Texas Register Table of Contents
- 1 Governor
- 2 Governor
- 3 Texas Department of State Health Services
- 4 Texas Health and Human Services Commission
- 5 Texas Health and Human Services Commission
- 6 Texas Board of Occupational Therapy Examiners
- 7 Texas Board of Occupational Therapy Examiners
- 8 Texas Board of Occupational Therapy Examiners
- 9 Texas Board of Occupational Therapy Examiners
- 10 Texas Department of Licensing and Regulation
- 11 Texas Board of Occupational Therapy Examiners
- 12 Texas Health and Human Services Commission
- 13 Texas Health and Human Services Commission
- 14 Texas Department of Licensing and Regulation
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
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- 60
Governor
Appointments
Governor reappoints four members and appoints one new member to the Advisory Council on Emergency Medical Services
Appointments for July 30, 2020Appointed to the Advisory Council on Emergency Medical Services, for terms to expire January 1, 2026: Cassandra “Cassie” Campbell of Salado, Texas (Ms. Campbell is being reappointed);Michael S. “Mike” Clements of Cypress, Texas (Captain Clements is being reappointed);Brian J. Eastridge, M.D. of San Antonio, Texas (Dr. Eastridge is being reappointed);Darrin R. “Rudy” Rudolph of Longview, Texas (Mr. Rudolph is being reappointed);Gerad A. Troutman, M.D. of Lubbock, Texas (replacing Robert D. “Bobby” Greenberg, M.D. of Belton, whose term expired).
Governor
Appointments
Governor designates Dr. Alan H. Tyroch as presiding officer of the Advisory Council on Emergency Medical Services
Appointments for July 30, 2020Designated as presiding officer of the Advisory Council on Emergency Medical Services, for a term to expire at the pleasure of the Governor, Alan H. Tyroch, M.D. of El Paso (Dr. Tyroch is replacing Robert D. “Bobby” Greenberg, M.D. of Belton).
Texas Department of State Health Services
Emergency Rule
Amending 25 TAC §448.603 to allow Chemical Dependency Treatment Facilities to conduct certain trainings virtually
CHAPTER 448. STANDARD OF CARESUBCHAPTER F. PERSONNEL PRACTICES AND DEVELOPMENT25 TAC §448.603OVERVIEWThe 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 §448.603, concerning an emergency rule in response to COVID-19 in order to expand a licensed Chemical Dependency Treatment Facility’s (CDTF) ability to provide abuse, neglect, and exploitation training and Nonviolent Crisis Intervention training to staff through live, interactive, instructor-led, electronic means, performed using synchronous audiovisual interaction, to reduce the risk of COVID-19 transmission.HHSC is adopting an emergency rule amendment to §448.603(d)(1) to temporarily permit a licensed CDTF to provide abuse, neglect, and exploitation training to staff through live, interactive, instructor-led, electronic means, performed using a synchronous audiovisual interaction, to reduce the risk of COVID-19 transmission. HHSC is also adopting an emergency rule amendment to §448.603(d)(4) to temporarily permit a licensed CDTF to provide Nonviolent Crisis Intervention training to staff through live, interactive, instructor-led, electronic means, performed using a synchronous audiovisual interaction, to reduce the risk of COVID-19 transmission. There are no other changes to §448.603.BACKGROUND AND JUSTIFICATIONThe 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 amendment to §448.603, Training.As authorized by Texas 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 Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC §370.1, detailing requirements for Human Trafficking Prevention Training
CHAPTER 370. HUMAN TRAFFICKING RESOURCE CENTER26 TAC §370.1OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §370.1, concerning Human Trafficking Prevention Training Requirements.SECTION-BY-SECTION SUMMARYProposed new §370.1(a) defines terms used in the section.Proposed new §370.1(b) establishes that a course must meet the human trafficking prevention training standards established by HHSC, in order to be approved by the Executive Commissioner.Proposed new §370.1(c) lists the categories of minimum standards that must be met for a training course to be approved.Proposed new §370.1(d) defines the time prescribed for a health care practitioner to complete an approved human trafficking prevention training course. It also confirms that at least one approved course will be available free of charge.Proposed new §370.1(e) states that the complete description of the human trafficking prevention training standards and approval process is posted on the HHSC website.BACKGROUND AND JUSTIFICATIONThe purpose of the proposal is to establish the review, approval, and update process of the list of human trafficking prevention training courses approved by the Executive Commissioner, pursuant to Texas Occupations Code, §116.002. The proposed rule also defines key terms and the time prescribed for a health care practitioner to successfully complete a training course on human trafficking prevention.The proposal is necessary to comply with Texas Occupations Code, §§116.001, 116.002, and 116.003, which require HHSC to approve, post, and update a list of human trafficking prevention training courses for certain health care practitioners.HHSC proposes the new rule as the result of House Bill (H.B.) 2059, 86th Legislature, Regular Session, 2019. H.B. 2059 requires the Executive Commissioner to approve training courses on human trafficking prevention, including at least one that is available without charge. It also requires the Executive Commissioner to post the list of approved training courses on the agency website and to update the list of approved trainings as necessary. The bill requires an HHSC rule to define the time allowed for health care practitioners to successfully complete a training course from the approved list.
Texas Health and Human Services Commission
Adopted Rules
Amending 1 TAC §371.37 to designate HHSC-OIG’s responsibilities in planning and conducting audits of Managed Care Organizations
CHAPTER 371. MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITYSUBCHAPTER B. OFFICE OF INSPECTOR GENERAL1 TAC §371.37OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §371.37, concerning Audit of Managed Care Organizations.The amendment to §371.37 is adopted without changes to the proposed text as published in the March 13, 2020, issue of the Texas Register (45 TexReg 1755). The rule will not be republished.BACKGROUND AND JUSTIFICATIONTexas Government Code §533.015(b), as amended by Senate Bill (S.B.) 200 and S.B. 207, 84th Legislature, Regular Session, 2015, directed the HHSC Executive Commissioner to issue rules defining the coordination between HHSC and HHSC-Office of Inspector General (HHSC-OIG) in conducting audits of managed care organizations (MCOs) participating in Medicaid.To comply with Texas Government Code §533.015(b), HHSC adopted 1 Texas Administrative Code (TAC) §353.6 and §371.37, effective July 14, 2016. These rules assign authority to the HHSC Executive Commissioner for establishing policy outlining the roles and responsibilities of divisions, departments, and offices of HHSC in performing audits of MCOs. The HHSC Medicaid and CHIP Services Division (MCSD), the Health and Human Services (HHS) Internal Audit Division, and HHSC-OIG are responsible for audits of MCOs and any entity with which an MCO contracts.In 2017, the Sunset Advisory Commission reported to the 85th Legislature that HHSC and HHSC-OIG had defined their respective audit roles, jurisdiction, and frequency in the HHSC Circular C-054, but the details were not defined in rule, as required by S.B. 200 and S.B. 207. The Sunset Advisory Commission recommended that the policies be prescribed in rule.The amendment to §371.37 is necessary to implement the Sunset Advisory Commission’s recommendation by codifying in rule a more detailed description of the coordination between HHSC and HHSC-OIG in planning and conducting audits of MCOs. The adoption of the counterpart to this rule, §353.6, which concerns Audit of Managed Care Organizations by HHSC, is published elsewhere in this issue of the Texas Register.
Texas Board of Occupational Therapy Examiners
Adopted Rules
Amending 40 TAC §§364.1 – 364.4 to increase the efficiency of licensing processes, including through the use of digital technology
CHAPTER 364. REQUIREMENTS FOR LICENSURE40 TAC §§364.1 – 364.4OVERVIEWThe Texas Board of Occupational Therapy Examiners adopts amendments to 40 Texas Administrative Code §364.1, Requirements for Licensure; §364.2, Initial License by Examination; §364.3, Temporary License; and §364.4, Licensure by Endorsement. The amendments to the sections are adopted to streamline and increase the efficiency of the Board’s licensing processes, including through the use of digital technology, and to reduce potential burdens for applicants.The amendments are adopted without changes to the proposed text as published in the June 19, 2020, issue of the Texas Register (45 TexReg 4163). The rules will not be republished.SECTION-BY-SECTION SUMMARYA description of all changes made to the rules is included in this week’s edition of the Texas Register (45 Tex Reg 5660).
Texas Board of Occupational Therapy Examiners
Adopted Rules
Amending 40 TAC §367.1 to require human trafficking prevention training as a condition of licensure
CHAPTER 367. CONTINUING EDUCATION40 TAC §367.1OVERVIEWThe Texas Board of Occupational Therapy Examiners adopts amendments to 40 Texas Administrative Code §367.1, Continuing Education. The amendments are adopted to add requirements concerning training on the prevention of human trafficking pursuant to House Bill 2059 of the 86th Regular Legislative Session in 2019. The amendments are adopted without changes to the proposed text as published in the June 19, 2020, issue of the Texas Register (45 TexReg 4166). The rule will not be republished.BACKGROUND AND JUSTIFICATIONHouse Bill 2059 requires that a health care practitioner successfully complete a training course on human trafficking prevention approved by the executive commissioner of the Health and Human Services Commission as a condition for license renewal. The Bill defines “health care practitioner” as an individual who provides direct patient care. The amendments to §367.1 and adopted amendments to other chapters of the Board rules will require the completion of human trafficking prevention training as condition for license renewal for all occupational therapy licensees. The amendments also pre-approve up to two contact hours for a human trafficking prevention training course and will allow a specific training course to be repeated for credit during a subsequent renewal period.
Texas Board of Occupational Therapy Examiners
Adopted Rules
Amending 40 TAC §370.2 and §370.3 to increase the efficiency of license-renewal processes, including through the use of digital technology
CHAPTER 370. LICENSE RENEWAL40 TAC §370.2, §370.3OVERVIEWThe Texas Board of Occupational Therapy Examiners adopts amendments to 40 Texas Administrative Code §370.2, Late Renewal, and §370.3, Restoration of a Texas License. The amendments are adopted to support the Board in streamlining and increasing the efficiency of its licensing processes, including through the use of digital technology, and reduce potential burdens for applicants. The amendments also cleanup and modify requirements for the renewal of an expired license and add human trafficking prevention training requirements pursuant to House Bill 2059 of the 86th Regular Legislative Session in 2019. The amendments are adopted without changes to the proposed text as published in the June 19, 2020, issue of the Texas Register (45 TexReg 4168). The rules will not be republished.SECTION-BY-SECTION SUMMARYA description of all changes made to the rules is included in this week’s edition of the Texas Register (45 Tex Reg 5661).
Texas Board of Occupational Therapy Examiners
Adopted Rules
Amending 40 TAC §371.1 and §371.2 to to increase the efficiency of inactive and retired status licensing determinations, including through the use of digital technology
CHAPTER 371. INACTIVE AND RETIRED STATUS40 TAC §371.1, §371.2OVERVIEWThe Texas Board of Occupational Therapy Examiners adopts amendments to 40 Texas Administrative Code §371.1, Inactive Status, and §371.2, Retired Status. The amendments to the sections are adopted to cleanup and clarify the sections and to reduce the requirements to initiate retired status. In addition, amendments to §371.2 are adopted to add requirements concerning training on the prevention of human trafficking pursuant to House Bill 2059 of the 86th Regular Legislative Session in 2019. Cleanups and clarifications to the sections include amendments to provisions concerning fees to add greater uniformity and clarity to the manner in which such are referenced. The amendments are adopted without changes to the proposed text as published in the June 19, 2020, issue of the Texas Register (45 TexReg 4172). The rules will not be republished.SECTION-BY-SECTION SUMMARYA description of all changes made to the rules is included in this week’s edition of the Texas Register (45 Tex Reg 5662).
Texas Department of Licensing and Regulation
Notices
Rule Review: The Department will review 16 TAC, Chapter 120 (Licensed Dyslexia Therapists and Licensed Dyslexia Practitioners) and consider for re-adoption, revision, or repeal
OVERVIEWThe Texas Department of Licensing and Regulation (Department) files this notice of intent to review and consider for re-adoption, revision, or repeal, Title 16, Texas Administrative Code, Chapter 120, Licensed Dyslexia Therapists and Licensed Dyslexia Practitioners. This review and consideration is being conducted in accordance with the requirements of Texas Government Code, §2001.039.An assessment will be made by the Department as to whether the reasons for adopting or readopting these rules continue to exist. Each rule will be reviewed to determine whether it is obsolete, whether the rule reflects current legal and policy considerations, and whether the rule reflects current procedures of the Department.PUBLIC COMMENTAny questions or written comments pertaining to this rule review may be submitted electronically on the Department’s website at https://ga.tdlr.texas.gov:1443/form/gcerules; by facsimile to (512) 475-3032; or by mail to Monica Nuñez, Legal Assistant, Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711. The deadline for comments is 30 days after publication in the Texas Register.Any proposed changes to these rules as a result of the rule review will be published in the Proposed Rule Section of the Texas Register. The proposed rules will be open for public comment prior to final adoption or repeal by the Department in accordance with the requirements of the Administrative Procedure Act, Texas Government Code, Chapter 2001.
Texas Board of Occupational Therapy Examiners
Notices
Following rule review, the Board readopts 40 TAC §367.4 (Process for Selecting a Peer Organization to Evaluate and Approve Continuing Education Courses)
The Texas Board of Occupational Therapy Examiners adopts the review of 40 Texas Administrative Code §367.4, Process for Selecting a Peer Organization to Evaluate and Approve Continuing Education Courses, in accordance with Texas Government Code §2001.039. The notice of intent to review §367.4, along with all other sections of the Board’s rules, was published in the March 20, 2020, issue of the Texas Register (45 TexReg 2055).The Board has assessed whether the reasons for adopting §367.4 continue to exist. As a result of the review, the Board finds the reasons for adopting the rule continue to exist and readopts the rule in accordance with the requirements of Texas Government Code §2001.039.
Texas Health and Human Services Commission
In Addition
HHSC has requested an amendment to the Youth Empowerment Services waiver to extend CPR and First Aid certifications until in-person classes become available
OVERVIEWBecause of the public health emergency resulting from COVID-19, the Health and Human Services Commission (HHSC) submitted a request to the Centers for Medicare & Medicaid Services (CMS) for an amendment to the Youth Empowerment Services (YES) waiver administered under §1915(c) of the Social Security Act through an Appendix K.HHSC has requested approval to allow CPR and First Aid certification of existing service providers to extend past the date the certification expires until in-person CPR and First Aid classes are available for the service providers to attend. Allowing this flexibility will help ensure a sufficient number of service providers and continuity of care for the individuals in the YES waiver. Because the situation is evolving, HHSC will determine the most appropriate timeframe for ending each change, which may be before the public health emergency ends. The proposed effective date for this amendment is March 13, 2020.ADDITIONAL INFORMATIONAdditionally, the state is working under the authority of the blanket waivers given by CMS. https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdfCMS has determined that public notice requirements normally applicable under 1915(c) do not apply to information contained in an Appendix K. Therefore, states applying for COVID-19 §1915 (c) Appendix K amendments are not required to conduct a public notice and input process.A free copy of the proposed request can be obtained and additional questions can be answered by HHSC. Contact information is listed in this week’s edition of the Texas Register (45 Tex Reg 5680).
Texas Health and Human Services Commission
In Addition
HHSC has requested to implement flexibilities regarding the inpatient hospital spell-of-illness limitation under the Texas Healthcare Transformation Quality Improvement Program
OVERVIEWDue to the public health emergency resulting from the impact of COVID-19 on the State of Texas, the state requests, via submission of the COVID-19 Section 1115 (a) Demonstration Application Template, waiver or modification of certain requirements outlined in the Texas Healthcare Transformation Quality Improvement Program Waiver (THTQIP-11-W-00278-6) and the Texas Medicaid State Plan. HHSC requests approval from the Centers for Medicare & Medicaid Services (CMS) to implement the following flexibilities related to the inpatient hospital spell of illness limitation:For inpatient hospital stays related to COVID-19, the state requests to extend the 30-day spell of illness limitation in STAR+PLUS for an additional 30 days, allowing an individual to stay up to 60 days in a hospital.For inpatient hospital stays related to COVID-19, the state also requests to extend the 30-day spell of illness limitation described in the State Plan for an additional 30 days to allow an individual to stay up to 60 days in a hospital. Additionally, for COVID-19 related stays, the state requests to allow an individual to exceed the $200,000 inpatient hospital benefit limitation outlined in the State Plan.ADDITIONAL INFORMATIONAdditionally, the state is working under the authority of the blanket waivers given by CMS. HHSC is requesting that these waivers and modifications become effective at the earliest possible date and be retroactive in Texas to the date of March 13, 2020.Pursuant to 42 CFR 431.416(g), CMS has determined that the existence of unforeseen circumstances resulting from the COVID-19 public health emergency warrants an exception to the normal state and federal public notice procedures to expedite a decision on a proposed COVID-19 section 1115 demonstration. States applying for a COVID-19 section 1115 demonstration are not required to conduct a public notice and input process.A free copy of the proposed waiver amendment can be obtained and additional questions can be answered by HHSC. Contact information is listed in this week’s edition of the Texas Register (45 Tex Reg 5680).
Texas Department of Licensing and Regulation
In Addition
The Department has corrected a typographical error made when it published adopted amendments to 16 TAC §121.75, relating to the Code of Ethics for Behavior Analysts
The Texas Department of Licensing and Regulation (TDLR) adopted amendments to 16 TAC §121.75, relating to the Code of Ethics for Behavior Analysts, in the July 24, 2020, issue of the Texas Register (45 TexReg 5192). The amendments were noted as being adopted without changes from the proposed rulemaking that was published in the February 21, 2020, issue of the Texas Register (45 TexReg 1161). Due to an error by TDLR, the existing text of subsection (a) paragraphs (1) and (2) was omitted from both the proposed rulemaking as well as the adopted rulemaking.The complete text of subsection (a) should include paragraphs (1) and (2) and should read as follows:(a) Individuals certified by the BACB are required to comply with the BACB Professional and Ethical Compliance Code for Behavior Analysts.(1) The department may consult the requirements of the certifying entity or the BACB Professional and Ethical Compliance Code for Behavior Analysts in the application and enforcement of the ethical standards included in this section.(2) The department will apply the requirements of this section consistent with the requirements, guidance, and interpretations of the certifying entity unless an alternate interpretation is reasonably necessary or required.