Texas Register August 27, 2021 Volume: 46 Number: 35

Texas Register Table of Contents

1 Texas Department of Licensing and Regulation
- - 1.0.1 Emergency Rules Re:
2 Health and Human Services Commission
3 Texas Board of Physical Therapy Examiners
- - 3.0.1 Proposed Rules Re:
    - 3.0.1.1 Amending 22 TAC §322.1 to allow certain physical therapists to treat patients for fifteen (15) consecutive business days before requiring a referral from a qualified healthcare practitioner.
    - 3.0.1.2 Amending 22 TAC §329.7 to update licensing exemption procedures.
4 Texas Optometry Board
- - 4.0.1 Adopted Rules Re:
    - 4.0.1.1 Amending 22 TAC §279.16 to allow for remote treatment and examination of certain patients.

Texas Department of Licensing and Regulation

Emergency Rules Re:

Amending 16 TAC §§111.2, 111.41, 111.50, 111.51, 111.91, 111.92, 111.210-111.212, 111.215, and 111.230-111.232 to update requirements for telehealth services for speech-language pathologists and audiologists.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
16 TAC §§111.2, 111.41, 111.50, 111.51, 111.91, 111.92, 111.210-111.212, 111.215, and 111.230-111.232

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission) adopts the emergency amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter E, §111.41; Subchapter F, §111.50 and §111.51; Subchapter J, §111.91 and §111.92; Subchapter V, §§111.210-111.212 and §111.215; and Subchapter X, §§111.230-111.232. The effective date for these emergency amendments and repeals (emergency rules) is September 1, 2021.

A section-by-section summary can be found at 46 Tex Reg 5315-5325.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists, and Chapter 51, the enabling statute of the Commission and the Texas Department of Licensing and Regulation (Department).

Repealing 16 TAC §§111.213 and 111.216 to update telehealth requirements for speech-language pathologists and audiologists.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
16 TAC §§111.213, 111.216

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission) adopts the emergency repeal of existing rules at Subchapter V, §111.213 and §111.216, regarding the Speech-Language Pathologists and Audiologists program. The effective date for these emergency amendments and repeals (emergency rules) is September 1, 2021.

A section-by-section summary can be found at 46 Tex Reg 5315-5325.

BACKGROUND AND JUSTIFICATION

Amending 16 TAC §112.150 to update requirements for the fitting and dispensing of hearing instruments via telehealth.

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER P. FITTING AND DISPENSING OF HEARING INSTRUMENTS BY TELEHEALTH
16 TAC §112.150

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission) adopts the emergency amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter P, §112.150, regarding the Hearing Instrument Fitters and Dispensers program. The effective date for these emergency amendments (emergency rule) is September 1, 2021.

A section-by-section summary can be found at 46 Tex Reg 5327.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers, and Chapter 51, the enabling statute of the Commission and the Texas Department of Licensing and Regulation (Department).

Health and Human Services Commission

Emergency Rules Re:

Renewing 26 TAC §§500.41 – 500.44 to adjust requirements for chemical dependency treatment facilities to address staff shortages, lower the risk of COVID-19 transmission, and reduce barriers for patients seeking treatment.

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES
26 TAC §§500.41 – 500.44

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §§500.41 – 500.44 for a 60-day period. The text of the emergency rule was originally published in the April 30, 2021, issue of the Texas Register (46 Tex Reg 2871).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 26 Texas Administrative Code, Chapter 500 COVID-19 Emergency Health Care Facility Licensing, new §500.41, concerning an emergency rule on telemedicine and telehealth in order to reduce the risk of transmission of COVID-19; new §500.42, concerning an emergency rule on maximum caseloads in order to permit an intensive residential program in a chemical dependency treatment facility (CDTF) to temporarily increase counselor caseloads to 20 clients per counselor; new §500.43, concerning an emergency rule on service delivery via two-way, real-time internet or telephone communications in order to reduce the risk of transmission of COVID-19; and new §500.44, concerning an emergency rule on treatment planning and service provision documentation deadlines in order to provide CDTFs additional time to document service delivery, as counselor caseloads may have increased in intensive residential treatment programs in response to the COVID-19 pandemic.

HHSC is renewing emergency rules to temporarily adjust CDTF operational requirements to: (1) permit a licensed CDTF to provide telehealth and telemedicine treatment services to clients in order to reduce the risk of transmission of COVID-19; (2) permit an intensive residential program in a CDTF to increase counselor caseloads from 10 to 20 clients per counselor due to CDTF staff shortages; (3) permit a licensed CDTF to provide treatment services through two-way, real-time internet or telephone communications to clients in order to reduce the risk of transmission of COVID-19; and (4) extend treatment planning and service provision documentation deadlines to provide CDTFs additional time to document service delivery, as counselor caseloads may have increased in intensive residential treatment programs. These emergency rules will address staff shortages, reduce the risk of transmission of COVID-19, and reduce barriers to treatment for patients seeking treatment for substance use disorders and chemical dependency.

BACKGROUND AND JUSTIFICATION

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 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 these emergency rules.

Renewing 26 TAC §500.51 to permit virtual supervision of licensed chemical dependency counselor interns.

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER E. LICENSED CHEMICAL DEPENDENCY COUNSELORS
26 TAC §500.51

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §500.51 for a 60-day period. The text of the emergency rule was originally published in the April 30, 2021, issue of the Texas Register (46 Tex Reg 2873).

HHSC is renewing an emergency rule to temporarily permit: (1) counselor interns with more than 1,000 hours of supervised work experience to provide services in person or through two-way, real-time internet or telephone communications; (2) supervisors of LCDC interns with less than 2,000 hours of supervised work experience to provide supervision in person or through two-way, real-time internet or telephone communications; and (3) a certified clinical supervisor, or the clinical training institution coordinator or intern’s supervising qualified credentialed counselor at a clinical training institution, to provide supervision to a counselor intern using two-way, real-time internet or telephone communications to observe and document the intern performing assigned activities and to provide and document one hour of face-to-face individual or group supervision. This emergency rule will address staff shortages, reduce the risk of transmission of COVID-19, and reduce barriers to treatment for patients seeking treatment for substance use disorders and chemical dependency.

BACKGROUND AND JUSTIFICATION

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 Supervision of LCDC Interns During the COVID-19 Pandemic.

New 26 TAC §551.48, requiring intermediate care facilities for individuals with an intellectual disability to report COVID-19 vaccination status of staff and other individuals in the facility.

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
SUBCHAPTER C. STANDARDS FOR LICENSURE
26 TAC §551.48

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Part 1, Texas Administrative Code, Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, Subchapter C, new §551.48, concerning ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement. HHSC is adopting this emergency rule to track vaccinations of staff and residents in intermediate care facilities in Texas in response to COVID-19. 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.

HHSC is adopting an emergency rule to require ICF/IID to report COVID-19 vaccinations of staff and individuals in ICF/IID and to require enrollment for the emergency communication system. The emergency rule describes the requirements related to such reporting and enrollment.

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.

Adopted Rules Re:

Amending 1 TAC §353.4 to set forth reimbursement methodology for a Medicaid health care MCO to pay out-of-network specialty providers performing certain services.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER A. GENERAL PROVISIONS
1 TAC §353.4

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §353.4, concerning Managed Care Organization Requirements Concerning Out-of-Network Providers.

The amendment to §353.4 is adopted without changes to the proposed text as published in the February 12, 2021, issue of the Texas Register (46 Tex Reg 997), and therefore will not be republished.

The amendment to §353.4 adds new subsection (d) which sets forth the reimbursement methodology for a Medicaid health care MCO to pay out-of-network specialty providers performing services in accordance with new §353.7. The amendment also reformats the section and updates references.

BACKGROUND AND JUSTIFICATION

The adopted rule implements Texas Government Code, §533.038(g), added by Senate Bill (S.B.) 1207, 86th Legislature, Regular Session, 2019. S.B. 1207 requires HHSC to establish a process for a Medicaid health care managed care organization (MCO) to allow a member with complex medical needs, who has established a relationship with a specialty provider through the member’s primary health benefit plan, to continue receiving care from that specialty provider, whether or not that provider is in the health care MCO’s network.

New 1 TAC §353.7, imposing requirements on Medicaid health care MCOs relating to certain out-of-network specialty providers.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER A. GENERAL PROVISIONS
1 TAC §353.7

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new §353.7, concerning Coordination of Benefits with Primary Health Insurance Coverage in Title 1, Part 15, Chapter 353, Medicaid Managed Care.

New §353.7 is adopted without changes to the proposed text as published in the February 12, 2021, issue of the Texas Register (46 Tex Reg 997), and therefore will not be republished.

New §353.7 sets forth the requirements imposed on Medicaid health care MCOs relating to certain out-of-network specialty providers. Subsection (a) clarifies that the rule applies to a member age 20 or younger who has complex medical needs and who has and maintains health care coverage under a primary health benefit plan. Subsection (b) defines “primary health benefit plan” in a manner consistent with Texas Human Resources Code, §32.0422(a). Subsection (c) defines “complex medical needs.” Subsection (d) defines “specialty provider” in a manner consistent with the specialty provider list already established in Chapter 3.1 of the Uniform Managed Care Manual (UMCM). Subsection (e) requires a health care MCO to utilize the reasonable reimbursement methodology for authorized services performed by out-of-network providers described in renumbered §353.4(f)(2) (previously §353.4(d)(2)), until: (1) an alternate reimbursement agreement is reached with the member’s specialty provider; (2) the member is no longer enrolled in a primary health benefit plan; (3) the member or the member’s legally authorized representative agree to select an alternate specialty provider; or (4) the member is no longer enrolled in the health care MCO.

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §§303.101 – 303.102 to update general provisions relating to preadmission screening and resident review (PASRR).

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §§303.101 – 303.102

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts in Texas Administrative Code (TAC), Title 26, Part 1, amendments to Chapter 303, concerning Preadmission Screening and Resident Review (PASRR), §§303.101 and 303.102.

Sections 303.101 and 303.102 are adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the amendments is to describe the new responsibilities of local intellectual and developmental disability authorities (LIDDAs) regarding intellectual and developmental disabilities (IDD) habilitative specialized services. The amendments make the requirements in Chapter 303 consistent with new rules currently being developed for IDD habilitative specialized services in Chapter 368 (Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services).

HHSC is also clarifying definitions, updating TAC references, adopting person-first respectful language, incorporating the abbreviation for IDD habilitative specialized services (IHSS) and nursing facility (NF), revising certain responsibilities of the LIDDA, local mental health authority (LMHA), and local behavioral health authority (LBHA) related to PASRR, clarifying and updating training requirements, and revising requirements of a LIDDA regarding transition planning.

New 26 TAC §303.103, allowing an individual seeking admission to a NF, a resident, or an individual’s or resident’s LAR to request a fair hearing to appeal certain PASRR level II evaluations.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §303.103

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts in Texas Administrative Code (TAC), Title 26, Part 1, new §303.103.

Section 303.103 are adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). This rule will not be republished.

Section 303.103, Fair Hearing Process, is deleted and replaced with a new §303.103, concerning fair hearing process for PASRR determination and specialized services. The new section permits an individual seeking admission to a NF, a resident, or an individual’s or resident’s LAR to request a fair hearing to appeal a PASRR level II evaluation (PE) that is negative for intellectual disability (ID), developmental disability (DD), or MI; a denial of a specialized service; or the reduction, suspension, or termination of an IHSS or MI specialized service. The new §303.103 also clarifies that the LIDDA, LMHA, LBHA, service provider agency, or NF, as applicable, must ensure the provision of the specialized service if the hearing officer reverses a denial, reduction, or termination of that specialized service.

BACKGROUND AND JUSTIFICATION

The purpose is to describe the new responsibilities of local intellectual and developmental disability authorities (LIDDAs) regarding intellectual and developmental disabilities (IDD) habilitative specialized services. The new section makes the requirements in Chapter 303 consistent with new rules currently being developed for IDD habilitative specialized services in Chapter 368 (Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services).

Amending 26 TAC §§303.201 – 303.204 to clarify the preadmission screening and resident review (PASSR) screening and evaluation process.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER B. PASRR SCREENING AND EVALUATION PROCESS
26 TAC §§303.201 – 303.204

OVERVIEW

Sections 303.201 – 303.204 are adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will not be republished.

The amendments to §§303.201, Preadmission Process, 303.203, Admission Process for Exempted Hospital Discharge, 303.301, Referring Entity Responsibilities Related to the PASRR Process, 303.401, Reimbursement for a PE or Resident Review, and 303.701, Transition Planning for a Designated Resident, replace references to a nursing facility with the abbreviation “NF.”

The amendment to §303.202, Expedited Admission Process, clarifies the expedited admission process.

The amendment §303.204, Resident Review Process, clarifies when a LIDDA, LMHA, or LBHA must conduct a resident review as a result of a change in condition of a resident with MI, ID, or DD.

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §§303.301 – 303.302 to update responsibilities for preadmission screening and resident review.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER C. RESPONSIBILITIES
26 TAC §§303.301 – 303.302

OVERVIEW

Sections 303.301 and 303.302, are adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will not be republished.

The amendment to §303.301, Referring Entity Responsibilities Related to the PASRR Process replaces references to a nursing facility with the abbreviation “NF.”

The amendment to §303.302, LIDDA, LMHA, and LBHA Responsibilities Related to the PASRR Process, adds and revises responsibilities for the LIDDA, LMHA, or LBHA related to the PASRR process. If a PE or resident review is positive for MI, ID, or DD, new subsection (a)(3)(A) requires the LIDDA, LMHA, or LBHA to provide the individual seeking admission, resident, or LAR with a summary of the results of the PE or resident review. If a PE or resident review is negative for MI, ID, or DD, new subsection (a)(3)(B) requires the LIDDA, LMHA, or LBHA to provide the individual seeking admission, resident, or LAR notice of the right to a fair hearing. Amended subsection (c)(1) revises the responsibilities of the LIDDA, LMHA, or LBHA to require the LIDDA, LMHA, or LBHA to coordinate with the NF to schedule the interdisciplinary team (IDT) meeting, to confirm in the long-term care online portal participation in the IDT meeting and the specialized services recommended, and initiate and provide MI specialized services rather than both MI specialized services and IHSS. New subsection (d) requires the LIDDA, LMHA, or LBHA to develop a written policy to address challenges related to a designated resident’s, resident with MI’s, or LAR’s participation in receiving IHSS or MI specialized services. New subsections (e) and (f) require the LIDDA, LMHA, or LBHA to inform a designated resident, resident with MI, or LAR orally and in writing of the processes for filing complaints. New subsection (g) states that the LIDDA is responsible for coordinating with the NF to schedule the IDT meeting for an individual seeking admission to a NF or a resident whose PE or resident review is positive for MI and ID or MI and DD.

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §303.303 to describe responsibilities for preadmission screening and resident review for certain intellectual and developmental disability authorities.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER C. RESPONSIBILITIES
26 TAC §303.303

OVERVIEW

Section 303.303 is adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). This rule will be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the amendment is to describe the new responsibilities of local intellectual and developmental disability authorities (LIDDAs) regarding intellectual and developmental disabilities (IDD) habilitative specialized services. The amendment makes the requirements in Chapter 303 consistent with new rules currently being developed for IDD habilitative specialized services in Chapter 368 (Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services).

Amending 26 TAC §303.401 to clarify vendor payments for preadmission screening and resident review.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER D. VENDOR PAYMENT
26 TAC §303.401

OVERVIEW

Section 303.401 is adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). This rule will not be republished.

The amendment to §303.401, Reimbursement for a PE or Resident Review, clarifies that a LIDDA’s, LMHA’s, or LBHA’s payment for a PE or resident review includes assisting with the selection of another NF that will certify it can meet the needs of an individual seeking admission to a NF or resident with ID, DD, or MI when the original NF refuses to do so.

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §§303.501, 303.502, 303.504 to update training and documentation requirements for preadmission screening and resident review for local intellectual and developmental disability authorities.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER E. HABILITATION COORDINATION
26 TAC §§303.501, 303.502, 303.504

OVERVIEW

Sections 303.501 and 303.504 are adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will not be republished.

Section 303.502 is adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). This rule will be republished.

The amendment to §303.502, Required Training for a Habilitation Coordinator, updates the required training for a habilitation coordinator to include training on other HHSC rules affecting the LIDDA and on community support services and removes the requirement for person-centered thinking training to be approved by HHSC.

The amendment to §303.504, Documentation Maintained by a LIDDA in a Designated Resident’s Record, updates the required documentation that must be maintained by a LIDDA in a designated resident’s record to include the current plan of care and an implementation plan for each IHSS that appears on the plan of care. It also clarifies that the documentation of the designated resident’s progress or lack of progress must reflect the designated resident’s and LAR’s perspectives.

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §§303.601 – 303.602 to clarify rules relating to habilitative service planning for a designated resident.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER F. HABILITATIVE SERVICE PLANNING FOR A DESIGNATED RESIDENT
26 TAC §§303.601 – 303.602

OVERVIEW

Sections 303.601 and 303.602 are adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will be republished.

BACKGROUND AND JUSTIFICATION

New 26 TAC §303.603 to describe habilitation coordination for a designated resident receiving IDD habilitative specialized services (IHSS).

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER F. HABILITATIVE SERVICE PLANNING FOR A DESIGNATED RESIDENT
26 TAC §303.603

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts in Texas Administrative Code (TAC), Title 26, Part 1, adopts new §303.603.

Section 303.603 is adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 TexReg 2314). This rule will not be republished.

New §303.603, Habilitation Coordination for a Designated Resident Receiving IHSS, describes habilitation coordination for a designated resident receiving IHSS. The section requires the habilitation coordinator to facilitate the coordination of the designated resident’s plan of care; assist a designated resident, LAR, or actively involved person in exercising the legal rights of the designated resident as a citizen and as a person with a disability; provide a designated resident, LAR, or family member with a written and oral explanation of the rights of a designated resident receiving IHSS; document the explanation of rights and ensure that the documentation is signed by the designated resident or LAR and the habilitation coordinator; immediately notify the NF and service provider agency if the habilitation coordinator becomes aware of an emergency that impacts the designated resident’s health or safety; be objective in assisting a designated resident or LAR in selecting a service provider agency; ensure that a designated resident, LAR, and service provider agency are informed of the name of the designated resident’s habilitation coordinator and how to contact the habilitation coordinator; and give the service provider agency a copy of the NF baseline care plan or NF comprehensive care plan. If the habilitation coordinator identifies a concern with the implementation of the plan of care, the habilitation coordinator must also ensure the concern is communicated to the service provider agency and attempts are made to resolve the concern.

BACKGROUND AND JUSTIFICATION

The purpose of the amendments, new sections, and repeal is to describe the new responsibilities of local intellectual and developmental disability authorities (LIDDAs) regarding intellectual and developmental disabilities (IDD) habilitative specialized services. The amendments, new sections, and repeal make the requirements in Chapter 303 consistent with new rules currently being developed for IDD habilitative specialized services in Chapter 368 (Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services).

Amending 26 TAC §303.701 and §303.703 to update rules relating to transition planning for certain local intellectual and developmental disability authorities.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER G. TRANSITION PLANNING
26 TAC §303.701, §303.703

OVERVIEW

Section 303.703 is adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 TexReg 2314). This rule will be republished.

Section 303.701 is adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). This rule will not be republished.

The amendment to §303.701, Transition Planning for a Designated Resident, replaces references to a nursing facility with the abbreviation “NF.”

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §303.801 to update compliance review requirements for local intellectual and developmental disability authorities.

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER H. COMPLIANCE REVIEW
26 TAC §303.801

OVERVIEW

Section 303.801 is adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 TexReg 2314). This rule will be republished.

BACKGROUND AND JUSTIFICATION

New 26 TAC §§303.901 – 303.913 describe the requirements of an LMHA and LBHA regarding specialized services for individuals with mental illness (MI).

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
SUBCHAPTER I. MI SPECIALIZED SERVICES
26 TAC §§303.901 – 303.913

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts in Texas Administrative Code (TAC), Title 26, Part 1, adopts new Subchapter I, concerning MI Specialized Services, §§303.901 – 303.913, and the repeal of §303.103.

Sections 303.901, 303.906, 303.908, and 303.912 are adopted with changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will be republished.

Sections 303.902 – 303.905, 303.907, 303.909 – 303.911, 303.913, and the repeal of 303.103 are adopted without changes to the proposed text as published in the April 9, 2021, issue of the Texas Register (46 Tex Reg 2314). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

Finally, a new subchapter and related provisions are added to this chapter. The new subchapter and related provisions describe the requirements of an LMHA and LBHA regarding specialized services for individuals with mental illness (MI) in accordance with 42 Code of Federal Regulations (CFR) §483.120 and the Performance Contracts with the LMHAs and LBHAs.

In Addition Re:

Public Notice – Texas State Plan for Medical Assistance Amendment effective February 1, 2022

OVERVIEW

The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendment is effective February 1, 2022.

BACKGROUND AND JUSTIFICATION

The purpose of this amendment (transmittal number 21-0002) is to implement Texas General Appropriations Act Rider 28, Article II, Senate Bill 1 for the 2022-23 Biennium, which appropriated funds for applied behavioral analysis (ABA) services for autism. This amendment clarifies the coverage of certain early and periodic screening, diagnostic, and treatment (EPSDT) services for children and youth with a diagnosis of autism spectrum disorder (ASD); HHSC is also identifying the provider types eligible to deliver the services. Additionally, this amendment will update the reimbursement methodology and/or the fee schedules in the current state plan by adjusting fees, rates, or charges for these services.

ABA services will be covered as an EPSDT service to the extent required by 42 U.S.C. 1396a(a)(43). ABA services for Medicaid-enrolled children/youth with a diagnosis of ASD will include: behavior identification assessment; individual and group treatment by protocol; individual and group treatment with protocol modification; family treatment guidance; and the related service of treatment team conferences.

Providing ABA services will allow HHSC to expand the array of services available for the treatment of individuals with a diagnosis of ASD. ABA services will be provided using an interdisciplinary model of care, which will include participation of the individual and their parent/caregiver and will ensure the coordination of care for the individual.

These services may be provided by Texas-licensed Licensed Behavior Analysts (LBAs), by Texas-licensed Licensed Assistant Behavior Analysts (LaBAs), and by authorized nationally-certified or registered behavior technicians (BTs). Only LBAs will enroll in Medicaid to provide these services, and they will submit for reimbursement on behalf of the LaBAs and BTs they supervise.

HEARING DETAILS

A rate hearing was conducted online on March 16, 2021, at 9:00 a.m. Information about the proposed rate changes and the hearing were published in the February 19, 2021, issue of the Texas Register (46 Tex Reg 1300-1301). The notice of hearing can be found at http://www.sos.state.tx.us/texreg/index.shtml.

Interested parties may obtain additional information and/or a free copy of the proposed amendment by contacting Holly Freed, State Plan Policy Advisor, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by telephone at (512) 487-3349; by facsimile at (512) 730-7472; or by e-mail at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us. Copies of the proposed amendment will be available for review at the local county offices of HHSC, which were formerly the local offices of the Texas Department of Aging and Disability Services.

Texas Board of Physical Therapy Examiners

Proposed Rules Re:

Amending 22 TAC §322.1 to allow certain physical therapists to treat patients for fifteen (15) consecutive business days before requiring a referral from a qualified healthcare practitioner.

CHAPTER 322. PRACTICE
22 TAC §322.1

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending §322.1(a), concerning Initiation of physical therapy services, pursuant to HB 1363 amendments to Sec. 453.301, Occupations Code during the 87th Legislative Session.

BACKGROUND AND JUSTIFICATION

The amendment is proposed in order to include physical therapists who have a doctoral degree in physical therapy and are certified by an entity approved by the PT Board in the group that can treat patients for fifteen (15) consecutive business days before requiring a referral from a qualified healthcare practitioner.

Amending 22 TAC §329.7 to update licensing exemption procedures.

CHAPTER 329. LICENSING PROCEDURE
22 TAC §329.7

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending §329.7. Exemptions from Licensure pursuant to HB 139 amendment of Sec. 55.0041. RECOGNITION OF OUT-OF-STATE LICENSE OF MILITARY SPOUSE to Chapter 55, Occupations Code during the 87th Legislative Session.

BACKGROUND AND JUSTIFICATION

The amendment is proposed in order to include providing a copy of the permanent change of station order for the military service member to whom the spouse is married to the proof of residency requirement.

Texas Optometry Board

Adopted Rules Re:

Amending 22 TAC §279.16 to allow for remote treatment and examination of certain patients.

CHAPTER 279. INTERPRETATIONS
22 TAC §279.16

At the July 30, 2021 meeting of the Texas Optometry Board, the Board moved unanimously to adopt amended Board Rule §279.16 with a minor change to the proposed text published in the March 5, 2021 issue of the Texas Register (46 Tex Reg 1454). This adopted amendment to §279.16 Telehealth Services allows the remote treatment and examination of patients as authorized by amendments to Texas Occupations Code Chapter 111.