Texas Register May 26, 2023 Volume: 48 Number: 21

Texas Register Table of Contents

Governor

Proclamations Re:

The Governor issues Proclamation 41-3971, to renew the disaster proclamation in response to the ongoing COVID–19 disaster.

OVERVIEW

In accordance with the authority vested by Section 418.014 of the Texas Government Code, the Governor hereby renews the disaster proclamation for all counties in Texas.


Texas Optometry Board

Proposed Rules Re:

Amending 22 TAC §§271.2, 271.3, 271.5, 271.6, to update the licensing and renewal processes.

CHAPTER 271. EXAMINATIONS
22 TAC §§271.2, 271.3, 271.5, 271.6

OVERVIEW

The Texas Optometry Board proposes amendments to 22 TAC Chapter 271, Examinations, §§271.2, 271.3, 271.5 and 271.6.

BACKGROUND AND JUSTIFICATION

The rules in the Chapter 271 were reviewed by the Board’s Administration and Licensing Committee in January 2023 to ensure the licensing and renewal process was efficient and effective. At the January 19, 2023, committee meeting, members voted to move forward with changes to update and modernize the process and to refer the proposal to the Rules Committee. At the April 27, 2023, Rules Committee meeting, the members concurred with the recommendations of the Administration and Licensing Committee and proposed the following amendments to the licensing and renewal process.

During the April 28, 2023, meeting the Board determined that there continues to be a need for the rules in Chapter 271. The Board has also determined that changes to certain rules as currently in effect are necessary. The specific rules being amended include: §271.2 Applications; §271.3 Jurisprudence Examination Administration; §271.5 Licensure without Examination; and §271.6 National Board Examination.

SECTION-BY-SECTION SUMMARY

The amendments outlined in this proposal include non-substantive changes to all references from “board” to “Board” and from “executive director” to “Executive Director.”

  • In §271.2 Applications, the Board proposes to amend the title of the rule to read “Applications for Licensure as Therapeutic Optometrist”; to update the documents required for licensure; to update the statutory reference to Texas Occupations Code Chapter 53 as it relates to convictions that must be reported upon application; to state that applications must be approved within one year of application submission or applicants will have to reapply; to set out requirements for applicants who are licensed in other states; and to remove arcane language related to scheduling the jurisprudence exam as the Board will allow an applicant to take the exam at any point.
  • In §271.3 Jurisprudence Examination Administration, the Board proposes to amend the title of the rule to read “Jurisprudence Examination”; to clarify the jurisprudence exam is an “open book” exam; to remove arcane language related to scheduling the jurisprudence exam as the Board will allow an applicant to take the exam at any point; to state that jurisprudence exam scores are only valid for one year and if an applicant fails to get licensed in that year, applicants will have to retake the exam; and to remove language related to the administration of the exam as the Board has outsourced the exam administration to another entity.
  • In §271.5 Licensure without Examination, the Board proposes to clarify that the rule only applies to those applicants who have not taken Part III of the National Board of Examiners in Optometry and to make other non-substantive grammatical changes and references to statute.
  • In §271.6 National Board Examination, the Board proposes to remove language regarding the jurisprudence exam as it is referenced in a separate rule; and to make other non-substantive grammatical changes and references to statute.

Amending 22 TAC § 279.1, to require the optometrist or therapeutic optometrist to “examine in-person” instead of “personally make” certain findings during the initial visit.

CHAPTER 279. INTERPRETATIONS
22 TAC §279.1

OVERVIEW

The Texas Optometry Board proposes amendments to 22 TAC Chapter 279, §279.1 – Contact Lens Examination.

The Board initially proposed amendments in the November 25, 2022, issue of the Texas Register (47 TexReg 7843), but officially withdrew those rules on April 28, 2023 (published in the May 12, 2023, issue of the Texas Register ). At the April 28, 2023, Board meeting the Board adopted a new proposal as follows.

The amendment requires the optometrist or therapeutic optometrist to “examine in-person” instead of “personally make” certain findings during an initial visit. It states that the findings must be made unless prohibited by the patient’s unique condition instead of “if possible.” It requires the optometrist or therapeutic optometrist to personally notate why it is not possible to record the required findings.

It clarifies that for discipline purposes, the charges must state the specific instances in which it is alleged that the optometrist or therapeutic optometrist did not comply with the rule.

Finally, the amendment makes non-substantive capitalization changes to ensure consistency across the Board’s rules.

BACKGROUND AND JUSTIFICATION

The rules in the Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code §2001.039. Notice of the review was published in the June 10, 2022, issue of the Texas Register (47 TexReg 3487). No comments were received regarding the Board’s notice of review.

The Board has determined that there continues to be a need for the rules in Chapter 279. The Board has also determined that changes to §279.1 as currently in effect are necessary.


Amending 22 TAC § 279.3, clarifying the requirements for a discipline charge.

CHAPTER 279. INTERPRETATIONS
22 TAC §279.3

OVERVIEW

The Texas Optometry Board proposes amendments to 22 TAC Chapter 279, §279.3 – Spectacle Examination.

BACKGROUND AND JUSTIFICATION

The rules in Chapter 279 were reviewed as a result of the Board’s general rule review under Texas Government Code §2001.039. Notice of the review was published in the June 10, 2022, issue of the Texas Register (47 TexReg 3487). No comments were received regarding the Board’s notice of review.

The Board has determined that there continues to be a need for the rules in Chapter 279. The Board has also determined that changes to §279.3 as currently in effect are necessary.


Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC § 181.62, to clarify the documentation requirements for a person’s name and place of birth.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER E. DELAYED REGISTRATION
25 TAC §181.62

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes an amendment to 25 TAC §181.62, concerning Documentary Evidence; Requirements and Acceptability.

BACKGROUND AND JUSTIFICATION

The purpose of this amendment is to assist people seeking a delayed registration of birth, despite having contradictory documents regarding parentage. Under the current rule, people are unable to obtain a delayed registration of birth if documents presented to the State Registrar contain contradictory information. An inability to obtain a birth certificate may impact a person’s ability to obtain state-issued identification documents, passports, or possibly other governmental benefits. This rule change would assist persons unable to have their birth recorded by requiring that documents not be contradictory on name, date and place of birth, and the identity of one parent. If there are contradictory documents regarding the second parent, the proposed amendment would require that the second parent will not be recorded and the field for that parent remain blank on any birth certificate issued.

The amendment also clarifies the number and types of acceptable documents to submit with a request to record a delayed registration of birth.

SECTION-BY-SECTION SUMMARY

  • The amendment to §181.62(a)(1)(A) and (B) states the name of the person and the date and place of birth shall be supported by at least two documents, only one of which may be an affidavit of personal knowledge, if the birth occurred at least four years but less than 15 years before the date of the application; or three documents, only one of which may be an affidavit of personal knowledge, if the birth occurred 15 or more years before the date of the application.
  • The amendment to §181.62(b)(5) states that documents shall not contain contradictory information regarding the person’s name, date and place of birth, and the identity of one parent. If documents contain contradictory information regarding a second parent, then no information for the second parent will be recorded or entered on any birth certificate issued.

In Addition Re:

Administrative Foods Group Penalty Matrix Guidance 2023

For more information, please visit this week’s edition of the Texas Register at 48 Tex Reg 2761.


Texas Health and Human Services Commission

Proposed Rules Re:

New 26 TAC §§284.101, 284.103, 284.105, 284.107, 284.109, 284.111, implementing the Competitive and Integrated Employment Initiative for certain Medicaid recipients.

CHAPTER 284. COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS
26 TAC §§284.101, 284.103, 284.105, 284.107, 284.109, 284.111

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §284.101, concerning Purpose; §284.103, concerning Applicability; §284.105, concerning Uniform Process; §284.107, concerning Strategies to Increase Number of Individuals Receiving Employment Services; §284.109, concerning Referrals to the Texas Workforce Commission; and §284.111 concerning Increasing the Number of Individuals Receiving Employment Services.

BACKGROUND AND JUSTIFICATION

The Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), Texas Home Living (TxHmL), and STAR+PLUS Home and Community-based Services (STAR+PLUS HCBS) programs each provide employment services. Employment assistance assists an individual in locating competitive employment in the community. Supported employment assists an individual in sustaining competitive employment.

The purpose of the proposed rules is to implement Texas Government Code §531.02448, regarding the employment first initiative, added by Senate Bill (S.B.) 50, 87th Legislature, Regular Session, 2021.

To implement S.B. 50, HHSC developed an HHSC Employment First Uniform Assessment Form to use in the CLASS, DBMD, HCS, TxHmL, and STAR+PLUS HCBS programs to determine an individual’s employment goals and the employment opportunities and employment services available to the individual in the individual’s program. The proposed rules require the entity responsible for developing an individual’s person-centered plan to determine an individual’s desire to work. The individual’s response will need to be documented in the individual’s person-centered service plan. When the individual indicates a desire to work, the responsible entity will complete the HHSC Employment First Uniform Assessment Form at the time the plan is developed, annual renewals, or revisions.

After completing the HHSC Employment First Uniform Assessment Form, if an individual’s person-centered service plan does not include employment services through the program in which the individual is enrolled, the proposed rules require an individual’s case manager, service coordinator, or managed care organization (MCO) to refer the individual to the Texas Workforce Commission (TWC) for employment services available through the TWC.

SECTION-BY-SECTION SUMMARY

  • Proposed new §284.101 describes the purpose of new Chapter 284. The proposed rule establishes that the rules in Chapter 284 must be read in conjunction with the rules and policies related to the Medicaid waiver program listed in proposed §284.103 in which an individual is enrolled.
  • Proposed new §284.103 lists the HHSC §1915(c) and §1115 Medicaid programs to which new Chapter 284 applies.
  • Proposed new §284.105 covers the steps a case manager, service coordinator, or MCO must follow if an individual’s service planning team records the individual’s desire to work, during completion of the Employment First Uniform Assessment Form. The proposed rule identifies reasons to use the HHSC Employment First Uniform Assessment Form and instances under which an individual’s service planning team must utilize the individual’s employment goals and the employment services to develop an individual’s person-centered service plan during enrollment, annual renewals, and revisions.
  • Proposed new §284.107 describes the strategies HHSC will utilize to increase the number of individuals receiving employment services from the TWC or through the program in which an individual is enrolled.
  • Proposed new §284.109 describes the terms under which an individual’s case manager, service coordinator, or MCO must refer the individual to the TWC for employment services available through the TWC.
  • Proposed new §284.111 specifies HHSC’s determination that the number of individuals receiving employments on December 31, 2023, from the TWC or through the program in which the individuals are enrolled will be at least five percent greater than the number of individuals receiving employment services on December 31, 2022.

Adopted Rules Re:

New 1 TAC §353.610, which establishes minimum performance standards for nursing facility providers that participate in the STAR+PLUS Program.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER G. STAR+PLUS
1 TAC §353.610

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new §353.610, concerning Minimum Performance Standards for Nursing Facilities that Participate in the STAR+PLUS Program.

The new section is adopted without changes to the proposed text as published in the February 17, 2023, issue of the Texas Register (48 TexReg 783). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The adopted rule implements Texas Government Code §533.00251(h), added by House Bill 2658, 87th Legislature, Regular Session, 2021. Texas Government Code §533.00251 requires HHSC to establish minimum performance standards for nursing facility providers seeking to participate in the STAR+PLUS Medicaid managed care program. Subsection (h) directs HHSC to adopt rules establishing standards for nursing facility providers that participate in the STAR+PLUS program; monitor provider performance in accordance with the standards and requiring corrective action, as HHSC determines necessary, from providers that do not meet the standards; and share data regarding the requirements with STAR+PLUS Medicaid managed care organizations, as appropriate.


Transferred Rules Re:

Transferring rules regarding Medicaid State Operating Agency Responsibilities, Subchapter D, Home and Community-Based Services (HCS) Program and Community First Choice (CFC), §9.181, and Administrative Penalties from DAD to HHSC.

OVERVIEW

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. The former DADS rule in Texas Administrative Code, Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, Subchapter D, Home and Community-Based Services (HCS) Program and Community First Choice (CFC), §9.181, Administrative Penalties is being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 565, Home and Community-Based Services (HCS) Program Certification Standards, Subchapter G, HHSC Actions, §565.45, Administrative Penalties.


Transferring rules regarding Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, Subchapter N, Texas Home Living (TXHML) Program and Community First Choice (CFC) from DAD to HHSC.

OVERVIEW

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. Certain former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, Subchapter N, Texas Home Living (TXHML) Program and Community First Choice (CFC) are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 566, Texas Home Living (TXHML) Program and Community First Choice (CFC) Certification Standards.


Department of Aging and Disability Services

Transferred Rules Re:

Transferring rules regarding Medicaid State Operating Agency Responsibilities, Subchapter D, Home and Community-Based Services (HCS) Program and Community First Choice (CFC), §9.181, and Administrative Penalties from DAD to HHSC.

OVERVIEW

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. The former DADS rule in Texas Administrative Code, Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, Subchapter D, Home and Community-Based Services (HCS) Program and Community First Choice (CFC), §9.181, Administrative Penalties is being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 565, Home and Community-Based Services (HCS) Program Certification Standards, Subchapter G, HHSC Actions, §565.45, Administrative Penalties.


Transferring rules regarding Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, Subchapter N, Texas Home Living (TXHML) Program and Community First Choice (CFC) from DAD to HHSC.

OVERVIEW

During the 84th Legislative Session, the Texas Legislature passed Senate Bill 200, addressing the reorganization of health and human services delivery in Texas. As a result, some agencies were abolished and their functions transferred to the Texas Health and Human Services Commission (HHSC). Texas Government Code, §531.0202(b), specified the Department of Aging and Disability Services (DADS) be abolished September 1, 2017, after all its functions were transferred to HHSC in accordance with Texas Government Code, §531.0201 and §531.02011. Certain former DADS rules in Texas Administrative Code, Title 40, Part 1, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, Subchapter N, Texas Home Living (TXHML) Program and Community First Choice (CFC) are being transferred to Texas Administrative Code, Title 26, Part 1, Chapter 566, Texas Home Living (TXHML) Program and Community First Choice (CFC) Certification Standards.