Texas Register August 9, 2024 Volume: 49 Number: 31

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Department of State Health Services
3 Texas Animal Health Commission
- - 3.0.1 Adopted Rules Re:
    - 3.0.1.1 Adopting 4 TAC §59.4, to detail the requirements of any memorandum of understanding entered into by the commission with DPS or local authorities.
  - 3.0.2 In Addition Re:
    - 3.0.2.1 Executive Director Order Declaring Intrastate Movement Restrictions of Lactating Dairy Cattle to Fairs, Shows, or Exhibitions
4 Texas Department of Licensing and Regulation
- - 4.0.1 Adopted Rules Re:
    - 4.0.1.1 Adopting 16 TAC §§114.1, 114.70, 114.90, to require certain health care providers to provide itemized bills and improve clarity and consistency of other rule formatting.
5 Texas Board of Physical Therapy Examiners
- - 5.0.1 Adopted Rule Reviews Re:
    - 5.0.1.1 Adopting Title 22, Part 16, concerning Definitions; Practice; Powers and Duties of the Board; Organization of the Board; Compensation; Licensing Procedure; Professional Title; Display of License; Fees; License Renewal; Open Records; Contested Case Procedure; Administrative Fines and Penalties; Practice Settings for Physical Therapy; and Physical Therapy Licensure Compact.
6 Texas Department of Aging and Disability Services
- - 6.0.1 Adopted Rule Reviews Re:
    - 6.0.1.1 Adopting Title 40, Part 1, concerning Quality Assurance Fees.

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §§355.8701 – 355.8705, 355.8707, to add and modify definitions, and improve clarity, consistency, and specificity of the rules.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER L. LOCAL FUNDS MONITORING
1 TAC §§355.8701 – 355.8705, 355.8707

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.8701, concerning Purpose; §355.8702, concerning Definitions; §355.8703, concerning Applicability; §355.8704, concerning Reporting and Monitoring; §355.8705, concerning Post-Determination Review; and §355.8707, concerning Notification Requirements for the Creation of a Local Provider Participation Fund (LPPF).

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to add and modify definitions and enhance clarity, consistency, and specificity of the rules. The amendments also reflect best practices learned after the completion of two Local Funding reporting periods and are based on an internal review of Local Funding’s processes.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §355.8701 replaces “local governmental entities” with “governmental entities;” as noted in the proposed amendment to §355.8702, the term “governmental entities” includes state agencies and “local governmental entities” (LGEs). The proposed amendment also replaces “HHSC” with “HHS” to specify which agencies collect the information to comply with state and federal law and associated reporting requirements.

The proposed amendment to §355.8702 modifies the definition of a governmental entity to distinguish between state agency and other political subdivisions of the state. The proposed amendment also adds two new definitions: Texas Health and Human Services system (HHS) and Local Education Agency (LEA) to conform to the term used by other state agencies to refer to this political subdivision of the state.

The proposed amendment to §355.8703 removes the staggered implementation of the rules, as reporting on all local funding provided to HHSC by governmental entities through Intergovernmental Transfer (IGT) or Certified Public Expenditure (CPE) for use as the non-federal share of Medicaid payments has begun. The proposed amendment also clarifies what HHSC will do if the electronic annual survey is not open at the start of the reporting period to ensure that governmental entities can provide any requested information or documentation relating to annual reporting and monitoring.

The proposed amendment to §355.8704 clarifies the processes HHSC uses to collect information from governmental entities for use in the annual survey as required by the 2024-25 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, Health and Human Services Commission, Rider 15 (b)). Additionally, the proposed amendment reiterates HHSC’s broad authority to refuse IGT used as the non-federal share of Medicaid at its discretion. Finally, the proposed amendment reflects best practices learned after implementing reporting for all funding sources and the completion of two fiscal years’ reporting periods. This includes additional specification regarding the types of information and documentation HHSC collects and how HHSC uses the information collected to determine compliance, assess risk, and conduct in-depth reviews.

The proposed amendment to §355.8705 conforms rule reference in this subchapter regarding post-determination reviews. The proposed amendment specifies governmental entity representatives that may request a post-determination review.

The proposed amendment to §355.8707 provides updated and additional detail regarding the steps that a local governmental entity must complete regarding the submission of the required documentation prior to transferring local funds generated by a Local Provider Participation Fund (LPPF) to HHSC via IGT.

Adopted Rules Re:

Adopting 26 TAC §§930.1, 930.3, 930.5, 930.7, 930.9, 930.11, to describe the role of an essential caregiver and when the essential caregiver can have in-person state hospital visitation.

CHAPTER 930. ADDITIONAL RIGHTS OF INDIVIDUALS RECEIVING SERVICES AT STATE FACILITIES
SUBCHAPTER A. STATE HOSPITAL ESSENTIAL CAREGIVER
26 TAC §§930.1, 930.3, 930.5, 930.7, 930.9, 930.11

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new §930.1, concerning Purpose; §930.3, concerning Application; §930.5, concerning Definitions; §930.7, concerning Essential Caregiver In-Person Visitation; §930.9, concerning Revocation; and §930.11, concerning Temporary Suspension of Essential Caregiver Visits.

Sections 930.1, 930.3, 930.5, 930.7, 930.9 and 930.11 are adopted with changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2966). These rules will be republished.

BACKGROUND AND JUSTIFICATION

The new sections are necessary to comply with Texas Health and Safety Code Chapter 552, Subchapter F, Right to Essential Caregiver Visits, enacted by Senate Bill 52, 88th Legislation, Regular Session, 2023, which requires HHSC to develop guidelines to assist state hospitals in establishing essential caregiver visitation policies and procedures. Specifically, §552.202 establishes the right for a patient in a state hospital, or their legally authorized representative, to designate an essential caregiver with whom a state hospital cannot prohibit in-person visitation. Section 552.203 further requires the HHSC Executive Commissioner to develop guidelines for the state hospitals regarding the patient’s, or their LAR’s, right to designate an essential caregiver, visitation schedules, physical contact, and safety protocols. Section 552.204 addresses when an essential caregiver designation can be revoked, and the related right to an appeal. Section 552.205 addresses when a state hospital may seek a temporary suspension of visits.

Proposed Rule Reviews Re:

Reviewing Title 1, Part 15, to consider for readoption, revision, or repeal of the chapter concerning Day Activity and Health Services (DAHS) Contractual Requirements.

The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 26, Part 1, of the Texas Administrative Code (TAC):

Chapter 211, Day Activity and Health Services (DAHS) Contractual Requirements

Adopted Rule Reviews Re:

Adopting Title 1, Part 15, concerning Medicare Savings Program.

The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 1, Part 15, of the Texas Administrative Code (TAC):

Chapter 359, Medicare Savings Program

Adopting Title 26, Part 1, concerning Comprehensive Rehabilitation Services.

The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code (TAC):

Chapter 352, Comprehensive Rehabilitation Services

In Addition Re:

Notice of Stakeholder Engagement Meetings for Medicaid and Non-Medicaid Payment Rates

Meeting. The Texas Health and Human Services Commission (HHSC) will conduct stakeholder engagement meetings on August 15, 2024, to receive comments on Medicaid and non-Medicaid payment rate topics that may potentially be addressed at the upcoming August 2024 and November 2024 rate hearings. Commentary will be collected solely on the topics listed in this notice. Proposed rates will not be published at this time. These meetings will be conducted online only.

Public Notice: CHIP State Plan Amendment Transmittal Number 24-0015

The Texas Health and Human Services Commission (HHSC) announces its intent to submit the following amendment: Transmittal number 24-0015 to amend the Texas State Plan for the Children’s Health Insurance Program (CHIP), under Title XXI of the Social Security Act.

The purpose of this amendment is to demonstrate compliance with Section 11405(b)(1) of the Inflation Reduction Act and the requirement to cover adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) without cost sharing. This proposed amendment also demonstrates compliance with existing child vaccine regulations in 42 Code of Federal Regulations §§ 457.410(b)(2) and 457.520(b)(4), which require states to provide CHIP coverage and payment of age-appropriate vaccines recommended by ACIP and their administration without cost sharing. The proposed amendment is effective October 1, 2023.

The proposed amendment is estimated to have no fiscal impact. Texas CHIP is already in compliance with these requirements. Texas CHIP covers vaccines recommended by the American Academy of Pediatrics periodicity schedule, which follows ACIP recommendations. Additionally, Texas CHIP already prohibits cost sharing for preventive services, including immunizations.

Public Notice of Updates to the APR-DRG Grouper 41

Hearing: The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on August 19, 2024, at 9:00 a.m., to receive public comments on proposed updates for the All Patient Refined-Diagnosis Related Group (APR-DRG) version update for Hospital Inpatient services, specifically DRG Grouper 41. These updates include Statistical Data Relative Weight (RW), Mean Length of Stay (MLOS), Day Threshold, and universal mean used to reimburse Medicaid Inpatient Hospital Services.

Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §§97.3, 97.4, 97.6, to update the public website link to include Cronobacter spp. in infants and melioidosis as notifiable conditions in Texas and update the preferred reporting option as electronic data transmissions.

CHAPTER 97. COMMUNICABLE DISEASES
SUBCHAPTER A. CONTROL OF COMMUNICABLE DISEASES
25 TAC §§97.3, 97.4, 97.6

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes amendments to §97.3, concerning What Condition to Report and What Isolates to Report or Submit; §97.4, concerning When and How to Report a Condition or Isolate; and §97.6, concerning Reporting and Other Duties of Local Health Authorities and Regional Directors.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement Senate Bill (S.B.) 969, 87th Regular Session, 2021, Kolkhorst, and to add melioidosis and Cronobacter spp. in infants as notifiable conditions in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §97.3 updates the public website link available for reviewing the summary list of notifiable conditions, adds Cronobacter spp. in infants and melioidosis as notifiable conditions in Texas, and corrects punctuation.

The proposed amendment to §97.4 updates the immediately notifiable conditions by adding melioidosis; removes faxing as an option for reporting immediately notifiable conditions; and identifies the preferred reporting option as electronic data transmission but allows persons to report via telephone or fax for all other notifiable conditions not listed in paragraphs (1) – (4) of this subsection. Additionally, this amendment removes mail or courier as reporting options and corrects punctuation. DSHS will allow a transition period and will continue to accept HIV reporting via mail while 25 TAC §97.134 is amended.

The proposed amendment to §97.6 lists the preferred reporting option as electronic data transmission but allows persons to report via telephone or fax; removes mail or courier as reporting options; and requires any notifiable conditions reported via telephone be followed up with an electronic data transmission through an approved electronic means within 24 hours of the original notification.

Adopted Rules Re:

Adopting 25 TAC §3.31, §3.41, to remove unnecessary rules.

CHAPTER 3. MEMORANDUMS OF UNDERSTANDING WITH OTHER STATE AGENCIES
25 TAC §3.31, §3.41

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of §3.31, concerning Memorandum of Understanding between the Texas Department of Criminal Justice, Texas Commission for the Blind, Texas Commission for the Deaf and Hard of Hearing, Texas Rehabilitation Commission, Texas Department of Human Services, and the Texas Department of Health; and §3.41, concerning Memorandum of Understanding Concerning Special Education Services to Students with Disabilities in Residential Facilities. The repeal of §3.31 and §3.41 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2925), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §3.31 and §3.41, from the Texas Administrative Code pursuant to Senate Bill 219, 84th Legislature, Regular Session, 2015.

Adopting 25 TAC §4.1, to remove an unnecessary rule.

CHAPTER 4. DSHS CONTRACTING RULES
SUBCHAPTER A. PROTEST PROCEDURES FOR CERTAIN DSHS PURCHASES
25 TAC §4.1

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §4.1, concerning Contract Protests; §4.11, concerning Purpose; §4.12, concerning Applicability; §4.13, concerning Definitions; §4.14, concerning Prerequisites to Suit; §4.15, concerning Notice of Claim of Breach of Contract; §4.16, concerning Agency Counterclaim; §4.17, concerning Request for Voluntary Disclosure of Additional Information; §4.18, concerning Timetable for Negotiation and Mediation; §4.19, concerning Conduct of Negotiation; §4.20, concerning Settlement Approval Procedures for Negotiation; §4.21, concerning Negotiated Settlement Agreement; §4.22, concerning Costs of Negotiation; §4.23, concerning Request for Contested Case Hearing; and §4.24, concerning Mediation. The repeal of §4.1 and §§4.11 – 4.24 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2926), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §4.1 and §§4.11 – 4.24, from the Texas Administrative Code pursuant to Senate Bill 200, 84th Legislature, Regular Session, 2015.

Adopting 25 TAC §§4.11 – 4.24, to remove an unnecessary rule.

CHAPTER 4. DSHS CONTRACTING RULES
SUBCHAPTER B. CERTAIN CONTRACT CLAIMS AGAINST THE DEPARTMENT
25 TAC §§4.11 – 4.24

OVERVIEW

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §4.1 and §§4.11 – 4.24, from the Texas Administrative Code pursuant to Senate Bill 200, 84th Legislature, Regular Session, 2015.

Adopting 25 TAC §§61.21 – 61.24, to delete unnecessary rules.

CHAPTER 61. CHRONIC DISEASES
SUBCHAPTER B. DIABETIC EYE DISEASE DETECTION INITIATIVE
25 TAC §§61.21 – 61.24

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §61.21, concerning General Information; §61.22, concerning Client Eligibility; §61.23, concerning Program Benefits; and §61.24, concerning Payment for Services. The repeal of §§61.21 – 61.24 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2927), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §§61.21 – 61.24, from the Texas Administrative Code. The Diabetic Eye Disease Detection Initiative has been inactive since 2011 and DSHS does not intend to reactivate the initiative.

Adopting 25 TAC §111.2, §111.3, to delete unnecessary rules.

CHAPTER 111. SPECIAL HEALTH SERVICES
25 TAC §111.2, §111.3

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §111.2, concerning Memorandum of Understanding Concerning Hospitals and Long-Term Care Facilities and §111.3, concerning Reporting Obligation by the Department of Agency Regulatory Survey Information. The repeal of §111.2 and §111.3 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2928), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §111.2 and §111.3, from the Texas Administrative Code pursuant to Senate Bill 200, 84th Legislature, Regular Session, 2015.

Adopting 25 TAC §113.1, §113.2, to remove unnecessary rules.

CHAPTER 113. SPECIAL HEALTH SERVICES PERMITS
25 TAC §113.1, §113.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §113.1, concerning Processing Permits for Special Health Services Professionals and §113.2, concerning Time Periods for Processing and Issuing Licenses for Health Care Providers. The repeal of §113.1 and §113.2 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2929), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §113.1 and §113.2, from the Texas Administrative Code pursuant to Senate Bill 202, 84th Legislature, Regular Session, 2015, which transferred this program to HHSC.

Adopting 25 TAC §§127.1 – 127.4, to remove unnecessary rules.

CHAPTER 127. REGISTRY FOR PROVIDERS OF HEALTH-RELATED SERVICES
25 TAC §§127.1 – 127.4

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §127.1, concerning Request for Placement of an Occupation on the Registry; §127.2, concerning Approved Occupations; §127.3, concerning Application and Approval of an Individual’s Placement on a Registry; and §127.4, concerning Fees. The repeal of §§127.1 – 127.4 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2930), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §§127.1 – 127.4, from the Texas Administrative Code pursuant to Senate Bill 970, 87th Legislature, Regular Session, 2021.

Adopting 25 TAC §§140.30 – 140.48, to remove unnecessary rules.

CHAPTER 140. HEALTH PROFESSIONS REGULATION
SUBCHAPTER B. PERSONAL EMERGENCY RESPONSE SYSTEM PROVIDERS PROGRAM
25 TAC §§140.30 – 140.48

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §140.30, concerning Introduction; §140.31, concerning Definitions; §140.32, concerning Fees; §140.33, concerning Petition for Rulemaking; §140.34, concerning Application Requirements and Procedures; §140.35, concerning Requirement for Insurance; §140.36, concerning Application Processing; §140.37, concerning Categories of Licensure and Registration; §140.38, concerning Renewal of License or Registration; §140.39, concerning Changes of Name or Address; §140.40, concerning Standards of Conduct for PERS Providers; §140.41, concerning Consumer Information; §140.42, concerning Filing Complaints and Complaint Investigations; §140.43, concerning Grounds for Disciplinary Action; §140.44, concerning Informal Disposition; §140.45, concerning Formal Hearings; §140.46, concerning Guidelines for Issuing Licenses and Registrations to Persons with Criminal Convictions; §140.47, concerning Immediate Suspension for Failure to Maintain Insurance Coverage; §140.48, concerning Registration of Military Service Members, Military Veterans, and Military Spouses; §140.250, concerning Introduction; §140.251, concerning Definitions; §140.252, concerning Fees; §140.253, concerning Petition for Rulemaking; §140.254, concerning Sale or Delivery of Contact Lenses and Prescription Verification; §140.255, concerning Display of Permit; §140.256, concerning Application Requirements and Procedures; §140.257, concerning Application Processing; §140.258, concerning Renewal of Permit; §140.259, concerning Changes of Name or Address; §140.260, concerning Filing Complaints and Complaint Investigations; §140.261, concerning Grounds for Disciplinary Actions; §140.262, concerning Informal Disposition; §140.263, concerning Formal Hearings; §140.264, concerning Guidelines for Issuing Permits to Persons with Criminal Convictions; §140.265, concerning Permitting of Military Service Members, Military Veterans, and Military Spouses; §140.275, concerning Purpose and Construction; §140.276, concerning Definitions; §140.277, concerning Fees; §140.278, concerning Application Procedures and Requirements for Registration; §140.279, concerning Issuance of Certificate of Registration; §140.280, concerning Renewal of Registration; §140.281, concerning Requirements for Continuing Education; §140.282, concerning Change of Name or Address; §140.283, concerning Violations, Complaints, Investigation of Complaints, and Disciplinary Actions; §140.284, concerning Registration of Applicants with Criminal Backgrounds; §140.285, concerning Professional and Ethical Standards; §140.286, concerning Request for Criminal History Evaluation Letter; and, §140.287, concerning Registration of Military Service Members, Military Veterans, and Military Spouses. The repeal of §§140.30 – 140.48, 140.250 – 140.265, and 140.275 – 140.287 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2935), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §§140.30 – 140.48, §§140.250 – 140.265, and §§140.275 – 140.287, from the Texas Administrative Code. Senate Bill (S.B.) 202, 84th Legislature, Regular Session, 2015, repealed the regulation of these health professions.

Adopting 25 TAC §§140.250 – 140.265, to remove unnecessary rules.

CHAPTER 140. HEALTH PROFESSIONS REGULATION
SUBCHAPTER F. CONTACT LENS DISPENSERS
25 TAC §§140.250 – 140.265

OVERVIEW

BACKGROUND AND JUSTIFICATION

Adopting 25 TAC §§140.275 – 140.287, to delete unnecessary rules.

SUBCHAPTER G. OPTICIANS
25 TAC §§140.275 – 140.287

OVERVIEW

BACKGROUND AND JUSTIFICATION

Adopting 25 TAC §§205.1 – 205.17, to delete unnecessary rules.

CHAPTER 205. PRODUCT SAFETY
SUBCHAPTER A. BEDDING RULES
25 TAC §§205.1 – 205.17

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §205.1, concerning Purpose and Scope; §205.2, concerning Definitions; §205.3, concerning General Requirements; §205.4, concerning Labeling Requirements; §205.5, concerning Definitions and Designations of Filling Materials; §205.6, concerning Adjunctive Terms; §205.7, concerning Suggested Terminology for Various Fiber By-Products; §205.8, concerning Germicidal Treatment Requirements; Methods; §205.9, concerning Sanitary Premises; §205.10, concerning Adjustments to the Minimum Requirements; §205.11, concerning Permit Requirements; Types; Application; Conditions; Suspension; §205.12, concerning Administrative Penalty; §205.13, concerning Detained or Embargoed Bedding; §205.14, concerning Removal Order for Detained or Embargoed Bedding; §205.15, concerning Condemnation; §205.16, concerning Recall Orders; and §205.17, concerning Inspection. The repeal of §§205.1 – 205.17 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2938), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §§205.1 – 205.17, from the Texas Administrative Code pursuant to Senate Bill 202, 84th Legislature, Regular Session, 2015.

Adopting 25 TAC §§297.1 – 297.10, to delete unnecessary rules.

CHAPTER 297. INDOOR AIR QUALITY
SUBCHAPTER A. GOVERNMENT BUILDINGS
25 TAC §§297.1 – 297.10

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the repeal of §297.1, concerning General Provisions; §297.2, concerning Definitions; §297.3, concerning Recommendations for Implementing a Governmental Building IAQ Program; §297.4, concerning Design/Construction/Renovation; §297.5, concerning Building Operation and Maintenance Guidelines; §297.6, concerning Recommended Building Occupant Responsibilities; §297.7, concerning Assessing and Resolving IAQ Problems; §297.8, concerning Guidelines for Comfort and Minimum Risk Levels; §297.9, concerning Lease Agreements; and §297.10, concerning Special Considerations. The repeal of §§297.1 – 297.10 is adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2939), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeal is to remove unnecessary rules, §§297.1 – 297.10, from the Texas Administrative Code pursuant to Senate Bill 202, 84th Legislature, Regular Session, 2015.

Adopted Rule Reviews Re:

Adopting Title 25, Part 1, concerning the Distribution of Tobacco Settlement Proceeds to Political Subdivisions.

The Texas Health and Human Services Commission (HHSC), in its own capacity and on behalf of the Texas Department of State Health Services (DSHS), adopts the review of the chapter below in Title 25, Part 1, of the Texas Administrative Code (TAC):

Chapter 102, Distribution of Tobacco Settlement Proceeds to Political Subdivisions

Texas Animal Health Commission

Adopted Rules Re:

Adopting 4 TAC §59.4, to detail the requirements of any memorandum of understanding entered into by the commission with DPS or local authorities.

CHAPTER 59. GENERAL PRACTICES AND PROCEDURES
4 TAC §59.4

OVERVIEW

The Texas Animal Health Commission (Commission) in a duly noticed meeting on July 16, 2024, adopted amendments to §59.4, concerning Cooperation with the Texas Department of Public Safety Regarding Enforcement of Entry Requirements. Section 59.4 is adopted without changes to the proposed text published in the May 31, 2024, issue of the Texas Register (49 TexReg 3867) and will not be republished.

BACKGROUND AND JUSTIFICATION

The Commission is tasked with the enforcement of livestock entry requirements. To carry out that mission, Commission staff routinely cooperate with Texas Department of Public Safety officers and local law enforcement. Recognizing the importance of this partnership, the Legislature enacted 161.051 and 161.052 of the Texas Agriculture Code which details the requirements of any memorandum of understanding entered into by the Commission with DPS or local authorities. Section 59.4 of the Commission’s administrative rules sets forth the responsibilities of Commission staff when partnering with DPS. The amendments add similar language regarding the responsibilities of Commission staff when partnering with local law enforcement.

In Addition Re:

Executive Director Order Declaring Intrastate Movement Restrictions of Lactating Dairy Cattle to Fairs, Shows, or Exhibitions

The Texas Animal Health Commission (the “Commission”) is authorized to establish movement restrictions against all or a portion of a state in which an animal disease exists to protect livestock, exotic livestock, domestic fowl, and exotic fowl in this state from the disease.

To protect animal health in this state, the Executive Director imposes the following movement restrictions on lactating dairy cows prior to their intrastate movement to a fair, show, or exhibition:

Each lactating dairy cow moving intrastate to a fair, show, or exhibition must have a negative PCR (polymerase chain reaction) test result for Influenza A virus from an individual milk sample collected and tested at an approved National Animal Health Laboratory Network (NAHLN) laboratory using a NAHLN approved assay within 7 days prior to movement. These animals may return to their home herd using the same negative test result provided the exhibition or show does not exceed 10 days of length. This testing is available to producers at no cost through USDA APHIS at NAHLN laboratories. Producers may also apply for reimbursement of shipping and veterinary fees for collection of samples.

Prior to interstate movement, lactating dairy cattle are required to receive a negative PCR test for Influenza A virus at an approved NAHLN laboratory using a NAHLN approved assay and in accordance with the Federal Order effective April 29, 2024 https://www.aphis.usda.gov/sites/default/files/federal-order-faq.pdf

The HPAI Dairy Testing Protocol requires the following:

Sample collection must be performed by a USDA category II accredited veterinarian or a person under the direct supervision of USDA category II accredited veterinarian working for the dairy cattle herd.

Milk from each quarter of the individual cow must be pooled together to create a total sample between 3-10 ml of milk.

Each lactating dairy cow’s sample must be kept individualized. Samples shall not be pooled between cows.

This order is issued pursuant to Texas Agriculture Code §161.054 and Title 4, Texas Administrative Code §58 and is effective immediately.

This order will remain in effect until 60 days after the last detection of H5N1 in cattle herds in the United States.

As previously noted, the USDA has developed and implemented interstate measures to control the spread of HPAI. In addition to the Federal movement requirements, please verify if the state of destination has any additional entry requirements if moving lactating dairy cows out-of-state to a show, fair, or exhibition, or for any other reason.

Texas Department of Licensing and Regulation

Adopted Rules Re:

Adopting 16 TAC §§114.1, 114.70, 114.90, to require certain health care providers to provide itemized bills and improve clarity and consistency of other rule formatting.

CHAPTER 114. ORTHOTISTS AND PROSTHETISTS
16 TAC §§114.1, 114.70, 114.90

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 114, §114.1 and §114.90, regarding the Orthotists and Prosthetists program, without changes to the proposed text as published in the March 29, 2024, issue of the Texas Register (49 TexReg 2035). These rules will not be republished.

The Commission also adopts amendments to existing rules at 16 TAC Chapter 114, §114.70, regarding the Orthotists and Prosthetists program, with changes to the proposed text as published in the March 29, 2024, issue of the Texas Register (49 TexReg 2035). This rule will be republished.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC, Chapter 114, implement Texas Occupations Code, Chapter 605, Orthotists and Prosthetists.

The adopted rules are necessary to implement Senate Bill (SB) 490, 88th Legislature, Regular Session (2023), which requires certain health care providers to provide itemized bills. SB 490 added new Chapter 185 to the Health and Safety Code to address this issue. The term “health care provider” is generally defined under Health and Safety Code §185.001(2) to include a facility licensed, certified, or otherwise authorized to provide health care services or supplies in this state in the ordinary course of business. Section 185.003 requires appropriate licensing authorities to take disciplinary action against providers who violate the requirements of Chapter 185 as if the provider violated an applicable licensing law.

The Department regulates numerous health care professions. Because the definition of the term “health care provider” is restricted in the bill to regulated facilities, however, SB 490 appears to directly impact only those health care professions for which facilities are regulated. The Department regulates the professions of orthotics and prosthetics under Occupations Code, Chapter 605, the Orthotics and Prosthetics Act (the Act). Under §605.260 of the Act, orthotic and prosthetic facilities are required to be accredited by the Department. Because these accredited facilities constitute health care providers under Health and Safety Code §185.001(2), the Department is required to treat a violation by an accredited facility of the itemized billing requirements as a violation of the Department’s licensing statutes. The adopted rules therefore provide that accredited facilities must comply with Health and Safety Code, Chapter 185, and that failure to do so is a basis for disciplinary action under both the Act and the enforcement provisions of Occupations Code, Chapter 51.

In addition to implementing SB 490, the adopted rules make non-substantive changes for purposes of clarity and consistency with the format of other rule chapters administered by the Department. These changes include the addition of clarifying language concerning the authority for and applicability of the rules, the addition and revision of headings, and the deletion of unnecessary language.

SECTION-BY-SECTION SUMMARY

The adopted rules amend §114.1, Authority. The heading is modified to “Authority and Applicability” and the rule is divided into two subsections to separately address each topic. The existing rule text is incorporated into new subsection (a) and language is inserted to clarify the statutory authority for the rule chapter and to include a reference to the new Health and Safety Code, Chapter 185. New subsection (b) is added to clarify that the rules in 16 TAC, Chapter 60, Procedural Rules of the Commission and the Department, and the rules in 16 TAC, Chapter 100, General Provisions for Health-Related Programs, apply to the Orthotists and Prosthetists program in addition to the rules in Chapter 114.

The adopted rules amend §114.70, Responsibilities of Licensees. The heading is modified to “Responsibilities of Licensees and Accredited Facilities” to more accurately reflect the scope of the rule. New subsection (e) is inserted to set forth the requirement of accredited facilities to comply with Health and Safety Code, Chapter 185, and that failure to comply is a basis for enforcement action. Paragraphs (e)(1) through (e)(3) outline the required components of the bills. In response to a public comment received, language was added to subsection (e) to state a clear prohibition on engaging in debt collection without first complying with the itemized billing requirements and to (e)(3) to use the term “the amount the facility alleges is due,” in place of “the amount due,” to more closely track the language of the statute.

The adopted rules amend §114.90, Professional Standards and Basis for Disciplinary Action.” A new subheading, “Enforcement Actions,” is added to subsection (a) to improve readability. Redundant verbiage concerning the authority for the rule is removed. Clarifying changes are made to the syntax of subsections (a)(1) and (a)(2). Subsection (a)(2) is revised to reflect that the sources of the Department’s enforcement authority under Chapter 114 may include a variety of statutes not specifically listed, as reflected in the revised §114.1. Lastly, a new subheading, “Fraud, misrepresentation, or concealment” is added to subsection (b) to improve readability.

Texas Board of Physical Therapy Examiners

Adopted Rule Reviews Re:

Adopting Title 22, Part 16, concerning Definitions; Practice; Powers and Duties of the Board; Organization of the Board; Compensation; Licensing Procedure; Professional Title; Display of License; Fees; License Renewal; Open Records; Contested Case Procedure; Administrative Fines and Penalties; Practice Settings for Physical Therapy; and Physical Therapy Licensure Compact.

The Texas Board of Physical Therapy Examiners (Board) readopts the following chapters of Title 22, Part 16 of the Texas Administrative Code in accordance with Texas Government Code §2001.039:

Chapter 321, Definitions

Chapter 322, Practice

Chapter 323, Powers and Duties of the Board

Chapter 325, Organization of the Board

Chapter 327, Compensation

Chapter 329, Licensing Procedure

Chapter 335, Professional Title

Chapter 337, Display of License

Chapter 339, Fees

Chapter 341, License Renewal

Chapter 342, Open Records

Chapter 343, Contested Case Procedure

Chapter 344, Administrative Fines and Penalties

Chapter 346, Practice Settings for Physical Therapy

Chapter 348, Physical Therapy Licensure Compact

Texas Department of Aging and Disability Services

Adopted Rule Reviews Re:

Adopting Title 40, Part 1, concerning Quality Assurance Fees.

The Texas Health and Human Services Commission (HHSC), as the successor agency of the Texas Department of Aging and Disability Services, adopts the review of the chapter below in Title 40, Part 1, of the Texas Administrative Code (TAC):

Chapter 11, Quality Assurance Fee