Texas Register December 1, 2023 Volume: 48 Number: 48

Texas Register Table of Contents

Texas Board of Chiropractic Examiners

Proposed Rules Re:

Repealing 22 TAC §72.21, to make room for a new rule affecting licensing of military spouses.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.21

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) proposes the repeal of 22 TAC §72.21 (Requirements for Military Spouses). The Board will propose a new §72.21 in a separate rulemaking action.

BACKGROUND AND JUSTIFICATION

Recent changes to Texas Occupations Code Chapter 55 (Licensing of Military Service Members, Military Veterans, and Military Spouses) have expanded the methods by which the spouse of an active duty military member may obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized by the Board. The proposed new §72.21 will reflect those changes.


New 22 TAC §72.21, to expand the methods which a spouse of an active duty service member can obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.21

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) proposes new 22 TAC §72.21 (Requirements for Military Spouses). The current §72.21 is being repealed in a separate rulemaking action.

BACKGROUND AND JUSTIFICATION

Recent changes to Texas Occupations Code Chapter 55 (Licensing of Military Service Members, Military Veterans, and Military Spouses) have expanded the methods by which the spouse of an active duty military member may obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized by the Board. This proposed new §72.21 reflects those changes and delineates the four methods.


Repealing 22 TAC §72.22, to make room for a new rule affecting licensing of active duty service members.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.22

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) proposes the repeal of 22 TAC §72.22 (Requirements for Military Members and Veterans). The Board will propose a new §72.22 in a separate rulemaking action.

BACKGROUND AND JUSTIFICATION

Recent changes to Texas Occupations Code Chapter 55 (Licensing of Military Service Members, Military Veterans, and Military Spouses) have expanded the methods by which an active duty military member or veteran may obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized by the Board. The proposed new §72.21 will reflect those changes.


New 22 TAC §72.22, to expand the methods which an active duty service member can obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.22

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) proposes new 22 TAC §72.22 (Requirements for Military Members and Veterans). The current §72.22 is being repealed in a separate rulemaking action.

BACKGROUND AND JUSTIFICATION

Recent changes to Texas Occupations Code Chapter 55 (Licensing of Military Service Members, Military Veterans, and Military Spouses) have expanded the methods by which an active duty military member or veteran may obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized by the Board. This proposed new §72.21 reflects those changes and delineates the four methods.


Adopted Rules Re:

Repealing 22 TAC §72.5, to remove typographical errors in the current rule concerning Approved Schools and Colleges.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.5

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts the repeal of 22 TAC §72.5 (Approved Schools and Colleges) without changes as published in the September 1, 2023, issue of the Texas Register (48 TexReg 4746). The rule will not be republished. The Board will adopt a new §72.5 in a separate rulemaking. This rulemaking action will remove typographical errors in the current rule.

BACKGROUND AND JUSTIFICATION

The Board received one comment on this rulemaking from Scott Kelley, D.C., the President of the Chiropractic Society of Texas. Dr. Kelley raised his concerns on the substance of the rule itself, not the corrections made in this rulemaking, so the Board declines to adopt any substantive changes to the rule at this time. The Board appreciates Dr. Kelley’s interest in the overall subject of chiropractic college accreditation and looks forward to his input when the Board looks at the issue in depth.


New 22 TAC §72.5, to correct typographical errors in the current rule regarding board fees, license applications, and renewals with no substantive changes to the rule.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.5

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §72.5 (Approved Schools and Colleges) without changes as published in the September 1, 2023, issue of the Texas Register (48 TexReg 4747). The rule will not be republished. The current §72.5 is being repealed in a separate rulemaking action. This rulemaking action will correct typographical errors in the current rule; there are no substantive changes to the existing text proposed.

BACKGROUND AND JUSTIFICATION

The Board received one comment on this rulemaking from Scott Kelley, D.C., the President of the Chiropractic Society of Texas. Dr. Kelley raised his concerns on the substance of the rule itself, not the corrections made in this rulemaking, so the Board declines to adopt any substantive changes to the rule at this time. The Board appreciates Dr. Kelley’s interest in the overall subject of chiropractic college accreditation and looks forward to his input when the Board looks at the issue in depth.


Repealing 22 TAC §78.4, to allow for the rule to be split into two different rules for increased clarity for requirements for delegating to chiropractic students and recent graduates.

CHAPTER 78. SCOPE OF PRACTICE AND DELEGATION
22 TAC §78.4

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts the repeal of 22 TAC §78.4 (Delegation to Chiropractic Students and Recent Graduates) without changes as published in the September 1, 2023, issue of the Texas Register (48 TexReg 4750). The rule will not be republished. The Board will adopt a new §78.4 (Delegation to Chiropractic Students) and a new §78.7 (Delegation to Recent Graduates) in separate rulemakings.

BACKGROUND AND JUSTIFICATION

The overall purpose of these rulemakings is to split the current §78.4 into two separate rules. Licensees have suggested this to the Board because some have found the current rule confusing due to the slightly differing requirements for delegating to chiropractic students and recent graduates. The Board agrees that creating separate rules for students and graduates will make it easier for licensees to comply with the requirements. Therefore, the Board will also adopt a new §78.7 (Delegation to Recent Graduates). There is no substantive changes to the current requirements for delegating to chiropractic students and recent graduates.


New 22 TAC §78.4, to create a separate rule for delegation to chiropractic students.

CHAPTER 78. SCOPE OF PRACTICE AND DELEGATION
22 TAC §78.4

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §78.4 (Delegation to Chiropractic Students) without changes as published in the September 1, 2023, issue of the Texas Register (48 TexReg 4751). The rule will not be republished. The Board will adopt the repeal of the current §78.4 (Delegation to Chiropractic Students and Recent Graduates) and adopt a new §78.7 (Delegation to Recent Graduates) in separate rulemakings.

BACKGROUND AND JUSTIFICATION

The overall purpose of these rulemakings is to split the current §78.4 into two separate rules. Licensees have suggested this to the Board because some have found the current rule confusing due to the slightly differing requirements for delegating to chiropractic students and recent graduates. The Board agrees that creating separate rules for students and graduates will make it easier for licensees to comply with the requirements. Therefore, the Board will also adopt a new §78.7 (Delegation to Recent Graduates). There will be no substantive changes to the current requirements for delegating to chiropractic students and recent graduates.


New 22 TAC §78.7, to create a separate rule for delegation to recent graduates.

CHAPTER 78. SCOPE OF PRACTICE AND DELEGATION
22 TAC §78.7

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §78.7 (Delegation to Recent Graduates) without changes as published in the September 1, 2023, issue of the Texas Register (48 TexReg 4752). The rule will not be republished. The Board will adopt the repeal of the current §78.4 (Delegation to Chiropractic Students and Recent Graduates) and adopt a new §78.4 (Delegation to Chiropractic Students) in separate rulemakings.

BACKGROUND AND JUSTIFICATION

The overall purpose of these rulemakings is to split the current §78.4 into two separate rules (§78.4 for chiropractic students only and new §78.7 for recent graduates only). Licensees have suggested this to the Board because some have found the current rule confusing due to the slightly differing requirements for delegating to chiropractic students and recent graduates contained in the rule. The Board agrees that creating separate stand-alone rules for students and graduates will make it easier for licensees to comply with the requirements. There will be no substantive changes to the current requirements for delegating to chiropractic students and recent graduates.


Texas Board of Physical Therapy Examiners

Proposed Rules Re:

Amending 22 TAC §341.3, to clarify which activities qualify for continuing competence units (CCUs).

CHAPTER 341. LICENSE RENEWAL
22 TAC §341.3

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending 22 TAC §341.3. Qualifying Continuing Competence Activities. The amendments are proposed in order to clarify certain activities that qualify for continuing competence units (CCUs).

BACKGROUND AND JUSTIFICATION

The amendments broaden the category of residencies and fellowships by allowing completion of a residency or fellowship accredited by an entity other than the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) and mentorship of a resident or fellow in an approved program to qualify for CCUs, and requires the Board to maintain a list of approved residencies and fellowships. Additionally, the amendments eliminate oPTion as a qualifying activity as the Federation of State Boards of Physical Therapy (FSBPT) has discontinued the self-assessment tool.


Texas State Board of Pharmacy

Adopted Rules Re:

Amending 22 TAC §283.12, to allow a military service member who is licensed in good standing by a jurisdiction with licensing requirements that are substantially similar to Texas’s requirements to obtain an interim pharmacist license.

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS
22 TAC §283.12

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §283.12, concerning Licenses for Military Service Members, Military Veterans, and Military Spouses. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5382). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments establish procedures for a military service member who is currently licensed in good standing by a jurisdiction with licensing requirements that are substantially similar to Texas’s requirements to obtain an interim pharmacist license, in accordance with Senate Bill 422 and make grammatical corrections.


Amending 22 TAC §291.3, to require notification to the board by any pharmacy which temporarily closes for the loss of a pharmacist-in-charge and to clarify the notification requirements for amending a pharmacy license.

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.3

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.3, concerning Required Notifications. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5384). The rule will not be republished.

The amendments clarify that a pharmacy must notify the board in writing if the pharmacy temporarily closes for the loss of a pharmacist-in-charge and clarify the notification requirements for amending a pharmacy license.


Amending 22 TAC §291.5, to provide that a pharmacy may temporarily close after the loss of a pharmacist-in-charge if the pharmacy notifies the board in writing.

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.5

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.5, concerning Closing a Pharmacy. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5388). The rule will not be republished.

The amendments provide that a pharmacy may temporarily close for the loss of a pharmacist-in-charge if the pharmacy timely notifies the board in writing of the temporary closure.


Amending 22 TAC §291.6, to increase pharmacy license fees, specify the application fee for initial or renewed certificates for remote pharmacy services, and to remove the fee for the insurance of a dual renewal certificate.

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.6

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.6, concerning Pharmacy License Fees. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5389). The rule will not be republished.

The amendments increase pharmacy license fees based on expected expenses, specify the application fee for an initial or renewed certificate to provide remote pharmacy services, and remove the fee for issuance of a duplicate renewal certificate.


Amending 22 TAC §291.8, to update the name of a state agency.

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.8

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.8, concerning Return of Prescription Drugs. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5390). The rule will not be republished.


Amending 22 TAC §291.33, to explain the prepackaging and labelling requirements for a participating provider to dispense donated prescription drugs.

CHAPTER 291. PHARMACIES
SUBCHAPTER B. COMMUNITY PHARMACY (CLASS A)
22 TAC §291.33

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.33, concerning Operational Standards. These amendments are adopted with changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5392). The rule will be republished.


Amending 22 TAC §291.74, to fix grammatical errors and to re-insert rule text that was removed by mistake.

CHAPTER 291. PHARMACIES
SUBCHAPTER D. INSTITUTIONAL PHARMACY (CLASS C)
22 TAC §291.74

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.74, concerning Operational Standards. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5403). The rule will not be republished.


Amending 22 TAC §291.121, to clarify the licensure process for remote pharmacy services.

CHAPTER 291. PHARMACIES
SUBCHAPTER G. SERVICES PROVIDED BY PHARMACIES
22 TAC §291.121

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.121, concerning Remote Pharmacy Services. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5412). The rule will not be republished.


Amending 22 TAC §291.129, to clarify the licensure process for satellite pharmacies.

CHAPTER 291. PHARMACIES
SUBCHAPTER G. SERVICES PROVIDED BY PHARMACIES
22 TAC §291.129

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §291.129, concerning Satellite Pharmacy. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5424). The rule will not be republished.


Amending 22 TAC §295.5, to increase pharmacist license fees.

CHAPTER 295. PHARMACISTS
22 TAC §295.5

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §295.5, concerning Pharmacist License or Renewal Fees. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5427). The rule will not be republished.


Amending 22 TAC §295.8, to remove expired continuing eduction requirements.

CHAPTER 295. PHARMACISTS
22 TAC §295.8

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §295.8, concerning Continuing Education Requirements. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5428). The rule will not be republished.


Amending 22 TAC §295.9, to make a grammatical correction and remove expired continuing education requirements.

CHAPTER 295. PHARMACISTS
22 TAC §295.9

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §295.9, concerning Inactive License. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5432). The rule will not be republished.


Amending 22 TAC §297.10, to create procedures for military service members licensed and in good standing in a jurisdiction with registration requirements that are substantially similar to Texas’s requirements to obtain an interim pharmacy technician registration.

CHAPTER 297. PHARMACY TECHNICIANS AND PHARMACY TECHNICIAN TRAINEES
22 TAC §297.10

OVERVIEW

The Texas State Board of Pharmacy adopts amendments to §297.10, concerning Registration for Military Service Members, Military Veterans, and Military Spouses. These amendments are adopted without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5433). The rule will not be republished.


Texas Department of State Health Services

Adopted Rules Re:

Repealing 25 TAC §131.1, §131.2, to allow for similar rules to be proposed in Title 26, Chapter 509 concerning the general provisions surrounding Freestanding Emergency Medical Care Facilities.

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER A. GENERAL PROVISIONS
25 TAC §131.1, §131.2

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 131, concerning Freestanding Emergency Medical Care Facilities, Subchapter A, concerning General Provisions; Subchapter B, concerning Licensing Requirements; Subchapter C, concerning Operational Requirements; Subchapter D, concerning Inspection and Investigation Procedures; and Subchapter E, concerning Enforcement. The repealed subchapters consist of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109.

The repeal of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109 are adopted without changes to the proposed repealed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3799). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals are necessary to remove the rules in Chapter 131, Freestanding Emergency Medical Care Facilities, Subchapters A – E, and adopt new rules in 26 TAC Chapter 509, Freestanding Emergency Medical Care Facilities.

The new rules in Title 26, Chapter 509 are adopted elsewhere in this issue of the Texas Register and are substantially similar to the repealed rules.


Repealing 25 TAC §§131.21 – 131.31, to allow for similar rules to be proposed in Title 26, Chapter 509 concerning the licensing requirements for Freestanding Emergency Medical Care Facilities.

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER B. LICENSING REQUIREMENTS
25 TAC §§131.21 – 131.31

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 131, concerning Freestanding Emergency Medical Care Facilities, Subchapter A, concerning General Provisions; Subchapter B, concerning Licensing Requirements; Subchapter C, concerning Operational Requirements; Subchapter D, concerning Inspection and Investigation Procedures; and Subchapter E, concerning Enforcement. The repealed subchapters consist of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109.

The repeal of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109 are adopted without changes to the proposed repealed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3799). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals are necessary to remove the rules in Chapter 131, Freestanding Emergency Medical Care Facilities, Subchapters A – E, and adopt new rules in 26 TAC Chapter 509, Freestanding Emergency Medical Care Facilities.

The new rules in Title 26, Chapter 509 are adopted elsewhere in this issue of the Texas Register and are substantially similar to the repealed rules.


Repealing 25 TAC §§131.41 – 131.68, to allow for similar rules to be proposed in Title 26, Chapter 509 concerning the operational requirements for Freestanding Emergency Medical Care Facilities.

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
25 TAC §§131.41 – 131.68

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 131, concerning Freestanding Emergency Medical Care Facilities, Subchapter A, concerning General Provisions; Subchapter B, concerning Licensing Requirements; Subchapter C, concerning Operational Requirements; Subchapter D, concerning Inspection and Investigation Procedures; and Subchapter E, concerning Enforcement. The repealed subchapters consist of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109.

The repeal of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109 are adopted without changes to the proposed repealed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3799). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals are necessary to remove the rules in Chapter 131, Freestanding Emergency Medical Care Facilities, Subchapters A – E, and adopt new rules in 26 TAC Chapter 509, Freestanding Emergency Medical Care Facilities.

The new rules in Title 26, Chapter 509 are adopted elsewhere in this issue of the Texas Register and are substantially similar to the repealed rules.


Repealing 25 TAC §131.81, §131.82, to allow for similar rules to be proposed in Title 26, Chapter 509 concerning the inspection and investigation procedures for Freestanding Emergency Medical Care Facilities.

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER D. INSPECTION AND INVESTIGATION PROCEDURES
25 TAC §131.81, §131.82

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 131, concerning Freestanding Emergency Medical Care Facilities, Subchapter A, concerning General Provisions; Subchapter B, concerning Licensing Requirements; Subchapter C, concerning Operational Requirements; Subchapter D, concerning Inspection and Investigation Procedures; and Subchapter E, concerning Enforcement. The repealed subchapters consist of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109.

The repeal of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109 are adopted without changes to the proposed repealed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3799). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals are necessary to remove the rules in Chapter 131, Freestanding Emergency Medical Care Facilities, Subchapters A – E, and adopt new rules in 26 TAC Chapter 509, Freestanding Emergency Medical Care Facilities.

The new rules in Title 26, Chapter 509 are adopted elsewhere in this issue of the Texas Register and are substantially similar to the repealed rules.


Repealing 25 TAC §§131.101 – 131.109, to allow for similar rules to be proposed in Title 26, Chapter 509 concerning the enforcement procedures for Freestanding Emergency Medical Care Facilities.

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER E. ENFORCEMENT
25 TAC §§131.101 – 131.109

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 131, concerning Freestanding Emergency Medical Care Facilities, Subchapter A, concerning General Provisions; Subchapter B, concerning Licensing Requirements; Subchapter C, concerning Operational Requirements; Subchapter D, concerning Inspection and Investigation Procedures; and Subchapter E, concerning Enforcement. The repealed subchapters consist of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109.

The repeal of §§131.1, 131.2, 131.21 – 131.31, 131.41 – 131.68, 131.81, 131.82, and 131.101 – 131.109 are adopted without changes to the proposed repealed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3799). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals are necessary to remove the rules in Chapter 131, Freestanding Emergency Medical Care Facilities, Subchapters A – E, and adopt new rules in 26 TAC Chapter 509, Freestanding Emergency Medical Care Facilities.

The new rules in Title 26, Chapter 509 are adopted elsewhere in this issue of the Texas Register and are substantially similar to the repealed rules.


Cancer Prevention and Research Institute of Texas

Adopted Rules Re:

Amending 25 TAC §701.25, to expand the electronic signature policy to include Grant Applicants and ASOs who submit applications through CPRIT’s electronic Application Receipt System.

CHAPTER 701. POLICIES AND PROCEDURES
25 TAC §701.25

OVERVIEW

The Cancer Prevention and Research Institute of Texas (“CPRIT” or “the Institute”) adopts the amendments to 25 Texas Administrative Code §701.25 without changes to the proposed amendments as published in the September 1, 2023, issue of the Texas Register (48 TexReg 4773); therefore, the rule will not be republished. The amendments relate to CPRIT’s electronic signature policy.

BACKGROUND AND JUSTIFICATION

CPRIT amends its electronic signature policy to include grant applicants so that the convenience and responsibilities associated with electronic signatures are available to grant applicants as well as grant recipients.


Texas Health and Human Services Commission

Adopted Rules Re:

New 26 TAC §509.1, §509.2, to describe the purpose of the chapter and definitions in the chapter.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §509.1, §509.2

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new rules in Texas Administrative Code (TAC), Title 26, Part 1, Chapter 509, concerning Freestanding Emergency Medical Care Facilities. The new chapter consists of §§509.1, 509.2, 509.21 – 509.30, 509.41 – 509.66, 509.81 – 509.86, and 509.101 – 509.108.

New §§509.2, 509.24, 509.26, 509.48, 509.51 – 509.54, 509.61, 509.62, and 509.81 – 509.83 are adopted with changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will be republished.

New §§509.1, 509.21 – 509.23, 509.25, 509.27 – 509.30, 509.41 – 509.47, 509.49, 509.50, 509.55 – 509.60, 509.63 – 509.66, 509.84 – 509.86, and 509.101 – 509.108 are adopted without changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections are necessary to comply with House Bill (H.B.) 2041 and H.B. 1112, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code (HSC), Chapter 254, relating to the regulation of Freestanding Emergency Medical Care Facilities. H.B. 2041 requires freestanding emergency medical care (FEMC) facilities to comply with updated advertising requirements, which includes disclosure of facility fees and clarification of health benefit plans that are accepted by the facility, and it requires FEMC facilities to provide a disclosure statement to patients. H.B. 2041 requires an FEMC facility that closes or whose license is expired, suspended, or revoked to remove their signs from the facility. H.B. 1112 similarly requires a closed FEMC facility or an FEMC facility whose license is expired, suspended, or revoked to remove their signage. This proposal also complies with Senate Bill (S.B.) 425, 84th Legislature, Regular Session, 2015, which amended HSC Chapter 254 to require an FEMC facility to post a notice regarding facility fees and provide other consumer information to patients.


New 26 TAC §§509.21 – 509.30, to give guidelines for licensing renewal, changes of ownership, facility closures, and fees.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER B. LICENSING REQUIREMENTS
26 TAC §§509.21 – 509.30

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new rules in Texas Administrative Code (TAC), Title 26, Part 1, Chapter 509, concerning Freestanding Emergency Medical Care Facilities. The new chapter consists of §§509.1, 509.2, 509.21 – 509.30, 509.41 – 509.66, 509.81 – 509.86, and 509.101 – 509.108.

New §§509.2, 509.24, 509.26, 509.48, 509.51 – 509.54, 509.61, 509.62, and 509.81 – 509.83 are adopted with changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will be republished.

New §§509.1, 509.21 – 509.23, 509.25, 509.27 – 509.30, 509.41 – 509.47, 509.49, 509.50, 509.55 – 509.60, 509.63 – 509.66, 509.84 – 509.86, and 509.101 – 509.108 are adopted without changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections are necessary to comply with House Bill (H.B.) 2041 and H.B. 1112, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code (HSC), Chapter 254, relating to the regulation of Freestanding Emergency Medical Care Facilities. H.B. 2041 requires freestanding emergency medical care (FEMC) facilities to comply with updated advertising requirements, which includes disclosure of facility fees and clarification of health benefit plans that are accepted by the facility, and it requires FEMC facilities to provide a disclosure statement to patients. H.B. 2041 requires an FEMC facility that closes or whose license is expired, suspended, or revoked to remove their signs from the facility. H.B. 1112 similarly requires a closed FEMC facility or an FEMC facility whose license is expired, suspended, or revoked to remove their signage. This proposal also complies with Senate Bill (S.B.) 425, 84th Legislature, Regular Session, 2015, which amended HSC Chapter 254 to require an FEMC facility to post a notice regarding facility fees and provide other consumer information to patients.


New 26 TAC §§509.41 – 509.66, to describe the required facility operations standards for freestanding emergency medical care facilities.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §§509.41 – 509.66

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new rules in Texas Administrative Code (TAC), Title 26, Part 1, Chapter 509, concerning Freestanding Emergency Medical Care Facilities. The new chapter consists of §§509.1, 509.2, 509.21 – 509.30, 509.41 – 509.66, 509.81 – 509.86, and 509.101 – 509.108.

New §§509.2, 509.24, 509.26, 509.48, 509.51 – 509.54, 509.61, 509.62, and 509.81 – 509.83 are adopted with changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will be republished.

New §§509.1, 509.21 – 509.23, 509.25, 509.27 – 509.30, 509.41 – 509.47, 509.49, 509.50, 509.55 – 509.60, 509.63 – 509.66, 509.84 – 509.86, and 509.101 – 509.108 are adopted without changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections are necessary to comply with House Bill (H.B.) 2041 and H.B. 1112, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code (HSC), Chapter 254, relating to the regulation of Freestanding Emergency Medical Care Facilities. H.B. 2041 requires freestanding emergency medical care (FEMC) facilities to comply with updated advertising requirements, which includes disclosure of facility fees and clarification of health benefit plans that are accepted by the facility, and it requires FEMC facilities to provide a disclosure statement to patients. H.B. 2041 requires an FEMC facility that closes or whose license is expired, suspended, or revoked to remove their signs from the facility. H.B. 1112 similarly requires a closed FEMC facility or an FEMC facility whose license is expired, suspended, or revoked to remove their signage. This proposal also complies with Senate Bill (S.B.) 425, 84th Legislature, Regular Session, 2015, which amended HSC Chapter 254 to require an FEMC facility to post a notice regarding facility fees and provide other consumer information to patients.


New 26 TAC §§509.81 – 509.86, to update and clarify the investigation and inspection procedures for FEMC facilities.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER D. INSPECTION AND INVESTIGATION PROCEDURES
26 TAC §§509.81 – 509.86

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new rules in Texas Administrative Code (TAC), Title 26, Part 1, Chapter 509, concerning Freestanding Emergency Medical Care Facilities. The new chapter consists of §§509.1, 509.2, 509.21 – 509.30, 509.41 – 509.66, 509.81 – 509.86, and 509.101 – 509.108.

New §§509.2, 509.24, 509.26, 509.48, 509.51 – 509.54, 509.61, 509.62, and 509.81 – 509.83 are adopted with changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will be republished.

New §§509.1, 509.21 – 509.23, 509.25, 509.27 – 509.30, 509.41 – 509.47, 509.49, 509.50, 509.55 – 509.60, 509.63 – 509.66, 509.84 – 509.86, and 509.101 – 509.108 are adopted without changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections are necessary to comply with House Bill (H.B.) 2041 and H.B. 1112, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code (HSC), Chapter 254, relating to the regulation of Freestanding Emergency Medical Care Facilities. H.B. 2041 requires freestanding emergency medical care (FEMC) facilities to comply with updated advertising requirements, which includes disclosure of facility fees and clarification of health benefit plans that are accepted by the facility, and it requires FEMC facilities to provide a disclosure statement to patients. H.B. 2041 requires an FEMC facility that closes or whose license is expired, suspended, or revoked to remove their signs from the facility. H.B. 1112 similarly requires a closed FEMC facility or an FEMC facility whose license is expired, suspended, or revoked to remove their signage. This proposal also complies with Senate Bill (S.B.) 425, 84th Legislature, Regular Session, 2015, which amended HSC Chapter 254 to require an FEMC facility to post a notice regarding facility fees and provide other consumer information to patients.


New 26 TAC §§509.101 – 509.108, to outline the procedure for enforcement actions, which include denial of licensure, suspension, revocation, probation, and administrative penalties.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER E. ENFORCEMENT
26 TAC §§509.101 – 509.108

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new rules in Texas Administrative Code (TAC), Title 26, Part 1, Chapter 509, concerning Freestanding Emergency Medical Care Facilities. The new chapter consists of §§509.1, 509.2, 509.21 – 509.30, 509.41 – 509.66, 509.81 – 509.86, and 509.101 – 509.108.

New §§509.2, 509.24, 509.26, 509.48, 509.51 – 509.54, 509.61, 509.62, and 509.81 – 509.83 are adopted with changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will be republished.

New §§509.1, 509.21 – 509.23, 509.25, 509.27 – 509.30, 509.41 – 509.47, 509.49, 509.50, 509.55 – 509.60, 509.63 – 509.66, 509.84 – 509.86, and 509.101 – 509.108 are adopted without changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3801). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections are necessary to comply with House Bill (H.B.) 2041 and H.B. 1112, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code (HSC), Chapter 254, relating to the regulation of Freestanding Emergency Medical Care Facilities. H.B. 2041 requires freestanding emergency medical care (FEMC) facilities to comply with updated advertising requirements, which includes disclosure of facility fees and clarification of health benefit plans that are accepted by the facility, and it requires FEMC facilities to provide a disclosure statement to patients. H.B. 2041 requires an FEMC facility that closes or whose license is expired, suspended, or revoked to remove their signs from the facility. H.B. 1112 similarly requires a closed FEMC facility or an FEMC facility whose license is expired, suspended, or revoked to remove their signage. This proposal also complies with Senate Bill (S.B.) 425, 84th Legislature, Regular Session, 2015, which amended HSC Chapter 254 to require an FEMC facility to post a notice regarding facility fees and provide other consumer information to patients.


Amending 26 TAC §555.2, to update definitions and information in the Nursing Facility Administrator rules, such as names and number of educational domains used by the NAB.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER A. GENERAL INFORMATION
26 TAC §555.2

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §555.2, concerning Definitions, §555.11, concerning Application Requirements, §555.12, concerning Licensure Requirements, §555.13, concerning Internship Requirements, §555.18, concerning Examinations and Requirements to Take the Examinations, §555.32, concerning Provisional License, and §555.35, concerning Continuing Education Requirements for License Renewal. The sections are adopted without changes to the proposed text as published in the September 8, 2023, issue of the Texas Register (48 TexReg 4988). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rules clarify requirements and provide additional options for individuals to qualify for nursing facility administrator (NFA) licensure. The amendments update definitions and associated references for consistency with changes made by the National Association of Long-Term Care Administrator Boards (NAB) regarding both educational domains for testing and the company conducting the NAB examination. The amended rules also provide a greater degree of flexibility for the administrator-in-training (AIT) internship. Other non-substantive changes are for clarification.


Amending 26 TAC §§555.11 – 555.13, 555.18, to describe the requirements for NFA licensure and to add additional options for licensure requirements.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER B. REQUIREMENTS FOR LICENSURE
26 TAC §§555.11 – 555.13, 555.18

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §555.2, concerning Definitions, §555.11, concerning Application Requirements, §555.12, concerning Licensure Requirements, §555.13, concerning Internship Requirements, §555.18, concerning Examinations and Requirements to Take the Examinations, §555.32, concerning Provisional License, and §555.35, concerning Continuing Education Requirements for License Renewal. The sections are adopted without changes to the proposed text as published in the September 8, 2023, issue of the Texas Register (48 TexReg 4988). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rules clarify requirements and provide additional options for individuals to qualify for nursing facility administrator (NFA) licensure. The amendments update definitions and associated references for consistency with changes made by the National Association of Long-Term Care Administrator Boards (NAB) regarding both educational domains for testing and the company conducting the NAB examination. The amended rules also provide a greater degree of flexibility for the administrator-in-training (AIT) internship. Other non-substantive changes are for clarification.


Amending 26 TAC §555.32, §555.35, to clarify the requirements for a provisional NFA license and the requirements for continuing education.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER C. LICENSES
26 TAC §555.32, §555.35

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §555.2, concerning Definitions, §555.11, concerning Application Requirements, §555.12, concerning Licensure Requirements, §555.13, concerning Internship Requirements, §555.18, concerning Examinations and Requirements to Take the Examinations, §555.32, concerning Provisional License, and §555.35, concerning Continuing Education Requirements for License Renewal. The sections are adopted without changes to the proposed text as published in the September 8, 2023, issue of the Texas Register (48 TexReg 4988). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rules clarify requirements and provide additional options for individuals to qualify for nursing facility administrator (NFA) licensure. The amendments update definitions and associated references for consistency with changes made by the National Association of Long-Term Care Administrator Boards (NAB) regarding both educational domains for testing and the company conducting the NAB examination. The amended rules also provide a greater degree of flexibility for the administrator-in-training (AIT) internship. Other non-substantive changes are for clarification.


Transferred Rules Re:

Rule Transfer

OVERVIEW

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. The former DADS rule in Texas Administrative Code, Title 40, Part 1, Chapter 2, Local Authority Responsibilities, Subchapter A, Local Authority Notification and Appeal is being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 301, IDD-BH Contractor Administrative Functions, new Subchapter D, LIDDA, LMHA, and LBHA Notification and Appeal Process.

For more information, please visit this week’s edition of the Texas Register at 48 Tex Reg 7081.


Department of Aging and Disability Services

Transferred Rules Re:

Rule Transfer

OVERVIEW

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. The former DADS rule in Texas Administrative Code, Title 40, Part 1, Chapter 2, Local Authority Responsibilities, Subchapter A, Local Authority Notification and Appeal is being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 301, IDD-BH Contractor Administrative Functions, new Subchapter D, LIDDA, LMHA, and LBHA Notification and Appeal Process.

For more information, please visit this week’s edition of the Texas Register at 48 Tex Reg 7081.