Texas Register June 17, 2022 Volume: 47 Number: 24

Texas Register Table of Contents

The Governor

Appointments Re:

The Governor appointed one individual to the Texas Board of Nursing, two individuals to the Texas Medical Board District One Review Committee, three individuals to the Texas Medical Board District Two Review Committee, and two individuals to the Texas Medical Board District Three Review Committee.

Appointments for June 8, 2022

Appointed to the Texas Board of Nursing for a term to expire January 31, 2023:

  • Tyrone P. Sharp, Ph.D. of Houston, Texas (replacing Tamara G. Rhodes of Amarillo, who resigned).

Appointed to the Texas Medical Board District One Review Committee for a term to expire January 15, 2028:

  • Laurel E. Coles of Houston, Texas (replacing Antoinette M. “Toni” Jackson of Houston, whose term expired).
  • Sheela L. Lahoti, M.D. of Houston, Texas (Dr. Lahoti is being reappointed).

Appointed to the Texas Medical Board District Two Review Committee for a term to expire January 15, 2024:

  • Annel Gonzalez Guadalupe of Huntsville, Texas (replacing Clyde D. Loll of Huntsville, who resigned).

Appointed to the Texas Medical Board District Two Review Committee for a term to expire January 15, 2028:

  • Lewis J. Benavides of Crossroads, Texas (Mr. Benavides is being reappointed).
  • Zachary S. “Zach” Jones, M.D. of Frisco, Texas (Dr. Jones is being reappointed).

Appointed to the Texas Medical Board District Three Review Committee for a term to expire January 15, 2028:

  • Celeste Caballero, M.D. of Lubbock, Texas (Dr. Caballero is being reappointed).
  • Mindi L. McLain of Amarillo, Texas (Ms. McLain is being reappointed).

Health and Human Services Commission

Emergency Rules Re:

New 26 TAC §500.4, allowing a currently licensed hospital to participate in the CMS hospitals at home program to expand hospital capacity in response to the COVID-19 pandemic.

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER A. HOSPITALS
26 TAC §500.4

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 500, COVID-19 Emergency Health Care Facility Licensing, new §500.4, concerning an emergency rule in response to COVID-19 in order to permit a licensed hospital to participate in the Centers for Medicare & Medicaid Services (CMS) Acute Hospital Care at Home Program to expand hospital capacity in response to the COVID-19 pandemic.

HHSC is adopting an emergency rule to temporarily permit a currently licensed hospital to participate in the CMS hospitals at home program to expand hospital capacity in response to the COVID-19 pandemic.

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 for Participating in the Centers for Medicare and Medicaid Services Acute Hospital Care at Home Program During the COVID-19 Pandemic.


In Addition Re:

Public Notice – American Rescue Plan Act

OVERVIEW

On May 20, 2022, the Health and Human Services Commission (HHSC) submitted to the Centers for Medicaid and Medicare Services (CMS) an amendment through an Appendix K based on HHSC’s spending plan pursuant to section 9817 of the American Rescue Plan Act for the following waivers:

  1. Community Living Assistance and Support Services (CLASS);
  2. Deaf Blind with Multiple Disabilities (DBMD);
  3. Texas Home Living (TxHmL);
  4. Home and Community-based Services (HCS); and
  5. Medically Dependent Children Program (MDCP).

HHSC administers the above waiver programs under the authority of section 1915(c) of the Social Security Act. The proposed effective date for the amendment is March 1, 2022, through six months following the end of the public health emergency.

Through this amendment, HHSC used the methodology described below to establish retention payments for providers of certain direct care services provided in 1915(c) waiver programs described in HHSC’s spending plan pursuant to section 9817 of the American Rescue Plan Act. Providers and provider agencies will be required to use at least 90 percent of these funds for one-time financial compensation for their direct care workforce delivering HCBS attendant and nursing services through the provider agency and consumer directed services option in Texas’ 1915(c) waivers. Permissible one-time compensation includes lump sum bonuses, retention bonuses, and paid time off for a COVID-19 vaccination.

HHSC will calculate payments made under section 9817 per the following methodology:

  1. Total approved funding pool will be divided proportionally based on historical claims paid from all HCBS services to calculate an anticipated funding amount for each service.
  2. Anticipated funding amount for each HCBS service is divided by projected utilization for the program period to calculate a per-unit payment factor for each service.
  3. Payments under this section will be distributed on claims for certain services delivered during the payment program’s specified duration. The payment program is anticipated to be effective on claims with dates of service between March 1, 2022, and August 31, 2022.

As agreed to by CMS, HHSC will disregard the impact of the temporary provider bonus payments on the cost limits for entry and continued participation in the waiver programs. For services rendered between March 1, 2022, and August 31, 2022, the retention payments for certain services under HHSC’s spending plan pursuant to section 9817 of the American Rescue Plan Act, as described in the appendix K, will not be added to the calculation of cost limits for the waiver.

CMS has determined that public notice requirements normally applicable under 1915(c) do not apply to information contained in an Appendix K. Therefore, states applying for 915(c) Appendix K amendments are not required to conduct a public notice and input process.


Texas Board of Nursing

Proposed Rules Re:

New 22 TAC §211.11, outlining the requirements regarding the sick leave pool and family leave pool.

CHAPTER 211. GENERAL PROVISIONS
22 TAC §211.11

OVERVIEW

The Texas Board of Nursing (Board) proposes new §211.11, relating to Employee Leave Pools. The new section is being proposed under the authority of the Government Code Chapter 661 and is necessary to implement the statutory requirements of that chapter.

SECTION-BY-SECTION SUMMARY

  • Sick Leave Pool. Section 661.002(a) authorizes the governing body of a state agency, through the establishment of a program, to allow an agency employee to voluntarily transfer to a sick leave pool sick leave earned by the employee. Section 661.002(b) and (c) require agencies to administer a sick leave pool and adopt rules and prescribe procedures relating to the operation of the agency sick leave pool. Section 661.004 provides that an agency employee may use time contributed to an agency sick leave pool if the employee has exhausted the employee’s sick leave because of a catastrophic illness or injury or a previous donation of time to the pool. Proposed new §211.11(a) establishes the Board’s sick leave pool.
  • Family Leave Pool. Section 661.022(a) authorizes the governing body of a state agency, through the establishment of a program, to allow an agency employee to voluntarily transfer sick or vacation leave earned by the employee to a family leave pool. Section 661.022(b) and (c) require agencies to administer a family leave pool and adopt rules and prescribe procedures relating to the operation of the agency family leave pool. Section 661.021 provides that the purpose of the state employee family leave program is to provide eligible state employees more flexibility in bonding with and caring for children during a child’s first year following birth, adoption, or foster placement; and caring for a seriously ill family member or the employee, including pandemic-related illnesses or complications caused by a pandemic; and allow employees to apply for leave time under the family leave pool. Proposed new §211.11(b) establishes the Board’s family leave pool.
  • Consistent with §661.002(b) and §661.022(b), proposed new §211.11(c) provides that the Human Resources Director or other employee designated by the Executive Director will act as Sick Leave Pool and Family Leave Pool Administrator for the Board.
  • Proposed new §211.11(d) provides that the Sick Leave Pool and Family Leave Pool Administrator, with the approval of the Executive Director, will prescribe and implement policies to effectuate the operation of the pools. The policies and procedures will be consistent with the provisions of Chapter 661 and will be included in the Board’s Employee Handbook.
  • Finally, proposed new §211.11(e) provides that all employee donations to the Board’s sick leave pool and family leave pool are strictly voluntary and must be made in writing.

Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §181.28, updating instructions and requirements for issuance of certified copies of vital records.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER B. VITAL RECORDS
25 TAC §181.28

OVERVIEW

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 §181.28, concerning Instructions and Requirements for Issuance of Certified Copies of Vital Records by the State Registrar, Local Registrar, or County Clerk.

BACKGROUND AND JUSTIFICATION

The purpose of the proposed amendment to §181.28 amends the list of security features in the rule. This change allows DSHS to increase the security of vital statistics paper by removing detailed information on security features from public access. The amendment also increases DSHS’s flexibility to address changes in security technology and ensures a steady supply of security paper from qualified vendors.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §181.28(c) revises the specific security features in the rule.
  • The proposed amendment to §181.28(d) deletes this subsection as it is no longer necessary.

In Addition Re:

Licensing Actions for Radioactive Materials

OVERVIEW

During the second half of April 2022, 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 (in alphabetical order by location). The subheading “Location” indicates the city in which the radioactive material may be possessed and/or used. The location listing “Throughout TX [Texas]” indicates that the radioactive material may be used on a temporary basis at locations throughout the state.

BACKGROUND AND JUSTIFICATION

In issuing new licenses and amending and renewing existing licenses, the Department’s Radiation 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.

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, Radioactive Material Licensing, MC 2835, PO Box 149347, Austin, Texas 78714-9347, or by fax to: (512) 206-3760, or by e-mail to: RAMlicensing@dshs.texas.gov.

For more information, visit this week’s issue of the Texas Register at 47 Tex Reg 3579.


Texas Board of Chiropractic Examiners

Withdrawn Rules Re:

Withdrawing proposed repeal of 22 TAC §78.1, concerning simplification of the rules defining the scope of practice.

CHAPTER 78. SCOPE OF PRACTICE AND DELEGATION
22 TAC §78.1

Proposed repeal of §78.1, published in the December 3, 2021, issue of the Texas Register (46 Tex Reg 8168), is withdrawn. The agency failed to adopt the proposal within six months of publication. (See Government Code, §2001.027, and 1 TAC §91.38(d).)


Withdrawing proposed rule 22 TAC §78.9, which clarified the rules regarding Instrumented Vestibular-Ocular-Nystagmus Testing.

CHAPTER 78. SCOPE OF PRACTICE AND DELEGATION
22 TAC §78.9

Proposed new §78.9, published in the December 3, 2021, issue of the Texas Register (46 TexReg 8170), is withdrawn. The agency failed to adopt the proposal within six months of publication. (See Government Code, §2001.027, and 1 TAC §91.38(d).)


Texas State Board of Examiners of Professional Counselors

Adopted Rules Re:

Repealing 22 TAC §681.6, which concerned meeting minutes.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER A. GENERAL PROVISIONS
22 TAC §681.6

OVERVIEW

The Texas Behavioral Health Executive Council adopts the repeal of §681.6, relating to Minutes. The repeal of §681.6 is adopted without changes to the proposed text as published in the December 10, 2021, issue of the Texas Register (46 Tex Reg 8309) and will not be republished.

BACKGROUND AND JUSTIFICATION

The repeal of this rule is necessary since recordings of entire meetings of the Texas State Board of Examiners of Professional Counselors will be posted on a publicly accessible website; therefore this rule is no longer necessary.


Amending 22 TAC §681.205 to provide consistency for rules relating to Schedule of Sanctions.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER D. SCHEDULE OF SANCTIONS
22 TAC §681.205

OVERVIEW

The Texas Behavioral Health Executive Council adopts amended §681.205, relating to Schedule of Sanctions. Section 681.205 is adopted with changes to the proposed text as published in the December 10, 2021, issue of the Texas Register (46 TexReg 8310) and will be republished. The changes made to the adopted version of the schedule of sanctions are non-substantive, and merely condense the format of the schedule to make it shorter and easier to use. These non-substantive changes are made by the Council pursuant to its authority found in 22 TAC §881.20.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to match other corresponding rule amendments made or proposed that are referenced in this rule. Substantively this schedule of sanctions is not changing, none of the sanctions are proposed to be changed. But the duplicative language that mirrors the language in each rule is being repealed as it is unnecessary and must be changed each time a corresponding rule is changed. Additionally, §681.91(l) has been deleted from this schedule since it was previously amended.


Texas Council for Developmental Disabilities

In Addition Re:

Request for Stipend Applications: TCDD Event Stipends Grants

OVERVIEW

The Texas Council for Developmental Disabilities (TCDD) announces the availability of funds for opportunities to help support education, access to resources, and self-advocacy at conferences and other training events in Texas.

Event Stipends Grants will provide an opportunity for organizations hosting conferences or other training events to receive funds to enable individuals with developmental disabilities and their families to attend the event. A grant received by an organization may be used to support participation at a series of trainings, as well as a single conference-type event. Sponsoring organizations may request up to $7,500 per year for the event(s) and must apply for funds at least 30 days in advance of the beginning of the event(s).

Individuals are not eligible to apply for these funds.

TCDD has available funding provided by the U.S. Department of Health and Human Services, Administration on Community Living, pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Non-federal matching funds of at least 10% of the total project costs are required. Funding awarded for a project will be dependent on the results of a review process established by TCDD and on the availability of funds.

Additional information concerning this Request for Stipend Applications and TCDD is available at https://tcdd.texas.gov/grants-rfps/funding-available-for-grants/. All questions pertaining to this RFA should be directed in writing to TCDD via email at apply@tcdd.texas.gov or via telephone at (512) 437-5432.