28 Aug 2020

Texas Register August 28, 2020 Volume: 45 Number: 35

by | posted in: Governor, Office of the Attorney General, Texas Department of Licensing and Regulation, Texas Department of State Health Services, Texas Department on Aging and Disability Services, Texas Health and Human Services Commission |

Texas Register Table of Contents

Governor

 

Appointments

Governor reappoints one member and appoints three new members to the Texas Physician Assistant Board

Appointments for August 17, 2020Appointed to the Texas Physician Assistant Board, for terms to expire February 1, 2021: Andrew W. Sauer, D.M.Sc. of Amarillo, Texas (replacing Maribel De Ponce of McAllen, who resigned); Steve S. Ahmed, M.D. of Big Spring, Texas (replacing Michael D. “Mike” Reis, M.D. of Woodway, whose term expired); Melinda A. Gottschalk of Georgetown, Texas (Ms. Gottschalk is being reappointed); Sandra Longoria, D.M.Sc. of Harlingen, Texas (replacing Teralea Davis Jones of Beeville, whose term expired).

Office of the Attorney General

Opinions

Request for Opinion #RQ-0371-KP, regarding delegation of authority from a physician to a certified registered nurse anesthetist

Briefs have been requested regarding whether Chapter 157 of the Occupation Code requires a physician to provide any level of supervision to a certified registered nurse anesthetist to whom the physician has delegated authority, and the potential liability for such delegation.Briefs should be submitted to Sherif Zaafran, M.D., President of the Texas Medical Board, at Post Office Box 2018, Austin, Texas 78768-2018. The deadline for brief submissions is September 14, 2020.

Texas Department of State Health Services

Emergency Rule

Amending 25 TAC §417.47 to require infection control training within state hospitals in response to the COVID-19 pandemic

CHAPTER 417. AGENCY AND FACILITY RESPONSIBILITIESSUBCHAPTER A. STANDARD OPERATING PROCEDURES25 TAC §417.47OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 25 Texas Administrative Code, Chapter 417, Agency and Facility Responsibilities, amended §417.47, concerning an emergency rule in response to COVID-19 to ensure necessary state hospital staffing levels and infection control training during the COVID-19 pandemic. HHSC previously adopted emergency rules concerning staff training in order to efficiently and effectively deploy staff to meet basic needs during the COVID-19 pandemic, without posing risk to the individuals served. As the COVID-19 pandemic and the Governor’s proclamation of disaster have continued, so has the need for training requirements that ensure adequate training and staffing levels at state hospitals. This emergency rule updates those training requirements to require training of infection control specific to COVID-19, including prevention, screening, isolation, and the use of personal protective equipment.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. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this standard operating procedures.

Texas Health and Human Services Commission

Emergency Rule

Renewing 26 TAC §500.41 to temporarily permit licensed Chemical Dependency Treatment Facilities to provide telehealth and telemedicine services

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES26 TAC §500.41OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.41 for a 60-day period. The text of the emergency rule was originally published in the May 1, 2020, issue of the Texas Register (45 TexReg 2772).To protect patients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC adopted this emergency rule to temporarily permit a licensed CDTF to provide telehealth and telemedicine treatment services to clients in order to reduce the risk of transmission of COVID-19, as well as to address shortages of available medical professionalsBACKGROUND AND JUSTIFICATION As authorized by 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 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 CDTF Telemedicine or Telehealth in Response to COVID-19.

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §551.46, establishing requirements for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions to mitigate and contain the spread of COVID-19

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONSSUBCHAPTER C. STANDARDS FOR LICENSURE26 TAC §551.46OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC or Commission) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, new §551.46, concerning an emergency rule for ICF/IID provider response to COVID-19 and requiring intermediate care facilities for individuals with an intellectual disability (ICF/IID) actions to mitigate and contain COVID-19.To protect individuals receiving ICF/IID services and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to require ICF/IID actions to mitigate and contain COVID-19. The purpose of the new rule is to describe these requirements.BACKGROUND AND JUSTIFICATION As authorized by 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 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 ICF/IID COVID-19 Response.

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §551.47, allowing limited indoor and outdoor visitation at Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions

INTELLECTUAL DISABILITY OR RELATED CONDITIONSSUBCHAPTER C. STANDARDS FOR LICENSURE26 TAC §551.47OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC or Commission) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, new §551.47, concerning an emergency rule for intermediate care facilities for individuals with an intellectual disability (ICF/IID) provider response to COVID-19 and describing requirements for limited indoor and outdoor visitation in a facility during Phase 1. To protect individuals receiving ICF/IID services and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency rule to allow limited indoor and outdoor visitation in an ICF/IID during Phase 1. The purpose of the emergency rule is to describe the requirements related to such visits.BACKGROUND AND JUSTIFICATION As authorized by 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 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. 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 ICF/IID Response to COVID-19.

Texas Department on Aging and Disability Services

Emergency Rule

Amending 40 TAC §§3.401 – 3.403 to require infection control training within state facilities in response to the COVID-19 pandemic

CHAPTER 3. RESPONSIBILITIES OF STATE FACILITIESSUBCHAPTER D. TRAINING40 TAC §§3.401 – 3.403OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40 Texas Administrative Code, Chapter 3, Responsibilities of State Facilities, amended §§3.401 – 3.403, concerning emergency rules in response to COVID-19 to ensure necessary state supported living center staffing levels and infection control during the COVID-19 pandemic.HHSC previously adopted emergency rules concerning staff training in order to efficiently and effectively deploy staff to meet basic needs during the COVID-19 pandemic, without posing risk to the individuals served. As the COVID-19 pandemic and the Governor’s proclamation of disaster have continued, so has the need for training requirements that ensure adequate training and staffing levels at state supported living centers. This emergency rule updates those training requirements to require training of infection control specific to COVID-19, including prevention, screening, isolation, and the use of personal protective equipment.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.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 these training rules.

Texas Department of State Health Services

Proposed Rules

Amending 25 TAC §37.350 to update composition, roles, and responsibilities of the Texas School Health Advisory Committee

CHAPTER 37. MATERNAL AND INFANT HEALTH SERVICESSUBCHAPTER R. ADVISORY COMMITTEES25 TAC §37.350OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes an amendment to §37.350, concerning the Texas School Health Advisory Committee (committee).BACKGROUND AND JUSTIFICATION The purpose of the proposal is to review and update §37.350 in accordance with Texas Government Code, §2001.039 regarding Agency Review of Existing Rules. The proposal updates the statutory reference establishing the committee and clarifies committee composition, roles, and responsibilities.

Texas Department of State Health Services

Proposed Rules

Repealing 25 TAC §85.1, which governs local public health authorities and is being re-published in new § 85.3

CHAPTER 85. HEALTH AUTHORITIESSUBCHAPTER A. LOCAL PUBLIC HEALTH25 TAC §85.1OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes the repeal of §85.1. The proposed repeal of §85.1, Health Authorities, deletes the rule because the rule text is included in a proposed new §85.3.BACKGROUND AND JUSTIFICATION The proposal complies with House Bill 3704, 86th Legislature, Regular Session, 2019, which added Texas Health and Safety Code, §1001.089(e). The new law requires DSHS to establish a review process for a local public health entity that requests public health data maintained by DSHS. The review process applies to public health data requests for which there is not an existing agreement to share data. The proposed new rule allows DSHS to enter into an agreement with a local public health entity to share public health data that are necessary to fulfill its essential public health services in compliance with federal and state law.The proposal also reorganizes the structure of the chapter and defines terms to improve clarity. The proposal also serves as the four-year review of rules in compliance with Texas Government Code, §2001.039.

Texas Department of State Health Services

Proposed Rules

New 25 TAC §§85.1, 85.3 and 85.4, updating responsibilities of local public health authorities and establishing a data request review process

CHAPTER 85. HEALTH AUTHORITIESSUBCHAPTER A. LOCAL PUBLIC HEALTH25 TAC §§85.1, 85.3, 85.4OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes new §85.1, concerning Definitions; new §85.3, concerning Health Authorities; and new §85.4, concerning Public Health Data Review Process.SECTION-BY-SECTION SUMMARY Proposed new §85.1, Definitions, creates definitions to provide clarity with terminology used in this chapter.Proposed new §85.3, Health Authorities, incorporates the functions of a health authority from repealed §85.1. Most language from the repealed §85.1 is retained in new §85.3. The terms “health authority,” “region,” and “regional director” are clarified as definitions in new §85.1.Proposed new §85.4, Public Health Data Review Process, complies with Texas Health and Safety Code, §1001.089(e). The new rule outlines a data request review process for local health entities seeking public health data from DSHS.BACKGROUND AND JUSTIFICATION The proposal complies with House Bill 3704, 86th Legislature, Regular Session, 2019, which added Texas Health and Safety Code, §1001.089(e). The new law requires DSHS to establish a review process for a local public health entity that requests public health data maintained by DSHS. The review process applies to public health data requests for which there is not an existing agreement to share data. The proposed new rule allows DSHS to enter into an agreement with a local public health entity to share public health data that are necessary to fulfill its essential public health services in compliance with federal and state law.The proposal also reorganizes the structure of the chapter and defines terms to improve clarity. The proposal also serves as the four-year review of rules in compliance with Texas Government Code, §2001.039.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.13 to include gender-neutral language in provisions governing the Hearing Instrument Fitters and Dispensers Advisory Board

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER B. HEARING INSTRUMENT FITTERS AND DISPENSERS ADVISORY BOARD16 TAC §112.13OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter B, §112.13, regarding the Hearing Instrument Fitters and Dispensers Program Advisory Board, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.The adopted rules amend §112.13, Officers. The adopted rules update the terminology in subsection (b) to use gender neutral language. (Terminology and Other Clean-up Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Repealing 16 TAC §112.21 and §112.22 as part of the re-structuring of Subchapter C, concerning Hearing Instrument Fitters and Dispensers examinations

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER C. EXAMINATIONS16 TAC §112.21, §112.22OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts the repeal of existing rules at Subchapter C, §112.21 and §112.22. SECTION-BY-SECTION SUMMARYThe adopted rules repeal existing §112.21, Examination Qualifications. The adopted rules repeal this section and relocate the provisions to new §112.22. (Bill Implementation Changes)The adopted rules repeal existing §112.22, Examination Tests and Contents. The adopted rules repeal this section and relocate the provisions to new §112.21. (Bill Implementation Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Establishing new 16 TAC §§112.21-112.22 and amending 16 TAC §§112.23-112.26 to update provisions regarding the Hearing Instrument Fitters and Dispensers examination process

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER C. EXAMINATIONS16 TAC §§112.21 – 112.26OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter C, §§112.24 – 112.26 and new rules at Subchapter C, §112.22, regarding Hearing Instrument Fitters and Dispensers Program examinations, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.The Commission also adopts new rules at 16 TAC Chapter 112, Subchapter C, §112.21, and amendments to existing rules at Subchapter C, §112.23, with changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will be republished.SECTION-BY-SECTION SUMMARYA detailed overview of changes made in the amended rules and new rules is included in this week’s edition of the Texas Register (45 Tex Reg 6101). BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §§112.30, 112.32 and 112.33 to update requirements for Hearing Instrument Fitters and Dispensers licensure

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER D. HEARING INSTRUMENT FITTER AND DISPENSER LICENSE16 TAC §§112.30, 112.32, 112.33OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter D, §§112.30, 112.32, and 112.33, regarding Hearing Instrument Fitters and Dispensers Program licensing, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARY A detailed overview of changes made in the amended rules is included in this week’s edition of the Texas Register (45 Tex Reg 6102). BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.40 and §112.42 to update requirements for Hearing Instrument Fitters and Dispensers apprentice permits

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER E. APPRENTICE PERMIT16 TAC §112.40, §112.42OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter E, §112.40 and §112.42, regarding Hearing Instrument Fitters and Dispensers Program apprentice permits, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARYThe adopted rules amend §112.40, Apprentice Permit–Application and Eligibility Requirements. The adopted rules change the references in subsection (c) from “examination” to “test” to implement HB 2699. (Bill Implementation Changes) The adopted rules also amend subsection (d) to insert the standardized criminal history background check language. (Terminology and Other Clean-up Changes)The adopted rules amend §112.42, Apprentice Permit–Permit Term; Extension. The adopted rules amend subsection (b) to specify the timing of when a person must submit the apprentice permit extension request. The adopted rules also add a new subsection (e) to explain the ramifications of not requesting an extension within the 90-day grace period. (Permit Extension Changes) The adopted rules also amend subsection (c) to insert the standardized criminal history background check language. (Terminology and Other Clean-up Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.52 and §112.53 to update requirements for Hearing Instrument Fitters and Dispensers temporary training permits

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER F. TEMPORARY TRAINING PERMIT16 TAC §112.52, §112.53OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter F, §112.52 and §112.53, regarding Hearing Instrument Fitters and Dispensers Program temporary training permits, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARY The adopted rules amend §112.52, Temporary Training Permit–Permit Term; Extension. The adopted rules amend subsection (b) to specify the timing of when a person must submit the temporary training permit extension request. The adopted rules also add a new subsection (e) to explain the ramifications of not requesting an extension within the 90-day grace period. (Permit Extension Changes)The adopted rules amend §112.53, Temporary Training Permit–Supervision and Temporary Training Requirements. The adopted rules update the terminology in subsection (c) to use gender neutral language. (Terminology and Other Clean-up Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.60 and §112.61 to update financial security requirements for the Hearing Instrument Fitters and Dispensers Program

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER G. FINANCIAL SECURITY REQUIREMENTS16 TAC §112.60, §112.61OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter G, §112.60 and §112.61, regarding financial security requirements for the Hearing Instrument Fitters and Dispensers Program, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARY A detailed overview of changes made in the amended rules is included in this week’s edition of the Texas Register (45 Tex Reg 6103). BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.71 to update terminology regarding continuing education requirements for the Hearing Instrument Fitters and Dispensers Program

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER H. CONTINUING EDUCATION REQUIREMENTS16 TAC §112.71OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter H, §112.71, regarding continuing education requirements for the Hearing Instrument Fitters and Dispensers Program, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.The adopted rules amend §112.71, Continuing Education–Records and Audits. The adopted rules update the terminology in subsections (a) and (c) to use gender neutral language. (Terminology and Other Clean-up Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.91 and §112.98 to update and clarify responsibilities of Hearing Instrument Fitters and Dispensers licensees

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER J. RESPONSIBILITIES OF THE LICENSEE16 TAC §112.91, §112.98OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter J, §112.91 and §112.98, regarding Hearing Instrument Fitters and Dispensers Program licensee responsibilities, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARYThe adopted rules amend §112.91, Change of Name, Address, or Other Information. The adopted rules change the reference under subsection (a) from “licensee,” which is defined to include license holders and permit holders, to “license holder or permit holder.” This terminology change is necessary for clarity purposes due to the addition of subsection (b), which only applies to license holders. (Terminology and Other Clean-up Changes)The adopted rules add a new requirement under subsection (b) for a license holder who changes employers to submit a copy of the surety bond or other form of financial security from the license holder’s new employer. In the alternative, the new employer may submit the financial security directly to the department. A new form has been developed to implement this requirement. (Surety Bond Clarification Changes)The adopted rules amend §112.98, Code of Ethics. The adopted rules update the terminology in subsections (c) and (d) to use gender neutral language. The adopted rules also make a clean-up change to subsection (d). (Terminology and Other Clean-up Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.110 to update terminology regarding Hearing Instrument Fitters and Dispensers Program fees

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER L. FEES16 TAC §112.110OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter L, §112.110, regarding Hearing Instrument Fitters and Dispensers Program fees, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.The adopted rules amend §112.110, Fees. The adopted rules change the references from “examination” to “test” in subsection (e) to implement HB 2699. (Bill Implementation Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §112.120 and establishing new §§112.121 – 112.125 to update and clarify Hearing Instrument Fitters and Dispensers Program complaints and enforcement procedures

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER M. COMPLAINTS AND ENFORCEMENT PROVISIONS16 TAC §§112.120 – 112.125OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter M, §112.120, and new rules at Subchapter M, §§112.121 – 112.125, regarding Hearing Instrument Fitters and Dispensers Program complaints and enforcement, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARYA detailed overview of changes made in the amended rules and new rules is included in this week’s edition of the Texas Register (45 Tex Reg 6104). BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department of Licensing and Regulation

Adopted Rules

Repealing 16 TAC §§112.130 – 112.134, which previously governed Hearing Instrument Fitters and Dispensers Program enforcement and is being streamlined into new Subchapter M

CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERSSUBCHAPTER N. ENFORCEMENT PROVISIONS16 TAC §§112.130 – 112.134OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts the repeal of existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter N, §§112.130-112.132 and 112.134, which previously governed Hearing Instrument Fitters and Dispensers Program enforcement, without changes to the proposed text as published in the February 21, 2020, issue of the Texas Register (45 TexReg 1128). These rules will not be republished.SECTION-BY-SECTION SUMMARYSubchapter N has been eliminated, and the complaints and enforcement provisions have been combined under Subchapter M. (Terminology and Other Clean-up Changes)The adopted rules repeal §112.130, Administrative Penalties and Sanctions. This section has been relocated to new §112.121. (Terminology and Other Clean-up Changes)The adopted rules repeal §112.131, Enforcement Authority. This section has been relocated to new §112.122. (Terminology and Other Clean-up Changes)The adopted rules repeal §112.132, Refund for Hearing Instrument. This section has been relocated to new §112.123. (Terminology and Other Clean-up Changes)The adopted rules repeal §112.134, Surrender of a License or Permit. This section has been relocated to new §112.124. (Terminology and Other Clean-up Changes)BACKGROUND AND JUSTIFICATION The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers. The adopted rules are necessary to implement bills from the 86th Legislature, Regular Session (2019); clarify the submission of surety bonds or other financial security to the Department; address the permit extension requirements; and make terminology and other clean-up changes.

Texas Department on Aging and Disability Services

Transferred Rule

Transferring oversight of contracting for the Intermediate Care Facilities For Individuals With An Intellectual Disability Or Related Conditions Program from DADS to HHSC

OVERVIEWThe former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 9 (Intellectual Disability Services–Medicaid State Operating Agency Responsibilities), Subchapter E (Intermediate Care Facilities For Individuals With An Intellectual Disability Or Related Conditions (ICF/IID) Program–Contracting) are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 261 (Intermediate Care Facilities For Individuals With An Intellectual Disability Or Related Conditions (ICF/IIID) Program–Contracting). ADDITIONAL INFORMATIONA table containing a detailed outline of the rule transfer is available at 45 Tex Reg 6127. The rules will be transferred in the Texas Administrative Code effective October 1, 2020.BACKGROUND AND JUSTIFICATION During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. 

Texas Health and Human Services Commission

In Addition

HHSC has increased maximum fees allowed for hospitals providing health care information

OVERVIEWThe Health and Human Services Commission, in accordance with Health and Safety Code, §241.154(e), has  increased the maximum hospital fees for providing a patient’s health care information by 1.0% to reflect the most recent changes to the consumer price index that measures the average changes in prices of goods and services purchased by urban wage earners and clerical workers as published by the Bureau of Labor Statistics of the United States Department of Labor.The current fees are effective as of September 1, 2020 and relate to Health and Safety Code §241.154(b) – (d). The exact fee changes are detailed at 45 Tex Reg 6151.  BACKGROUND AND JUSTIFICATIONThe Health and Human Services Commission licenses and regulates the operation of general and special hospitals in accordance with Chapter 241 of the Texas Health and Safety Code. In 1995, the Texas Legislature amended this law to address the release and confidentiality of health care information. In 2009, the Texas Legislature amended the statute again to change the definition of health care information and to add a category of fees for records provided on digital or other electronic media and delivered electronically.This information is provided only as a courtesy to licensed hospitals. Hospitals are responsible for verifying that fees for health care information are charged in accordance with Health and Safety Code Chapters 241, 311, and 324.

Texas Health and Human Services Commission

In Addition

HHSC will submit an amendment to the Texas State Plan for Medical Assistance regarding reimbursement of telehealth services to Federally Qualified Health Centers

OVERVIEWThe 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 amendment is proposed to be effective September 1, 2020.The proposed amendment will ensure that a Federally Qualified Health Center (FQHC) is reimbursed for a covered telemedicine medical service or telehealth service delivered by a health care provider to a Medicaid recipient at the facility. A medical visit for an FQHC, as “medical visit” is defined in Attachment 4.19-B, will include covered telemedicine medical services. The proposed amendment will also clarify how rates are set for multiple FQHCs that are authorized to file a consolidated cost report.ADDITIONAL INFORMATIONInterested parties may obtain a copy of the proposed amendment and/or additional information about the amendment by contacting Cynthia Henderson, State Plan Coordinator, by mail at the Texas Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by telephone at (512) 428-1932; by facsimile at (512) 730-7472; or by email 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 Department of Aging and Disability Services).PUBLIC COMMENT Public comment may be submitted through U.S. mail, overnight mail, special delivery mail, hand delivery, fax or email. Addresses are listed at 45 Tex Reg 6152. 

Texas Department of State Health Services

In Addition

DSHS issues order placing controlled substances FUB-AMB into Schedule I and Lemborexant into Schedule IV

OVERVIEWIn the capacity as Commissioner of the Texas Department of State Health Services, John Hellerstedt, M.D., does hereby order that substance FUB-AMB be placed into schedule I and the substance lemborexant be placed into schedule IV.BACKGROUND AND JUSTIFICATION The Drug Enforcement Administration (DEA) issued a final rule placing methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3-methylbutanoate (other names: FUB-AMB, MMB-FUBINACA, AMB-FUBINACA), including its salts, isomers, and salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible, into schedule I of the Controlled Substances Act (CSA). This final rule was published in the Federal Register, Volume 85, Number 61, pgs. 17494-17497. The effective date of the final rule was March 30, 2020. This action was taken for reasons listed at 45 Tex Reg 6152. The DEA issued an interim final rule placing lemborexant, including its salts, isomers, and salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible in schedule IV of the CSA. This rule was published in the Federal Register, Volume 85, Number 67, pages 19387-19391. The effective date of the interim final rule was April 7, 2020.Pursuant to Section 481.034(g), as amended by the 75th legislature, of the Texas Controlled Substances Act, Health and Safety Code, Chapter 481, at least thirty-one days have expired since notice of the above referenced actions were published in the Federal Register.