Texas Register March 31, 2023 Volume: 48 Number: 13

Texas Register Table of Contents

Governor

Proclamation 41-3963

TO ALL TO WHOM THESE PRESENTS SHALL COME:

WHEREAS, I, Greg Abbott, Governor of Texas, issued a disaster proclamation on March 13, 2020, certifying under Section 418.014 of the Texas Government Code that COVID-19 poses an imminent threat of disaster for all counties in the State of Texas; and

WHEREAS, in each subsequent month effective through today, I have issued proclamations renewing the disaster declaration for all Texas counties; and

WHEREAS, pursuant to the Texas Disaster Act of 1975, I have issued a series of executive orders and suspensions of Texas laws aimed at protecting the health and safety of Texans, ensuring uniformity throughout the State, and achieving the least restrictive means of combating the evolving threat posed by COVID-19; and

WHEREAS, Executive Orders GA-13, GA-37, GA-38, GA-39, and GA-40 remain in effect with “the force and effect of law” under Section 418.012 of the Texas Government Code; and

WHEREAS, ending the disaster declaration would terminate the executive orders that protect Texans’ freedom by suspending the power of local governments to require masks, compel vaccinations, and close businesses; and

WHEREAS, I intend to keep these executive orders and suspensions in place until the Legislature can enact laws this session to prohibit local governments from imposing restrictions like mask mandates and vaccine mandates; and

WHEREAS, renewing the disaster declaration in no way infringes on the rights or liberties of any law-abiding Texans; and

WHEREAS, under the Texas Disaster Act of 1975, a state of disaster continues to exist in all counties during Texas’ successful economic recovery from COVID-19;

NOW, THEREFORE, in accordance with the authority vested in me by Section 418.014 of the Texas Government Code, I do hereby renew the disaster proclamation for all counties in Texas.


Texas Health and Human Services Commission

Proposed Rules Re:

New 1 TAC §355.8707, specifying the content of required notifications.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER L. LOCAL FUNDS MONITORING
1 TAC §355.8707

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §355.8707, concerning Notification Requirements for the Creation of a Local Provider Participation Fund (LPPF).

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement House Bill 4289, 86th Legislature, Regular Session, 2019 by establishing a process that requires certain political subdivisions to notify HHSC of the creation of a new local provider participation fund (LPPF) as authorized by Texas Health and Safety Code Chapter 300 or Texas Health and Safety Code Chapter 300A. This rule will ensure that HHSC receives appropriate and timely notices of newly created LPPFs, which will enable the agency to maintain oversight and reduce the risk of federal recoupment.

The proposal is also necessary to comply with the requirements of 42 CFR §433.51, Public Funds as the State share of Financial Participation, 42 CFR §433.68, Permissible Health Care-Related Taxes, 42 CFR §433.74, Reporting Requirements, and Section 1903(w)(1)(A)(i)-(iii) of the Social Security Act.

SECTION-BY-SECTION SUMMARY

Proposed new §355.8707(a) provides for the required notification and specifies content of the notification, including where to direct the notification, contact information for the political subdivision, and documents related to LPPF formation and adoption. Subsection (b) clarifies that any political subdivision implementing an LPPF is subject to annual local funds monitoring reporting requirements.


In Addition Re:

Criminal History Requirements for Child Care Operations

OVERVIEW

(Editor’s note: In accordance with Texas Government Code, §2002.014, which permits the omission of material which is “cumbersome, expensive, or otherwise inexpedient,” the charts are not included in the print version of the Texas Register. The charts are available in the on-line version of the March 31, 2023, issue of the Texas Register.)

26 TAC §745.661 (relating to What types of criminal convictions may affect a person’s ability to be present at an operation?) states that HHSC will review the three criminal history requirements charts with information regarding specific crimes that may affect a person’s ability to be present at a child care operation annually to determine whether any changes are needed. HHSC will then publish any changes in January as an “In Addition” document in the Texas Register and make them available on the Child Care Regulation public website. The three charts are entitled: (1) Licensed or Certified Child Care Operations: Criminal History Requirements; (2) Foster or Adoptive Placements: Criminal History Requirements; and (3) Registered Child Care Homes and Listed Family Homes: Criminal History Requirements.


Public Notice – Texas State Plan Amendment

OVERVIEW


The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. The proposed amendment is effective March 11, 2021.

The proposed amendment documents coverage of COVID-19 vaccines and administration of the vaccines for children under the age of 21.

The proposed amendment is estimated to result in an additional annual aggregate expenditure of $23,542,073 in federal funds for federal fiscal year (FFY) 2021, $76,641,752 in federal funds for FFY 2022, and $58,879,671 in federal funds for FFY 2023.


State Board of Dental Examiners

Proposed Rules Re:

Amending 22 TAC §104.2, which takes into account the merger of the regional examining board CDCA-WREB-CITA.

CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.2

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §104.2, concerning continuing education providers. The proposed amendment reflects the merger of the regional examining board CDCA-WREB-CITA. The proposed amendment includes the States Resources for Testing and Assessments (SRTA), Central Regional Dental Testing Services Inc. (CRDTS), and the American Association of Dental Boards – Accredited Continuing Education Program (AADB-ACE) as board approved continuing education providers. The proposed amendment removes Dental Quality Assurance and Dentist Secure Labs as continuing education providers.


Withdrawn Rules Re:

Withdrawing 22 TAC §104.2, regarding continuing education providers.

CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.2

OVERVIEW

The State Board of Dental Examiners withdraws the proposed amendment to §104.2, which appeared in the December 23, 2022, issue of the Texas Register (47 TexReg 8454).


Texas State Board of Examiners of Psychologists

Proposed Rules Re:

Amending 22 TAC §463.8, correcting typographical errors and explaining what kind of experience can count towards licensure.

CHAPTER 463. APPLICATIONS AND EXAMINATIONS
SUBCHAPTER B. LICENSING REQUIREMENTS
22 TAC §463.8

OVERVIEW

The Texas Behavioral Health Executive Council proposes amendments to §463.8, relating to Licensed Psychological Associate.

BACKGROUND AND JUSTIFICATION

The proposed amendments correct typographical errors in subsections (a)(3), (b)(3), and (c)(3). The proposed amendment to subsection (a)(2) will allow for the supervised experience from an internship, practicum, or the like to count towards licensure if it is obtained under an individual licensed as an LSSP, instead of only under the supervision of a psychologist. Subsection (c)(5) has been amended to allow a provisionally licensed psychologist to count supervision hours obtained towards the independent practice requirements as an LPA. Subsection (d) has been deleted to correspond with changes made to §463.11, which deletes the gap requirements for when supervised experience was obtained and when an application was submitted. Subsection (f) extends a grandfathering provision for degrees in psychology that began before August 31, 2019. And subsection (g) creates a way for applicants with deficiencies to petition to remediate certain areas of deficiency.


Withdrawn Rules Re:

Amending 22 TAC §463.8, concerning supervision hours requirement for licensure.

CHAPTER 463. APPLICATIONS AND EXAMINATIONS
SUBCHAPTER B. LICENSING REQUIREMENTS
22 TAC §463.8

The Texas State Board of Examiners of Psychologists withdraws the proposed amendment to §463.8, which appeared in the September 30, 2022, issue of the Texas Register (47 TexReg 6382).


Texas State Board of Examiners of Professional Counselors

Proposed Rules Re:

New 22 TAC §681.35, which transfers the existing requirement for informed consent from one section to this new section, as well as new language.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER B. RULES OF PRACTICE
22 TAC §681.35

OVERVIEW

The Texas Behavioral Health Executive Council proposes new §681.35, relating to Informed Consent.

BACKGROUND AND JUSTIFICATION

This proposed new rule transfers the existing requirements for informed consent from current §681.41 to this new rule, and it adds new language in subsection (d). Subsection (d) is intended to create a standard by which informed consent can be provided by licensees to clients while licensees are employed by agencies or institutions, where obtaining signed documentation may not be possible or easily accomplished. The proposed amendment requires the same level of notice and public protection that is currently required, while also creating a regulation that is not overly burdensome or impossible to comply with for licensees.


New 22 TAC §681.36, which transfers the existing requirements for rules of practice from another section to the new section.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER B. RULES OF PRACTICE
22 TAC §681.36

OVERVIEW

The Texas Behavioral Health Executive Council proposes new §681.36, relating to Client Records.

BACKGROUND AND JUSTIFICATION

This proposed new rule transfers the existing requirements for records from current §681.41 to this new rule.


New 22 TAC §681.37, which transfers existing billing and financial arrangement requirements to this new section.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER B. RULES OF PRACTICE
22 TAC §681.37

OVERIVEW

The Texas Behavioral Health Executive Council proposes new §681.37, relating to Billing and Financial Arrangements.

BACKGROUND AND JUSTIFICATION

This proposed new rule transfers the existing requirements for billing and financial arrangements from current §681.41 to this new rule.


New 22 TAC §681.38, which transfers conflicts, boundaries, dual relationships, and termination of relationships with clients requirements to this new section.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER B. RULES OF PRACTICE
22 TAC §681.38

OVERVIEW

The Texas Behavioral Health Executive Council proposes new §681.38, relating to Conflicts, Boundaries, Dual Relationships, and Termination of Relationships.

BACKGROUND AND JUSTIFICATION

This proposed new rule transfers the existing requirements regarding conflicts, boundaries, dual relationships, and termination of relationships with clients from current §681.41 to this new rule.


Amending 22 TAC §681.41, deleting certain subsections and moving them to other rules for organizational purposes.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER B. RULES OF PRACTICE
22 TAC §681.41

OVERVIEW

The Texas Behavioral Health Executive Council proposes amendments to §681.41, relating to General Ethical Requirements.

BACKGROUND AND JUSTIFICATION

Subsections (e), (f), (h), (i), (j), (k), (l), (m), (n), (q), (r), (s), (t), (v), (w), and (x) are proposed to be deleted from this rule and adopted in separate rules to organize the rules of practice in a more accessible and intuitive manner. Additionally, subsection (u) is proposed to be deleted as duplicative, because the same requirement already exists in §681.45.


Amending 22 TAC §681.52, amending a subsection of this rule.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER B. RULES OF PRACTICE
22 TAC §681.52

OVERVIEW

The Texas Behavioral Health Executive Council proposes amendments to §681.52, relating to Parenting Facilitation.

BACKGROUND AND JUSTIFICATION

Rule 681.41 has been proposed to be amended so a corresponding amendment to subsection (y) of this rule has been proposed.


Amending 22 TAC §681.205, to comply with corresponding amendments to the rule.

SUBCHAPTER D. SCHEDULE OF SANCTIONS
22 TAC §681.205

OVERVIEW

The Texas Behavioral Health Executive Council proposes amendments to §681.205, relating to Schedule of Sanctions.

BACKGROUND AND JUSTIFICATION

Amendments to §681.41 have been proposed, so corresponding amendments to this rule are also being proposed.


Texas Behavioral Health Executive Council

Proposed Rules Re:

Repealing 22 TAC §882.10, because it is being replaced by a new rule concerning reasons for abeyance of an application.

CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER A. LICENSE APPLICATIONS
22 TAC §882.10

OVERVIEW

The Texas Behavioral Health Executive Council proposes the repeal of §882.10, relating to Applicants with Pending Complaints.

BACKGROUND AND JUSTIFICATION

The proposed repeal of this rule is necessary because it is proposed to be replaced with a new rule. The new rule will allow for the abeyance of an application up to 180 days when there is a pending complaint against the applicant that involves sexual misconduct or imminent physical harm to the public. All other applicants with complaints will have their application processed as normal, the complaint will not impact the licensure application. The pending complaint will still be investigated and processed according to the normal route as well.


New 22 TAC §882.10, which changes the way applications are processed when the applicant has a pending complaint.

CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER A. LICENSE APPLICATIONS
22 TAC §882.10

OVERVIEW

The Texas Behavioral Health Executive Council proposes new §882.10, relating to Applicants with Pending Complaints.

BACKGROUND AND JUSTIFICATION

The proposed new rule changes the way Council staff will process applications when the applicant has a pending complaint. If the applicant has a pending complaint that involves sexual misconduct or imminent physical harm to the public then the application may be held in abeyance for up to 180 days while a determination on the complaint is made. All other applicants with complaints will have their application processed as normal, the complaint will not impact the licensure application. The pending complaint will still be investigated and processed according to the normal route as well.


Amending 22 TAC §884.10, to change the priority rating system for complaints from four level to two levels.

CHAPTER 884. COMPLAINTS AND ENFORCEMENT
SUBCHAPTER B. INVESTIGATIONS AND DISPOSITION OF COMPLAINTS
22 TAC §884.10

OVERVIEW

The Texas Behavioral Health Executive Council proposes amendments to §884.10, relating to Investigation of Complaints.

BACKGROUND AND JUSTIFICATION

The proposed amendments reduce the priority rating system for complaints from four levels to two. The high priority shall be for all complaints involving sexual misconduct or imminent physical harm and all other complaints shall be a normal priority.


Texas Department of State Health Services

Adopted Rules Re:

Amending 25 TAC §§101.1 – 101.4, 101.7, 101.10, to update the process requiring tobacco manufacturers to submit annual tobacco ingredient reports (annual reports) to DSHS on an annual basis.

CHAPTER 101. TOBACCO
25 TAC §§101.1 – 101.4, 101.7, 101.10

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendments to §101.1, concerning Purpose; §101.2, concerning Definitions; §101.3, concerning General Requirements for Annual Reports by Manufacturers; §101.4, concerning Ingredient Reporting Requirements; §101.7, concerning Security of Report Information; and §101.10, concerning Public Information; and the repeal of §101.5, concerning Cigarette Nicotine Yield Rating Reporting Requirements; and §101.6, concerning Tobacco Products–Excluding Cigars, Nicotine Reporting Requirements.

The amendments to §§101.1 – 101.4, 101.7, and 101.10; and the repeal of §101.5 and §101.6 are adopted without changes to the proposed text as published in the December 9, 2022, issue of the Texas Register (47 TexReg 8088). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeal of §101.5 and §101.6 is necessary to implement Senate Bill (S.B.) 970, 87th Legislature, Regular Session, 2021, which repealed Texas Health and Safety Code §161.353. S.B. 970 removed the requirement for tobacco manufacturers to report nicotine yield ratings in cigarettes and tobacco products to DSHS. The amendments to §§101.2, 101.3, and 101.7 remove definitions and requirements no longer needed after the repeal of Texas Health and Safety Code §161.353.

DSHS is also amending §§101.1 – 101.4, 101.7, and 101.10 to update the process requiring tobacco manufacturers to submit tobacco ingredient lists to DSHS on an annual basis. Needed updates were identified through a rule review process conducted in accordance with Texas Government Code §2001.039. The amendments modernize and simplify the process for receiving and storing annual reports.


Repealing 25 TAC §101.5, §101.6, as they relate to Tobacco, because the sections are no longer necessary following the repeal of Texas Health and Safety Code §161.353.

CHAPTER 101. TOBACCO
25 TAC §101.5, §101.6

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendments to §101.1, concerning Purpose; §101.2, concerning Definitions; §101.3, concerning General Requirements for Annual Reports by Manufacturers; §101.4, concerning Ingredient Reporting Requirements; §101.7, concerning Security of Report Information; and §101.10, concerning Public Information; and the repeal of §101.5, concerning Cigarette Nicotine Yield Rating Reporting Requirements; and §101.6, concerning Tobacco Products–Excluding Cigars, Nicotine Reporting Requirements.

The amendments to §§101.1 – 101.4, 101.7, and 101.10; and the repeal of §101.5 and §101.6 are adopted without changes to the proposed text as published in the December 9, 2022, issue of the Texas Register (47 TexReg 8088). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeal of §101.5 and §101.6 is necessary to implement Senate Bill (S.B.) 970, 87th Legislature, Regular Session, 2021, which repealed Texas Health and Safety Code §161.353. S.B. 970 removed the requirement for tobacco manufacturers to report nicotine yield ratings in cigarettes and tobacco products to DSHS. The amendments to §§101.2, 101.3, and 101.7 remove definitions and requirements no longer needed after the repeal of Texas Health and Safety Code §161.353.

DSHS is also amending §§101.1 – 101.4, 101.7, and 101.10 to update the process requiring tobacco manufacturers to submit tobacco ingredient lists to DSHS on an annual basis. Needed updates were identified through a rule review process conducted in accordance with Texas Government Code §2001.039. The amendments modernize and simplify the process for receiving and storing annual reports.


Review of Agency Rules Re:

Adopting the review of Title 25, Part 1, concerning vital statistics, vital records, and registries.

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

Chapter 181, Vital Statistics

Subchapter A, Miscellaneous Provisions

Subchapter B, Vital Records

Subchapter C, Central Adoption Registry

Subchapter D, Birth Registration Certification

Subchapter E, Delayed Registration

Notice of the review of this chapter was published in the November 25, 2022, issue of the Texas Register (47 TexReg 7931). HHSC received one comment concerning this chapter.

One individual commented to propose a change to Chapter 181, Vital Statistics by repealing §181.24, relating to Abused, Misused, or Flagged Records, specifically referencing the 10-certificate limit on birth records.