Texas Register March 15, 2024 Volume: 49 Number: 11

Texas Register Table of Contents

1 Texas Board of Physical Therapy Examiners
- - 1.0.1 Proposed Rules Re:
    - 1.0.1.1 Amending 22 TAC §329.5, to increase the number of acceptable versions of the Casework Wool (CWT) for applicants by endorsement.
    - 1.0.1.2 Amending 22 TAC §346.1, to eliminate the requirement that rexamination for students with disabilities must happen onsite as to allow for the the reexamination to be performed via telehealth.
2 Texas Health and Human Services Commission
3 Teacher Retirement System of Texas
- - 3.0.1 Proposed Rules Re:
    - 3.0.1.1 New 34 TAC §41.15, to establish the rules which will apply to the new Optional Dental Benefits Plan.
    - 3.0.1.2 Amending 34 TAC §41.16, to to establish the rules which will apply to the new Optional Vision Benefits Plan.
4 Texas Board of Chiropractic Examiners
- - 4.0.1 Withdrawn Rules Re:
    - 4.0.1.1 Withdrawing the repeal of 22 TAC §73.1, to remove incorrect references from subsection (d) of the rule.
    - 4.0.1.2 Withdrawing proposed new 22 TAC §73.1, to correct references in subsection (d) of the rule with no substantive changes to the rule.
  - 4.0.2 Adopted Rules Re:
5 Texas Board of Nursing
- - 5.0.1 Adopted Rules Re:
6 Texas Department of State Health Services
7 Texas Department of Aging and Disability Services
- - 7.0.1 Adopted Rules Re:
    - 7.0.1.1 Repealing 40 TAC §§3.401 – 3.404, to remove the rule concerning training for new employees, direct support professionals, and refresher training from DADS so they may be replaced by new rules under HHSC.
  - 7.0.2 Proposed Rule Reviews Re:
    - 7.0.2.1 Reviewing Title 40, Part 1, to consider for readoption, revision, or repeal the chapter regarding State Authority Responsibilities.
8 Texas State Board of Pharmacy
- - 8.0.1 Proposed Rule Reviews Re:

Texas Board of Physical Therapy Examiners

Proposed Rules Re:

Amending 22 TAC §329.5, to increase the number of acceptable versions of the Casework Wool (CWT) for applicants by endorsement.

CHAPTER 329. LICENSING PROCEDURE
22 TAC §329.5

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending 22 TAC §329.5. Licensing Procedures for Foreign-Trained Applicants to remove unnecessary barriers to the licensing of foreign-educated applicants.

BACKGROUND AND JUSTIFICATION

The amendment for the requirement of an evaluation of professional education and training in paragraph (1)(A) differentiates between applicants by exam and applicants by endorsement. Applicants by exam will require the most current version of the Coursework Tool (CWT) in accordance with immigration requirements. Applicants by endorsement will have a range of acceptable versions of the CWT appropriate to the year they graduated from the foreign physical therapy program or a more current version. This will prevent an applicant who has already been evaluated by a version of the CWT for immigration purposes or for licensure in another jurisdiction from being evaluated by a different version of the CWT for Texas licensure. The amendment also authorizes acceptance of a copy of an evaluation that has been used as a licensure requirement by another jurisdiction for extenuating circumstances beyond the applicant’s control if the evaluation is sent directly to the board by the jurisdiction.

Amending 22 TAC §346.1, to eliminate the requirement that rexamination for students with disabilities must happen onsite as to allow for the the reexamination to be performed via telehealth.

CHAPTER 346. PRACTICE SETTINGS FOR PHYSICAL THERAPY
22 TAC §346.1

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending 22 TAC §346.1, Educational Settings to clarify the role of physical therapists and physical therapist assistants in the educational setting.

BACKGROUND AND JUSTIFICATION

The amendments update the references to federal law that pertain to physical therapy services provided to students with disabilities in the education setting, eliminates the requirement for a reexamination to be performed onsite to allow for the reexamination to be performed via telehealth, and updates the section to reflect contemporary practice within the setting.

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 26 TAC §554.101, to add a definition for “reportable conduct.”

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER B. DEFINITIONS
26 TAC §554.101

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §554.101, concerning Definitions; §554.405, concerning Additional Requirements for Trust Funds in Medicaid-certified Facilities; §554.601, concerning Freedom from Abuse, Neglect, and Exploitation; and §554.1920, concerning Operating Policies and Procedures.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement two bills from the 88th Legislature, Regular Session, 2023. House Bill (H.B.) 1009 relates to employment suspension for nursing facility employees accused of committing reportable conduct, such as abuse, neglect, or exploitation. Senate Bill (S.B.) 240 relates to health facility employee workplace violence prevention in facilities, including nursing facilities. This rule project proposes revisions related to trust fund monitoring and audits, with the purpose of decreasing the amount of time nursing facilities are allowed to complete corrective action plans to return to compliance prior to the imposition of a hold on payments due to the facility. This proposal also makes non-substantive edits to update references within the rules.

SECTION-BY-SECTION SUMMARY

Proposed amendments to §§554.101, 554.405, 554.601, and 554.1920 update references in the rules and make non-substantive edits to improve readability, in addition to the proposed amendments listed below.
The proposed amendment to §554.101 revises definitions to nursing facility rules. Paragraph (123) adds a definition for “reportable conduct” in response to H.B. 1009.

Amending 26 TAC §554.405, to reduce the amount of time nursing facilities are given to complete corrective action plans to return to compliance before the imposition of a hold on payments due to the facility.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER E. RESIDENT RIGHTS
26 TAC §554.405

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed amendments to §§554.101, 554.405, 554.601, and 554.1920 update references in the rules and make non-substantive edits to improve readability, in addition to the proposed amendments listed below.
The proposed amendment to §554.405 decreases the amount of time nursing facilities are allowed to complete corrective action plans to return to compliance prior to the imposition of a hold on payments due to the facility.

Amending 26 TAC §554.601, to update references and implement H.B. 1009 which relates to reportable conduct and employment suspension.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER G. FREEDOM FROM ABUSE, NEGLECT, AND EXPLOITATION
26 TAC §554.601

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed amendments to §§554.101, 554.405, 554.601, and 554.1920 update references in the rules and make non-substantive edits to improve readability, in addition to the proposed amendments listed below.
The proposed amendment to §554.601 implements H.B. 1009 related to reportable conduct and employment suspension.

Amending 26 TAC §554.1920, to implement S.B. 240 which concerns workplace violence and prevention policies and procedures.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER T. ADMINISTRATION
26 TAC §554.1920

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed amendments to §§554.101, 554.405, 554.601, and 554.1920 update references in the rules and make non-substantive edits to improve readability, in addition to the proposed amendments listed below.
The proposed amendment to §554.1920 implements S.B. 240 related to workplace violence and prevention policies and procedures.

Amending 26 TAC §555.2, §555.3, to update definitions and remove the cost of a duplicate license.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER A. GENERAL INFORMATION
26 TAC §555.2, §555.3

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§555.2, 555.3, 555.11 – 555.16, 555.18, 555.31 – 555.36, 555.38 – 555.42, and 555.51, 555.53 – 555.57.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement two bills from the 88th Texas Legislature, Regular Session, 2023. House Bill (H.B.) 4123 relates to HHSC obtaining criminal history information from the Federal Bureau of Investigation (FBI) and Texas Department of Public Safety for nursing facility administrator (NFA) applicants. Senate Bill (S.B.) 681 relates to Texas Occupation Code, Chapter 53, exemption for HHSC Long-Term Care Regulation (LTCR)-regulated Nursing Facility Administrators. This rule project also included revisions related to the Texas Unified Licensure Information Portal (TULIP), with the purpose of changing from a paper process to a digital process. This proposal also makes non-substantive edits to references in the rules.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.2 revises definitions to NFA rules. Paragraph (22) defines the “National Association of Long Term Care Administrator Boards (NAB)” and paragraph (29) defines “online portal.” HHSC also made non-substantive changes to improve readability and updated a reference.
The proposed amendment to §555.3 removes the cost of a duplicate license.

Amending 26 TAC §§555.11 – 555.16, 555.18, to implement H.B. 4123 regarding FBI criminal history and to update the rule to reflect the current automated process using TULIP.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER B. REQUIREMENTS FOR LICENSURE
26 TAC §§555.11 – 555.16, 555.18

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.11 implements H.B. 4123 related to FBI criminal history and adds language clarifying the use of the online portal TULIP.
The proposed amendment to §555.12 makes non-substantive grammar edits.
The proposed amendment to §555.13 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.14 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.15 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.16 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.18 makes a non-substantive rule clarifying edit.

Amending 26 TAC §§555.31 – 555.36, 555.38 – 555.42, to implement H.B. 4123 concerning FBI criminal history and update rule to reflect the current automated process using TULIP.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER C. LICENSES
26 TAC §§555.31 – 555.36, 555.38 – 555.42

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.31 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.32 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.33 adds language clarifying that NFAs can print duplicate licenses through the online portal.
The proposed amendment to §555.34 implements H.B. 4123 related to FBI criminal history and updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.35 makes non-substantive grammar edits.
The proposed amendment to §555.36 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.38 updates the rule to reflect the current automated process using TULIP and corrects a reference in the rule.
The proposed amendment to §555.39 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.40 updates the rule to reflect the current automated process using TULIP.
The proposed amendment to §555.41 updates references in the rule and implements H.B. 4123 relating to criminal convictions.
The proposed amendment to §555.42 implements H.B. 4123 relating to FBI criminal history, updates rule to reflect the current automated process using TULIP, makes non-substantive grammar and reference updates, and clarifies that a military spouse with an active license can print duplicate licenses and make name changes through the online portal.

Amending 26 TAC §§555.51, 555.53 – 555.57, to implement H.B. 4123 regarding criminal convictions and make substantive grammar edits.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER D. REFERRALS, COMPLAINT PROCEDURES, AND SANCTIONS
26 TAC §§555.51, 555.53 – 555.57

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.51 makes non-substantive grammar edits.
The proposed amendment to §555.53 updates a reference in the rule.
The proposed amendment to §555.54 implements H.B. 4123 relating to criminal convictions and updates a reference.
The proposed amendment to §555.55 makes non-substantive grammar edits.
The proposed amendment to §555.56 removes language requiring a person with an expired license to return the license certificate to HHSC.
The proposed amendment to §555.57 makes a non-substantive grammar edit.

Amending 26 TAC §§557.101, 557.103, 557.105, 557.107, 557.109, 557.111, 557.113, 557.115, 557.117, 557.119, 557.121, 557.123, 557.125, 557.127 – 557.129, to update references, make non-substantive grammar edits, and implement H.B. 4123.

CHAPTER 557. MEDICATION AIDES–PROGRAM REQUIREMENTS
26 TAC §§557.101, 557.103, 557.105, 557.107, 557.109, 557.111, 557.113, 557.115, 557.117, 557.119, 557.121, 557.123, 557.125, 557.127 – 557.129

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §557.101, concerning Introduction; §557.103, concerning Requirements for Administering Medications; §557.105, concerning Allowable and Prohibited Practices of a Medication Aide; §557.107, concerning Training Requirements; Nursing Graduates; Reciprocity; §557.109, concerning Application Procedures; §557.111, concerning Examination; §557.113, concerning Determination of Eligibility; §557.115, concerning Permit Renewal; §557.117, concerning Changes; §557.119, concerning Training Program Requirements; §557.121, concerning Permitting of Persons with Criminal Backgrounds; §557.123, concerning Violations, Complaints, and Disciplinary Actions; §557.125, concerning Requirements for Corrections Medication Aides; §557.127, concerning Application Processing; §557.128, concerning Home Health Medication Aides; and §557.129, concerning Alternate Licensing Requirements for Military Service.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement two bills from the 88th Texas Legislature, Regular Session, 2023. House Bill (H.B.) 4123 relates to HHSC obtaining criminal history information from the Federal Bureau of Investigation (FBI) and Texas Department of Public Safety for medication aide (MA) applicants. Senate Bill (S.B.) 681 relates to the Texas Occupations Code, Chapter 53, exemption for HHSC Long-Term Care Regulation (LTCR)-regulated Medication Aides. This rule project also proposes revisions related to the Texas Unified Licensure Information Portal (TULIP), with the purpose of changing from a paper process to a digital process. This proposal also makes non-substantive edits to update references in the rules.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §557.101 revises definitions for MA rules. Paragraph (1) revises the definition of “abuse” to be consistent with the definition in other rule chapters. Paragraph (26) adds a definition for “‘online portal.” HHSC also updated a reference in the rule.
The proposed amendment to §557.103 updates references, incorporates requirements for home health medication aides that were previously in other sections, and makes non-substantive edits to improve readability.
The proposed amendment to §557.105 makes non-substantive grammar and sentence structure edits, updates references in the rule, and incorporates requirements for home health medication aides that were previously in other sections.
The proposed amendment to §557.107 updates references in the rule, makes grammar and sentence structure edits, incorporates requirements for home health medication aides that were previously in other sections, and updates the rule to reflect the current automated process using TULIP. Additionally, HHSC removed the word “accredited” to include persons who were home-schooled.
The proposed amendment to §557.109 adds language clarifying the use of the online portal TULIP and updates references in the rule. HHSC also removed the word “accredited” to include persons who were home-schooled.
The proposed amendment to §557.111 updates the rule to reflect the current automated process using TULIP and makes grammar and sentence structure edits to the rule.
The proposed amendment to §557.113 makes grammar and sentence structure edits, updates the rule to reflect the current automated process using TULIP, and updates references in the rule.
The proposed amendment to §557.115 makes grammar and sentence structure edits, updates references in the rule, updates the rule to reflect the current automated process using TULIP, and incorporates permit renewal requirements for medication aides that were previously in other sections.
The proposed amendment to §557.117 updates the rule to reflect the current automated process using TULIP and clarifies that a medication aide can request a name change and print a duplicate license through the online portal.
The proposed amendment to §557.119 implements H.B. 4123 relating to FBI criminal history and S.B. 681 relating to criminal convictions, updates the rule to reflect the current automated process using TULIP, makes grammar and sentence structure edits, and makes non-substantive reference updates.
The proposed amendment to §557.121 implements H.B. 4123 relating to FBI criminal history and updates references in the rule.
The proposed amendment to §557.123 makes grammar and sentence structure edits and updates references in the rule.
The proposed amendment to §557.125 updates the rule to reflect the current automated process using TULIP, makes grammar and sentence structure edits, and updates references in the rule.
The proposed amendment to §557.127 updates the rule to reflect the current automated process using TULIP and updates references in the rule.
The proposed amendment to §557.128 repeals redundant requirements and makes other revisions necessary to clarify that home health medication aides must meet medication aide requirements.
The proposed amendment to §557.129 updates references in the rule, makes grammar and sentence structure edits, updates the rule to reflect the current automated process using TULIP, and adds language clarifying that a military spouse with an active medication aide permit can print duplicate licenses and make name changes though the online portal.

Withdrawn Rules Re:

Withdrawing proposed new and amended §§745.901 and 745.903 – 745.905.

CHAPTER 745. LICENSING
SUBCHAPTER G. CONTROLLING PERSONS
26 TAC §§745.901, 745.903 – 745.905

OVERVIEW

The Health and Human Services Commission withdraws proposed new and amended §§745.901 and 745.903 – 745.905, which appeared in the December 8, 2023, issue of the Texas Register (48 TexReg 7125).

Adopted Rules Re:

New 26 TAC §§926.1 – 926.6, to outline the training and refresher training required for state hospital employees, SSLC employees, facility employees, and new facility employees.

CHAPTER 926. TRAINING FOR FACILITY STAFF
26 TAC §§926.1 – 926.6

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new §926.1, concerning Application; §926.2, concerning Definitions; §926.3, concerning Training for New Employees; §926.4, concerning Additional Training for Employees who Provide Direct Care to Individuals; §926.5, concerning State Hospital Refresher Training; and §926.6, concerning State Supported Living Center (SSLC) Refresher Training.

Sections 926.1 – 926.6 are adopted without changes to the proposed text as published in the December 8, 2023, issue of the Texas Register (48 TexReg 7127). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections reflect the move of the state hospitals from the Department of State Health Services and the SSLCs from the Department of Aging and Disability Services to HHSC. In this rulemaking, HHSC moved certain state hospital rules from Title 25 of the Texas Administrative Code (TAC), Chapter 417, Subchapter A and SSLC rules from 40 TAC Chapter 3, Subchapter D, Training, to 26 TAC and consolidated state hospital and SSLC rules under 26 TAC Chapter 926. The rules update agency information, provide uniform training topics and timeframes, and remove text regarding expedited training due to the COVID-19 disaster declaration. The repeal of certain rules from 25 TAC Chapter 417, Subchapter A and 40 TAC Chapter 3, Subchapter D is adopted simultaneously elsewhere in this issue of the Texas Register.

Proposed Rule Reviews Re:

Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal the chapter concerning Area Agencies on Aging.

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 213, Area Agencies on Aging

In Addition Re:

Criminal History Requirements for Child Care Operations

OVERVIEW

(Editor’s note: In accordance with Texas Government Code, §2002.014, which permits the omission of material which is “cumbersome, expensive, or otherwise inexpedient,” the charts are not included in the print version of the Texas Register. The charts are available in the on-line version of the March 15, 2024, issue of the Texas Register.)

26 Texas Administrative Code §745.661 (relating to What types of criminal convictions may affect a subject’s ability to be present at an operation?) states that HHSC will review the three charts listed in subsection (a) of the section annually and publish any changes for public comment in the Texas Register as an “In Addition” document. Questions or comments about the content of the proposed changes may be directed to Child Care Regulation at (512) 438-3269.

Teacher Retirement System of Texas

Proposed Rules Re:

New 34 TAC §41.15, to establish the rules which will apply to the new Optional Dental Benefits Plan.

CHAPTER 41. HEALTH CARE AND INSURANCE PROGRAMS
SUBCHAPTER A. RETIREE HEALTH CARE BENEFITS (TRS-CARE)
34 TAC §41.15

OVERVIEW

The Board of Trustees of the Teacher Retirement System of Texas (TRS) proposes new §41.15 (relating to Optional Dental Benefits Plan) under Subchapter A (relating to Retiree Health Care Benefits (TRS-CARE)) of Chapter 41 in Part 3 of Title 34 of the Texas Administrative Code.

BACKGROUND AND JUSTIFICATION

The purpose of this proposed new rule is to implement Senate Bill (S.B.) 1854, 88th Legislature, Regular Session, 2023.

S.B. 1854 amended Chapter 1575 of the Insurance Code (TRS-Care) by adding a new Section 1575.1601, concerning Group Benefits for Dental and Vision Care, requiring the Board of Trustees (“the trustee”) to establish or contract for and make available under the group program an optional plan that provides coverage for dental care.

Proposed new §41.15 implements Insurance Code §1575.1601 by establishing the rules that will apply to the optional dental benefits plan, including eligibility terms, definition of the plan year, enrollment and disenrollment terms, payment of contributions towards coverage, effective dates of coverage, expulsion for fraud, and competitive bidding.

Amending 34 TAC §41.16, to to establish the rules which will apply to the new Optional Vision Benefits Plan.

CHAPTER 41. HEALTH CARE AND INSURANCE PROGRAMS
SUBCHAPTER A. RETIREE HEALTH CARE BENEFITS (TRS-CARE)
34 TAC §41.16

OVERVIEW

The Board of Trustees of the Teacher Retirement System of Texas (TRS) proposes new §41.16 (relating to Optional Vision Benefits Plan) under Subchapter A (relating to Retiree Health Care Benefits (TRS-CARE)) of Chapter 41 in Part 3 of Title 34 of the Texas Administrative Code.

BACKGROUND AND JUSTIFICATION

The purpose of this proposed new rule is to implement Senate Bill (S.B.) 1854, 88th Legislature, Regular Session, 2023.

Proposed new §41.16 implements Insurance Code §1575.1601 by establishing the rules that will apply to the optional vision benefits plan, including eligibility terms, definition of the plan year, enrollment and disenrollment terms, payment of contributions towards coverage, effective dates of coverage, expulsion for fraud, and competitive bidding.

Texas Board of Chiropractic Examiners

Withdrawn Rules Re:

Withdrawing the repeal of 22 TAC §73.1, to remove incorrect references from subsection (d) of the rule.

CHAPTER 73. CONTINUING EDUCATION
22 TAC §73.1

OVERVIEW

The proposed repeal of §73.1, published in the September 1, 2023, issue of the Texas Register (48 TexReg 4748), 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 new 22 TAC §73.1, to correct references in subsection (d) of the rule with no substantive changes to the rule.

CHAPTER 73. CONTINUING EDUCATION
22 TAC §73.1

OVERVIEW

Proposed new §73.1, published in the September 1, 2023, issue of the Texas Register (48 TexReg 4749), 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).)

Adopted Rules Re:

Repealing 22 TAC §72.21, to make room for a new rule affecting licensing of military spouses.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.21

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts the repeal of 22 TAC §72.21 (Requirements for Military Spouses), without changes as published in the December 1, 2023, issue of the Texas Register (48 TexReg 6991). The repeal will not be republished. The Board will adopt a new §72.21 in a separate rulemaking action.

New 22 TAC §72.21, to expand the methods which a spouse of an active duty service member can obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.21

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §72.21 (Requirements for Military Spouses), with changes to the text as published in the December 1, 2023, issue of the Texas Register (48 TexReg 6992). Changes include corrections to title, paragraph, and subparagraph reference locations. The rule will be republished. The current §72.21 is being repealed in a separate rulemaking action.

Repealing 22 TAC §72.22, to make room for a new rule affecting licensing of active duty service members.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.22

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts the repeal of 22 TAC §72.22 (Requirements for Military Members and Veterans), without changes as published in the December 1, 2023, issue of the Texas Register (48 TexReg 6994). The repeal will not be republished. The Board will adopt a new §72.22 in a separate rulemaking action.

New 22 TAC §72.22, to expand the methods which an active duty service member can obtain a license to practice chiropractic in Texas or have a license from another jurisdiction recognized.

CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.22

OVERVIEW

The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §72.22 (Requirements for Military Members and Veterans), with changes to the text as published in the December 1, 2023, issue of the Texas Register (48 TexReg 6994). Changes include corrections to the location reference for an outside section. The rule will be republished. The current §72.22 is being repealed in a separate rulemaking action.

Texas Board of Nursing

Adopted Rules Re:

New 22 TAC §213.36, §213.37, to set forth the procedures the Board must follow when investigating a standard of care violation by an APRN.

CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.36, §213.37

OVERVIEW

The Texas Board of Nursing (Board) adopts new 22 Texas Administrative Code §213.36 and §213.37. The Board simultaneously proposed both new sections in the December 22, 2023, issue of the Texas Register (48 TexReg 7740). The adopted rule text of 22 Texas Administrative Code §213.36 contains a change that will result in the republication of this section. There are no changes to the proposed text of 22 Texas Administrative Code §213.37, which will not be republished.

BACKGROUND AND JUSTIFICATION

During the 88th Legislative Session, the Texas Legislature enacted SB 1343 which requires that complaints alleging a standard-of-care violation by an Advanced Practice Registered Nurse (APRN) be reviewed by an expert reviewer, appointed by the Board, who is an APRN practicing in the same advanced practice role and with the same population focus as the APRN who is the subject of the complaint. The bill further requires that the appointed expert reviewer determine whether the APRN violated the standard-of-care applicable to the circumstances of the allegation, record the expert reviewer’s conclusions in a report, and submit the report to the Board. Before initiating informal proceedings involving the APRN, the Board must provide notice of the proceedings along with a deidentified copy of the expert reviewer’s report. These new sections are adopted under the authority of the Occupations Code § 301.151 and are necessary for compliance with the statutory mandates found in Texas Occupations Code §§ 301.457, 301.4575, and 301.464.

New 22 TAC §214.14, to explain the permissible and impermissible ways a vocational nursing education program may use a student’s score on a standardized examination.

CHAPTER 214. VOCATIONAL NURSING EDUCATION
22 TAC §214.14

OVERVIEW

The Texas Board of Nursing (Board) adopts new 22 Texas Administrative Code §214.14, relating to Standardized Examination Prepared by Private Entity, without changes to the proposed text published in the December 22, 2023, issue of the Texas Register (48 TexReg 7742) and will not be republished.

BACKGROUND AND JUSTIFICATION

During the 88th Legislative Session, the Texas Legislature enacted S.B. 1429, which required the Board to adopt rules related to the use of a standardized examination prepared by a private entity. The rules must be applicable to all schools of nursing regulated by the Board. S.B. 1429 requires that the rules prohibit the use of a standardized examination as a graduation requirement or to deny students an affidavit of graduation. The required rules authorize the use of standardized examination only to familiarize students with computerized testing and for the enumerated and limited purposes in Texas Occupations Code § 301.1571(a)(2)&(3). S.B. 1429 further requires that a standardized examination, prepared by a private entity, may not account for more than ten (10) percent of a course grade. Additionally, S.B. 1429 requires that the adopted rules prohibit the regulated school from requiring a student to attend a course offered by the private entity which provides the standardized examination. The rules adopted by the Board are necessary to implement this legislation.

New 22 TAC §215.14, to explain the permissible and impermissible ways a professional nursing education program may use a student’s score on a standardized examination.

CHAPTER 215. PROFESSIONAL NURSING EDUCATION
22 TAC §215.14

OVERVIEW

The Texas Board of Nursing (Board) adopts new 22 Texas Administrative Code §215.14, relating to Standardized Examination Prepared by Private Entity, without changes to the proposed text published in the December 22, 2023, issue of the Texas Register (48 TexReg 7743) and will not be republished.

BACKGROUND AND JUSTIFICATION

Amending 22 TAC §217.5, to allow for the recognition of out-of-state occupational licenses for spouses of military service members.

CHAPTER 217. LICENSURE, PEER ASSISTANCE, AND PRACTICE
22 TAC §217.5

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to 22 Texas Administrative Code §217.5, relating to Temporary License and Endorsement, with changes to the proposed text published in the December 15, 2023, issue of the Texas Register (48 TexReg 7286). The rule will be republished.

BACKGROUND AND JUSTIFICATION

In 2019, the Texas Legislature enacted S.B. 1200 which created Texas Occupations Code § 55.0041, to recognize out-of-state occupational licenses for a spouse of a military service member. This allows the portability of a license for the spouse of a service member, so the spouse does not have to redo any curriculum and testing from one state to another when the service member changes duty station. In 2021, during the 87th Regular Legislative Session, the Legislature enacted H.B. 139 that further amended Texas Occupations Code § 55.0041, requiring a state agency that issues a license with a residency requirement for license eligibility to adopt rules regarding the documentation necessary for a military spouse applicant to establish residency; allowing the provision to the agency a copy of the permanent change of station order for the military service member to whom the spouse is married.

Texas Department of State Health Services

Adopted Rules Re:

Repealing 25 TAC §§417.47, 417.49, 417.50, to delete the rules from 25 TAC to reflect the move of the state hospitals from DSHS to HHSC.

CHAPTER 417. AGENCY AND FACILITY RESPONSIBILITIES
SUBCHAPTER A. STANDARD OPERATING PROCEDURES
25 TAC §§417.47, 417.49, 417.50

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of §417.47, concerning Training Requirements for State Mental Health Facilities; §417.49, concerning References; and §417.50, concerning Distribution.

The repeal of §§417.47, 417.49, and 417.50 is adopted without changes to the proposed text as published in the December 8, 2023, issue of the Texas Register (48 TexReg 7122). These repeals will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the repeals is to reflect the move of the Department of State Health Services state hospital rules in Texas Administrative Code (TAC) Title 25, Chapter 417, Subchapter A to HHSC in 26 TAC Chapter 926. The new rules are adopted simultaneously elsewhere in this issue of the Texas Register.

Proposed Rule Reviews Re:

Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Product Safety.

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 205, Product Safety

Adopted Rule Reviews Re:

Adopting the review of Title 25, Part 1, concerning End Stage Renal Disease Facilities.

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the review of the chapter below in Title 25, Part 1, of the Texas Administrative Code:

Chapter 117, End Stage Renal Disease Facilities

Adopting the review of Title 25, Part 1, regarding Occupational Health.

Chapter 295, Occupational Health

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 1773.

Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 49 Tex Reg 1779.

Texas Department of Aging and Disability Services

Adopted Rules Re:

Repealing 40 TAC §§3.401 – 3.404, to remove the rule concerning training for new employees, direct support professionals, and refresher training from DADS so they may be replaced by new rules under HHSC.

CHAPTER 3. RESPONSIBILITIES OF STATE FACILITIES
SUBCHAPTER D. TRAINING
40 TAC §§3.401 – 3.404

OVERVIEW

The Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, and all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with now repealed Texas Government Code §531.0201 and §531.02011. Pursuant to §531.0011, references to DADS regarding functions transferred under now repealed §531.0201 and §531.02011 are now references to HHSC. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC adopts the repeal of §3.401, concerning Training for New Employees; §3.402, concerning Additional Training for Direct Support Professionals; §3.403, concerning Refresher Training; and §3.404, concerning Specialized Training for of a Forensic Facility Employee.

The repeal of §§3.401 – 3.404 is adopted without changes to the proposed text as published in the December 8, 2023, issue of the Texas Register (48 TexReg 7164). These repeals will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals reflect the move of the Department of Aging and Disability Services state supported living center rules in Texas Administrative Code (TAC) Title 40, Chapter 3, Subchapter D to HHSC under 26 TAC Chapter 926. The new rules are adopted simultaneously elsewhere in this issue of the Texas Register.

Proposed Rule Reviews Re:

Reviewing Title 40, Part 1, to consider for readoption, revision, or repeal the chapter regarding State Authority Responsibilities.

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of Aging and Disability Services, proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 40, Part 1, of the Texas Administrative Code:

Chapter 1, State Authority Responsibilities

Texas State Board of Pharmacy

Proposed Rule Reviews Re:

Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter concerning Administrative Practice and Procedures.

The Texas State Board of Pharmacy files this notice of intent to review Chapter 281, (§§281.1 – 281.23, 281.30 – 281.35, 281.60 – 281.70), concerning Administrative Practice and Procedures, pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.

Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter regarding Pharmacies.

The Texas State Board of Pharmacy files this notice of intent to review Chapter 291, Subchapter A (§§291.1 – 291.11, 291.14 – 291.19, 291.22, 291.23, 291.27 – 291.29), concerning Pharmacies (All Classes of Pharmacies), pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.

Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter concerning Pharmacies (Clinic Pharmacy (Class D)).

The Texas State Board of Pharmacy files this notice of intent to review Chapter 291, Subchapter E (§§291.91 – 291.94), concerning Pharmacies (Clinic Pharmacy (Class D)), pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.

Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter regarding Pharmacies (Non-Resident Pharmacy (Class E)).

The Texas State Board of Pharmacy files this notice of intent to review Chapter 291, Subchapter F (§§291.101 – 291.106), concerning Pharmacies (Non-Resident Pharmacy (Class E)), pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.

Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter concerning Pharmacists.

The Texas State Board of Pharmacy files this notice of intent to review Chapter 295, (§§295.1 – 295.9, 295.11 – 295.16), concerning Pharmacists, pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.

Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter regarding Code of Conduct.

The Texas State Board of Pharmacy files this notice of intent to review Chapter 311, (§311.1, §311.2), concerning Code of Conduct, pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.