is to describe the requirements related to such visits.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. This emergency rulemaking reflects the continued reopening of the State of Texas as well as the new requirements for visitation of nursing facility residents provided by the Centers for Medicare & Medicaid Services (CMS) in Memorandum QSO-20-39-NH, as revised April 27, 2021. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Nursing Facility COVID-19 Response – Expansion of Reopening Visitation.

46 TexReg 3596
June 11, 2021: Withdrawn Rule Withdrawing 26 TAC §554.2802, which allowed certain nursing facilities to request a temporary Medicaid capacity increase in response to COVID-19

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

SUBCHAPTER CC. COVID-19 EMERGENCY RULE

26 TAC §554.2802

The Health and Human Services Commission withdraws the emergency adoption of new §554.2802, which appeared in the February 19, 2021, issue of the Texas Register (46 TexReg 1126).

HHSC adopted this rule to allow certain nursing facilities to request a temporary Medicaid capacity increase in response to COVID-19.

46 TexReg 3605
June 11, 2021: Withdrawn Rule Withdrawing 26 TAC §554.2803, which allowed limited indoor and outdoor visitation in a nursing facility

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

SUBCHAPTER CC. COVID-19 EMERGENCY RULE

26 TAC §554.2803

The Health and Human Services Commission withdraws the emergency adoption of new §554.2803, which appeared in the May 7, 2021, issue of the Texas Register (46 TexReg 2957).

HHSC adopted this rule to allow limited indoor and outdoor visitation in a nursing facility.

46 TexReg 3605
June 11, 2021: Transferred Rule Transferring responsibility for emergency-response services contracting from DADS to HHSC

OVERVIEW

The former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 52, Contracting to Provide Emergency Response Services, are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 279, Contracting to Provide Emergency Response Services.

The rules will be transferred in the Texas Administrative Code effective July 1, 2021.

BACKGROUND AND JUSTIFICATION

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. 

A chart outlining the specific rules to be transferred is included in this week’s edition of the Texas Register (46 Tex Reg 3617).

46 TexReg 3617
June 11, 2021: Emergency Rule New 26 TAC §558.961, implementing rules for the purchase, storage, and transportation of COVID-19 vaccines by Home and Community Support Services Agencies

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES

SUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE

26 TAC §558.961

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 558, Licensing Standards for Home and Community Support Services Agencies, new §558.961, concerning an emergency rule in response to COVID-19 to implement provisions in House Bill 797, passed by the 87th Legislature, Regular Session, 2021, relating to possession and administration of certain vaccines by a home and community support services agency (HCSSA) or its employees.

HHSC is adopting thus emergency rule to allow HCSSAs to purchase, store, and transport COVID-19 vaccine for the purposes of vaccinating clients and staff.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for HCSSAs in response to COVID-19.