26 Feb 2021

Texas Register February 26, 2021 Volume: 46 Number: 9

by | posted in: Governor, Texas Commission on Jail Standards, Texas Department of State Health Services, Texas Department on Aging and Disability Services, Texas Health and Human Services Commission |

Texas Register Table of Contents

Governor

 

Appointments

Governor reappoints four members to the Council on Cardiovascular Disease and Stroke

Appointments for February 10, 2021Appointed to the Council on Cardiovascular Disease and Stroke, for terms to expire February 1, 2027: Stanley M. Duchman, M.D. of Houston, Texas (Dr. Duchman is being reappointed);Sherron D. Franks-Meeks, Ph.D. of Odessa, Texas (Ms. Franks-Meeks is being reappointed);Shilpa Shamapant of Austin, Texas (Ms. Shamapant is being reappointed);Maricela “Marcie” Gonzalez Wilson of Lakeway, Texas (Ms. Wilson is being reappointed).

Texas Department of State Health Services

Emergency Rule

Amending 25 TAC §417.47 to update training requirements for infection control within state hospitals

CHAPTER 417. AGENCY AND FACILITY RESPONSIBILITIESSUBCHAPTER A. STANDARD OPERATING PROCEDURES25 TAC §417.47OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 25 Texas Administrative Code, Chapter 417, Agency and Facility Responsibilities, amended §417.47, concerning an emergency rule in response to COVID-19 to ensure necessary state hospital staffing levels and infection control training during the COVID-19 pandemic. HHSC previously adopted emergency rules concerning staff training in order to efficiently and effectively deploy staff to meet basic needs during the COVID-19 pandemic, without posing risk to the individuals served. As the COVID-19 pandemic and the Governor’s proclamation of disaster have continued, so has the need for training requirements that ensure adequate training and staffing levels at state hospitals. This emergency rule updates those training requirements to require training of infection control specific to COVID-19, including prevention, screening, isolation, and the use of personal protective equipment.BACKGROUND AND JUSTIFICATIONAs authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this standard operating procedures.

Texas Health and Human Services Commission

Emergency Rule

Renewing 26 TAC §500.3, temporarily allowing a licensed hospital to designate a specific part of its hospital for use as an off-site facility by another hospital

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER A. HOSPITALS26 TAC §500.3OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.3 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7659).HHSC is adopting this emergency rule to temporarily permit a currently licensed hospital to designate a specific part of its hospital for use as an off-site facility by another hospital, and to allow another currently licensed hospital to apply to use the first hospital’s designated hospital space as an off-site facility for inpatient care.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Designation of Licensed Hospital Space During the COVID-19 Pandemic.

Texas Health and Human Services Commission

Emergency Rule

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

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES26 TAC §500.41 OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.41 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7660).HHSC is renewing this emergency rule to temporarily adjust CDTF operational requirements to permit a licensed CDTF to provide telehealth and telemedicine treatment services to clients in order to reduce the risk of transmission of COVID-19.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these emergency rules.

Texas Health and Human Services Commission

Emergency Rule

Renewing 26 TAC §500.43, temporarily allowing Chemical Dependency Treatment Facilities to provide services through two-way, real-time internet or telephone communications

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES26 TAC §500.43OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.43 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7660).HHSC is renewing this emergency rule to temporarily adjust CDTF operational requirements to permit a licensed CDTF to provide treatment services through two-way, real-time internet or telephone communications to clients in order to reduce the risk of transmission of COVID-19. BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these emergency rules.

Texas Health and Human Services Commission

Emergency Rule

Renewing 26 TAC §500.44, temporarily extending documentation deadlines for Chemical Dependency Treatment Facilities

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES26 TAC §500.44OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.44 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7660).HHSC is renewing this emergency rule to temporarily adjust CDTF operational requirements to extend treatment planning and service provision documentation deadlines to provide CDTFs additional time to document service delivery, as counselor caseloads may have increased in intensive residential treatment programs. These emergency rules will address staff shortages, reduce the risk of transmission of COVID-19, and reduce barriers to treatment for patients seeking treatment for substance use disorders and chemical dependency.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these emergency rules.

Texas Health and Human Services Commission

Emergency Rule

Renewing 26 TAC §500.51, temporarily allowing supervisors of Licensed Chemical Dependency Counselor interns to provide supervision through two-way, real-time internet or telephone communications

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER E. LICENSED CHEMICAL DEPENDENCY COUNSELORS26 TAC §500.51OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.51 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7662).HHSC is renewing this emergency rule to temporarily permit: (1) counselor interns with more than 1,000 hours of supervised work experience to provide services in person or through two-way, real-time internet or telephone communications; (2) supervisors of LCDC interns with less than 2,000 hours of supervised work experience to provide supervision in person or through two-way, real-time internet or telephone communications; and (3) a certified clinical supervisor, or the clinical training institution coordinator or intern’s supervising qualified credentialed counselor at a clinical training institution, to provide supervision to a counselor intern using two-way, real-time internet or telephone communications to observe and document the intern performing assigned activities and to provide and document one hour of face-to-face individual or group supervision. This emergency rule will address staff shortages, reduce the risk of transmission of COVID-19, and reduce barriers to treatment for patients seeking treatment for substance use disorders and chemical dependency.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Supervision of LCDC Interns During the COVID-19 Pandemic.

Texas Health and Human Services Commission

Emergency Rule

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

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONSSUBCHAPTER C. STANDARDS FOR LICENSURE26 TAC §551.46OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Part 1, Texas Administrative Code, Chapter 551, Subchapter C, new §551.46, concerning an emergency rule to mitigate and contain COVID-19 in an intermediate care facility for individuals with an intellectual disability (ICF/IID) or related condition. HHSC is adopting an emergency rule to mitigate and contain COVID-19. The purpose of the new rule is to describe requirements for ICF/IID Provider Response to COVID-19.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of this emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for ICF/IID Provider Response to COVID-19 – Mitigation.

Texas Health and Human Services Commission

Adopted Rules

Renewing 26 TAC §551.47, establishing limitations for indoor and outdoor visitation at Intermediate Care Facilities

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONSSUBCHAPTER C. STANDARDS FOR LICENSURE26 TAC §551.47OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §551.47 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7663).HHSC is renewing this emergency rule to require limited indoor and outdoor visitation in an intermediate care facility. The purpose of the new rule is to describe the requirements related to such visits.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. This emergency rulemaking reflects the continued reopening of the State of Texas. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Intermediate Care Facility COVID-19 Response–Expansion of Reopening Visitation.

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §551.48, establishing vaccination reporting requirements for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IIDs)

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONSSUBCHAPTER C. STANDARDS FOR LICENSURE26 TAC §551.48OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Part 1, Texas Administrative Code, Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, Subchapter C, new §551.48. HHSC is adopting this emergency rule to track vaccinations of staff and residents in intermediate care facilities in Texas in response to COVID-19. HHSC is adopting an emergency rule to require ICF/IIDs to accurately report COVID-19 vaccination data for staff and residents in the format established by HHSC within 24 hours of completing or receiving a round of vaccinations. The emergency rule is necessary to accurately track vaccinations of staff and residents in intermediate care facilities in Texas.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code, §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code, §2001.034, may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.

Texas Health and Human Services Commission

Adopted Rules

Renewing 26 TAC §553.2003 to re-establish limitations for indoor and outdoor visitation at Assisted Living Facilities

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIESSUBCHAPTER K. COVID-19 EMERGENCY RULES26 TAC §553.2003OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §553.2003 for a 60-day period. The text of the emergency rule was originally published in the October 30, 2020, issue of the Texas Register (45 TexReg 7668).HHSC is renewing this emergency rule to require limited indoor and outdoor visitation in an assisted living facility. The purpose of the new rule is to describe the requirements related to such visits.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Assisted Living Facility COVID-19 Response – Expansion of Reopening Visitation.

Texas Department on Aging and Disability Services

Emergency Rule

Amending 40 TAC §§3.401 – 3.403 to update infection-control training requirements within state facilities

CHAPTER 3. RESPONSIBILITIES OF STATE FACILITIESSUBCHAPTER D. TRAINING40 TAC §§3.401 – 3.403OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40 Texas Administrative Code, Chapter 3, Responsibilities of State Facilities, amendments to the following rules to ensure necessary state supported living center staffing levels and infection control during the COVID-19 pandemic:§3.401 (Training for New Employees)§3.402 (Additional Training for Direct Support Professionals)§3.403 (Refresher Training)HHSC previously adopted emergency rules concerning staff training to efficiently and effectively deploy staff to meet basic needs during the COVID-19 pandemic, without posing risk to the individuals served. As the COVID-19 pandemic and the Governor’s proclamation of disaster have continued, so has the need for training requirements that ensure adequate training and staffing levels at state supported living centers. These emergency rules update training requirements to require training of infection control specific to COVID-19, including prevention, screening, isolation, and the use of personal protective equipment.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these training rules.

Texas Commission on Jail Standards

Adopted Rules

Amending 37 TAC §273.5 to expand the scope of inmates eligible to receive mental health services

CHAPTER 273. HEALTH SERVICES37 TAC §273.5OVERVIEWThe Texas Commission on Jail Standards adopts an amendment to §273.5, concerning mental health and intellectual disabilities of inmates in Texas county jails, without changes to the proposed text as published in the December 18, 2020, issue of the Texas Register (45 TAC 9171) and will not be republished. The amendment adds language to 37 TAC §273.5(c) to expand the scope of inmates for whom county jails must perform a mental history check to include inmates with Intellectual and Developmental Disabilities. It expands the scope of records jails must keep in relation to such inmates and of the jails’ notification to other entities of their incarceration. The amendment also expands the information to be recorded on the mental health screening form to include information related to intellectual and developmental disability.BACKGROUND AND JUSTIFICATION When booking an inmate into a county jail, the jail uses the Continuity of Care Query (CCQ) system to learn whether an arrestee has a recorded history of mental illness. The Department of State Health Services (DSHS) was recently able to fully integrate their existing database in order to allow the Texas Law Enforcement Telecommunication System (TLETS) to access the information through the CCQ, which is required, pursuant to Code of Criminal Procedure Article 16.22, to notify a magistrate of an inmate who may have a mental illness or Intellectual or Developmental Disability (IDD). The CCQ is now able to also show whether an arrestee has a recorded history of having IDD. The adopted amendment requires county jails when using the CCQ to include inmates with Intellectual and Developmental Disabilities.

Texas Health and Human Services Commission

Transferred Rule

Transferring oversight of independent living services from DARS to HHSC

OVERVIEWFormer Department of Assistive and Rehabilitative Services (DARS) rules in Texas Administrative Code (TAC), Title 40, Part 2, Chapter 104, Independent Living Services are being transferred to 26 TAC Part 1, Chapter 357, Independent Living Services.BACKGROUND AND JUSTIFICATION During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(a), specified DARS be abolished September 1, 2017, after all its functions were transferred to HHSC or the Department of Family and Protective Services in accordance with Texas Government Code, §531.0201. 

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