11 Sep 2021

Texas Register September 10, 2021 Volume: 46 Number: 37

by | posted in: Governor, Texas Board of Chiropractic Examiners, Texas Board of Nursing, Texas Department of Licensing and Regulation, Texas Department of State Health Services, Texas Health and Human Services Commission, Texas Medical Board |

Texas Register Table of Contents

The Governor

Executive Order GA-39

Executive Order GA-39, prohibiting governmental entities from issuing vaccine mandates and from requiring vaccine passports.

NOW, THEREFORE, Greg Abbott, Governor of Texas, by virtue of the power and authority vested by the Constitution and laws of the State of Texas, does hereby order the following on a statewide basis effective immediately:

  1. No governmental entity can compel any individual to receive a COVID-19 vaccine. I hereby suspend Section 81.082(f)(1) of the Texas Health and Safety Code, and any other relevant statutes, to the extent necessary to ensure that no governmental entity can compel any individual to receive a COVID-19 vaccine.
  2. State agencies and political subdivisions shall not adopt or enforce any order, ordinance, policy, regulation, rule, or similar measure that requires an individual to provide, as a condition of receiving any service or entering any place, documentation regarding the individual’s vaccination status for any COVID-19 vaccine. I hereby suspend Section 81.085(i) of the Texas Health and Safety Code, and any other relevant statutes, to the extent necessary to enforce this prohibition. This paragraph does not apply to any documentation requirements necessary for the administration of a COVID-19 vaccine.
  3. Any public or private entity that is receiving or will receive public funds through any means, including grants, contracts, loans, or other disbursements of taxpayer money, shall not require a consumer to provide, as a condition of receiving any service or entering any place, documentation regarding the consumer’s vaccination status for any COVID-19 vaccine. No consumer may be denied entry to a facility financed in whole or in part by public funds for failure to provide documentation regarding the consumer’s vaccination status for any COVID-19 vaccine.
  4. Nothing in this executive order shall be construed to limit the ability of a nursing home, state supported living center, assisted living facility, or long-term care facility to require documentation of a resident’s vaccination status for any COVID-19 vaccine.
  5. This executive order shall supersede any conflicting order issued by local officials in response to the COVID-19 disaster. Pursuant to Section 418.016(a) of the Texas Government Code, I hereby suspend Sections 418.1015(b) and 418.108 of the Texas Government Code, Chapter 81, Subchapter E of the Texas Health and Safety Code, and any other relevant statutes, to the extent necessary to ensure that local officials do not impose restrictions in response to the COVID-19 disaster that are inconsistent with this executive order.
    This executive order supersedes only paragraph No. 2 of Executive Order GA-38, and does not supersede or otherwise affect the remaining paragraphs of Executive Order GA-38. This executive order shall remain in effect and in full force unless it is modified, amended, rescinded, or superseded by the governor. This executive order may also be amended by proclamation of the governor.

Proclamation 41-3856

Renewing Proclamation 41-3856 to address the ongoing COVID-19 disaster.

NOW, THEREFORE, in accordance with the authority vested by Section 418.014 of the Texas Government Code, the Governor does hereby renew the disaster proclamation for all counties in Texas.

Pursuant to Section 418.017, the Governor authorizes the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster.

Pursuant to Section 418.016, any regulatory statute prescribing the procedures for conduct of state business or any order or rule of a state agency that would in any way prevent, hinder, or delay necessary action in coping with this disaster shall be suspended upon written approval of the Office of the Governor. However, to the extent that the enforcement of any state statute or administrative rule regarding contracting or procurement would impede any state agency’s emergency response that is necessary to cope with this declared disaster, Governor hereby suspends such statutes and rules for the duration of this declared disaster for that limited purpose.

Texas Department of Licensing and Regulation

Proposed Rules Re:

Amending 16 TAC §111.2 to update general provisions and definitions related to speech-language pathology and audiology.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §111.2

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter E, §111.41; Subchapter F, §111.50 and §111.51; Subchapter J, §111.91 and §111.92; and Subchapter V, §111.210 and §111.211.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Amending 16 TAC §111.41 to update requirements for intern in speech-language pathology licenses.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER E. REQUIREMENTS FOR INTERN IN SPEECH-LANGUAGE PATHOLOGY LICENSE
16 TAC §111.41

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter E, §111.41; Subchapter F, §111.50 and §111.51; Subchapter J, §111.91 and §111.92; and Subchapter V, §111.210 and §111.211.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Amending 16 TAC §111.50 and §111.51 to modernize assistant requirements for speech-language pathology licenses.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER F. REQUIREMENTS FOR ASSISTANT IN SPEECH-LANGUAGE PATHOLOGY LICENSE
16 TAC §111.50, §111.51

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter E, §111.41; Subchapter F, §111.50 and §111.51; Subchapter J, §111.91 and §111.92; and Subchapter V, §111.210 and §111.211.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Amending 16 TAC §111.91 and §111.92 to update assistant requirements for audiology licenses.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER J. REQUIREMENTS FOR ASSISTANT IN AUDIOLOGY LICENSE
16 TAC §111.91, §111.92

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter E, §111.41; Subchapter F, §111.50 and §111.51; Subchapter J, §111.91 and §111.92; and Subchapter V, §111.210 and §111.211.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Amending 16 TAC §§111.210 – 111.212 to authorize the provision of services to clients and supervision of certain licensees through telehealth.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER V. TELEHEALTH
16 TAC §§111.210 – 111.212

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter E, §111.41; Subchapter F, §111.50 and §111.51; Subchapter J, §111.91 and §111.92; and Subchapter V, §111.210 and §111.211.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Repealing 16 TAC §§111.212 – 111.216 and implementing new §111.212 to update rules regarding telehealth for speech-language pathologists and audiologists.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER V. TELEHEALTH
16 TAC §§111.212 – 111.216

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes a new rule at Subchapter V, §111.212; and proposes the repeal of existing rules at Subchapter V, §§111.212 – 111.216.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Repealing 16 TAC §§111.230 – 111.232 to update rules for the fitting and dispensing of hearing instruments through telemedicine.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER X. JOINT RULES FOR FITTING AND DISPENSING OF HEARING INSTRUMENTS BY TELEPRACTICE
16 TAC §§111.230 – 111.232

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes the repeal of existing rules at Subchapter X, §§111.230 – 111.232, regarding the Speech-Language Pathologists and Audiologists Program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth and remote supervision (tele-supervision). The proposed rules also reorganize the current provisions and eliminate duplicative provisions.

Amending 16 TAC §112.2 to improve rules regarding hearing instrument fitters and dispensers.

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §112.2

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; proposes new rules at Subchapter N, §112.130 and §112.132; and proposes the repeal of an existing rule at Subchapter P, §112.150, regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth. The proposed rules also reorganize the existing provisions.

New 16 TAC §112.130, §112.132, codifying the waivers granted by the Governor during the COVID-19 pandemic, which allow the provision of hearing instrument services through Telehealth

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER N. TELEHEALTH
16 TAC §112.130, §112.132

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; proposes new rules at Subchapter N, §112.130 and §112.132; and proposes the repeal of an existing rule at Subchapter P, §112.150, regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth. The proposed rules also reorganize the existing provisions.

Repealing 16 TAC §112.150 to update rules for the Hearing Instrument Fitters and Dispensers program.

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER P. JOINT RULES FOR FITTING AND DISPENSING OF HEARING INSTRUMENTS BY TELEPRACTICE
16 TAC §112.150

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; proposes new rules at Subchapter N, §112.130 and §112.132; and proposes the repeal of an existing rule at Subchapter P, §112.150, regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers; Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department; and Chapter 111, Telemedicine and Telehealth.

The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth. The proposed rules also reorganize the existing provisions.

Texas Board of Chiropractic Examiners

Proposed Rules Re:

Repealing 22 TAC §72.18 to remove the current language regarding the reporting of criminal convictions and put that language into a stand-alone rule.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.18

The Texas Board of Chiropractic Examiners (Board) proposes repealing 22 TAC §72.18 (Criminal History). The Board will propose a new §72.18 in a separate rulemaking. This rulemaking action will remove the current language in §72.18 concerning the reporting of criminal convictions and put that language into a stand-alone rule.

New 22 TAC §72.18, regarding criminal history requirements for license applications and renewals.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.18

The Texas Board of Chiropractic Examiners (Board) proposes new 22 TAC §72.18 (Criminal History); the current rule is being repealed in a separate rulemaking action. The only purpose is to remove language in the current rule about a licensee’s or applicant’s requirement to report criminal convictions and deferred adjudications to the Board. That language will be placed in a stand-alone rule (proposed 22 TAC §72.19), making that information easier to find. Other than this change, the provisions about a licensee’s or applicant’s criminal history remain the same.

New 22 TAC §72.19, moving language in the current 22 TAC §72.18 (Criminal History) about reporting convictions and deferred adjudications into a stand-alone rule.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.19

The Texas Board of Chiropractic Examiners (Board) proposes new 22 TAC §72.19 (Requirement to Report a Conviction or Deferred Adjudication). This rulemaking simply moves the language in the current 22 TAC §72.18 (Criminal History) about reporting convictions and deferred adjudications into a stand-alone rule, making it easier for licensees and applicants to find the information. Other than this change, the provisions about a licensee’s or applicant’s criminal history remain the same.

Repealing 22 TAC §77.1 to move certain terms in advertising and public communications into a stand-alone rule.

CHAPTER 77. ADVERTISING AND PUBLIC COMMUNICATIONS
22 TAC §77.1

The Texas Board of Chiropractic Examiners (Board) proposes repealing 22 TAC §77.1 (Advertising and Public Communications). The Board will propose a new §77.1 in a separate rulemaking. This rulemaking action will remove the current language in §77.1 concerning the use of “D.C.” and similar terms in advertising and public communications and put that language into a stand-alone rule.

New 22 TAC §77.1,  establishing new requirements for advertising and public communications.

establishing CHAPTER 77. ADVERTISING AND PUBLIC COMMUNICATIONS
22 TAC §77.1

The Texas Board of Chiropractic Examiners (Board) proposes new 22 TAC §77.1 (Advertising and Public Communications). This rulemaking simply removes the language in the current 22 TAC §77.1 about the use of “D.C.” and similar terms, which will be placed into a stand-alone rule (proposed §77.3). The purpose of the change is make finding this information in the Board’s rules easier.

New 22 TAC §77.3, establishing rules about the proper use of “D.C.” and similar terms in advertising and public communications.

CHAPTER 77. ADVERTISING AND PUBLIC COMMUNICATIONS
22 TAC §77.3

The Texas Board of Chiropractic Examiners (Board) proposes new 22 TAC §77.3 (Proper Use of “D.C.” or Similar Terms and Restrictions). This rulemaking simply removes the language in the current 22 TAC §77.1 about the proper use of “D.C.” and similar terms, and places it in this new stand-alone rule. The purpose of moving this language into a stand-alone rule is to make finding this information in the Board’s rules easier.

Texas Board of Nursing

Proposed Rules Re:

Amending 22 TAC §213.28 to provide sectional clarity for rules relating to licensure of individuals with criminal history.

CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.28

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to §213.28, relating to Licensure of Individuals with Criminal History. The amendments are being proposed under the authority of the Occupations Code §301.151 and House Bills (HB) 375 and 757, both effective September 1, 2021.

BACKGROUND AND JUSTIFICATION

Two bills were enacted during the 87th Legislative Session that impact Board Rule §213.28 and the Board’s Disciplinary Guidelines for Criminal Conduct (Guidelines). First, HB 375, effective September 1, 2021, amends the existing criminal offense found in the Texas Penal Code §21.02, Continuous Sexual Abuse of Young Child or Children, to include disabled individuals. This offense is currently specified in the enumerated list of crimes in the Occupations Code §301.4535 that mandates licensure revocation and denial, as applicable. The proposed amendments to the Guidelines, located in §213.28(c), amend the title of the offense for consistency with the statutory change made by HB 375.

Second, HB 757, also effective September 1, 2021, prohibits a licensing agency from denying, suspending, or revoking a license based upon a deferred adjudication that has been successfully completed and dismissed, except in certain, specified circumstances. Under the terms of the bill, a successfully completed deferred adjudication may be considered by a licensing agency when issuing, renewing, denying, or revoking a license if the offense is listed in the Texas Code of Criminal Procedure Article 42A.054(a); is described by the Texas Code of Criminal Procedure Article 62.001(5) or (6); is committed under Texas Penal Code Chapter 21 or 43; or is related to the activity or conduct for which the individual seeks or holds the license. Further, an agency may also consider a completed deferred adjudication if the profession for which the individual holds or seeks a license involves direct contact with children in the normal course of official duties or duties for which the license is required.

The proposed amendments to §213.28 are necessary for consistency with these statutory directives. Board Rule 213.28 currently requires a criminal offense to be directly related to the practice of nursing in order for the Board to consider the offense in licensure decisions. As such, the Board finds the majority of Rule 213.28 already complies with the mandates of HB 757. The proposed amendments make minor changes to the rule text, however, to incorporate the additional exception permitted by HB 757 (Texas Code of Criminal Procedure Article 42A.111(d)(4)(B)) into the rule. The remaining proposed amendments make editorial changes for additional clarity.

SECTION-BY-SECTION SUMMARY

  • The proposal makes one change to the Board’s Guidelines, located in §213.28(c). The proposed amendment to the Guidelines changes the title of the listed offense from Continuous Sexual Abuse of Young Child or Children to Continuous Sexual Abuse of Young Child or Disabled Individual for compliance with the statutory changes made by HB 375.
  • The proposed change to §213.28(a) includes a reference to the Code of Criminal Procedure Article 42A.111 because the changes made by HB 757 govern the criteria to be used by the Board in determining the effect of criminal history on nursing licensure and eligibility. The proposed change to §213.28(c) incorporates one of the statutory exceptions provided by HB 757 and provides that the Board may consider an individual’s prior deferred adjudication community supervision, even if successfully completed, in its licensure decisions, since the practice of nursing may involve direct contact with children in the normal course of official nursing duties. The proposed changes to §213.28(g) and (j) make editorial changes to the section for additional clarity.

Amending 22 TAC §213.33 to modernize rules relating to factors considered in the imposition of penalties and sanctions.

CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.33

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to 22 TAC §213.33, relating to Factors Considered for Imposition of Penalties/Sanctions. The amendments are being proposed under the authority of the Occupations Code §301.151 and House Bill (HB) 1434, effective September 1, 2021.

BACKGROUND AND JUSTIFICATION

HB 1434, enacted during the 87th Legislative Session, creates a new disciplinary cause of action for practitioners who conduct pelvic examinations on unconscious or anesthetized patients without proper informed consent, where the procedure is not within the standard scope of a scheduled procedure or diagnostic examination, where the examination is not necessary for the diagnosis or treatment of the patient’s medical condition, or where the examination is not for the purpose of collecting evidence. The new disciplinary cause of action is located in the Occupations Code §301.452(b)(13). The proposed amendments to the Board’s Disciplinary Matrix (Matrix) are necessary for consistency with this statutory change.

First, the proposed amendments add a new subsection to the Matrix that corresponds to the new disciplinary cause of action. The proposed amendments also renumber existing §301.452(b)(13) accordingly. The proposed amendments also include a range of disciplinary sanctions applicable to the new violation and aggravating and mitigating factors that could apply to a violation of §301.452(b)(13). The proposed range of sanctions includes licensure suspension, including temporary suspension on an emergency basis under the Occupations Code §301.455; licensure revocation, or licensure denial. The Board has determined that these levels of discipline are appropriate given the seriousness of the conduct that would constitute a violation of §301.452(b)(13). Further, the aggravating factors include actual patient harm; impairment at the time of the incident; severity of patient harm; prior complaints or discipline for similar conduct; and patient vulnerability. These factors, if present in a given case, could justify a higher sanction. The proposed mitigating factors include mistaken consent or a good faith belief that a statutory exception applied. These factors, if present in a given case, could justify a lower sanction.

The remaining proposed amendments to the Matrix correct outdated references to website addresses; remove obsolete provisions; make editorial changes; and clarify sanctions that are not available as the result of a contested case proceeding. Specifically, the proposed amendments make clear that participation in a peer assistance program, such as the Texas Peer Assistance Program for Nurses (TPAPN), or participation in a targeted assessment and remediation program, such as the Knowledge, Skills, Training, Assessment, and Research Program (KSTAR), are not available as the result of a contested case hearing. Like a corrective action, participation in a targeted assessment and remediation program is only available as a condition of settlement. See 22 Texas Administrative Code §213.32(4) (relating to Corrective Action Proceedings and Schedule of Administrative Fines) and §213.35(k)(2) (relating to Targeted Assessment and Remediation Pilot Program). Likewise, participation in a peer assistance program must be voluntary, not forced, as the program contains rigorous requirements for the participant’s successful completion of the program. See 22 Texas Administrative Code §217.13 (relating to Peer Assistance Program). The proposed amendments clarify the applicability of these existing rules and policies of the Board as they apply to contested case proceedings. The remaining proposed amendments to §213.33 make editorial, non- substantive changes to the section.

SECTION-BY-SECTION SUMMARY

  • The proposal makes several changes to the Board’s Disciplinary Matrix, located in §213.33(b).
  • The most substantial proposed changes relate to new §301.452(b)(13). Existing §301.452(b)(13) has been re-numbered as §301.452(b)(14).
  • The proposed changes to new §301.452(b)(13) include a range of new disciplinary sanctions, as well as aggravating and mitigating factors applicable to the new disciplinary cause of action.
  • Other proposed changes affect §301.452(b)(1) – (b)(4) and (b)(7) – (b)(12).
  • These proposed changes correct outdated references to website addresses in (b)(4) and (b)(8) – (b)(10); remove obsolete provisions from (b)(9); make editorial changes in (b)(1) – (b)(3) and (b)(7), (b)(10), (b)(11), and (b)(12); and clarify sanctions that are not available as the result of a contested case proceeding in (b)(9), (b)(12), and (b)(14).
  • The proposal also makes editorial, non-substantive changes to §213.33(c).

Amending 22 TAC §214.4 to improve rules relating to vocational nursing education.

CHAPTER 214. VOCATIONAL NURSING EDUCATION
22 TAC §214.4

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to 22 TAC §214.4(c), relating to Approval. The amendments are being proposed under the authority of the Occupations Code §301.151 and §301.157(b).

BACKGROUND AND JUSTIFICATION

House Bill (HB) 2426, enacted by the 80th Legislature, required the Board to identify national nursing accreditation agencies recognized by the United States Department of Education with standards equivalent to the Board’s ongoing approval standards. In order to implement the requirements of HB 2426, the Board conducted a comprehensive comparative review of national accreditation standards and identified two accreditation agencies with equivalent standards: the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Based upon these findings, the Board adopted Education Guideline 3.2.4.a, which provided guidance to accredited programs regarding their exemption from compliance with certain Board rules. This guidance was also included in Board §214.4. However, the rule did not include a specific reference to ACEN or CCNE at that time. In October 2012, Board §214.4(c)(8) was amended to specifically incorporate the title of Education Guideline 3.2.4.a. into the rule. The title of Education Guideline 3.2.4.a specifically referenced the names of the Board’s approved national nursing accreditation agencies, the ACEN and CCNE. These two accreditation agencies have remained the only accreditation agencies recognized by the Board until recently.

The National League for Nursing (NLN) launched a third nursing accreditation organization in 2013, and 115 education programs across 29 states representing all program types have been pre-accredited or accredited by the NLN Commission for Nursing Education Accreditation (CNEA). On May 25, 2021, the NLN CNEA was recognized by the United States Department of Education as a fully accrediting agency for an initial five-year period. At its July 2021 meeting, the Board voted to add the NLN CNEA to its list of approved accreditation agencies, recognized by the United States Department of Education, and determined to have standards equivalent to the Board’s ongoing approval standards for nursing education programs. Due to the addition of an additional accreditation agency, the title of Education Guideline 3.2.4.a was also amended to eliminate reference to the specific approved accreditation agencies. Instead, the title of the guideline was amended to refer more generically to Board-approved national nursing accreditation agencies.

The proposed amendments to §214.4(c)(8) are now necessary for consistency with these recent changes made by the Board. The proposed amendments reference the newly amended title of Education Guideline 3.2.4.a by referring generically to Board-approved national nursing accreditation organizations instead of including specific reference to the ACEN and CCNE.

SECTION-BY-SECTION SUMMARY

Proposed amended §214.4(c)(8) references the newly amended title of Board Education Guideline 3.2.4.a: Specific Exemptions from Education Rule Requirements for Nursing Education Programs Accredited by a Board-Approved National Nursing Accreditation Organization.

Amending 22 TAC §215.2 to define a professional nursing education program.

CHAPTER 215. PROFESSIONAL NURSING EDUCATION
22 TAC §215.2

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to §215.2, relating to Definitions. The amendments are being proposed under the authority of the Occupations Code §301.151 and §301.157(a) & (b).

Proposed amended §215.2(4) defines a professional nursing education program.

BACKGROUND AND JUSTIFICATION

22 Texas Administrative Code Chapter 215 relates to professional nursing education programs, not vocational nursing education programs. The proposed amendments are necessary to correct a typographical error in §215.2 from vocational to professional.

Amending 22 TAC §215.4 to update rules relating to approval for professional nursing education.

CHAPTER 215. PROFESSIONAL NURSING EDUCATION
22 TAC §215.4

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to §215.4(c), relating to Approval. The amendments are being proposed under the authority of the Occupations Code §301.151 and §301.157(b).

Proposed amended §215.4(c)(8) references the newly amended title of Board Education Guideline 3.2.4.a: Specific Exemptions from Education Rule Requirements for Nursing Education Programs Accredited by a Board-Approved National Nursing Accreditation Organization.

BACKGROUND AND JUSTIFICATION

House Bill (HB) 2426, enacted by the 80th Legislature, required the Board to identify national nursing accreditation agencies recognized by the United States Department of Education with standards equivalent to the Board’s ongoing approval standards. In order to implement the requirements of HB 2426, the Board conducted a comprehensive comparative review of national accreditation standards and identified two accreditation agencies with equivalent standards: the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Based upon these findings, the Board adopted Education Guideline 3.2.4.a, which provided guidance to accredited programs regarding their exemption from compliance with certain Board rules. This guidance was also included in Board Rule 215.4. However, the rule did not include a specific reference to ACEN or CCNE at that time. In October 2012, Board Rule 215.4(c)(8) was amended to specifically incorporate the title of Education Guideline 3.2.4.a. into the rule. The title of Education Guideline 3.2.4.a specifically referenced the names of the Board’s approved national nursing accreditation agencies, the ACEN and CCNE. These two accreditation agencies have remained the only accreditation agencies recognized by the Board until recently.

The National League for Nursing (NLN) launched a third nursing accreditation organization in 2013, and 115 education programs across 29 states representing all program types have been pre-accredited or accredited by the NLN Commission for Nursing Education Accreditation (CNEA). On May 25, 2021, the NLN CNEA was recognized by the United States Department of Education as a fully accrediting agency for an initial five-year period. At its July 2021 meeting, the Board voted to add the NLN CNEA to its list of approved accreditation agencies, recognized by the United States Department of Education, and determined to have standards equivalent to the Board’s ongoing approval standards for nursing education programs. Due to the addition of an additional accreditation agency, the title of Education Guideline 3.2.4.a was also amended to eliminate reference to the specific approved accreditation agencies. Instead, the title of the guideline was amended to refer more generically to Board-approved national nursing accreditation agencies.

The proposed amendments to §215.4(c)(8) are now necessary for consistency with these recent changes made by the Board. The proposed amendments reference the newly amended title of Education Guideline 3.2.4.a by referring generically to Board-approved national nursing accreditation organizations instead of including specific reference to the ACEN and CCNE.

Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §181.2 to update rules for expediting a death certificate for religious purposes in certain counties.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER A. MISCELLANEOUS PROVISIONS
25 TAC §181.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendments to §181.2, concerning Assuming Custody of Body; §181.22, concerning Fees Charged for Vital Records Services; and §181.30, concerning Instructions and Requirements for Filing of Amendments to Medical Certification of Certificate of Death with a Local Registrar.

The proposed amendment to §181.2 concerns expediting a death certificate for religious purposes in certain counties and changes the title of the Vital Statistics Unit to Vital Statistics Section.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with House Bill (H.B.) 1011, Senate Bill (S.B.) 798, and H.B. 4048, 87th Legislature, Regular Session, 2021. H.B. 1011 created new Texas Health and Safety Code §193.0025 to establish a process for an individual to request an expedited death certificate for religious purposes in applicable counties. The proposed amendment to §181.2 specifies how DSHS will provide technical support, as needed, to local offices who will fulfill these requests.

S.B. 798 created new Texas Health and Safety Code §191.00491, waiving the fee for issuing a certified copy of a person’s birth record to victims and the children of victims of family or dating violence. The proposed amendment to §181.22 establishes a fee waiver for persons who meet all requirements as defined by statute and rule.

H.B. 4048 repealed Texas Health and Safety Code §193.005(a-1), to permit a physician assistant or advanced practice resident nurse of the decedent to complete the medical certification for a death certificate or a fetal death certificate, if the death occurred under the care of the person in connection with the treatment of the condition or disease process that contributed to the death, and does not limit this permission to hospice or palliative care. The proposed amendment to §181.30 removes the prior statutory limitations.

Amending 25 TAC §181.22 and §181.30 to update requirements relating to vital record-keeping.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER B. VITAL RECORDS
25 TAC §181.22, §181.30

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendments to §181.2, concerning Assuming Custody of Body; §181.22, concerning Fees Charged for Vital Records Services; and §181.30, concerning Instructions and Requirements for Filing of Amendments to Medical Certification of Certificate of Death with a Local Registrar.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with House Bill (H.B.) 1011, Senate Bill (S.B.) 798, and H.B. 4048, 87th Legislature, Regular Session, 2021. H.B. 1011 created new Texas Health and Safety Code §193.0025 to establish a process for an individual to request an expedited death certificate for religious purposes in applicable counties. The proposed amendment to §181.2 specifies how DSHS will provide technical support, as needed, to local offices who will fulfill these requests.

S.B. 798 created new Texas Health and Safety Code §191.00491, waiving the fee for issuing a certified copy of a person’s birth record to victims and the children of victims of family or dating violence. The proposed amendment to §181.22 establishes a fee waiver for persons who meet all requirements as defined by statute and rule.

H.B. 4048 repealed Texas Health and Safety Code §193.005(a-1), to permit a physician assistant or advanced practice resident nurse of the decedent to complete the medical certification for a death certificate or a fetal death certificate, if the death occurred under the care of the person in connection with the treatment of the condition or disease process that contributed to the death, and does not limit this permission to hospice or palliative care. The proposed amendment to §181.30 removes the prior statutory limitations.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §181.22 establishes a fee waiver for issuing a certified copy of a person’s birth record to an applicant who represents that the applicant is a victim, or child of a victim, of dating or family violence who is fleeing a dating or family violence living situation and does not have personal identification documents.
  • The proposed amendment to §181.30 defines who may file an amendment to a death certificate.
  • The proposed amendments to §§181.22 and 181.30 change the title of the Vital Statistics Unit to Vital Statistics Section and make minor formatting changes.

Repealing 25 TAC §412.272 to consolidate HHSC rules and reflect the move of governance over state hospitals from the Department of State Health Services (DSHS) to HHSC.

CHAPTER 412. LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES
SUBCHAPTER F. CONTINUITY OF SERVICES–STATE MENTAL RETARDATION FACILITIES
25 TAC §412.272

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §412.272, concerning Transfer of an Individual from a State MR Facility to a State MH Facility.

The proposed repeal of §412.272 removes the rule from 25 TAC Chapter 412, Subchapter F.

BACKGROUND AND JUSTIFICATION

The purpose of the proposed repeal is to reflect the move of the state hospitals from the Department of State Health Services (DSHS) to HHSC by moving an HHSC rule from Texas Administrative Code (TAC) Title 25, Chapter 412, Subchapter F to 26 TAC Chapter 902 to consolidate HHSC rules. The current rule will be repealed from 25 TAC, updated, and placed in 26 TAC Chapter 902. The new rule is proposed simultaneously elsewhere in this issue of the Texas Register.

In Addition Re:

Correcting an error published in a miscellaneous document regarding the scheduling of certain controlled substances. 

The Department of State Health Services (DSHS) published a miscellaneous document entitled “Amendment Extending the Temporary Schedule I Status of Five Synthetic Substances; Removing Samidorphan from Schedule II; Placing Fourteen Fentanyl Related Substances into Schedule I; and Placing Serdexmethylphenidate in Schedule IV” in the July 23, 2021, issue of the Texas Register (46 Tex Reg4479).

Due to an error by DSHS, an incorrect reference was included in the document. The incorrect reference followed the heading “Schedule II substances, vegetable origin or chemical synthesis”. The revised schedule can be found in this week’s issue of the Texas Register at 46 Tex Reg 5922-32.

Health and Human Services Commission

Proposed Rules Re:

Amending 26 TAC §306.192 to update rules relating to the transfer of an individual from a state-supported living center to a state hospital.

CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER D. MENTAL HEALTH SERVICES–ADMISSION, CONTINUITY, AND DISCHARGE
DIVISION 4. TRANSFERS AND CHANGING LOCAL MENTAL HEALTH AUTHORITIES OR LOCAL BEHAVIORAL HEALTH AUTHORITIES
26 TAC §306.192

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendment to §306.192, concerning Transfers Between a State Mental Health Facility and a State Supported Living Center.

The proposed amendment to §306.192 removes references to 25 TAC §412.272 and adds a reference to 26 TAC §902.1 relating to Transfer of an Individual from a State Supported Living Center to a State Hospital. Other edits are made for clarity and consistency.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reflect the move of an HHSC rule from Texas Administrative Code (TAC) Title 25 Chapter 412, Subchapter F to 26 TAC Chapter 902 to consolidate HHSC rules. Section 306.192 is amended to reference the new rule. The rule repeal in 25 TAC Chapter 412, Subchapter F and the new rule in 26 TAC Chapter 902 are proposed simultaneously elsewhere in this issue of the Texas Register.

New 26 TAC §556.100, concerning nurse aid transition from temporary status.

CHAPTER 556. NURSE AIDES
26 TAC §556.100

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §556.100, concerning Nurse Aide Transition from Temporary Status.

BACKGROUND AND JUSTIFICATION

Because of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) waived federal requirements prohibiting nursing facilities from employing anyone for longer than four months unless the person meets the training and certification requirements under 42 Code of Federal Regulations (CFR) §483.35(d). The Office of the Governor approved a corresponding suspension of state regulations. On April 9, 2020, HHSC issued a provider letter (PL 20-26) related to the governor’s approval to suspend provisions prohibiting a nursing facility from hiring a non-certified nurse aide to complete nurse aide tasks for longer than four months. The suspension was intended to provide flexibility in staffing during the COVID-19 public health emergency issued by the United States Secretary of Health and Human Services (COVID-19 public health emergency). The waiver did not suspend the requirements for supervision, competency, employee misconduct registry verification, or criminal background checks (Texas Health and Safety Code Chapter 250).

Under this waiver, nursing facilities have employed and trained numerous staff to complete nurse aide tasks who are not certified nurse aides. Once this waiver is no longer available, either through the termination of the emergency declaration or through other means, the staff completing these tasks will no longer be able to do so unless they have become certified as nurse aides. To ensure continued staffing at nursing facilities, a transition plan needs to be in place.

The individuals at issue have been trained as nurse aides and have been completing nurse aide tasks under the current waiver. To provide individuals with credit for this experience, the proposed rule will allow time trained and time worked at a nursing facility during the pandemic (work training and experience) to be counted as classroom and clinical training hours required as part of a Nurse Aide Training and Competency Evaluation Program (NATCEP).

Under current regulations, the training provided by a NATCEP must be associated with a nursing facility that meets the requirements of 42 CFR §483.151(b)(2) – (3). This requirement is included in Title 26 Texas Administrative Code §556.3(e). State regulations provide a waiver for this requirement under certain circumstances, but only for nursing facilities prohibited from providing a NATCEP when another NATCEP is not available within a reasonable distance from the facility employing the individual. In the current pandemic, no nursing facility was a “reasonable” distance from another, considering the risk of exposure to COVID-19 posed to facility residents by non-employees or by non-essential visitors of their facility.

To provide a path for certification of nurse aides who have been working in nursing facilities under the waiver of training requirements during the COVID-19 public health emergency, HHSC adopted a new emergency rule on May 20, 2021. This emergency rule allowed time trained and time worked in a nursing facility during the COVID-19 public health emergency to be counted as classroom and clinical hours required as part of a NATCEP. The purpose of the proposed new section is to ensure continued staffing at nursing facilities by adopting the process established under the May 20, 2021 emergency rule into permanent rule.

SECTION-BY-SECTION SUMMARY

  • Proposed new §556.100 describes the process for an individual who accumulated hours of work training and experience in a nursing facility during the COVID-19 public health emergency to count those hours towards the classroom and clinical training hours required as part of a NATCEP.
  • Subsection (a) states the purpose of the section.
  • Subsections (b) and (c) provide the eligibility requirements for work and training experience hours to be counted towards NATCEP classroom and clinical training hours.
  • Subsection (d) contains the required documentation for a nurse aide’s qualifying work training and experience hours.
  • Subsections (e) and (f) provide that nurse aides seeking certification under this section must still successfully complete both the written or oral examination and skill demonstration requirements for nurse aide certification and that nursing facilities without a NATCEP seeking certification for employees under this section must work with a NATCEP to complete the criminal background check and approve employees for nurse aide certification examinations.
  • Subsection (g) provides that an individual’s work training and experience hours must be completed during the duration of the COVID-19 public health emergency to be counted towards NATCEP classroom and clinical training hours.
  • Subsection (h) requires that a nurse aide be certified within four months following the end of the COVID-19 public health emergency.

Amending 26 TAC §§557.101, 557.107, 557.109, 557.113, 557.115, 557.119, 557.121, 557.123, 557.128 and 557.129 to modernize program requirements for medication aides.

CHAPTER 557. MEDICATION AIDES–PROGRAM REQUIREMENTS
26 TAC §§557.101, 557.107, 557.109, 557.113, 557.115, 557.119, 557.121, 557.123, 557.128, 557.129

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 557, Medication Aides–Program Requirements, amendments to §557.101, concerning Introduction; §557.107, concerning Training Requirements; Nursing Graduates; Reciprocity; §557.109, concerning Application Procedures; §557.113, concerning Determination of Eligibility; §557.115, concerning Permit Renewal; §557.119, concerning Training Program Requirements; §557.121, concerning Permitting of Persons with Criminal Backgrounds; §557.123, concerning Violations, Complaints, and Disciplinary Actions; §557.128, concerning Home Health Medication Aides; and §557.129, concerning Alternate Licensing Requirements for Military Services.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement House Bill (H.B.) 1342 and Senate Bill (S.B.) 1200, 86th Legislature, Regular Session, 2019. H.B. 1342 eliminates certain grounds for disqualification for an occupational license based on prior criminal convictions that are unrelated to the duties and responsibilities of an occupational license. S.B. 1200 allows for military spouses who have occupational licensing from other states to engage in that occupation in Texas without obtaining an additional license by notifying the applicable state agency.

The proposed amendments require medication aides to submit fingerprints to the Texas Department of Public Safety for a criminal background check and clarify the utilization of online courses in medication aide training programs.

The proposed amendments also update outdated rule references resulting from the administrative transfer of the rules from 40 TAC Chapter 97 to 26 TAC Chapter 558, update terminology, and remove other outdated references for clarity and consistency.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §557.101 updates definitions for “classroom instruction and training” and “clinical experience” to clarify the utilization of online courses in Medication Aide training programs. The proposed amendment also updates the definition of “armed forces of the United States” to include the Space Force as a military branch.
  • The proposed amendment to §557.107 updates the criteria for applying to be a medication aide to refer to the criminal history requirements listed in §557.121.
  • The proposed amendment to §557.109 revises the application material requirements to include the requirement to submit fingerprints to the Texas Department of Public Safety for a criminal background check. The proposed amendment also adds references to §557.121 regarding denial of an application based on criminal history.
  • The proposed amendment to §557.113 updates the criteria for determination of approval of a medication aide permit to refer to the criminal history requirements listed in §557.121.
  • The proposed amendment to §557.115 adds a one-time submission of fingerprints to the Texas Department of Public Safety for a criminal background check as a requirement for renewal of a medication aide permit.
  • The proposed amendment to §557.119 clarifies that classroom instruction and training requirements can be provided through online instruction. The proposed amendment also removes the requirement for training programs to perform a criminal background check on trainees since this will be replaced by the proposed requirement to submit fingerprints to the Texas Department of Public Safety for a criminal background check added to §557.109.
  • The proposed amendment to §557.121 revises requirements for permitting persons with criminal backgrounds in accordance with H.B. 1342 which amends Occupations Code, Chapter 51. The proposed amendment outlines the factors that must be considered by HHSC which determining a whether a criminal conviction directly relates to the duties and responsibilities of a medication aide. The proposed amendment also adds reference to §557.123 for an applicant who is denied a permit, or a medication aide whose permit is suspended based on criminal background.
  • The proposed amendment to §557.123 adds processes for denials of medication aide applications and suspension or revocation of medication aide permits based on criminal history in accordance with H.B. 1342 which amends Occupations Code, Chapter 51. The proposed amendment adds processes for a medication aide or medication aide applicant to provide additional information for further review by HHSC. The proposed amendment also adds processes for a medication aide or medication aide applicant to request a formal hearing or judicial review relating to HHSC’s decision to deny, suspend, or revoke a permit based on criminal background.
  • The proposed amendment to §557.128 revises the application material requirements for home health medication aides to include the requirement to submit fingerprints to the Texas Department of Public Safety for a criminal background check. The proposed amendment also adds references to §557.121 regarding criteria for applying to become a home health medication aide and denial of an application based on criminal history. The proposed amendment also adds a one-time submission of fingerprints to the Texas Department of Public Safety for a criminal background check as a requirement for renewal of a home health medication aide permit. The proposed amendment also clarifies that classroom instruction and training requirements for home health medication aide training programs can be provided through online instruction.
  • The proposed amendment to §557.129 adds processes for military spouses with an out-of-state medication aide permit to engage in the practice of a medication aide in Texas in accordance with S.B. 1200, which amends Occupations Code, Chapter 55. The proposed amendment adds processes for military spouses to request recognition of an out-of-state medication aide permit from HHSC and requirements to be approved for recognition of a military spouse’s out-of-state permit. The proposed amendment adds that a permit issued for a military spouse under this section is not subject to fees and will expire three years from the date of issuance. The proposed amendment also adds military spouses to the list of individuals who can request reciprocity for training and experience requirements related to applying for a medication aide permit.

New 26 TAC §902.1, concerning the transfer of an individual from a state- supported living center to a state hospital.

CHAPTER 902. CONTINUITY OF SERVICES–TRANSFERRING INDIVIDUALS FROM STATE SUPPORTED CENTERS TO STATE HOSPITALS
26 TAC §902.1

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §902.1, concerning Transfer of an Individual from a State Supported Living Center to a State Hospital.

The proposed new §902.1 provides parameters for the transfer of individuals who have been committed or voluntarily admitted to a state supported living center (SSLC) from an SSLC to a state

BACKGROUND AND JUSTIFICATION

The purpose of the proposed new rule is to reflect the move of the state hospitals from the Department of State Health Services to HHSC by moving an HHSC rule from Texas Administrative Code (TAC) Title 25, Chapter 412, Subchapter F to

26 TAC Chapter 902 to consolidate HHSC rules. The current rule will be repealed from 25 TAC, updated, and placed in 26 TAC Chapter 902. The proposed rule has updated agency information and appropriate population language. The rule repeal in 25 TAC Chapter 412, Subchapter F is proposed simultaneously elsewhere in this issue of the Texas Register.

Texas State Board of Pharmacy

Withdrawn Rules Re:

Withdrawing 22 TAC §291.1 and §291.3, relating to all classes of pharmacies. 

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.1, §291.3

Proposed amended §291.1 and §291.3, published in the October 2, 2020, issue of the Texas Register (45 Tex Reg 6875-76), is withdrawn. The agency failed to adopt the proposals within six months of publication. (See Government Code, §2001.027, and 1 TAC §91.38(d).).

Texas Medical Board

Adopted Rules Re:

Amending 22 TAC §187.2 and §187.6 to ensure consistent usage of the term “appear” and “appearance” with regard to general provisions and definitions.

CHAPTER 187. PROCEDURAL RULES
SUBCHAPTER A. GENERAL PROVISIONS AND DEFINITIONS
22 TAC §187.2, §187.6

OVERVIEW

The Texas Medical Board (Board) adopts amendments to Subchapter A: General Provisions and Definitions, §187.2 concerning Definitions and §187.6 concerning Appearances Personally or by Representative. The amendments to §§187.2 and 187.6 are being adopted without changes to the proposed text as published in the July 23, 2021, issue of the Texas Register (46 Tex Reg 4433). The adopted amendments to §§187.2 and 187.6 will not be republished.

SECTION-BY-SECTION SUMMARY

  • §187.2(6), relating to Definitions, adds a definition of “appear/appearance.”
  • §187.6, relating to Appearances Personally or by Representative, was amended to incorporate consistent usage of the term “appear” and “appearance.”

Amending 22 TAC §187.16 to provide consistency of the terms “appear” and “appearance” with regard to informal board proceedings.

CHAPTER 187. PROCEDURAL RULES
SUBCHAPTER B. INFORMAL BOARD PROCEEDINGS
22 TAC §187.16

The Texas Medical Board (Board) adopts amendments to Subchapter B: Informal Board Proceedings, §187.16, concerning Informal Show Compliance (ISC) Information and Notices. The amendments to §187.16 are being adopted without changes to the proposed text as published in the July 23, 2021, issue of the Texas Register (46 Tex Reg 4433). The adopted amendments to §187.16 will not be republished.

§187.16, relating to Informal Show Compliance (ISC) Information and Notices, was amended to incorporate consistent usage of the term “appear” and “appearance.”