Texas Register Table of Contents
- 1 Governor
- 2 Governor
- 3 Governor
- 4 Texas Health and Human Services Commission
- 5 Texas Department on Aging and Disability Services
- 6 Texas Board of Nursing
- 7 Texas Board of Nursing
- 8 Texas Board of Nursing
- 9 Advisory Board of Athletic Trainers
- 10 Texas Board of Nursing
- 11 Texas Board of Nursing
- 12 Texas Department of State Health Services
- 13 Texas Department of State Health Services
- 14 Texas Department of State Health Services
- 15 Texas Department of State Health Services
- 16 Texas Department of State Health Services
- 17 Texas Department of State Health Services
- 18 Texas Department of State Health Services
- 19 Texas Department of State Health Services
- 20 Texas Department of State Health Services
- 21 Texas Department of State Health Services
- 22 Texas Department of State Health Services
- 23 Texas Department of State Health Services
- 24 Texas Department of State Health Services
- 25 Texas Health and Human Services Commission
- 26 Texas Health and Human Services Commission
- 27 Texas Health and Human Services Commission
- 28 Texas Health and Human Services Commission
- 29 Texas Health and Human Services Commission
- 30 Texas Health and Human Services Commission
- 31 Texas Health and Human Services Commission
- 32 Texas Health and Human Services Commission
- 33 Texas Health and Human Services Commission
- 34 Texas Health and Human Services Commission
- 35 Texas Health and Human Services Commission
- 36 Texas Health and Human Services Commission
- 37 Texas Health and Human Services Commission
- 38 Texas Health and Human Services Commission
- 39 Texas Health and Human Services Commission
- 40 Texas Health and Human Services Commission
- 41 Texas Health and Human Services Commission
- 42 Texas Health and Human Services Commission
- 43 Texas Health and Human Services Commission
- 44 Texas Health and Human Services Commission
- 45 Texas Health and Human Services Commission
- 46 Texas Health and Human Services Commission
- 47 Texas Health and Human Services Commission
- 48 Texas Health and Human Services Commission
- 49 Texas Health and Human Services Commission
- 50 Texas Health and Human Services Commission
- 51 Texas Health and Human Services Commission
- 52 Texas Health and Human Services Commission
- 53 Texas Health and Human Services Commission
- 54 Texas Health and Human Services Commission
- 55 Texas Health and Human Services Commission
- 56 Texas Health and Human Services Commission
- 57 Texas Health and Human Services Commission
- 58 Texas Health and Human Services Commission
- 59 Texas Department of Assistive and Rehabilitative Services
- 60 Texas Health and Human Services Commission
- 61 Texas Health and Human Services Commission
- 62 Texas Health and Human Services Commission
- 63 Texas Health and Human Services Commission
- 64 Texas Health and Human Services Commission
- 65 Texas Health and Human Services Commission
- 66 Texas Health and Human Services Commission
- 67 Texas Health and Human Services Commission
- 68 Texas Health and Human Services Commission
- 69 Texas Department of State Health Services
- 70 Texas Department of State Health Services
- 71 Texas Department of Insurance
- 72 Texas Department on Aging and Disability Services
- 73 Texas Department on Aging and Disability Services
- 74 Texas Department on Aging and Disability Services
- 75 Texas Department on Aging and Disability Services
- 76 Texas Department on Aging and Disability Services
- 77 Texas Department on Aging and Disability Services
- 78 Texas Department on Aging and Disability Services
- 79 Texas Department on Aging and Disability Services
- 80 Texas Department on Aging and Disability Services
- 81 Texas Department on Aging and Disability Services
- 82 Texas Department on Aging and Disability Services
- 83 Texas Department on Aging and Disability Services
- 84 Texas Department on Aging and Disability Services
- 85 Texas Department on Aging and Disability Services
- 86 Texas Department of State Health Services
- 87 Texas Department of State Health Services
- 88 Texas Department of State Health Services
- 89 Texas State Board of Pharmacy
- 90
Governor
Appointments
Governor appoints Kristopher “Kris” Workman to the Committee on People with Disabilities
Appointments for December 2, 2020Appointed to the Governor’s Committee on People with Disabilities, for a term to expire February 1, 2021, Kristopher “Kris” Workman of Adkins, Texas (replacing Archer S. Hadley of Austin, who resigned).
Governor
Appointments
Governor appoints Gregory “Greg” Rowin to the Texas Physician Assistant Board
Appointments for December 2, 2020Appointed to the Texas Physician Assistant Board, for a term to expire February 1, 2023, Gregory S. “Greg” Rowin, D.O. of Harlingen, Texas (replacing John S. Scott, Jr., D.O. of Keller, who resigned).
Governor
Notices
Proclamation 41-3787: Renewing the disaster proclamation for all Texas counties due to COVID-19
OVERVIEWIn accordance with authority vested by Section 418.014 of the Texas Government Code, I do hereby renew the disaster proclamation for all counties in Texas.Pursuant to Section 418.017, I authorize 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, I hereby suspend such statutes and rules for the duration of this declared disaster for that limited purpose.BACKGROUND AND JUSTIFICATION Governor’s rationale for issuing Proclamation 41-3787 is detailed in this week’s edition of the Texas Register (45 Tex Reg 8937).
Texas Health and Human Services Commission
Emergency Rule
Renewing emergency rule 26 TAC §553.2001, which established temporary requirements for assisted living facilities in response to COVID-19
CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIESSUBCHAPTER K. COVID-19 RESPONSE26 TAC §553.2001OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §553.2001 for a 60-day period. The text of the emergency rule was originally published in the August 21, 2020, issue of the Texas Register (45 TexReg 5707).HHSC is renewing the emergency rule to require assisted living facility actions to mitigate and contain COVID-19. The purpose of the new rule is to describe these requirements.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Assisted Living Facility COVID-19 Response.
Texas Department on Aging and Disability Services
Emergency Rule
Renewing emergency rule 40 TAC §19.2802, which established temporary requirements for nursing facilities in response to COVID-19
CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATIONSUBCHAPTER CC. COVID-19 EMERGENCY RULE40 TAC §19.2802OVERVIEWThe Department of Aging and Disability Services is renewing the effectiveness of emergency new §19.2802 for a 60-day period. The text of the emergency rule was originally published in the August 21, 2020, issue of the Texas Register (45 TexReg 5711).HHSC is renewing this emergency rule to require nursing facility actions to mitigate and contain COVID-19. The purpose of the new rule is to describe these requirements.BACKGROUND AND JUSTIFICATIONAs authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Nursing Facility COVID-19 Response.
Texas Board of Nursing
Proposed Rules
CHAPTER 211. GENERAL PROVISIONS22 TAC §211.6OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §211.6(b), relating to Committees of the Board. Proposed amended §211.6(b)(3)(ii) authorizes the Eligibility and Disciplinary Committee to approve the adoption of rules on an emergency basis pursuant to Tex. Gov’t Code §2001.034. The remainder of the proposed changes re-order paragraph (3) appropriately.BACKGROUND AND JUSTIFICATION Pursuant to the Government Code §2001.034, the Board is authorized to adopt rules on an emergency basis if the Board finds that an imminent peril to the public health, safety, or welfare, or a requirement of state or federal law, requires adoption of the rule on fewer than 30 days’ notice. Under the Board’s current rules, a quorum of the thirteen-member Board is required to convene in order to deliberate and vote on the adoption of emergency rules. Coordinating the appearance of a quorum of the Board on short notice can cause delay in situations that require flexibility, fluidity, and a rapid response. The proposed amendments authorize the Eligibility and Disciplinary Committee (Committee) of the Board to convene and consider and approve the adoption of emergency rules. The Committee is a standing committee comprised of three members of the Board, one consumer member and two nurse members. Because Committee members are pre-assigned to serve on the Committee in three month intervals, convening the three-member Committee, as opposed to a quorum of the full Board, is less likely to cause delay in the adoption of rules under emergency conditions. The conditions of the Government Code §2001.034 would still be required to be met in order for the Committee to consider the adoption of emergency rules.
Texas Board of Nursing
Proposed Rules
Amending 22 TAC §213.1 to remove an outdated definition of Texas Board of Nurse Examiners
CHAPTER 213. PRACTICE AND PROCEDURE22 TAC §213.1The Texas Board of Nursing (Board) proposes amendments to §213.1, relating to Definitions.The proposed amendments to §213.1 are necessary to correct outdated references to the Texas Board of Nurse Examiners.
Texas Board of Nursing
Proposed Rules
Amending 22 TAC §213.20 to remove an outdated reference to the Texas Board of Nurse Examiners with regard to informal proceedings and alternative dispute resolution
CHAPTER 213. PRACTICE AND PROCEDURE22 TAC §213.20The Texas Board of Nursing (Board) proposes amendments to §213.20, relating to Informal Proceedings and Alternative Dispute Resolution (ADR). The proposed amendments to §213.20 are necessary to correct outdated references to the Texas Board of Nurse Examiners within the text of the rule.
Advisory Board of Athletic Trainers
Proposed Rules
Amending 22 TAC §215.2 to define the examination year for a professional nursing education program
CHAPTER 215. PROFESSIONAL NURSING EDUCATION22 TAC §215.2OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §215.2, relating to Definitions.Proposed amended §215.1(20) defines the examination year for a professional nursing education program, for the purpose of determining its annual NCLEX-RN® examination pass rate, as beginning January 1 and ending December 31.BACKGROUND AND JUSTIFICATION Minimum examination pass rates are required for a nursing education program’s continued approval status. Examination pass rates are determined based upon a program’s examination year. The current examination year for Texas professional nursing education programs is October 1 – September 30. This is a different time period than the examination year for Texas vocational nursing education programs, which is based on the calendar year (January 1 – December 31). The proposed rule amendments align the professional nursing education program exam year with the vocational nursing education program exam year, as well as with the exam year utilized by most accreditors and other boards of nursing.
Texas Board of Nursing
Proposed Rules
Amending 22 TAC §222.4 to establish when and how a prescriber may waive the electronic prescribing requirement for controlled substances
CHAPTER 222. ADVANCED PRACTICE REGISTERED NURSES WITH PRESCRIPTIVE AUTHORITY22 TAC §222.4OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §222.4, relating to Minimum Standards for Prescribing or Ordering Drugs and Devices. SECTION-BY-SECTION SUMMARY Proposed amended §222.4(c) sets forth the Board’s waiver process from electronic prescribing requirements.Proposed §222.4(c)(1) makes clear that licensee prescribers must issue their prescriptions electronically beginning January 1, 2021, unless one of the specified circumstances in the Health & Safety Code §481.0755(a) applies.Under proposed §222.4(c)(2), a licensee prescriber may request a waiver from electronic prescribing requirements by submitting a waiver request to the Board that demonstrates the circumstances necessitating a waiver from the electronic prescribing requirements, including: (A) economic hardship, taking into account factors including: (i) any special situational factors affecting either the cost of compliance or ability to comply; (ii) the likely impact of compliance on profitability or viability; and (iii) the availability of measures that would mitigate the economic impact of compliance; (B) technological limitations not reasonably within the control of the licensee prescriber; and (C) other exceptional circumstances demonstrated in the waiver request.Proposed §222.4(c)(3) limits the waiver to a one-year period, consistent with the Health & Safety Code §481.0756(f). If circumstances that originally necessitated the waiver continue beyond that time period, the proposal permits the licensee prescriber to re-apply to the Board for a subsequent waiver no earlier than the 30th day prior to the expiration of the original waiver. This is also consistent with the limitations of §481.0756(f).BACKGROUND AND JUSTIFICATION House Bill (HB) 2174, enacted during the 86th Legislative Session, requires prescriptions for controlled substances to be issued electronically after January 1, 2021, unless certain prescribed exceptions apply. One of the specified statutory exceptions provides for a waiver process. Pursuant to the Health & Safety Code §481.0755(a)(9) and §481.0756, a prescriber may issue a non-electronic prescription for a controlled substance if the prescriber has received a waiver from the prescriber’s respective licensing agency. The waiver is valid for one year after issuance. A prescriber may re-apply for a subsequent waiver not earlier than 30 days prior to the expiration of the waiver, so long as circumstances that necessitated the waiver continue. The proposed amendments are necessary to implement the Board’s waiver process under HB 2174.
Texas Board of Nursing
Proposed Rules
Amending 22 TAC §223.1 to update the endorsement licensure fee
CHAPTER 223. FEES22 TAC §223.1OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §223.1, concerning Fees. Proposed amended §223.1(a)(2) sets the endorsement licensure fee at $125.BACKGROUND AND JUSTIFICATION On October 8, 2019, the Office of the Governor requested that occupational licensing agencies review their licensing rules and policies to identify areas where they could remove burdensome or unreasonable obstacles to licensure, specifically developing and implementing plans to reduce license application fees to 75% or less of the national average for equivalent or comparable occupations. In response, the Board reviewed the 2018 member profiles maintained by the National Council of State Boards of Nursing, which reports comprehensive, detailed fee information from the responding boards of nursing. The profile revealed that the Board’s current endorsement licensure fee is at 81% of the national fee average. The proposed amendments are necessary to reduce the Board’s current endorsement fee from $161 to $125 in order to meet the Office of the Governor’s request and maintain legislative budget requirements.
Texas Department of State Health Services
Proposed Rules
Amending 25 TAC §133.46 to update balance-billing prohibitions and complaint investigation procedures for general and special hospitals
CHAPTER 133. HOSPITAL LICENSINGSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §133.46OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §133.46, concerning Hospital Billing.The proposed amendment to §133.46 adds language prohibiting a general or special hospital from violating a law that prohibits balance billing and requires hospitals to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.The proposed amendment to subsection (d) updates the complaint investigation procedures to the agency responsible for the procedures.BACKGROUND AND JUSTIFICATION The proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Department of State Health Services
Proposed Rules
Amending 25 TAC §135.4 to update balance-billing prohibitions for Ambulatory Surgical Centers
CHAPTER 135. AMBULATORY SURGICAL CENTERSSUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS25 TAC §135.4OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §135.4, concerning Ambulatory Surgical Center (ASC) Operation.The proposed amendment to §135.4 adds language prohibiting an ASC from violating a law that prohibits balance billing and requires an ASC to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.BACKGROUND AND JUSTIFICATION The proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Department of State Health Services
Proposed Rules
Amending 25 TAC §137.39 to update balance-billing prohibitions for birthing centers
CHAPTER 137. BIRTHING CENTERSSUBCHAPTER D. OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES25 TAC §137.39OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §137.39, concerning General Requirements for the Provision and Coordination of Treatment and Services.The proposed amendment to §137.39 adds language prohibiting a birthing center from violating a law that prohibits balance billing and requires a birthing center to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.BACKGROUND AND JUSTIFICATIONThe proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Department of State Health Services
Proposed Rules
Amending 25 TAC §139.60 to update balance-billing prohibitions for licensed abortion facilities
CHAPTER 139. ABORTION FACILITY REPORTING AND LICENSINGSUBCHAPTER D. MINIMUM STANDARDS FOR LICENSED ABORTION FACILITIES25 TAC §139.60OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §139.60, concerning Other State and Federal Compliance Requirements.The proposed amendment to §139.60 adds language prohibiting an abortion facility from violating a law that prohibits balance billing and requires an abortion facility to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.BACKGROUND AND JUSTIFICATION The proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §§411.601 – 411.604, regarding general requirements for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 1. GENERAL REQUIREMENTS25 TAC §§411.601 – 411.604OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §§411.601 – 411.604 (General Requirements) in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §§411.601 – 411.604 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATIONAs required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §§411.608 – 411.613, regarding admission for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 2. ADMISSION25 TAC §§411.608 – 411.613OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §§411.608 – 411.613 (Admission), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §§411.608 – 411.613 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATIONAs required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §411.617, regarding emergency treatment protocol for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 3. EMERGENCY TREATMENT25 TAC §411.617OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §411.617 (Emergency Treatment), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §411.617 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §§411.621 – 411.624, regarding service requirements for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 4. SERVICE REQUIREMENTS25 TAC §§411.621 – 411.624OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §§411.621 – 411.624 (Service Requirements), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §§411.621 – 411.624 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §§411.628 – 411.633, regarding discharge from crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 5. DISCHARGE25 TAC §§411.628 – 411.633OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §§411.628 – 411.633 (Discharge), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §§411.628 – 411.633 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATIONAs required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §411.637, regarding documentation requirements for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 6. DOCUMENTATION25 TAC §411.637OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §411.637 (Documentation), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §411.637 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §411.641, regarding staff development at crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 7. STAFF DEVELOPMENT25 TAC §411.641OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §411.641 (Staff Development), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §411.641 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §411.645 and §411.646, regarding sentinel events and external reviews for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 8. SENTINEL EVENTS AND EXTERNAL REVIEWS25 TAC §411.645, §411.646OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §411.645 and §411.646 (Sentinel Events and External Reviews), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §411.645 and §411.646 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §411.649 and §411.650, regarding references and distribution for crisis stabilization units
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER M. STANDARDS OF CARE AND TREATMENT IN CRISIS STABILIZATION UNITSDIVISION 9. REFERENCES AND DISTRIBUTION25 TAC §411.649, §411.650OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §411.649 and §411.650 (References and Distribution), in Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units.The proposed repeal of §411.649 and §411.650 allows similar rules to be proposed as new rules in Title 26, Chapter 306, Subchapter B.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to the HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal the rules in Title 25, Part 1, Chapter 411, Subchapter M, Standards of Care and Treatment in Crisis Stabilization Units. New rules in Title 26, Part 1, Chapter 306, Subchapter B, Standards of Care in Crisis Stabilization Units are proposed elsewhere in this issue of the Texas Register and are substantially similar as the rules proposed for repeal.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §§306.41 – 306.47, establishing HHSC’s oversight of general requirements for crisis stabilization units
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITSDIVISION 1. GENERAL REQUIREMENTS26 TAC §§306.41, 306.43, 306.45, 306.47OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Subchapter B, concerning Standards of Care in Crisis Stabilization Units, in new Chapter 306. The new subchapter is comprised of §§306.41, 306.43, 306.45, 306.47, 306.51, 306.53, 306.55, 306.57, 306.59, 306.61, 306.63, 306.65, 306.67, 306.71, 306.73, 306.75, 306.77, 306.79, 306.81, 306.83, 306.85, 306.87, 306.89, 306.91, 306.93, and 306.95.SECTION-BY-SECTION SUMMARY Proposed new §306.41 establishes the purpose of the subchapter and its application to individuals diagnosed with a mental illness or serious emotional disturbance.Proposed new §306.43 establishes rule applicability to CSUs licensed under Texas Health and Safety Code, Chapter 577 and 26 TAC Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).Proposed new §306.45 provides definitions for terminology used in the subchapter.Proposed new §306.47 describes general provisions and administrative responsibilities related to CSU policies and procedures. This rule requires CSUs to be open and provide services 24 hours a day, seven days a week, in compliance with HHSC TAC rules, including 25 TAC Chapter 414, Subchapter I (relating to Consent to Treatment with Psychoactive Medications – Mental Health Services) and 25 TAC Chapter 417, Subchapter K (relating to Abuse, Neglect and Exploitation in TDMHMR Facilities). This rule requires the CSU medical director to approve the CSU’s written policies and procedures and prohibits a CSU physician from administering electroconvulsive therapy.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011.New rules in Title 26, Part 1, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units, address the content of rules in Title 25, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units. The rules in Chapter 411 are proposed for repeal elsewhere in this issue of the Texas Register.The purpose of these rules is to establish guidelines for the standards of care and treatment of individuals with mental illness or serious emotional disturbance who are receiving crisis stabilization services in crisis stabilization units (CSUs) licensed under Texas Health and Safety Code, Chapter 577 and Texas Administrative Code (TAC) Title 26, Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §§306.51- 306.59, establishing HHSC’s oversight of admission for crisis stabilization units
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITSDIVISION 2. ADMISSION26 TAC §§306.51, 306.53, 306.55, 306.57, 306.59OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Subchapter B, concerning Standards of Care in Crisis Stabilization Units, in new Chapter 306. The new subchapter is comprised of §§306.41, 306.43, 306.45, 306.47, 306.51, 306.53, 306.55, 306.57, 306.59, 306.61, 306.63, 306.65, 306.67, 306.71, 306.73, 306.75, 306.77, 306.79, 306.81, 306.83, 306.85, 306.87, 306.89, 306.91, 306.93, and 306.95.SECTION-BY-SECTION SUMMARY Proposed new §306.51 establishes that the CSU medical director must approve the CSU voluntary and involuntary admission criteria for adults diagnosed with a mental illness, or for children and adolescents diagnosed with a serious emotional disturbance. This rule incorporates language prohibiting CSU admission for children under three years of age and for individuals who need specialized care or medical care not available at the CSU.Proposed new §306.53 establishes requirements for CSU pre-admission screening and assessment processes in the CSU or the community. This rule incorporates language allowing CSU pre-admission screening and assessment interviews to be conducted by appropriately licensed or credentialed staff members within the scope of their practices, including a QMHP-CS and a licensed practitioner of the healing arts (LPHA) credentialed staff members. It also includes language that a physician’s examination of an individual requesting voluntary admission to a CSU may not be delegated to a non-physician.Proposed new §306.55 establishes admission criteria for children, adolescents, and adults requesting voluntary admission to a CSU. This rule requires a physician to conduct, or consult with a physician who has conducted, an admission examination of an individual 72 hours before admission or 24 hours after admission and allows such examinations to be conducted through telemedicine services. The rule establishes intake process requirements and designates staff who may conduct intakes.Proposed new §306.57 establishes requirements for CSU admission criteria and intake process requirements for individuals of any age who are assessed for emergency detention or who are being involuntarily admitted under an order of emergency detention or order of protective custody. This rule requires a physician to conduct a preliminary examination of an individual under order of emergency detention within 12 hours.Proposed new §306.59 allows a CSU to provide crisis stabilization services to an individual who was involuntarily admitted under certain conditions.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011.New rules in Title 26, Part 1, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units, address the content of rules in Title 25, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units. The rules in Chapter 411 are proposed for repeal elsewhere in this issue of the Texas Register.The purpose of these rules is to establish guidelines for the standards of care and treatment of individuals with mental illness or serious emotional disturbance who are receiving crisis stabilization services in crisis stabilization units (CSUs) licensed under Texas Health and Safety Code, Chapter 577 and Texas Administrative Code (TAC) Title 26, Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §§306.61 – 306.67, establishing HHSC’s oversight of service requirements for crisis stabilization units
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITSDIVISION 3. SERVICE REQUIREMENTS26 TAC §§306.61, 306.63, 306.65, 306.67OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Subchapter B, concerning Standards of Care in Crisis Stabilization Units, in new Chapter 306. The new subchapter is comprised of §§306.41, 306.43, 306.45, 306.47, 306.51, 306.53, 306.55, 306.57, 306.59, 306.61, 306.63, 306.65, 306.67, 306.71, 306.73, 306.75, 306.77, 306.79, 306.81, 306.83, 306.85, 306.87, 306.89, 306.91, 306.93, and 306.95.SECTION-BY-SECTION SUMMARY Proposed new for §306.61 establishes requirements for the provision, monitoring, and evaluation of CSU medical services in accordance with an individual’s recovery or treatment plan. It allows CSU medical services through telemedicine services. This rule further allows, and provides requirements for, the provision of physician-delegated PA and APRN medical services.Proposed new §306.63 establishes requirements for the provision, monitoring, and evaluation of CSU nursing services.Proposed new §306.65 establishes requirements for crisis stabilization services and recovery or treatment planning and allows legally authorized representatives to be involved in recovery or treatment planning. This rule includes requirements for assessments and evaluations, including risk of harm, history of trauma, and emerging health issues. This rule further allows the provision of peer specialist services, as available, as a treatment intervention in a CSU recovery or treatment plan.Proposed new §306.67 establishes standards of care for children and adolescents, including a developmental assessment and history of trauma assessment performed by an LPHA appropriately trained and experienced in assessment and treatment of children in a crisis setting. This rule introduces protocol and procedure for child and adolescent assessments, educational services, and transfers of children and adolescents, including adolescents turning 18 years old while receiving CSU services. This rule also allows adult caregivers, as well as parents and LARs to be involved with an individual’s recovery or treatment planning.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011.New rules in Title 26, Part 1, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units, address the content of rules in Title 25, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units. The rules in Chapter 411 are proposed for repeal elsewhere in this issue of the Texas Register.The purpose of these rules is to establish guidelines for the standards of care and treatment of individuals with mental illness or serious emotional disturbance who are receiving crisis stabilization services in crisis stabilization units (CSUs) licensed under Texas Health and Safety Code, Chapter 577 and Texas Administrative Code (TAC) Title 26, Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §§306.71 – 306.79, establishing HHSC’s oversight of discharge from crisis stabilization units
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITSDIVISION 4. DISCHARGE26 TAC §§306.71, 306.73, 306.75, 306.77, 306.79OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Subchapter B, concerning Standards of Care in Crisis Stabilization Units, in new Chapter 306. The new subchapter is comprised of §§306.41, 306.43, 306.45, 306.47, 306.51, 306.53, 306.55, 306.57, 306.59, 306.61, 306.63, 306.65, 306.67, 306.71, 306.73, 306.75, 306.77, 306.79, 306.81, 306.83, 306.85, 306.87, 306.89, 306.91, 306.93, and 306.95.SECTION-BY-SECTION SUMMARY Proposed new §306.71 requires a CSU to begin discharge planning at the time of admission. This rule requires discharge planning policies and procedures, discharge planning consultation between a CSU and an individual’s assigned local mental health authority, local behavioral health authority, or local intellectual and developmental disability authority, as applicable, prior to an individual’s discharge. This rule also includes language related to a physician’s ability to request a judicial extension of an individual’s detention period when extremely hazardous weather conditions exist, or a disaster occurs.Proposed new §306.73 establishes requirements for discharge notices for children, adolescents, and adults, including the requirement to notify the Texas Department of Family and Protective Services if notifying a child’s or adolescent’s parent, LAR, or adult caregiver of the child’s or adolescent’s discharge is clinically contraindicated. This rule also requires the CSU to provide the Texas protection and advocacy system’s contact information, in writing, to the individual being discharged.Proposed new §306.75 establishes discharge requirements when a voluntarily-admitted individual requests to leave the CSU. This rule includes requirements for physician processes for discharge examination and application for court-ordered treatment of an individual in a CSU. This rule establishes a protocol for discharging an individual under the age of 18.Proposed new §306.77 establishes requirements for the 14-day maximum length of stay for a voluntarily admitted individual and clarifies CSU response time frames for discharge requests. This rule requires a physician, or physician-designee, to document in an individual’s medical record the medical necessity and clinical rationale for extending the individual’s length of CSU stay beyond 14 days.Proposed new §306.79 establishes discharge requirements for an involuntarily admitted individual, including the maximum 48-hour period an individual can be detained under an order of emergency detention. This rule addresses physician determination related to an individual’s discharge or need for continued involuntary treatment under an order of protective custody.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011.New rules in Title 26, Part 1, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units, address the content of rules in Title 25, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units. The rules in Chapter 411 are proposed for repeal elsewhere in this issue of the Texas Register.The purpose of these rules is to establish guidelines for the standards of care and treatment of individuals with mental illness or serious emotional disturbance who are receiving crisis stabilization services in crisis stabilization units (CSUs) licensed under Texas Health and Safety Code, Chapter 577 and Texas Administrative Code (TAC) Title 26, Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §§306.81 – 306.95, establishing HHSC’s oversight of operational requirements for crisis stabilization units
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITSDIVISION 5. OPERATIONAL REQUIREMENTS26 TAC §§306.81, 306.83, 306.85, 306.87, 306.89, 306.91, 306.93, 306.95OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Subchapter B, concerning Standards of Care in Crisis Stabilization Units, in new Chapter 306. The new subchapter is comprised of §§306.41, 306.43, 306.45, 306.47, 306.51, 306.53, 306.55, 306.57, 306.59, 306.61, 306.63, 306.65, 306.67, 306.71, 306.73, 306.75, 306.77, 306.79, 306.81, 306.83, 306.85, 306.87, 306.89, 306.91, 306.93, and 306.95.SECTION-BY-SECTION SUMMARY Proposed new §306.81 establishes the information that must be maintained in each individual’s medical record, including signed informed consent to treatment forms, release of information forms, medical health information, recovery or treatment plan, and progress notes, as applicable.Proposed new §306.83 establishes requirements for the provision, documentation, oversight, and required elements, topics, and time frames of CSU staff orientation and training, including specialized training and required competencies required for staff holding specific credentials or providing specialized services.Proposed new §306.85 establishes CSU minimum staffing requirements and requires a minimum staffing plan that includes the number and availability of licensed, credentialed, and unlicensed staff members required per shift, including a nurse supervisor.Proposed new §306.87 establishes requirements for protection of an individual in a CSU. This rule includes child and adolescent requirements for lodging and programming separate from adults and environmental safeguards. This rule requires the development and implementation of policies and procedures for ensuring individual rights in a CSU and during transfers when the CSU provides transportation.Proposed new §306.89 establishes requirements for CSU staff members’ response to emergency medical conditions occurring in a CSU. This rule requires the CSU to develop policies and procedures for identifying, treating, and transferring individuals experiencing emergency medical conditions in a CSU. This rule includes requirements for physician protocols, administration of Basic Life Support techniques, and emergency supplies and equipment, including a first aid kit.Proposed new §306.91 establishes requirements for transfers due to dangerous behavior, restraint, seclusion, medical conditions, or commitment orders. This rule includes requirements for transferring an individual from a child and adolescent CSU program to an inpatient mental health facility serving adults when the adolescent turns 18 years of age and does not meet criteria for discharge from CSU treatment services.Proposed new §306.93 establishes requirements for developing and implementing procedures for identifying, reporting, and investigating sentinel events, including reporting the sentinel event as soon as possible to the Health Facility Licensing Complaint Line, reporting time frames, and reporting sentinel event determination and documentation.Proposed new §306.95 establishes requirements for a CSU administrator, or administrator’s designee, to develop and implement a written plan to evaluate the effectiveness of any plan of correction the CSU submits to an external review entity.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011.New rules in Title 26, Part 1, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units, address the content of rules in Title 25, Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units. The rules in Chapter 411 are proposed for repeal elsewhere in this issue of the Texas Register.The purpose of these rules is to establish guidelines for the standards of care and treatment of individuals with mental illness or serious emotional disturbance who are receiving crisis stabilization services in crisis stabilization units (CSUs) licensed under Texas Health and Safety Code, Chapter 577 and Texas Administrative Code (TAC) Title 26, Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
Texas Health and Human Services Commission
Proposed Rules
CHAPTER 280. PEDIATRIC TELECONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS26 TAC §280.1OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §280.1, concerning Purpose, in the Texas Administrative Code (TAC), Title 26, Chapter 280, Pediatric Tele-Connectivity Resource Program for Rural Texas.Proposed new §280.1 defines the purpose of the chapter and provides the statutory authority for HHSC to establish a pediatric tele-connectivity resource program for rural Texas by awarding grants to support nonurban health care facilities in establishing the capability to provide pediatric telemedicine services.BACKGROUND AND JUSTIFICATION The purpose of the proposed new rules is to implement Texas Government Code, Chapter 541, added by House Bill (H.B) 1697, 85th Legislature, Regular Session, 2017. Chapter 541 directs HHSC to establish a pediatric tele-connectivity resource program for rural Texas to award grants to nonurban health care facilities to connect the facilities with pediatric specialists and pediatric subspecialists who provide telemedicine services. Rider 94 of the 2020-21 General Appropriations Act (H.B. 1, 86th Legislature, Regular Session, 2019, Article II, Special Provisions) appropriates funds to HHSC to implement Chapter 541.The purpose of this grant program is to provide financial assistance to enable eligible, nonurban healthcare facilities to connect with pediatric specialists who provide telemedicine services and to cover related expenses, including necessary equipment.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §280.3, establishing definitions relevant to the Pediatric Tele-connectivity Resource Program for Rural Texas
CHAPTER 280. PEDIATRIC TELECONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS26 TAC §280.3OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §280.3, concerning Definitions, in the Texas Administrative Code (TAC), Title 26, Chapter 280, Pediatric Tele-Connectivity Resource Program for Rural Texas.Proposed new §280.3 provides definitions for terms used in the chapter.BACKGROUND AND JUSTIFICATION The purpose of the proposed new rules is to implement Texas Government Code, Chapter 541, added by House Bill (H.B) 1697, 85th Legislature, Regular Session, 2017. Chapter 541 directs HHSC to establish a pediatric tele-connectivity resource program for rural Texas to award grants to nonurban health care facilities to connect the facilities with pediatric specialists and pediatric subspecialists who provide telemedicine services. Rider 94 of the 2020-21 General Appropriations Act (H.B. 1, 86th Legislature, Regular Session, 2019, Article II, Special Provisions) appropriates funds to HHSC to implement Chapter 541.The purpose of this grant program is to provide financial assistance to enable eligible, nonurban healthcare facilities to connect with pediatric specialists who provide telemedicine services and to cover related expenses, including necessary equipment.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §280.5, establishing administrative requirements for the Pediatric Tele-Connectivity Resource Program for Rural Texas
CHAPTER 280. PEDIATRIC TELECONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS26 TAC §280.5OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §280.5, concerning Grant Program Administration, in the Texas Administrative Code (TAC), Title 26, Chapter 280, Pediatric Tele-Connectivity Resource Program for Rural Texas.Proposed new §280.5 provides guidance on administration of the grant program, including a description of roles and responsibilities of all involved parties. Subsection (a) specifies allowable uses of the grant funds by grant recipients. Subsection (b) defines the role of the Texas Health and Human Services Commission (HHSC) in this project. Subsection (c) provides further guidance for identifying and selecting eligible grant recipients. Subsection (d) defines the role of the stakeholder workgroup. Subsection (e) advises no form of compensation for participants of a stakeholder workgroup. Subsection (f) specifies compliance with all program requirements by grant recipients. Subsection (g) tasks HHSC with developing measures for evaluating the grants program. Subsection (h) enables HHSC to set up a schedule for awarding funds. Subsection (i) identifies reporting responsibilities for grant recipients and HHSC. Subsection (j) provides notification of possible audit of grant recipients by the HHSC Office of the Inspector General in accordance with 1 TAC §371.11.BACKGROUND AND JUSTIFICATION The purpose of the proposed new rules is to implement Texas Government Code, Chapter 541, added by House Bill (H.B) 1697, 85th Legislature, Regular Session, 2017. Chapter 541 directs HHSC to establish a pediatric tele-connectivity resource program for rural Texas to award grants to nonurban health care facilities to connect the facilities with pediatric specialists and pediatric subspecialists who provide telemedicine services. Rider 94 of the 2020-21 General Appropriations Act (H.B. 1, 86th Legislature, Regular Session, 2019, Article II, Special Provisions) appropriates funds to HHSC to implement Chapter 541.The purpose of this grant program is to provide financial assistance to enable eligible, nonurban healthcare facilities to connect with pediatric specialists who provide telemedicine services and to cover related expenses, including necessary equipment.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC, Chapter 360, Subchapter C, establishing the Specialized Telecommunications Assistance Program for deaf and hard-of-hearing individuals
CHAPTER 360. OFFICE OF DEAF AND HARD OF HEARING SERVICESSUBCHAPTER C. SPECIALIZED TELECOMMUNICATIONS ASSISTANCE PROGRAM26 TAC §§360.501, 360.503, 360.505, 360.507, 360.509, 360.511, 360.513, 360.515, 360.517, 360.519, 360.521, 360.523, 360.525, 360.527, 360.529, 360.531, 360.533, 360.535OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Chapter 360, Subchapter C, concerning Specialized Telecommunications Assistance Program, consisting of §§360.501, 360.503, 360.505, 360.507, 360.509, 360.511, 360.513, 360.515, 360.517, 360.519, 360.521, 360.523, 360.525, 360.527, 360.529, 360.531, 360.533, and 360.535.SECTION-BY-SECTION SUMMARYA detailed summary of the provisions of each new rule is included in this week’s edition of the Texas Register (45 Tex Reg 9020). BACKGROUND AND JUSTIFICATION The purpose of the proposal is to update and relocate the Specialized Telecommunications Assistance Program (STAP) rules from 40 TAC Chapter 109, Subchapter C to 26 TAC Chapter 360, Subchapter C. The relocation of the rules is necessary to implement Senate Bill 200, 84th Legislature, Regular Session, 2015, which transferred the functions of the legacy Department of Assistive and Rehabilitative Services (DARS) to HHSC. These proposed rules intend to replace repealed rules in 40 TAC Chapter 109, Subchapter C. The rule repeals are proposed simultaneously elsewhere in this issue of the Texas Register.The text of the rules is largely carried over from 40 TAC Chapter 109, Subchapter C with some changes. One such change is to reflect the modernization of STAP. More specifically, HHSC developed a new online STAP database allowing registered vendors to claim vouchers issued through the system. Therefore, the proposed rules require registered vendors to claim vouchers online to be eligible for reimbursement.Another change is made to the eligibility requirements which establishes an age requirement of 5 years old to be eligible for vouchers toward equipment for telephone network access. This mitigates the likelihood of applicants and their families applying for STAP for communication access purposes rather than telephone access.Other changes include expanding the categories of professionals authorized to certify program applicants for vouchers, clarifying certifier and vendor responsibilities, and changing references from the legacy DARS to HHSC.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §506.37, prohibiting special care facilities from engaging in balance-billing practices
Proposed Rules
New 26 TAC §507.50, prohibiting end stage renal disease facilities from engaging in balance-billing practices
CHAPTER 507. END STAGE RENAL DISEASE FACILITIESSUBCHAPTER D. OPERATIONAL REQUIREMENTS FOR PATIENT CARE AND TREATMENT26 TAC §507.50OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §507.50, concerning Balance Billing.The proposed new §507.50 adds language prohibiting an end stage renal disease facility from violating a law that prohibits balance billing and requires an end stage renal disease facility to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.BACKGROUND AND JUSTIFICATION The proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §509.67, prohibiting freestanding emergency medical care facilities from engaging in balance-billing practices
CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIESSUBCHAPTER C. OPERATIONAL REQUIREMENTS26 TAC §509.67OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §509.67, concerning Balance Billing.The proposed new §509.67, Balance Billing, prohibits a freestanding emergency medical care facility from violating a law that prohibits balance billing and requires a freestanding emergency care facility to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.BACKGROUND AND JUSTIFICATIONThe proposal is also necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §510.45 to update balance-billing prohibitions and complaint investigation procedures for private psychiatric hospitals and crisis stabilization units
CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITSSUBCHAPTER C. OPERATIONAL REQUIREMENTS26 TAC §510.45OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §510.45, concerning Facility Billing.The proposed amendment to §510.45 adds language prohibiting a private psychiatric hospital and a crisis stabilization unit from violating a law that prohibits balance billing and requires a private psychiatric hospital and a crisis stabilization unit to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.The proposed amendment to subsection (c) updates the complaint investigation procedures to the agency responsible for the procedures.BACKGROUND AND JUSTIFICATION The proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Health and Human Services Commission
Proposed Rules
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER A. GENERAL PROVISIONS26 TAC §§558.1 – 558.3OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.1 – 558.3 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The proposed amendment to §558.1, Purpose and Scope, updates references and agency name and clarifies that the rules of this chapter are adopted to protect clients of HCSSAs by establishing minimum standards relating to quality of care and quality of life.The proposed amendment to §558.2, Definitions, adds definitions for the terms “accreditation organization,” “controlled substance,” “HCSSA,” “online portal,” “palliative,” “supportive palliative care,” and “TAC.” The proposed amendment revises the definitions for the terms “HHSC,” “hospice services,” and “pharmacy” and changes the term “presurvey conference” to “presurvey training.” Also, the proposed amendment replaces the term and definition of “home and community support services agency” with “HCSSA” and replaces the term and definition of “licensed vocational nurse” with “LVN.” The proposed amendment deletes the definitions for “CHAP,” “DADS,” “JCAHO,” and “palliative care.”The proposed amendment to §558.3, License Fees, increases the fee for an initial license from $1750 to $2625 to accommodate the additional year of the licensure period provided for in proposed §558.15(b). The proposed amendment also adds a three-year licensure period for license renewal and increases the fee comparatively to accommodate the additional year of licensure. The same change and addition are made to an initial branch license, branch license renewal, and an alternate delivery site license renewal. To renew a branch office or ADS license, the proposed amendment requires a licensee to submit the renewal application and payment of all applicable licensing fees in full for each branch office and ADS sought to be renewed at the same time as the parent agency’s submission for license renewal. The proposed amendment also refers to the online portal as the source for identifying fee payment options.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC, Chapter 558, Subchapter B to update eligibility requirements and application procedures for issuance of a home and community support service license
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER B. CRITERIA AND ELIGIBILITY, APPLICATION PROCEDURES, AND ISSUANCE OF A LICENSE26 TAC §§558.11 – 558.13, 558.15, 558.17, 558.19, 558.21, 558.23, 558.25, 558.27. 558.29 – 558.31OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.11, 558.13, 558.15, 558.17, 558.19, 558.21, 558.23, 558.25, 558.27, 558.29 – 558.31 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY A detailed summary of changes proposed for each rule is included in this week’s edition of the Texas Register (45 Tex Reg 9044). BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.202 to include a cross-reference to category-specific requirements for home and community support service agencies that provide habilitation
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIESDIVISION 1. GENERAL PROVISIONS26 TAC §558.202OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §558.202 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §558.202 (Habilitation) are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.208, 558.213 – 558.220, 558.222 to update conditions of licensure for home and community support service agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIESDIVISION 2. CONDITIONS OF A LICENSE26 TAC §§558.208, 558.213 – 558.220, 558.222OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.208, 558.213, 558.214 – 558.220, 558.222 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY A detailed summary of changes proposed for each rule is included in this week’s edition of the Texas Register (45 Tex Reg 9053). BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.241 – 558.250, 558.252, 558.255 – 558.257, 558.259, 558.260 to update administrative requirements for home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIESDIVISION 3. AGENCY ADMINISTRATION26 TAC §§558.241 – 558.250, 558.252, 558.255 – 558.257, 558.259, 558.260OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.241 – 558.250, 558.252, 558.255 – 558.257, 558.259, 558.260 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY A detailed summary of changes proposed for each rule is included in this week’s edition of the Texas Register (45 Tex Reg 9057). BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.281 – 558.287, 558.289 – 558.292, 558.295 – 558.299, 558.301 – 558.303 to update requirements for the provision and coordination of treatment services by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIESDIVISION 4. PROVISION AND COORDINATION OF TREATMENT SERVICES26 TAC §§558.281 – 558.287, 558.289 – 558.292, 558.295 – 558.299, 558.301 – 558.303OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.281 – 558.287, 558.289, 558.290, 558.291, 558.292, 558.295 – 558.299, 558.301 – 558.303 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY A detailed summary of changes proposed for each rule is included in this week’s edition of the Texas Register (45 Tex Reg 9065). BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.321 and §558.322 to make non-substantive updates to requirements for the operation of branch offices and alternative delivery sites by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIESDIVISION 5. BRANCH OFFICES AND ALTERNATE DELIVERY SITES26 TAC §558.321, §558.322OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.321 and 558.322 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.321 and 558.322 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structureBACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.401, 558.402, 558.404 – 558.407 to clarify additional requirements for certain categories of home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER D. ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES26 TAC §§558.401, 558.402, 558.404 – 558.407OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.401, 558.402, 558.404 – 558.407 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.401, 558.404 – 558.407 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. The proposed amendment to §558.402, Standards Specific to Licensed and Certified Home Health Services, requires an agency providing licensed and certified home health services to comply with applicable requirements of 42 USC, Chapter 7, Subchapter XVII and the regulations in 42 CFR Part 484. In addition, language is deleted that adopts by reference the cited USC and CFR and language that states that copies of the cited USC and CFR are indexed and filed at the Texas Department of Human Services.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.501, 558.503, 558.505, 558.507 to update general requirements for the completion of licensure surveys by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER E. LICENSURE SURVEYSDIVISION 1. GENERAL26 TAC §§558.501, 558.503, 558.505, 558.507OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.501, 558.503, 558.505, 558.507 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.501,558.505, 558.507 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. The proposed amendment to §558.503, Exemption From a Survey, requires an accredited agency to maintain accreditation status for the services for which the agency seeks exemption and that is applicable to the agency’s category of license. Further, the accreditation organization must have current HHSC approval. In addition, the proposed amendment states that, as of the effective date of this rule, accreditation organizations with current HHSC approval on its HCSSA licensure website are the Joint Commission, Community Health Accreditation Partner, and Accreditation Commission for Health Care, Inc.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.521, 558.523, 558.525, 558.527 to clarify the licensure survey process for home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER E. LICENSURE SURVEYSDIVISION 2. THE SURVEY PROCESS26 TAC §§558.521, 558.523, 558.525, 558.527OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.521, 558.523, 558.525, 558.527 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.521, 558.523, 558.525, 558.527 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.601 – 558.604 to clarify enforcement procedures for home and community services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER F. ENFORCEMENT26 TAC §§558.601 – 558.604OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.601 -558.604 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.601 -558.604 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.701 to clarify requirements for home health aides working under home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER G. HOME HEALTH AIDES26 TAC §558.701OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §558.701 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §558.701 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.801 to require that home and community support services agencies providing hospice care inform patients of alternative treatment options
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 1. HOSPICE GENERAL PROVISIONS26 TAC §558.801OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §558.801 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The proposed amendment to §558.801, Subchapter H Applicability, adds that a client or client’s legal representative, as applicable, must be given understanding of the potential availability of supportive palliative care options outside a hospice setting as required by statute.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.810 and §558.811 to clarify assessment procedures for hospices operated by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 2. INITIAL AND COMPREHENSIVE ASSESSMENT OF A HOSPICE26 TAC §558.810, §558.811OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.810 and 558.811 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.810 and 558.811 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.820, 558.821, 558.823 to clarify requirements for the coordination of services at hospices operated by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 3. HOSPICE INTERDISCIPLINARY TEAM, CARE PLANNING, AND COORDINATION OF SERVICES26 TAC §§558.820, 558.821, 558.823OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.820, 558.821, 558.823 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.820, 558.821, 558.823 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.830, 558.832, 558.834 to clarify core services for hospices operated by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 4. HOSPICE CORE SERVICES26 TAC §§558.830, 558.832, 558.834OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.830, 558.832, 558.834 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.830, 558.832, 558.834 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.842 – 558.845 to clarify non-core services for hospices operated by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 5. HOSPICE NON-CORE SERVICES26 TAC §§558.842 – 558.845OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.842 – 558.845 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §§558.842 – 558.845 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §§558.852 – 558.857, 558.859 – 558.863 to update administrative requirements for hospices operated by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 6. HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES26 TAC §§558.852 – 558.857, 558.859 – 558.863OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§558.852 – 558.857, 558.859 – 558.860, and new §§558.861 – 558.863 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY A detailed summary of changes proposed for each rule is included in this week’s edition of the Texas Register (45 Tex Reg 9096). BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Repealing 26 TAC §558.861 to eliminate a duplicative rule governing short-term inpatient care in hospices operated by home and community support services centers
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 6. HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES26 TAC §558.861OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §558.861 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The proposed repeal of §558.861, Hospice Short-term Inpatient Care, deletes the section and incorporates the language into new §558.863.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.870 and §558.871 to update requirements for hospice inpatient units operated by home and community support services agencies
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 7. HOSPICE INPATIENT UNITS26 TAC §558.870, §558.871OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §558.870 and §558.871 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The amendments to §558.870 are non-substantial and contain updates to citations, agency name, position titles, and terminology; correct minor grammatical and punctuation errors; and revise sentence structure. The proposed amendment to §558.871, Physical Environment in a Hospice Inpatient Unit, deletes the requirement to use an obsolete web-based program. It also deletes the statement that the hospice may register its facility with 2-1-1 Texas.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
Amending 26 TAC §558.880 to update requirements for hospices operated by home and community support services agencies that provide care to certain facilities
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER H. STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICESDIVISION 8. HOSPICES THAT PROVIDE HOSPICE CARE TO RESIDENTS OF A SKILLED NURSING FACILITY, NURSING FACILITY, OR INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS26 TAC §558.880OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §558.880 in Title 26, Part 1, Chapter 558, concerning Licensing Standards for Home and Community Support Services Agencies.SECTION-BY-SECTION SUMMARY The proposed amendment to §558,880, Providing Hospice Care to a Resident of a Skilled Nursing Facility (SNF), Nursing Facility (NF), or Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions (ICF/IID), adds a provision regarding the management and disposal of drugs, including controlled substance prescription drugs and biologicals in compliance with state statute. It also prohibits a hospice’s policies and procedures relating to management disposal of drugs and biologicals from impeding a SNF’s, NF’s, or ICF/IID’s ability to adhere to state, federal, and local law.BACKGROUND AND JUSTIFICATION The proposal implements changes made to the Texas Health and Safety Code Chapter 142, and the Texas Occupations Code Chapters 56 and 57, made by Senate Bills 916 and 37, and House Bills 2594 and 3193, all enacted during the 86th Legislature, Regular Session, 2019.House Bill (HB) 3193 increases the licensing period from two years to three years and increases the maximum amount that HHSC may charge for licensure fee. Senate Bill (SB) 916 removes “palliative care for terminally ill clients” from services described as being included in the statutory definition of “hospice services.” It also establishes a definition for “supportive palliative care services.” SB 37 amends the subparagraph that prohibits certain disciplinary action against a person based on the person’s default on a student loan default based on the amendments to the Texas Occupations Code. HB 3079 gives HHSC the authority to investigate abuse, neglect, and exploitation of a home and community support services agency (HCSSA) client receiving inpatient hospice services. HB 2594 allows a health care professional employee of a hospice provider who meets certain requirements to dispose of a patient’s controlled substance prescriptions.This proposal also amends the licensure process to reflect the transition from paper applications to the use of the online licensure portal called Texas Unified Licensure Information Portal (TULIP) and clarifying other processes relating to licensure.Additionally, the proposal updates rule references throughout the chapter as a result of the administrative transfer of the chapter from 40 TAC Chapter 97 to 26 TAC Chapter 558 in May 2019. The proposal also updates the agency name throughout the chapter from “DADS” to “HHSC.”
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §564.28, prohibiting substance-disorder treatment facilities from engaging in balance-billing practices
CHAPTER 564. TREATMENT FACILITIES FOR INDIVIDUALS WITH SUBSTANCE-RELATED DISORDERSSUBCHAPTER B. LICENSING REQUIREMENTS26 TAC §564.28OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §564.28, concerning Balance Billing.The proposed new §564.28 adds language prohibiting a chemical dependency treatment facility from violating a law that prohibits balance billing and requires the chemical dependency treatment facility to comply with S.B. 1264 and related Texas Department of Insurance rules. This change is consistent with the provision in S.B. 1264 requiring HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities.BACKGROUND AND JUSTIFICATION The proposal is necessary to comply with Senate Bill (S.B.) 1264, 86th Legislature, Regular Session, 2019, which requires HHSC to adopt rules relating to consumer protections against certain medical and health care billing by out-of-network licensed health care facilities, including abortion facilities, ambulatory surgical centers, birthing centers, chemical dependency treatment facilities, crisis stabilization units, end stage renal disease facilities, freestanding emergency medical care facilities, general and special hospitals, narcotic treatment programs, private psychiatric hospitals, and special care facilities.
Texas Department of Assistive and Rehabilitative Services
Proposed Rules
Repealing 40 TAC, Chapter 109, Subchapter C to allow for HHSC’s oversight of the Specialized Telecommunications Assistance Program for deaf and hard-of-hearing individuals
CHAPTER 109. OFFICE FOR DEAF AND HARD OF HEARING SERVICESSUBCHAPTER C. SPECIALIZED TELECOMMUNICATIONS ASSISTANCE PROGRAM40 TAC §§109.501, 109.503, 109.505, 109.507, 109.509, 109.511, 109.513, 109.515, 109.517, 109.519, 109.521, 109.523, 109.525, 109.527, 109.529, 109.531, 109.533OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Chapter 109, Subchapter C, concerning Specialized Telecommunications Assistance Program, consisting of §§109.501, 109.503, 109.505, 109.507, 109.509, 109.511, 109.513, 109.515, 109.517, 109.519, 109.521, 109.523, 109.525, 109.527, 109.529, 109.531, and 109.533.The proposed repeal of 40 TAC Chapter 109, Subchapter C deletes the STAP rules in 40 TAC and updates and relocates them to 26 TAC Chapter 360.BACKGROUND AND JUSTIFICATION The purpose of the proposal is to update and relocate the Specialized Telecommunications Assistance Program (STAP) rules from 40 TAC Chapter 109, Subchapter C to 26 TAC Chapter 360, Subchapter C. The relocation of the rules is necessary to implement Senate Bill 200, 84th Legislature, Regular Session, 2015, which transferred the functions of the legacy Department of Assistive and Rehabilitative Services (DARS) to HHSC. The new rules are proposed simultaneously elsewhere in this issue of the Texas Register.
Texas Health and Human Services Commission
Withdrawn Rule
Withdrawing the emergency adoption of 26 TAC §558.950, which allowed limited indoor and outdoor visitation at hospice inpatient units during the COVID-19 crisis
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE26 TAC §558.950OVERVIEWThe Health and Human Services Commission withdraws the emergency adoption of new §558.950, which appeared in the October 2, 2020, issue of the Texas Register (45 TexReg 6845).HHSC adopted this emergency rule to allow limited indoor and outdoor visitation in a hospice inpatient unit. The purpose of the rule is to describe the requirements related to such visits.BACKGROUND AND JUSTIFICATIONAs authorized by Government Code §2001.034 the Commission 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. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Hospice Inpatient Units COVID-19 Response – Reopening Visitation.
Texas Health and Human Services Commission
Adopted Rules
New 1 TAC §351.841, consolidating rules governing the Joint Committee on Access and Forensic Services
CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICESSUBCHAPTER B. ADVISORY COMMITTEESDIVISION 1. COMMITTEES1 TAC §351.841OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts in Texas Administrative Code (TAC) Title 1, Part 15, Chapter 351, Subchapter B, Division 1, new §351.841, concerning Joint Committee on Access and Forensic Services. Section 351.841 is adopted without changes to the proposed text as published in the September 18, 2020, issue of the Texas Register (45 TexReg 6428). Therefore, the rule will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of this rulemaking is to move HHSC rules in 25 TAC Chapter 411, Subchapter A to 1 TAC Chapter 351, Subchapter B, Division 1 to consolidate HHSC advisory committee rules into one place. The relocation of the Joint Committee on Access and Forensic Services (JCAFS) rules to Chapter 351 will make it easier for the public to locate advisory committee rules in a chapter where HHSC advisory committee rules are situated. The current rule is reorganized and updated. The new rule has two new provisions that are not substantive changes so it does not result in new or increased requirements for the JCAFS. The repeal of the rules in 25 TAC Chapter 411, Subchapter A, concerning Joint Committee on Access and Forensic Services, appears elsewhere in this issue of the Texas Register.
Texas Health and Human Services Commission
Adopted Rules
Repealing 1 TAC §354.1177 to eliminate a duplicative rule concerning the Medicaid Electronic Verification System
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER A. PURCHASED HEALTH SERVICESDIVISION 11. GENERAL ADMINISTRATION1 TAC §354.1177OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of §354.1177, concerning Electronic Visit Verification (EVV) System. BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.
Texas Health and Human Services Commission
Adopted Rules
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER O. ELECTRONIC VISIT VERIFICATION1 TAC §354.4001OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.4001, concerning Purpose and Authority. BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.The new rules are based on federal and state laws that require HHSC to implement EVV, specifically, Title XIX, Section 1903(l) of the Social Security Act (42 United States Code Section 1396b), as amended by Section 12006 of the 21st Century Cures Act; Texas Government Code Section 531.024172, as amended by Senate Bill 894, 85th Legislature, Regular Session, 2017; and Texas Human Resources Code Section 161.086.
Texas Health and Human Services Commission
Adopted Rules
New 1 TAC §354.4003, defining terms relevant to the Medicaid electronic visit verification requirement
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER O. ELECTRONIC VISIT VERIFICATION1 TAC §354.4003OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.4003, concerning Definitions. BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.The new rules are based on federal and state laws that require HHSC to implement EVV, specifically, Title XIX, Section 1903(l) of the Social Security Act (42 United States Code Section 1396b), as amended by Section 12006 of the 21st Century Cures Act; Texas Government Code Section 531.024172, as amended by Senate Bill 894, 85th Legislature, Regular Session, 2017; and Texas Human Resources Code Section 161.086.
Texas Health and Human Services Commission
Adopted Rules
New 1 TAC §354.4005, describing the applicability of the Medicaid electronic visit verification requirement
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER O. ELECTRONIC VISIT VERIFICATION1 TAC §354.4005OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.4005, concerning Applicability. BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.The new rules are based on federal and state laws that require HHSC to implement EVV, specifically, Title XIX, Section 1903(l) of the Social Security Act (42 United States Code Section 1396b), as amended by Section 12006 of the 21st Century Cures Act; Texas Government Code Section 531.024172, as amended by Senate Bill 894, 85th Legislature, Regular Session, 2017; and Texas Human Resources Code Section 161.086.
Texas Health and Human Services Commission
Adopted Rules
New 1 TAC §354.4007, establishing rules to govern the Medicaid Electronic Visit Verification System
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER O. ELECTRONIC VISIT VERIFICATION1 TAC §354.4007OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.4007, concerning EVV System. BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.The new rules are based on federal and state laws that require HHSC to implement EVV, specifically, Title XIX, Section 1903(l) of the Social Security Act (42 United States Code Section 1396b), as amended by Section 12006 of the 21st Century Cures Act; Texas Government Code Section 531.024172, as amended by Senate Bill 894, 85th Legislature, Regular Session, 2017; and Texas Human Resources Code Section 161.086.
Texas Health and Human Services Commission
Adopted Rules
New 1 TAC §354.4009, establishing claims procedures for the Medicaid Electronic Visit Verification System
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER O. ELECTRONIC VISIT VERIFICATION1 TAC §354.4009OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.4009, concerning Requirements for Claims Submission and Approval. BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.The new rules are based on federal and state laws that require HHSC to implement EVV, specifically, Title XIX, Section 1903(l) of the Social Security Act (42 United States Code Section 1396b), as amended by Section 12006 of the 21st Century Cures Act; Texas Government Code Section 531.024172, as amended by Senate Bill 894, 85th Legislature, Regular Session, 2017; and Texas Human Resources Code Section 161.086.
Texas Health and Human Services Commission
Adopted Rules
New 1 TAC §354.4011, establishing member rights and responsibilities for the Medicaid Electronic Visit Verification System
Adopted Rules
New 1 TAC §354.4013, establishing additional requirements for the Medicaid Electronic Visit Verification System
CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER O. ELECTRONIC VISIT VERIFICATION1 TAC §354.4013OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.4013, concerning Additional Requirements.BACKGROUND AND JUSTIFICATION HHSC currently has rules concerning EVV in Titles 1 and 40 of the Texas Administrative Code (TAC). This proposal consolidates the EVV rules into one location, implements federal and state requirements for the Texas EVV system, and removes unnecessary or duplicative rules from TAC. The new rules in Chapter 354, Subchapter O also implement the requirements for the Texas EVV system to electronically verify that Medicaid-funded personal care services are provided to a member in accordance with a prior authorization or plan of care, as applicable to the program in which the member receives the service. An EVV system electronically verifies and documents basic information relating to the delivery of services, such as the member’s name and the precise time the service begins and ends. HHSC requires the use of an EVV system to help ensure that members receive services authorized for their care, ensure accurate Medicaid payments and to prevent fraud, waste and abuse.The new rules are based on federal and state laws that require HHSC to implement EVV, specifically, Title XIX, Section 1903(l) of the Social Security Act (42 United States Code Section 1396b), as amended by Section 12006 of the 21st Century Cures Act; Texas Government Code Section 531.024172, as amended by Senate Bill 894, 85th Legislature, Regular Session, 2017; and Texas Human Resources Code Section 161.086.
Texas Department of State Health Services
Adopted Rules
Repealing 25 TAC §§37.501 – 37.507 and replacing with new 25 TAC §§37.501 – 37.509 to clarify requirements for the Newborn Hearing Screening Program
CHAPTER 37. MATERNAL AND INFANT HEALTH SERVICESSUBCHAPTER S. NEWBORN HEARING SCREENING25 TAC §§37.501 – 37.509OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of §§37.501 – 37.507, and new §§37.501 – 37.509, concerning Newborn Hearing Screening.The new §§37.501, 37.506 – 37.509 are adopted without changes to the proposed text as published in the August 7, 2020, issue of the Texas Register (45 TexReg 5502). These sections will not be republished. New §§37.502 – 37.505 are adopted with changes and will be republished.The repeal of §§37.501 – 37.507 is adopted without changes to the proposed text as published in the August 7, 2020, issue of the Texas Register (45 TexReg 5502), and therefore will not be republished.BACKGROUND AND JUSTIFICATION The repeal of the rules in Chapter 37, Subchapter S, and replacement with new rules is necessary to comply with amendments to Texas Health and Safety Code Chapter 47, Hearing Loss in Newborns, made by House Bill 2255 and Senate Bill 1404 passed during the 86th Legislature, Regular Session, 2019. This replacement of the rules also serves as the four-year review of rules required by Texas Government Code §2001.039.DSHS administers the Newborn Hearing Screening Program and provides guidance for performing point-of-care hearing screening required for all newborns in the state. The adopted new rules are structured to refine roles and responsibilities, update definitions, emphasize required reporting, and clarify the purpose of consent. The adopted new rules also implement new legislative mandates.Referrals to the primary statewide resource center at the Texas School for the Deaf are required for infants who are suspected or confirmed to be deaf or hard of hearing, and DSHS will make educational materials available for parents.
Texas Department of State Health Services
Adopted Rules
Repealing 25 TAC §411.1 and §411.3 to allow for HHSC’s oversight of the Joint Committee on Access and Forensic Services
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER A. JOINT COMMITTEE ON ACCESS AND FORENSIC SERVICES25 TAC §411.1, §411.3OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 411, Subchapter A, §411.1, concerning Definitions, and §411.3, concerning Joint Committee on Access and Forensic Services. The repeals are adopted without changes to the proposed text as published in the September 18, 2020, issue of the Texas Register (45 TexReg 6577). Therefore, the rule repeals will not be republished.BACKGROUND AND JUSTIFICATION As required by Texas Government Code §531.0201(a)(2)(C), client services functions previously performed by the Department of State Health Services were transferred to HHSC on September 1, 2016, in accordance with Texas Government Code §531.0201 and §531.02011. The purpose of this proposal is to repeal 25 TAC Chapter 411, Subchapter A, concerning Joint Committee on Access and Forensic Services, in its entirety. New rules are adopted in 1 TAC Chapter 351, Subchapter B, Division 1 and is published elsewhere in this issue of the Texas Register. The new rule is substantially similar to the rules being repealed.
Texas Department of Insurance
Adopted Rules
Amending 28 TAC §26.301 to allow an employer group that qualifies as a “bona fide employer association” to buy a large employer health benefit plan
CHAPTER 26. EMPLOYER-RELATED HEALTH BENEFIT PLAN REGULATIONSSUBCHAPTER C. LARGE EMPLOYER HEALTH INSURANCE REGULATIONS28 TAC §26.301OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §26.301, relating to Applicability, Definitions, and Scope. The section is adopted with changes to the proposed text published in the September 25, 2020, issue of the Texas Register (45 TexReg 6700). TDI revised §26.301(g) in response to public comments. The rule will be republished.Section 26.301(g) is amended to increase the employee health insurance options available to Texas employers by permitting an employer group or association that qualifies as a bona fide employer association to buy a large employer health benefit plan under Insurance Code Chapter 1501.BACKGROUND AND JUSTIFICATIONAn employer group or association can seek designation as a bona fide employer association through the issuer’s form filing, as is done for other association plans under 28 TAC Chapter 3, Subchapter A. The issuer’s form filing and documentation must include either a DOL advisory opinion specifically identifying it as a bona fide employer association or an attorney’s attestation with supporting documentation that the employer group or association meets the criteria established in §26.301(g).Specifically, the new rule is intended to confirm the group’s or association’s eligibility by showing the following factors:(A) The employer group or association has a formal organizational structure with a governing body.(B) The functions and activities of the employer group or association are controlled by its employer members.(C) The employer group or association has at least one substantial business purpose unrelated to offering and providing health coverage or other employee benefits to its member employers and their employees.(D) The member employers of the group or association are in the same trade, industry, line of business, or profession. For example, an association in which all member employers are dentists or dental practices would satisfy this provision, while a city’s Chamber of Commerce would not.(E) The member employers that participate in the group health plan control the plan itself in both form and in substance.(F) Each member employer participating in the group health plan is a person acting directly as an employer of at least one employee who is a participant covered under the plan. For instance, a sole proprietor of a business with two common law employees enrolled in the plan would qualify. A working owner of a trade or business without common law employees would not.(G) Health coverage through the group health plan is only available to:- an eligible employee of a current member employer of the employer group or association;- a former employee of a current member employer of the employer group or association who became eligible for coverage under the group health plan when the former employee was an employee of the employer;- a current employer; or- a dependent of an employee, former employee, or current employer (for example, spouses and dependent children).(H) The employer group or association is not owned or controlled by a health insurance issuer.
Texas Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §9.153 to clarify contracting requirements for the Medicaid Home and Community-based Services (HCS) Program and Community First Choice (CFC)
CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIESSUBCHAPTER D. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)40 TAC §9.153OVERVIEWExecutive Commissioner of HHSC adopts amendments to §9.153 in Subchapter D, Home and Community-based Services (HCS) Program and Community First Choice (CFC), in Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities.BACKGROUND AND JUSTIFICATION The amendments are necessary to revise the definitions of “provisional contract” and “standard contract” to ensure consistency with the definitions of those terms in Title 40, Part 1, Chapter 49, Contracting for Community Services. HHSC is also adopting amendments to Chapter 49 to allow HHSC to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years. The Chapter 49 amendments are adopted elsewhere in this issue of the Texas Register. The amendments specify that the maximum term lengths do not include any extensions to which HHSC and a contractor may agree.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §9.553 to clarify contracting requirements for the Medicaid Texas Home Living (TxHmL) Program and Community First Choice (CFC)
CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIESSUBCHAPTER N. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)40 TAC §9.553OVERVIEWExecutive Commissioner of HHSC adopts amendments to §9.553 in Subchapter N, Texas Home Living (TxHmL) Program and Community First Choice (CFC), in Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities.BACKGROUND AND JUSTIFICATION The amendments are necessary to revise the definitions of “provisional contract” and “standard contract” to ensure consistency with the definitions of those terms in Title 40, Part 1, Chapter 49, Contracting for Community Services. HHSC is also adopting amendments to Chapter 49 to allow HHSC to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years. The Chapter 49 amendments are adopted elsewhere in this issue of the Texas Register. The amendments specify that the maximum term lengths do not include any extensions to which HHSC and a contractor may agree.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §42.103 to clarify contracting requirements for the 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) SERVICESSUBCHAPTER A. INTRODUCTION40 TAC §42.103OVERVIEWThe Executive Commissioner of HHSC adopts an amendment to §42.103 in Title 40, Part 1, Chapter 42, Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.BACKGROUND AND JUSTIFICATION The amendment is necessary to revise the definition of “contract” to ensure consistency with the definitions of “provisional contract” and “standard contract” in Title 40, Part 1, Chapter 49, Contracting for Community Services. HHSC is adopting amendments to Chapter 49 to allow HHSC to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years. The Chapter 49 amendments are adopted elsewhere in this issue of the Texas Register. The amendments specify that the maximum term lengths do not include any extensions to which HHSC and a contractor may agree.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §45.103 to clarify contracting 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) SERVICESSUBCHAPTER A. GENERAL PROVISIONS40 TAC §45.103OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §45.103 in Title 40, Part 1, Chapter 45, Community Living Assistance and Support Services and Community First Choice (CFC) Services.BACKGROUND AND JUSTIFICATIONThe amendment is necessary to revise the definition of “contract” to ensure consistency with the definitions of “provisional contract” and “standard contract” in Title 40, Part 1, Chapter 49, Contracting for Community Services. HHSC is adopting amendments to Chapter 49 to allow HHSC to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years. The Chapter 49 amendments are adopted elsewhere in this issue of the Texas Register. The amendments specify that the maximum term lengths do not include any extensions to which HHSC and a contractor may agree.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §49.102 to clarify definitions relevant to rules on contracting for community services
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER A. APPLICATION AND DEFINITIONS40 TAC §49.102OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §49.102 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §§49.208 – 49.210 to clarify rules on contractor enrollment for community services
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER B. CONTRACTOR ENROLLMENT40 TAC §§49.208 – 49.210OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §§49.208 – 49.210 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §49.532 to update sanctions for violating a community service contract
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER E. ENFORCEMENT BY HHSC, TERMINATION BY CONTRACTOR, AND NO OFFER OF STANDARD CONTRACT BY HHSCDIVISION 4. SANCTIONS40 TAC §49.532OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §49.532 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §49.551 to update rules on community service contract termination
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER E. ENFORCEMENT BY HHSC, TERMINATION BY CONTRACTOR, AND NO OFFER OF STANDARD CONTRACT BY HHSCDIVISION 6. CONTRACTOR TERMINATING CONTRACT OR NOT ENTERING INTO STANDARD CONTRACT40 TAC §49.551OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §49.551 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
New 40 TAC §49.561, establishing rules concerning non-standard community service contracts
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER E. ENFORCEMENT BY HHSC, TERMINATION BY CONTRACTOR, AND NO OFFER OF STANDARD CONTRACT BY HHSCDIVISION 7. HHSC DOES NOT OFFER A STANDARD CONTRACT40 TAC §49.561OVERVIEWThe Executive Commissioner of HHSC adopts new §49.561 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §49.601 to update procedures for HHSC review of an expired or terminated community service contract
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER F. REVIEW BY HHSC OF EXPIRING OR TERMINATED CONTRACT40 TAC §49.601OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §49.601 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
Amending 40 TAC §49.702 to update rules defining the application denial period for community service contracts
CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER G. APPLICATION DENIAL PERIOD40 TAC §49.702OVERVIEWThe Executive Commissioner of HHSC adopts amendments to §49.702 in Title 40, Part 1, Chapter 49, Contracting for Community Care Services.BACKGROUND AND JUSTIFICATION Chapter 49, Contracting for Community Services, governs contracting with HHSC to provide the community-based services for which DADS previously contracted. The amendments and new rule are necessary to limit a provisional contract to a term of no more than three years, and a standard contract to a term of no more than five years, not including any contract extensions.The rules also implement changes in the enrollment and renewal processes for contractors subject to Chapter 49 and change a standard contract from being open-ended to having a term of no more than five years. HHSC will determine, before each provisional or standard contract term expires, whether the contractor will be offered a standard contract. This operational change will ensure that HHSC contracts for community-based services are routinely reviewed and updated to contain current contract provisions.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 Department on Aging and Disability Services
Adopted Rules
Repealing 40 TAC, Chapter 51 (Medically Dependent Children Program) to allow HHSC to provide services to previous MDCP recipients through the Medicaid managed care program
CHAPTER 51. MEDICALLY DEPENDENT CHILDREN PROGRAMOVERVIEWThe Executive Commissioner of HHSC adopts the repeal of rules in Texas Administrative Code (TAC) Title 40, Part 1, Chapter 51, concerning Medically Dependent Children Program consisting of §§51.101, 51.103, 51.201, 51.203, 51.207, 51.211, 51.213, 51.215, 51.217, 51.219, 51.221, 51.231, 51.233, 51.235, 51.237, 51.241, 51.243, 51.245, 51.247, 51.251, 51.301, 51.303, 51.305, 51.307, 51.309, 51.321, 51.323, 51.325, 51.327, 51.329, 51.331, 51.401, 51.403, 51.405, 51.407, 51.409, 51.411, 51.413, 51.415, 51.417, 51.418, 51.419, 51.421, 51.423, 51.431, 51.433, 51.441, 51.461, 51.463, 51.465, 51.471, 51.473, 51.475, 51.477, 51.479, 51.481, 51.483, 51.485, 51.505, 51.509, 51.511, 51.513, and 51.515 are adopted without changes to the proposed text as published in the July 24, 2020, issue of the Texas Register (45 TexReg 5133). These rules will not be republished.BACKGROUND AND JUSTIFICATION The purpose of the adoption is to repeal obsolete rules for the Medically Dependent Children Program (MDCP), a Medicaid §1915(c) waiver program that provides medical assistance benefits to children and young adults. The rules in 40 TAC, Chapter 51 governed the delivery of MDCP under a fee-for-service payment system.Senate Bill 7, 83rd Legislature, Regular Session, 2013, amended the Texas Government Code, Chapter 533, by adding §533.00253, STAR Kids Medicaid Managed Care Program. Section 533.00253 required HHSC to establish a STAR Kids capitated managed care program to provide medical assistance benefits to children with disabilities. Section 533.00253 also required HHSC to provide medical assistance benefits through the STAR Kids managed care program to children who were receiving benefits in MDCP.HHSC adopted managed care rules in 1 TAC, Chapter 353, Medicaid Managed Care, including §353.1155, Medically Dependent Children Program, effective November 1, 2016, that govern MDCP services provided under a Medicaid managed care program. On November 1, 2016, HHSC transitioned children and young adults enrolled in MDCP to the Medicaid managed care program.In addition to adopting MDCP rules in 1 TAC §353.1155, HHSC staff completed an analysis in January 2018, to ensure that all MDCP requirements under managed care were included in the Uniform Managed Care Contract, Uniform Managed Care Manual, STAR Kids Managed Care Contract, STAR Health Managed Care Contract, or the STAR Kids Handbook, as applicable.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 Department on Aging and Disability Services
Adopted Rules
Repealing 40 TAC §§68.101 – 68.103 to allow for HHSC’s oversight of the Electronic Visit Verification System
CHAPTER 68. ELECTRONIC VISIT VERIFICATION (EVV) SYSTEM40 TAC §§68.101 – 68.103OVERVIEWThe Executive Commissioner of HHSC adopts the repeals of §§68.101, concerning Application; 68.102, concerning Definitions; and 68.103, concerning Use and Availability of EVV System.BACKGROUND AND JUSTIFICATION The repeals delete rules that are unnecessary or duplicative from the Texas Administrative Code (TAC). The new rules for EVV are adopted in 1 TAC Chapter 354, published elsewhere in this issue of the Texas Register.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 Department on Aging and Disability Services
Transferred Rule
Former DADS rules governing day activity and health services requirements have been transferred to HHSC
OVERVIEWThe former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 98, Day Activity and Health Services Requirements, Subchapters A – G are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 559, Day Activity and Health Services Requirements.The rules will be transferred in the Texas Administrative Code effective January 15, 2021.BACKGROUND AND JUSTIFICATION During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011.
Texas Department of State Health Services
In Addition
Order establishing Remimazolam as a Schedule IV controlled substance and maintaining Crotonyl Fentanyl as Schedule I controlled substance
OVERVIEWIn the capacity as Commissioner of the Texas Department of State Health Services, John Hellerstedt, M.D., does hereby order the substance remimazolam be placed into schedule IV and the substance crotonyl fentanyl be maintained in schedule I.BACKGROUND AND JUSTIFICATION The Acting Administrator of the Drug Enforcement Administration maintains the placement of crotonyl fentanyl ((E )-N-(1-phenethylpiperidin-4-yl)-N-phenylbut-2-enamide) including its isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, in schedule I of the Controlled Substances Act. This order was published in the October 2, 2020 issue of the Federal Register, Volume 85, Number 192, pages 62215-62218 and was effective October 2, 2020. The order was issued to discharge the obligation to control crotonyl fentanyl under the Single Convention on Narcotic Drugs (1961).The Drug Enforcement Administration issued an interim final rule placing remimazolam (4H-imidazol[1,2-&agr;][1,4]benzodiazepine-4-propionic acid,8-bromo-1-methyl-6-(2-pyridinyl)-(4S)-methyl ester, benzenesulfonate (1:1), including its salts, isomers, and salts of isomers, whenever the existence of such salts, isomers, and salts of isomers is possible, in schedule IV of the Controlled Substances Act. This order was published in the October 6, 2020, issue of the Federal Register, Volume 85, Number 194, pages 63014 – 63019 and was effective October 6, 2020. This action was taken for the following reasons:1) Remimazolam has a low potential for abuse relative to the drugs or other substances in schedule III;2) Remimazolam has a currently accepted medical use in the United States; and,3) Remimazolam may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule III.Pursuant to Section 481.034(g), as amended by the 75th legislature, of the Texas Controlled Substances Act, Health and Safety Code, Chapter 481, at least thirty-one days have expired since notice of the above referenced actions were published in the Federal Register.
Texas Department of State Health Services
In Addition
DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the second half of October 2020
OVERVIEWDuring the second half of October 2020, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials. Licensing decisions pertaining to each applicant is included in this week’s edition of the Texas Register. BACKGROUND AND JUSTIFICATIONIn 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.AFFECTED PERSONS’ RIGHT TO HEARINGA person affected by the actions published in this notice may request a hearing within 30 days of the publication date. A “person affected” is defined as a person who demonstrates that the person has suffered or will suffer actual injury or economic damage and, if the person is not a local government, is (a) a resident of a county, or a county adjacent to the county, in which radioactive material is or will be located, or (b) doing business or has a legal interest in land in the county or adjacent county. 25 TAC §289.205(b)(15); Health and Safety Code §401.003(15). Requests must be made in writing and should contain the words “hearing request,” the name and address of the person affected by the agency action, the name and license number of the entity that is the subject of the hearing request, a brief statement of how the person is affected by the action what the requestor seeks as the outcome of the hearing, and the name and address of the attorney if the requestor is represented by an attorney. Send hearing requests by mail to: Hearing Request, Radiation Material Licensing, MC 2835, PO Box 149347, Austin, Texas 78714-9347, or by fax to: 512-834-6690, or by e-mail to: RAMlicensing@dshs.texas.gov.
Texas Department of State Health Services
In Addition
DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the first half of November 2020
OVERVIEWDuring the first half of November 2020, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials. Licensing decisions pertaining to each applicant is included in this week’s edition of the Texas Register. BACKGROUND AND JUSTIFICATIONIn 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.AFFECTED PERSONS’ RIGHT TO HEARINGA 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 State Board of Pharmacy
In Addition
Correction of error for previously adopted amendments to 22 TAC §291.74, regarding operational standards for Class C pharmacies
The Texas State Board of Pharmacy adopted amendments to 22 TAC §291.74 in the December 11, 2020, issue of the Texas Register (45 TexReg 8855). Due to a publication error, subsection (f)(3)(A)(iii) was not printed correctly. Subsection (f)(3)(A)(iii) should appear as follows:(iii) Records of prepackaging shall be maintained to show:(I) name of the drug, strength, and dosage form;(II) facility’s unique lot number;(III) manufacturer or distributor;(IV) manufacturer’s lot number;(V) expiration date;(VI) quantity per prepackaged unit;(VII) number of prepackaged units;(VIII) date packaged;(IX) name, initials, or electronic signature of the prepacker; and(X) name, initials, or electronic signature of the responsible pharmacist.