31 Jan 2025

Texas Register January 31, 2025 Volume: 50 Number: 5

by | posted in: Governor, Texas Department of State Health Services, Texas Health and Human Services Commission, Uncategorized |

Texas Register Table of Contents

Governor

Appointments Re:

Appointed to the Statewide Health Coordinating Council for a term to expire August 31, 2027, Billie Bell.
Appointed to the Statewide Health Coordinating Council for a term to expire August 31, 2029, Lauren H. Day.
Appointed to the Rehabilitation Council of Texas for a term to expire October 29, 2027, Melva S. Henderson.

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §355.8085, to clarify the current reimbursement methodologies for certain services and programs administered by HHSC.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 5. GENERAL ADMINISTRATION
1 TAC §355.8085

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.8085, concerning Reimbursement Methodology for Physicians and Other Practitioners; and §355.8441, concerning Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to clarify the current structure of reimbursement methodologies for certain services and programs administered by HHSC. The amendments add details to describe the methodology HHSC uses to determine reimbursement amounts to Licensed Behavior Analysts (LBAs) and Licensed Assistant Behavior Analysts (LaBAs) for Applied Behavior Analysis (ABA) professional services. The amendment also adds wage statistic data as an element to be considered for reimbursement methodology for Physicians and Other Practitioners.

In addition, following a Centers for Medicare & Medicaid Services (CMS) revision of their reimbursement methodologies, references to the Medicare reimbursement methodology are being updated to be in line with the CMS changes. The intent is to remove outdated reimbursement percentages and references to the Medicare average sales price and replace them with simpler references to the Medicare fee schedules where applicable. Where §355.8085 currently specifies its applicability to the Texas Medicaid program, the language has been revised to include “and other programs administered by Texas HHSC” in order to add clarity that the rule can apply to other programs in addition to Medicaid. This update provides clarification regarding the scope of the reimbursement methods.

SECTION-BY-SECTION SUMMARY

Edits were made throughout §355.8085 and §355.8441 to correct punctuation, grammar, and references, and to clarify phrases.

Proposed amendment to §355.8085(a) adds an analysis of wage statistics data as one of the elements HHSC considers when reviewing fees for individual services at least every two years.

Proposed amendment to §355.8085(b) adds LBAs and LaBAs to the list of eligible providers.

Proposed amendment to §355.8085(e)(5) removes any references to a percentage of Medicare average sales price and replaces previous references with a reference to the Medicare rate.

Proposed amendment §355.8085(g)(6) adds a reference to §355.8441 as the location in which reimbursement methodology for LaBAs is defined.

Amending 1 TAC §355.8441, to define reimbursement methodologies for LBAs and LaBAs.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
1 TAC §355.8441

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.8085, concerning Reimbursement Methodology for Physicians and Other Practitioners; and §355.8441, concerning Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to clarify the current structure of reimbursement methodologies for certain services and programs administered by HHSC. The amendments add details to describe the methodology HHSC uses to determine reimbursement amounts to Licensed Behavior Analysts (LBAs) and Licensed Assistant Behavior Analysts (LaBAs) for Applied Behavior Analysis (ABA) professional services. The amendment also adds wage statistic data as an element to be considered for reimbursement methodology for Physicians and Other Practitioners.

In addition, following a Centers for Medicare & Medicaid Services (CMS) revision of their reimbursement methodologies, references to the Medicare reimbursement methodology are being updated to be in line with the CMS changes. The intent is to remove outdated reimbursement percentages and references to the Medicare average sales price and replace them with simpler references to the Medicare fee schedules where applicable. Where §355.8085 currently specifies its applicability to the Texas Medicaid program, the language has been revised to include “and other programs administered by Texas HHSC” in order to add clarity that the rule can apply to other programs in addition to Medicaid. This update provides clarification regarding the scope of the reimbursement methods.

SECTION-BY-SECTION SUMMARY

Proposed amendment §355.8441(a)(13) defines reimbursement methodologies for LBAs and LaBAs.

Adopted Rules Re:

Adopting 26 TAC §§364.51, 364.53, 364.55, 364.57, to repeal Subchapter D, concerning Clearinghouse for Primary Care Providers Seeking Collaborative Practice.

CHAPTER 364. PRIMARY HEALTH CARE SERVICES PROGRAM
SUBCHAPTER D. CLEARINGHOUSE FOR PRIMARY CARE PROVIDERS SEEKING COLLABORATIVE PRACTICE
26 TAC §§364.51, 364.53, 364.55, 364.57

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of Subchapter D, concerning Clearinghouse for Primary Care Providers Seeking Collaborative Practice consisting of §364.51, concerning Purpose and Authority; §364.53, concerning Definitions; §364.55, concerning Provider Registration; and §364.57, concerning Duties of the Department. The repeal of §§364.51, 364.53, 364.55, and 364.57 is adopted without changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8693). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the adoption is to remove rules which are no longer necessary and to increase clarity in the Texas Administrative Code (TAC). The rules applied to a Department of State Health Services (DSHS) program regarding a clearinghouse for primary care providers seeking collaborative practice. Texas Health and Safety Code §105.007, which covered the clearinghouse, was repealed by Senate Bill 970, 87th Legislature, Regular Session, 2021.

Adopting 26 TAC §745.11, to define terms used in the chapter.

CHAPTER 745. LICENSING
SUBCHAPTER A. PRECEDENCE AND DEFINITIONS
DIVISION 1. DEFINITIONS FOR THE LANGUAGE USED IN THIS CHAPTER
26 TAC §745.11

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §§745.8901, 745.8903, 745.8905, 745.8907 – 745.8909, 745.8923, to repeal these sections.

CHAPTER 745. LICENSING
SUBCHAPTER N. ADMINISTRATOR’S LICENSING
DIVISION 1. OVERVIEW OF ADMINISTRATOR’S LICENSING
26 TAC §§745.8901, 745.8903, 745.8905, 745.8907 – 745.8909, 745.8923

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §§745.8905 – 745.8907, 745.8911, 745.8913, 745.8914, 745.8925, to define child-care administrators, child-placing agency administrators, licensed administrators, and set forth the situations in which one may serve as a child-care administrator with a Child-Care Administrator’s License.

CHAPTER 745. LICENSING
SUBCHAPTER N. ADMINISTRATOR’S LICENSING
DIVISION 1. OVERVIEW OF ADMINISTRATOR’S LICENSING
26 TAC §§745.8905 – 745.8907, 745.8911, 745.8913, 745.8914, 745.8925

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §745.8933, to update application requirements to be consistent with current policy and clarify language.

CHAPTER 745. LICENSING
DIVISION 2. SUBMITTING APPLICATION MATERIALS
26 TAC §745.8933

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §745.8965, §745.8967, to improve readability and understanding, update titles and clarify when the Associate Commissioner or designee will review whether CCR exceeded application time frames.

CHAPTER 745. LICENSING
DIVISION 3. LICENSING’S REVIEW OF AN APPLICATION
26 TAC §745.8965, §745.8967

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §745.8976, to update citations and improve readability and understanding.

CHAPTER 745. LICENSING
DIVISION 4. MAINTAINING AN ADMINSTRATOR’S LICENSE
26 TAC §745.8976

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §§745.9023 – 745.9030, to incorporate the repeals of specific sections with some changes for clarity; rewrites and incorporates repeals of certain methods; update the expedited application process for military members, spouses, or veterans; change language for improve readability and understanding; and delete unnecessary language.

CHAPTER 745. LICENSING
DIVISION 6. MILITARY MEMBERS, MILITARY SPOUSES, AND MILITARY VETERANS
26 TAC §§745.9023 – 745.9030

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

Adopting 26 TAC §§745.9025 – 745.9027, to incorporate the proposed repeal into the updated application requirements that are consistent with current policy.

CHAPTER 745. LICENSING
26 TAC §§745.9025 – 745.9027

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; the repeal of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027.

Amendments to §§745.11, 745.8906, 745.8911, 745.8913, 745.8914, 745.8925, 745.8933, 745.8965, 745.8967, 745.8976, 745.9028, 745.9029, and 745.9030; and new §§745.8905, 745.8907, 745.9023, 745.9024, 745.9025, 745.9026, and 745.9027 are adopted with changes to the proposed text as published in the in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will be republished.

The repeals of §§745.8901, 745.8903, 745.8905, 745.8907, 745.8908, 745.8909, 745.8923, 745.9025, 745.9026, and 745.9027 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7279). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments, repeals, and new sections update and clarify rules pertaining to the licensure of child-care administrators for general residential operations and child-placing agencies.

Some of the adopted changes are necessary to implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, and to be consistent with the recent changes made by HHSC to §351.3 and §351.6 in Texas Administrative Code, Title 1, Part 15. The changes update the administrator’s licensing rules related to a military member, spouse, or veteran, including (1) updating the expedited application process for a military member, spouse, or veteran who applies for an administrator’s license or to act as an administrator without a license, by clarifying that Child Care Regulation (CCR) will process a complete application within 30 days after CCR receives the application; (2) adding that a military member licensed in good standing by another state with substantially equivalent requirements to Texas may apply to act as an administrator without obtaining an administrator’s license under certain circumstances, which is already allowed for a military spouse; (3) clarifying that a military spouse approved to act as an administrator without a license may continue to do so for three years from the date of the approval even if there is a divorce or similar event that changes the marital status of the military spouse; and (4) clarifying that an approval of a military member or spouse to act as an administrator without a license may not be renewed.

Other adopted changes not related to the statutory changes include (1) clarifying when a child-care administrator must have a Child-Care Administrator’s License (CCAL) or a Child-Placing Agency Administrator’s License (CPAAL), including clarifying and consolidating the exceptions and the deletion of an exception for a CPAAL; (2) clarifying that CCR will waive examination, experience, and education requirements for an applicant with a license in good standing by another state that has licensing requirements substantially equivalent to Texas, including an applicant who is a miliary member, spouse, or veteran, if the applicant meets the background check requirements and is otherwise eligible to apply for an administrator’s license; (3) updating the application requirements, including those for a military member, spouse, or veteran, to be consistent with current application and policy requirements; (4) clarifying substitute methods a military member, spouse, or veteran may use to demonstrate competency in the examination, experience, or education requirements for an administrator’s license; (5) waiving the replacement fee for a military member, spouse, or veteran to obtain a copy of a lost or destroyed administrator’s license or approval letter to act as an administrator without an administrator’s license; (6) clarifying that CCR Administrator Enforcement may revoke a military member’s or spouse’s ability to act as an administrator without a license if the military member or spouse fails to comply with relevant statutes, rules, and minimum standards or if the military member or spouse is no longer licensed in good standing by another state; and (7) consolidating rules, updating citations and titles, and improving the readability and understanding of the rules.

In Addition Re:

Notice of Public Hearing on Proposed Updates to Medicaid Payment Rates for Calendar Fee Review, Medical Policy Reviews, and Annual HCPCS Updates

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on February 14th, 2025, at 9:00 a.m., to receive public comments on proposed updates to Calendar Fee Review, Medical Policy Reviews, and Annual HCPCS Updates.

Texas Department of State Health Services

In Addition Re:

Licensing Actions for Radioactive Materials (.pdf)

For more information, please visit this week’s edition of the Texas Register at 50 Tex. Reg. 686.