21 Aug 2020

Texas Register August 21, 2020 Volume: 45 Number: 34

by | posted in: Advisory Board of Athletic Trainers, Governor, Texas Board of Nursing, Texas Board of Occupational Therapy Examiners, Texas Board of Physical Therapy Examiners, Texas Department of Insurance, Texas Department of State Health Services, Texas Health and Human Services Commission |

Texas Register Table of Contents

Governor

 

Appointments

Governor appoints Joel B. Brock, D.N.P., to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council

Appointments for August 6, 2020Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council, for a term to expire August 31, 2021, Joel B. “Brandon” Brock, D.N.P. of Sunnyvale, Texas (replacing Darcy J. McMaughan, Ph.D. of College Station, who resigned).

Governor

Appointments

Governor appoints four new members to the Texas State Board of Acupuncture Examiners

Appointments for August 6, 2020Appointed to the Texas State Board of Acupuncture Examiners, for terms to expire January 31, 2021: Maria M. Garcia of Plano, Texas (replacing Peggy L. “Lew” Vassberg of Lyford, who resigned); and Dawn Lin of Sugar Land, Texas (replacing Claudine K. Vass of Richmond, who resigned).Appointed to the Texas State Board of Acupuncture Examiners, for terms to expire January 31, 2025: Elisabeth Lee “Ellee” Carlson, D.A.O.M. of Garland, Texas (replacing Allen D. Cline of Austin, whose term expired); and Sheri J. Davidson of Houston, Texas (replacing Rachelle L. Webb of Austin, whose term expired).

Governor

Appointments

Governor appoints Donna S. Guthery, D.A.O.M., as presiding officer of the Texas State Board of Acupuncture Examiners

Appointments for August 6, 2020Designated as presiding officer of the Texas State Board of Acupuncture Examiners, for a term to expire at the pleasure of the Governor, Donna S. Guthery, D.A.O.M. of Bellaire, Texas (Dr. Guthery is replacing Allen D. Cline of Austin).

Advisory Board of Athletic Trainers

Appointments

Governor reappoints three members to the OneStar Foundation

Appointments for August 11, 2020Appointed to the OneStar Foundation, for terms to expire March 15, 2023:George L. Green of New Braunfels, Texas (Mr. Green is being reappointed); Elexis Grimes of Cedar Park, Texas (Ms. Grimes is being reappointed); andShelley R. Rayburn of Fort Worth, Texas (Ms. Rayburn is being reappointed).

Texas Health and Human Services Commission

Emergency Rule

Renewing emergency rule 26 TAC §500.21 to update certain regulatory requirements for end stage renal disease (ESRD) facilities in response to COVID-19

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER B. END STAGE RENAL DISEASE FACILITIES26 TAC §500.21OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.21 for a 60-day period. The text of the emergency rule was originally published in the April 24, 2020, issue of the Texas Register (45 TexReg 2607).To protect current and future patients in health care facilities and the public health, safety, and welfare of the state during the COVID-19 pandemic, emergency rule §500.21 reduces barriers to treatment for dialysis patients by updating ESRD regulatory guidelines regarding staffing ratios, in-home visits, telemedicine, incident reporting, and education and training requirements for staff.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. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state exists and requires immediate adoption of this new rule to ensure that dialysis patients receive safe treatment.

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §553.2001, establishing 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 Executive Commissioner of the Health and Human Services Commission (HHSC or Commission) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities, new §553.2001, concerning an emergency rule in response to COVID-19 and requiring assisted living facility actions to mitigate and contain COVID-19.To protect assisted living facility residents and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting an 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 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 emergency rule for Assisted Living Facility COVID-19 Response.

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §553.2003, allowing limited visitation at assisted living facilities during the COVID-19 pandemic

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIESSUBCHAPTER K. COVID-19 RESPONSE26 TAC §553.2003OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities, new §553.2003, concerning an emergency rule in response to COVID-19 and permitting limited visitation in assisted living facilities. To protect assisted living facility residents and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting the emergency rule to reduce the risk of spreading the coronavirus (COVID-19) to residents. The purpose of the new rule is to describe the requirements assisted living facilities must put into place in order to be able to move to a Phase 1 reopening with limited visitation.BACKGROUND AND JUSTIFICATIONAs 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 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 Facility Response to COVID-19.

Texas Department of Insurance

Emergency Rule

Division of Workers’ Compensation renews emergency rule 28 TAC §167.1, requiring billing parity between telemedicine/telehealth services and in-person services

PART 2. TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS’ COMPENSATIONCHAPTER 167. EMERGENCY RULESSUBCHAPTER A. COVID-19 EMERGENCY RULES28 TAC §167.1OVERVIEWThe Texas Department of Insurance, Division of Workers’ Compensation is renewing the effectiveness of emergency new §167.1 for a 60-day period. The text of the emergency rule was originally published in the April 24, 2020, issue of the Texas Register (45 TexReg 2611).This emergency rule builds on the existing telemedicine and telehealth rules, as adopted by DWC and described in the section below, by creating an exception to current CMS distant site practitioner requirements. This rule allows health care providers licensed to perform physical medicine and rehabilitation services, including physical therapists, occupational therapists, and speech pathologists to bill and be reimbursed for services currently allowed under CMS telemedicine and telehealth billing codes.Health care providers must bill for telemedicine or telehealth services using the same billing, coding, reporting, and documentation requirements used for in-person services and include a place of service code “02 – telehealth” on the bill. Services will be reimbursed at DWC’s fee schedule rate or network contracted rate, whether provided in person or through telemedicine or telehealth. An originating site facility fee is not eligible for reimbursement.BACKGROUND AND JUSTIFICATIONTexas workers’ compensation allows for billing and reimbursement of certain telemedicine and telehealth services when they are available as an alternative to office-based health care. Physicians licensed in Texas provide telemedicine services. Health care professionals other than physicians, as defined in Occupations Code §111.001, provide telehealth services. 28 TAC §134.203 sets the reimbursement rates for telemedicine and telehealth services for non-network claims. For certified network claims and claims receiving telemedicine and telehealth services under Labor Code §504.053(b)(2), reimbursement rates are determined by network contracts. 28 TAC §133.30 provides health care provider procedures for billing and reimbursement of certain telemedicine and telehealth services in the Texas workers’ compensation system. Health care providers must bill for services according to Medicare payment policies and provisions in Chapters 133 and 134. Medicare policies adopted by the Division of Workers’ Compensation (DWC) do not allow or pay for a full array of physical medicine and rehabilitation services when delivered through telemedicine or telehealth. Medicare also does not currently reimburse for asynchronous telemedicine services.

Texas Department of State Health Services

Emergency Rule

New 40 TAC §19.2802, establishing 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 Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40, Texas Administrative Code, Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification, new §19.2802, concerning an emergency rule in response to COVID-19 and requiring nursing facility actions to mitigate and contain COVID-19.To protect nursing facility residents and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting 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 Department of State Health Services

Emergency Rule

New 40 TAC §19.2803, allowing limited visitation at nursing facilities during the COVID-19 pandemic

CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATIONSUBCHAPTER CC. COVID-19 EMERGENCY RULE40 TAC §19.2803OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40, Texas Administrative Code, Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification, new §19.2803, concerning an emergency rule in response to COVID-19 describing requirements for limited outdoor visitation in a facility during Phase 1.To protect nursing facility residents and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to allow limited outdoor visitation in a nursing facility during phase 1. The purpose of the new rule is to describe the requirements related to such visits.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.BACKGROUND AND PURPOSEThe 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 – Phase 1 Visitation.

Texas Health and Human Services Commission

Proposed Rules

Amending 1 TAC §355.112 to establish methodology for calculating attendant compensation rate components for HCS and TxHmL DH and respite services

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER A. COST DETERMINATION PROCESS1 TAC §355.112OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.112, concerning Attendant Compensation Rate Enhancement, for Home and Community-Based Services and Texas Home Living Programs. The proposed amendment to §355.112 adds new subsection (l)(3), which establishes the methodology for calculating the attendant compensation rate components for HCS and TxHmL DH and respite services.BACKGROUND AND JUSTIFICATIONThe purpose of the proposed amendments to §355.112 and §355.723 is to ensure compliance with the 21st Century Cures Act, which added Section 1903(l) to the Social Security Act to require that all states implement the use of electronic visit verification (EVV). Section 1903(l) requires that EVV be used for all Medicaid personal care services requiring an in-home visit by a service provider. EVV is a computer-based system that verifies that a service is provided and electronically documents information about the service visit such as the name of the individual who received the service, the name of the service provider, the date and time the service begins and ends, and the location at which the service was provided.Currently, Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) providers bill day habilitation (DH) using a service code that does not distinguish between in-home and out-of-home DH and bill respite using a service code that does not distinguish between in-home and out-of-home respite. The proposed amendments establish separate service codes for in-home and out-of-home DH and respite to allow HHSC to compare service claims for in-home DH and in-home respite with the information in the EVV aggregator regarding the provision of those services. Further, the proposed amendments establish multiple service codes for out-of-home respite based on the location in which the service is provided to allow HHSC to collect appropriate service cost and claims information. HHSC is currently working to transition HCS and TxHmL claims processing to the Texas Medicaid & Healthcare Partnership. The proposed changes to service codes will be effective when that transition is complete.

Texas Health and Human Services Commission

Proposed Rules

Amending 1 TAC §355.723 to establish reimbursement methodology for HCS and TxHmL programs serving persons with mental illness or intellectual and developmental disabilities

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER F. REIMBURSEMENT METHODOLOGY FOR PROGRAMS SERVING PERSONS WITH MENTAL ILLNESS OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY1 TAC §355.723OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.723, concerning Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs.SECTION-BY-SECTION SUMMARYThe proposed amendment to §355.723(b)(1) specifies the HCS and TxHmL DH and respite services with rates that vary by level of need (LON).The proposed amendment to §355.723(b)(2) specifies the HCS and TxHmL DH and respite services with rates that do not vary by LON.The proposed amendment to §355.723(d)(10) revises the methodology for calculating the administration and operations cost component to include HCS and TxHmL DH and respite services.The proposed amendments to §355.723(c); §355.723(d)(1) – (d)(9); and §355.723(d)(11) – (d)(12) implement clarifying edits.BACKGROUND AND JUSTIFICATIONThe purpose of the proposed amendments to §355.112 and §355.723 is to ensure compliance with the 21st Century Cures Act, which added Section 1903(l) to the Social Security Act to require that all states implement the use of electronic visit verification (EVV). Section 1903(l) requires that EVV be used for all Medicaid personal care services requiring an in-home visit by a service provider. EVV is a computer-based system that verifies that a service is provided and electronically documents information about the service visit such as the name of the individual who received the service, the name of the service provider, the date and time the service begins and ends, and the location at which the service was provided.Currently, Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) providers bill day habilitation (DH) using a service code that does not distinguish between in-home and out-of-home DH and bill respite using a service code that does not distinguish between in-home and out-of-home respite. The proposed amendments establish separate service codes for in-home and out-of-home DH and respite to allow HHSC to compare service claims for in-home DH and in-home respite with the information in the EVV aggregator regarding the provision of those services. Further, the proposed amendments establish multiple service codes for out-of-home respite based on the location in which the service is provided to allow HHSC to collect appropriate service cost and claims information. HHSC is currently working to transition HCS and TxHmL claims processing to the Texas Medicaid & Healthcare Partnership. The proposed changes to service codes will be effective when that transition is complete.

Texas Board of Physical Therapy Examiners

Proposed Rules

Amending 22 TAC §329.5 to update methods by which foreign-trained applicants may prove English language proficiency

CHAPTER 329. LICENSING PROCEDURE22 TAC §329.5The Texas Board of Physical Therapy Examiners proposes amending 22 Texas Administrative Code (TAC) §329.5, Licensing Procedures for Foreign-Trained Applicants.The amendment is proposed to update the Test of English as a Foreign Language (TOEFL) minimum standards accepted by the board as proof of English language proficiency for a foreign-trained licensure applicant. The amendment eliminates outdated scores and adds the most recent TOEFL scores adopted by the Federation of State Boards of Physical Therapy (FSBPT).

Texas Board of Physical Therapy Examiners

Proposed Rules

Amending 22 TAC §344.1 to update the schedule of administrative sanctions

CHAPTER 344. ADMINISTRATIVE FINES AND PENALTIES22 TAC §344.1The Texas Board of Physical Therapy Examiners proposes amending 22 Texas Administrative Code (TAC) §344.1 regarding changes to the Schedule of Sanctions graphic.The amendment is proposed to update the Schedule of Sanctions graphic by removing the sanctions for not registering a physical therapy facility and practicing in an unregistered physical therapy facility pursuant to the repeal of physical therapy facility registration and annual renewal pursuant to SB 317 during the 85th Legislative Session; and to add a range of fines that can be imposed per violation to each category of disciplinary action.

Texas Board of Occupational Therapy Examiners

Proposed Rules

Amending 40 TAC §374.1 to ensure consistency among language regarding monetary penalties for disciplinary action

CHAPTER 374. DISCIPLINARY ACTIONS/DETRIMENTAL PRACTICE/COMPLAINT PROCESS/CODE OF ETHICS/LICENSURE OF PERSONS WITH CRIMINAL CONVICTIONS40 TAC §374.1OVERVIEWThe Texas Board of Occupational Therapy Examiners proposes amendments to the Schedule of Sanctions Figure in 40 Texas Administrative Code §374.1, concerning Disciplinary Actions. The amendments are proposed to replace “investigative costs” with “administrative penalties” in the Schedule of Sanctions, and to update other language to make the schedule consistent with other provisions in the chapter.SECTION-BY-SECTION SUMMARY Changes to the Schedule of Sanctions include replacing investigative costs with administrative penalties. The Occupational Therapy Practice Act, Texas Occupations Code §454.3521, authorizes the Board to impose an administrative penalty for a violation of the chapter or a rule adopted under the chapter. The proposed amendments to the Schedule of Sanctions Figure in §374.1 will impose administrative penalties, not to exceed $200 for each day a violation continues or occurs, to the “Minimum Discipline,” “Intermediate Discipline,” and “Maximum Discipline” levels per §454.3521. The graduated penalty amounts are assessed based on the severity and type of violation per §454.3025(a).Additional changes to the Schedule of Sanctions include updating citations to the “OT Act/Rule” column. The changes also include removing from the “Failed to Properly Renew a License” violation the reference to §367.1(b) and replacing such with a reference to the full §367.1, concerning continuing education, as further provisions in the section concern the violation. Such a change, concomitantly, will ensure that the schedule’s reference to the section remains intact in the event that changes to the lettering of the section’s provisions are made.An additional cleanup removes the phrase “until conditions are met or indefinitely” from the “Maximum Discipline” column, with regard to the revocation or surrender of a license. The change is made to reflect that the administrative penalty assessed in an order is fixed, not indefinitely cumulative.A further change to the section concerns removing from the “Minimum Discipline” and “Intermediate Discipline” columns the extraneous term “provisional” when it precedes “restricted practice.” The removal is a cleanup to increase consistency in the schedule, as in other areas of the schedule, just the phrase “restricted practice” is employed for an equivalent sanction. A further change to the section involves a cleanup to correct “licensee” to “license.”

Texas Board of Nursing

Adopted Rules

Amending 22 TAC §217.4 to expand the scope of credentialing services that may be used by a foreign-trained applicant

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.4OVERVIEWThe Texas Board of Nursing (Board) adopts amendments to §217.4, relating to Requirements for Initial Licensure by Examination for Nurses Who Graduate from Nursing Education Programs Outside of United States’ Jurisdiction, without changes to the proposed text as published in the March 20, 2020, issue of the Texas Register (45 TexReg 1941). The rule will not be republished.BACKGROUND AND JUSTIFICATION Rule 217.4 addresses applicants who graduated from nursing education programs outside the United States’ jurisdiction and are seeking initial nurse licensure by examination in Texas. Under the current rule, these applicants must provide a credential evaluation service full education course-by-course report from the Commission on Graduates of Foreign Nursing Schools, the Educational Records Evaluation Service, or the International Education Research Foundation. The adopted amendments, however, eliminate the requirement that an applicant must choose from these three specific credential evaluation services traditionally recognized by the Board, and, instead, allow applicants to utilize any credential evaluation service meeting the standards adopted by the Board. This change is intended to provide additional options for applicants and additional opportunity for credential evaluation services seeking to do business in Texas.

Texas Board of Nursing

Adopted Rules

Amending 22 TAC §217.5 to expand the scope of credentialing services that may be used by an applicant for temporary licensure

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.5OVERVIEWThe Texas Board of Nursing (Board) adopts amendments to §217.5, relating to Temporary License and Endorsement, without changes to the proposed text as published in the March 20, 2020, issue of the Texas Register (45 TexReg 1944). The rule will not be republished.BACKGROUND AND JUSTIFICATION Section 217.5 addresses applicants who have been licensed in another state or Canadian province and are seeking nurse licensure by endorsement in Texas. Under the current rule, these applicants must provide a credential evaluation service full education course-by-course report from the Commission on Graduates of Foreign Nursing Schools, the Educational Records Evaluation Service, or the International Education Research Foundation. The adopted amendments, however, eliminate the requirement that an applicant must choose from these three specific credential evaluation services traditionally recognized by the Board, and, instead, allow applicants to utilize any credential evaluation service meeting the standards adopted by the Board. This change is intended to provide additional options for applicants and additional opportunity for credential evaluation services seeking to do business in Texas.

Texas Health and Human Services Commission

In Addition

Notice of public hearing on Health and Human Services System Coordinated Strategic Plan 2021-2025

OVERVIEWThe Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) will conduct a public hearing on September 1, 2020, at 1:00 p.m. Central Daylight Time, to receive stakeholder input on the Health and Human Services (HHS) Draft Strategic Planning Elements for 2021-2025.The HHS Coordinated Strategic Plan covers both health and human services agencies. Please see https://hhs.texas.gov/about-hhs/budget-planning/health-human-services-system-strategic-plans-2021-2025 for the HHS Draft Strategic Planning Elements for 2021-2025.HEARING INFORMATIONDue to the COVID-19 pandemic, this hearing will be conducted online using Microsoft Teams only. To attend the hearing, go to https://texashhsmeetings.org/HHSSP_Sept2020.There is not a physical location for this meeting.PUBLIC COMMENTInstructions for submitting public comment are detailed in this week’s edition of the Texas Register (45 Tex Reg 5979).