Texas Register July 9, 2021 Volume: 46 Number: 28

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 State Board of Dental Examiners
- - 2.0.1 Proposed Rules Re:
3 Department of State Health Services
- - 3.0.1 Proposed Rules Re:
  - 3.0.2 In Addition Re:

Texas Health and Human Services Commission

Emergency Rules Re:

Renewing 26 TAC §339.101 to ensure that essential services are provided to individuals with intellectual and developmental disabilities (IDD).

CHAPTER 339. EMERGENCY RULE RELATED TO A STATE FACILITY, LOCAL INTELLECTUAL AND DEVELOPMENTAL DISABILITY AUTHORITY, LOCAL MENTAL HEALTH AUTHORITY, AND LOCAL BEHAVIORAL HEALTH AUTHORITY
SUBCHAPTER A. COVID-19 EMERGENCY RULE
26 TAC §339.101

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §339.101 for a 60-day period. The text of the emergency rule was originally published in the March 12, 2021, issue of the Texas Register (46 TexR eg 1574).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code (TAC), new Chapter 339, Subchapter A, §339.101, concerning an emergency rule in response to COVID-19 in order to ensure essential services are provided to individuals with intellectual and developmental disabilities (IDD).

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule regarding Temporary Changes to Requirements.

The rule allows individuals additional time to request certain reviews conducted by a local intellectual and developmental disability authority (LIDDA) and administrative hearings conducted by HHSC, and to act to comply with certain accountability requirements. The rule allows a LIDDA or state facility more time to submit to HHSC an individual’s request for an administrative hearing, a meeting between a service coordinator and an individual to be conducted by telephone or video conference, rather than face-to-face, and a visit to community living options to be conducted virtually rather than in-person. The rule changes the requirement that a LIDDA withdraw an offer of Home and Community-based Services Program services for certain reasons to a requirement that the LIDDA not withdraw an offer or obtain HHSC’s approval before withdrawing an offer. The rule allows additional time for a LIDDA to complete certain activities after the LIDDA is notified of changes to an individual’s level of need (LON) and additional time to notify HHSC if the LIDDA is unable to complete the activities, a LIDDA to assess an individual by telecommunication after the LIDDA is notified by HHSC of changes to an individual’s LON, and a LIDDA more time to submit a plan of correction to HHSC after a review exit conference. The rule permits a LIDDA, local mental health authority, or local behavioral health authority to conduct preadmission screening and resident review level II evaluations and resident reviews, and a habilitation coordinator to provide habilitation coordination by telephone or video conference, rather than face-to-face.

Proposed Rules Re:

Repealing 26 TAC §506.61 and §506.62 to update the inspections and complaint investigations procedures for special care facilities.

CHAPTER 506. SPECIAL CARE FACILITIES
SUBCHAPTER E. INSPECTIONS AND INVESTIGATIONS
26 TAC §506.61, §506.62

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §506.61, concerning Inspection and Investigation Procedures; and §506.62, concerning Complaint Against a Texas Department of Health Representative.

The proposed repeal of §506.61 and §506.62 deletes this content as no longer necessary. These procedures are being updated and new content will be provided in new §§506.61 – 506.66.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update the inspections and complaint investigations procedures for special care facilities. These procedures require updating in order to hold facilities accountable during the inspection and investigation processes and ensure that necessary documentation is provided in a timely manner to HHSC surveyors. The proposal revises enforcement procedures to ensure accuracy and conform to statute. In addition, these updates ensure consistent practices across all Health Care Regulation (HCR) rulesets.

New 26 TAC §§506.61 – 506.66, updating the inspections and complaint investigations procedures for special care facilities.

CHAPTER 506. SPECIAL CARE FACILITIES
SUBCHAPTER E. INSPECTIONS AND INVESTIGATIONS
26 TAC §§506.61 – 506.66

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §§506.61, concerning Integrity of Inspections and Investigations; 506.62, concerning Inspections; 506.63, concerning Complaint Investigations; 506.64, concerning Notice; 506.65, concerning Professional Conduct; and 506.66, concerning Complaint Against an HHSC Representative.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

The proposed repeal of §506.61 and §506.62 deletes this content as no longer necessary. These procedures are being updated and new content will be provided in new §§506.61 – 506.66.
Proposed new §506.61, Integrity of Inspections and Investigations, places limits on a facility’s authority to record HHSC interviews and internal discussions.
Proposed new §506.62, Inspections, makes necessary updates to requirements for inspections of special care facilities.
Proposed new §506.63, Complaint Investigations, makes necessary updates to requirements for investigations of special care facilities following a complaint.
Proposed new §506.64, Notice, informs providers of the required timeframes regarding responding to deficiencies, plans of correction, and the provision of additional evidence.
Proposed new §506.65, Professional Conduct, notifies providers that enforcement actions are reported to appropriate licensing authorities.
Proposed new §506.66, Complaint Against an HHSC Representative, informs providers about registering a complaint against an HHSC inspector or investigator.

Amending 26 TAC §506.71 and §506.73 to ensure consistency and reflect the transition of authority over special care facilities from the DSHS to HHSC.

CHAPTER 506. SPECIAL CARE FACILITIES
SUBCHAPTER F. ENFORCEMENT
26 TAC §506.71, §506.73

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §506.71, concerning License Denial, Suspension, Revocation and Probation; and §506.73, concerning Administrative Penalties.

The proposed amendment to §506.71, License Denial, Suspension, Revocation and Probation, creates consistency between this ruleset and other HHSC facility types regarding enforcement procedures and makes necessary corrections and updates to this section to reflect current practices and conform with statute.

The proposed amendment to §506.73, Administrative Penalties, makes necessary updates to reflect the transition of responsibility from the Texas Department of State Health Services to HHSC.

BACKGROUND AND PURPOSE

Amending 26 TAC §510.1 and §510.2 to correct cross-references in definitions relating to private psychiatric hospitals and crisis stabilization units.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §510.1, §510.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §510.1, concerning Purpose and §510.2, concerning Definitions.

BACKGROUND AND PURPOSE

The purpose of the proposal is to correct cross-references throughout 26 TAC, Chapter 510. When this chapter was transferred from 25 TAC, Chapter 134 to 26 TAC, Chapter 510, the cross-references and other relevant citations within the rules were not updated to accurately refer to other sections in 25 TAC and 26 TAC. These non-substantive changes will allow HHSC to enforce regulations for Private Psychiatric Hospitals and Crisis Stabilization Units following the mandated movement of rules to 26 TAC, while maintaining accurate references to necessary rules in both 25 TAC and 26 TAC. The proposed amendments also correct various outdated citations and references to programs that no longer exist, and update language to reflect current HHSC organization and consistency with statute and HHSC rule.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §510.1 updates the statutory reference for the rules and replaces the term “department” to “commission” due to the transition from the Texas Department of State Health Services (DSHS) to HHSC. The proposed amendment also replaces the term “mental hospital” with “psychiatric hospital.”
The proposed amendment to §510.2 adds definitions for “commission” and “plan of correction” to increase consistency across the rule sets for licensed health care facilities; updates the definitions for “applicant” and “mental illness” for consistency across rule sets and for conformity to statute; removes the definitions for “board,” “department,” “director,” “division,” “learning disability,” and “mental retardation,” as they refer to defunct entities or inactive programs or are outdated terms no longer used in the chapter; and removes the following definitions as the information contained therein was moved to the applicable section of the chapter where the term appears: “legally reproduced form” moved to §510.41(g)(6), and “oral surgeon” moved to §510.41(a)(1)(C). The proposed amendment also deletes the definitions for “medical error,” “reportable event,” and “root cause analysis” related to the patient safety program. The patient safety program was created by House Bill 1614 during the 78th Legislature, Regular Session, 2003, however, the requirements set forth by the bill expired in 2007.

Amending 26 TAC §§510.21 – 510.26 to correct cross-references in rules relating to licensure for private psychiatric hospitals and crisis stabilization units.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER B. APPLICATION AND ISSUANCE OF A LICENSE
26 TAC §§510.21 – 510.26

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §510.21, concerning General; §510.22, concerning Application and Issuance of Initial License; §510.23, concerning Application of Issuance Renewal License; §510.24, concerning Change of Ownership; §510.25, concerning Time Periods for Processing and Issuing Licenses; and §510.26, concerning Fees.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

The proposed amendment to §510.21 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC and replaces the term “department” with “commission” due to the transition from DSHS to HHSC.
The proposed amendment to §510.22 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC and replaces the term “department” with “commission” due to the transition from DSHS to HHSC. The proposed amendment also updates language in §510.22(d)(2)(A) regarding “expiration date” by removing language for licenses issued prior to 2005 as these initial licenses have since expired and this language is no longer needed to distinguish between licenses issued prior to 2005. The reference to §510.87 located in subsection (f) is based on rules proposed elsewhere in this issue of the Texas Register.
The proposed amendment to §510.23 replaces the term “department” with “commission” due to the transition from DSHS to HHSC and deletes language in §510.23(b)(1) related to the patient safety program. The proposed amendment also updates language in §510.23(b)(3) regarding “expiration date” by removing language for licenses issued prior to 2005 as these renewal licenses have since expired and this language is no longer needed to distinguish between licenses issued prior to 2005. The reference to §510.82 located in subsection (b)(2) is based on rules proposed elsewhere in this issue of the Texas Register.
The proposed amendment to §510.24 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC and replaces the term “department” with “commission” due to the transition from DSHS to HHSC.
The proposed amendment to §510.26 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC and replaces the term “department” with “commission” due to the transition from DSHS to HHSC. The proposed amendment also updates the licensure period to 24 months as outlined in §510.23.

Amending 26 TAC §§510.41, 510.43, 510.46 to correct cross-references in rules outlining operational requirements for private psychiatric hospitals and crisis stabilization units.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §§510.41, 510.43, 510.46

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §510.41, concerning Facility Functions and Services; §510.43, concerning Patient Transfer Policy; and §510.46, concerning Abuse and Neglect Issues.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

The proposed amendment to §510.41 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC and replaces the term “department” with “commission” due to the transition from DSHS to HHSC. The proposed amendment also adds the licensing entity for oral surgeons, describes the types of legally reproduced medical records and corrects grammar.
The proposed amendment to §510.43 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC, removes reference to a defunct agency, and updates language to present tense.
The proposed amendment to §510.46 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC, replaces the term “department” with “commission” due to the transition from DSHS to HHSC, and corrects grammar. The proposed amendment to §510.46(c)(3) updates the language for reporting responsibilities when reporting abuse; neglect; and illegal, unprofessional, and unethical conduct to communicate the need for immediacy. The change provides specificity and increases consistency with other rule sets for licensed health care facilities. The reference to §510.82 located in subsection (d)(2) is based on rules proposed elsewhere in this issue of the Texas Register.

Amending 26 TAC §510.61 and §510.62 to correct cross-references in rules relating to voluntary agreements with private psychiatric hospitals and crisis stabilization units.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER D. VOLUNTARY AGREEMENTS
26 TAC §510.61, §510.62

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §510.61, concerning Patient Transfer Agreements; and §510.62, concerning Cooperative Agreements.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

The proposed amendment to §510.61 updates rule references to reflect the movement of rules from 25 TAC to 26 TAC.
The proposed amendment to §510.62 updates a rule reference to reflect the movement of the rule from 25 TAC to 26 TAC and replaces the term “department” with “commission” due to the transition from DSHS to HHSC. The proposed amendment also replaces the term “mental hospital” with “psychiatric hospital.”

Repealing 26 TAC §§510.81 – 510.83 to update the inspections and complaint investigations procedures for private psychiatric hospitals and crisis stabilization units.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER E. ENFORCEMENT
26 TAC §§510.81 – 510.83

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §510.81, concerning Survey and Investigation Procedures; and §510.82, concerning Complaint Against a Texas Department of Health Representative; and §510.83, concerning Enforcement.

The proposed repeal of §§510.81 – 510.83 deletes this content as no longer necessary. These procedures are being updated and new content will be provided in proposed new §§510.81 – 510.87.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update the inspections and complaint investigations procedures for private psychiatric hospitals and crisis stabilization units (PPHCSUs). These procedures require updating in order to hold facilities accountable during the survey and investigation processes and ensure that necessary documentation is provided in a timely manner to HHSC surveyors. The proposal revises enforcement procedures to ensure accuracy and conform to statute. In addition, these updates ensure consistent practices across all Health Care Regulation (HCR) rulesets.

New 26 TAC §§510.81 – 510.87, updating the inspections and complaint investigations procedures for private psychiatric hospitals and crisis stabilization units.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER E. ENFORCEMENT
26 TAC §§510.81 – 510.87

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §§510.81, concerning Integrity of Inspections and Investigations; 510.82, concerning Inspections; 510.83, concerning Complaint Investigations; 510.84, concerning Notice; 510.85, concerning Professional Conduct, 510.86, concerning Complaint Against an HHSC Representative; and 510.87, concerning Enforcement.

BACKGROUND AND PURPOSE

SECTION-BY-SECTION SUMMARY

Proposed new §510.81, Integrity of Inspections and Investigations, places limits on a facility’s authority to record HHSC interviews and internal discussions.
Proposed new §510.82, Inspections, makes necessary updates to requirements for inspections of PPHCSUs.
Proposed new §510.83, Complaint Investigations, makes necessary updates to requirements for investigations of PPHCSUs following a complaint.
Proposed new §510.84, Notice, informs providers of the required timeframes regarding responding to deficiencies, Plans of Correction (POC), and the provision of additional evidence.
Proposed new §510.85, Professional Conduct, notifies providers that enforcement actions are reported to appropriate licensing authorities.
Proposed new §510.86, Complaint Against an HHSC Representative, informs providers about registering a complaint against an HHSC inspector or investigator.
Proposed new §510.87, Enforcement, creates consistency between this ruleset and other HHSC facility types regarding enforcement procedures and makes necessary corrections and updates to this section to reflect current practices and conform with statute.

Adopted Rules Re:

New 26 TAC §368.101 and §368.102, establishing general requirements for intellectual and developmental disabilities habilitative specialized service providers.

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §368.101, §368.102

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts in Texas Administrative Code (TAC), Title 26, Part 1, new Chapter 368, Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services, Subchapters A through H, comprising §§368.101, 368.102, 368.201 – 368.204, 368.301, 368.302, 368.401 – 368.407, 368.501 – 368.505, 368.601, 368.602, 368.701, and 368.801.

Sections 368.101, 368.201, 368.301, 368.402, 368.403, 368.502, and 368.601 are adopted with changes to the proposed text as published in the January 1, 2021, issue of the Texas Register (46 Tex Reg 84). These rules will be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the new rules is to describe the requirements applicable to a service provider agency providing preadmission screening and resident review (PASRR) IDD habilitative specialized services (IHSS) to Medicaid-eligible nursing facility (NF) residents who are 21 years of age and older and who have been found through the PASRR process to need IHSS. PASRR is a federal requirement in 42 CFR Part 483, Subpart C. Since 2015, local intellectual and developmental disability authorities (LIDDAs) have provided certain specialized services to eligible NF residents funded by state general revenue funds. In accordance with a Medicaid state plan amendment approved by the Centers for Medicare & Medicaid Services, new Medicaid-funded services delivered as NF add-on services by service provider agencies will replace the state general revenue-funded specialized services LIDDAs currently provide.

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

In accordance with the state plan amendment, a service provider agency is eligible to contract with HHSC to provide IHSS if the service provider agency is licensed or certified by HHSC to provide program services for the Home and Community-based Services waiver, Texas Home Living waiver, Community Living Assistance and Support Services waiver, or Deaf Blind with Multiple Disabilities waiver. The services the service provider agencies will be providing are behavioral support, day habilitation, independent living skills training, employment assistance, and supported employment.

New 26 TAC §§368.201 – 368.204, establishing disclosure and initiation requirements for intellectual and developmental disabilities habilitative specialized service providers

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER B. SERVICES DESCRIPTION AND INITIATION
26 TAC §§368.201 – 368.204

OVERVIEW

Sections 368.102, 368.202 – 368.204, 368.302, 368.401, 368.404 – 368.407, 368.501, 368.503 – 368.505, 368.602, 368.701, and 368.801 are adopted without changes to the proposed text as published in the January 1, 2021, issue of the Texas Register (46 Tex Reg 84). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

New 26 TAC §368.301, §368.302, establishing authorization requirements for intellectual and developmental disabilities habilitative specialized service providers.

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER C. SERVICE AUTHORIZATIONS
26 TAC §368.301, §368.302

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

New 26 TAC §§368.401 – 368.407, establishing agency requirements for intellectual and developmental disabilities habilitative specialized service providers.

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER D. SERVICE PROVIDER AGENCY REQUIREMENTS
26 TAC §§368.401 – 368.407

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

New 26 TAC §§368.501 – 368.505, establishing transfer requirements for intellectual and developmental disabilities habilitative specialized service providers.

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER E. TRANSFERS
26 TAC §§368.501 – 368.505

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

New 26 TAC §368.601, §368.602, establishing requirements for the suspension, termination, or denial of intellectual and developmental disabilities habilitative specialized services

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER F. SERVICE SUSPENSION, TERMINATION, OR DENIAL
26 TAC §368.601, §368.602

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

New 26 TAC §368.701, establishing requirements for vendor payments to intellectual and developmental disabilities habilitative specialized service providers.

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER G. VENDOR PAYMENT
26 TAC §368.701

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

New 26 TAC §368.801, describing the roles and responsibilities of a LIDDA regarding the initiation and provision of IHSS.

CHAPTER 368. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDD) HABILITATIVE SPECIALIZED SERVICES
SUBCHAPTER H LIDDA REQUIREMENTS
26 TAC §368.801

BACKGROUND AND JUSTIFICATION

A service provider agency is a community-based provider with experience delivering services to individuals with intellectual disabilities or developmental disabilities.

The new rules also describe the roles and responsibilities of a LIDDA related to the initiation and provision of IHSS.

Transferred Rules Re:

Transferring authority over the Children’s Autism Program from DARS to HHSC.

OVERVIEW

The former DARS rules in Texas Administrative Code (TAC), Title 40, Part 2, Chapter 105, Children’s Autism Program are being transferred to 26 TAC Part 1, Chapter 358, Children’s Autism Program.

The rules will be transferred in the Texas Administrative Code effective August 1, 2021.

A table outlining the rule transfer is available at 46 Tex Reg 4173.

BACKGROUND AND JUSTIFICATION

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, some agencies were abolished, and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(a), specified the Department of Assistive and Rehabilitative Services (DARS) be abolished September 1, 2017, after all its functions were transferred to HHSC or the Department of Family and Protective Services in accordance with Texas Government Code, §531.0201.

State Board of Dental Examiners

Proposed Rules Re:

Amending 22 TAC §101.1 to require dental applicants to complete a human trafficking prevention course.

CHAPTER 101. DENTAL LICENSURE
22 TAC §101.1

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §101.1, concerning the general qualifications for dental licensure. To be eligible for licensure, this amendment requires dental applicants to complete a human trafficking prevention course approved by the executive commissioner of the health and human services commission.

Amending 22 TAC §103.1 to require dental hygiene applicants to complete a human trafficking prevention course.

CHAPTER 103. DENTAL HYGIENE LICENSURE
22 TAC §103.1

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §103.1, concerning the general qualifications for dental hygiene licensure. To be eligible for licensure, this amendment requires dental hygiene applicants to complete a human trafficking prevention course approved by the executive commissioner of the health and human services commission.

Amending 22 TAC §108.7 to remove the requirements pertaining to the minimum standards for safe practice during the COVID-19 pandemic.

CHAPTER 108. PROFESSIONAL CONDUCT
SUBCHAPTER A. PROFESSIONAL RESPONSIBILITY
22 TAC §108.7

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §108.7, concerning the minimum standard of care. This amendment removes the requirements pertaining to the minimum standards for safe practice during the COVID-19 pandemic because the Board’s emergency rule pertaining to the pandemic has since expired on June 18, 2021.

Amending 22 TAC §108.55 to establish oral medicine, dental anesthesiology, and orofacial pain as specialty areas.

CHAPTER 108. PROFESSIONAL CONDUCT
SUBCHAPTER E. BUSINESS PROMOTION
22 TAC §108.55

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §108.55, concerning advertising for general dentists. This amendment updates subsection (a) to include the three additional specialty areas (oral medicine, dental anesthesiology, and orofacial pain) that were recently added to 22 TAC §108.54(b).

Amending 22 TAC §114.6 to require dental assistant applicants to complete a human trafficking prevention course.

CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS
22 TAC §114.6

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §114.6, concerning the general qualifications for dental assistant registration or certification. To be eligible for registration or certification, this amendment requires dental assistant applicants to complete a human trafficking prevention course approved by the executive commissioner of the health and human services commission.

Department of State Health Services

Proposed Rules Re:

Repealing 25 TAC §§133.101, 133.102 to update the inspections and complaint investigations procedures for general and special hospitals.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER F. INSPECTION AND INVESTIGATION PROCEDURES
25 TAC §§133.101, 133.102

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §133.101, concerning Inspection and Investigation Procedures; and §133.102, concerning Complaint Against Department of State Health Services Surveyor.

The proposed repeal of §133.101 and §133.102 deletes this content as no longer necessary.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to update the inspections and complaint investigations procedures for general and special hospitals. These procedures require updating in order to hold facilities accountable during the inspection and investigation processes and ensure that necessary documentation is provided in a timely manner to HHSC surveyors. The proposal revises enforcement procedures to ensure accuracy and conform to statute. In addition, these updates ensure consistent practices across all Health Care Regulation (HCR) rulesets.

New 25 TAC §§133.101 – 133.106 to update the inspections and complaint investigations procedures for general and special hospitals.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER F. INSPECTION AND INVESTIGATION PROCEDURES
25 TAC §§133.101 – 133.106

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §§133.101, concerning Integrity of Inspections and Investigations; 133.102, concerning Inspections; 133.103, concerning Complaint Investigations; 133.104, concerning Notice; 133.105, concerning Professional Conduct; and 133.106, concerning Complaint Against an HHSC Representative.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of §133.101 and §133.102 deletes this content as no longer necessary. These procedures are updated and new content provided in proposed new §§133.101 – 133.106.
Proposed new §133.101, Integrity of Inspections and Investigations, places limits on a facility’s authority to record HHSC interviews and internal discussions.
Proposed new §133.102, Inspections, makes necessary updates to guidelines for inspections of hospitals and special hospitals.
Proposed new §133.103, Complaint Investigations, makes necessary updates to guidelines for investigations of hospitals and special hospitals following a complaint.
Proposed new §133.104, Notice, informs providers of the required timeframes regarding responding to deficiencies, plans of correction, and the provision of additional evidence.
Proposed new §133.105, Professional Conduct, notifies providers that enforcement actions are reported to appropriate licensing authorities.
Proposed new §133.106, Complaint Against an HHSC Representative, informs providers about registering a complaint against an HHSC inspector or investigator.

Amending 25 TAC §133.121 to ensure consistent practices across all Health Care Regulation (HCR) rulesets.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER G. ENFORCEMENT
25 TAC §133.121

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §133.121, concerning Enforcement Action.

The proposed amendment to §133.121, Enforcement Action, creates consistency between this ruleset and other HHSC facility types regarding enforcement procedures and makes necessary corrections and updates to this section to reflect current practices and conform with statute.

BACKGROUND AND JUSTIFICATION

Repealing 25 TAC §§135.21, 135.24, 135.25 to update the inspections and complaint investigations procedures for ambulatory surgical centers (ASC).

CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
25 TAC §§135.21, 135.24, 135.25

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §§135.21, concerning Inspections; 135.24, concerning Enforcement; and 135.25, concerning Complaints.

The proposed repeal of §§135.21, 135.24, and 135.25 deletes this content as no longer necessary. These procedures are being updated and new content will be provided in proposed new §§135.61 – 135.66 in new Subchapter D, Inspection, Investigation, and Enforcement Procedures.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to update the inspections and complaint investigations procedures for ambulatory surgical centers (ASC). These procedures require updating in order to hold facilities accountable during the inspection and investigation processes and ensure that necessary documentation is provided in a timely manner to HHSC surveyors. The proposal revises enforcement procedures to ensure accuracy and conform to statute. In addition, these updates ensure consistent practices across all Health Care Regulation (HCR) rulesets.

Amending 25 TAC §135.22 to update requirements for license renewal and reflect the transition of authority over ambulatory surgical centers from DSHS to HHSC.

CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
25 TAC §135.22

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the amendment of §135.22, concerning Renewal of License.

The proposed amendment to §135.22, Renewal of License, makes necessary updates to reflect the transition of responsibility from the Texas Department of State Health Services to HHSC. The proposed amendment to §135.22 also specifies the time frame for an ASC to return the license to HHSC when the ASC cannot provide sufficient evidence that the submission of a renewal application and fee was submitted within 30 days prior to the expiration date of the license.

BACKGROUND AND JUSTIFICATION

New 25 TAC §§135.61 – 135.66, updating the inspections and complaint investigations procedures for ambulatory surgical centers (ASC).

CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER D. INSPECTION, INVESTIGATION, AND ENFORCEMENT PROCEDURES
25 TAC §§135.61 – 135.66

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §§135.61, concerning Integrity of Inspections and Investigations; 135.62, concerning Inspections; 135.63, concerning Complaint Investigations; 135.64, concerning Notice; 135.65, concerning Professional Conduct; and 135.66, concerning Enforcement.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §135.61, Integrity of Inspections and Investigations, places limits on a facility’s authority to record HHSC interviews and internal discussions.
Proposed new §135.62, Inspections, makes necessary updates to guidelines for inspections of ASCs.
Proposed new §135.63, Complaint Investigations, makes necessary updates to guidelines for investigations of ASCs following a complaint.
Proposed new §135.64, Notice, informs providers of the required timeframes regarding responding to deficiencies, Plans of Correction (POC), and the provision of additional evidence.
Proposed new §135.65, Professional Conduct, notifies providers that enforcement actions are reported to appropriate licensing authorities.
Proposed new §135.66, Enforcement, creates consistency between this ruleset and other HHSC facility types regarding enforcement procedures and makes necessary corrections and updates to this section to reflect current practices and conform with statute.

In Addition Re:

DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the first half of May 2021

OVERVIEW

During the first half of May 2021, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials as listed in the tables included in this week’s edition of the Texas Register (46 Tex Reg 4191).

ADDITIONL INFORMATION

In issuing new licenses and amending and renewing existing licenses, the Department’s Business Filing and Verification Section has determined that the applicant has complied with the licensing requirements in Title 25 Texas Administrative Code (TAC), Chapter 289, for the noted action. In granting termination of licenses, the Department has determined that the licensee has complied with the applicable decommissioning requirements of 25 TAC, Chapter 289. In granting exemptions to the licensing requirements of Chapter 289, the Department has determined that the exemption is not prohibited by law and will not result in a significant risk to public health and safety and the environment.

AFFECTED PERSONS

A person affected by the actions published in this notice may request a hearing within 30 days of the publication date. A “person affected” is defined as a person who demonstrates that the person has suffered or will suffer actual injury or economic damage and, if the person is not a local government, is (a) a resident of a county, or a county adjacent to the county, in which radioactive material is or will be located, or (b) doing business or has a legal interest in land in the county or adjacent county. 25 TAC §289.205(b)(15); Health and Safety Code §401.003(15). Requests must be made in writing and should contain the words “hearing request,” the name and address of the person affected by the agency action, the name and license number of the entity that is the subject of the hearing request, a brief statement of how the person is affected by the action what the requestor seeks as the outcome of the hearing, and the name and address of the attorney if the requestor is represented by an attorney. Send hearing requests by mail to: Hearing Request, Radiation Material Licensing, MC 2835, PO Box 149347, Austin, Texas 78714-9347, or by fax to: 512-834-6690, or by e-mail to: RAMlicensing@dshs.texas.gov.

DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the second half of May 2021

OVERVIEW

During the second half of May 2021, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials as listed in the tables included in this week’s edition of the Texas Register (46 Tex Reg 4191).

ADDITIONL INFORMATION

AFFECTED PERSONS

DSHS publishes decisions regarding the issuance, amendment or renewal of certain parties’ licensure for the possession and use of radioactive material for the second half of April 2021

OVERVIEW

During the second half of April 2021, the Department of State Health Services (Department) has taken actions regarding Licenses for the possession and use of radioactive materials as listed in the tables included in this week’s edition of the Texas Register (46 Tex Reg 4191).

ADDITIONL INFORMATION

AFFECTED PERSONS