Texas Register January 15, 2021 Volume: 46 Number: 3

Texas Register Table of Contents

Governor

 

Appointments

Governor appoints Richard “Jack” Cagle to the Task Force on Disaster Issues Affecting Persons who are Elderly and Persons with Disabilities

Appointments for December 21, 2020Appointed to the Task Force on Disaster Issues Affecting Persons who are Elderly and Persons with Disabilities, for a term to expire February 1, 2025, Richard “Jack” Cagle of Spring, Texas.


Governor

Appointments

Governor appoints John K. Bielamowicz as presiding officer of the Texas State Board of Examiners of Psychologists

Appointments for December 21, 2020Designated as presiding officer of the Texas State Board of Examiners of Psychologists, for a term to expire at the pleasure of the Governor, John K. Bielamowicz of Waxahachie (Mr. Bielamowicz is replacing Tim F. Branaman, Ph.D. of Dallas as presiding officer).


Governor

Appointments

Governor appoints three new members to the Texas State Board of Examiners of Psychologists

Appointments for December 21, 2020Appointed to the Texas State Board of Examiners of Psychologists, for terms to expire October 31, 2025:Jamie A. Becker, Ph.D. of Austin, Texas (replacing Lou Ann Todd Mock, Ph.D. of Bellaire, whose term expired);Jeanette Deas Calhoun, Ph.D. of Tyler, Texas (replacing Angela A. Downes of Irving, whose term expired);Sangeeta S. Singg, Ph.D. of San Angelo, Texas (replacing Tim F. Branaman, Ph.D. of Dallas, whose term expired).


Governor

Appointments

Governor appoints Nathan A. Pullen to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council

Appointments for January 5, 2021Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council, for a term to expire August 31, 2021, Nathan A. Pullen of Austin, Texas (replacing Carol H. Trautman, Ph.D. of Austin, who resigned).


Texas Board of Nursing

Emergency Rule

Amending 22 TAC §217.24 to allow the prescription of controlled substances for certain existing patients using telemedicine

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.24OVERVIEWThe Texas Board of Nursing (Board) adopts emergency amendments to §217.24, relating to Telemedicine Medical Service Prescriptions, pursuant to a finding of imminent peril to the public health, safety, and welfare, which requires adoption in fewer than thirty (30) days’ notice, as authorized by Tex. Gov’t. Code §2001.034.SUMMARY OF CHANGES The adoption of emergency amendments to §217.24(e)(1) is immediately necessary to allow APRNs to continue to provide necessary treatment to established patients with chronic pain while mitigating the risk of exposure to COVID-19. Under the emergency amendments, an APRN may treat chronic pain with scheduled drugs through use of telemedicine medical services if a patient is an established chronic pain patient of the APRN, is seeking a telephone refill of an existing prescription, and the APRN determines that the telemedicine treatment is needed due to the COVID-19 pandemic. Further, the medical records must document the exception and the reason that a telemedicine visit was conducted instead of an in-person visit. The APRN must exercise appropriate professional judgment in determining whether to utilize telemedicine medical services for the treatment of chronic pain with controlled substances. The emergency amendments will only apply to those APRNs whose delegating physicians agree to permit them to issue re-fills for these patients, and the services provided are limited to refills of controlled substances in Schedules III through V. Finally, these emergency amendments will only be in effect for a period of 60 days or the duration of the time period that the Governor’s disaster declaration of March 13, 2020 in response to the COVID-19 pandemic is in effect, whichever is shorter.BACKGROUND AND JUSTIFICATION Because the continuation of the effects of the COVID-19 pandemic necessitated the continuation of the emergency rule beyond the July 7, 2020 expiration date, the Board held a public meeting on July 6, 2020, and again adopted emergency amendments to §217.24(e)(1). The emergency amendments took effect July 7, 2020; were published in the Texas Register on July 17, 2020; and expired on September 4, 2020. The Board again considered the need for the adoption of emergency amendments to §217.24(e)(1) in public meeting on September 4, 2020 and voted to adopt emergency amendments to §217.24(e)(1) at the conclusion of that meeting. The emergency amendments took effect September 5, 2020; were published in the Texas Register on September 18, 2020; and expired on November 3, 2020. The Board again considered the need for the adoption of emergency amendments to §217.24(e)(1) in public meeting on November 4, 2020, and voted to adopt emergency amendments to §217.24(e)(1) at the conclusion of that meeting. The emergency amendments took effect November 4, 2020; were published in the Texas Register on November 20, 2020; and will expire on January 3, 2021. The Board has determined that the continuation of the effects of the COVID-19 pandemic necessitates the continuation of an emergency rule beyond the rule’s last effective day.


Texas Health and Human Services Commission

Adopted Rules

Repealing 1 TAC, Chapter 383 to allow for the adoption of updated rules on the Interstate Compact on Mental Health and Intellectual and Developmental Disabilities

CHAPTER 383. INTERSTATE COMPACT ON MENTAL HEALTH AND MENTAL RETARDATION1 TAC §§383.101, 383.103, 383.105, 383.107, 383.109, 383.111, 383.113, 383.115, 383.117, 383.119, 383.121, 383.123OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of §383.101, concerning Purpose; §383.103, concerning Application; §383.105, concerning Definitions; §383.107, concerning Prerequisite for Transfer; §383.109, concerning Legal Basis for Institutionalization; §383.111, concerning Coordinating Requests for Interstate Transfer; §383.113, concerning Requests for Persons with Mental Retardation To Be Transferred from Texas; §383.115, concerning Requests for Persons with Mental Illness To Be Transferred from Texas; §383.117, concerning Requests for Persons with Mental Retardation to Transfer to Texas; §383.119, concerning Requests for Persons with Mental Illness to Transfer to Texas; §383.121, concerning Exhibits; and §383.123, concerning References.The repeal of the rules is adopted without changes to the proposed text as published in the October 16, 2020, issue of the Texas Register (45 TexReg 7356). The rules will not be republished.BACKGROUND AND JUSTIFICATION The rules are repealed from Texas Administrative Code (TAC) Title 1, Part 15, Chapter 383 and new rules are adopted elsewhere in this issue of the Texas Register, in 26 TAC Chapter 903, Interstate Compact on Mental Health and Intellectual and Developmental Disabilities. The new rules in Chapter 903 update and reorganize rules addressing the interstate compact on mental health and intellectual and developmental disabilities.


Texas Department of State Health Services

Adopted Rules

Amending 25 TAC §1.462 to update informed consent requirements for investigational stem cell treatment

CHAPTER 1. MISCELLANEOUS PROVISIONSSUBCHAPTER V. ADULT STEM CELLS25 TAC §1.462OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendment to §1.462, relating to Informed Consent for Investigational Stem Cell Treatment.The amendment to §1.462 is adopted without changes to the proposed text as published in the September 11, 2020, issue of the Texas Register (45 TexReg 6313); the rule will not be republished.BACKGROUND AND JUSTIFICATION The amendment is necessary to implement House Bill (H.B.) 3148, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code, §1003.054(c), to require the Executive Commissioner of HHSC, by rule, to adopt an informed consent form that must be signed by an eligible patient before receiving an investigational stem cell treatment. The Executive Commissioner delegated the development of the informed consent form and rule amendment to DSHS. H.B. 3148 requires the informed consent form to provide notice that DSHS administers Texas Health and Safety Code, Chapter 1003, Adult Stem Cells.Before this amendment, Texas Health and Safety Code, Chapter 1003, was permissive and did not require the Executive Commissioner to adopt an informed consent form. Under the current §1.462, physicians are required to provide the written informed consent to the eligible patient. The adopted standard informed consent form helps ensure that eligible patients are informed that investigational stem cell treatments, as defined by Chapter 1003, must be part of a clinical trial and are not approved for general use by the United States Food and Drug Administration.


Texas Health and Human Services Commission

Adopted Rules

Amending 26 TAC §306.204 to require that certain mental health facilities provide psychoactive medication upon a patient’s discharge

CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER D. MENTAL HEALTH SERVICES–ADMISSION, CONTINUITY, AND DISCHARGEDIVISION 5. DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED26 TAC §306.204OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts an amendment to §306.204, concerning Discharge of an Individual Involuntarily Receiving Treatment. The amendment to §306.204 is adopted with changes to the proposed text as published in the September 25, 2020, issue of the Texas Register (45 TexReg 6665). This rule will be republished.BACKGROUND AND JUSTIFICATIONThe amendment is necessary to implement §574.081(c-2) of the Texas Health and Safety Code, as amended by Senate Bill 362, 86th Legislature, Regular Session, 2019. The amendment outlines requirements for private mental health facilities with a contracted psychiatric bed (CPB) through HHSC, or funded and operated by a local mental health authority or local behavioral health authority, to provide psychoactive medication, and any other medication prescribed to counteract adverse side effects of psychoactive medication, at the time an individual receiving court-ordered inpatient mental health services is furloughed or discharged from a facility with a CPB. The facility with a CPB is only required to provide the medication if funding is available from HHSC to cover the cost of the medications. The facility with a CPB is not required to provide or pay for more than a seven-day supply of the medication.


Texas Health and Human Services Commission

Adopted Rules

New 26 TAC, Chapter 903, establishing updated rules on the Interstate Compact on Mental Health and Intellectual and Developmental Disabilities

CHAPTER 903. INTERSTATE COMPACT ON MENTAL HEALTH AND INTELLECTUAL AND DEVELOPMENTAL DISABILITIES26 TAC §§903.1 – 903.8OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §903.1, concerning Purpose; §903.2, concerning Application; §903.3, concerning Definitions; §903.4, concerning Prerequisite for Transfer; §903.5, concerning Legal Basis for Institutionalization; §903.6, concerning Coordinating Requests for Interstate Transfer; §903.7, concerning Requests for a Person with Mental Illness or Intellectual and Developmental Disabilities to Transfer from Texas; and §903.8, concerning Requests for a Person with Mental Illness or Intellectual and Developmental Disabilities to Transfer to Texas.Section 903.7 is adopted with changes to the proposed text as published in the October 16, 2020, issue of the Texas Register (45 TexReg 7390). The rule will be republished in the Texas Register. Sections 903.1 – 903.6 and 903.8 will be adopted without changes to the proposed text as published in the October 16, 2020, issue of the Texas Register (45 TexReg 7390). The rules will not be republished.BACKGROUND AND JUSTIFICATIONThe new chapter contains updated and reorganized rules related to the interstate compact on mental health and intellectual and developmental disabilities. These rules replace rules in 1 TAC Chapter 383. The repeal of 1 TAC Chapter 383 is located elsewhere in this issue of the Texas Register. 


Texas Department of Insurance

Notices

The Division of Workers’ Compensation intends to conduct official rule review for ten chapters in 28 TAC

OVERVIEWThe Texas Department of Insurance, Division of Workers’ Compensation (DWC) will review all sections in 28 Texas Administrative Code Chapters 140 – 144, 147 – 148, 150, 152, and 156. This review will be in accordance with the requirements for periodic rule review under Texas Government Code §2001.039.DWC will consider whether the initial reasons for adopting these rules continue to exist and whether these rules should be repealed, readopted, or readopted with amendments.PUBLIC COMMENTTo comment on this rule review project, submit your written comments by 5:00 p.m., Central time, on February 16, 2021. Comments received after that date will not be considered.Relevant addresses for comment submission are included in this week’s edition of the Texas Register (46 Tex Reg 475). 


Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the 2021 Annual Healthcare Common Procedure Coding System (HCPCS) Updates

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on February 5, 2021, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Annual Healthcare Common Procedure Coding System (HCPCS) Updates.The payment rates for the 2021 Annual HCPCS Updates are proposed to be effective January 1, 2021, for the following services:Physician Administered Drugs – TOS 1 (Medical Services);Medical Services – TOS 1 (Medical Services);Surgery and Assistant Surgery Services – TOS 2 (Surgery Services) and TOS 8 (Assistant Surgery);Hospital Diagnostic Imaging – TOS 4 (Radiology);Radiological Services – TOS 4 (Radiology), TOS I (Professional Component), and TOS T (Technical Component);Clinical Diagnostic Laboratory Services – TOS 5 (Laboratory);Nonclinical Laboratory Services – TOS 5, TOS I, and TOS T;Ambulatory Surgical Center and Hospital Ambulatory Surgical Center – TOS F (Ambulatory Surgical Center); andDental Services – TOS W (Texas Health Steps Dental/Orthodontia).BRIEFING PACKETSBriefing packets describing the proposed payment rates for each topic will be available at http://rad.hhs.texas.gov/rate-packets on or after January 26, 2021. Packets will be posted separately by topic as soon as they are complete. Interested parties may obtain copies of the briefing packets prior to the hearing by contacting Rate Analysis by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for the Annual Healthcare Common Procedure Coding System (HCPCS) updates to be held on February 5, 2021, 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/8996719121083795470. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent to addresses provided in this week’s edition of the Texas Register (46 Tex Reg 487). 

Texas Department of State Health Services

In Addition

DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the first half of December 2020

OVERVIEWDuring the first half of December 2020, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials. Licensing decisions pertaining to each applicant is included in this week’s edition of the Texas Register. BACKGROUND AND JUSTIFICATIONIn issuing new licenses and amending and renewing existing licenses, the Department’s Business Filing and Verification Section has determined that the applicant has complied with the licensing requirements in Title 25 Texas Administrative Code (TAC), Chapter 289, for the noted action. In granting termination of licenses, the Department has determined that the licensee has complied with the applicable decommissioning requirements of 25 TAC, Chapter 289. In granting exemptions to the licensing requirements of Chapter 289, the Department has determined that the exemption is not prohibited by law and will not result in a significant risk to public health and safety and the environment.AFFECTED PERSONS’ RIGHT TO HEARINGA person affected by the actions published in this notice may request a hearing within 30 days of the publication date. A “person affected” is defined as a person who demonstrates that the person has suffered or will suffer actual injury or economic damage and, if the person is not a local government, is (a) a resident of a county, or a county adjacent to the county, in which radioactive material is or will be located, or (b) doing business or has a legal interest in land in the county or adjacent county. 25 TAC §289.205(b)(15); Health and Safety Code §401.003(15). Requests must be made in writing and should contain the words “hearing request,” the name and address of the person affected by the agency action, the name and license number of the entity that is the subject of the hearing request, a brief statement of how the person is affected by the action what the requestor seeks as the outcome of the hearing, and the name and address of the attorney if the requestor is represented by an attorney. Send hearing requests by mail to: Hearing Request, Radiation Material Licensing, MC 2835, PO Box 149347, Austin, Texas 78714-9347, or by fax to: 512-834-6690, or by e-mail to: RAMlicensing@dshs.texas.gov.


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