Texas Register Table of Contents
- 1 Governor
- 1.1 May 21, 2021: Appointments Governor reappoints two members and appoints two new members to the State Board of Dental Examiners
- 1.2 May 21, 2021: Appointments Governor appoints David H. Yu, D.D.S., as presiding officer of the State Board of Dental Examiners
- 1.3 May 21, 2021: Notices Proclamation 41-3815: Renewing the disaster proclamation for all Texas counties in response to COVID-19
- 2 Texas Department on Aging and Disability Services
- 3 Texas Department of State Health Services
- 3.1 May 21, 2021: Emergency Rule Amending 25 TAC §448.911 to temporarily allow Chemical Dependency Treatment Facilities to provide services through electronic means
- 3.2 May 21, 2021: Adopted Rules Repealing 25 TAC, Chapter 411, Subchapter J to allow the transfer of authority over psychiatric hospitals to HHSC
- 4 Texas Health and Human Services Commission
- 4.1 May 21, 2021: Emergency Rule Renewing 26 TAC §553.2004, which established reporting requirements for vaccinations of staff and residents in assisted living facilities
- 4.2 May 21, 2021: Withdrawn Rule Withdrawing 26 TAC §306.93, which would have established procedures for crisis stabilization units to identify and address sentinel events
- 4.3 May 21, 2021: Adopted Rules New 26 TAC, Chapter 306, Subchapter B, establishing HHSC’s authority over standard of care in crisis stabilization units
- 4.4 May 21, 2021: Adopted Rules New 26 TAC, Chapter 568, establishing HHSC’s authority over standards of care and treatment in psychiatric hospitals
- 4.5 May 21, 2021: In Addition Public Notice: Amendment expanding the provider network for Preadmission Screening and Resident Review (PASRR) specialized services
- 5 Texas Medical Board
- 5.1 May 21, 2021: Emergency Rule Renewing the 22 TAC §187.2 and §187.6 emergency amendments to allow the use of videoconference in conducting Board investigations
- 5.2 May 21, 2021: Emergency Rule Renewing the 22 TAC §187.16 emergency amendment to allow the use of videoconference in conducting Informal Show Compliance Proceedings and Settlement Conferences
Governor
May 21, 2021: Appointments Governor reappoints two members and appoints two new members to the State Board of Dental Examiners
Appointments for May 6, 2021
Appointed to the State Board of Dental Examiners for terms to expire February 1, 2027:
Yvonne E. Maldonado, D.D.S. of El Paso, Texas (replacing Michael D. “David” Tillman, D.D.S. of Aledo, whose term expired);
Robert G. “Bob” McNeill, D.D.S., M.D. of Dallas, Texas (Dr. McNeill is being reappointed);
Margo Y. Melchor, Ed.D. of Houston, Texas (Dr. Melchor is being reappointed);
Marquita F. Pride of Little Elm, Texas (replacing Rodney Bustamante of Austin, whose term expired).
46 TexReg 3217
May 21, 2021: Appointments Governor appoints David H. Yu, D.D.S., as presiding officer of the State Board of Dental Examiners
Appointments for May 6, 2021
Appointed as presiding officer of the State Board of Dental Examiners for a term to expire at the pleasure of the Governor, David H. Yu, D.D.S. of Austin (Dr. Yu is replacing Michael D. “David” Tillman, D.D.S. of Aledo).
46 TexReg 3217
May 21, 2021: Notices Proclamation 41-3815: Renewing the disaster proclamation for all Texas counties in response to COVID-19
OVERVIEW
In accordance with the authority vested by Section 418.014 of the Texas Government Code, Governor renews the disaster proclamation for all counties in Texas.
Pursuant to Section 418.017, Governor authorizes the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster.
Pursuant to Section 418.016, any regulatory statute prescribing the procedures for conduct of state business or any order or rule of a state agency that would in any way prevent, hinder, or delay necessary action in coping with this disaster shall be suspended upon written approval of the Office of the Governor. However, to the extent that the enforcement of any state statute or administrative rule regarding contracting or procurement would impede any state agency’s emergency response that is necessary to cope with this declared disaster, Governor 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 41-3815 in included in this week’s edition of the Texas Register (46 Tex Reg 3218).
46 TexReg 3218
Texas Department on Aging and Disability Services
May 21, 2021: Emergency Rule Renewing 40 TAC §19.2804, which established reporting requirements for vaccinations of staff and residents in long-term nursing facilities
CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER CC. COVID-19 EMERGENCY RULE
40 TAC §19.2804
OVERVIEW
The Texas Department of Licensing and Regulation is renewing the effectiveness of emergency amended §19.2804 for a 60-day period. The text of the emergency rule was originally published in the January 22, 2021, issue of the Texas Register (46 TexReg 514).
This emergency rule requires nursing facilities to accurately report COVID-19 vaccination data for staff and residents to HHSC in the format established by HHSC within 24 hours of completing a round of vaccinations. The rule is necessary to accurately track vaccinations of staff and residents in long-term care facilities in Texas.
BACKGROUND AND JUSTIFICATION
As authorized by Government Code, §2001.034, HHSC may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code, §2001.034, may be effective for not longer than 120 days and may be renewed for not longer than 60 days.
The proposed emergency rulemaking is to support the governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Nursing Facility COVID-19 Vaccination Data Reporting.
Texas Department of State Health Services
May 21, 2021: Emergency Rule Amending 25 TAC §448.911 to temporarily allow Chemical Dependency Treatment Facilities to provide services through electronic means
CHAPTER 448. STANDARD OF CARE
SUBCHAPTER I. TREATMENT PROGRAM SERVICES
25 TAC §448.911
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 25 Texas Administrative Code, Chapter 448, Standard of Care, an amendment to §448.911, concerning an emergency rule in response to COVID-19 to expand a licensed chemical dependency treatment facility’s ability to provide treatment services through electronic means to adults and adolescents to reduce the risk of COVID-19 transmission.
HHSC is adopting this emergency rule amendment to §448.911(a)(1) to temporarily permit a currently licensed chemical dependency treatment facility (CDTF) to provide treatment services through electronic means to both adult and adolescent clients. This emergency rule amendment will reduce the risk of COVID-19 transmission and expand access to treatment for clients.
BACKGROUND AND JUSTIFICATION
As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.
The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule amendment to Treatment Services Provided by Electronic Means.
46 TexReg 3224
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES
SUBCHAPTER J. STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts the repeal of Title 25, Chapter 411, Subchapter J, concerning Standards of Care and Treatment in Psychiatric Hospitals. The repeal is comprised of §§411.451 – 411.455, 411.459, 411.461 – 411.465, 411.468, 411.471 – 411.477, 411.482 – 411.485, 411.488, 411.490, 411.493 – 411.496, 411.499, and 411.500.
BACKGROUND AND JUSTIFICATION
The repeals are necessary to remove the rules in Chapter 411, Subchapter J, Standards of Care and Treatment in Psychiatric Hospitals and adopt new rules in Title 26, Part 1, Chapter 568, Standards of Care and Treatment in Psychiatric Hospitals. The rules for Title 26, Chapter 568 are published elsewhere in this issue of the Texas Register and are substantially similar to the rules proposed for repeal. The new rules comply with current statute, create consistent training guidelines, correct outdated citations, and update language throughout to reflect the transition to the new title.
Texas Health and Human Services Commission
May 21, 2021: Emergency Rule Renewing 26 TAC §553.2004, which established reporting requirements for vaccinations of staff and residents in assisted living facilities
CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER K. COVID-19 RESPONSE
26 TAC §553.2004
OVERVIEW
The Health and Human Services Commission is renewing the effectiveness of emergency amended §553.2004 for a 60-day period. The text of the emergency rule was originally published in the January 22, 2021, issue of the Texas Register (46 TexReg 513).
HHSC is renewing this emergency rule to require assisted living facilities to accurately report COVID-19 vaccination data for staff and residents to HHSC in the format established by HHSC within 24 hours of completing a round of vaccinations. This rule is necessary to accurately track vaccinations of staff and residents in long-term care facilities in Texas.
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. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Assisted Living Facility COVID-19 Vaccination Data Reporting.
46 TexReg 3224
May 21, 2021: Withdrawn Rule Withdrawing 26 TAC §306.93, which would have established procedures for crisis stabilization units to identify and address sentinel events
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITS
DIVISION 5. OPERATIONAL REQUIREMENTS
26 TAC §306.93
The Health and Human Services Commission withdraws the proposed new §309.93 which appeared in the December 18, 2020, issue of the Texas Register (45 TexReg 9016).
Proposed §306.93 established 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.
46 TexReg 3247
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITS
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts new §306.41, concerning Purpose; §306.43, concerning Application; §306.45, concerning Definitions; §306.47, concerning General Provisions; §306.51, concerning Admission Criteria; §306.53, concerning Pre-admission Screening and Assessment; §306.55, concerning Voluntary Admission Criteria and Intake Process; §306.57, concerning Involuntary Admission Criteria and Intake Process; §306.59, concerning Voluntary Treatment Following Voluntary Admission; §306.61, concerning Crisis Stabilization Unit Medical Services; §306.63, concerning Crisis Stabilization Unit Nursing Services; §306.65, concerning Crisis Stabilization Services and Recovery or Treatment Planning; §306.67, concerning Additional Standards of Care for Children and Adolescents; §306.71, concerning Discharge Planning; §306.73, concerning Discharge Notices; §306.75, concerning Discharge of a Voluntarily-Admitted Individual; §306.77, concerning Maximum Length of Stay for a Voluntarily-Admitted Individual; §306.79, concerning Discharge of an Involuntarily-Admitted Individual; §306.81, concerning Medical Record; §306.83, concerning Staff Training; §306.85, concerning Minimum Staffing Requirements; §306.87, concerning Protection of an Individual Receiving Crisis Stabilization Unit Services; §306.89, concerning Crisis Stabilization Unit Response to an Emergency Medical Condition; §306.91, concerning Transfers; §306.95, concerning Response to External Reviews.
BACKGROUND AND JUSTIFICATION
The new sections are necessary to comply with Texas Government Code §531.0201(a)(2)(C), which requires the Department of State Health Services (DSHS) to ensure that client services functions previously performed by DSHS were transferred to HHSC on September 1, 2016. The new rules in the Texas Administrative Code (TAC) Title 26, Part 1, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units, address the content of rules in 25 TAC Chapter 411, Subchapter M, concerning Standards of Care and Treatment in Crisis Stabilization Units. The rules in Chapter 411 are repealed elsewhere in this issue of the Texas Register.
The rules establish guidelines for the standards of care and treatment of individuals with mental illness or serious emotional disturbance who receive crisis stabilization services in crisis stabilization units (CSUs) licensed under Texas Health and Safety Code, Chapter 577 and 26 TAC Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
The rules outline the requirements for voluntary or involuntary admission, pre-admission screening and assessment, intake processes, treatment, services, and discharge for individuals in CSUs. The new rules establish responsibilities of CSU administrators and staff members, and introduce standards related to services provided to children and adolescents. The new rules allow licensed physician assistants (PAs) and advanced practice registered nurses (APRNs) to perform physician-delegated medical services and evaluations within their respective scopes of practice. The new rules also allow peer specialists to perform peer specialist services in accordance with 1 TAC Chapter 354, Subchapter N (relating to Peer Specialist Services), and allow qualified mental health professional-community services in accordance with 26 TAC Chapter 301, Subchapter G (relating to Mental Health Community Services Standards). The new rules establish standards related to staffing practices, staff training, and credentialing; and permit the use of telecommunication or information technology.
46 TexReg 3261
CHAPTER 568. STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts new Texas Administrative Code (TAC) Title 26, Chapter 568, concerning Standards of Care and Treatment in Psychiatric Hospitals. The new chapter comprises §§568.1 – 568.5, 568.21 – 568.26, 568.41, 568.61 – 568.67, 568.81 – 568.84, 568.101,568.121, and 568.141 – 568.144.
BACKGROUND AND JUSTIFICATION
The new sections are necessary to comply with Senate Bill (S.B.) 1238, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code Chapter 572, regarding Voluntary Mental Health Services, and to relocate the rules to 26 TAC. The rules in 25 TAC Chapter 411, Subchapter J are repealed and published elsewhere in this issue of the Texas Register. The new rules are substantially similar to the rules in Chapter 411, but updates have been made to comply with current statute, create consistent training guidelines, correct outdated citations, and update language throughout to reflect the transition to the new title.
S.B. 1238 adjusts the time frame in which a prospective voluntary mental health patient must be examined by a physician from within 72 hours before admission to either within 72 hours before admission or 24 hours after admission. The new rules allow prospective patients to be admitted to an inpatient facility before being examined by a physician. The new rules also allow a person to be discharged immediately if a physician then determines that they do not meet the clinical standards to receive inpatient mental health services.
The rules make minor updates to language throughout the rules, remove outdated citations, delete references to departments and programs that no longer exist, and reflect the transition from Title 25, Health Services, to Title 26, Health and Human Services. The rules update training requirements and citations for abuse, neglect, exploitation, and unprofessional and unethical conduct in facilities to comply with current statute and to create greater clarity regarding these guidelines.
46 TexReg 3280
May 21, 2021: In Addition Public Notice: Amendment expanding the provider network for Preadmission Screening and Resident Review (PASRR) specialized services
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit transmittal number 21-0011 to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act.
BACKGROUND AND JUSTIFICATION
The purpose of this amendment is to expand the community-based provider agency options for Medicaid recipients who have been found through the Preadmission Screening and Resident Review (PASRR) process to need specialized add-on services. The community-based provider agency can be a local intellectual and developmental disability authority, or must be licensed or certified by HHSC to provide program services for a specified waiver program. Additional edits were made to behavioral support and day habilitation services regarding setting locations. Behavioral support provider qualifications were also updated for consistency with current Texas state law. The proposed amendment is effective September 01, 2021.
ADDITIONAL INFORMATION
To obtain copies of the proposed amendment, interested parties may contact Holly Freed, State Plan Team Lead, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by email at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us. Copies of the proposal will also be made available for public review at the local offices of the Texas Health and Human Services Commission.
Texas Medical Board
May 21, 2021: Emergency Rule Renewing the 22 TAC §187.2 and §187.6 emergency amendments to allow the use of videoconference in conducting Board investigations
CHAPTER 187. PROCEDURAL RULES
SUBCHAPTER A. GENERAL PROVISIONS AND DEFINITIONS
22 TAC §187.2, §187.6
OVERVIEW
The Texas Medical Board is renewing the effectiveness of emergency amended §187.2 and §187.6 for a 60-day period. The text of the emergency rule was originally published in the January 29, 2021, issue of the Texas Register (46 TexReg 671).
BACKGROUND AND JUSTIFICATION
The emergency amendments are necessary to facilitate safe continuity of operations of the Texas Medical Board with respect to resolution of complaint investigations. These complaint investigations and disciplinary process comprise essential functions of the Board. The Board currently has approximately 175 cases postponed. The emergency amendment will provide the Board with the ability to implement maximum safety measures mitigating against the spread of COVID-19.
Pursuant to §2001.034 and §2001.036(a)(2) of the Texas Government Code, the emergency amendment is adopted on an emergency basis and with an expedited effective date because an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. The emergency amendment will eliminate potential unnecessary exposure to COVID-19 for agency staff, gubernatorial appointees (including physicians and other health professionals), complainants (including patients and/or family members), licensees, and their representatives when addressing complaints through Informal Show Compliance Proceedings and Settlement Conferences (ISC).
In order to comply with public health officials’ recommendations about how to protect against the spread of COVID-19, the emergency rules provide a means of providing maximum safety measures (virtually eliminating potential exposure) when conducting statutorily required ISCs regarding alleged violations of the Medical Practice Act and other applicable laws. In addition, the rules eliminate unnecessary expenditure of state funds during a time of decreased state revenue. The rules also provide adequate means for licensees and their representatives to respond to and address alleged violations of laws regarding the practice of medicine through the statutory ISC process.
46 TexReg 3223
May 21, 2021: Emergency Rule Renewing the 22 TAC §187.16 emergency amendment to allow the use of videoconference in conducting Informal Show Compliance Proceedings and Settlement Conferences
CHAPTER 187. PROCEDURAL RULES
SUBCHAPTER B. INFORMAL BOARD PROCEEDINGS
22 TAC §187.16
OVERVIEW
The Texas Medical Board is renewing the effectiveness of emergency amended §187.16 for a 60-day period. The text of the emergency rule was originally published in the January 29, 2021, issue of the Texas Register (46 TexReg 673).
BACKGROUND AND JUSTIFICATION
The emergency amendment is necessary to facilitate safe continuity of operations of the Texas Medical Board with respect to resolution of complaint investigations. These complaint investigations and disciplinary process comprise essential functions of the Board. The Board currently has approximately 175 cases postponed. The emergency amendment will provide the Board with the ability to implement maximum safety measures mitigating against the spread of COVID-19.
Pursuant to §2001.034 and §2001.036(a)(2) of the Texas Government Code, the emergency amendment is adopted on an emergency basis and with an expedited effective date because an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. The emergency amendment will eliminate potential unnecessary exposure to COVID-19 for agency staff, gubernatorial appointees (including physicians and other health professionals), complainants (including patients and/or family members), licensees, and their representatives when addressing complaints through Informal Show Compliance Proceedings and Settlement Conferences (ISC).
In order to comply with public health officials’ recommendations about how to protect against the spread of COVID-19, the emergency rules provide a means of providing maximum safety measures (virtually eliminating potential exposure) when conducting statutorily required ISCs regarding alleged violations of the Medical Practice Act and other applicable laws. In addition, the rules eliminate unnecessary expenditure of state funds during a time of decreased state revenue. The rules also provide adequate means for licensees and their representatives to respond to and address alleged violations of laws regarding the practice of medicine through the statutory ISC process.