Texas Register July 19, 2024 Volume: 49 Number: 29

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Education Agency
- - 2.0.1 Proposed Rule Re:
    - 2.0.1.1 Amending 19 TAC §§89.1035, 89.1053, 89.1070, to provide clarification as to student eligibility; procedures for the use of restraint and time-out; and graduation requirements for students receiving special education and related services.
3 Texas Department of State Health Services
4 Department of Aging and Disability Services
- - 4.0.1 Adopted Rule Reviews Re:
    - 4.0.1.1 Adopting Title 40, Part 1, concerning Contracts to Provide Special Services to Persons with Disabilities.

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §351.805, to improve the language and structure for better readability; clarify the tasks and requirements for SMMCAC meetings; restructure the membership subcategories for individuals and providers enrollment in Medicaid managed care; add training requirements for SMMCAC members; describe SMMCAC member travel reimbursements; and update the numbering of the subsections and paragraphs.

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER B. ADVISORY COMMITTEES
DIVISION 1. COMMITTEES
1 TAC §351.805

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §351.805, concerning State Medicaid Managed Care Advisory Committee.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to extend the State Medicaid Managed Care Advisory Committee (SMMCAC) and align the rule with HHSC advisory committee rule standards. Under the general authority of the Executive Commissioner, the SMMCAC was re-established in 2016 to consider managed care issues and make recommendations to HHSC. The SMMCAC is currently set to abolish on December 31, 2024. The proposed rule amendment changes the SMMCAC abolish date from December 31, 2024, to December 31, 2028, which will allow SMMCAC to continue providing recommendations and ongoing input to HHSC on the statewide operation of Medicaid managed care programs for an additional four years. Additionally, the rule amendment restructures membership subcategories to increase representation for youth and adult populations and adds a new membership subcategory for persons transitioning from children to adult Medicaid managed care programs. The rule amendment will align §351.805 with agency standards for advisory committees by including a subsection on how eligible SMMCAC members may be reimbursed for travel.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §351.805: (1) updates language and structure for better readability and understanding; (2) clarifies what tasks the SMMCAC performs; (3) clarifies the frequency of SMMCAC meetings; (4) clarifies how many members constitute a quorum; (5) restructures the membership subcategories for persons enrolled in Medicaid managed care and adds a new membership subcategory for youth transitioning from children to adult Medicaid managed care programs; (6) expands the membership subcategory for persons dually eligible for both Medicare and Medicaid to allow persons of any age to be represented; (7) restructures the membership subcategory for providers contracted with a Medicaid managed care organization and clarifies requirements for the membership subcategory of a community-based organization; (8) clarifies the membership subcategory for managed care organizations that are national and community-based; (9) adds requirements that the SMMCAC members complete training on the HHS Ethics Policy, the Advisory Committee Member Code of Conduct; and other relevant HHSC policies; (10) adds a subsection to describe when HHSC may reimburse a SMMCAC member for travel; (11) extends the SMMCAC abolishment date from December 31, 2024, to December 31, 2028; and (12) updates the numbering of the subsections and paragraphs accordingly.

Amending 1 TAC §351.815, to update language to conform with HHSC’s advisory committee rule template guidelines.

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER B. ADVISORY COMMITTEES
DIVISION 1. COMMITTEES
1 TAC §351.815

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §351.815, concerning the Policy Council for Children and Families.

BACKGROUND AND JUSTIFICATION

The Policy Council for Children and Families (PCCF) was established by the HHSC Executive Commissioner under the authority of Texas Government Code §531.012. This statute requires the HHSC Executive Commissioner to establish and maintain advisory committees, establish rules for the operation of advisory committees, and for advisory committees to provide recommendations to the HHSC Executive Commissioner and the Texas Legislature.

The PCCF advises the HHSC Executive Commissioner and Health and Human Services system agencies (HHS agencies) to improve the coordination, quality, efficiency, and outcomes of services provided to children and the families of children with disabilities and special health care needs, including mental health needs, through the state’s health, education, and human services systems. Members meet approximately four times a year in Austin.

Section 351.815 is set to expire on December 31, 2024, which will abolish the PCCF. The proposed amendment would extend the committee by four years to December 31, 2028, and update existing membership categories for one voting and one ex-officio members. Other edits align the rule with current HHSC advisory committee rulemaking guidelines.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §351.815 adds “HHSC” in front of “Executive Commissioner” and uses the acronym “PCCF” for the “Policy Council for Children and Families” or “committee.” The section is revised to ensure it conforms with HHSC’s advisory committee rule template guidelines.

The proposed amendment to subsection (a) adds that the section is subject to §351.801, relating to Authority and General Provisions.

The proposed amendment adds a new paragraph (8) in subsection (c) providing that the PCCF adopts bylaws to guide the operation of the committee.

The proposed amendment updates subsection (d) for clarity.

The proposed amendment adds new paragraphs (2) and (3) in subsection (e), regarding frequency of meetings and quorum, respectively.

The proposed amendment adds language to subsection (f) regarding membership requirements and terms of service, including adding HHSC’s Community Services Division as an ex-officio representative and specifying that a previously “at large” voting membership category should be for a person with cross-system experience supporting children and the families of children with a disability.

The proposed amendment adds language to subsection (g) regarding the selection of a chair and vice chair and the terms of the officers.

The proposed amendment edits subsection (h) to update training requirements.

New subsection (i) explains the travel reimbursement policy.

The proposed amendment to subsection (j) extends the date of abolition of the PCCF from December 31, 2024, to December 31, 2028.

Amending 1 TAC §353.421, to require a Medicaid health care managed care organization (MCO) with low active participation rates in the MCO’s special disease management program to identify the reason and develop approaches to increase active participation.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER E. STANDARDS FOR MEDICAID MANAGED CARE
1 TAC §353.421

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §353.421, concerning Special Disease Management for Health Care MCOs.

BACKGROUND AND JUSTIFICATION

The purpose of proposal is to implement House Bill (H.B.) 2658, 87th Legislature, Regular Session, 2021. H.B. 2658 amended Texas Government Code §533.009(c), to require a Medicaid health care managed care organization (MCO) with low active participation rates in the MCO’s special disease management program to identify the reason for the low rates and develop approaches to increase active participation in the program for high-risk recipients.

The proposed amendment to §353.421 includes a new subsection (a) to organize the definition of “special disease management” with the new definitions “active participation” and “high-risk member” into one rule. The proposed definitions identify what these terms mean when used in the section.

The proposed amendment adds a new paragraph (5) in subsection (b) to require a health care MCO to include mechanisms to identify low active participation rates in the MCO’s special disease management program and the reason for the low rates and to increase active participation in the program for high-risk members. This is proposed to implement Texas Government Code Section 533.009(c)(3) added by H.B. 2658.

The proposed amendment, throughout the section and in the rule title, includes editorial changes to use correct formatting, use consistent terminology, and correct the use of acronyms to improve the readability of the section.

Amending 1 TAC §353.1311, to implement a quality reporting component required for the TIPPS pay-for-performance component and improve the language for greater consistency.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES
1 TAC §353.1311

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §353.1311, concerning Quality Metrics for the Texas Incentives for Physicians and Professional Services Program.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to amend §353.1311 to implement the quality reporting necessary for the pay-for-performance component of §353.1309.

Each directed payment program (DPP) has a quality rule and a financial rule. Effective January 28, 2024, HHSC amended the Texas Incentives for Physicians and Professional Services (TIPPS) financial rule to add a pay-for-performance component to TIPPS beginning with state fiscal year 2026. The proposed changes amend the TIPPS quality rule to implement the quality reporting necessary for the pay-for-performance component of the TIPPS financial rule. The amendment will also align the TIPPS quality rule with the quality rules for other DPPs.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §353.1311 implements the quality reporting necessary for the TIPPS pay-for-performance component in §353.1309. The amendment also makes the language in this TIPPS quality rule more consistent with the language in the Comprehensive Hospital Increase Reimbursement Program quality rule in §353.1307, a directed payment program with a pay-for-performance component.

Subsection (a) of the rule makes nonsubstantive changes to the text of the rule to make the rule language mirror the quality rules for other DPPs.

Subsection (b) of the rule makes nonsubstantive changes to the text of the rule to make the rule language mirror the quality rules for other DPPs.

Subsection (c) of the rule makes nonsubstantive changes to the text of the rule to make the rule language mirror the quality rules for other DPPs, provides that metrics may change from one program period to the next, and provides that quality metrics will be presented to the public for comment.

Subsection (d) of the rule provides that HHSC will specify performance requirements for each quality metric, that achievement of performance requirements will trigger payments, and that quality metrics will be presented to the public for comment.

Subsection (e) of the rule specifies that HHSC will use reported performance of quality metrics to evaluate the degree to which the program advances certain goals and objectives. The proposed amendment renumbers the remaining subsections in §353.1311 accordingly, given the addition of subsection (e).

Subsection (f) of the rule consists of language previously contained in former subsection (d) and makes nonsubstantive changes to the text of the rule to make the rule language mirror the quality rules for other DPPs.

Subsection (g) of the rule consists of language previously contained in former subsection (e), changes the dates by which the proposed metrics and performance requirements will be published, and increases the number of days that interested parties may comment on the proposed metrics.

Subsection (h) of the rule consists of language previously contained in former subsection (f) and changes the date by which the final metrics and performance requirements will be published to give participating physician groups more notice of the final measures and requirements.

Subsection (i) of the rule consists of language previously contained in former subsection (f) and adds language to authorize HHSC to substitute measures for those suggested or published by HHSC if CMS requires the substituted measures.

Subsection (j) renumbers former subsection (g).

Amending 1 TAC §§375.101 – 375.103, to repeal Subchapter A, which is no longer applicable.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER A. PROGRAM PURPOSE AND SCOPE
1 TAC §§375.101 – 375.103

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Subchapter A, concerning Program Purpose and Scope, comprising of §§375.101 – 375.103; Subchapter B, concerning Contractor Requirements for the Refugee Cash Assistance Program (RCA), comprising of §§375.201, 375.203, 375.205, 375.207, 375.209, 375.211, 375.213, 375.215, 375.217, 375.219, 375.221; Subchapter C, concerning Program Administration for the Refugee Cash Assistance Program (RCA), comprising of §§375.301, 375.303, 375.305, 375.307, 375.309, 375.311, 375.313, 375.315, 375.317, 375.319, 375.321, 375.323, 375.325, 375.327, 375.329, 375.331, 375.333, 375.335, 375.337, 375.339, 375.341, 375.343, 375.345, 375.347, 375.349, 375.351, 375.353; Subchapter D, concerning Refugee Cash Assistance Participant Requirements, comprising of §§375.401, 375.403, 375.405, 375.407, 375.409, 375.411, 375.413, 375.415, 375.417, 375.419; Subchapter E, concerning Refugee Medical Assistance, comprising of §§375.501, 375.503, 375.505, 375.507, 375.509, 375.511, 375.513, 375.515, 375.517, 375.519, 375.521, 375.523, 375.525, 375.527, 375.529, 375.531; Subchapter F, concerning Modified Adjusted Gross Income Methodology, comprising of §§375.601, 375.603, 375.605, 375.607, 375.609, 375.611, 375.613, 375.615, and an amendment to §375.701 in Subchapter G, concerning Local Resettlement Agency Requirements, in Title 1, Part 15, Chapter 375, concerning Refugee Cash Assistance and Medical Assistance Programs.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to remove rules which are no longer necessary and to update a rule that is required by statute. On September 30, 2016, the State of Texas withdrew from the administration of federally funded refugee services and benefits program effective January 31, 2017, following refusal by the federal Office of Refugee Resettlement to unconditionally approve Texas’ amended state refugee plan. Texas Government Code §531.0411 requires rules regarding refugee resettlement program; therefore, §375.701 will be retained and updated.

SECTION-BY-SECTION SUMMARY

The proposed repeal of Subchapter A, Program Purpose and Scope; Subchapter B, Contractor Requirements for The Refugee Cash Assistance Program (RCA); Subchapter C, Program Administration for the Refugee Cash Assistance Program (RCA); Subchapter D, Refugee Cash Assistance Participant Requirements; Subchapter E, Refugee Medical Assistance; and Subchapter F, Modified Adjusted Gross Income Methodology, deletes the rules because they are no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

The proposed amendment to §375.701 deletes subsection (i) which no longer applies. The terms “C.F.R.” and “refugee” are defined and minor non-substantive edits are made to correct formatting to align with HHSC rulemaking guidelines.

Amending 1 TAC §§375.201, 375.203, 375.205, 375.207, 375.209, 375.211, 375.213, 375.215, 375.217, 375.219, 375.221 to repeal Subchapter B, which is no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER B. CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA)
1 TAC §§375.201, 375.203, 375.205, 375.207, 375.209, 375.211, 375.213, 375.215, 375.217, 375.219, 375.221

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§375.301, 375.303, 375.305, 375.307, 375.309, 375.311, 375.313, 375.315, 375.317, 375.319, 375.321, 375.323, 375.325, 375.327, 375.329, 375.331, 375.333, 375.335, 375.337, 375.339, 375.341, 375.343, 375.345, 375.347, 375.349, 375.351, 375.353, to repeal Subchapter C, which is no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER C. PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA)
1 TAC §§375.301, 375.303, 375.305, 375.307, 375.309, 375.311, 375.313, 375.315, 375.317, 375.319, 375.321, 375.323, 375.325, 375.327, 375.329, 375.331, 375.333, 375.335, 375.337, 375.339, 375.341, 375.343, 375.345, 375.347, 375.349, 375.351, 375.353

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§375.401, 375.403, 375.405, 375.407, 375.409, 375.411, 375.413, 375.415, 375.417, 375.419, to repeal Subchapter D which is no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER D. REFUGEE CASH ASSISTANCE PARTICIPANT REQUIREMENTS
1 TAC §§375.401, 375.403, 375.405, 375.407, 375.409, 375.411, 375.413, 375.415, 375.417, 375.419

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§375.501, 375.503, 375.505, 375.507, 375.509, 375.511, 375.513, 375.515, 375.517, 375.519, 375.521, 375.523, 375.525, 375.527, 375.529, 375.531, to repeal Subchapter E, which is no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER E. REFUGEE MEDICAL ASSISTANCE
1 TAC §§375.501, 375.503, 375.505, 375.507, 375.509, 375.511, 375.513, 375.515, 375.517, 375.519, 375.521, 375.523, 375.525, 375.527, 375.529, 375.531

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§375.601, 375.603, 375.605, 375.607, 375.609, 375.611, 375.613, 375.615, to repeal Subchapter F, which is no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER F. MODIFIED ADJUSTED GROSS INCOME METHODOLOGY
1 TAC §§375.601, 375.603, 375.605, 375.607, 375.609, 375.611, 375.613, 375.615

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §375.701, to reformat paragraphs and improve language for greater clarity.

CHAPTER 375. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS
SUBCHAPTER G. LOCAL RESETTLEMENT AGENCY REQUIREMENTS
1 TAC §375.701

OVERVIEW

BACKGROUND AND JUSTIFICATION

Amending 1 TAC §§376.101 – 376.104, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER A. PURPOSE AND SCOPE
1 TAC §§376.101 – 376.104

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Subchapter A, concerning Purpose and Scope, comprised of §§376.101 – 376.104; Subchapter B, concerning Contractor Requirements, comprised of §§376.201, 376.203, 376.205, 376.207, 376.209, 376.211, 376.213, 376.215, 376.217, 376.219, 376.221, 376.223, 376.225, 376.227, 376.229, 376.231, 376.233, 376.235, 376.237; Subchapter C, concerning General Program Administration, comprised of §§376.301, 376.303, 376.305, 376.307, 376.309, 376.311, 376.313, 376.315, 376.317, 376.319, 376.321, 376.323, 376.325, 376.327, 376.329, 376.331, 376.333; Subchapter D, concerning Employment Services: Refugee Social Services (RSS), comprised of §§376.401, 376.403, 376.405, 376.407, 376.409, 376.411, 376.413, 376.415, 376.417, 376.419, 376.421, 376.423, 376.425, 376.427; Subchapter E, concerning Employment Services: Refugee Cash Assistance (RCA), comprised of §§376.501, 376.503, 376.505, 376.507, 376.509, 376.511, 376.513, 376.515, 376.517, 376.519; Subchapter F, concerning English as a Second Language (ESL) Services, comprised of §376.601 and §376.602; Subchapter G, concerning Other Employability Services, comprised of §§376.701, 376.703, 376.705, 376.707, 376.709, 376.711, 376.713, 376.715, 376.717, 376.719, 376.721; Subchapter H, concerning Targeted Assistance Grant (TAG) Services, comprised of §§376.801 – 376.806; Subchapter I, concerning Unaccompanied Refugee Minor (URM) Program, comprised of §§376.901 – 376.907; and an amendment to §376.1001 in Subchapter J, concerning Local Resettlement Agency Requirements, in Title 1, Chapter 376, concerning Refugee Social Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of Subchapter A, Purpose and Scope; Subchapter B, Contractor Requirements; Subchapter C, General Program Administration; Subchapter D, Employment Services: Refugee Social Services (RSS); Subchapter E, Employment Services: Refugee Cash Assistance (RCA); Subchapter F, English As a Second Language (ESL) Services; Subchapter G, Other Employability Services; Subchapter H, Targeted Assistance Grant (TAG) Services; and Subchapter I, Unaccompanied Refugee Minor (URM) Program, deletes the rules because they are no longer necessary as HHSC no longer administers the federally funded refugee services and benefits in Texas.

The proposed amendment to §376.1001 deletes subsection (i) which no longer applies. The terms “C.F.R.” and “refugee” are defined and minor non-substantive edits are made to correct formatting to align with HHSC rulemaking guidelines.

Amending 1 TAC §§376.201, 376.203, 376.205, 376.207, 376.209, 376.211, 376.213, 376.215, 376.217, 376.219, 376.221, 376.223, 376.225, 376.227, 376.229, 376.231, 376.233, 376.235, 376.237, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER B. CONTRACTOR REQUIREMENTS
1 TAC §§376.201, 376.203, 376.205, 376.207, 376.209, 376.211, 376.213, 376.215, 376.217, 376.219, 376.221, 376.223, 376.225, 376.227, 376.229, 376.231, 376.233, 376.235, 376.237

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§376.301, 376.303, 376.305, 376.307, 376.309, 376.311, 376.313, 376.315, 376.317, 376.319, 376.321, 376.323, 376.325, 376.327, 376.329, 376.331, 376.333, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER C. GENERAL PROGRAM ADMINISTRATION
1 TAC §§376.301, 376.303, 376.305, 376.307, 376.309, 376.311, 376.313, 376.315, 376.317, 376.319, 376.321, 376.323, 376.325, 376.327, 376.329, 376.331, 376.333

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§376.401, 376.403, 376.405, 376.407, 376.409, 376.411, 376.413, 376.415, 376.417, 376.419, 376.421, 376.423, 376.425, 376.427, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER D. EMPLOYMENT SERVICES: REFUGEE SOCIAL SERVICES (RSS)
1 TAC §§376.401, 376.403, 376.405, 376.407, 376.409, 376.411, 376.413, 376.415, 376.417, 376.419, 376.421, 376.423, 376.425, 376.427

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§376.501, 376.503, 376.505, 376.507, 376.509, 376.511, 376.513, 376.515, 376.517, 376.519, to repeal unnecessary rules because Texas withdrew from the administration of the federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER E. EMPLOYMENT SERVICES: REFUGEE CASH ASSISTANCE (RCA)
1 TAC §§376.501, 376.503, 376.505, 376.507, 376.509, 376.511, 376.513, 376.515, 376.517, 376.519

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §376.601, §376.602, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER F. ENGLISH AS A SECOND LANGUAGE (ESL) SERVICES
1 TAC §376.601, §376.602

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§376.701, 376.703, 376.705, 376.707, 376.709, 376.711, 376.713, 376.715, 376.717, 376.719, 376.721, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER G. OTHER EMPLOYABILITY SERVICES
1 TAC §§376.701, 376.703, 376.705, 376.707, 376.709, 376.711, 376.713, 376.715, 376.717, 376.719, 376.721

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§376.801 – 376.806, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER H. TARGETED ASSISTANCE GRANT (TAG) SERVICES
1 TAC §§376.801 – 376.806

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §§376.901 – 376.907, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER I. UNACCOMPANIED REFUGEE MINOR (URM) PROGRAM
1 TAC §§376.901 – 376.907

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 1 TAC §376.1001, to repeal unnecessary rules because Texas withdrew from the administration of a federally funded refugee services and benefits program.

CHAPTER 376. REFUGEE SOCIAL SERVICES
SUBCHAPTER J. LOCAL RESETTLEMENT AGENCY REQUIREMENTS
1 TAC §376.1001

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Amending 26 TAC §509.47, to add new subsections requiring a freestanding emergency medical care facility to comply with forensic medical examination training requirements.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §509.47

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §509.47, concerning Emergency Services.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to implement Senate Bill (S.B.) 1402, 88th Legislature, Regular Session, 2023.

S.B. 1402 amended Texas Health and Safety Code (HSC) §323.0045 and added new HSC §323.0046. Amended HSC §323.0045 requires a person who performs a forensic medical examination on a sexual assault survivor to complete at least two hours of basic forensic evidence collection training or equivalent education. Amended HSC §323.0045 also requires each health care facility with an emergency department that is not a sexual assault forensic exam-ready facility (SAFE-ready facility) to develop a written policy to require staff who perform forensic medical examinations on sexual assault survivors to complete at least two hours of basic forensic evidence collection training. New HSC §323.0046 requires each health care facility with an emergency department to provide at least one hour of basic sexual assault response training to certain facility employees and outlines the training content requirements. New HSC §323.0046 also requires each non-SAFE-ready health care facility with an emergency department to develop a written policy to ensure all appropriate facility personnel complete the basic sexual assault response training.

The proposed amendment adds the new training requirements in HSC §323.0045 and §323.0046 to the freestanding emergency medical care facility rules.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §509.47 adds new subsection (h)(3) and (4), which require a freestanding emergency medical care facility to comply with the forensic medical examination training requirements under HSC §323.0045 and the basic sexual assault response training requirements under HSC §323.0046.

The proposed amendment also corrects a typographical error in subsection (d)(2), updates the term “sexual assault survivor” to “survivor of sexual assault” for consistency with industry standard language, and updates a reference.

Amending 26 TAC §510.44, to require a private psychiatric hospital or a crisis stabilization to unit to comply with discharge requirements in HSC §256.003; update outdated information; align rule language with the other rules; and update references.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §510.44

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §510.44, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to implement Senate Bill (S.B.) 186, 88th Legislature, Regular Session, 2023.

S.B. 186 added new Texas Health and Safety Code (HSC) §256.003, which prohibits a hospital or other health care facility from discharging or otherwise releasing a patient to a group home, boarding home facility, or similar group-centered facility unless the person operating the group-centered facility holds a license or permit in accordance with applicable state law. New HSC §256.003 also contains provisions to allow a hospital or other health care facility to discharge a patient to a group-centered facility that does not hold an applicable license or permit under certain circumstances.

The proposed amendment adds information regarding the new discharge requirements in HSC §256.003.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §510.44 adds new subsection (e), which requires a private psychiatric hospital or a crisis stabilization unit to comply with the discharge requirements in HSC §256.003. The proposed amendment also makes other minor changes to correct outdated information; align with the other rules in 26 Texas Administrative Code Chapter 510, such as replacing “hospital” with “facility;” and updates references.

Amending 26 TAC §511.62, to require a limited services rural hospital to comply with discharge requirements set forth by HSC §256.003.

CHAPTER 511. LIMITED SERVICES RURAL HOSPITALS
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §511.62

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §511.62, concerning Discharge Planning.

BACKGROUND AND PURPOSE

The proposal is necessary to implement Senate Bill (S.B.) 186, 88th Legislature, Regular Session, 2023.

The proposed amendment adds information regarding the new discharge requirements in HSC §256.003.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §511.62 adds new subsection (m), which requires a limited services rural hospital (LSRH) to comply with the discharge requirements in HSC §256.003.

Amending 26 TAC §568.22, to authorize a private psychiatric hospital to voluntarily admit a prospective patient only if the hospital has available space when the prospective patient requests voluntary admission and makes minor changes to the formatting and grammar for increased clarity and consistency.

CHAPTER 568. STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS
SUBCHAPTER B. ADMISSION
26 TAC §568.22

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §568.22, concerning Voluntary Admission, and new §568.42, concerning Responding to a Psychiatric Emergency.

BACKGROUND AND PURPOSE

This proposal is necessary to implement Senate Bill (S.B.) 26, 88th Legislature, Regular Session, 2023, which, in part, amended Texas Health and Safety Code (THSC) Chapter 572 by adding new THSC §572.0026.

This statute authorizes a private psychiatric hospital’s facility administrator or their designee to approve the admission of a person who files a request for voluntary inpatient services only if the hospital has available space when the person files the request.

This proposal is also necessary to increase consistency in emergency medication monitoring requirements between state rules and federal Centers for Medicare & Medicaid Services (CMS) Conditions of Participation for psychiatric hospitals.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §568.22(f)(5) is consistent with THSC §572.0026 and authorizes a private psychiatric hospital to voluntarily admit a prospective patient only if the hospital has available space at the time the prospective patient requests voluntary admission. The proposed amendment to §568.22 also makes minor, non-substantive changes to formatting and grammar for clarity and consistency with HHSC rulemaking guidelines and corrects an internal reference in §568.22(h)(1).

Amending 26 TAC §568.42, to define terms and outline requirements for responding to a psychiatric emergency.

CHAPTER 568. STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS
SUBCHAPTER C. EMERGENCY TREATMENTS
26 TAC §568.42

OVERVIEW

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

Proposed new §568.42 defines certain terms and outlines requirements for responding to a psychiatric emergency, including ordering and administering a psychoactive medication; monitoring a patient after administering a psychoactive medication; adopting, implementing, and enforcing certain policies and procedures; requiring staff, physicians, registered nurses, and other licensed practitioners to receive certain trainings; requiring a patient evaluation within one hour after administering a psychoactive medication; and documenting certain information in the patient’s clinical record.

Amending 26 TAC §745.8401, §745.8411, to add requirements for HHSC in investigating allegations of abuse, neglect, or exploitation of elderly adults or adults with disabilities and make non-substantive changes for improved clarity.

CHAPTER 745. LICENSING
SUBCHAPTER K. INSPECTIONS, INVESTIGATIONS, AND CONFIDENTIALITY
DIVISION 1. OVERVIEW OF INSPECTIONS AND INVESTIGATIONS
26 TAC §745.8401, §745.8411

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §745.8401, concerning Who may inspect or investigate an operation under this division, and §745.8411, concerning What are my responsibilities when Licensing or the Texas Department of Family and Protective Services inspects or investigates my operation.

BACKGROUND AND PURPOSE

The proposal is necessary to implement House Bill (H.B.) 4696, 88th Legislature, Regular Session, 2023. H.B. 4696 amended Texas Health and Safety Code §253.001(4), and Texas Human Resources Code §48.251(a)(3) and §48.252(b) and (c) to specify that HHSC is responsible for investigating an allegation of abuse, neglect, and exploitation of an elderly person or an adult with a disability who resides in a residential child-care facility. Accordingly, HHSC Child Care Regulation (CCR) is proposing to amend rules that clarify what authorized entities may inspect or investigate according to Title 26, Chapter 745, Subchapter K, Division 1, and responsibilities an operation has when an authorized entity conducts an inspection or investigation. This rule project contains most of the rules needed to implement H.B. 4696, and a separate rule project is amending one rule relating to confidentiality to complete the rule development needed to implement the bill.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §745.8401 (1) adds that HHSC is responsible for investigating an allegation of abuse, neglect, or exploitation of an elderly adult or an adult with a disability in a residential child-care operation; and (2) makes non-substantive changes for better readability and understanding.

The proposed amendment to §745.8411 (1) amends the title of the rule so that it is not specific to CCR and the Texas Department of Family and Protective Services, since a department of HHSC other than CCR is responsible for conducting some investigations; (2) extends an operation’s responsibilities during an inspection or investigation to a representative of an HHSC department other than CCR; and (3) makes non-substantive changes for better readability and understanding.

Amending 26 TAC §745.9037, to update the rule that individuals who have been rejected by the HHSC are not eligible to apply for an administrator’s license under HRC Chapter 43 for five years.

CHAPTER 745. LICENSING
SUBCHAPTER N. ADMINISTRATOR’S LICENSING
DIVISION 7. REMEDIAL ACTIONS
26 TAC §745.9037

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §745.9037, concerning Under what circumstances may Licensing take remedial action against my administrator’s license or administrator’s license application.

BACKGROUND AND PURPOSE

The purpose of the proposal is to implement House Bill (H.B.) 4170, 88th Legislature, Regular Session, 2023. H.B. 4170 amended Texas Human Resources Code (HRC) §43.010, which makes a person ineligible to apply for another administrator’s license for five years after the date HHSC refused to renew the person’s administrator’s license. Prior to this amendment, this subsection only applied the five-year ban to when HHSC revoked an administrator’s license. The proposed amendment to §745.9037 is necessary to be consistent with HRC §43.010(b).

SECTION-BY-SECTION SUMMARY

The proposed amendment to §745.9037 updates the rule to include that a person is not eligible to apply for an administrator’s license under HRC Chapter 43 for five years after HHSC refuses to renew the administrator’s license.

Amending 26 TAC §§746.1053, 746.1065, 746.1067, 746.1069, to improve clarity and reorganize the rule; provide definitions for interim director; outline designation process of interim director of a child-care center; and clarify the circumstances under which someone serving as an interim director may continue to serve as a director after a child-care center receives a full license.

CHAPTER 746. MINIMUM STANDARDS FOR CHILD-CARE CENTERS
SUBCHAPTER D. PERSONNEL
DIVISION 1. CHILD-CARE CENTER DIRECTOR
26 TAC §§746.1053, 746.1065, 746.1067, 746.1069

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §746.1053, concerning Will the director’s certificate expire; and new §746.1065, concerning What is an interim director; §746.1067, concerning When may I designate someone as the interim director of my child-care center; and §746.1069, concerning May someone serving as interim director of my child-care center continue to serve as director after my child-care center receives a full license.

BACKGROUND AND PURPOSE

The purpose of the proposal is to implement Senate Bill (S.B.) 1327, 88th Legislature, Regular Session, 2023. S.B. 1327 amended Texas Human Resources Code (HRC), Chapter 42, by adding §42.04201 and amending §42.0761(a). HRC §42.04201 allows a child-care center operating under an initial license to designate an individual who meets all the director qualifications, except the education requirement, to serve as an interim director. Since an initial license is valid for six months from the date that HHSC Child Care Regulation (CCR) issues it and may be renewed for an additional six months, the statute allows a person to serve as an interim director for up to 12 months. Before the prospective 12-month period expires, the interim director may obtain the education requirements and be designated as a qualified director. If the interim director does not meet the education requirements at the end of the 12-month period, the child-care center must obtain an approved waiver for the requirements or employ a new director. HRC §42.04761(a) adds the term “interim director” to the statute that requires a child-care center to designate a qualified director who is routinely present at the operation. Accordingly, CCR is proposing to add rules to provide a definition of “interim director” and describe the requirements related to qualifying for that designation. CCR is also proposing to amend one rule related to expiring director certificates.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §746.1053 (1) updates language to improve readability; (2) reorganizes the rule to separate the types of expiring director certificates into paragraphs; and (3) adds an interim director certificate to the list of types of director’s certificates that expire.

New §746.1065 provides a definition of “interim director.” The definition specifies that the interim director (1) is an individual the child-care center designates to serve in that role if the individual meets the requirements in proposed new §746.1067; and (2) has the same responsibilities as a child-care center director.

New §746.1067 outlines when a child-care center may designate someone as the interim director of the child-care center. The rule specifies that the child-care center may designate an individual to serve as the interim director if (1) the child-care center is operating with an initial license; and (2) the individual meets all director requirements except for the educational requirements.

New §746.1069 clarifies the circumstances under which someone serving as an interim director may continue to serve as a director after a child-care center receives a full license. The rule specifies that (1) an individual serving as an interim director may serve as the child-care center director for an operation with a full license if (A) the individual has completed the required education and fully qualifies as a director, or (B) the child-care center obtains a waiver or variance from CCR that allows the child-care center to employ a director who does not meet the educational requirement; and (2) the child-care center must employ a new director if the individual does not qualify under subsection (a) of the rule.

Amending 26 TAC §748.303, to clarify the reporting requirements for a general residential operation and makes non-substantive changes for increased readability and understanding.

CHAPTER 748. MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS
SUBCHAPTER D. REPORTS AND RECORD KEEPING
DIVISION 1. REPORTING SERIOUS INCIDENTS AND OTHER OCCURRENCES
26 TAC §748.303

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §748.303, concerning When must I report and document a serious incident.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

The proposed amendment to §748.303 (1) clarifies that a general residential operation must report a serious incident involving the possible abuse, neglect, or exploitation of an adult resident to HHSC through the Texas Abuse and Neglect Hotline; and (2) makes non-substantive changes to the rule for better readability and understanding.

Amending 26 TAC §749.503, to clarify the reporting requirements of a child-placing agency and makes non-substantive changes to the rule for better readability and understanding.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER D. REPORTS AND RECORD KEEPING
DIVISION 1. REPORTING SERIOUS INCIDENTS AND OTHER OCCURRENCES
26 TAC §749.503

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §749.503, concerning When must I report and document a serious incident.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

The proposed amendment to §749.503 (1) clarifies that a child placing agency must report a serious incident involving the possible abuse, neglect, or exploitation of an adult resident to HHSC through the Texas Abuse and Neglect Hotline; and (2) makes non-substantive changes to the rule for better readability and understanding.

Transferred Rules Re:

Transferring the HHSC rules in Texas Administrative Code, Title 1, Part 15, Chapter 392 Purchase of Goods and Services for Specific Health and Human Services Commission Programs, Subchapter H, DFPS Contracted Services to DFPS under Texas Administrative Code, Title 40, Part 19, Chapter 732, Contracted Services, Subchapter C, Community-Based Care Services.

OVERVIEW

During the 85th Legislative Session, the Texas Legislature passed House Bill 5, directing that the Texas Department of Family and Protective Services (DFPS) become a stand-alone agency that is separate from the Texas Health and Human Services System (HHSC). The HHSC rules in Texas Administrative Code, Title 1, Part 15, Chapter 392 Purchase of Goods and Services for Specific Health and Human Services Commission Programs, Subchapter H, DFPS Contracted Services are now being transferred to DFPS under Texas Administrative Code, Title 40, Part 19, Chapter 732, Contracted Services, Subchapter C, Community-Based Care Services.

The rules will be transferred in the Texas Administrative Code effective August 15, 2024.

Transferring the DSHS rules in Texas Administrative Code, Title 25, Part 1, Chapter 412, Local Mental Health Authority Responsibilities, that are related to these transferred functions, to HHSC under Texas Administrative Code, Title 26, Part 1, Chapter 301, Local Authority Responsibilities.

OVERVIEW

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, certain functions previously performed by the Department of State Health Services (DSHS), including client services, certain regulatory functions, and the operation of state hospitals, transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code, §531.0201 and §531.02011. The DSHS rules in Texas Administrative Code, Title 25, Part 1, Chapter 412, Local Mental Health Authority Responsibilities, that are related to these transferred functions, are being transferred to HHSC under Texas Administrative Code, Title 26, Part 1, Chapter 301, Local Authority Responsibilities.

The rules will be transferred in the Texas Administrative Code effective August 15, 2024.

Proposed Rule Reviews Re:

Reviewing Title 1, Part 15, to consider for readoption, revision, or repeal of the chapter concerning Information Practices.

The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 1, Part 15, of the Texas Administrative Code:

Chapter 390, Information Practices

Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal of the chapter concerning Primary Home Care, Community Attendant Services, and Family Care Programs.

Chapter 277, Primary Home Care, Community Attendant Services, and Family Care Programs

In Addition Re:

Notice of Public Hearing on Proposed Medicaid Payment Rates for Medical Policy Reviews

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on August 2, 2024, at 9:00 a.m., to receive public comments on proposed updates to Medicaid payment rates.

Public Notice: Biennial Fee Review for Medicaid and Non-Medicaid Payment Rates and Rate Methodologies

Online Meeting. The Texas Health and Human Services Commission (HHSC) will conduct stakeholder engagement meetings on August 8, 2024, to receive comments as part of HHSC’s biennial fee review for Medicaid and non-Medicaid payment rates and rate methodologies.

Texas Education Agency

Proposed Rule Re:

Amending 19 TAC §§89.1035, 89.1053, 89.1070, to provide clarification as to student eligibility; procedures for the use of restraint and time-out; and graduation requirements for students receiving special education and related services.

CHAPTER 89. ADAPTATIONS FOR SPECIAL POPULATIONS
SUBCHAPTER AA. COMMISSIONER’S RULES CONCERNING SPECIAL EDUCATION SERVICES
DIVISION 2. CLARIFICATION OF PROVISIONS IN FEDERAL REGULATIONS
19 TAC §§89.1035, 89.1053, 89.1070

OVERVIEW

The Texas Education Agency (TEA) proposes amendments to §§89.1035, 89.1053, and 89.1070, concerning clarification of provisions in federal regulations and state law. The proposed amendment to §89.1053 would implement Senate Bill (SB) 133, 88th Texas Legislature, Regular Session, 2023. The proposed amendments to §89.1035 and §89.1070 would clarify graduation requirements for students receiving special education and related services as well as remove outdated language.

BACKGROUND AND JUSTIFICATION

Section 89.1035 addresses age ranges for student eligibility for special education and related services. The proposed amendment would update cross references and terminology to align with changes proposed in §89.1070.

Section 89.1053 addresses procedures for the use of restraint and time-out for students receiving special education and related services. SB 133, 88th Texas Legislature, Regular Session, 2023, modified Texas Education Code, §37.0021, to prohibit a peace officer or school security personnel from restraining or using a chemical irritant spray or Taser on a student enrolled in Grade 5 or below unless the student poses a serious risk of harm to the student or another person. The proposed amendment would add new §89.1053(l) to address the requirements of SB 133. TEA also plans to engage in stakeholder communications over the next several months to review §89.1053 and potentially propose additional changes at a later date.

Section 89.1070 addresses graduation requirements for students receiving special education and related services. The proposed amendment would clarify the requirements based on questions from stakeholders and remove obsolete language.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §89.1070(a) would clarify when a student’s eligibility for special education services terminates.

The proposed amendment to §89.1070(b) would clarify the expectations around the conditions that make a student eligible to graduate. Subsection (b)(1) would be modified to clarify that this condition equates to the same expectation for graduation as students without disabilities. The proposed amendment to subsection (b)(2) would clarify that this condition means that an admission, review, and dismissal committee has determined that a student would not have to meet satisfactory performance on state assessments beyond what is otherwise required for students without disabilities. Conditions in subsection (b)(3) would be amended to reflect graduation eligibility for a student who has received modified content or curriculum and completed their individualized education program.

The proposed amendment to §89.1070(d) would state that a student in Grade 11 or 12 who has failed to achieve satisfactory performance on no more than two state assessments would be eligible to graduate under the first condition described in §89.1070(b)(1).

Section 89.1070(e) and (f), related to students who entered Grade 9 before the 2014-2015 school year, would be deleted.

Proposed new §89.1070(e) would specify that if a student reaches maximum age eligibility but has not met the requirements for graduation, the student may receive a certificate of attendance.

Proposed new §89.1070(f) would address the summary of academic achievement and functional performance that must be provided to students who are graduating.

Section 89.1070(g) would be modified and new subsection (h) would be added to provide additional requirements for the summary of performance.

Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §133.45, to add a new subsection (k), which requires general or special hospital compliance with the discharge requirements, and subsections (l) and (m), which require general or special hospital compliance with forensic medical examination training and basic sexual assault response training requirements.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
25 TAC §133.45

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §133.45, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to implement Senate Bill (S.B.) 186 and S.B. 1402, 88th Legislature, Regular Session, 2023.

S.B. 1402 amended HSC §323.0045 and added new HSC §323.0046. Amended HSC §323.0045 requires a person who performs a forensic medical examination on a sexual assault survivor to complete at least two hours of basic forensic evidence collection training or equivalent education. Amended HSC §323.0045 also requires each health care facility with an emergency department that is not a sexual assault forensic exam ready facility (SAFE-ready facility) to develop a written policy to require staff who perform forensic medical examinations on sexual assault survivors to complete at least two hours of basic forensic evidence collection training. New HSC §323.0046 requires each health care facility with an emergency department to provide at least one hour of basic sexual assault response training to certain facility employees and outlines the training content requirements. New HSC §323.0046 also requires each non-SAFE-ready health care facility with an emergency department to develop a written policy to ensure all appropriate facility personnel complete the basic sexual assault response training.

The proposed amendment adds information regarding the new discharge requirements in HSC §256.003, new training requirements in HSC §323.0045 and §323.0046 to the general and special hospital rules, and more statutory language to further align the rule requirements for providing parents or caregivers of newborn infants with a resource pamphlet, as required by Texas Health and Safety Code §161.501.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §133.45 adds new subsection (k), which requires a general or special hospital to comply with the discharge requirements in HSC §256.003. The proposed amendment also adds new subsections (l) and (m), which require a general or special hospital to comply with the forensic medical examination training requirements under HSC §323.0045 and the basic sexual assault response training requirements under HSC §323.0046. The proposed amendment makes changes to correct outdated information and references and improve readability.

Amending 25 TAC §140.433, to reorganize the rule language and update each subsection with the new rule.

CHAPTER 140. HEALTH PROFESSIONS REGULATION
SUBCHAPTER I. LICENSED CHEMICAL DEPENDENCY COUNSELORS
25 TAC §140.433

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §140.433, concerning Licensing, Certification, or Registration of Military Service Members, Military Veterans, and Military Spouses, and new §140.433, concerning Licensing, Certification, or Registration of Military Service Members, Military Spouses, and Military Veterans.

BACKGROUND AND PURPOSE

The proposal is necessary to comply with and implement Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023. S.B. 422, in part, amended Texas Occupations Code (TOC) Chapter 55 to update requirements for a state agency’s recognition of a military service member’s and military spouse’s out-of-state professional license, which includes a licensed chemical dependency counselor (LCDC) license.

The proposal increases consistency between the proposed rule, the HHSC rules at 1 Texas Administrative Code (TAC) §351.3 and §351.6, and the statutory requirements regarding the licensing process for military service members, military spouses, and military veterans. The proposal also retains and updates certain language currently found in 25 TAC §140.433.

SECTION-BY-SECTION SUMMARY

Proposed repeal of §140.433 removes the current rule language because the new proposed §140.433 reorganizes language and updates every subsection in the current rule.

Amending 25 TAC §140.433, to set forth the licensing requirements for military service members, military spouses, and military veterans.

CHAPTER 140. HEALTH PROFESSIONS REGULATION
SUBCHAPTER I. LICENSED CHEMICAL DEPENDENCY COUNSELORS
25 TAC §140.433

OVERVIEW

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

Proposed new §140.433 outlines definitions used in the rule; sets forth out-of-state and alternative licensing requirements for military service members, military spouses, and military veterans; references HHSC rules at 1 TAC §351.3 and §351.6, which updates the timeframe requirement for HHSC to process an application for alternative licensing; and retains and updates certain language currently found in 25 TAC §140.433.

Amending 25 TAC §§229.901 – 229.903, to outline the purpose of the subchapter; add definitions for clarity; and include labeling requirements for analogue, meatless, plant-based, made from plants, or similar qualifying terms describing the contents of the product.

CHAPTER 229. FOOD AND DRUG
SUBCHAPTER HH. LABELING OF ANALOGUE PRODUCTS
25 TAC §§229.901 – 229.903

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes new Subchapter HH, §§229.901 – 229.903, concerning Labeling of Analogue Products.

BACKGROUND AND PURPOSE

The proposal is necessary to comply with Senate Bill (S.B.) 664, 88th Legislature, Regular Session, 2023, which adds Texas Health and Safety Code §431.0805. S.B. 664 defines “analogue product,” “cell-cultured product,” “close proximity,” “egg,” “egg product,” “fish,” “meat,” “meat food product,” “poultry,” and “poultry product.”

S.B. 664 also includes labeling requirements for an analogue meat product, a meat food product, poultry, a poultry product, an egg product, or fish.

SECTION-BY-SECTION SUMMARY

Proposed new §229.901 outlines the purpose of the subchapter.

Proposed new §229.902 adds definitions to clarify the terms product name and statement of identity, and adds definitions for different classifications of food products.

Proposed new §229.903 includes labeling requirements for analogue, meatless, plant-based, made from plants, or a similar qualifying term describing the contents of the product.

Amending 25 TAC §289.252, to update the NRC information used to determine the categorization of radionuclides and provide an update to the 21 Code of Federal Regulations (CFR) reference used when evaluating applications for specific licenses for the manufacture, preparation, or transfer of radioactive drugs for commercial distribution.

CHAPTER 289. RADIATION CONTROL
SUBCHAPTER F. LICENSE REGULATIONS
25 TAC §289.252

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes an amendment to §289.252, concerning Licensing of Radioactive Material.

BACKGROUND AND PURPOSE

The proposed amendment is necessary for Texas (an Agreement State) to comply with United States Nuclear Regulatory Commission (NRC) requirements, as identified in the Review Summary Sheets for Regulation Amendments (RATS Identification). The amendment updates NRC information, including the sum of ratios equation, used for determining whether aggregate quantities of radionuclides exceed the category 1 or category 2 radioactive material thresholds. An additional RATS Identification prescribes an update to the 21 Code of Federal Regulations (CFR) reference used when evaluating applications for specific licenses to manufacture, prepare, or transfer for commercial distribution, radioactive drugs containing radioactive material.

The proposed amendment clarifies Radiation Safety Officer training requirements; updates licensee responsibility for providing documentation to support nuclear pharmacist designation; specifies cut-off dates for nuclear pharmacy practice experience as they relate to authority to designate nuclear pharmacists; corrects the reference for reporting and notifying DSHS when radiopharmaceutical generator eluates exceed permissible concentrations; and simplifies the “Form of records” requirements for category 1 and category 2 protection standards by removing references to obsolete storage media. The amendment ensures compatibility with NRC requirements not specifically mentioned in the RATS Identification.

The proposed amendment updates, corrects, improves, and clarifies the rule language and incorporates plain language where appropriate while ensuring compatibility with NRC regulation.

SECTION-BY-SECTION SUMMARY

Proposed amendment to §289.252(f)(7)(A) and §289.252(f)(7)(B) adds “or” to the end of the qualification description to clarify that these are alternate pathways and ensures compliance with equivalent NRC regulation.

Proposed amendment to §289.252(l)(4), §289.252(l)(4)(C), and §289.252(l)(7)(A)(i)(II) clarifies to whom the listed documents must be furnished, adds “if applicable” to provide regulatory relief when the General License Acknowledgement does not apply, and clarifies the timeline for filing the report of all commercial distributions of devices.

Proposed amendment to §289.252(r)(1)(A)(i) updates the reference to “21 CFR §207.17(a)” for applicants registered with the United States Food and Drug Administration (FDA). This update is required by RATS Identification 2023-1.

Proposed amendment to §289.252(r)(3)(E) adds “NRC master materials licensee permit” to the list of documents provided by licensees to DSHS for consideration when designating nuclear pharmacists. This addition complies with the equivalent NRC regulation (10 CFR Part 32.72). Subsequent clauses are renumbered.

Proposed amendment to §289.252(r)(3)(D)(ii) and §289.252(r)(3)(E)(v) specifies cut-off dates for nuclear pharmacy practice as they relate to nuclear pharmacist designation and documentation requirements. This change complies with equivalent NRC regulation (10 CFR Part 32.72).

Proposed amendment to §289.252(x)(10)(B) updates the reference to reporting and notification requirements of “§289.256(www)” for generator eluates exceeding permissible concentrations.

Proposed amendment to §289.252(cc)(6) changes the paragraph to “Requirements for a specific license to initially transfer source material to persons generally licensed under §289.251(f)(3) of this subchapter” as is consistent with other subsections listing requirements for specific licenses.

Proposed amendment to §289.252(dd)(1) and §289.252(dd)(2)(C) adds a reference to “court” orders to reflect that only a court can issue a civil penalty under Texas Health & Safety Code Chapter 401; the issuance of civil penalties is considered in matters of modification, suspension, and revocation of licenses.

Proposed amendment to §289.252(gg)(8) deletes the paragraph and removes the obsolete reference to licensees applying for license renewal before January 1, 1995.

Proposed amendment to §289.252(ii)(24) simplifies the “Form of records” requirements for category 1 and category 2 protection standards by removing references to obsolete storage media.

Proposed amendment to §289.252(jj)(9) updates the sum of ratios equation in 25 TAC §289.252(jj)(9) – Figure, which is used for determining whether aggregate quantities of radionuclides exceed the category 1 or category 2 radioactive material thresholds. This update is required by RATS Identification 2021-2.

Adopted Rules Re:

Adopting 25 TAC §296.131, to repeal a rule no longer required due to the implementation of Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, which extends occupational reciprocity to military service members.

CHAPTER 296. TEXAS ASBESTOS HEALTH PROTECTION
SUBCHAPTER H. LICENSE AND REGISTRATION PROVISIONS RELATED TO MILITARY SERVICE MEMBERS, MILITARY VETERANS, AND MILITARY SPOUSES
25 TAC §296.131

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of Texas Administrative Code (TAC), Title 25, Subchapter H, concerning License and Registration Provisions Related to Military Service Members, Military Veterans, and Military Spouses, and §296.131, concerning Military Service Members, Military Veterans, and Military Spouses without changes to the proposed text as published in the April 19, 2024, issue of the Texas Register (49 TexReg 2381), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The repeal is necessary to remove a rule no longer required due to implementation of Senate Bill (S.B.) 422, 88th Legislature, Regular Session, 2023, extending occupational reciprocity to military service members. DSHS implemented S.B. 422 by adopting amended 25 TAC §1.81, concerning Recognition of Out-of-State License of a Military Service Member and Military Spouse, and new §1.91, concerning Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans.

The repeal removes Subchapter H because the only rule it contains is being repealed.

Transferred Rules Re:

Transferring the DSHS rules in Texas Administrative Code, Title 25, Part 1, Chapter 412, Local Mental Health Authority Responsibilities, that are related to these transferred functions, to HHSC under Texas Administrative Code, Title 26, Part 1, Chapter 301, Local Authority Responsibilities.

OVERVIEW

The rules will be transferred in the Texas Administrative Code effective August 15, 2024.

In Addition Re:

Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 49 Tex Reg 5398.

Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 49 Tex Reg 5406.

Department of Aging and Disability Services

Adopted Rule Reviews Re:

Adopting Title 40, Part 1, concerning Contracts to Provide Special Services to Persons with Disabilities.

The Texas Health and Human Services Commission (HHSC), as the successor agency of the Texas Department of Aging and Disability Services, adopts the review of the chapter below in Title 40, Part 1 of the Texas Administrative Code (TAC):

Chapter 58, Contracting to Provide Special Services to Persons with Disabilities