Texas Register Table of Contents
- 1 Department of State Health Services
- 2 Texas Health and Human Services Commission
- 2.0.1 Proposed Rules Re:
- 2.0.1.1 Amending 1 TAC §353.1155 to update requirements concerning the Medically Dependent Children Program.
- 2.0.1.2 Amending 1 TAC §355.108 and §355.109 to clarify the cost determination process in response to inflation and payroll tax rate changes.
- 2.0.1.3 Amending 1 TAC §355.8095 to update requirements related to the Medicaid Administrative Claiming Program.
- 2.0.1.4 New 26 TAC §§910.1 – 910.10 to reflect the move of the state hospitals from the Department of State Health Services and the state supported living centers from the Department of Aging and Disability Services to HHSC.
- 2.0.2 Adopted Rules Re:
- 2.0.1 Proposed Rules Re:
- 3 Texas Department of Licensing and Regulation
- 4 Department of Aging and Disability Services
- 4.0.1 Proposed Rules Re:
- 4.0.1.1 Repealing 40 TAC §§7.101 – 7.110 to reflect the move of the state supported living centers from DADS to HHSC.
- 4.0.1.2 Amending 40 TAC §9.157 and §9.158 to update requirements concerning the Home and Community-Based Services (HCS) program and Community First Choice (CFC).
- 4.0.1.3 Amending 40 TAC §9.566 and §9.567 to provide updated requirements related to the Texas Home Living (TXHML) Program and Community First Choice (CFC).
- 4.0.1.4 Amending 40 TAC §42.202 to clarify eligibility and enrollment requirements for Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.
- 4.0.1.5 Amending 40 TAC §42.211 to edit requirements related to the enrollment process for DBMD and CFC.
- 4.0.1.6 Amending 40 TAC §42.402 to clarify certain educational requirements and add a licensing requirement for a service provider of dental treatment.
- 4.0.1.7 Amending 40 TAC §45.202 and §45.211 to update eligibility and enrollment requirements for Community Living Assistance and Support Services and Community First Choice (CFC) Services.
- 4.0.1 Proposed Rules Re:
- 5 Texas State Board of Examiners of Psychologists
- 5.0.1 Adopted Rules Re:
- 5.0.1.1 Amending 22 TAC §463.9 to reflect the change that future trainee status for Licensed Specialist in School Psychology applicants will no longer be issued.
- 5.0.1.2 Amending 22 TAC §465.2 to reflect changes in rules relating to supervision.
- 5.0.1.3 Amending 22 TAC §465.38 to update requirements relating to Psychological Services for Schools.
- 5.0.1 Adopted Rules Re:
- 6 Texas Behavioral Health Executive Council
- 6.0.1 Adopted Rules Re:
- 6.0.1.1 Amending 22 TAC §881.21 to correct a typographical error.
- 6.0.1.2 Amending 22 TAC §882.11 to expand the number of acceptable foreign degree evaluation services who conduct foreign degree evaluations to include members of the Association of International Credential Evaluators, Inc.
- 6.0.1.3 Amending 22 TAC §885.1 to clarify fee requirements.
- 6.0.1 Adopted Rules Re:
Department of State Health Services
Emergency Rules Re:
Renewing 25 TAC §448.911 to expand electronic treatment services for adults and adolescents in a licensed chemical dependency treatment facilities.
CHAPTER 448. STANDARD OF CARE
SUBCHAPTER I. TREATMENT PROGRAM SERVICES
25 TAC §448.911
OVERVIEW
The Department of State Health Services is renewing the effectiveness of emergency amended §448.911 for a 60-day period. The text of the emergency rule was originally published in the May 21, 2021, issue of the Texas Register (46 Tex Reg 3224).
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 25 Texas Administrative Code, Chapter 448, Standard of Care, an amendment to §448.911, concerning an emergency rule in response to COVID-19 to expand a licensed chemical dependency treatment facility’s ability to provide treatment services through electronic means to adults and adolescents to reduce the risk of COVID-19 transmission.
HHSC is renewing an emergency rule amendment to §448.911(a)(1) to temporarily permit a currently licensed chemical dependency treatment facility (CDTF) to provide treatment services through electronic means to both adult and adolescent clients. This emergency rule amendment will reduce the risk of COVID-19 transmission and expand access to treatment for clients.
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 amendment to Treatment Services Provided by Electronic Means.
Proposed Rules Re:
Amending 25 TAC §229.261 to revise administrative penalties within food and drug programs.
CHAPTER 229. FOOD AND DRUG
SUBCHAPTER P. ASSESSMENT OF ADMINISTRATIVE PENALTIES
25 TAC §229.261
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 §229.261, concerning Assessment of Administrative Penalties.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to revise the administrative penalty level ranges to facilitate transparent and efficient compliance actions. DSHS is currently developing penalty matrixes to provide flexibility in assessing administrative penalties within food and drug programs. An amendment to adjust penalty levels is necessary to avoid a conflict with the administrative penalty levels currently in the rule.
The rule currently provides a set of ranges for administrative penalties based on the severity level for food and drug programs as well as tattoo and body-piercing studios. The amendment revises the penalty range by stating that penalties can be assessed up to the maximum amount provided in each severity level. This change alleviates any conflicts with the rule that may arise when assessing administrative penalties using the penalty matrixes. The administrative penalty matrixes will be published in the Texas Register.
Additional amendments remove two programs that are no longer DSHS’s jurisdiction, correct grammar, and format the rule.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §229.261(a) removes the references to Texas Health and Safety Code, Chapter 145, Tanning Facility Regulation Act, and Texas Health and Safety Code, Chapter 466, Regulation of Narcotic Treatment Program, because the programs are no longer DSHS’s jurisdiction. Subsection (a) also corrects Texas Government Code to “Chapter 2001” instead of “§§2001.051 – 2001.902” for the general cite.
- The proposed amendment to §229.261 revises penalty level ranges in subsections (e), (f), and (g) to state that the penalties can be assessed up to the maximum amount provided in each severity level. It also revises subsection (h) by deleting the words “make adjustments to” and replacing them with “adjust.”
- Section 229.261(a), (f), and (g) clarify the statute as “Texas” Health and Safety Code. Section 229.261(h) corrects grammar and formatting.
CHAPTER 417. AGENCY AND FACILITY RESPONSIBILITIES
SUBCHAPTER C. CHARGES FOR SERVICES IN TDMHMR FACILITIES
25 TAC §§417.101 – 417.110
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §417.101, concerning Purpose; §417.102, concerning Application; §417.103, concerning Definitions; §417.104, concerning Fee Assessment and Notification of Charges; §417.105, concerning Accruing Charges; §417.106, concerning Appeal Process; §417.107, concerning Filing Notice of Lien; §417.108, concerning Exhibits; §417.109, concerning References; and §417.110, concerning Distribution.
BACKGROUND AND JUSTIFICATION
The purpose of the proposed repeals is to reflect the move of the state hospitals from the Department of State Health Services (DSHS) to HHSC by moving HHSC rules from Texas Administrative Code (TAC) Title 25, Chapter 417, Subchapter C to 26 TAC Chapter 910 and consolidate HHSC rules. The current rules will be repealed, updated, and placed in 26 TAC Chapter 910. The new rules are proposed simultaneously elsewhere in this issue of the Texas Register.
SECTION-BY-SECTION SUMMARY
The repeal of 25 TAC Chapter 417, Subchapter C rules will delete the rules from 25 TAC and place updated rules in 26 TAC to reflect the transfer of functions from DSHS to HHSC.
In Addition Re:
Licensing Actions for Radioactive Materials
OVERVIEW
During the first half of August 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.
BACKGROUND AND JUSTIFICATION
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. 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.
HEARING DETAILS
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 Health and Human Services Commission
Proposed Rules Re:
Amending 1 TAC §353.1155 to update requirements concerning the Medically Dependent Children Program.
CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER M. HOME AND COMMUNITY BASED SERVICES IN MANAGED CARE
1 TAC §353.1155
OVERVIEW
The Texas Health and Human Services Commission (HHSC) proposes an amendment to 1 TAC §353.1155, concerning Medically Dependent Children Program.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists, for individuals enrolled in the Medically Dependent Children Program (MDCP) who, on or after December 1, 2019, become ineligible for MDCP for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019.
The proposed amendment also ensures the eligibility criteria for where an individual may reside is consistent with federal regulations, the MDCP waiver application, and state law on the number of children who can reside in an “agency foster home.”
The proposed amendment aligns the MDCP interest list rules with the interest list rules in the Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), and Texas Home Living (TxHmL) waiver programs.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §353.1155 deletes subsection (a) because it is no longer necessary to include these applicability statements. The statements are not necessary because MDCP services are only provided under Medicaid managed care and because the rules under 40 TAC, Chapter 51 Medically Dependent Children Program were repealed effective December 22, 2020. The proposed amendment also reformats the rule section due to the deletion of subsection (a).
- The proposed amendment in subsection (b), reformatted as subsection (a), makes changes in two of the MDCP eligibility criteria a managed care organization (MCO) assesses for an individual. The proposed amendment clarifies the criteria of not being enrolled in “another Medicaid HCBS waiver program” by listing each of the current waiver programs approved by the Centers for Medicare & Medicaid Services. The proposed amendment makes changes in the criteria for where an individual must reside to: (1) ensure the MDCP rule complies with the Code of Federal Regulations, Title 42, §441.301(b)(1)(ii) and (c)(5), that requires Home and Community Based Services (HCBS) be provided in a home and community-based setting; (2) clarify that the residency criteria applies to all individuals, not just individuals under 18 years of age; and (3) replace the “foster home” limit of no more than four children with “agency foster home.” “Agency foster home” is defined in Texas Human Resources Code, §42.002, as a foster home that provides care for not more than six children and is considered to be an HCBS setting. The proposed amendment also makes minor editorial changes.
- The proposed amendment in subsection (c), reformatted as subsection (b), makes the MDCP interest list rules consistent with the other waiver program interest list rules by adding: (1) the actions HHSC takes after receiving a request to add an individual’s name to the MDCP interest list; and (2) how HHSC manages the MDCP interest list for an individual determined diagnostically or functionally ineligible during the enrollment process for the CLASS Program, DBMD Program, HCS Program, or TxHmL Program. The proposed amendment: (1) for an individual who becomes ineligible for MDCP due to the level of care criteria, specifies that the individual or the individual’s legally authorized representative (LAR) may request one time that HHSC add the individual’s name to the first position on the MDCP interest list; and (2) for an individual who becomes ineligible due to the level of care criteria or the criteria of being under 21 years of age, specifies that the individual or LAR may request that HHSC add the individual’s name to the interest list for any of the listed waiver programs or change the individual’s interest list date for any of the listed waiver programs in accordance with the interest list rules cited for each program. The proposed amendment, for an individual on the MDCP interest list who is assessed for MDCP and determined to be ineligible, adds that the individual has had an opportunity to exercise the individual’s right to a fair hearing as described in 1 TAC Chapter 357, relating to Hearings. The proposed amendment, for an individual assessed for MDCP and determined to be ineligible, specifies that the individual may request to have the individual’s name added to the MDCP interest list as described in paragraph (1) of this subsection to replace that the individual may request to be placed at the end of the interest list.
- The proposed amendments in subsections (d) – (h), reformatted as subsections (c) – (g), make minor editorial changes.
Amending 1 TAC §355.108 and §355.109 to clarify the cost determination process in response to inflation and payroll tax rate changes.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER A. COST DETERMINATION PROCESS
1 TAC §355.108, §355.109
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.108, concerning Determination of Inflation Indices, and §355.109, concerning Adjusting Reimbursement When New Legislation, Regulations, or Economic Factors Affect Costs.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to clarify how the agency calculates reimbursement rate adjustments in response to inflation and payroll tax rate changes. The inflation methodologies pertaining to the proposed amendments are used to calculate payment rates for long-term services and supports programs. Calculating rates of inflation and applying them to appropriate costs allows HHSC to account for economic inflation when estimating the costs of rate changes implemented as a result of Legislative direction, calculating periodic rate changes such as biennial fee reviews, establishing rates for new programs, and completing other special analyses.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §355.108(a) clarifies the purpose of adjusting allowable costs for inflation when HHSC conducts reimbursement reviews.
- The proposed amendment to §355.108(b) makes general clarifying edits.
- The proposed amendment to §355.108(c) replaces language about which indices HHSC may utilize with language about how costs are adjusted. The contents of subsections (d) and (e) are moved to new paragraphs (1) and (2), respectively, under subsection (c), and edited for clarity.
- The proposed amendment to §355.108(e) deletes paragraphs (1), (2), and (3) because the language is unrelated to inflation. The language in paragraphs (1) and (2) are covered by §355.109, and paragraph (3) is moved to §355.109. Paragraphs (4) and (5) under subsection (e) are deleted and moved to new paragraph (2) under subsection (c). The content in paragraph (4) is moved to new paragraphs (2)(A) and (2)(C) under subsection (c), modified to specify the inflation index for the wages and salaries of licensed vocational nurses and nurse aides, and modified to reduce redundancy and increase clarity. The content of paragraph (5) is moved to new paragraph (2)(B) under subsection (c), modified to reduce redundancy and increase clarity, and modified to remove language regarding the Omnibus Reconciliation Act of 1984 and the Consolidated Omnibus Budget Reconciliation Act of 1985 because they are no longer applicable in this context.
- The proposed amendment to §355.108 adds new subsection (d) to clarify how adjustments to costs are calculated using the inflation indices specified in subsection (c). New paragraph (1) adds information about the source of data HHSC uses to forecast inflation. New paragraph (2) and subparagraphs (A) and (B) outline how certain variables may be multiplied and divided to calculate a rate of inflation.
- The proposed amendment to §355.109 adds subsection (a)(3) regarding adjustments to reimbursement in response to changes to unemployment tax rates. The content of paragraph (3) is from its current location in §355.108(e)(3) and revised to clarify the calculation. Minor edits are made throughout the rule for consistency and to correct spelling.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 5. GENERAL ADMINISTRATION
1 TAC §355.8095
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8095, concerning Medicaid Administrative Claiming Program.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to allow Aging and Disability Resource Centers (ADRCs) the opportunity to participate in the Medicaid Administrative Claiming (MAC) program. MAC is a joint federal-state funded program authorized by the Centers for Medicare & Medicaid Services (CMS) which provides reimbursement for the costs of Medicaid administrative activities that refer eligible or potentially eligible Medicaid recipients to appropriate Medicaid and health-related services. HHSC serves as a pass-through entity to administer these federal funds. MAC in Texas currently provides funding for school districts, mental health programs/programs serving individuals with intellectual and developmental disabilities, local health departments/districts, and early childhood intervention programs. Access to this reimbursement opportunity allows ADRCs a mechanism to better serve the healthcare needs of Medicaid beneficiaries.
The rule change also amends a statement regarding costs allowable for submission through a MAC claim to better reflect the staff requirements for cost reporting, as per the CMS-approved Time Study Implementation Guide.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §355.8095(c)(2)(E) adds ADRCs as an eligible provider type.
- The proposed amendment to §355.8095(f)(2)(A) and (B) adds the ADRC provider type and §355.8095(f)(2)(B)(iii) is amended to better explain allowable costs related to administrative and administrative support staff.
- Minor edits are made to correct punctuation, capitalization, and a department name, and an edit is made for consistency.
New 26 TAC §§910.1 – 910.10 to reflect the move of the state hospitals from the Department of State Health Services and the state supported living centers from the Department of Aging and Disability Services to HHSC.
CHAPTER 910. CHARGES FOR SERVICES IN STATE FACILITIES
26 TAC §§910.1 – 910.10
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §910.1, concerning Purpose; §910.2, concerning Application; §910.3, concerning Definitions; §910.4, concerning Fee Assessment and Notification of Charges; §910.5, concerning State Hospital Accruing Charges; §910.6, concerning State Supported Living Center Accruing Charges; §910.7, concerning Rate Review Process at State Hospitals; §910.8, concerning Appeal Process; §910.9, concerning Filing Notice of Lien; and §910.10, concerning Taxable Income of the Parents.
BACKGROUND AND JUSTIFICATION
The purpose of the proposed new rules is to reflect the move of the state hospitals from the Department of State Health Services and the state supported living centers from the Department of Aging and Disability Services to HHSC by moving HHSC rules from Texas Administrative Code (TAC) Title 25, Chapter 417, Subchapter C and 40 TAC Chapter 7, Subchapter C to 26 TAC Chapter 910 and consolidate HHSC rules. The current rules will be repealed, updated, and placed in 26 TAC Chapter 910. The proposed rules have updated agency information, appropriate population language, and a new fee schedule. The repeal of 25 TAC Chapter 417, Subchapter C and 40 TAC Chapter 7, Subchapter C is proposed simultaneously elsewhere in this issue of the Texas Register.
SECTION-BY-SECTION SUMMARY
- Proposed new §910.1 establishes the purpose of the chapter.
- Proposed new §910.2 establishes to whom the chapter applies.
- Proposed new §910.3 provides terminology used in the chapter.
- Proposed new §910.4 describes how fees for services are assessed, how an individual is notified of the fees, and the information contained in a notice.
- Proposed new §910.5 describes when charges are accrued for services at state hospitals.
- Proposed new §910.6 describes when charges are accrued for services at state supported living centers.
- Proposed new §910.7 describes what an individual can do to request a reduction in charges at state hospitals.
- Proposed new §910.8 describes the appeal process for an individual who disagrees with any fees assessed.
- Proposed new §910.9 describes the steps HHSC must take to file a written notice of lien.
- Proposed new §910.10 establishes the parameters of the monthly fee of a minor based on the taxable income of the parents.
Adopted Rules Re:
Amending 1 TAC §355.8052 to enhance clarity concerning Inpatient Hospital Reimbursement.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 4. MEDICAID HOSPITAL SERVICES
1 TAC §355.8052
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.8052, concerning Inpatient Hospital Reimbursement. The amendment to §355.8052 is adopted with changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 Tex Reg 3785). The rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendment to §355.8052 is adopted to comply with Senate Bill 170 (S.B. 170), 86th Legislature, Regular Session, 2019 and Senate Bill 1621 (S.B. 1621), 86th Legislature, Regular Session, 2019, and to make other amendments to enhance clarity, consistency, and specificity. HHSC is required by S.B. 170, to the extent allowed by law, to calculate Medicaid rural hospital inpatient rates using a cost-based prospective reimbursement methodology. Additionally, HHSC must calculate rates for rural hospitals once every two years, using the most recent cost information available. The current rule does not require a biennial review of the rural hospital rates. Rates have not been realigned or rebased since state fiscal year (SFY) 2014. Previously, HHSC converted the rural hospital reimbursement from the methodology described in the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) to the prospective payment All Patient Refined Diagnosis Related Group (APR-DRG) methodology.
Pursuant to S.B. 1621 and S.B. 170, HHSC’s managed care contracts require managed care organizations (MCO) to reimburse rural hospitals using a minimum fee schedule for services delivered through the Medicaid managed care program. The proposed amendment adds subsection (e)(4), requiring a Medicaid minimum fee schedule for all rural hospitals, to conform the rule to the current law.
Presently, §355.8052 explains the standard dollar amount (SDA) rate setting process by concurrently addressing the multiple hospital types (rural, urban, and children’s). The proposed amendment arranges the rule by hospital type to enhance clarity, consistency, and specificity. The amendment adds and modifies definitions, including “rebasing” and “realignment.” The proposed amendment also specifies a policy for updating DRG statistical calculations to align with 3M Grouper changes.
Texas Department of Licensing and Regulation
Proposed Rules Re:
Amending 16 TAC §115.14 and §115.115 to clarify and update requirements regarding the Midwives Program.
CHAPTER 115. MIDWIVES
16 TAC §115.14, §115.115
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 115, §115.14 and §115.115, regarding the Midwives Program. These proposed changes are referred to as “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC Chapter 115 implement Texas Occupations Code, Chapter 203, Midwives.
The proposed rules add specific uterine and fetal heart rate conditions to the list of conditions during labor or delivery that require a midwife to initiate immediate emergency transfer of a client to a physician. The proposed rules articulate a standard for assessing fetal heart rates by intermittent auscultation and require midwives to complete two hours of continuing education covering the topic as a condition for license renewal. These changes are necessary to implement recommendations of the Standard of Care workgroup of the Midwives Advisory Board to clarify the standards of care for midwives and ensure that all midwives possess the knowledge and skills necessary to meet the standards.
The proposed rules also provide an audit system for reporting completion of continuing education for license renewal and make other clean-up changes to the license renewal provisions. These changes are necessary to implement recommendations by Department staff to improve the effectiveness and efficiency of the program.
The proposed rules were presented to and discussed by the Midwives Advisory Board at its meeting on August 24, 2021. The Advisory Board did not make any changes to the proposed rules. The Advisory Board voted and recommended that the proposed rules be published in the Texas Register for public comment.
SECTION-BY-SECTION SUMMARY
- The proposed rules amend §115.14, License Renewal, by rephrasing subsection (a) for clarity; removing from subsection (a)(1) unnecessary details about the application form; rephrasing subsection (a)(2) for clarity; adding language to subsection (a)(4) to allow the Department to accept an equivalent to the neonatal resuscitation certificate issued by the American Academy of Pediatrics; rephrasing subsection (a)(5) for consistency with other fee references; changing the punctuation in subsection (a)(6); adding new subsection (a)(7) to relocate the requirement for human trafficking prevention training from subsection (b); adding to subsection (b) a new license renewal requirement of two hours of continuing education covering the topic of assessing fetal heart rates by intermittent auscultation; adding new subsection (c) to provide an audit system for reporting completion of continuing education; and adding new subsection (d) to provide the process for the audit system and the responsibilities of licensees.
- The proposed rules amend §115.115, Labor and Delivery, by rephrasing and expanding subsection (e)(6) to provide clarity and list specific examples of fetal heart rate conditions that require immediate emergency transfer of the client to a physician; adding to subsection (e)(16) “uterine tachysystole” as a condition requiring immediate emergency transfer of the client to a physician; relocating the language in current subsection (e)(16) to proposed new subsection (e)(17); and adding new subsection (f) to require intermittent auscultation to be performed as recommended by the American College of Nurse-Midwives.
Department of Aging and Disability Services
Proposed Rules Re:
Repealing 40 TAC §§7.101 – 7.110 to reflect the move of the state supported living centers from DADS to HHSC.
CHAPTER 7. DADS ADMINISTRATIVE RESPONSIBILITIES
SUBCHAPTER C. CHARGES FOR SERVICES IN STATE FACILITIES
40 TAC §§7.101 – 7.110
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §7.101, concerning Purpose; §7.102, concerning Application; §7.103, concerning Definitions; §7.104, concerning Fee Assessment and Notification of Charges; §7.105, concerning Accruing Charges; §7.106, concerning Appeal Process; §7.107, concerning Filing Notice of Lien; §7.108, concerning Exhibits; §7.109, concerning References; and §7.110, concerning Distribution.
BACKGROUND AND JUSTIFICATION
The purpose of the proposed repeals is to reflect the move of the state supported living centers from DADS to HHSC by moving HHSC rules from Texas Administrative Code (TAC) Title 40, Chapter 7, Subchapter C to 26 TAC Chapter 910 and consolidate HHSC rules. The current rules will be repealed, updated, and placed in 26 TAC Chapter 910. The new rules are proposed simultaneously elsewhere in this issue of the Texas Register.
SECTION-BY-SECTION SUMMARY
The repeal of 40 TAC Chapter 7, Subchapter C rules will delete the rules from 40 TAC and place updated rules in 26 TAC to reflect the transfer of functions from DADS to HHSC.
Amending 40 TAC §9.157 and §9.158 to update requirements concerning the Home and Community-Based Services (HCS) program and Community First Choice (CFC).
CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER D. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
40 TAC §9.157, §9.158
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes amendments to §9.157, concerning HCS Interest List; §9.158, concerning Process for Enrollment of Applicants; §9.566, concerning TxHmL Interest List; and §9.567, concerning Process for Enrollment.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019. Section 531.0601 provides, in part, that the name of an individual who is enrolled in but becomes ineligible for the Medically Dependent Children Program (MDCP) may, under some circumstances, be added to the interest list of the Home and Community-based Services (HCS) Program or the interest list of the TxHmL Program using a date other than the date of the request as the interest list date. The proposed amendments to §9.157(f) and §9.566(e), which describe those circumstances, apply to an individual who is determined ineligible for MDCP, for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age, after November 30, 2019 and before the date §531.0601 expires.
The proposed amendments to §9.157 and §9.566 more clearly describe how the name of an individual determined diagnostically or functionally ineligible while enrolling in another waiver program may be added to the HCS interest list or TxHmL interest list. The proposed amendments to these sections also clarify how an individual’s name that was removed from the HCS interest list or TxHmL interest list is added to the list.
The proposed amendments to §9.158 and §9.567 update a reference to §9.157 and §9.566, respectively, and make minor editorial changes.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §9.157(c) clarifies that a local intellectual and developmental disability authority (LIDDA) must add an applicant’s name to the HCS interest list using the date the LIDDA receives the request as the HCS interest list date.
- The proposed amendment to §9.157 replaces subsection (d) with new subsections (d) and (e). New subsection (d) describes how an applicant who is under 22 years of age and residing in an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions or a nursing facility is added to the HCS interest list. New subsection (e) describes how an applicant for the Community Living Assistance and Support Services (CLASS) Program, Deaf-Blind with Multiple Disabilities (DBMD) Program, or MDCP Program who is determined diagnostically or functionally ineligible for the program is added to the HCS interest list.
- Proposed new §9.157(f) describes how an applicant who was enrolled in MDCP but determined ineligible for not meeting the level of care criteria for medical necessity for nursing facility care or the MDCP age requirement is added to the HCS interest list. The new subsection also describes when the HCS interest list date for such an applicant is changed to the MDCP interest list date.
- The proposed amendment to §9.157(e) – (h), reformatted as subsections (g) – (j), replaces “reinstates” and “placed on” with “adds,” replaces “original request date” with “the HCS interest list date,” and uses other clarifying language to more accurately describe the actions HHSC takes to add an applicant’s name to the HCS interest list and the date HHSC uses as the HCS interest list date. The proposed amendment to these subsections also updates rule references.
- The proposed amendment to §9.158 deletes subsection (s) because the information in subsection (s) is included in other subsections of §9.158. The proposed amendment updates rule references and websites; corrects titles of rules and forms; and adds the title of the form a service coordinator is required to use to provide an explanation of services and supports and the eligibility requirements to receive services. The proposed amendment also makes minor editorial changes for clarity.
CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER N. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
40 TAC §9.566, §9.567
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes amendments to §9.157, concerning HCS Interest List; §9.158, concerning Process for Enrollment of Applicants; §9.566, concerning TxHmL Interest List; and §9.567, concerning Process for Enrollment.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019. Section 531.0601 provides, in part, that the name of an individual who is enrolled in but becomes ineligible for the Medically Dependent Children Program (MDCP) may, under some circumstances, be added to the interest list of the Home and Community-based Services (HCS) Program or the interest list of the TxHmL Program using a date other than the date of the request as the interest list date. The proposed amendments to §9.157(f) and §9.566(e), which describe those circumstances, apply to an individual who is determined ineligible for MDCP, for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age, after November 30, 2019 and before the date §531.0601 expires.
The proposed amendments to §9.157 and §9.566 more clearly describe how the name of an individual determined diagnostically or functionally ineligible while enrolling in another waiver program may be added to the HCS interest list or TxHmL interest list. The proposed amendments to these sections also clarify how an individual’s name that was removed from the HCS interest list or TxHmL interest list is added to the list.
The proposed amendments to §9.158 and §9.567 update a reference to §9.157 and §9.566, respectively, and make minor editorial changes.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §9.566(c) clarifies that a LIDDA must add an applicant’s name to the TxHmL interest list using the date the LIDDA receives the request as the TxHmL interest list date.
- The proposed amendment to §9.566(d) more accurately describes how an applicant for the CLASS Program, DBMD Program, or MDCP Program who is determined diagnostically or functionally ineligible for the program is added to the TxHmL interest list.
- Proposed new §9.566(e) describes how an applicant who was enrolled in MDCP but determined ineligible for not meeting the level of care criteria for medical necessity for nursing facility care or the MDCP age requirement is added to the TxHmL interest list. The new subsection also describes when the TxHmL interest list date for such an applicant is changed to the MDCP interest list date.
- The proposed amendment to §9.566(e) – (h), reformatted as subsections (f) – (i), replaces “reinstates” and “placed on” with “adds,” replaces “original request date” with “the TxHmL interest list date,” and uses other clarifying language to more accurately describe the actions HHSC takes to add an applicant’s name to the TxHmL interest list and the date HHSC uses as the TxHmL interest list date. The proposed amendments to these subsections also update rule references.
- The proposed amendment to §9.567 updates rule references and websites; corrects titles of forms; and adds the title of the form a service coordinator is required to use to provide an explanation of services and supports and the eligibility requirements to receive services. The proposed amendment also makes minor editorial changes for clarity.
- The proposed amendments change “DADS” to “HHSC” throughout Chapter 9 to reflect that DADS was abolished effective September 1, 2017, and functions have transferred to HHSC.
Amending 40 TAC §42.202 to clarify eligibility and enrollment requirements for Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.
CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
DIVISION 1. ELIGIBILITY
40 TAC §42.202
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes an amendment to §42.202, concerning DBMD Interest List; §42.211, concerning Written Offer of Enrollment in the DBMD Program; and §42.402, concerning Qualifications of Program Provider Staff.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019. Section 531.0601 provides, in part, that the name of an individual who is enrolled in but becomes ineligible for the Medically Dependent Children Program (MDCP) may, under some circumstances, be added to the interest list of the Deaf Blind with Multiple Disabilities (DBMD) Program using a date other than the date of the request as the interest list date. The proposed amendment to §42.202(e), which describes those circumstances, applies to an individual who is determined ineligible for MDCP, for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age, after November 30, 2019 and before the date §531.0601 expires.
The proposed amendment to §42.202 also more clearly describes how HHSC adds an individual’s name to the DBMD interest list after the individual makes a request to be added to the interest list, including when the individual is determined diagnostically or functionally eligible during the enrollment process for another waiver program.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §42.202 replaces subsection (c) with new subsections (c) and (d) to more clearly describe two different circumstances for adding an individual’s name to the DBMD interest list in separate subsections. Subsection (c) describes how HHSC adds the name of an individual who resides in Texas to the DBMD interest list; subsection (d) describes how HHSC adds the name of an individual who is determined diagnostically or functionally ineligible for another HHSC waiver program. In addition, the waiver programs–the Community Living Assistance and Support Services Program, the Home and Community-based Services Program, the Texas Home Living Program, and MDCP–are identified in the proposed amendment.
- As proposed, subsection (e) of §42.202 describes how HHSC adds an individual’s name to the DBMD interest list, or changes the DBMD interest list date to the MDCP interest list date, if the individual was enrolled in MDCP but was determined ineligible for not meeting the level of care criteria for medical necessity for nursing facility care or the age requirement of being under 21 years of age, after November 30, 2019 and before the date Texas Government Code §531.0601 expires.
- The amendment in §42.202(f) – (i), as proposed, more accurately describes the actions taken and dates used by HHSC in managing the DBMD interest list.
- The proposed amendments change “DADS” to “HHSC” in each section to reflect that DADS was abolished effective September 1, 2017, and its functions have transferred to HHSC.
CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
DIVISION 2. ENROLLMENT PROCESS
40 TAC §42.211
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes an amendment to §42.202, concerning DBMD Interest List; §42.211, concerning Written Offer of Enrollment in the DBMD Program; and §42.402, concerning Qualifications of Program Provider Staff.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019. Section 531.0601 provides, in part, that the name of an individual who is enrolled in but becomes ineligible for the Medically Dependent Children Program (MDCP) may, under some circumstances, be added to the interest list of the Deaf Blind with Multiple Disabilities (DBMD) Program using a date other than the date of the request as the interest list date. The proposed amendment to §42.202(e), which describes those circumstances, applies to an individual who is determined ineligible for MDCP, for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age, after November 30, 2019 and before the date §531.0601 expires.
The proposed amendment to §42.211 deletes subsection (e)(2) because if an individual or LAR declines an offer of enrollment in the DBMD Program, it is not necessary for HHSC to withdraw the offer.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §42.211 deletes (e)(2) because if an individual declines an offer of enrollment in the DBMD Program, as described in proposed §42.202(f)(3), it is not necessary for HHSC to withdraw the offer. The proposed amendment also corrects a reference to §42.202 based on the proposed amendments to that section and makes minor editorial changes.
- The proposed amendments change “DADS” to “HHSC” in each section to reflect that DADS was abolished effective September 1, 2017, and its functions have transferred to HHSC.
Amending 40 TAC §42.402 to clarify certain educational requirements and add a licensing requirement for a service provider of dental treatment.
CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER D. ADDITIONAL PROGRAM PROVIDER PROVISIONS
40 TAC §42.402
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes an amendment to §42.202, concerning DBMD Interest List; §42.211, concerning Written Offer of Enrollment in the DBMD Program; and §42.402, concerning Qualifications of Program Provider Staff.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019. Section 531.0601 provides, in part, that the name of an individual who is enrolled in but becomes ineligible for the Medically Dependent Children Program (MDCP) may, under some circumstances, be added to the interest list of the Deaf Blind with Multiple Disabilities (DBMD) Program using a date other than the date of the request as the interest list date. The proposed amendment to §42.202(e), which describes those circumstances, applies to an individual who is determined ineligible for MDCP, for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age, after November 30, 2019 and before the date §531.0601 expires.
The proposed amendment to §42.402 clarifies the requirement for an intervener to complete a practicum in deafblind-related course work that is at least one semester credit hour at a college or university; adds a requirement for a service provider of dental treatment to be licensed to practice dentistry or dental hygiene; and prohibits a relative or guardian from being the provider of an adaptive aid.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §42.402 clarifies the requirement for an intervener to complete a practicum in deafblind-related course work that is at least one semester credit hour at an accredited college or university. To be consistent with the service provider qualifications described in the DBMD waiver application approved by the Centers for Medicare & Medicaid Services, the proposed amendment also adds a requirement for a service provider of dental treatment to be licensed to practice dentistry or dental hygiene and prohibits a relative or guardian from being the provider of an adaptive aid. The proposed amendment also makes minor editorial changes.
- The proposed amendments change “DADS” to “HHSC” in each section to reflect that DADS was abolished effective September 1, 2017, and its functions have transferred to HHSC.
Amending 40 TAC §45.202 and §45.211 to update eligibility and enrollment requirements for Community Living Assistance and Support Services and Community First Choice (CFC) Services.
CHAPTER 45. COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §§45.202, 45.211
OVERVIEW
As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes an amendment to §45.202, concerning CLASS Interest List; and §45.211, concerning Enrollment Process.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement Texas Government Code, §531.0601, Long-term Care Services Waiver Program Interest Lists. Section 531.0601 was added to the Texas Government Code by Senate Bill 1207, 86th Legislature, Regular Session, 2019. Section 531.0601 provides, in part, that the name of an individual who is enrolled in but becomes ineligible for the Medically Dependent Children Program (MDCP) may, under some circumstances, be added to the interest list of the Community Living Assistance and Support Services (CLASS) Program using a date other than the date of the request as the interest list date. The proposed amendment to §45.202(f), which describes those circumstances, applies to an individual who is determined ineligible for MDCP, for not meeting the level of care criteria for medical necessity for nursing facility care or the criteria of being under 21 years of age, after November 30, 2019 and before the date §531.0601 expires.
The proposed amendment to §45.202 also more clearly describes how HHSC adds an individual’s name to the CLASS interest list after the individual makes a request to be added to the interest list, including when the individual is determined diagnostically or functionally ineligible for another waiver program during the enrollment process, or the individual is under 22 years of age and resides in a nursing facility.
The proposed amendment to §45.211 corrects a reference to §45.202 based on the proposed amendment to that section and makes minor editorial changes.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §45.202 replaces subsection (c), with new subsections (c), (d), and (e) to more clearly describe three different circumstances for adding an individual’s name to the CLASS interest list in separate subsections. Subsection (c) describes how HHSC adds the name of an individual who resides in Texas; subsection (d) describes how HHSC adds the name of an individual under 22 years of age who resides in a nursing facility; and subsection (e) describes how HHSC adds the name of an individual who is determined to be diagnostically or functionally ineligible for another HHSC waiver program. In addition, the waiver programs–the Deaf Blind with Multiple Disabilities Program, the Home and Community-based Services Program, the Texas Home Living Program, and MDCP–are identified in the proposed amendment.
- As proposed, subsection (f) of §45.202 describes how HHSC adds an individual’s name to the CLASS interest list, or changes the CLASS interest list date to the MDCP interest list date, if the individual was enrolled in MDCP but was determined ineligible for not meeting the level of care criteria for medical necessity for nursing facility care or the age requirement of being under 21 years of age, after November 30, 2019 and before the date Texas Government Code §531.0601 expires.
- The proposed amendment in §45.202 (g) – (j) more accurately describes the actions taken and dates used by HHSC in managing the CLASS interest list.
- The proposed amendment to §45.211 corrects a reference to §45.202 based on the proposed amendment to that section and makes minor editorial changes.
- The proposed amendments change “DADS” to “HHSC” in each section to reflect that DADS was abolished effective September 1, 2017, and its functions have transferred to HHSC.
Texas State Board of Examiners of Psychologists
Adopted Rules Re:
Amending 22 TAC §463.9 to reflect the change that future trainee status for Licensed Specialist in School Psychology applicants will no longer be issued.
CHAPTER 463. APPLICATIONS AND EXAMINATIONS
SUBCHAPTER B. LICENSING REQUIREMENTS
22 TAC §463.9
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendments to §463.9, relating to Licensed Specialist in School Psychology. Section 463.9 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3671). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
Trainee status for LSSPs is now obsolete since applicants are no longer preapproved to take the jurisprudence examination. Since applicants must pass the examination prior to application, future trainee status for LSSP applicants will no longer be issued; therefore §463.9 is amended to reflect this change.
If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The amended rule pertains to the qualifications necessary to obtain a license to practice psychology; therefore, this rule is covered by §507.153 of the Tex. Occ. Code.
The Texas State Board of Examiners of Psychologists, in accordance with §501.1515 of the Tex. Occ. Code, previously voted and, by a majority, approved to propose the adoption of this rule to the Executive Council. Therefore, the Executive Council has complied with Chapters 501 and 507 of the Tex. Occ. Code and may adopt this rule.
Amending 22 TAC §465.2 to reflect changes in rules relating to supervision.
CHAPTER 465. RULES OF PRACTICE
22 TAC §465.2
OVERVIEW
The Texas Behavioral Health Executive Council adopts amended §465.2, relating to Supervision. Section 465.2 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3674). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
Trainee status for LSSPs is now obsolete since applicants are no longer preapproved to take the jurisprudence examination. Since applicants must pass the examination prior to application, future trainee status for LSSP applicants will no longer be issued; therefore §465.2 is amended to reflect this change.
If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The amended rule pertains to the scope of practice, standards of care, or ethical practice for the profession of psychology; therefore, this rule is covered by §507.153 of the Tex. Occ. Code.
The Texas State Board of Examiners of Psychologists, in accordance with §501.2015 of the Tex. Occ. Code, previously voted and, by a majority, approved to propose the adoption of this rule to the Executive Council. Therefore, the Executive Council has complied with Chapters 501 and 507 of the Tex. Occ. Code and may adopt this rule.
Amending 22 TAC §465.38 to update requirements relating to Psychological Services for Schools.
CHAPTER 465. RULES OF PRACTICE
22 TAC §465.38
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendments to §465.38, relating to Psychological Services for Schools. Section 465.38 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3677). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
Sections 463.10, 463.11, and 465.12 have been amended, so the references to these rules in subsection (e) of this rule are amended to reflect these changes.
If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The amended rule pertains to the scope of practice, standards of care, or ethical practice for the profession of psychology; therefore, this rule is covered by §507.153 of the Tex. Occ. Code.
The Texas State Board of Examiners of Psychologists, in accordance with §501.1515 of the Tex. Occ. Code, previously voted and, by a majority, approved to propose the adoption of this rule to the Executive Council. Therefore, the Executive Council has complied with Chapters 501 and 507 of the Tex. Occ. Code and may adopt this rule.
Texas Behavioral Health Executive Council
Adopted Rules Re:
Amending 22 TAC §881.21 to correct a typographical error.
CHAPTER 881. GENERAL PROVISIONS
SUBCHAPTER B. RULEMAKING
22 TAC §881.21
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendment to §881.21, relating to Petition for Rulemaking. In response to public comment, §881.21 is adopted with changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 TexReg 3696). The rule will be republished.
BACKGROUND AND JUSTIFICATION
The amended rule corrects a typographical error. Subsection (f) of this rule referenced §201.021(d) of the Tex. Gov’t Code, but the correct citation is §2001.021(d). Therefore, this amended rule is necessary to correct this statutory reference.
Amending 22 TAC §882.11 to expand the number of acceptable foreign degree evaluation services who conduct foreign degree evaluations to include members of the Association of International Credential Evaluators, Inc.
CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER A. LICENSE APPLICATIONS
22 TAC §882.11
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendment to §882.11, relating to Applicants with Foreign Degrees. Section 882.11 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3697). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amended rule expands the number of acceptable foreign degree evaluation services who conduct foreign degree evaluations to include members of the Association of International Credential Evaluators, Inc. This change is based, in part, upon the suggestion of the Registrar’s Office at the University of Texas at Austin.
Amending 22 TAC §885.1 to clarify fee requirements.
CHAPTER 885. FEES
22 TAC §885.1
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendments to §885.1, relating to Fees. Section 885.1 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3700). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amended rule clarifies that late fees are not applicable to licenses on inactive status, which is currently stated in §882.21. Additionally, the amended rule clarifies that when a person’s license has been expired for certain periods of time, it is referring to delinquent license status as stated in §882.21.