Texas Register January 24, 2020 Volume: 45 Number: 4

Texas Register Table of Contents

Texas Health and Human Services Commission

 

Adopted Rules

Terminating the Behavioral Health Integration Advisory Committee, the Employment First Task Force, and the Advisory Committee on Qualifications for Health Care Translators and Interpreters

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICESSUBCHAPTER B. ADVISORY COMMITTEESDIVISION 1. COMMITTEESOVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of §351.819, concerning the Behavioral Health Integration Advisory Committee; §351.831, concerning the Employment First Task Force; and §351.835, concerning the Advisory Committee on Qualifications for Health Care Translators and Interpreters, without changes to the proposed text as published in the November 22, 2019, issue of the Texas Register (44 TexReg 7101). The repeals will not be republished.BACKGROUND AND JUSTIFICATIONIn 2015, the Texas Legislature removed 38 advisory committees from HHSC that were established by statute and, by adopting Texas Government Code §531.012, authorized the Executive Commissioner to establish advisory committees by rule. The Executive Commissioner’s advisory committee rules were effective July 1, 2016. Consistent with Texas Government Code §2110.008, the advisory committee rules designated an abolition date for advisory committees established under Texas Government Code §531.012 approximately four years from the date of the rules’ effective date. Several of the advisory committees were set to expire December 31, 2019.The repeals are necessary to terminate advisory committees that have expired or are abolished. 


Texas Health and Human Services Commission

Adopted Rules

Adopting amendments related to term extensions for six advisory committees

OVERVIEWThe Texas Health and Human Services Commission adopts without changes amendments to §351.805, concerning the State Medicaid Managed Care Advisory Committee; §351.821, concerning the Value-Based Payment and Quality Improvement Advisory Committee; §351.823, concerning the e-Health Advisory Committee; §351.827, concerning the Palliative Care Interdisciplinary Advisory Council; and §351.833, concerning the STAR Kids Managed Care Advisory Committee. The rules will not be republished. §351.837, concerning the Texas Autism Council, is adopted with changes to the proposed text as published in the November 22, 2019, issue of the Texas Register (44 TexReg 7101). The rule will be republished.BACKGROUND AND JUSTIFICATIONIn 2015, the Texas Legislature removed 38 advisory committees from HHSC that were established by statute and, by adopting Texas Government Code §531.012, authorized the Executive Commissioner to establish advisory committees by rule. The Executive Commissioner’s advisory committee rules were effective July 1, 2016. Consistent with Texas Government Code §2110.008, the advisory committee rules designated an abolition date for advisory committees established under Texas Government Code §531.012 approximately four years from the date of the rules’ effective date. Several of the advisory committees were set to expire December 31, 2019.The amendments are necessary to extend committees whose terms expire December 31, 2019, and whose work is not completed. In addition, the amendments for the Palliative Care Interdisciplinary Advisory Council and the STAR Kids Managed Care Advisory Committee are necessary to comply with statute.


Texas Health and Human Services Commission

Adopted Rules

Creating the Nursing Facility Payment Methodology Advisory Committee (NF-PMAC)

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICESSUBCHAPTER B. ADVISORY COMMITTEESDIVISION 1. COMMITTEES1 TAC §351.839OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts §351.839, concerning Nursing Facility Payment Methodology Advisory Committee. Section 351.839 is adopted without changes to the proposed text as published in the November 29, 2019, issue of the Texas Register (44 TexReg 7237). This rule will not be republished.BACKGROUND AND JUSTIFICATIONThe Centers for Medicare & Medicaid Services implemented a new payment model for Medicare Skilled Nursing Facilities effective October 1, 2019. Due to changes resulting from this implementation, the data HHSC uses to calculate the current Texas Medicaid reimbursement methodology for nursing facilities (NFs) will not be accessible through the current federal source after September 30, 2020. HHSC is using this opportunity to consider revisions to the Medicaid NF payment rate methodology.The new section creates the Nursing Facility Payment Methodology Advisory Committee (NF-PMAC) to advise HHSC on the establishment and implementation of recommended improvements to the NF payment methodology and other NF reimbursement topics. By establishing the NF-PMAC, HHSC will benefit from stakeholder knowledge and expertise as HHSC considers possible changes to the NF payment methodology.


Texas Health and Human Services Commission

Adopted Rules

Amending reimbursement methodology for state payments caps of Disproportionate Share Hospitals and Uncompensated Care

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER J. PURCHASED HEALTH SERVICESDIVISION 4. MEDICAID HOSPITAL SERVICES1 TAC §355.8065, §355.8066The Texas Health and Human Services Commission (HHSC) adopts amendments to §355.8065, concerning Disproportionate Share Hospital Reimbursement Methodology and §355.8066, concerning Hospital-Specific Limit Methodology. The amendments are adopted without changes to the proposed text as published in the November 29, 2019, issue of the Texas Register (44 TexReg 7239), and therefore will not be republished.DIVISION 11. TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM REIMBURSEMENT1 TAC §355.8212HHSC also adopts amendments to §355.8212, concerning Waiver Payments to Hospitals for Uncompensated Charity Care. The amendments are adopted without changes to the proposed text as published in the November 29, 2019, issue of the Texas Register (44 TexReg 7239), and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThe rule amendments describe new payment caps for the Disproportionate Share Hospital (DSH) and Uncompensated Care (UC) Medicaid supplemental payment programs. When combined, DSH and UC represent almost $5.5 billion in Medicaid payments for Texas hospitals. The programs are meant to reimburse hospitals that provide services to predominantly Medicaid and low-income patients. So, the allocation methodology among such providers should account for the relative amounts of Medicaid and low-income patients served, as well as the overall payments hospitals receive for those patients.In Texas, two payment caps exist for hospitals that participate in DSH and UC. There is a federal payment cap, known as the final hospital-specific limit (final HSL), that is described in federal law. There is also a state payment cap, known as the interim hospital-specific limit (interim HSL), that HHSC may define. The state payment cap is calculated in the payment year for DSH and UC, but the federal payment cap is calculated two years after the payment year using updated data. HHSC linked the interim HSL to the final HSL so that there would be a limited chance that a recoupment would occur after the final HSL was calculated.The federal payment cap has been the subject of ongoing federal litigation for several years. That litigation relates to the inclusion of payments from other insurance payors and Medicare when a Medicaid client also has other insurance or Medicare. HHSC will continue to monitor this litigation and examine if the Texas payment cap should change in response to the outcome of the federal litigation. However, HHSC is implementing a full offset methodology for the state payment cap. That means any payment for services provided to a Medicaid client from any source will be included as an offset to all appropriate Medicaid costs.


Texas Department of Licensing and Regulation

Adopted Rules

Eliminating technician registration from the Orthotists and Prosthetists program

CHAPTER 114. ORTHOTISTS AND PROSTHETISTS16 TAC §§114.10, 114.20, 114.21, 114.23, 114.28, 114.50, 114.80, 114.90OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 114, §§114.10, 114.20, 114.21, 114.23, 114.50, 114.80, and 114.90, and the rule chapter heading, regarding the Orthotists and Prosthetists program, without changes to the proposed text as published in the October 4, 2019, issue of the Texas Register (44 TexReg 5694). These rules will not be republished.The amendments to §114.28 regarding the Orthotists and Prosthetists program are adopted with changes to the proposed text as published in the October 4, 2019, issue of the Texas Register (44 TexReg 5694). This rule will be republished.EXPLANATION OF AND JUSTIFICATION FOR THE RULESThe rules under 16 TAC Chapter 114 implement Texas Occupations Code, Chapter 605, Orthotists and Prosthetists.The adopted rules eliminate the technician registration from the Orthotists and Prosthetists program. The registration of technicians was voluntary, and there was little demand for the credential, so eliminating it was supported by the Department and the professionals in this field. The adopted rules are necessary to remove all requirements in Chapter 114 that are related to the technician registration and maintain consistency with the statute, remove unnecessary text, and improve wording choice.


Texas Department of Licensing and Regulation

Adopted Rules

Adopting new Massage Therapy licensing requirements

CHAPTER 117. MASSAGE THERAPYOVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to the following rules at 16 Texas Administrative Code (TAC), Chapter 117, without changes to the proposed text as published in the October 11, 2019, issue of the Texas Register (44 Tex Reg 5841). These rules are not being republished: SUBCHAPTER A: General Provisions (§117.2)SUBCHAPTER C: Licensed Massage Therapist And Student Permit (§§117.20, 117.21, 117.23, 117.25)SUBCHAPTER D: Continuing Education (§117.31)SUBCHAPTER E: Licensed Massage Therapy Instructors (§117.40)SUBCHAPTER F: Licensed Massage Schools (§§117.50 – 117.55, 117.57 – 117.59, 117.61, 117.62, 117.65 – 117.68)SUBCHAPTER G: Licensed Massage Establishments (§§117.80, 117.82, 117.83)SUBCHAPTER H: Responsibilities Of The Licensee And Code Of ETHICS (§§117.90, 117.91, 117.93)SUBCHAPTER I. Fees (§117.100)The Commission adopts the repeal of the following rules at 16 Texas Administrative Code (TAC), Chapter 117, without changes to the proposed text as published in the October 11, 2019, issue of the Texas Register (44 Tex Reg 5841). These repeals are not being republished:SUBCHAPTER F: Licensed Massage Schools (§117.56, §117.60)The Commission adopts amendments to the following rule at 16 Texas Administrative Code (TAC), Chapter 117, with changes to the proposed text as published in the October 11, 2019, issue of the Texas Register (44 Tex Reg 5841) and are republished.SUBCHAPTER F: Licensed Massage Schools (§117.64)–EXPLANATION OF AND JUSTIFICATION FOR THE RULESThe rules under 16 TAC Chapter 117 implement Texas Occupations Code, Chapter 455, Massage Therapy. The adopted rules implement necessary changes required by House Bill (HB) 1865 and HB 2747, 86th Legislature, Regular Session (2019).As required by HB 1865, the adopted rules remove the five-year ban to obtain a license for violations of Chapter 455, Texas Occupations Code; require fingerprint criminal history checks; create a student permit and provides for a fee; and require massage schools report to the Department monthly student progress reports.As required by HB 2747, the adopted rules prohibit residing on the premises of a licensed massage establishment; require a photograph on the licenses of massage therapists; and require the posting of human trafficking information in massage schools and establishments.The adopted rules include recommendations from the Massage Therapy Advisory Board (Advisory Board) Standard of Care workgroup to address draping standards and remove the prohibition on using testimonials in advertisements as addressed in two opinions issued by the Office of the Attorney General (JC-0342 and JC-0458).The adopted rules also include recommendations from the Advisory Board’s Education and Examination workgroup to reduce regulatory burdens and streamline processes and procedures for massage schools to provide more efficiencies and clarity to the industry.


Texas Board of Nursing

Adopted Rules

Adopting an editorial amendment to §216.8, concerning the re-licensure process

CHAPTER 216. CONTINUING COMPETENCY22 TAC §216.8OVERVIEWThe Texas Board of Nursing (Board) adopts amendments to §216.8, concerning Relicensure Process. The amendments are adopted with a minor editorial change to subsection (e) to include the term “applicable” for consistency with the other amended subsections of the section. The remainder of the adopted text is unchanged from the proposed text as published in the November 29, 2019, issue of the Texas Register (44 TexReg 7293). This rule will be republished.Section 216.8(b) – (e) eliminates the references to §216.3(d) because targeted continuing competency requirements are contained in other subsections of §216.3 and may apply when a nurse seeks reinstatement pursuant to §216.8.REASONED JUSTIFICATIONThe amendments make conforming changes to the section for consistency with 22 TAC §216.3, which was amended and adopted by the Board on November 19, 2019. Those adopted amendments affected §216.3(c) and added new §216.3(i), making the current references in §216.8 inconsistent and outdated. The adopted changes to §216.8 align the section with the provisions of newly amended §216.3.


Texas Board of Nursing

Adopted Rules

Adopting an amendment allowing the renewal of Temporary Authorization to Practice / Temporary Permit

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.3OVERVIEWThe Texas Board of Nursing (Board) adopts an amendment to §217.3, concerning Temporary Authorization to Practice/Temporary Permit. The amendment is adopted without changes to the proposed text published in the November 29, 2019, issue of the Texas Register (44 TexReg 7294). The rules will not be republished.Section 217.3 removes the current limitation from the rule that a temporary authorization to practice/temporary permit is unable to be re-issued/renewed. Under the adoption, a temporary authorization to practice/temporary permit may be re-issued/renewed if the nurse is unable to complete a refresher course, extensive orientation, or academic course within a six-month time period in order to grant the nurse additional time to complete the course/orientation.REASONED JUSIFICATION The amendment is necessary to allow temporary authorizations to practice/temporary permits to be re-issued if a nurse is unable to complete the required courses/orientation within a six-month period. Due to scheduling challenges and an individual’s performance pace, it sometimes takes a nurse longer than six months to complete a refresher course, extensive orientation, or academic course. The intent of §217.3 is to provide a mechanism for nurses to demonstrate their competency to return to nursing practice. Since they cannot practice nursing while completing a refresher course, extensive orientation, or academic course, they pose no risk of harm to the public during this time. The amendment merely allows the nurse a sufficient amount of time to re-establish current licensure after demonstrating he/she is safe and competent to do so. There is no cost associated with the issuance of a temporary authorization to practice/temporary permit under this section.


Texas Board of Nursing

Adopted Rules

Adopting amendments regarding licensure exceptions for military spouses and licensees of the Canadian NCLEX-RN

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.5OVERVIEWThe Texas Board of Nursing (Board) adopts amendments to §217.5, concerning Temporary License and Endorsement. The amendments are adopted without changes to the proposed text as published in the November 29, 2019, issue of the Texas Register (44 TexReg 7295) and will not be republished.The adopted amendments establish and outline licensure exceptions for qualifying military spouses and for qualifying licensees of the Canadian NCLEX-RN. REASONED JUSTIFICATION The amendments are adopted under the authority of the Texas Occupations Code §301.151 and §301.253 and implement the requirements of Senate Bill (SB) 1200, enacted by the 86th Texas Legislature, effective September 1, 2019.Military SpousesSB 1200 requires agencies like the Board to establish a process to allow qualifying military spouses to practice nursing in Texas without obtaining a license. Because employers, consumers, and other members of the public routinely utilize the Board’s on-line licensure verification system to determine the licensure status of nurses in Texas, the Board has determined that issuing licenses to qualifying military spouses is most consistent with its current licensure and verification processes. These licenses will be limited to three-year terms and will be searchable through the Board’s on-line verification system in the same manner as other license types. Further, individuals receiving a license under the rule will not be required to complete continuing education requirements for the duration of the license, which is limited to a three-year time period.Canadian NCLEX-RNThe remainder of the adopted changes are necessary to allow the successful completion of the Canadian NCLEX-RN and licensure from a Canadian province by NCLEX-RN to satisfy a portion of the Board’s endorsement requirements. On January 5, 2015, the NCLEX-RN replaced the CRNE as Canada’s national examination for those applying to be a registered nurse. The Board currently requires the successful completion of the U.S. NCLEX-RN for licensure as a registered nurse in Texas if the applicant is applying by endorsement. The Board also currently requires licensure by another U.S. jurisdiction for licensure as a registered nurse in Texas if the applicant is applying by endorsement. The adopted amendments extend this licensure opportunity to applicants successfully passing the Canadian NCLEX-RN and holding licensure from a Canadian province by NCLEX-RN. This opportunity will only apply to applicants seeking registered nurse licensure because the Canadian NCLEX-PN has not been approved for use at this time.


Texas Board of Veterinary Medical Examiners

Adopted Rules

Compiling current regulations concerning telemedicine

CHAPTER 573. RULES OF PROFESSIONAL CONDUCTSUBCHAPTER G. OTHER PROVISIONS22 TAC §573.68The Texas Board of Veterinary Medical Examiners adopts new §573.68, concerning telemedicine. The new rule is adopted without changes to the proposed text as published in the August 16, 2019, issue of the Texas Register (44 TexReg 4288) and will not be republished.The purpose of the new rule is to compile current regulations concerning telemedicine for the ease and convenience of the regulated population. The new rule merely restates existing law and does not add or modify existing regulations in any manner.


Texas Board of Veterinary Medical Examiners

Adopted Rules

Repealing old §575.25, concerning Schedule of Sanctions

CHAPTER 575. PRACTICE AND PROCEDURE22 TAC §575.25The Texas Board of Veterinary Medical Examiners adopts the repeal of §575.25, concerning Recommended Schedule of Sanctions. The repeal is adopted without changes to the proposed text as published in the August 16, 2019, issue of the Texas Register (44 TexReg 4289) and will not be republished.This repeal is necessary because the Board is simultaneously adopting a new rule that outlines a new and updated schedule of sanctions. It is the goal of this new schedule of sanctions to bring more uniformity and predictability to the Board’s disciplinary process.

Texas Board of Veterinary Medical Examiners

Adopted Rules

Adopting new §575.25, concerning Schedule of Sanctions

CHAPTER 575. PRACTICE AND PROCEDURE22 TAC §575.25The Texas Board of Veterinary Medical Examiners adopts new §575.25, concerning Schedule of Sanctions. The new rule is adopted with changes to the proposed text as published in the August 16, 2019, issue of the Texas Register (44 TexReg 4290) and will be republished.The purpose of the new rule is to provide greater uniformity and fairness in the Board’s disciplinary process. This schedule of sanctions should provide clarity to both the licensees and the public about the recourse available to the Board in pursuing a complaint.


Texas Department of State Health Services

Adopted Rules

Defining and regulating Sexual Assault Forensic Exam ready facilities

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIESSUBCHAPTER A. GENERAL PROVISIONS25 TAC §131.2OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts amendments to §131.2, concerning Definitions. The amendments are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4935), and therefore will not be republished.BACKGROUND AND JUSTIFICATION These amendments are necessary to comply with House Bill (H.B.) 3152, 85th Legislature, Regular Session, 2017, which amends the Texas Health and Safety Code, Chapter 323. H.B. 3152 requires HHSC to define facilities as sexual assault forensic exam-ready (SAFE-ready) facilities, and requires certain health-care facilities to provide sexual assault survivors the option to transfer to a facility that is SAFE-ready. 


Texas Department of State Health Services

Adopted Rules

Adopting amendments concerning the treatment of certain sexual assault survivors at freestanding emergency medical care facilities

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIESSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §131.46OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts amendments to §131.46, concerning Emergency Services. The amendments are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4935), and therefore will not be republished.BACKGROUND AND JUSTIFICATION These amendments are necessary to comply with House Bill (H.B.) 3152, 85th Legislature, Regular Session, 2017, which amends the Texas Health and Safety Code, Chapter 323. H.B. 3152 requires HHSC to define facilities as sexual assault forensic exam-ready (SAFE-ready) facilities, and requires certain health-care facilities to provide sexual assault survivors the option to transfer to a facility that is SAFE-ready. The amendment to §131.46 also implements H.B. 4531, 86th Legislature, Regular Session, 2019, concerning the rights and treatment of and services provided to certain adult sexual assault survivors.


Texas Department of State Health Services

Adopted Rules

Updating requirements for nursing peer review committees in freestanding emergency medical care facilities

CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIESSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §131.45OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts an amendment to §131.45, concerning Facility Staffing and Training. The amendment to §131.45 is adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4937), and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of this amendment is to update the requirements for establishing a nursing peer review committee. The amendment to §131.45 is necessary to comply with House Bill (H.B.) 3296, 85th Legislature, Regular Session, 2017, which amended the Texas Occupations Code, Chapter 303, related to nursing peer review committees.


Texas Department of State Health Services

Adopted Rules

Defining and regulating Sexual Assault Forensic Exam ready facilities for purposes of hospital licensure

CHAPTER 133. HOSPITAL LICENSINGSUBCHAPTER A. GENERAL PROVISIONS25 TAC §133.2OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §133.2, concerning Definitions. Section 133.2 is adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4939). This rule will not be republished.BACKGROUND AND JUSTIFICATIONThese amendments are necessary to comply with House Bill (H.B.) 3152, 85th Legislature, Regular Session, 2017, which amends the Texas Health and Safety Code, Chapter 323. H.B. 3152, requires HHSC to define facilities as sexual assault forensic exam-ready (SAFE-ready) facilities, and requires certain health-care facilities to provide sexual assault survivors the option to transfer to a facility that is SAFE-ready. 


Texas Department of State Health Services

Adopted Rules

Adopting amendments concerning the treatment of certain sexual assault survivors for purposes of hospital licensure

CHAPTER 133. HOSPITAL LICENSINGSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §133.41OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §133.41, concerning Hospital Functions and Services. Section 133.41 is adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4939). This rule will be republished.BACKGROUND AND JUSTIFICATIONThe amendments to §133.41 implement H.B. 4531, 86th Legislature, Regular Session, 2019, concerning the rights and treatment of and services provided to certain adult sexual assault survivors; and H.B. 531, 86th Legislature, Regular Session, 2019, concerning the retention of medical records from the forensic examination of a sexual assault survivor.


Texas Department of State Health Services

Adopted Rules

Updating requirements for nursing peer review committees in Ambulatory Surgical Centers

CHAPTER 135. AMBULATORY SURGICAL CENTERSSUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS25 TAC §135.15OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts an amendment to §135.15, concerning Facility Staffing and Training. The amendment is adopted without changes to the proposed text as published in the September 13, 2019 issue of the Texas Register (44 TexReg 4944), and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of this amendment is to update the requirements for establishing a nursing peer review committee. The amendment to §135.15 is necessary to comply with House Bill (H.B.) 3296, 85th Legislature, Regular Session, 2017, which amended the Texas Occupations Code, Chapter 303, related to nursing peer review committees.


Texas Department of State Health Services

Adopted Rules

Repealing §451, regarding Peer Assistance, in its entirety

CHAPTER 451. PEER ASSISTANCE25 TAC §§451.101 – 451.112OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 1, Chapter 451, Peer Assistance, in its entirety, including §451.101, concerning Authority; §451.102, concerning Program Purpose; §451.103, concerning Applicability; §451.104, concerning Relationship to Licensing/Disciplinary Authority; §451.105, concerning Program Requirements; §451.106, concerning Definitions; §451.107, concerning Organization; §451.108, concerning Staffing; §451.109, concerning Program Description; §451.110, concerning Policies and Procedures; §451.111, concerning Referrals to Assessment/Treatment Resources; and §451.112, concerning Certification. The repeal was proposed in the October 18, 2019, issue of the Texas Register (44 TexReg 5998). These rules will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose is to repeal 40 TAC Chapter 451, Peer Assistance, in its entirety. New rules in 26 TAC Chapter 8, Peer Assistance for Impaired Professionals, are adopted elsewhere in this issue of the Texas Register and are substantially similar to the rules being repealed.


Texas Health and Human Services Commission

Adopted Rules

Adopting a set of rules regarding peer assistance programs for impaired professionals

CHAPTER 8. PEER ASSISTANCE PROGRAMS FOR IMPAIRED PROFESSIONALS26 TAC §§8.101, 8.103, 8.105, 8.107, 8.109, 8.111, 8.113, 8.115, 8.117, 8.119, 8.121, 8.123, 8.125OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new Chapter 8, concerning Peer Assistance Programs for Impaired Professionals. Section 8.105 is adopted with changes to the proposed text as published in the October 18, 2019, issue of the Texas Register (44 TexReg 5999); therefore, the rule will be republished. Sections 8.101, 8.103, 8.107, 8.109, 8.111, 8.113, 8.115, 8.117, 8.119, 8.121, 8.123, and 8.125 are adopted without changes to the proposed text as published in the October 18, 2019, issue of the Texas Register (44 TexReg 5999); therefore, the rules will not be republished.BACKGROUND AND JUSTIFICATIONThe new rules move the Department of State Health Services (DSHS) rules in Texas Administrative Code (TAC) Title 25, Chapter 451 to 26 TAC Chapter 8 as part of consolidating all HHSC rules in TAC Title 26. The new rules are reorganized and updated, but do not make changes from the language currently in 25 TAC Chapter 451 that would result in new or increased requirements for a peer assistance program for impaired professionals or for any associated state licensing authority. The repeal of 25 TAC Chapter 451, Peer Assistance, appears elsewhere in this issue of the Texas Register.


Texas Department of State Health Services

In Addition

Emergency Medical Services Penalty Matrix

The Department of State Health Services publishes the EMS Penalty Matrix (matrix) to inform the public and the regulated EMS industry about the department’s enforcement policies. The penalties set forth in the matrix are created to promote compliance with the EMS statute and rules, promote public confidence in the EMS industry, and deter conduct detrimental to the health and safety of the citizens of and visitors to Texas. The matrix promotes transparency in the department’s regulatory efforts to protect Texas consumers, and provides notice of these regulatory standards to the public and the regulated EMS industry. The matrix encourages consistent, uniform, and fair assessment of penalties by the department for violations of the EMS rules promulgated in Texas Administrative Code, Title 25, Part 1, Chapter 157, Subchapters A, B, C, and D. The list of violations in the matrix provides a corresponding citation to the appropriate section of the EMS rules for each violation.


Texas Department of State Health Services

In Addition

Detailing decisions made regarding licensing for radioactive materials during early December 2019

During the first half of December, 2019, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials. In the Texas Register, the Department includes a chart detailing information on newly issued licenses and amendments to existing licenses. 


Texas Department of State Health Services

In Addition

Detailing decisions made regarding licensing for radioactive materials during late December 2019

During the second half of December, 2019, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials. In the Texas Register, the Department includes a chart detailing information on newly issued licenses and amendments to existing licenses. 


Texas Department of State Health Services

In Addition

Order Extending the Temporary Scheduling of FUB-AMB

The Acting Administrator of the Drug Enforcement Administration issued a temporary scheduling order to extend the temporary schedule I status of a synthetic cannabinoid methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3-methylbutanoate (other names: FUB-AMB, MMB-FUBINACA, AMB-FUBINACA), including its optical, positional and geometric isomers, salts, and salts of isomers. The schedule I status of FUB-AMB currently is in effect until November 4, 2019. This temporary order will extend the temporary scheduling of FUB-AMB for one year, or until the permanent scheduling action for this substance is completed, whichever occurs first. This order was published in the Federal Register, Volume 84, Number 210, pages 58045-58047, and is effective November 3, 2019.Schedule I temporarily listed substances subject to emergency scheduling by the United States Drug Enforcement Administration.


Texas Department of Insurance

In Addition

FY 2020 Research Agenda for the Workers’ Compensation Research and Evaluation Group

The commissioner of workers’ compensation considers the Fiscal Year (FY) 2020 Research Agenda for the Workers’ Compensation Research and Evaluation Group (REG) at the Texas Department of Insurance, Division of Workers’ Compensation (DWC).The commissioner adopts the FY 2020 Research Agenda for the Workers’ Compensation Research and Evaluation Group, as follows:1. Completion and publication of the 2020 Workers’ Compensation Health Care Network Report Card (required under Insurance Code §1305.502 and Labor Code §405.0025).2. An update of the 2018 “Setting the Standard,” biennial report on the impact of the 2005 legislative reforms to the Texas workers’ compensation system. This report presents results on the affordability and availability of workers’ compensation insurance for Texas employers, and the impact of certified workers’ compensation health care networks on medical costs, quality of care issues, return-to-work outcomes, and medical dispute resolution (required by Insurance Code §2053.012 and Labor Code §405.0025). The report is due on December 1, 2020.3. An update of the 2018 biennial study to estimate employer participation in the Texas workers’ compensation system (required by Insurance Code §2053.012 and Labor Code §405.0025). The report is due on December 1, 2020.


































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