Texas Register February 2, 2024 Volume: 49 Number: 5

Texas Register Table of Contents

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 26 TAC §88.2, to update terms in the rule.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER A. PURPOSE AND DEFINITIONS
26 TAC §88.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §88.2, Definitions, adds definitions for the following new terms: “grievance;” “grievant;” “informed consent;” and “ombudsman database.” The proposed amendment removes the term “state fiscal year” because this term is no longer used in the rules. The proposed amendment also renumbers the definitions.


Amending 26 TAC §§88.101, 88.102, 88.104 – 88.105 and new 88.106 – 88.107, to update the format of the rules, describe an onsite visit of a local ombudsman entity and a host agency, and to explain the purpose of a desk review.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER B. ESTABLISHMENT OF THE OFFICE
26 TAC §§88.101, 88.102, 88.104 – 88.107

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §88.101, Responsibilities of the State Ombudsman and the Office, references Subchapter G related to Grievances instead of §88.309 relating to Grievances Regarding Performance of a Representative of the Office or Certification Decisions by the State Ombudsman because §88.309 is proposed for repeal. The proposed amendment makes minor editorial changes.
  • The proposed amendment to §88.102, Certification of an Ombudsman, makes edits to clarify the type of employee or independent contractor the State Ombudsman certifies as a staff ombudsman. The proposed amendment also corrects a rule reference regarding §88.2 because the proposed amendment to §88.2 renumbers the definitions.
  • The proposed amendment to §88.104, Designation of a Local Ombudsman Entity, in subsection (b)(1) and (2) of the rule updates references regarding §88.2 because the proposed amendment to §88.2 renumbers the definitions. The proposed amendment in subsection (c)(2) references proposed new §§88.106, 88.107, and 88.409 instead of §88.105 because the content in §88.105 related to onsite monitoring, desk review, and non-compliance is addressed in proposed new §§88.106, 88.107, and 88.409. The proposed amendment in subsection (c)(2)(B) of the rule adds “written” before “plan of correction” and reformats the rule for clarity. The proposed amendment in subsection (c)(2)(C) clarifies that the State Ombudsman may remove the designation of a local ombudsman entity if the local ombudsman entity does not complete the actions in accordance with an approved plan of correction or an approved modified plan of correction. The proposed amendment in subsection (f) of the rule updates a rule reference.
  • The proposed amendment to §88.105, Fiscal Management and Monitoring of a Local Ombudsman Entity, retitles the rule as “Fiscal Management of a Local Ombudsman Entity.” The proposed amendment in subsection (b) of the rule adds “through the HHSC Office of the Area Agencies on Aging” to clarify how the State Ombudsman distributes funds to a host agency, corrects a reference to the Older Americans Act, removes outdated funding formulas, clarifies the description of state general revenue funds and their allocation by the State Ombudsman for the performance of Ombudsman Program functions, changes the term “state fiscal year” to “federal fiscal year” and reformats the rule to improve readability and clarity. The proposed amendment removes subsections (c) – (k) related to onsite monitoring, desk review, and non-compliance because these topics are addressed in proposed new §§88.106, 88.107, and 88.409.
  • Proposed new §88.106, Onsite Monitoring of a Local Ombudsman Entity and a Host Agency, describes what the Office monitors when it conducts an onsite visit of a local ombudsman entity and a host agency. The proposed rule specifies that the Office conducts at least one onsite visit every three years and describes the activities performed in an onsite visit. The proposed rule describes how the Office schedules a date for an onsite visit and notifies the host agency of a scheduled visit at least 30 days before the visit. The proposed rule provides that the Office gives the local ombudsman entity and the host agency a written report that may contain findings and recommendations from the onsite visit within 45 days after the visit. Currently, §88.105(e)(3) allows the Office 30 days after the onsite visit to provide the report. The proposed rule extends the time frame to 45 days to give the Office adequate time to review information obtained from the visit. The proposed rule requires the host agency to submit a written plan of correction to the Office within 45 days after receipt of the written report that contains one or more findings, instead of within 30 days after receipt of the report as provided by the current rule. This change in timeframe allows the host agency adequate time to develop a plan of correction. The proposed rule provides that the Office notifies the local ombudsman entity and host agency of whether the plan is approved or requires modification within 45 days after receipt of the plan of correction, instead of 30 days after receipt of the plan of correction. This change in timeframe allows the Office adequate time to review the plan of correction. The proposed rule requires the local ombudsman entity or host agency to complete the actions contained in the plan of correction by the dates in the plan and requires the host agency to, if the Office determines that the plan requires modification, submit a modified written plan of correction within a time period determined by the Office for approval by the Office. The proposed rule describes the actions the Office may take to determine if the local ombudsman or host agency entity has completed the actions in accordance with an approved plan of correction or approved modified plan of correction. The proposed rule provides that if the Office determines that the local ombudsman entity or host agency did not complete an action in accordance with an approved plan of correction or an approved modified plan of correction, the Office may allow the local ombudsman entity or host agency additional time to complete the action, HHSC may impose a Level Two sanction in accordance with 26 TAC §213.5, or the State Ombudsman may remove the designation of a local ombudsman entity. The proposed rule provides that if the Office allows a local ombudsman entity or host agency additional time to complete an action and the Office determines that the local ombudsman entity did not complete the action within the time allowed, HHSC may impose a Level Two sanction in accordance with 26 TAC §213.5, or the State Ombudsman may remove the designation of a local ombudsman entity. The proposed rule provides that, at the request of a local ombudsman entity or host agency, the Office provides technical assistance to a local ombudsman entity or host agency regarding developing a plan of correction.
  • Proposed new §88.107, Desk Review Monitoring of a Local Ombudsman Entity, describes the purpose of a desk review, which includes determining if a local ombudsman entity has conducted at least one visit to each long-term care (LTC) facility in the ombudsman service area each quarter of a federal fiscal year. The proposed rule also describes how often the Office conducts a desk review and that if the Office identifies a finding from a desk review, the Office provides to the local ombudsman entity and the host agency a written report that contains the finding and may include recommendations. Currently, §88.105(j) allows the Office to provide the report within 30 days after the desk review. The proposed rule does not include a time frame to allow the Office a flexible timeline to provide the report. The proposed rule requires a host agency to submit a written plan of correction containing certain information to the Office within 14 days after receipt of a report. The proposed rule provides a time frame for the Office to notify the local ombudsman entity and host agency of whether the plan is approved or requires modification. The proposed rule requires the local ombudsman entity to complete the actions contained in the plan of correction by the dates in the plan if the Office approves the plan. The proposed rule requires the host agency to submit a modified written plan of correction within a time period determined by the Office for approval by the Office, if the Office determines that the plan requires modification. The proposed rule describes the actions the Office takes to determine if the local ombudsman entity has completed the actions in an approved plan of correction or approved modified plan of correction. The proposed rule provides that, if the Office determines that the local ombudsman entity did not complete an action in an approved plan of correction or a modified plan of correction, the Office may allow the local ombudsman entity additional time to complete the action, HHSC may impose a Level Two sanction in accordance with 26 TAC §213.5, or the State Ombudsman may remove the designation of a local ombudsman entity. The proposed rule also provides that if the Office allows a local ombudsman entity additional time to complete an action in the approved plan and the Office determines that the local ombudsman entity did not complete the action within the time allowed, HHSC may impose a Level Two sanction in accordance with 26 TAC §213.5 or the State Ombudsman may remove the designation of the local ombudsman entity. The proposed rule also provides that upon request by a local ombudsman entity or host agency, the Office provides technical assistance to a local ombudsman entity or host agency regarding developing a plan of correction.

Amending 26 TAC §88.201, and new §88.202, to provide a specific description of the records which a certified ombudsman has access to and to describe when and the type of form a certified ombudsman must provide when requesting access to a confidential record.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER C. ACCESS BY THE STATE OMBUDSMAN AND REPRESENTATIVES OF THE OFFICE
26 TAC §88.201, §88.202

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §88.201, Access to Facilities, Residents, and Resident Records, in subsection (c)(1) of the rule adds a reference to 45 CFR §1324.11(e)(2) and uses language from 45 CFR §1324.11(e)(2) instead of the Older Americans Act for a more specific description of the records to which a certified ombudsman has access, including that a certified ombudsman has access to records regardless of format. The proposed amendment in subsection (c)(1)(A) and (B) of the rule uses the term “informed consent” instead of “consent” to be consistent with 45 CFR Part 1324. The proposed amendment adds a new subsection (d) to provide that, in accordance with 45 CFR §1324.11(e)(2), access by the State Ombudsman and a certified ombudsman to a record as described in subsection (c) of this section, includes obtaining a copy of the record upon request.
  • Proposed new §88.202, Notification to LTC Facility of Authorization to Access Resident Records, requires a certified ombudsman to, at the request of an LTC facility, provide a completed HHSC form “Acknowledgement of Ombudsman Access to Confidential Record” to the facility at the time the certified ombudsman is requesting access to a confidential record concerning a resident of the facility to help to ensure a record of the request for access exists.

Amending 26 TAC §88.305, §88.307, to explain when an ombudsman is required to tell a complainant that a complaint will be investigated and the timeline of when a local ombudsman must enter activities and casework into the ombudsman database.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER D. REQUIREMENTS OF A LOCAL OMBUDSMAN ENTITY
26 TAC §88.305, §88.307

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §88.305, Complaints, in subsection (b)(1) and (2) of the rule uses the term “informed consent” instead of “consent” to be consistent with 45 CFR Part 1324. The proposed amendment requires a certified ombudsman to inform a complainant that one of the situations in which a complaint will be investigated is when the resident is unable to communicate informed consent to investigate the complaint, has a legally authorized representative, and (1) the complaint relates to an action, inaction, or decision of the legally authorized representative that may adversely affect the health, safety, welfare, or rights of the resident; (2) the certified ombudsman does not have evidence that the resident would object to the complaint being investigated; (3) the certified ombudsman has reasonable cause to believe that it is in the best interest of the resident to investigate the complaint; and (4) the State Ombudsman approves the request of the certified ombudsman to investigate the complaint. The proposed amendment requires a certified ombudsman to request approval from the State Ombudsman to investigate the complaint if this situation exists. The proposed amendment adds a new paragraph (5) in subsection (b) of the rule to require a certified ombudsman to, if the State Ombudsman gives approval, make the referral to the appropriate agency; and determine whether the complaint is satisfactorily resolved. The proposed amendment requires the certified ombudsman to follow the instruction of the State Ombudsman if the State Ombudsman does not approve the request to investigate the complaint. The proposed amendment also requires a certified ombudsman to document the type of consent or authority that allows for a complaint to be investigated. The amendments related to requesting approval from the State Ombudsman to investigate a complaint, making a referral to an appropriate agency, following State Ombudsman instruction if approval is not given, and documenting consent or authority reflect current policies of the Ombudsman Program. The proposed amendment renumbers the paragraphs in subsection (b) because a new paragraph (5) is added.
  • The proposed amendment to §88.307, changes the title of the rule from “Requirements Regarding LTC Visits and Submitting Information to the Office” to “Requirements Regarding LTC Facility Visits and Submitting Information to the Office.” The change is made to use the defined term “LTC facility” in the title of this rule. The proposed amendment requires a local ombudsman entity to enter activities and casework into the ombudsman database within 14 days after completion of the activity or receipt of the complaint instead of on the 16th day of each month if the 16th is a business day or the first business day after the 16th if the 16th is not a business day. This change in the deadline to enter the information was made to help ensure the accuracy and completeness of the information entered.

Repealing 26 TAC §88.309, to delete and unnecessary rule pertaining to grievances which is addressed in new Subchapter G.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER D. REQUIREMENTS OF A LOCAL OMBUDSMAN ENTITY
26 TAC §88.309

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §88.309, Grievances Regarding Performance of a Representative of the Office or Certification Decisions by the State Ombudsman, deletes the rule as no longer necessary, because the content of the rule is addressed in proposed new Subchapter G.


Amending 26 TAC §§88.403 – 88.404, 88.406, and new 88.405, 88.407 – 88.409, to reformat the rules, describe performance measures, include procedures for approval of staffing plans, and explain certain non-compliance procedures.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER E. REQUIREMENTS OF A HOST AGENCY
26 TAC §§88.403 – 88.409

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §88.403, Conflicts of Interest Regarding a Host Agency, updates references regarding §88.2 because the proposed amendment to §88.2 renumbers the definitions. The proposed amendment also changes a reference to “§88.2(19)(B)” to specify a governmental entity or nonprofit organization contracting with a host agency.
  • The proposed amendment to §88.404, Provision of Records to the Office, Disclosure of Confidential Information, and Allegations of Abuse, Neglect, or Exploitation, updates a reference regarding §88.2 because the proposed amendment to §88.2 renumbers the definitions. The proposed amendment also changes a reference to “§88.2(19)(B)” to specify a governmental entity or nonprofit organization contracting with a host agency.
  • Proposed new §88.405, Performance Measures, describes the performance measures of a local ombudsman entity in proposed subsection (a) including the number of visits to nursing facilities by certified ombudsmen that will occur during a state fiscal year; compliance with the complaint response requirements; compliance with the requirement to submit activities and casework; and compliance with the minimum expenditure requirement. Proposed subsection (b) of the rule requires a host agency to work with the local ombudsman entity to develop projections for certain performance measures for a state fiscal year as directed by the HHSC Office of the Area Agencies on Aging and submit the projections to the Office by July 31st of each year using the HHSC form “Ombudsman Performance Measure Projections.” The proposed rule provides that the Office reviews a form submitted by the host agency and approves the form or recommends modifications to the form. If the Office recommends modifications to the form, the proposed rule requires the host agency to submit a revised form to the Office for approval within a time period determined by the Office. The current rule requires that a host agency submit the performance measure projections to the HHSC Office of the Area Agencies on Aging but the proposed rule makes the recipient of the projections the Office because the projections concern the Ombudsman Program. Proposed subsections (c) and (d) of the rule require a host agency to ensure that a local ombudsman entity, by the end of each state fiscal year, meets the performance measure projections approved by the Office as described in subsection (b) and certain performance measures by (1) being within a variance of minus ten percent of the projections or performance measures; or (2) exceeding the projections or performance measures. Proposed subsection (e) of the rule requires that a host agency meets or exceeds the performance measure in subsection (a)(7) of the rule regarding the minimum funding requirement because this requirement is in §306(a)(9) of the Older Americans Act. The term “state fiscal year” is changed to “federal fiscal year” in all subsections of the rule.
  • The proposed amendment to §88.406, Requirements Regarding Expenditures for the Ombudsman Program, requires a host agency to expend for a federal fiscal year at least the amount of federal funds expended in federal fiscal year 2019, instead of in federal fiscal year 2000, to be in compliance with §306(a)(9) of the Older Americans Act. The proposed amendment provides that in determining the amount of funds expended, the host agency may include all funds except the state general revenue funds allocated to the host agency described in proposed §88.105(b)(3). The proposed amendment also removes a title to a federal regulation for brevity.
  • Proposed new §88.407, Requirement for Approval of Ombudsman Staffing Plan Form, provides that the Office sends a host agency an Ombudsman Staffing Plan form each year and requires a host agency to complete and submit the Ombudsman Staffing Plan form as specified in the form. The proposed rule also provides that the Office reviews the form and notifies the host agency if the staffing plan form is approved. The proposed rule provides that the Office will not reimburse a host agency for expenditures made by the host agency for Ombudsman Program functions until the Office approves an Ombudsman Staffing Plan form submitted by the host agency.
  • Proposed new §88.408, Prohibition of Interference and Retaliation by a Host Agency, in proposed subsection (a) of the rule, prevents a host agency from willfully interfering with the State Ombudsman or a representative of the Office performing any of the functions of the Ombudsman Program, retaliating against the State Ombudsman or a representative of the Office, and having personnel policies or practices that prohibit a representative of the Office from performing the functions of the Ombudsman Program or from adhering to the requirements of the Older Americans Act, §712. Proposed subsection (b) of the rule requires a host agency to ensure that a governmental entity or nonprofit organization contracting with a host agency, complies with §88.408(a) of this section as if the entity or organization is a host agency. Proposed subsection (c) of the rule allows a host agency to require a representative of the Office to notify the host agency of comments or recommendations made in accordance with §88.302(a)(1)(F) and of certain information relating to a legislator or the media.
  • Proposed new §88.409, Noncompliance by a Host Agency, in proposed subsection (a) of the rule provides that if the Office determines that a host agency is not in compliance with Subchapter E, relating to Requirements of a Host Agency, and the determination is not based on onsite monitoring or a desk review, the Office sends the local ombudsman entity and host agency a written notice describing the determination of non-compliance. Proposed subsection (b) of the rule requires the host agency or local ombudsman entity to respond to the written notice within 14 days with a plan of correction describing the action that will be taken to address the non-compliance and the date the action will be completed. Proposed subsection (c) of the rule provides that the Office will notify the host agency within 14 days if the plan of correction is approved or requires modification. Proposed subsection (d) of the rule provides that the Office will determine compliance with the plan of correction by reviewing information in the ombudsman database, requesting that the host agency submit evidence of correction to the Office, or visiting the host agency or local ombudsman entity. Proposed subsection (e) of the rule provides that if the Office determines that the host agency did not complete an action in accordance with an approved plan of correction or an approved modified plan of correction, the Office may allow the host agency additional time to complete the action, HHSC may impose a Level Two or Level Three sanction in accordance with 26 TAC §213.5, or the State Ombudsman may remove the designation of a local ombudsman entity. Proposed subsection (f) of the rule provides that if the Office allows a host agency additional time to complete an action and the Office determines that the host agency did not complete the action within the time allowed, HHSC may impose a Level Two or Level Three sanction in accordance with §213.5 of this title, or the State Ombudsman may remove the designation of the local ombudsman entity. Proposed subsection (g) of the rule provides that the Office will provide technical assistance, upon request, to the host agency or local ombudsman entity regarding the plan of correction.

Repealing 26 TAC §88.405, §88.407, to delete unnecessary rules which have been replaced by other proposed rules.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER E. REQUIREMENTS OF A HOST AGENCY
26 TAC §88.405, §88.407

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

  • The proposed repeal of §88.405, Meeting Performance Measure Projections, deletes the rule as no longer necessary because the content of the rule has been addressed in proposed new §88.405.
  • The proposed repeal of §88.407, Prohibition of Interference and Retaliation by a Host Agency, deletes the rule as no longer necessary because the content of the rule is addressed in proposed new §88.408.

Amending 26 TAC §88.501, to correct a reference to another rule.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER F. REQUIREMENTS OF HHSC
26 TAC §88.501

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §88.501, HHSC Responsibilities Regarding Individual Conflicts of Interest, corrects a rule reference regarding §88.2 because the proposed amendment to §88.2 renumbers the definitions.


New 26 TAC §§88.601 – 88.603, to describe the grievance procedures concerning the performance of a representative of the Office who is an employee, independent contractor, volunteer of a Host Agency, the State Ombudsman or a representative of the Office Who Is an employee or volunteer of HHSC, and reconsideration procedures for a person whose certification was refused, suspended, or terminated.

CHAPTER 88. STATE LONG-TERM CARE OMBUDSMAN PROGRAM
SUBCHAPTER G. GRIEVANCES
26 TAC §§88.601 – 88.603

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§88.2, 88.101, 88.102, 88.104, 88.105, 88.201, 88.305, 88.307, 88.403, 88.404, 88.406, and 88.501; new §§88.106, 88.107, 88.202, 88.405, 88.407, 88.408, 88.409, 88.601, 88.602, and 88.603; and the repeal of §§88.309, 88.405, and 88.407.

BACKGROUND AND JUSTIFICATION

The State Long-Term Care Ombudsman Program (Ombudsman Program) is a federally and state funded program authorized by §711 and §712 of the Older Americans Act (Title 42 United States Code §3058f and §3058g). The Ombudsman program protects and advocates for the health, safety, welfare, and rights of residents of nursing facilities and assisted living facilities.

SECTION-BY-SECTION SUMMARY

  • Proposed new §88.601, Grievances Regarding Performance of a Representative of the Office Who is an Employee, Independent Contractor, or Volunteer of a Host Agency, Including a Managing Local Ombudsman, describes the process and requirements for a local ombudsman entity in receiving and investigating a grievance about the performance of Ombudsman Program functions by a representative of the Office, other than a grievance about a managing local ombudsman. The proposed rule also describes the actions the Office takes regarding a grievance about the performance of Ombudsman Program functions by a managing local ombudsman.
  • Proposed new §88.602, Grievances Regarding the Performance of the State Ombudsman or a Representative of the Office Who Is an Employee or Volunteer of HHSC, describes the actions taken by the Office for a grievance about the performance of Ombudsman Program functions by the State Ombudsman. The proposed rule requires a grievance about the State Ombudsman that is not related to fraud, waste, or abuse to be submitted to the Director of the Office of the Ombudsman and a grievance about the State Ombudsman related to fraud, waste, or abuse to be submitted to the Office of the Inspector General. The proposed rule also describes the actions taken by the Office for a grievance about the performance of Ombudsman Program functions by a representative of the Office who is an employee or volunteer of HHSC.
  • Proposed new §88.603, Grievances Regarding Certification Decisions by the State Ombudsman, provides that if the State Ombudsman refuses, suspends, or terminates certification of a representative of the Office, the person whose certification was refused, suspended, or terminated may file a grievance to request a reconsideration of the decision. The proposed rule describes how the grievance must be submitted and the actions the Office takes in reviewing the grievance.

Adopted Rule Reviews Re:

Adopting the review of Title 1, Part 15, concerning the Disaster Assistance Program.

The 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 386, Disaster Assistance Program


Texas Department of State Health Services

Proposed Rule Reviews Re:

Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter pertaining to Health Planning and Resource Development.

The Texas Health and Human Services Commission (HHSC), on behalf of Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 13, Health Planning and Resource Development


Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter pertaining to Health Care Information.

The Texas Health and Human Services Commission (HHSC), on behalf of Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 421, Health Care Information


In Addition Re:

Correction of Error, to correct language regarding mobilizing the stroke care team.

The Department of State Health Services proposed amendments to 25 TAC §157.2 in the January 19, 2024, issue of the Texas Register (49 TexReg 199). Due to an error by the Texas Register, some of the rule text in new paragraph (133) is incorrect. The corrected language reads as follows:

(133) Stroke activation–The process of mobilizing the stroke care team when a patient screens positive for stroke symptoms; may be referred to as a “stroke alert” or “code stroke.”


Texas Council for Developmental Disabilities

In Addition Re:

Request for Applications: Increasing Employment Opportunities for Adult Texans with DD in South Texas

The Texas Council for Developmental Disabilities (TCDD) announces the availability of funds for activities to increase opportunities for employment for early career adult Texans with DD of Hispanic origin who live in the deep south area of Texas through outreach, training, and inter-agency communication post-transition. Applicants will investigate barriers to employment in the region and create programs that are culturally and linguistically responsive aimed at increasing employment opportunities for people with disabilities. Applications must be submitted by an organization established and working in Cameron, Hidalgo, Willacy, and Starr counties in Texas.

TCDD has approved funding for one organization for up to two years. Funding is approved for up to $125,000 per year. Funds available for this project are provided to TCDD by the Administration for Community Living (ACL), U.S. Department of Health and Human Services, with 100% federal funding pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Funding for the project is dependent on the results of a review process established by TCDD and on the availability of funds. Non-federal matching funds at a reduced rate of 10% of the total project costs are required for project activities conducted in these four designated poverty counties.