Texas Register Table of Contents
- 1 Office of the Attorney General
- 2 Texas Health and Human Services Commission
- 2.0.1 Emergency Rules Re:
- 2.0.2 Proposed Rule Reviews Re:
- 2.0.3 In Addition Re:
- 2.0.3.1 Notice of Public Hearing on Proposed Changes to Payment Rates Related to Nursing Facility (NF) Services
- 2.0.3.2 Public Notice: Amendment to the Waiver Application for the Home and Community-based Services (HCS) Program
- 2.0.3.3 Public Notice: CLASS Amendment 9-1-2023, concerning changes to the waiver application under Appendix J.
- 2.0.3.4 Public Notice: DBMD Amendment Effective 9-1-2023, amending the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) program.
- 2.0.3.5 Public Notice: Texas State Plan for Medical Assistance Amendment
- 2.0.3.6 Public Notice: Texas State Plan for Medical Assistance Amendment – Home and Community-Based Services Adult Mental Health (HCBS-AMH) §1915(i) State Plan Benefit
- 2.0.3.7 Public Notice: TxHML Amendment Effective 9-1-2023, concerning amending the waiver application for the Texas Home Living (TxHmL) program.
- 3 Texas State Board of Examiners of Psychologists
- 4 Texas Behavioral Health Executive Council
- 4.0.1 Adopted Rules Re:
- 4.0.1.1 Repealing 22 TAC §882.10, to allow for an updated rule concerning reasons for abeyance of an application.
- 4.0.1.2 New 22 TAC §882.10, modifying how license applications are processed when the applicant has a pending complaint.
- 4.0.1.3 Amending 22 TAC §884.10, to change the priority rating system for complaints from four levels to two levels.
- 4.0.1 Adopted Rules Re:
Office of the Attorney General
Requests for Opinions Re:
OVERVIEW
Requesting opinions regarding whether the Texas Board of Chiropractic Examiners has discretion to suspend or revoke a chiropractor’s license under Texas Occupations Code section 201.5065 if the chiropractor is convicted of certain offenses (RQ-0510-KP)
BACKGROUND INFORMATION:
Requestor:
- Mark Bronson, D.C.
- President
- Texas Board of Chiropractic Examiners
Briefs requested by June 26, 2023
Texas Health and Human Services Commission
Emergency Rules Re:
Renewing 26 TAC § 500.4, to extend a licensed hospital’s ability to participate in the CMS Acute Hospital Care at Home Program for a 60-day period.
CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER A. HOSPITALS
26 TAC §500.4
OVERVIEW
The Health and Human Services Commission is renewing the effectiveness of emergency new §500.4 for a 60-day period. The text of the emergency rule was originally published in the February 3, 2023, issue of the Texas Register (48 TexReg 451).
Proposed Rule Reviews Re:
Reviewing Title 26, Part 1, Chapter 711, regarding investigations of individuals receiving services from certain providers.
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 26, Part 1, of the Texas Administrative Code:
Chapter 88, State Long-Term Care Ombudsman Program
This review is conducted in accordance with the requirements of Texas Government Code §2001.039, which requires state agencies, every four years, to assess whether the initial reasons for adopting a rule continue to exist. After reviewing its rules, the agency will readopt, readopt with amendments, or repeal its rules.
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 26, Part 1, of the Texas Administrative Code:
CHAPTER 711. INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS
- SUBCHAPTER A. INTRODUCTION
- SUBCHAPTER C. DUTY TO REPORT
- SUBCHAPTER E. CONDUCTING THE INVESTIGATION
- SUBCHAPTER F. PROVISION OF SERVICES
- SUBCHAPTER G. RELEASE OF REPORT AND FINDINGS
- SUBCHAPTER J. APPEALING THE INVESTIGATION FINDING
- SUBCHAPTER L. EMPLOYEE MISCONDUCT REGISTRY
This review is conducted in accordance with the requirements of Texas Government Code §2001.039, which requires state agencies, every four years, to assess whether the initial reasons for adopting a rule continue to exist. After reviewing its rules, the agency will readopt, readopt with amendments, or repeal its rules.
In Addition Re:
Notice of Public Hearing on Proposed Changes to Payment Rates Related to Nursing Facility (NF) Services
OVERVIEW
Notice of Public Hearing on proposed changes to payment rates related to Nursing Facility (NF) services, proposed to be effective June 10, 2023, through August 31, 2023.
Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on June 13, 2023, at 9:00 a.m. to receive public comments on proposed changes to payment rates related to NF services resulting from Legislative Reviews.
Members of the public may attend the rate hearing in person, which will be held in the HHSC John H Winters Building, Public Hearing Room 125, First Floor, at 701 W. 51st Street, Austin, Texas 78751. HHSC will also broadcast the public hearing; the broadcast can be accessed on the HHS webpage (https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings). The broadcast will be archived and accessible on demand at the same website. HHSC will hold the hearing in compliance with Texas Human Resources Code Section 32.0282, which requires public notice of hearings on proposed Medicaid reimbursements.
BACKGROUND AND JUSTIFICATION
Proposal. HHSC is proposing to implement temporary add-on rates for NFs for miscellaneous costs to be effective June 10, 2023, through August 31, 2023.
Methodology and Justification. The proposed payment rates maintain the emergency add-on reimbursement rate increase for NFs originally implemented for the federally declared COVID-19 public health emergency as described in Senate Bill 30, 88th Legislature, Regular Session, 2023. The proposed payment rates were calculated following S.B. 30, 88th Legislature, Regular Session.
Public Notice: Amendment to the Waiver Application for the Home and Community-based Services (HCS) Program
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Home and Community-based Services (HCS) program. HHSC administers the HCS Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the HCS waiver application through August 31, 2023. The proposed effective date for this amendment is August 31, 2023.
This amendment request proposes to make the following changes:
Appendix B
HHSC updated waiver year (WY) 5 to reflect an increase in the Point-in-Time (PIT) and unduplicated participants (Factor C).
Appendix J
HHSC revised the unduplicated number of participants (Factor C) and PIT calculations for the overall projected cost of waiver services (Factor D) and the overall projected cost of other Medicaid services furnished to waiver participants (D Prime (D’)) for WY5.
The HCS waiver program provides services and supports to individuals with intellectual disabilities who live in their own homes, in the home of a family member, or another community setting such as a three-person or four-person residence operated by an HCS program provider. Services and supports are intended to enhance quality of life, functional independence, and health and well-being in continued community-based living and to supplement, rather than replace, existing informal or formal supports and resources. Services in the HCS waiver program include individualized skills and socialization, respite, supported employment, adaptive aids, audiology, occupational therapy, physical therapy, prescribed drugs, speech and language pathology, financial management services, support consultation, behavioral support, cognitive rehabilitation therapy, dental treatment, dietary services, employment assistance, minor home modifications, nursing, residential assistance, social work, supporting home living, and transition assistance services.
Public Notice: CLASS Amendment 9-1-2023, concerning changes to the waiver application under Appendix J.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Community Living Assistance and Support Services (CLASS) program. HHSC administers the CLASS Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the CLASS waiver application through August 31, 2024. The proposed effective date for this amendment is September 1, 2023.
The amendment request proposes to make changes to Appendix J of the waiver application based on the 2024-2025 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023, (Article II, HHSC Rider 30(a)) that appropriates funding to increase attendant base wages in the CLASS program.
Public Notice: DBMD Amendment Effective 9-1-2023, amending the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) program.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) program. HHSC administers the DBMD Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the DBMD waiver application through February 29, 2028. The proposed effective date for this amendment is September 1, 2023.
The amendment request proposes to make changes to Appendix J of the waiver application based on the 2024 – 2025 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023, (Article II, HHSC Rider 29 and 30(a)) that appropriates funding to increase the case management services reimbursement rate and attendant base wages in the DBMD program. Additionally, case management services will be allowed to be billed on a monthly basis, rather than hourly, as directed by Rider 29.
Public Notice: Texas State Plan for Medical Assistance Amendment
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. The proposed amendment is effective June 10, 2023, and will end on August 31, 2023.
The purpose of the amendment is to update the payment rates for Nursing Facilities (NF). The amendment will establish a temporary add-on for NFs for miscellaneous costs pursuant to Senate Bill 30, 88th Legislature, Regular Session, 2023.
The proposed amendment is estimated to result in an annual aggregate expenditure of $19,312,432 for federal fiscal year 2023, consisting of $12,045,164 in federal funds and $7,267,268 in state general revenue.
Public Notice: Texas State Plan for Medical Assistance Amendment – Home and Community-Based Services Adult Mental Health (HCBS-AMH) §1915(i) State Plan Benefit
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit transmittal number (TN) 23-0024 to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act.
The Centers for Medicare and Medicaid Services approved the Home and Community-Based Services Adult Mental Health (HCBS-AMH) §1915(i) State Plan benefit through August 31, 2025. The requested effective date for this proposed amendment is September 1, 2023.
The proposed amendment updates the Methods and Standards for Establishing Payment Rates based on the 2024 – 2025 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023, (Article II, HHSC Rider 30(a) which appropriated funding to increase attendant base wages in the Adult Mental Health §1915(i) HCBS AMH State Plan benefit.
Public Notice: TxHML Amendment Effective 9-1-2023, concerning amending the waiver application for the Texas Home Living (TxHmL) program.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Texas Home Living (TxHmL) program. HHSC administers the TxHmL Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the TxHmL waiver application through February 28, 2027. The proposed effective date for this amendment is September 1, 2023.
The amendment request proposes to make the following changes based on the 2024-2025 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023, (Article II, HHSC Rider 30(a)) which appropriated funding to increase attendant base wages in the TxHmL program:
Appendix J
Texas State Board of Examiners of Psychologists
Adopted Rules Re:
Amending 22 TAC §465.38, to allow a licensed specialist in school psychology (LSSP) to use the title “school psychologist,” as referenced in the Education Code.
CHAPTER 465. RULES OF PRACTICE
22 TAC §465.38
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendments to §465.38, relating to Psychological Services for Schools. Section 465.38 is adopted with changes to the proposed text as published in the December 16, 2022, issue of the Texas Register (47 TexReg 8212) and will be republished. Proposed §465.38(d) stated that an LSSP could use the title school psychologist or licensed school psychologist, as referenced in the Education Code. Turning to Education Code §21.003(b), the title school psychologist is listed but the title licensed school psychologist is not. Therefore, §465.38(d) is adopted with a change; the title licensed school psychologist has been removed but the title school psychologist remains so that this adopted amendment matches the exact language of the Education Code.
BACKGROUND AND JUSTIFICATION
The adopted amendments allow a licensed specialist in school psychology (LSSP) to use the title school psychologist, as referenced in the Education Code. The Council has received comments regarding the public’s confusion and unfamiliarity with the title LSSP. The intent behind this rule change is to help address the public’s confusion regarding this license type, so the public can better understand and recognize who they are and what activities they are licensed to perform.
Texas Behavioral Health Executive Council
Adopted Rules Re:
Repealing 22 TAC §882.10, to allow for an updated rule concerning reasons for abeyance of an application.
CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER A. LICENSE APPLICATIONS
22 TAC §882.10
OVERVIEW
The Texas Behavioral Health Executive Council adopts the repeal of §882.10, relating to Applicants with Pending Complaints. Section 882.10 is adopted without any changes, as published in the March 31, 2023, issue of the Texas Register (48 TexReg 1716) and will not be republished.
BACKGROUND AND JUSTIFICATION
The repeal of this rule is necessary because it is replaced with a new rule that is adopted in this issue of the Texas Register. The new rule will allow for the abeyance of an application up to 180 days when there is a pending complaint against the applicant that involves sexual misconduct or imminent physical harm to the public. All other applicants with complaints will have their application processed as normal, the complaint will not impact the licensure application. The pending complaint will still be investigated and processed according to the normal route as well.
New 22 TAC §882.10, modifying how license applications are processed when the applicant has a pending complaint.
CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER A. LICENSE APPLICATIONS
22 TAC §882.10
OVERVIEW
The Texas Behavioral Health Executive Council adopts new §882.10, relating to Applicants with Pending Complaints. Section 882.10 is adopted without changes to the proposed text as published in the March 31, 2023, issue of the Texas Register (48 TexReg 1717) and will not be republished.
BACKGROUND AND JUSTIFICATION
The adopted new rule changes the way Council staff will process applications when the applicant has a pending complaint. If the applicant has a pending complaint that involves sexual misconduct or imminent physical harm to the public then the application may be held in abeyance for up to 180 days while a determination on the complaint is made. All other applicants with complaints will have their application processed as normal, the complaint will not impact the licensure application. The pending complaint will still be investigated and processed according to the normal route as well.
Amending 22 TAC §884.10, to change the priority rating system for complaints from four levels to two levels.
CHAPTER 884. COMPLAINTS AND ENFORCEMENT
SUBCHAPTER B. INVESTIGATIONS AND DISPOSITION OF COMPLAINTS
22 TAC §884.10
OVERVIEW
The Texas Behavioral Health Executive Council adopts amendments to §884.10, relating to Investigation of Complaints. Section 884.10 is adopted without changes to the proposed text as published in the March 31, 2023, issue of the Texas Register (48 TexReg 1718) and will not be republished.
BACKGROUND AND JUSTIFICATION
The adopted amendments reduce the priority rating system for complaints from four levels to two. The high priority shall be for all complaints involving sexual misconduct or imminent physical harm and all other complaints shall be a normal priority.