Texas Register May 1, 2020 Volume: 45 Number: 18

Governor

 

Notices

Executive Order GA-15: Requiring the suspension of elective surgeries and procedures

OVERVIEWI, Greg Abbott, Governor of Texas, by virtue of the power and authority vested in me by the Constitution and laws of the State of Texas, do hereby order the following on a statewide basis beginning at 11:59 p.m. on April 21, 2020, and continuing until 11:59 p.m. on May 8, 2020:All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician; provided, however, that this prohibition shall not apply to either of the following:Any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID-19 disaster; orAny surgery or procedure performed in a licensed health care facility that has certified in writing to the Texas Health and Human Services Commission both: (1) that it will reserve at least 25% of its hospital capacity for treatment of COVID-19 patients, accounting for the range of clinical severity of COVID-19 patients; and (2) that it will not request any personal protective equipment from any public source, whether federal, state, or local, for the duration of the COVID- 19 disaster.ADDITIONAL INFORMATIONI hereby continue the suspension of the following provisions to the extent necessary to implement increased occupancy in the event of surge needs for hospital capacity due to COVID-19:25 TAC Sec. 133.162(d)(4)(A)(iii)(I); 25 TAC Sec. 133.163(f)(l)(A)(i)(II)-(III); 25 TAC Sec. 133.163(f)(l)(B)(i)(III)-(IV); 25 TAC Sec. 133.163(m)(l)(B)(ii); 25 TAC Sec. 133.163(t)(l)(B)(iii)-(iv); 25 TAC Sec. 133.163(t)(l)(C); 25 TAC Sec. 133.163(t)(5)(B)-(C); and Any other pertinent regulations or statutes, upon written approval of the Office of the Governor. This executive order shall remain in effect and in full force until 11:59 p.m. on May 8, 2020, unless it is modified, amended, rescinded, or superseded by the governor.BACKGROUND AND JUSTIFICATIONThe Governor’s rationale for issuing Executive Order GA-15 is listed in this week’s edition of the Texas Register. 

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Governor

Notices

Executive Order GA-15: Establishing the Governor’s Strike Force to Open Texas

OVERVIEWNOW, THEREFORE, I, Greg Abbott, Governor of Texas, by virtue of the power and authority vested in me by the Constitution and laws of the State of Texas, do hereby order the following:The Governor’s Strike Force to Open Texas, hereafter referred to as the Strike Force, is hereby created to advise the governor on safely and strategically restarting and revitalizing all aspects of the Lone Star State- work, school, entertainment, and culture. The Strike Force will represent a collaboration among medical professionals and public and private leaders, and shall have as its principal charges the following advisory duties, as well as any other advisory tasks assigned by the governor:1. Study and make recommendations, in consultation with state health officials, for revitalizing the Texas economy during our recovery from the COVID-19 disaster, including without limitation on the following topics:a. Safely reopening Texas businesses across a variety of sectors in a strategic, healthy, and productive manner that protects workers and consumers, especially our most vulnerable populations, while also spurring economic recovery and growth;b. Providing the necessary training and resources, based on White House and Centers for Disease Control and Prevention best practices, to position Texas workers and businesses to recover from and thrive after the COVID-19 disaster;c. Re-stabilizing individuals and families who have been economically affected by the COVID-19 disaster;d. Safely and responsibly revitalizing key Texas institutions, including without limitation those focused on workforce and economic development, education, health care, energy, infrastructure, and arts, culture, and entertainment;e. Maximizing the use of federal funding and other available resources to recharge the Texas economy;f. Restoring health care services for Texans as soon as reasonably practicable for each type of service in light of the health and safety concerns and in consultation with each applicable state regulatory agency;g. Spurring the recovery and growth of small businesses in Texas;h. Advancing economic growth in rural communities in Texas;i. Ensuring fiscal responsibility and accountability in the coming phases of economic revitalization, including the expeditious and efficient deployment of resources provided by the federal government through stimulus programs; andj. Keeping Texas the top destination for businesses looking to move or reopen.2. Study and make recommendations, in consultation with state health officials, to safely ease restrictions on Texas businesses in the aftermath of the spread of COVID-19, including without limitation the restrictions imposed by my executive orders and those imposed by local officials; and3. In coordination with the Office of the Governor, collaborate with key partners, including state leaders, state regulatory agencies, local governments and entities, and private-sector professionals, in studying and making recommendations of strategies and best practices for economic revitalization.This executive order shall remain in effect and in full force until modified, amended, rescinded, or superseded by the governor.BACKGROUND AND JUSTIFICATIONThe Governor’s rationale for issuing Executive Order GA-15 is listed in this week’s edition of the Texas Register. 

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State Board of Dental Examiners

Emergency Rule

Amending 22 TAC §108.9 to expand the definition of dishonorable conduct to include the failure to postpone elective surgeries or operations in violation of Executive Order GA-15

CHAPTER 108. PROFESSIONAL CONDUCTSUBCHAPTER A. PROFESSIONAL RESPONSIBILITY22 TAC §108.9OVERVIEWThe State Board of Dental Examiners (Board) adopts on an emergency basis an amendment to 22 TAC §108.9, relating to Dishonorable Conduct, in response to the COVID-19 disaster declaration. The amendment is being made pursuant to Executive Order GA-15, and expands dishonorable conduct to include failure to postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s dentist.BACKGROUND AND JUSTIFICATIONThe amended rule is adopted on an emergency basis due to the imminent peril to the public health, safety and welfare caused by unnecessary exposure of both patients and health care professionals in undertaking and performing non-urgent elective surgeries and procedures during the COVID-19 pandemic.The amended definitions are applicable only for purposes of the COVID-19 disaster declaration and shall only remain effective until the COVID-19 disaster declaration is terminated.

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Texas Medical Board

Emergency Rule

Amending 22 TAC §190.8 to consider the failure to postpone elective surgeries or operations in violation of Executive Order GA-15 as grounds for disciplinary action

CHAPTER 190. DISCIPLINARY GUIDELINESSUBCHAPTER B. VIOLATION GUIDELINES22 TAC §190.8OVERVIEWThe Texas Medical Board (Board) adopts on an emergency basis the emergency amendment to 22 TAC §190.8(2)(U) for purposes of the COVID-19 disaster declaration. The amendment is being made pursuant to Executive Order GA 15 and adds to the definition of “Unprofessional and Dishonorable Conduct” under 22 TAC §190.8(2)(U), which implements Executive Order GA 15, requiring the suspension of elective surgeries and procedures. BACKGROUND AND JUSTIFICATIONThe amended rule is adopted on an emergency basis due to the imminent peril to the public health, safety and welfare caused by unnecessary exposure of both patients and health care professionals in undertaking and performing non-urgent elective surgeries and procedures during the COVID-19 pandemic in violation of the Executive Order.The amended definition of unprofessional and dishonorable conduct is applicable only for purposes of the COVID-19 disaster declaration and shall only remain effective until 11:59 p.m. on May 8, 2020, unless terminated, modified, or extended by the governor.

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Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §500.41, temporarily permitting licensed Chemical Dependency Treatment Facilities to provide telehealth and telemedicine services

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES26 TAC §500.41OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 500 COVID-19 Emergency Health Care Facility Licensing, new §500.41 concerning an emergency rule in response to COVID-19 on telemedicine and telehealth in order to reduce the risk of transmission of COVID-19.To protect patients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting emergency rules to temporarily permit a licensed CDTF to provide telehealth and telemedicine treatment services to clients in order to reduce the risk of transmission of COVID-19, as well as to address shortages of available medical professionalsBACKGROUND AND JUSTIFICATIONAs authorized by Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this CDTF Telemedicine or Telehealth in Response to COVID-19.

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Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §500.42, temporarily allowing licensed Chemical Dependency Treatment Facilities to increase counselor caseloads

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER D. CHEMICAL DEPENDENCY TREATMENT FACILITIES26 TAC §500.41OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 500 COVID-19 Emergency Health Care Facility Licensing, new §500.42, concerning an emergency rule in response to COVID-19 on maximum caseloads in order to permit an intensive residential program in a Chemical Dependency Treatment Facility (CDTF) to temporarily increase counselor caseloads to twenty clients per counselor. To protect patients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting emergency rules to address shortages of available medical professionals and permit an intensive residential program in a CDTF to increase counselor caseloads from 10 to 20 clients per counselor because of CDTF staff shortages.BACKGROUND AND JUSTIFICATIONAs authorized by Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this CDTF Telemedicine or Telehealth in Response to COVID-19.

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Texas Department of Insurance

Emergency Rule

Renewing the effectiveness of new 28 TAC §§21.4901 – 21.4904, concerning disclosures by out-of-network providers

CHAPTER 21. TRADE PRACTICESSUBCHAPTER OO. DISCLOSURES BY OUT-OF-NETWORK PROVIDERS28 TAC §§21.4901 – 21.4904OVERVIEWThe Texas Department of Insurance is renewing the effectiveness of new Title 28, Chapter 21, Subchapter OO, Disclosures By Out-Of-Network Providers, §§21.4901 – 21.4904, concerning disclosures by out-of-network providers, which was adopted on an emergency basis. The text of the emergency rules was originally published in the January 3, 2020, issue of the Texas Register (45 TexReg 13). Under the authority of Government Code §2001.034(c), the renewal will be effective for 60 days.

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Texas Department on Aging and Disability Services

Emergency Rule

Amending 40 TAC §§3.401 – 3.403 to update training requirements for state supported living center staff in response to the COVID-19 crisis

CHAPTER 3. RESPONSIBILITIES OF STATE FACILITIESSUBCHAPTER D. TRAINING40 TAC §§3.401 – 3.403OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40 Texas Administrative Code, Chapter 3, Responsibilities of State Facilities, amended §§3.401 – 3.403, concerning emergency rules in response to COVID-19 to ensure necessary state supported living center staffing levels in the wake of the COVID-19 disaster. The amendments to §§3.401 – 3.402 update training requirements for new employees and direct support professionals at a state supported living center. The amendment to §3.403 updates requirements for refresher training for all staff at a state supported living center.  BACKGROUND AND JUSTIFICATIONAs authorized by Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these training rules.To protect individuals served by the state supported living center and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting emergency amendments to efficiently and effectively deploy staff to meet basic needs during this unprecedented time, without posing risk to the individuals served.

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State Board of Dental Examiners

Proposed Rules

Amending 22 TAC §101.3 to place the responsibility of performing Level II background verification for dental licensure on the Board

CHAPTER 101. DENTAL LICENSURE22 TAC §101.3The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §101.3, concerning the requirements for licensure by credentials. This amendment will remove the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. This rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.

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State Board of Dental Examiners

Proposed Rules

Amending 22 TAC §101.4 to eliminate two procedural requirements for temporary dental license holders

CHAPTER 101. DENTAL LICENSURE22 TAC §101.4The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §101.4, concerning the requirements for temporary licensure by credentials. This amendment will remove the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. The amendment also clarifies that biennual not annual renewals are required. This rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.

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State Board of Dental Examiners

Proposed Rules

New 22 TAC §101.14, exempting certain military spouses from dental licensure requirements

CHAPTER 101. DENTAL LICENSURE22 TAC §101.14The State Board of Dental Examiners (Board) proposes new rule §101.14 concerning Exemption from Licensure for Certain Military Spouses. The proposed new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.New rule §101.14, Exemption from Licensures for Certain Military Spouses regarding dentists, allows qualified military spouses to practice dentistry without obtaining a license to practice dentistry during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

State Board of Dental Examiners

Proposed Rules

New 22 TAC §101.15, clarifying considerations for the renewal of a cancelled dental license

CHAPTER 101. DENTAL LICENSURE22 TAC §101.15The State Board of Dental Examiners (Board) proposes new rule 22 TAC §101.15, concerning Reinstatement of a Cancelled License. This rule will clarify the Board’s considerations when reviewing an application for licensure for an applicant who previously held a Texas license that expired and was subsequently cancelled.

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State Board of Dental Examiners

Proposed Rules

Amending 22 TAC §103.3 to place the responsibility of performing Level II background verification for dental hygiene licensure on the Board

CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.3The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §103.3, concerning the requirements for licensure by credentials. This amendment will remove the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. This rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.

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State Board of Dental Examiners

Proposed Rules

Amending 22 TAC §103.4 to eliminate two procedural requirements for temporary dental hygiene license holders

CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.4The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §103.4, concerning the requirements for temporary licensure by credentials. This amendment will remove the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. The amendment also clarifies that biennial not annual renewals are required. This rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.

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State Board of Dental Examiners

Proposed Rules

New 22 TAC §103.10, exempting certain military spouses from dental hygiene licensure requirements

CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.10The State Board of Dental Examiners (Board) proposes new rule 22 TAC §103.10, concerning Exemption from Licensure for Certain Military Spouses. The proposed new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.New rule 22 TAC §103.10, Exemption from Licensures for Certain Military Spouses, regarding dental hygienists, allows qualified military spouses to practice as a dental hygienist without obtaining a dental hygienist license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

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State Board of Dental Examiners

Proposed Rules

New 22 TAC §103.11, clarifying considerations for the renewal of a cancelled dental hygiene license

CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.11The State Board of Dental Examiners (Board) proposes new rule 22 TAC §103.11 concerning Reinstatement of a Cancelled License. This rule will clarify the Board’s considerations when reviewing an application for licensure for an applicant who previously held a Texas license that expired and was subsequently cancelled.

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State Board of Dental Examiners

Proposed Rules

New 22 TAC §114.7, exempting certain military spouses from dental assistant licensure requirements

CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS22 TAC §114.7The State Board of Dental Examiners (Board) proposes new rule 22 TAC §114.7 concerning Exemption from Licensure for Certain Military Spouses. The proposed new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.New rule 22 TAC §114.7, Exemption from Licensure for Certain Military Spouses regarding dental assistants, allows qualified military spouses to practice as a dental assistant without obtaining a registration to practice as a dental assistant during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active registration in good standing in another state with substantially equivalent requirements for registration as Texas.

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Texas Medical Board

Withdrawn Rule

Withdrawing the emergency adoption of the amendment to 22 TAC §178.4, concerning complaints

CHAPTER 178. COMPLAINTS22 TAC §178.4The Texas Medical Board withdraws the emergency adoption of the amendment to §178.4, which appeared in the April 3, 2020, issue of the Texas Register (44 TexReg 2277).

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Texas Medical Board

Withdrawn Rule

Withdrawing the emergency adoption of the amendment to 22 TAC §187.57, concerning temporary suspension and restriction proceedings

SUBCHAPTER F. TEMPORARY SUSPENSION AND RESTRICTION PROCEEDINGS22 TAC §187.57The Texas Medical Board withdraws the emergency adoption of the amendment to §187.57, which appeared in the April 3, 2020, issue of the Texas Register (45 TexReg 2278).

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Texas Health and Human Services Commission

Adopted Rules

New 1 TAC §354.1369, updating base wage requirements for personal attendants in Community First Choice personal assistances services and habilitation programs

CHAPTER 354. MEDICAID HEALTH SERVICESSUBCHAPTER A. PURCHASED HEALTH SERVICESDIVISION 27. COMMUNITY FIRST CHOICE1 TAC §354.1369OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §354.1369, concerning Attendant Base Wage. New §354.1369 is adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 823). Therefore, the rule will not be republished.New §354.1369, Attendant Base Wage, requires that providers of Community First Choice (CFC) personal assistance services and CFC Habilitation pay a personal attendant at least the base wage specified in new §355.7051, which is $8.11 per hour. BACKGROUND AND JUSTIFICATIONThe purpose of the new rule is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of this new rule, the minimum hourly base wage for a personal attendant was referenced in multiple rules. The Executive Commissioner is adopting new §355.7051, Base Wage for a Personal Attendant, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section. Elsewhere in this issue of the Texas Register, HHSC is amending rules in Title 40, Chapters 9, 41, 44, and 49, and Title 1, Chapter 363, to cross-reference new §355.7051 and remove specific base wage provisions or superseded cross-references to base wage requirements.

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Texas Health and Human Services Commission

Adopted Rules

New 1 TAC §355.7051, consolidating personal attendant base wage requirements for all HHSC programs and services into one section

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER H. BASE WAGE REQUIREMENTS FOR PERSONAL ATTENDANTS1 TAC §355.7051OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §355.7051, concerning Base Wage for a Personal Attendant, in new Subchapter H, Base Wage Requirements for Personal Attendants. New §355.7051 is adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 825). Therefore, the rule will not be republished.The executive commissioner is adopting new §355.7051, Base Wage for a Personal Attendant, so that the base wage requirements for all of HHSC’s programs and services will be contained in this one section.BACKGROUND AND JUSTIFICATIONThe purpose of the new rule is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of this new rule, the minimum hourly base wage for a personal attendant was referenced in multiple rules. Elsewhere in this issue of the Texas Register, the executive commissioner is amending or adding new rules in Title 40, Chapters 9, 41, 44, and 49, and Title 1, Chapter 354 and 363, to cross-reference the base wage requirements in new §355.7051 and remove specific base wage provisions or superseded cross-references to base wage requirements.

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Texas Health and Human Services Commission

Adopted Rules

Amending 1 TAC §363.603 to update references to personal attendant base wage requirements for Texas Health Steps Comprehensive Care Program providers

CHAPTER 363. TEXAS HEALTH STEPS COMPREHENSIVE CARE PROGRAMSUBCHAPTER F. PERSONAL CARE SERVICES1 TAC §363.603OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts an amendment to §363.603, concerning Provider Participation Requirements. The amendment to §363.603 is adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 828). Therefore, the rule will not be republished.BACKGROUND AND JUSTIFICATIONThe purpose of the amendment is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of this amendment, the minimum hourly base wage for a personal attendant was referenced in multiple rules. The executive commissioner is adopting new §355.7051, Base Wage for a Personal Attendant, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section. As a result of this consolidation, the executive commissioner is, at the same time, amending §363.603 and amending or adding new rules in Title 40, Chapters 9, 41, 44, and 49, and Title 1, Chapter 354, to cross-reference the base wage requirements in new §355.7051 and remove specific base wage provisions or superseded cross-references to base wage requirements.

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Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §9.177 and §9.579 to update references to personal attendant base wage requirements for the Home and Community Based Services and Community First Choice programs

CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIESSUBCHAPTER D. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)40 TAC §9.177, §9.579OVERVIEWThe Executive Commissioner of HHSC adopts amendments to Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, §9.177, concerning Certification Principles: Staff Member and Service Provider Requirements; and §9.579, concerning Certification Principles: Staff Member and Service Provider Requirements. The amendments are adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 877). The rules will not be republished.As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of 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. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants’ from $8.00 to $8.11 per hour. Prior to the adoption of these amendments, the minimum hourly base wage for a personal attendant was referenced in multiple rules. The Executive Commissioner is adopting new §355.7051 in Texas Administrative Code, Title 1, Chapter 355, Base Wage for a Personal Attendant, in this issue of the Texas Register, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section of Title 1. As a result of the consolidation of base wage requirements in Chapter 355 of Title 1, amendments are being adopted in §49.312 to delete the base wage requirements in that section and instead reference new §355.7051. Because §49.312 is being amended, amendments to §9.177 and §9.579 are also being adopted to correct the references to §49.312.

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Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §44.302 to update references to personal attendant base wage requirements for the Consumer Managed Personal Attendant Services program

CHAPTER 44. CONSUMER MANAGED PERSONAL ATTENDANT SERVICES (CMPAS) PROGRAMSUBCHAPTER C. SERVICE DELIVERY IN ALL CMPAS OPTIONS40 TAC §44.302OVERVIEWThe Executive Commissioner of HHSC adopts amendments to Title 40, Part 1, Chapter 44, Consumer Managed Personal Attendant Services (CMPAS) Program, §44.302, concerning Provider Qualifications and Responsibilities in All CMPAS Service Delivery Options.As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of 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. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of these amendments, the minimum hourly base wage for a personal attendant was referenced in multiple rules. In the Consumer Managed Personal Attendant Services (CMPAS) Program, CMPAS providers in all service delivery options have been required in §44.302 to comply with Chapter 49, including the requirements in §49.312 for payment of a base wage to personal attendants. However, the Executive Commissioner is adopting new §355.7051, Base Wage for a Personal Attendant, in Texas Administrative Code, Title 1, Part 15, Chapter 355, in this issue of the Texas Register, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section of Title 1. As a result of this consolidation of base wage requirements in Chapter 355 of Title 1, §49.312 in Title 40, as amended in this issue of the Texas Register, no longer refers to the base wage requirements, and instead references new §355.7051. Amendments to §44.302 are therefore being adopted in this issue of the Texas Register to specifically cross-reference the base wage requirements in new §355.7051 of Title 1, rather than including through general cross reference to Chapter 49 in Title 40. Clarifying amendments to §44.442 are also adopted to more clearly and directly reference the base wage requirements of new §355.7051.

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Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §41.505 to update references to personal attendant base wage requirements for consumer directed services

CHAPTER 41. CONSUMER DIRECTED SERVICES OPTIONSUBCHAPTER E. BUDGETS40 TAC §41.505OVERVIEWThe Executive Commissioner of HHSC adopts an amendment to Title 40, Part 1, Chapter 41, Consumer Directed Services Option, §41.505, concerning Payroll Budgeting. The amendment is adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 879). The rule will be not republished.As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of 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. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. BACKGROUND AND JUSTIFICATIONThe purpose of the amendment is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of this amendment, the minimum hourly base wage for a personal attendant was referenced in multiple rules. In the consumer-directed services (CDS) option, the requirements for payment of a base wage to personal attendants were in §41.505. The Executive Commissioner is adopting new §355.7051, Base Wage for a Personal Attendant, in Texas Administrative Code (TAC) Title 1, Part 15, Chapter 355, in this issue of the Texas Register, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section of Title 1. As a result of the consolidation of base wage requirements in Chapter 355 of Title 1, §41.505 is being amended in this issue of the Texas Register to replace its specific base wage requirements with a cross reference to new §355.7051.

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Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §44.422 to update references to personal attendant base wage requirements for the block grant option in the Consumer Managed Personal Attendant Services program

CHAPTER 44. CONSUMER MANAGED PERSONAL ATTENDANT SERVICES (CMPAS) PROGRAMSUBCHAPTER D. SERVICE DELIVERY OPTIONSDIVISION 2. BLOCK GRANT OPTION40 TAC §44.422OVERVIEWThe Executive Commissioner of HHSC adopts amendments to Title 40, Part 1, Chapter 44, Consumer Managed Personal Attendant Services (CMPAS) Program, §44.422, concerning Individual Responsibilities in the Block Grant Option. The amendments are adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 881). The rules will not be republished.As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of 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. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of these amendments, the minimum hourly base wage for a personal attendant was referenced in multiple rules. In the Consumer Managed Personal Attendant Services (CMPAS) Program, CMPAS providers in all service delivery options have been required in §44.302 to comply with Chapter 49, including the requirements in §49.312 for payment of a base wage to personal attendants. However, the Executive Commissioner is adopting new §355.7051, Base Wage for a Personal Attendant, in Texas Administrative Code, Title 1, Part 15, Chapter 355, in this issue of the Texas Register, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section of Title 1. As a result of this consolidation of base wage requirements in Chapter 355 of Title 1, §49.312 in Title 40, as amended in this issue of the Texas Register, no longer refers to the base wage requirements, and instead references new §355.7051. Amendments to §44.302 are therefore being adopted in this issue of the Texas Register to specifically cross-reference the base wage requirements in new §355.7051 of Title 1, rather than including through general cross reference to Chapter 49 in Title 40. Clarifying amendments to §44.442 are also adopted to more clearly and directly reference the base wage requirements of new §355.7051.

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Texas Department on Aging and Disability Services

Adopted Rules

Amending 40 TAC §49.102 and §49.312 to update references to personal attendant base wage requirements regarding contracting for community services

CHAPTER 49. CONTRACTING FOR COMMUNITY SERVICESSUBCHAPTER A. APPLICATION AND DEFINITIONS40 TAC §49.102SUBCHAPTER C. REQUIREMENTS OF A CONTRACTOR40 TAC §49.312OVERVIEWThe Executive Commissioner of HHSC adopts amendments to Title 40, Part 1, Chapter 49, Contracting for Community Services, §49.102, concerning Definitions; and §49.312, concerning Personal Attendants. The amendments are adopted without changes to the proposed text as published in the February 7, 2020, issue of the Texas Register (45 TexReg 883). The rules will not be republished.As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of 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. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. BACKGROUND AND JUSTIFICATIONThe purpose of the amendments is to implement Rider 45 of the 2020-21 General Appropriations Act (GAA), Article II, HHSC, House Bill (H.B.) 1, 86th Legislature, Regular Session, 2019 (Rider 45). Rider 45 appropriated funds to HHSC to increase the minimum base wage paid to “personal attendants” from $8.00 to $8.11 per hour. Prior to the adoption of these amendments, the minimum hourly base wage for a personal attendant in programs and services administered by HHSC was referenced in multiple rules. HHSC is adopting new §355.7051 in Texas Administrative Code, Title 1 Chapter 355, Base Wage for a Personal Attendant, in this issue of the Texas Register, so that the base wage requirements for all of HHSC’s programs and services will be contained in that one section of Title 1. For contractors subject to Chapter 49, the requirements for payment of a base wage to personal attendants were in §49.312, Personal Attendants. As a result of the consolidation of base wage requirements in Chapter 355 of Title 1, an amendment to §49.312 is being adopted to delete the base wage requirements in that section and instead reference new §355.7051. An amendment is also being adopted to §49.102 to delete the definition of “personal attendant” because the definition of that term is in new §355.7051.

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Texas Council for Developmental Disabilities

In Addition

TCDD requests applications for funding to promote family support and financial planning for adults with intellectual and developmental disabilities

OVERVIEWThe Texas Council for Developmental Disabilities (TCDD) announces the availability of funds for one organization to develop a project to increase the number of adults with intellectual and developmental disabilities (IDD) who have effective financial and family support plans. While individuals and/or their caregivers age, plans will ensure funds, services, and supports are available and flexible enough to allow adults with IDD to remain in their homes and in the community, and to exercise control over their own lives. Trainings and tools may be developed so family members and caregivers can implement individualized financial planning strategies for individuals with IDD. Also, trainings may be developed so service providers and other professionals can support individuals and families to plan for future financial and support needs.FUNDINGTCDD has approved funding for up to one project for up to $100,000, per year, for up to two years. Funds available for this project is provided to TCDD by the U.S. Department of Health and Human Services, Administration on Disabilities, pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Funding for the project is dependent on the results of a review process established by TCDD and on the availability of funds. Non-federal matching funds of at least 10% of the total project costs are required for a project in federally designated poverty areas. Non-federal matching funds of at least 25% of total project costs are required for a project in other areas.APPLICATION PROCESSAdditional information concerning this Request for Applications (RFA) and TCDD is available at https://tcdd.texas.gov/grants-rfas/funding-available-for-grants/. All questions pertaining to this RFA should be directed in writing to TCDD via email at apply@tcdd.texas.gov or via telephone at (512) 437-5432.Applications must be submitted through https://tcdd.smapply.org/prog/lst/ and will be reviewed by TCDD according to the following schedule: applications received by 11:59 p.m. on June 29, 2020, may be reviewed at the August 2020 Council meeting; applications received by 11:59 p.m. on September 28, 2020, may be reviewed at the November 2020 Council meeting.

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Texas Council for Developmental Disabilities

In Addition

TCDD requests applications for funding to promote money management skills among adults with intellectual and developmental disabilitie

OVERVIEWThe Texas Council for Developmental Disabilities (TCDD) announces the availability of funds for one organization to develop a universally available or replicable model that will increase the money management skills of adults with intellectual and developmental disabilities (IDD). If people with IDD manage their money effectively, they will be more likely to be able to save for the future, stay out of debt, and ultimately have more control over their own lives. The project will develop and provide money management skills training, and also develop resources and tools adults with IDD can use in real-life situations beyond the duration of the project.FUNDINGTCDD has approved funding for up to one project for up to $150,000, per year, for up to five years. Funds available for this project is provided to TCDD by the U.S. Department of Health and Human Services, Administration on Disabilities, pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Funding for the project is dependent on the results of a review process established by TCDD and on the availability of funds. Non-federal matching funds of at least 10% of the total project costs are required for a project in federally designated poverty areas. Non-federal matching funds of at least 25% of total project costs are required for a project in other areas.APPLICATION PROCESSAdditional information concerning this Request for Applications (RFA) and TCDD is available at https://tcdd.texas.gov/grants-rfas/funding-available-for-grants/. All questions pertaining to this RFA should be directed in writing to TCDD via email at apply@tcdd.texas.gov or via telephone at (512) 437-5432.Deadline: Applications must be submitted through https://tcdd.smapply.org/prog/lst/ and will be reviewed by TCDD according to the following schedule: applications received by 11:59 p.m. on June 29, 2020, may be reviewed at the August 2020 Council meeting; applications received by 11:59 p.m. on September 28, 2020, may be reviewed at the November 2020 Council meeting.

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Texas Health and Human Services Commission

In Addition

HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, requesting funding for in vitro COVID-19 diagnostic testing

Public Notice – Texas State Plan for Medical Assistance Amendments Related to the COVID-19 PandemicThe Texas Health and Human Services Commission (HHSC) announces its intent to submit a disaster amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act as authorized under the Presidential emergency in response to the COVID-19 pandemic. The proposed amendment is effective March 18, 2020, during the period of the Presidential emergency declarations related to the COVID-19 outbreak. The amendment expires at the end of the emergency period.The purpose of the amendment is for Medicaid to provide coverage of specific services for individuals who meet Medicaid citizenship or immigration status requirements, are uninsured, and do not have Medicaid, CHIP, or another form of minimum essential coverage health insurance (as defined in the Social Security Act, Section 1902(ss)). The amendment is for Medicaid to cover the following services: In vitro COVID-19 diagnostic testing and administration of that testing.

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