Texas Register March 20, 2020 Volume: 45 Number: 12

Texas Register Table of Contents

1 Texas Health and Human Services Commission
- - 1.0.1 Proposed Rules
    - 1.0.1.1 Amending 1 TAC §355.112 to create separate rate enhancement categories for HCS and TxHmL programs
2 Texas Medical Board
- - 2.0.1 Proposed Rules
    - 2.0.1.1 Amending 22 TAC §175.1 to add application, registration and renewal fees for Radiology Assistance Certificate
3 Texas Board of Nursing
- - 3.0.1 Proposed Rules
    - 3.0.1.1 Amending 22 TAC §217.2 to clarify certain requirements for initial licensure by examination
4 Texas Board of Nursing
- - 4.0.1 Proposed Rules
    - 4.0.1.1 Amending 22 TAC §217.3 to update requirements for temporary authorization to practice as a graduate nurse or graduate vocational nurse
5 Texas Board of Nursing
- - 5.0.1 Proposed Rules
    - 5.0.1.1 Amending 22 TAC §217.5 to update requirements for licensees of another state or Canadian province who seek temporary licensure and endorsement
6 Texas Board of Nursing
- - 6.0.1 Proposed Rules
    - 6.0.1.1 Amending 22 TAC §217.6 to eliminate redundant provisions regarding a nurse’s failure to renew a license
7 Texas Board of Nursing
- - 7.0.1 Proposed Rules
    - 7.0.1.1 Repealing 22 TAC §217.8 regarding duplicate or substitute credentials for licensure
8 Texas Board of Nursing
- - 8.0.1 Proposed Rules
    - 8.0.1.1 Amending 22 TAC §217.9 to eliminate redundant requirements for the reactivation of an inactive license
9 Texas Board of Nursing
- - 9.0.1 Proposed Rules
    - 9.0.1.1 Amending 22 TAC §222.3 to update requirements for the renewal of prescriptive authority by advanced practice registered nurses
10 Texas Department of State Health Services
- - 10.0.1 Proposed Rules
    - 10.0.1.1 Amending various sections in 25 TAC, Subchapter B to clarify criminal background check and sexual abuse training requirements for certain individuals employed by Texas youth camps
11 Texas Department of State Health Services
- - 11.0.1 Adopted Rules
    - 11.0.1.1 New 25 TAC §§40.1-40.8 setting minimum standards for epinephrine auto-injector policies at institutions of higher education
12 Texas Medical Disclosure Panel
- - 12.0.1 Adopted Rules
    - 12.0.1.1 Amending 25 TAC §601.9 to update informed consent requirements for anesthesia and preoperative pain management patients
13 Texas Department on Aging and Disability Services
- - 13.0.1 Adopted Rules
    - 13.0.1.1 Amending 40 TAC §19.1, which dictates the basis and scope of the subchapter on licensure and Medicaid certification for nursing facilities
14 Texas Department on Aging and Disability Services
- - 14.0.1 Adopted Rules
    - 14.0.1.1 Amending 40 TAC §19.101, which provides definitions for the subchapter on licensure and Medicaid certification for nursing facilities
15 Texas Department on Aging and Disability Services
- - 15.0.1 Adopted Rules
    - 15.0.1.1 Amending various sections of 40 TAC, Subchapter E, which outlines residents’ rights in Medicaid-certified nursing facilities
16 Texas Department on Aging and Disability Services
- - 16.0.1 Adopted Rules
    - 16.0.1.1 Amending various sections of 40 TAC, Subchapter G, which mandates freedom from abuse, neglect and exploitation in in Medicaid-certified nursing facilities
17 Texas Department on Aging and Disability Services
- - 17.0.1 Adopted Rules
    - 17.0.1.1 Amending 40 TAC §§19.801 – 19.803 to update resident assessment requirements in Medicaid-certified nursing facilities
18 Texas Department on Aging and Disability Services
- - 18.0.1 Adopted Rules
    - 18.0.1.1 Amending various sections of 40 TAC, Subchapter L, regarding food and nutrition services in Medicaid-certified nursing facilities
19 Texas Department on Aging and Disability Services
- - 19.0.1 Adopted Rules
    - 19.0.1.1 Amending 40 TAC §19.1401 to update dental service requirements in Medicaid-certified nursing facilities
20 Texas Department on Aging and Disability Services
- - 20.0.1 Adopted Rules
    - 20.0.1.1 Amending 40 TAC §§19.501 – 19.504 to update admission, transfer and discharge rights in Medicaid-certified nursing facilities
21 Texas Department on Aging and Disability Services
- - 21.0.1 Adopted Rules
    - 21.0.1.1 Repealing 40 TAC §19.701 and §19.705, regarding quality of life measures in Medicaid-certified nursing facilities
22 Texas Department on Aging and Disability Services
- - 22.0.1 Adopted Rules
    - 22.0.1.1 New 40 TAC §19.701, regarding quality of life measures in Medicaid-certified nursing facilities
23 Texas Department on Aging and Disability Services
- - 23.0.1 Adopted Rules
    - 23.0.1.1 Amending 40 TAC §§19.702 – 19.703 and 19.706, regarding quality of life measures in Medicaid-certified nursing facilities
24 Texas Department on Aging and Disability Services
- - 24.0.1 Adopted Rules
    - 24.0.1.1 Amending 40 TAC §19.901 and adopting new §19.904, regarding quality of care measures in Medicaid-certified nursing facilities
25 Texas Department on Aging and Disability Services
- - 25.0.1 Adopted Rules
    - 25.0.1.1 Amending 40 TAC §19.1001, §19.1010 to update nursing service requirements in Medicaid-certified nursing facilities
26 Texas Department on Aging and Disability Services
- - 26.0.1 Adopted Rules
    - 26.0.1.1 Repealing 40 TAC §19.1102 and §19.1103, regarding food and nutrition services in Medicaid-certified nursing facilities
27 Texas Department on Aging and Disability Services
- - 27.0.1 Adopted Rules
    - 27.0.1.1 New 40 TAC §19.1102 and §19.1116, regarding food and nutrition services in Medicaid-certified nursing facilities
28 Texas Department on Aging and Disability Services
- - 28.0.1 Adopted Rules
    - 28.0.1.1 Amending 40 TAC §§19.1201 – 19.1203, 19.1205 to update physician service requirements in Medicaid-certified nursing facilities
29 Texas Department on Aging and Disability Services
- - 29.0.1 Adopted Rules
    - 29.0.1.1 Amending 40 TAC §19.1501 to update pharmacy service requirements in Medicaid-certified nursing facilities
30 Texas Department on Aging and Disability Services
- - 30.0.1 Adopted Rules
    - 30.0.1.1 Amending 40 TAC §19.1601, regarding infection control measures in Medicaid-certified nursing facilities
31 Texas Department on Aging and Disability Services
- - 31.0.1 Adopted Rules
    - 31.0.1.1 Amending various sections in 40 TAC, Subchapter T, regarding administrative requirements in Medicaid-certified nursing facilities
32 Texas Department on Aging and Disability Services
- - 32.0.1 Adopted Rules
    - 32.0.1.1 New 40 TAC §19.1931, regarding administrative requirements in Medicaid-certified nursing facilities
33 Texas Department on Aging and Disability Services
- - 33.0.1 Adopted Rules
    - 33.0.1.1 Repealing 40 TAC §19.1903 and §19.1904, regarding administrative requirements in Medicaid-certified nursing facilities
34 Texas Department on Aging and Disability Services
- - 34.0.1 Adopted Rules
    - 34.0.1.1 Amending 40 TAC §19.2704, concerning nursing facility responsibilities with regard to Preadmission Screening and Resident Review (PASRR)
  - 34.0.2 In Addition
    - 34.0.2.1 Council intends to review 22 TAC, Chapter 651 (Fees) and either readopt, readopt with amendments, or repeal
35 Texas Board of Occupational Therapy Examiners
- - 35.0.1 In Addition
    - 35.0.1.1 Board intends to review various chapters of 40 TAC, Part 12 and either readopt, readopt with amendments, or repeal
36 Texas Health and Human Services Commission
- - 36.0.1 In Addition
    - 36.0.1.1 Notice of public hearing on proposed Medicaid payment rates for COVID-19 test panels
37
- - 37.0.1
    - 37.0.1.1
38
- - 38.0.1
    - 38.0.1.1
39
- - 39.0.1
    - 39.0.1.1
40
- - 40.0.1
    - 40.0.1.1
41
- - 41.0.1
    - 41.0.1.1
42
- - 42.0.1
    - 42.0.1.1
43
- - 43.0.1
    - 43.0.1.1
44
- - 44.0.1
    - 44.0.1.1
45
- - 45.0.1
    - 45.0.1.1
46
- - 46.0.1
    - 46.0.1.1
47
- - 47.0.1
    - 47.0.1.1
48
- - 48.0.1
    - 48.0.1.1
49
- - 49.0.1
    - 49.0.1.1
50
- - 50.0.1
    - 50.0.1.1
51
- - 51.0.1
    - 51.0.1.1
52
- - 52.0.1
    - 52.0.1.1
53
- - 53.0.1
    - 53.0.1.1
54
- - 54.0.1
    - 54.0.1.1
55
- - 55.0.1
    - 55.0.1.1
56
- - 56.0.1
    - 56.0.1.1
57
- - 57.0.1
    - 57.0.1.1
58
- - 58.0.1
    - 58.0.1.1

Texas Health and Human Services Commission

Proposed Rules

Amending 1 TAC §355.112 to create separate rate enhancement categories for HCS and TxHmL programs

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER A. COST DETERMINATION PROCESS1 TAC §355.112OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.112, concerning Attendant Compensation Rate Enhancement.The proposed amendment to §355.112 would create separate rate enhancement categories for day habilitation (DH) services and non-DH services for the Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) programs and for services in a residential setting for the HCS program. The proposed change allows flexibility in the rate enhancement program for HCS and TxHmL providers of services that do not utilize an hourly unit of service.BACKGROUND AND PURPOSEThe purpose of the proposed amendment to §355.112 is to implement Rider 44 of the 2020-21 General Appropriations Act, Article II, House Bill 1, 86th Legislature, Regular Session, 2019 (Rider 44). Rider 44(a)(4) appropriates funds for the creation of separate categories in the Attendant Compensation Rate Enhancement (rate enhancement) programs which serve individuals with intellectual and developmental disabilities in order to increase participation in those rate enhancement programs. The rider directs that the groupings be based on the number of attendant hours included in the billing unit. SECTION-BY-SECTION SUMMARYThe proposed amendment to §355.112 makes clarifying edits to improve readability in subsections (a), (b)(1) – (3), (e), (f)(1)(A), (j), (l)(1)(A), (l)(2), and (t)(1) – (2).The proposed amendment to §355.112(b) clarifies the definition of “attendant” under this section.The proposed amendment to §355.112(f)(2) separates rate enhancement for HCS and TxHmL programs into three categories (residential services, DH services, and non-DH services) and specifies that the participating provider must choose the categories to which rate enhancement will apply.The proposed amendment to §355.112(f)(7) specifies that Intermediate Care Facilities for Individuals with Intellectual Disability or Related Conditions (ICF/IID), HCS, and TxHmL providers must request to modify their enrollment status during the 2021 enrollment period.The proposed amendment to §355.112(h) removes language that is no longer applicable in paragraph (2)(A) and renumbers the remaining subparagraphs.The proposed amendment to §355.112(l)(2) creates new subparagraph (F) which provides that, as of January 1, 2020, the HCS supervised living and residential support services (SL/RSS) rate component will be calculated using cost data from the most recently audited cost report multiplied by a factor of 1.07.The proposed amendment to §355.112(s)(4) provides that recoupment will be calculated for SL/RSS services pursuant to §355.727(f).

Texas Medical Board

Proposed Rules

Amending 22 TAC §175.1 to add application, registration and renewal fees for Radiology Assistance Certificate

CHAPTER 175. FEES AND PENALTIES22 TAC §175.1, §175.2OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §175.1, concerning Application and Administrative Fees, and §175.2, concerning Registration and Renewal Fees.Sections 175.1 and 175.2 are amended to add application, registration and renewal fees for Radiology Assistance, a new certificate type mandated by and in accordance with House Bill 1504 (86th Regular Session).SECTION-BY-SECTION SUMMARYProposed amendments under §175.1 regarding fees for processing an application for a certificate, add an application and certificate fee for a Radiologist Assistant Certificate in the amount of $140.00, and also add a fee for an application for a temporary certificate in the amount of $140.00.Proposed amendments under §175.2 provide the fee amount for biennial renewal of a Radiologist Assistant Certificate, in the amount of $100.00.

Texas Board of Nursing

Proposed Rules

Amending 22 TAC §217.2 to clarify certain requirements for initial licensure by examination

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.2OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §217.2, relating to Licensure by Examination for Graduates of Nursing Education Programs Within the United States, its Territories, or Possessions.Proposed amended §217.2(a)(5) clarifies that applicants for initial licensure by examination must submit fingerprints for a complete criminal background check. The proposal eliminates §217.2(f), regarding military programs, from the section in its entirety.BACKGROUND AND JUSTIFICATIONThe proposed amendments require applicants to submit fingerprints for a complete criminal background check prior to licensure, in compliance with the Occupations Code §301.2511, and eliminate subsection (f) of the section because military programs, like the U.S. Army Practical Nurse Course, are reviewed and approved by the Board in the same manner as all other nursing programs, and military courses other than the U.S. Army Practical Nurse Course are approved by the Board.

Texas Board of Nursing

Proposed Rules

Amending 22 TAC §217.3 to update requirements for temporary authorization to practice as a graduate nurse or graduate vocational nurse

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.3OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §217.3, relating to Temporary Authorization to Practice/Temporary Permit.BACKGROUND AND JUSTIFICATIONFirst, the proposed amendments require new graduates seeking temporary authorization to practice as a graduate nurse or graduate vocational nurse to submit fingerprints for a complete criminal background check prior to licensure, in compliance with the Occupations Code §301.2511, and pass the jurisprudence exam, in compliance with the Occupations Code §301.252, prior to receiving a graduate nurse or graduate vocational nurse permit. Graduate nurses who are issued graduate permits may practice nursing if appropriately supervised. Second, the proposed amendments make non-substantive changes to paragraph (3) to increase the readability of the paragraph. Third, the proposed amendments clarify that a temporary permit may be re-issued if a nurse is unable to complete requirements that are necessary for the nurse’s licensure reinstatement within a six-month period. Due to an individual’s performance pace, it may take a nurse longer than six months to complete requirements necessary for licensure reinstatement. SECTION-BY-SECTION-SUMMARYProposed amended §217.3(a)(1) corrects a typographical error.Proposed amended §217.3(a)(1)(E) requires individuals seeking temporary authorization to practice to submit fingerprints for a complete criminal background check prior to receipt of the permit. Proposed amended §217.3(a)(1)(F) requires individuals seeking temporary authorization to practice to obtain a passing score on the jurisprudence exam approved by the Board, effective September 1, 2009, prior to receipt of the permit. Proposed amended §217.3(a)(3) clarifies that a new graduate who has been authorized to practice nursing as a graduate vocational nurse pending the results of the licensing examination must work under the direct supervision of a licensed vocational nurse or a registered nurse who is physically present in the facility or practice setting and who is readily available to the graduate vocational nurse for consultation and assistance. Further, a new graduate who has been authorized to practice nursing as a graduate nurse pending the results of the licensing examination must work under the direct supervision of registered nurse who is physically present in the facility or practice setting and who is readily available to the graduate nurse for consultation and assistance. Proposed §217.3(c) clarifies that a permit may be renewed beyond six months

Texas Board of Nursing

Proposed Rules

Amending 22 TAC §217.5 to update requirements for licensees of another state or Canadian province who seek temporary licensure and endorsement

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.5OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §217.5, relating to Temporary License and Endorsement. BACKGROUND AND JUSTIFICATIONRule 217.5 addresses applicants who have been licensed in another state or Canadian province and are seeking nurse licensure by endorsement in Texas. Under the current rule, these applicants must provide a credential evaluation service full education course-by-course report from the Commission on Graduates of Foreign Nursing Schools, Educational Records Evaluation Service, or the International Education Research Foundation. The proposed amendments, however, eliminate the requirement that an applicant must choose from these three specific credential evaluation services traditionally recognized by the Board, and, instead, allow applicants to utilize any credential evaluation service meeting the standards set by the Board. This proposed change is intended to provide additional options for applicants and additional opportunity for credential evaluation services seeking to do business in Texas.SECTION-BY-SECTION-SUMMARYSection 217.5(a) requires an applicant who has graduated from a nursing education program outside of the United States or National Council jurisdictions to submit verification of licensure from the country of education or as evidenced in a credential evaluation service full education course by course report from a credential evaluation service approved by the Board, as well as meeting all other requirements in paragraphs (2) and (3) of the subsection. Proposed §217.5(b) sets forth the requirements that a credential evaluation service must meet in order to be approved by the Board. The proposed amendments to §217.5(c)(3) eliminate the requirement that an applicant submit to the Board a course completion form from the online Texas Board of Nursing Jurisprudence Prep Course; the Texas Board of Nursing Jurisprudence and Ethics Workshop; or a Texas Board of Nursing approved Nursing Jurisprudence and Ethics course. The remaining proposed amendment re-number the section appropriately.

Texas Board of Nursing

Proposed Rules

Amending 22 TAC §217.6 to eliminate redundant provisions regarding a nurse’s failure to renew a license

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.6OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §217.6, relating to Failure to Renew License. The proposed amendment eliminates §217.6(b)(3) from the section. The remaining proposed amendments re-number the section accordingly.BACKGROUND AND JUSTIFICATIONBoard §217.6(b) addresses the licensure renewal of a nurse who is not currently practicing nursing and who has failed to maintain current licensure from any licensing authority for four or more years. The rule currently sets out the criteria that an individual must meet in order to renew his/her license under these circumstances. Among the various requirements, an individual must currently complete the online Texas Board of Nursing Jurisprudence Prep Course; the Texas Board of Nursing Jurisprudence and Ethics Workshop; or a Texas Board of Nursing approved Nursing Jurisprudence and Ethics course in addition to completing a refresher course, extensive orientation, or program of study. Fifteen percent (15%) of the required content of a Board approved refresher course, extensive orientation, or program of study must include the review of the Nursing Practice Act, Rules, Position Statements. This is the same content that is included in the online Texas Board of Nursing Jurisprudence Prep Course; the Texas Board of Nursing Jurisprudence and Ethics Workshop; and a Texas Board of Nursing approved Nursing Jurisprudence and Ethics course. The Board recognizes that the existing requirements of the rule may be unnecessarily redundant in this regard. The proposed amendments, therefore, eliminate these redundant requirements from the rule. Individuals will still be required to complete a Board approved refresher course, extensive orientation, or program of study, which must include an adequate focus on nursing jurisprudence and ethics. Further, because a nurse will still be required to successfully pass the Board’s nursing jurisprudence exam, the public can be adequately assured that the nurse has successfully mastered this content prior to renewal of licensure.

Texas Board of Nursing

Proposed Rules

Repealing 22 TAC §217.8 regarding duplicate or substitute credentials for licensure

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.8OVERVIEWThe Texas Board of Nursing (Board) proposes the repeal of §217.8, relating to Duplicate or Substitute Credentials. The proposed amendments to §217.8 eliminate the section in its entirety.BACKGROUND AND JUSTIFICATIONThe proposed repeal eliminates the section in its entirety, as the Board’s processes have changed over time, and the current section is now obsolete. Because an individual may now verify his/her license and print a wall certificate directly from the Board’s website, the Board has stopped printing duplicate wall certificates for licensees whose original wall certificate was lost or destroyed. Additionally, the Board no longer issues wallet-sized licenses to any licensee. Further, when an individual changes his/her name and notifies the Board, the Board’s online licensure verification system will reflect the name change, but the individual is not able to print a new wall certificate reflecting the name change. The wall certificate will continue to reflect the name of the individual as it was issued on the original wall certificate. As such, the processes outlined in Board §217.8 are no longer applicable.

Texas Board of Nursing

Proposed Rules

Amending 22 TAC §217.9 to eliminate redundant requirements for the reactivation of an inactive license

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.9OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §217.9, relating to Inactive and Retired Status.The proposed amendments eliminate §217.9(g)(4) in its entirety and renumber the remaining paragraphs accordingly.BACKGROUND AND JUSTIFICATIONBoard Rule 217.9 addresses a nurse who has not practiced nursing and whose license has been in inactive status for four or more years. The rule currently sets out the criteria that an individual must meet in order to reactivate his/her license under these circumstances. Among the various requirements, an individual must currently complete the online Texas Board of Nursing Jurisprudence Prep Course; the Texas Board of Nursing Jurisprudence and Ethics Workshop; or a Texas Board of Nursing approved Nursing Jurisprudence and Ethics course in addition to completing a refresher course, extensive orientation, or program of study. Fifteen percent (15%) of the required content of a Board approved refresher course, extensive orientation, or program of study must include the review of the Nursing Practice Act, Rules, and Position Statements. This is the same content that is included in the online Texas Board of Nursing Jurisprudence Prep Course; the Texas Board of Nursing Jurisprudence and Ethics Workshop; and a Texas Board of Nursing approved Nursing Jurisprudence and Ethics course. The Board recognizes that the existing requirements of the rule may be unnecessarily redundant in this regard. The proposed amendments, therefore, eliminate these redundant requirements from the rule. Individuals will still be required to complete a Board approved refresher course, extensive orientation, or program of study, which must include an adequate focus on nursing jurisprudence and ethics. Further, because a nurse will still be required to successfully pass the Board’s nursing jurisprudence exam, the public can be adequately assured that the nurse has successfully mastered this content prior to reactivation of licensure.

Texas Board of Nursing

Proposed Rules

Amending 22 TAC §222.3 to update requirements for the renewal of prescriptive authority by advanced practice registered nurses

CHAPTER 222. ADVANCED PRACTICE REGISTERED NURSES WITH PRESCRIPTIVE AUTHORITY22 TAC §222.3OVERVIEWThe Texas Board of Nursing (Board) proposes amendments to §222.3, relating to Renewal of Prescriptive Authority.Proposed amended §222.3(b) requires an advanced practice registered nurse seeking to maintain prescriptive authority to attest, on forms provided by the Board, to completing at least five contact hours of continuing education in pharmacotherapeutics within the preceding biennium. The other requirements of the subsection have been eliminated.BACKGROUND AND JUSTIFICATIONThe proposed amendments are necessary for consistency with adopted changes to §216.3, pertaining to Continuing Competency. Section 216.3 was amended on November 19, 2019, in order to implement the requirements of HB 2454, HB 2059, HB 3285, and HB 2174.Prior to its amendment in November 2019, §216.3 required advanced practice registered nurses holding prescriptive authority to complete at least three contact hours of continuing education related to prescribing controlled substances each biennium, in addition to at least five contact hours of continuing education in pharmacotherapeutics within the same licensing period. The Board originally adopted this requirement in November 2013, following the passage of SB 406, enacted by the 83rd Texas Legislature, Regular Session, effective November 1, 2013. SB 406 expanded the scope of advanced practice registered nurses by authorizing the ordering/prescribing of Schedule II controlled substances in certain settings. The additional targeted continuing education adopted by the Board at that time was reasonably related to the expanded scope of practice authorized by SB 406. Further, the requirement was also adopted during a time when the Board began seeing an increase in the number of its non-therapeutic prescribing cases related to the then up-and-coming opioid crisis.The new continuing education requirements enacted during the 86th Legislative Session, however, were designed to provide specific education regarding many of the issues affecting the opioid crisis. The Board found many of its prior concerns to be adequately addressed by the new continuing education course requirements. Further, the Board recognized the potential overlap between the new continuing education courses and the existing education requirements for advanced practice registered nurses. As such, the Board eliminated the potentially duplicative requirements to only require advanced practice registered nurses holding prescriptive authority to complete at least five contact hours of continuing education in pharmacotherapeutics each biennium. The Board believed this change could reduce some of the financial burden associated with required continuing education courses without sacrificing the safety of the public or the competency of its practitioners.

Texas Department of State Health Services

Proposed Rules

Amending various sections in 25 TAC, Subchapter B to clarify criminal background check and sexual abuse training requirements for certain individuals employed by Texas youth camps

CHAPTER 265. GENERAL SANITATIONSUBCHAPTER B. TEXAS YOUTH CAMPS SAFETY AND HEALTH25 TAC §§265.11 – 265.13, 265.15, 265.16, 265.23, 265.24, 265.27, 265.28OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendments to §265.11, concerning Definitions; §265.12, concerning Directors, Supervisors, and Staff; §265.13, concerning Site and Physical Facilities; §265.15, concerning Medical and Nursing Care; §265.16, concerning Waterfront Safety; §265.23, concerning Application and Denial of a New License; Non-transferable; §265.24, concerning Application and Denial of a Renewal License; §265.27, concerning Revocation, Administrative Penalties, and Hearings; and §265.28, concerning Fees.The proposed amendments revise definitions and clarify the requirements for a criminal background check and completion of a sexual abuse and child molestation awareness training and examination program for an individual having unsupervised contact with campers. BACKGROUND AND JUSTIFICATION The purpose of this proposal is to amend §265.12 and §265.15 to address the requirements in House Bill (H.B.) 4372, 86th Legislature, Regular Session, 2019, which amended Texas Health and Safety Code, Chapter 141. H.B. 4372 requires that DSHS consider whether a youth camp employs an individual who was convicted of an act of sexual abuse in making a determination on issuance, renewal, or revocation of a youth camp operator’s license and requires that DSHS forward a report of alleged abuse of a camper received by DSHS to the Department of Family and Protective Services or another appropriate agency. H.B. 4372 also creates a new retention period for camp staff records related to an investigation of, or conviction of, an act of sexual abuse; and requires a written policy for youth camps reporting suspected abuse.The proposed amendments revise definitions and clarify the requirements for a criminal background check and completion of a sexual abuse and child molestation awareness training and examination program for an individual having unsupervised contact with campers. The amendments update the requirements concerning preclusion of persons at a youth camp by excluding Class C assault misdemeanors under Texas Penal Code, §22.01 from the types of criminal convictions and deferred adjudications requiring preclusion, and allow for the employment of persons with Class C assault misdemeanors under Texas Penal Code, §22.01 committed within the past ten years at the discretion of the youth camp. The amendments also update license application sections to reflect changes to youth camp definitions and simplify the rule language. The amendments update the references to Texas statutes throughout the subchapter to include the word “Texas.”

Texas Department of State Health Services

Adopted Rules

New 25 TAC §§40.1-40.8 setting minimum standards for epinephrine auto-injector policies at institutions of higher education

CHAPTER 40. EPINEPHRINE AUTO-INJECTOR AND ANAPHYLAXIS POLICIESSUBCHAPTER A. EPINEPHRINE AUTO-INJECTOR POLICIES IN INSTITUTIONS OF HIGHER EDUCATION25 TAC §§40.1 – 40.8OVERVIEW The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts new §§40.1 – 40.8, concerning Epinephrine Auto-Injector Policies in Institutions of Higher Education.New §40.1 is adopted with changes to the proposed text as published in the November 29, 2019, issue of the Texas Register (44 TexReg 7313) and will be republished. New §§40.2 – 40.8 are adopted without changes and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThe new sections are necessary to implement Senate Bill (S.B.) 1367, 85th Legislature, Regular Session, 2017, and House Bill (H.B.) 476 and H.B. 4260, 86th Legislature, Regular Session, 2019. S.B. 1367 added Texas Education Code, Chapter 51, Subchapter Y-1, which requires the adoption of rules for the maintenance, administration, and disposal of epinephrine auto-injectors in institutions of higher education that voluntarily adopt epinephrine auto-injector policies. H.B. 476 amended §51.882 of the Texas Education Code to require institutions of higher education that adopt a policy to submit the policy to DSHS. The new rules set the minimum standards for institutions of higher education to follow when adopting an epinephrine auto-injector policy, based on recommendations of the DSHS Stock Epinephrine Advisory Committee. An institution of higher education that voluntarily adopts an unassigned epinephrine auto-injector policy must stock at least one unassigned adult epinephrine auto-injector pack on each campus and conduct individual campus assessments to determine if additional epinephrine auto-injectors are needed. The new rules allow flexibility so that institutions of higher education may develop policies that address issues specific to each campus, including campus geography and student population size. Personnel and volunteers that are trained to administer unassigned epinephrine auto-injectors may administer an epinephrine auto-injector to a person suspected of experiencing anaphylaxis, including students, personnel, volunteers, and visitors. Public institutions of higher education that adopt epinephrine auto-injector policies are required to report the administration of an epinephrine auto-injector to DSHS within 10 business days.

Texas Medical Disclosure Panel

Adopted Rules

Amending 25 TAC §601.9 to update informed consent requirements for anesthesia and preoperative pain management patients

CHAPTER 601. INFORMED CONSENT25 TAC §601.9OVERVIEWThe Texas Medical Disclosure Panel (panel) adopts an amendment to §601.9 concerning informed consent of patients. The amendment to §601.9 is adopted with changes to the proposed text as published in the November 1, 2019, issue of the Texas Register (44 TexReg 6500). The rule will be republished.Amendments to §601.9 replace references to the “Department of State Health Services” with references to the “Health and Human Services Commission.” Amendments to §601.9 also modify the disclosure and consent form in English and Spanish for anesthesia and/or perioperative pain management (analgesia) to ensure the physician delegating, supervising or performing the anesthetic will be privileged with the rebuttable presumption intended.BACKGROUND AND JUSTIFICATIONThese amendments are in accordance with the Texas Civil Practice and Remedies Code, §74.102, which requires the panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure. Section 601.9 contains the Disclosure and Consent Form for Anesthesia and/or Perioperative Pain Management (Analgesia).

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.1, which dictates the basis and scope of the subchapter on licensure and Medicaid certification for nursing facilities

CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION40 TAC §19.1OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.1 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.1 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). This section will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The Code of Federal Regulations (CFR), Title 42, Subpart B, §§483.1, 483.5, 483.10, 483.12, 483.15, 483.20, 483.21, 483.24, 483.25, 483.30, 483.35, 483.40, 483.45, 483.50, 483.55, 483.60, 483.65, 483.70, 483.75, 483.80, 483.85, 483.90 and 483.95, was amended effective November 28, 2016, to revise the requirements that nursing facilities must meet to participate in the Medicare and Medicaid programs.The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.101, which provides definitions for the subchapter on licensure and Medicaid certification for nursing facilities

CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION40 TAC §19.101OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.101 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.101 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The Code of Federal Regulations (CFR), Title 42, Subpart B, §§483.1, 483.5, 483.10, 483.12, 483.15, 483.20, 483.21, 483.24, 483.25, 483.30, 483.35, 483.40, 483.45, 483.50, 483.55, 483.60, 483.65, 483.70, 483.75, 483.80, 483.85, 483.90 and 483.95, was amended effective November 28, 2016, to revise the requirements that nursing facilities must meet to participate in the Medicare and Medicaid programs.The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending various sections of 40 TAC, Subchapter E, which outlines residents’ rights in Medicaid-certified nursing facilities

CHAPTER 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION40 TAC §§19.401 – 19.411, 19.413, 19.414, 19.416, 19.417, 19.418, 19.421OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.401 – 19.411, 19.413, 19.414, 19.416, 19.417, 19.418, and 19.421 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §§19.406 and 19.421 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §§19.401 – 19.405, 19.407 – 19.411, 19.413, 19.414, 19.416, and 19.417 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending various sections of 40 TAC, Subchapter G, which mandates freedom from abuse, neglect and exploitation in in Medicaid-certified nursing facilities

SUBCHAPTER G. FREEDOM FROM ABUSE, NEGLECT, AND EXPLOITATION40 TAC §§19.601, 19.602, 19.606OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.601, 19.602, and 19.606 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §§19.602, 19.606 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §19.601 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §§19.801 – 19.803 to update resident assessment requirements in Medicaid-certified nursing facilities

SUBCHAPTER I. RESIDENT ASSESSMENT40 TAC §§19.801 – 19.803OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.801 – 19.803 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §§19.801 and 19.802 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §19.803 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending various sections of 40 TAC, Subchapter L, regarding food and nutrition services in Medicaid-certified nursing facilities

SUBCHAPTER L. FOOD AND NUTRITION SERVICES40 TAC §§19.1101, 19.1104, 19.1107 – 19.1111, 19.1113OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.1101, 19.1104, 19.1107 – 19.1111, 19.1113 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §§19.1109, 19.1110, 19.1113 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §§19.1101, 19.1104, 19.1107, 19.1108, 19.1111 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.1401 to update dental service requirements in Medicaid-certified nursing facilities

SUBCHAPTER O. DENTAL SERVICES40 TAC §19.1401OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.1401 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. These sections will be republished. The amendments to §19.1401 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §§19.501 – 19.504 to update admission, transfer and discharge rights in Medicaid-certified nursing facilities

SUBCHAPTER F. ADMISSION, TRANSFER, AND DISCHARGE RIGHTS IN MEDICAID-CERTIFIED FACILITIES40 TAC §§19.501 – 19.504OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.501 – 19.504 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.502 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §§19.501, 19.503, 19.504 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Repealing 40 TAC §19.701 and §19.705, regarding quality of life measures in Medicaid-certified nursing facilities

SUBCHAPTER H. QUALITY OF LIFE40 TAC §19.701, §19.705OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts the repeal of §19.701 and §19.705 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

New 40 TAC §19.701, regarding quality of life measures in Medicaid-certified nursing facilities

SUBCHAPTER H. QUALITY OF LIFE40 TAC §19.701OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts new §19.701 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §§19.702 – 19.703 and 19.706, regarding quality of life measures in Medicaid-certified nursing facilities

SUBCHAPTER H. QUALITY OF LIFE40 TAC §§19.702 – 19.703, 19.706OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.702 – 19.703, 19.706 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.702 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §§19.703, 19.706 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.901 and adopting new §19.904, regarding quality of care measures in Medicaid-certified nursing facilities

SUBCHAPTER J. QUALITY OF CARE40 TAC §19.901, §19.904OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.901 and adopts new §19.904 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.901 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.1001, §19.1010 to update nursing service requirements in Medicaid-certified nursing facilities

SUBCHAPTER K. NURSING SERVICES40 TAC §19.1001, §19.1010OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.1001 and §19.1010 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.1001 and §19.1010 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Repealing 40 TAC §19.1102 and §19.1103, regarding food and nutrition services in Medicaid-certified nursing facilities

SUBCHAPTER L. FOOD AND NUTRITION SERVICES40 TAC §19.1102, §19.1103OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts the repeal of §19.1102, §19.1103 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

New 40 TAC §19.1102 and §19.1116, regarding food and nutrition services in Medicaid-certified nursing facilities

SUBCHAPTER L. FOOD AND NUTRITION SERVICES40 TAC §§19.1102, 19.1116OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts new §§19.1102, 19.1116 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §§19.1201 – 19.1203, 19.1205 to update physician service requirements in Medicaid-certified nursing facilities

SUBCHAPTER M. PHYSICIAN SERVICES40 TAC §§19.1201 – 19.1203, 19.1205OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.1201 – 19.1203, 19.1205 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.1201 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments to §§19.1202, 19.1203, 19.1205 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.1501 to update pharmacy service requirements in Medicaid-certified nursing facilities

SUBCHAPTER P. PHARMACY SERVICES40 TAC §19.1501OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.1501 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.1501 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.1601, regarding infection control measures in Medicaid-certified nursing facilities

SUBCHAPTER Q. INFECTION CONTROL40 TAC §19.1601OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §19.1601 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.1601 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending various sections in 40 TAC, Subchapter T, regarding administrative requirements in Medicaid-certified nursing facilities

SUBCHAPTER T. ADMINISTRATION40 TAC §§19.1901, 19.1902, 19.1908 – 19.1912, 19.1915, 19.1917, 19.1929OVERVIEWAs required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts amendments to §§19.1901, 19.1902, 19.1908 – 19.1912, 19.1915, 19.1917, 19.1929 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. The amendments to §19.1912 are adopted with changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will be republished. The amendments §§19.1901, 19.1902, 19.1908 – 19.1911, 19.1915, 19.1917, 19.1929 are adopted without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4979). These sections will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

New 40 TAC §19.1931, regarding administrative requirements in Medicaid-certified nursing facilities

SUBCHAPTER T. ADMINISTRATION40 TAC §19.1931As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts new §19.1931 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Repealing 40 TAC §19.1903 and §19.1904, regarding administrative requirements in Medicaid-certified nursing facilities

SUBCHAPTER T. ADMINISTRATION40 TAC §19.1903, §19.1904As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. 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. Therefore, the Executive Commissioner of HHSC adopts the repeal of §19.1903, §19.1904 in Title 40, Part 1, Chapter 19, concerning Nursing Facility Requirements for Licensure and Medicaid Certification. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments, new sections, and repeals in 40 Texas Administrative Code (TAC), Chapter 19, is to make HHSC rules consistent with federal regulations for nursing facilities participating in Medicare and Medicaid and to protect the health and safety of nursing facility residents. The adopted rules focus on person-centered care and culture change, quality of life improvement, care and services, health outcomes, individual choice, resident safety, professional standards, and quality assurance and performance improvement. The rule changes are necessary to enhance health and safety protections for nursing facility residents, streamline regulatory requirements for nursing facility providers, and improve consistency of regulatory survey activity.HHSC also replaces references to both the “Texas Department of Human Services” or “DHS” and the “Department of Aging and Disability Services” or “DADS” with references to the “Texas Health and Human Services Commission” or “HHSC” throughout the proposal. The terms “responsible party,” “legal representative,” and other similar terms are replaced with the term “resident representative,” throughout the proposal. The word “Texas” is added to the beginning of Texas codes. HHSC also makes editorial changes throughout the proposal to remove gender-specific language, adopt person-first respectful language, make plural nouns singular such as “resident” instead of “residents,” and improve clarity and readability of the rules.

Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §19.2704, concerning nursing facility responsibilities with regard to Preadmission Screening and Resident Review (PASRR)

In Addition

Council intends to review 22 TAC, Chapter 651 (Fees) and either readopt, readopt with amendments, or repeal

Title 22, Part 28The Executive Council of Physical Therapy and Occupational Therapy Examiners files this notice of its intent to review Title 22 Texas Administrative Code Chapter 651, Fees. The review is conducted in accordance with Texas Government Code §2001.039, which requires a state agency to review and consider its rules for readoption, readoption with amendments, or repeal every four years. During the review, the Executive Council of Physical Therapy and Occupational Therapy Examiners will assess whether the reasons for initially adopting the rules continue to exist.Comments on the review may be submitted to Randall Glines, Staff Services Officer, Executive Council of Physical Therapy and Occupational Therapy Examiners, 333 Guadalupe Street, Suite 2-510, Austin, Texas 78701-3942 or to randall@ptot.texas.gov no later than 30 days after the date that this notice is published in the Texas Register.Any proposed changes to these rules as a result of the review will be published in the Proposed Rules section of the Texas Register and will be open for an additional 30-day public comment period prior to final adoption.

Texas Board of Occupational Therapy Examiners

In Addition

Board intends to review various chapters of 40 TAC, Part 12 and either readopt, readopt with amendments, or repeal

Title 40, Part 12The Texas Board of Occupational Therapy Examiners files this notice of its intent to review the following chapters of Title 40, Part 12 of the Texas Administrative Code: Chapter 361, Statutory Authority; Chapter 362, Definitions; Chapter 363, Consumer/Licensee Information; Chapter 364, Requirements for Licensure; Chapter 367, Continuing Education; Chapter 368, Open Records; Chapter 369, Display of Licenses; Chapter 370, License Renewal; Chapter 371, Inactive and Retired Status; Chapter 372, Provision of Services; Chapter 373, Supervision; Chapter 374, Disciplinary Actions/Detrimental Practice/Complaint Process/Code of Ethics/Licensure of Persons with Criminal Convictions; and Chapter 375, Fees. The review is conducted in accordance with Texas Government Code §2001.039, which requires a state agency to review and consider its rules for readoption, readoption with amendments, or repeal every four years. During the review, the Board will assess whether the reasons for initially adopting the rules continue to exist.Comments on the review may be submitted to Lea Weiss, Occupational Therapy Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe Street, Suite 2-510, Austin, Texas 78701-3942 or to lea@ptot.texas.gov no later than 30 days after the date that this notice is published in the Texas Register.Any proposed changes to these rules as a result of the review will be published in the Proposed Rules section of the Texas Register and will be open for an additional 30-day public comment period prior to final adoption.

Texas Health and Human Services Commission

In Addition

Notice of public hearing on proposed Medicaid payment rates for COVID-19 test panels

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Quarterly Healthcare Common Procedure Coding System (HCPCS) Update for 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test PanelsHEARINGThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on March 23, 2020, beginning at 9:00 a.m. and ending at 10:00 a.m., to receive comment on proposed Medicaid payment rates for the Quarterly HCPCS Update for 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panels (COVID-19 test panels).The public hearing will be held in conference room 2301 of HHSC’s Brown-Heatly Building, located at 4900 North Lamar Blvd., Austin, Texas. Entry is through security at the main entrance of the building, which faces Lamar Boulevard. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.Only testimony related to the Medicaid reimbursement rates for the COVID-19 test panels will be accepted during the public hearing.PROPOSALThe payment rates for the COVID-19 test panels are proposed to be effective February 4, 2020.METHODOLOGY AND JUSTIFICATIONThe proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:Section 355.8061, which addresses outpatient hospital reimbursement;Section 355.8085, which addresses the reimbursement methodology for physicians and other practitioners;Section 355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps); andSection 355.8610, which addresses the reimbursement for clinical laboratory services.BRIEFING PACKETA briefing packet describing the proposed payments rates will be available at https://rad.hhs.texas.gov/rate-packets on March 13, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Rate Analysis by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us. The briefing packet will also be available at the public hearing.WRITTEN COMMENTSWritten comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Rate Analysis, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Rate Analysis at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail or hand delivered to Texas Health and Human Services Commission, Attention: Rate Analysis, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.