Texas Register Table of Contents
- 1 Governor
- 2 Governor
- 3 Texas Optometry Board
- 4 Texas Health and Human Services Commission
- 5 Texas Health and Human Services Commission
- 6 Texas Department of State Health Services
- 7 Texas Health and Human Services Commission
- 8 Texas Health and Human Services Commission
- 9 Texas Department of State Health Services
- 10 Texas Department of State Health Services
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Governor
Appointments
Governor reappoints two members and appoints five new members to the Texas Medical Board District One Review Committee
Appointments for December 16, 2020Appointed to the Texas Medical Board District One Review Committee, for terms to expire January 15, 2022: Antoinette M. “Toni” Jackson of Houston, Texas (replacing Larry V. Buehler of Angleton, whose term expired); Sheela L. Lahoti, M.D. of Houston, Texas (replacing Kathy C. Flanagan, M.D. of Houston, whose term expired).Appointed to the Texas Medical Board District One Review Committee, for terms to expire January 15, 2024: David D. Davila, D.O. of Cypress, Texas (Dr. Davila is being reappointed); Courtney M. Townsend, Jr., M.D. of Galveston, Texas (Dr. Townsend is being reappointed); Aundrea Young of Houston, Texas (replacing Sharon J. Barnes of Rosharon, whose term expired).Appointed to the Texas Medical Board District One Review Committee, for terms to expire January 15, 2026: Imran A. Dar, M.D. of Houston, Texas (replacing Stanley M. Duchman, M.D. of Houston, whose term expired); Kimberley R. Phillips of Houston, Texas (replacing Michael E. Cokinos of Houston, whose term expired).
Governor
Appointments
Governor reappoints one member and appoints six new members to the Texas Medical Board District Two Review Committee
Appointments for December 16, 2020Appointed to the Texas Medical Board District Two Review Committee, for terms to expire January 15, 2022: Lewis J. Benavides of Crossroads, Texas (Mr. Benavides is being reappointed); Zachary J. “Zach” Jones, M.D. of Frisco, Texas (replacing Louie Royce Hill, MD. of Carthage, whose term expired).Appointed to the Texas Medical Board District Two Review Committee, for terms to expire January 15, 2024: Carrie E. de Moor, M.D. Frisco, Texas (replacing Melissa D. Tonn, M.D. of Dallas, whose term expired); Clyde D. Loll of Huntsville, Texas (replacing Randall Blair Isenberg of Dallas, whose term expired); Robert B. Simonson, D.O. of Duncanville, Texas (replacing Hari Reddy, M.D. of Fairview, whose term expired).Appointed to the Texas Medical Board District Two Review Committee, for terms to expire January 15, 2026: Angela A. Downes of Irving, Texas (replacing Catherine B. “Trinka” Taylor of Dallas, whose term expired);Ivan D. Rovner, M.D., of Plano, Texas (replacing Todd A. Pollock, M.D. of Dallas, whose term expired).
Texas Optometry Board
Emergency Rule
New 22 TAC §273.15, providing for the emergency extension of license expiration dates in response to COVID-19
CHAPTER 273. GENERAL RULES22 TAC §273.15OVERVIEWThe Texas Optometry Board adopts emergency rule §273.15 to allow emergency extension of license expiration dates during a declared state of emergency as authorized by the Texas Optometry Act, Section 351.302. The emergency rule authorizes the Board to issue an extension of no more than 90 days.Subsection (a) of the emergency rule permits the Board to issue emergency extensions to licenses under Texas Occupations Code §351.302 due to the COVID-19 disaster declaration issued by the Governor of Texas. These emergency licenses will expire when the agency makes a final determination on a renewal application, or at 90 days after issuance, whichever is earlier. Subsection (b) requires licensees to initiate the renewal process by paying the required fee and submitting continuing education documentation by December 31, 2020. The agency will make information available on its website for license holders and the public to verify that an emergency extension has been granted.BACKGROUND AND JUSTIFICATION On March 13, 2020, the Governor of Texas issued a disaster proclamation under Texas Government Code §418.014 certifying that COVID-19 poses an imminent threat of disaster for all counties in the State of Texas. This disaster proclamation has been renewed continuously since that date, most recently on December 6, 2020. The agency has implemented safety measures and work from home initiatives to minimize the effects of COVID-19 on agency operations. However, due to the limited availability of staff and several positive tests for COVID-19 among agency staff, delays in agency operations have occurred.The delays in agency operations present imminent peril to the public health, safety, or welfare requiring adoption of the emergency rule on fewer than 30 days’ notice. The agency issues license renewals for licensed optometrists. Delays in license renewal may prevent optometrists from providing services and impact continuity of care for patients. Additionally, license holders cannot legally provide services after the expiration of their license, placing these individuals in the precarious position of violating the law to continue employment during the COVID-19 pandemic. The emergency rule addresses these issues by permitting the Board to extend license expiration dates as needed.
Texas Health and Human Services Commission
Proposed Rules
Amending 1 TAC §353.1305 to clarify timing limitations for the Medicaid Uniform Hospital Rate Increase Program
CHAPTER 353. MEDICAID MANAGED CARESUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES1 TAC §353.1305OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §353.1305, concerning Uniform Hospital Rate Increase Program. The proposed amendment of §353.1305 adds “before September 1, 2021” to the title of the section and to subsection (a) to clarify that this rule applies to UHRIP prior to September 1, 2021.BACKGROUND AND JUSTIFICATIONTo continue incentivizing hospitals to improve access, quality, and innovation in the provision of hospital services in Year 5 of the program (i.e., September 1, 2021, through August 31, 2022) and beyond, HHSC is proposing new quality metrics, eligibility requirements and financing components for the program. HHSC is also proposing these amendments to comply with federal regulations that require directed-payment programs to advance goals included in the state’s managed care quality strategy and to align with the ongoing efforts to transition from the Delivery System Reform Incentive Payment program.Additional justification for the proposed amendment is included in this week’s edition of the Texas Register (46 Tex Reg 13).
Texas Health and Human Services Commission
Proposed Rules
New 1 TAC §353.1307, establishing quality metrics for the evaluation of the Comprehensive Hospital Increase Reimbursement Program
CHAPTER 353. MEDICAID MANAGED CARESUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES1 TAC §353.1307OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §353.1307, concerning Quality Metrics and Required Reporting Used to Evaluate the Success of the Comprehensive Hospital Increase Reimbursement Program.RULE SUMMARY Proposed new §353.1307 describes the quality metrics and required reporting used to evaluate the success of the CHIRP. Subsection (a) establishes the purpose of the section. Subsection (b) defines key terms used in the section. Subsection (c) describes the quality metrics HHSC can designate for each CHIRP capitation rate component. Possible metrics include structure or pay-for-reporting measures and will be evidence-based. Subsection (d) discusses the performance requirements that will be associated with the designated quality metrics. Achievement of performance requirements will be used to evaluate the degree to which the CHIRP advances at least one of the goals and objectives that are incentivized by the payments described in §353.1306(g) of this subchapter. Subchapter (e) provides that HHSC will publish notice of the proposed metrics and their associated performance requirements no later than January 31 preceding the first month of the program period. The notice will be published by publication on HHSC’s website. Subsection (f) provides that final quality metrics and performance requirements will be provided through HHSC’s website on or before February 28 of the calendar year that also contains the first month of the program period. Subsection (g) provides that HHSC will evaluate the success of the program based on a statewide review of reported metrics and that HHSC will publish interim evaluation findings. HHSC will publish a final evaluation report within 270 days of the conclusion of the program period.BACKGROUND AND JUSTIFICATIONTo continue incentivizing hospitals to improve access, quality, and innovation in the provision of hospital services in Year 5 of the program (i.e., September 1, 2021, through August 31, 2022) and beyond, HHSC is proposing new quality metrics, eligibility requirements and financing components for the program. HHSC is also proposing these amendments to comply with federal regulations that require directed-payment programs to advance goals included in the state’s managed care quality strategy and to align with the ongoing efforts to transition from the Delivery System Reform Incentive Payment program.Additional justification for the proposed amendment is included in this week’s edition of the Texas Register (46 Tex Reg 13).
Texas Department of State Health Services
Proposed Rules
CHAPTER 411. STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIESSUBCHAPTER J. STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALSOVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Title 25, Chapter 411, Subchapter J, concerning Standards of Care and Treatment in Psychiatric Hospitals. The repeal is comprised of §§411.451 – 411.455, 411.459, 411.461 – 411.465, 411.468, 411.471 – 411.477, 411.482 – 411.485, 411.488, 411.490, 411.493 – 411.496, 411.499, and 411.500.The proposed repeal of Title 25, Chapter 411, Subchapter J allows similar rules to be proposed as new rules in Title 26, Chapter 568.BACKGROUND AND JUSTIFICATION The purpose of this proposal is to repeal the rules in Chapter 411, Subchapter J, Standards of Care and Treatment in Psychiatric Hospitals to replace with new rules in Title 26, Part 1, Chapter 568, Standards of Care and Treatment in Psychiatric Hospitals. The rules for Title 26, Chapter 568 are proposed elsewhere in this issue of the Texas Register and are substantially similar to the rules proposed for repeal. The new rules will comply with current statute, create consistent training guidelines, correct outdated citations, and update language throughout to reflect the transition to the new title.
Texas Health and Human Services Commission
Proposed Rules
New 26 TAC, Chapter 368, establishing requirements for preadmission screening and resident review at certain Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services facilities
CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICESOVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code (TAC) Title 26, Part 1, new Chapter 368, Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services, Subchapters A through H, comprising §§368.101, 368.102, 368.201 – 368.204, 368.301, 368.302, 368.401 – 368.407, 368.501 – 368.505, 368.601, 368.602, 368.701, and 368.801.SECTION-BY-SECTION SUMMARYA detailed summary of the proposed new rules is included in this week’s edition of the Texas Register (46 Tex Reg 87). BACKGROUND AND PURPOSEThe purpose of the proposal is to describe the requirements applicable to a service provider agency providing preadmission screening and resident review (PASRR) IDD habilitative specialized services (IHSS) to Medicaid-eligible nursing facility (NF) residents who are 21 years of age and older and who have been found through the PASRR process to need such services. PASRR is a federal requirement in 42 CFR Part 483, Subpart C. Since 2015, local intellectual and developmental disability authorities (LIDDAs) have provided certain specialized services to eligible NF residents funded by state general revenue funds. In accordance with a Medicaid state plan amendment approved by the Centers for Medicare & Medicaid Services, new Medicaid-funded services delivered as NF add-on services by service provider agencies will replace the state general revenue-funded specialized services LIDDAs currently provide.A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.In accordance with the state plan amendment, a service provider agency is eligible to contract with HHSC to provide IHSS if the service provider agency is licensed or certified by HHSC to provide program services for the Home and Community-based Services waiver, Texas Home Living waiver, Community Living Assistance and Support Services waiver, or Deaf Blind and Multiple Disabilities waiver. The services the service provider agencies will be providing are behavioral support, day habilitation, independent living skills training, employment assistance, and supported employment.The proposed new rules also describe the roles and responsibilities of a LIDDA related to the initiation and provision of IHSS.
Texas Health and Human Services Commission
Proposed Rules
CHAPTER 568. STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALSOVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Texas Administrative Code (TAC) Title 26, Chapter 568, concerning Standards of Care and Treatment in Psychiatric Hospitals. The new chapter is comprised of §§568.1 – 568.5, 568.21 – 568.26, 568.41, 568.61 – 568.67, 568.81 – 568.84, 568.101, 568.121, 568.141 – 568.144.SECTION-BY-SECTION SUMMARYMost provisions in the new rules are substantively the same as the rules from 25 TAC Chapter 411, Subchapter J, except for edits made to correct grammar, improve outdated language and terms, and update necessary citations and contact information. However, the following sections contain substantive changes from 25 TAC Chapter 411, Subchapter J, which are detailed in this week’s edition of the Texas Register (46 Tex Reg 105):Proposed new §568.22 (Voluntary Admission)Proposed new §568.83 (Discharge of a Voluntary Patient Requesting Discharge)Proposed new §568.121 (Staff Member Training)BACKGROUND AND PURPOSEThe proposal is necessary to comply with Senate Bill (S.B.) 1238, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code, Chapter 572, regarding Voluntary Mental Health Services, and to relocate the rules to 26 TAC. The rules in 25 TAC Chapter 411, Subchapter J are proposed for repeal and these new rules are proposed in Chapter 568. The proposed repeal is elsewhere in this issue of the Texas Register. The new rules are substantially similar to the rules proposed for repeal, but updates have been made to comply with current statute, create consistent training guidelines, correct outdated citations, and update language throughout to reflect the transition to the new title.S.B. 1238 adjusts the time frame in which a prospective voluntary mental health patient must be examined by a physician from within 72 hours before admission to either within 72 hours before admission or 24 hours after admission. The proposed new rules allow prospective patients to be admitted to an inpatient facility before being examined by a physician. The new rules also allow a person to be discharged immediately if a physician then determines that they do not meet the clinical standards to receive inpatient mental health services.The proposed rules make minor updates to language throughout the rules, remove outdated citations, delete references to departments and programs that no longer exist, and reflect the transition from Title 25 to Title 26, Health and Human Services. The new rules update training requirements and citations for abuse, neglect, exploitation (ANE), and unprofessional and unethical conduct in facilities to comply with current statute and to create greater clarity regarding these guidelines.
Texas Department of State Health Services
Adopted Rules
Amending 25 TAC §97.3 and §97.4 to clarify reporting requirements for communicable diseases
CHAPTER 97. COMMUNICABLE DISEASESSUBCHAPTER A. CONTROL OF COMMUNICABLE DISEASES25 TAC §97.3, §97.4OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendments to §97.3, concerning What Condition to Report and What Isolates to Report or Submit, and §97.4, concerning When and How to Report a Condition or Isolate. The amendments to §97.3 and §97.4 are adopted without changes to the proposed text as published in the September 11, 2020, issue of the Texas Register (45 TexReg 6315), and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThe amendments clarify the conditions and diseases that must be reported; clarify the minimal reportable information requirements for the conditions and diseases; and adjust the list of reportable diseases to include diseases and conditions of concern to public health. The amendments comply with guidance from the Centers for Disease Control and Prevention regarding surveillance for reportable conditions and allow DSHS to conduct more relevant and efficient disease surveillance.The amendments comply with Texas Health and Safety Code, Chapter 81, which requires DSHS to identify each communicable disease or health condition which is reportable under the chapter. The adoption also complies with Texas Government Code, §2001.039, which requires that each state agency review and consider for re-adoption each rule adopted by that agency pursuant to the Texas Government Code, Chapter 2001 (Administrative Procedure Act). Sections 97.3 and 97.4 have been reviewed and DSHS has determined that the rules should continue to exist because rules on this subject are needed.
Texas Department of State Health Services
In Addition
Correcting an error to a previously published amendment to 25 TAC §97.3, which updated the types of communicable diseases that must be reported
The Department of State Health Services proposed an amendment to 25 TAC §97.3 in the September 11, 2020, issue of the Texas Register (45 TexReg 6315). Due to a publishing error by the Texas Register, the text in 25 TAC §97.3(a)(4) was published incorrectly. The text should be published as follows: Staphylococcus aureus with a vancomycin MIC greater than 2 µg/mL.
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