Texas Register - November 12, 2021 Volume: 46 Number: 46

Texas Register Table of Contents

1 The Governor
- - 1.0.1 Appointments Re:
    - 1.0.1.1 Governor appoints three individuals to the Texas State Board of Examiners of Psychologists.
2 Department of State Health Services
- - 2.0.1 Emergency Rules Re:
    - 2.0.1.1 Amending 25 TAC §448.911 to temporarily permit a currently licensed chemical dependency treatment facility (CDTF) to provide treatment services through electronic means to both adult and adolescent clients.
  - 2.0.2 Adopted Rules Re:
    - 2.0.2.1 New 25 TAC §1.65, describing requirements for low-THC cannabis research.
3 State Board of Dental Examiners
- - 3.0.1 Proposed Rules Re:
    - 3.0.1.1 New 22 TAC §108.16, describing requirements concerning teledentistry.
4 Health and Human Services Commission
- - 4.0.1 Proposed Rules Re:
  - 4.0.2 Adopted Rules Re:
5 Texas State Board of Examiners of Professional Counselors
- - 5.0.1 Adopted Rules Re:
6 Texas Behavioral Health Executive Council
- - 6.0.1 Adopted Rules Re:
    - 6.0.1.1 Amending 22 TAC §883.1 to modify the assessment of late fees related to renewal of a license.
7 Texas Board of Occupational Therapy Examiners
- - 7.0.1 Adopted Rules Re:
    - 7.0.1.1 Amending 40 TAC §364.5 to update requirements for licensure by allowing a military spouse to show proof of residency by submitting a permanent change of station order.

The Governor

Appointments Re:

Governor appoints three individuals to the Texas State Board of Examiners of Psychologists.

Appointments for November 1, 2021

Appointed to the Texas State Board of Examiners of Psychologists, for a term to expire October 31, 2027:

John K. Bielamowicz of Waxahachie, Texas (Mr. Bielamowicz is being reappointed).
Mark E. Cartwright, Ph.D. of Dallas, Texas (replacing Ronald S. “Ron” Palomares, Ph.D. of Dallas, whose term expired).
Roxana I. Lambdin, Ph.D. of Kerrville, Texas (replacing Susan Fletcher, Ph.D. of Plano, whose term expired).

Department of State Health Services

Emergency Rules Re:

Amending 25 TAC §448.911 to temporarily permit a currently licensed chemical dependency treatment facility (CDTF) to provide treatment services through electronic means to both adult and adolescent clients.

CHAPTER 448. STANDARD OF CARE
SUBCHAPTER I. TREATMENT PROGRAM SERVICES
25 TAC §448.911

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 25 Texas Administrative Code, Chapter 448, Standard of Care, an amendment to §448.911, concerning an emergency rule in response to COVID-19 to expand a licensed chemical dependency treatment facility’s ability to provide treatment services through electronic means to adults and adolescents to reduce the risk of COVID-19 transmission.

HHSC is adopting an emergency rule amendment to §448.911(a)(1) to temporarily permit a currently licensed chemical dependency treatment facility (CDTF) to provide treatment services through electronic means to both adult and adolescent clients. This emergency rule amendment will reduce the risk of COVID-19 transmission and expand access to treatment for clients.

BACKGROUND AND JUSTIFICATION

As authorized by Texas 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 Texas 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. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule amendment to Treatment Services Provided by Electronic Means.

Adopted Rules Re:

New 25 TAC §1.65, describing requirements for low-THC cannabis research.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER D. LOW-THC CANNABIS FOR COMPASSIONATE USE
25 TAC §1.65

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts new §1.65, relating to Compassionate-use Research and Reporting. The new section is adopted with changes to the proposed text as published in the August 20, 2021, issue of the Texas Register (46 Tex Reg 5164). The rule will be republished.

BACKGROUND AND JUSTIFICATION

The new section is necessary to comply with House Bill (H.B.) 1535, 87th Legislature, Regular Session, 2021, which amended Texas Health and Safety Code, Chapter 487 by adding Subchapter F, Compassionate-use Research and Reporting. H.B. 1535 requires the Executive Commissioner of HHSC to adopt rules to implement Subchapter F. H.B. 1535 also states that a compassionate-use institutional review board (CIRB) may be established to evaluate, approve, and oversee research programs to study the medical use of low-THC cannabis and must submit written reports that describe and assess the research findings to HHSC and the Legislature. The Executive Commissioner charged the implementation of H.B. 1535 to DSHS.

State Board of Dental Examiners

Proposed Rules Re:

New 22 TAC §108.16, describing requirements concerning teledentistry.

CHAPTER 108. PROFESSIONAL CONDUCT
SUBCHAPTER A. PROFESSIONAL RESPONSIBILITY
22 TAC §108.16

The State Board of Dental Examiners (Board) proposes new rule 22 TAC §108.16, concerning teledentistry. The proposed rule pertains to standards for the provision of teledentistry dental services as set out in House Bill 2056 of the 87th Texas Legislature, Regular Session (2021), and Chapter 111, Texas Occupations Code.

Health and Human Services Commission

Proposed Rules Re:

Amending 26 TAC §558.303 to outline vaccine standards for a Home and Community Support Services Agency (HCSSA) to treat or mitigate the spread of a communicable disease.

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
DIVISION 4. PROVISION AND COORDINATION OF TREATMENT SERVICES
26 TAC §558.303

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §558.303, concerning Standards for Possession of Sterile Water or Saline, Certain Vaccines or Tuberculin, and Certain Dangerous Drugs.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement Texas Health and Safety Code §142.0062(a) amended by House Bill 797, 87th Legislature, Regular Session, 2021. Section 142.0062(a) allows a Home and Community Support Services Agency (HCSSA) to purchase, store, or transport for administering any vaccine approved, authorized for emergency use, or otherwise permitted by the United States Food and Drug Administration to treat or mitigate the spread of a communicable disease.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §558.303, Standards for Possession of Sterile Water or Saline, Certain Vaccines or Tuberculin, and Certain Dangerous Drugs, allows a HCSSA to purchase, store, or transport for administration any vaccine approved, authorized for emergency use, or otherwise permitted by the United States Food and Drug Administration to treat or mitigate the spread of a communicable disease.
The proposed amendment adds the word “household” to the list of entities that a HCSSA’s registered or licensed vocational nurses may administer vaccine to.
The proposed amendment requires a HCSSA to transport vaccines in a sealed portable container and requires a HCSSA to have policies and procedures that ensure the container is handled and stored properly in accordance with the vaccine manufacturer’s instructions and guidance from the Centers for Disease Control and Prevention.

New 26 TAC §570.1, §570.2, implementing provider rules during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER A. INTRODUCTION
26 TAC §570.1, §570.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.1, 570.2.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to create provider rules that apply to Assisted Living Facilities (ALFs), Day Activity Health Services (DAHS), Home and Community Support Services Agencies (HCSSAs), Prescribed Pediatric Extended Care Centers (PPECCs), Nursing Facilities (NFs), Intermediate Care Facilities for Individuals with and Intellectual Disability or Related Conditions (ICF/IIDs), Home and Community-based Services (HCS) program providers, and Texas Home Living (TxHmL) program providers during a contagious disease outbreak, epidemic, or pandemic.

The proposed rules implement Texas Health and Safety Code, Chapter 260B, Right to Essential Caregiver Visits for Certain Residents, created by Senate Bill (S.B.) 25, 87th Legislature, Regular Session, 2021. Chapter 260B states that all residents of an ALF, NF or ICF/IID and individuals receiving services through an HCS program provider in a residence have the right to designate an essential caregiver and have essential caregiver visits. A facility or program provider may not prohibit in-person visitation with an essential caregiver, except for certain limited periods of time as provided in Chapter 260B.

The proposed rules also implement Texas Health and Safety Code, Chapter 260C, In-Person Visitation with Religious Counselor, created by S.B. 572, 87th Legislature, Regular Session, 2021. Chapter 260C protects the religious liberty of each individual or resident of an HCSSA, NF, or ALF by prohibiting a HCSSA, NF, or ALF from preventing a resident or client from receiving in-person visitation with a religious counselor during a public health emergency unless there is a federal law or a federal agency that prohibits in-person visitation during that period.

The proposed rules were developed based on issues and concerns that arose during the COVID-19 pandemic and lessons learned that might be helpful to providers. The intent is to provide minimum standards for what a facility, DAHS, HCSAA, PPECC, and program provider must do during a contagious disease outbreak, epidemic, or pandemic related to visitation, testing, screening, reporting, quarantining or isolating of residents and individuals, and other infection prevention and control measures.

SECTION-BY-SECTION SUMMARY

Proposed new §570.1, Purpose and Application, states that proposed new Chapter 570 applies to all long-term care providers, including: ALFs, Day Activity Health Services (DAHS), HCSSAs, Prescribed Pediatric Extended Care Centers (PPECC), NFs, ICF/IIDs, HCS providers and TxHmL providers. The chapter requires all providers to comply with the chapter during a contagious disease outbreak, epidemic, or pandemic unless an executive order from the Governor of Texas, the President of the United States, or another applicable authority is more restrictive than these rules.
Proposed new §570.2, Definitions, provides definitions related to the new rules and includes clinical terms related to a contagious disease, outbreak, epidemic, or pandemic.

New 26 TAC §§570.101, 570.103, 570.105, 570.107, 570.109, 570.111, 570.113, describing requirements for assisted living facilities during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER B. ASSISTED LIVING FACILITIES
26 TAC §§570.101, 570.103, 570.105, 570.107, 570.109, 570.111, 570.113

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.101, 570.103, 570.105, 570.107, 570.109, 570.111, 570.113.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.101, Emergency Response to Outbreak, Epidemic, or Pandemic, requires an ALF to regularly check for and implement federal, state, and local guidance during a contagious disease outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic an ALF is required to maintain infection prevention and control measures. An ALF must put a protocol in place for receiving resident deliveries and develop communication plans for communicating with current and prospective residents, resident representatives, emergency contacts, and ALF staff.
Proposed new §570.103, Testing, describes an ALF’s testing and monitoring activities that must take place during a contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.105, Reporting, requires an ALF to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.107, Screening, provides screening criteria requirements, and requires an ALF to screen all visitors prior to them entering a facility, except emergency services personnel during an emergency. An ALF must keep a visitor log and post signage at all entrances of a facility prohibiting entry prior to being screened. Staff who do not pass screening must leave the facility. Residents who do not pass screening must be quarantined and monitored. The facility must allow those providing critical assistance including essential caregiver visitors into the facility if they pass the screening criteria.
Proposed new §570.109, Staff Requirements, requires an ALF to maintain adequate staffing levels and have a staffing plan in place to ensure staff are trained and supervised. At least one staff member must be responsible for infection control protocol. The ALF must document training was provided to staff about providing care to residents in isolation or quarantine, proper donning and doffing of PPE, disinfecting procedures, emergency preparedness plans, and other infection control plans.
Proposed new §570.111, Visitation, permits an ALF to change its visitation policies and procedures during a contagious disease outbreak, epidemic, or pandemic in response to directives from DSHS or HHSC. However, the new section prohibits an ALF from adopting visitation policies and procedures that are more restrictive than these directives or executive or local orders. The new section also requires an ALF to permit clergy, religious counselor, and end-of-life visits and allows an ALF to permit salon services visits. An ALF must adopt policies and procedures for in-person visitation with a religious counselor that comply with the provisions in this section. If an ALF allows salon services visits, the ALF must establish policies and procedures that provide conditions for a salon services visit to occur. Finally, the new section requires an ALF to immediately communicate to the resident representative any changes in a resident’s condition that would qualify the resident for end of life visits.
Proposed new §570.113, Essential Caregiver Visits, requires an ALF to permit essential caregiver visits. It requires a facility to inform the resident of the right to appeal a facility’s revocation of a person’s designation as an essential caregiver.

New 26 TAC §§570.201, 570.203, 570.205, 570.207, 570.209, 570.211, outlining requirements for day activity and health services during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER C. DAY ACTIVITY AND HEALTH SERVICES
26 TAC §§570.201, 570.203, 570.205, 570.207, 570.209, 570.211

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.201, Emergency Response to Outbreak, Epidemic, or Pandemic, requires a DAHS to regularly check for and implement federal, state, and local guidance during a contagious disease outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic a DAHS is required to maintain infection prevention and control measures. A DAHS must put a protocol in place for receiving resident deliveries and develop communication plans for communicating with current and prospective residents, resident representatives, emergency contacts, and DAHS staff.
Proposed new §570.203, Monitoring, requires a DAHS to monitor clients and staff for signs and symptoms, monitor staff for possible exposure, and activate outbreak infection control measures if a positive case is identified in a client or staff member.
Proposed new §570.205, Reporting, requires a DAHS to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the outbreak, epidemic, or pandemic.
Proposed new §570.207, Screening, provides screening criteria requirements, and requires a DAHS to screen all visitors prior to them entering a facility, except emergency services personnel during an emergency. The proposed new rule also requires that the facility keep a screening log. Staff who do not pass screening must leave the facility. Clients who do not pass screening must be quarantined and monitored. The facility must allow essential caregiver visitors into the facility, if they pass the screening criteria.
Proposed new §570.209, Staff Requirements, requires a DAHS to maintain adequate staffing levels and have a staffing plan in place to ensure staff are trained and supervised. At least one staff member must be responsible for infection control protocol. The DAHS must document training was provided to staff about providing care to residents in isolation or quarantine, proper donning and doffing of PPE, disinfecting procedures, emergency preparedness plans, and other infection control plans.
Proposed new §570.211, Visitation, requires a DAHS to permit clergy or religious counselor visits. It also permits a DAHS’ visitation policies and procedures to change in response to a public health emergency, requires visitation procedures to conform to any guidance or directives issued by the Centers for Disease Control and Prevention (CDC), HHSC, or DSHS.

New 26 TAC §§570.301 – 570.303, 570.305, 570.307, 570.309, 570.311, 570.313, 570.315, describing requirements for home and community support services agencies during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER D. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
DIVISION 1. ALL HCSSAS EXCEPT HOSPICE INPATIENT UNITS
26 TAC §§570.301 – 570.303, 570.305, 570.307, 570.309, 570.311, 570.313, 570.315

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.301, 570.302, 570.303, 570.305, 570.307, 570.309, 570.311, 570.313, 570.315.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.301, Emergency Response to Outbreak, Epidemic, or Pandemic, requires a HCSSA to regularly check for and implement federal, state, and local guidance during an outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic a HCSSA is required to maintain infection prevention and control measures. A HCSSA must put a protocol in place for receiving deliveries and develop communication plans for communicating with current and prospective clients, client representatives, emergency contacts, and HCSSA staff.
Proposed new §570.302, Documentation of Physician’s or Practitioner’s Signatures, requires an HCSSA to document efforts to obtain a physician or practitioner’s signature of verbal orders and plans of care.
Proposed new §570.303, Testing, describes the testing and monitoring activities that must take place during a contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.305, Reporting, requires an HCSSA to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.307, Screening, provides screening criteria requirements, and requires an HCSSA to screen all staff at the beginning of each workday or shift prior to staff conducting a home visit. Staff who do not pass screening are prohibited from conducting a home visit. An HCSSA must document each required screening.
Proposed new §570.309, Staff Requirements, requires an HCSSA to maintain adequate staffing levels and have a staffing plan in place to ensure staff are trained and supervised. At least one staff member must be responsible for infection control protocol. The HCSSA must document training was provided to staff about providing care to residents in isolation or quarantine, proper donning and doffing of PPE, disinfecting procedures, emergency preparedness plans, and other infection control plans.
Proposed new §570.311, Determining Essential Visit, requires an HCSSA to determine if a scheduled home visit is an essential visit.
Proposed new §570.313, Supervisory Visits by Telecommunication, permits a parent agency administrator or alternate administrator, supervising nurse or alternate supervising nurse, to make the monthly supervisory visit through virtual communication, such as phone or videoconference.
Proposed new §570.315, Client Symptoms, requires an HCSSA to coordinate care if a home health, hospice, or personal assistance services client reports symptoms associated with the contagious disease that caused an outbreak, epidemic, or pandemic.

New 26 TAC §§570.317 – 570.319, 570.321, 570.323, 570.325, 570.327, 570.329, implementing standards for hospice agencies operating an inpatient facility during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER D. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
DIVISION 2. HOSPICE AGENCIES OPERATING AN INPATIENT FACILITY
26 TAC §§570.317 – 570.319, 570.321, 570.323, 570.325, 570.327, 570.329

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.317, 570.318, 570.319, 570.321, 570.323, 570.325, 570.327, 570.329.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.317, Emergency Response to Outbreak, Epidemic, or Pandemic for Hospice Inpatient Unit, requires a hospice agency operating an inpatient hospice unit to regularly check for and implement federal, state, and local guidance during an outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic a hospice inpatient unit is required to maintain infection prevention and control measures. A hospice inpatient unit must put a protocol in place for receiving deliveries and develop communication plans for communicating with current and prospective clients, client representatives, emergency contacts, and hospice inpatient unit staff.
Proposed new §570.318, Testing, describes the testing and monitoring activities that must take place during a contagious disease outbreak, epidemic, or pandemic. A hospice agency operating an inpatient hospice facility must develop protocol for clients and staff who refuse testing.
Proposed new §570.319, Reporting, requires a hospice agency operating an inpatient hospice facility to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.321, Screening, provides screening criteria requirements, and requires a hospice agency operating an inpatient hospice facility to screen all staff at the beginning of each workday or shift prior to staff conducting a home visit. Staff who do not pass screening are prohibited from conducting a home visit. A hospice agency operating an inpatient hospice facility must document each required screening.
Proposed new §570.323, Staff Requirements, requires the hospice agency operating a hospice inpatient unit to ensure staffing levels are adequate to meet the needs of all clients, including those in isolation and quarantine. Each hospice agency operating a hospice inpatient unit is required to have the infection control coordinator develop and review infection control protocols. Each hospice agency operating a hospice inpatient unit is required to document training was provided to staff about providing care to residents in isolation or quarantine, proper donning and doffing of PPE, disinfecting procedures, emergency preparedness plans, and other infection control plans.
Proposed new §570.325, Visitation, permits a hospice agency operating a hospice inpatient unit to change its visitation policies and procedures during a contagious disease outbreak, epidemic, or pandemic in response to directives from DSHS or HHSC. The new section also requires a hospice operating a hospice inpatient unit to permit clergy, religious counselor, and end-of-life visits and allows a hospice agency operating a hospice inpatient unit to permit salon services visits. A hospice operating an inpatient hospice unit must adopt policies and procedures for in-person visitation with a religious counselor that comply with the provisions in this section. If a hospice operating an inpatient hospice unit allows salon services visits, the hospice operating an inpatient hospice unit must establish policies and procedures that provide conditions for a salon services visit to occur. Finally, the new section requires a hospice operating an inpatient hospice unit to immediately communicate to the client representative any changes in a client’s condition that would qualify the client for end of life visits.
Proposed new §570.327, Essential Caregiver Visits, requires that a hospice operating an inpatient hospice unit permit essential caregiver visits. A hospice operating an inpatient hospice unit must develop procedures to enable physical contact between the client and the essential caregiver. The hospice operating an inpatient hospice unit may revoke an essential caregiver designation if the caregiver violates safety protocols. Within 24 hours of a revocation, the hospice agency operating an inpatient hospice unit must inform the client of his or her right to appeal the revocation.
Proposed new §570.329, Temporary Partial or Full Closure to Allow for Space to Be Used to Treat Non-Hospice Clients in an Emergency, permits a hospice agency operating an inpatient unit to temporarily fully or partially close to allow space to be used by a hospital for overflow services to infectious patients who are not hospice clients.

New 26 TAC §§570.401, 570.403, 570.405, 570.407, 570.409, 570.411, outlining standards for prescribed pediatric extended care centers during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER E. PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
26 TAC §§570.401, 570.403, 570.405, 570.407, 570.409, 570.411

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.401, Emergency Response to Outbreak, Epidemic, or Pandemic, requires a PPECC to regularly check for and implement federal, state, and local guidance during a contagious disease outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic a PPECC is required to maintain infection prevention and control measures. A PPECC must put a protocol in place for receiving deliveries and develop communication plans for communicating with current and prospective minors, minor’s representatives, emergency contacts, and PPECC staff.
Proposed new §570.403, Testing, requires a PPECC to conduct routine testing of all staff and minors per HHSC or DSHS issued guidance during a contagious disease outbreak, epidemic, or pandemic. A PPECC must monitor minors and staff for signs and symptoms, possible exposure, and activate outbreak infection control measures if a positive case is identified in a minor or staff.
Proposed new §570.405, Reporting, requires a PPECC to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.407, Screening, a PPECC must screen all visitors prior to allowing them into the center, except emergency services personnel entering the center in an emergency. Visitors showing signs and symptoms must leave the center. The PPECC is required to keep a screening log and document each person’s screening information who enters the building. A PPECC must screen all staff at the beginning of each shift, prior to entering the center; staff who do not pass must leave the center. The PPECC must screen minors in accordance with any HHSC or DSHS issued guidance.
Proposed new §570.409, Staff Requirements, requires a PPECC to ensure staffing levels are adequate to meet the needs of all minors. A PPECC must have a staffing plan in place that includes a staffing contingency plan in the event multiple employees are out due to illness. The proposed new rule also requires a PPECC to have at least one staff member responsible for infection control protocol. A PPECC must document training was provided to staff about providing care to residents in isolation or quarantine, proper donning and doffing of PPE, disinfecting procedures, emergency preparedness plans, and other infection control plans.
Proposed new §570.411, Visitation, requires a PPECC to permit clergy or spiritual counselor to visit a minor.

New 26 TAC §§570.501, 570.503, 570.505, 570.507, 570.509, 570.511, 570.513 – 570.515, 570.517, detailing requirements for nursing facilities during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER F. NURSING FACILITIES
26 TAC §§570.501, 570.503, 570.505, 570.507, 570.509, 570.511, 570.513 – 570.515, 570.517

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.501, 570.503, 570.505, 570.507, 570.509, 570.511, 570.513, 570.514, 570.515, 570.517.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.501, Planning for Outbreak, Epidemic, or Pandemic, requires a NF to update infection control plans to include information specific to the emerging contagious disease, outbreak, epidemic, or pandemic, including addressing preparation by maintaining at least two weeks of PPE supplies, training staff on infection control plans, and dedicating staff to various resident populations. The infection control plan must include staff training to address which PPE is appropriate for use in each area of the facility, donning and doffing of PPE, cleaning and disinfecting policies and procedures, and contingency plans for staffing shortages due to employee illness. The infection control plan must address mitigation through isolation and quarantine plans and designating staff to work an assigned cohort. The infection control plan must also include testing procedures, protecting resident rights, and promoting socialization and preventing isolation. Proposed new §570.501 also requires a NF to ensure that its emergency preparedness plans address emerging contagious diseases, epidemics, and pandemics.
Proposed new §570.503, Emergency Response to Outbreak, Epidemic, or Pandemic, requires a NF to have a plan to check for and implement federal, state, and local guidance during a contagious disease outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic a NF is required to maintain infection prevention and control measures. Proposed new §570.503 also requires a NF put a protocol in place for receiving resident deliveries and develop communication plans for communicating with current and prospective residents, resident representatives, emergency contacts, and NF staff.
Proposed new §570.505, Testing, requires a NF to conduct routine testing of all staff and residents during a contagious disease outbreak, epidemic, or pandemic. During a facility outbreak, the NF is required to test all residents and staff with signs and symptoms of the illness. The NF must also develop and implement protocols for residents and staff who refuse testing. During a contagious disease outbreak, epidemic, or pandemic the NF must monitor residents and staff for signs and symptoms, or possible exposure. The NF must activate outbreak infection control measures if a positive case is identified, a resident or staff exhibits related symptoms, or there is a suspected or known exposure.
Proposed new §570.507, Reporting, requires a NF to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the contagious disease outbreak, epidemic, or pandemic. The NF must also inform residents, resident representatives, and families of residents about the occurrence of a positive case of the contagious disease among residents or staff by 5:00 p.m. the next calendar day following the occurrence.
Proposed new §570.509, Screening, requires a NF, during the contagious disease outbreak, epidemic, or pandemic, to screen all visitors prior to entering the facility except emergency services personnel entering during an emergency. Visitors who fail the screening must not enter the NF. A NF must screen all staff at the beginning of each shift prior to entering the facility. Staff that do not pass screening must leave the NF immediately. A NF must screen residents at least three times per day. Residents who do not pass screening must be quarantined immediately, monitored, and tested in accordance with any guidance issued by the CDC, HHSC, or DSHS. A resident has the right to refuse testing. The facility must allow those providing critical assistance including essential caregiver visitors into the facility if they pass the screening criteria. Proposed new §570.511, Staff Requirements, a NF is required to ensure staffing levels meet the needs of all residents. A NF must have a staffing plan in place that ensures staff are designated to each area of the facility, ensures staff are supervised in each area of the facility, ensures staff who work at multiple facilities are assigned to the same cohort in each facility during an outbreak, epidemic, or pandemic, and has a contingency plan in the event multiple staff are out due to illness. A NF is required to document that training was provided to each employee regarding providing care to residents in isolation or quarantine, the proper use of PPE, proper cleaning and disinfecting procedures, the facility infection control plans, the emergency preparedness plans, standard assessment protocols, and enhanced assessment protocols.
Proposed new §570.513, Visitation, permits a NF to change its visitation policies and procedures during a contagious disease outbreak, epidemic, or pandemic in response to directives from the Centers Medicare and Medicaid Services, DSHS, or HHSC. However, the new section prohibits a NF from adopting visitation policies and procedures that are more restrictive than these directives or executive or local orders. The new section also requires a NF to permit clergy, religious counselor, and end-of-life visits and allows a NF to permit salon services visits. A NF must adopt policies and procedures for in-person visitation with a religious counselor that comply with the provisions in this section. If a NF allows salon services visits, the NF must establish policies and procedures that provide conditions for a salon services visit to occur. Finally, the new section requires a NF to immediately communicate to the resident representative any changes in a resident’s condition that would qualify the resident for end of life visits.
Proposed new §570.514, Essential Caregiver Visits, requires a facility to permit essential caregiver visits. A facility must allow essential caregiver visits for at least two hours per day and develop procedures to enable physical contact between the resident and the essential caregiver. The facility may revoke an essential caregiver designation if the caregiver violates a facility’s safety protocols. If a facility revokes an essential caregiver designation, the resident or the resident’s legally authorized representative has a right to designate a new essential caregiver immediately. Within 24 hours of a revocation, the facility must inform the resident of their right to appeal the revocation.
Proposed new §570.515, Resident Focused Assessment or Monitoring, requires a NF to continue conducting resident assessments during a contagious disease outbreak, epidemic, or pandemic and increase the frequency of assessments when a positive case of the contagious disease is identified in the facility. A NF is required to update the baseline or comprehensive care plan for a resident during a contagious disease outbreak, epidemic, or pandemic and must address a resident’s physical, mental and psychosocial needs and both virtual visitation and in-person visitation.
Proposed new §570.517, Continuity of Facility Operations, requires a NF to designate isolation and quarantine areas for residents with contagious disease or unknown status, and those exhibiting symptoms. Requires a NF to designate an area for residents who do not require isolation or quarantine. Requires a NF to designate an area for the storage of PPE, an area for donning PPE, and for doffing PPE. Requires a NF to ensure space for physical distancing needs related to the outbreak, epidemic, or pandemic. Requires a NF to issue specific guidance related to facility activities and establish communal dining precautions related to the contagious disease outbreak, epidemic, or pandemic.

New 26 TAC §§570.601, 570.603, 570.605, 570.607, 570.609, 507.611, 570.613, describing requirements for Intermediate Care Facilities for Individuals with and Intellectual Disability or Related Conditions (ICF/IIDs) during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER G. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
26 TAC §§570.601, 570.603, 570.605, 570.607, 570.609, 507.611, 570.613

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.601, 570.603, 570.605, 570.607, 570.609, 570.611, 570.613.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.601, Emergency Response to Outbreak, Epidemic, or Pandemic, requires an ICF/IID to have a plan to check for federal, state, and local guidance during an outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic an ICF/IID is required to maintain infection prevention and control measures. An ICF/IID must put a protocol in place for receiving deliveries and develop communication plans for communicating with individuals, individual’s representatives, emergency contacts, and ICF/IID staff.
Proposed new §570.603, Testing, requires an ICF/IID to develop testing protocols to test staff and individuals during an outbreak, epidemic, or pandemic. An ICF/IID must develop protocol for staff and individuals who refuse testing. An ICF/IID is required to monitor individuals and staff for: signs, symptoms, and possible exposures. An ICF/IID is required to activate infection control measures if a positive case is identified, an individual or staff are exhibiting symptoms, or there is a suspected or known exposure to a positive case.
Proposed new §570.605, Reporting, requires an ICF/IID to report new positive cases of the disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the outbreak, epidemic, or pandemic.
Proposed new §570.607, Screening, requires an ICF/IID to screen all visitors prior to entering the facility except emergency services personnel during an emergency. Visitors who fail screening must leave and reschedule their visit. An ICF/IID must keep a visitor screening log and document each screening. Requires an ICF/IID to screen each staff member at the beginning of each shift, prior to entering the facility; staff who fail screening must leave the facility. Individuals must be screened in accordance with any HHSC or DSHS issued guidance; individuals who fail screening must be quarantined and monitored. The facility must allow those providing critical assistance including essential caregiver visitors into the facility if they pass the screening criteria.
Proposed new §570.609, Staff Requirements, requires an ICF/IID to ensure staffing levels meet the needs of all individuals and have a staffing plan in place to make sure staff are trained to provide care to individuals in their assigned cohort, staff are supervised in each cohort of the facility, and includes a staffing contingency plan in the event multiple employees are out due to illness. An ICF/IID is required to have at least one staff member responsible for infection control. An ICF/IID must document that training was provided to each employee regarding providing care to residents in isolation or quarantine, the proper use of PPE, proper cleaning and disinfecting procedures, the facility infection control plans, the emergency preparedness plans, standard assessment protocols, and enhanced assessment protocols.
Proposed new §570.611, Visitation, permits an ICF to change its visitation policies and procedures during a contagious disease outbreak, epidemic, or pandemic in response to directives from the DSHS or HHSC. The new section also requires an ICF to permit clergy, religious counselor, and end-of-life visits and allows an ICF to permit salon services visits. An ICF must adopt policies and procedures for in-person visitation with a religious counselor that comply with the provisions in this section. If an ICF allows salon services visits, the ICF must establish policies and procedures that provide conditions for a salon services visit to occur. Finally, the new section requires an ICF to immediately communicate to the resident representative any changes in a resident’s condition that would qualify the resident for end of life visits.
Proposed new §570.613, Essential Caregiver Visits, requires a facility to permit essential caregiver visits. A facility must develop procedures to enable physical contact between the individual and the essential caregiver. The facility may revoke an essential caregiver designation if the caregiver violations a facility’s safety protocols. Within 24 hours of a revocation, the facility must inform the individual of their right to appeal the revocation.

New 26 TAC §§570.701, 570.703, 570.705, 570.707, 570.709, 570.711, 570.713, outlining standards for home and community-based services during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER H. HOME AND COMMUNITY-BASED SERVICES
26 TAC §§570.701, 570.703, 570.705, 570.707, 570.709, 570.711, 570.713

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code, Title 26, Part 1, new Chapter 570, consisting of §§570.701, 570.703, 570.705, 570.707, 570.709, 570.711, 570.713.

570.801, 570.802, 570.803, 570.805, and 570.807, concerning Subchapter A, Introduction; Subchapter B, Assisted Living Facilities; Subchapter C, Day Activity and Health Services; Subchapter D, Home and Community Support Services Agencies; Subchapter E, Prescribed Pediatric Extended Care Centers; Subchapter F, Nursing Facilities; Subchapter G, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions; Subchapter H, Home and Community-Based Services; and Subchapter I, Texas Home Living.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.701, Emergency Response to Outbreak, Epidemic, or Pandemic, requires an HCS program provider to have a plan to check for federal, state, and local guidance during a contagious disease outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic an HCS program provider is required to maintain infection prevention and control measures. An HCS program provider is required to have protocol in place for residences that receive deliveries from vendors, family members, and visitors. The proposed new rule also requires an HCS program provider to have a communication plan to communicate updates and information to individuals or an individual’s legally authorized representative (LAR).
Proposed new §570.703, Testing, requires an HCS program provider to develop a testing strategy if testing is required by the CDC, HHSC, or DSHS. An HCS program provider is required to monitor individuals and staff for signs, symptoms, and possible exposures. An HCS program provider is required to activate infection control measures if a positive case is identified, an individual or staff are exhibiting symptoms, or there is a suspected or known exposure to a positive case.
Proposed new §570.705, Reporting, requires an HSC program provider to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the contagious disease outbreak, epidemic, or pandemic.
Proposed new §570.707, Screening, requires an HCS program provider to screen all visitors outside the residence prior to allowing them to enter, except emergency services personnel responding to an emergency. Visitors who fail screening must leave the residence. Staff who fail screening must leave the residence. An HCS program provider is required to permit an individual who lives in the residence, to enter the residence, even if the individual meets any of the screening criteria. An HCS program provider must allow those providing critical assistance including essential caregiver visitors into the residence if they pass the screening criteria.
Proposed new §570.709, Staff Requirements, requires an HCS program provider to have adequate staffing levels to meet the needs of individuals, including those in isolation or quarantine. An HCS program provider is required to have a staffing plan in place that: ensures staff are trained to provide care to individuals and includes a contingency plan in the event multiple employees are out due to illness. An HCS program provider must have at least one staff member responsible for infection control protocol. An HCS program provider is required to document that training was provided to each employee regarding providing care to residents in isolation or quarantine, the proper use of PPE, proper cleaning and disinfecting procedures, the facility infection control plans, the emergency preparedness plans, standard assessment protocols, and enhanced assessment protocols.
Proposed new §570.711, Visitation, permits a program provider to change its visitation policies and procedures during a contagious disease outbreak, epidemic, or pandemic in response to directives from DSHS or HHSC. The new section requires a program provider to permit clergy, religious counselor, and end-of-life visits and allows a program provider to permit salon services visits. A program provider must adopt policies and procedures for in-person visitation with a religious counselor that comply with the provisions in this section. If a program provider allows salon services visits, the program provider must establish policies and procedures that provide conditions for a salon services visit to occur. Finally, the new section requires a program provider to immediately communicate to the individual’s representative any changes in an individual’s condition that would qualify the individual for end of life visits.
Proposed new §570.713, Essential Caregiver Visits, requires a program provider to permit essential caregiver visits. A program provider must develop procedures to enable physical contact between the individual and the essential caregiver. The facility may revoke an essential caregiver designation if the caregiver violations a facility’s safety protocols. Within 24 hours of a revocation, the program provider must inform the individual of their right to appeal the revocation.

New 26 TAC §§570.801 – 570.803, 570.805, 570.807, describing requirements for a Texas Home Living provider during a contagious disease outbreak, epidemic, or pandemic.

CHAPTER 570. LONG-TERM CARE PROVIDER RULES DURING A CONTAGIOUS DISEASE OUTBREAK, EPIDEMIC, OR PANDEMIC
SUBCHAPTER I. TEXAS HOME LIVING
26 TAC §§570.801 – 570.803, 570.805, 570.807

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §570.801, Emergency Response to Outbreak, Epidemic, or Pandemic, requires a TxHmL program provider to have a plan to check for federal, state, and local guidance during a contagious disease outbreak, epidemic, or pandemic. During a contagious disease outbreak, epidemic, or pandemic a TxHmL program provider is required to maintain infection prevention and control measures. A TxHmL program provider must have protocol in place for residences that receive deliveries from vendors, family members, and visitors. A TxHmL program provider is required to have a communication plan to communicate updates and information to individuals or an individual’s LAR.
Proposed new §570.802, Testing, requires a program provider to have a testing strategy for staff and individuals, if testing is available and is required.
Proposed new §570.803, Reporting, requires a TxHmL program provider to report new positive cases of the contagious disease that is the basis of the outbreak, epidemic, or pandemic that are identified to HHSC in accordance with any guidance that HHSC or the Texas Department of State Health Services (DSHS) issues in relation to the outbreak, epidemic, or pandemic.
Proposed new §570.805, Screening, requires a TxHmL program provider to screen all individuals and staff prior to providing services to an individual. If an individual fails screening, the service provider must not provide services and must notify the program provider. If a staff member fails screening, they must not provide services and must notify the program provider.
Proposed new §570.807, Staff Requirements, requires a TxHmL program provider to have adequate staffing levels to meet the needs of individuals, including those in isolation or quarantine. A TxHmL program provider must have a staffing plan in place that: ensures staff are trained to provide care to individuals and includes a contingency plan in the event multiple employees are out due to illness. A TxHmL program provider is required to have at least one staff member responsible for infection control protocol. The proposed new rule also requires a TxHmL program provider to document that training was provided to each employee regarding providing care to residents in isolation or quarantine, the proper use of PPE, proper cleaning and disinfecting procedures, the facility infection control plans, the emergency preparedness plans, standard assessment protocols, and enhanced assessment protocols.

Adopted Rules Re:

Repealing 26 TAC §§555.4, 555.11-555.16 to eliminate duplicative rules governing Nursing Facility Administrators.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
26 TAC §§555.4, 555.11 – 555.16

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of §§555.4 and 555.11 – 555.16; new §§555.3 and 555.11 – 555.18; and amendments to §§555.1, 555.2, 555.31 – 555.42, and 555.51 – 555.57, in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 555, concerning Nursing Facility Administrators.

Amendments to §§555.2, 555.32, 555.41, 555.42, 555.55, and 555.56, and new §555.18 are adopted with changes to the proposed text as published in the May 7, 2021, issue of the Texas Register (46 Tex Reg 2985). These rules will be republished.

Amendments to §§555.1, 555.31, 555.33 – 555.40, 555.51 – 555.54, and 555.57; new §§555.3 and 555.11 – 555.17; and the repeal of §§555.4 and 555.11 – 555.16 are adopted without changes to the proposed text as published in the May 7, 2021, issue of the Texas Register (46 Tex Reg 2985). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The adopted rules amend existing, add new, and repeal portions of the nursing facility administrators (NFA) licensure requirements to correspond with the National Association of Long Term Care Administrators Board (NAB) requirements, including reciprocity. This includes adopting the NAB Administrator-in-Training (AIT) manual and preceptor training and allowing more flexibility with reciprocity, such as license by endorsement and accepting internships or AIT completed in other states or a NAB accredited program.

The adopted rules amend Subchapter A, General Information, by adding new §555.3, Schedule of Fees. The new §555.3 adjusts the administrative and licensure fees collected by HHSC and other administrative fees collected by the NAB designee or contractor.

The adopted rules amend Subchapter C, Licenses, §555.31 and §555.41, to implement House Bill 1342, 86th Legislature, Regular Session, 2019, which requires HHSC to eliminate certain grounds for disqualification for an occupational license based on prior criminal convictions that are unrelated to the duties and responsibilities of an occupational license. This includes requiring a licensing authority to provide an applicant an opportunity to submit relevant information in the event of a potential denial of a license based on prior criminal convictions.

The adopted rules amend Subchapter C, Licenses, §555.42, to implement Senate Bill 1200, 86th Legislature, Regular Session, 2019, which allows military spouses who have occupational licensing from other states to engage in that occupation without obtaining an additional license by following the notification and reciprocal licensing procedures laid out in the rule.

The adopted rules amend Subchapter A, General Information, §555.2, to implement House Bill 139, 87th Legislature, Regular Session, 2021, which added the term Space Force to the Occupations Code definition of Armed Forces.

NFAs will be able to take required training, to become or maintain certification as a preceptor, at their convenience and via computer-based training (CBT), instead of having to travel to an in-person training location. The in-person training is currently held twice a year. On-demand CBT will allow preceptors to complete the training at a time that works for them, and without incurring travel costs. Allowing reciprocity for an individual credentialed as a Health Services Executive will also streamline the process for obtaining credentialing as an NFA.

The adopted rules also respond to challenges presented by the COVID-19 pandemic and the need for greater awareness and emphasis on infection control and personal protective equipment by increasing infection control training and continuing education requirements for NFAs.

New 26 TAC §555.3, adding the fee for the National Association of Long-Term Care Administrator Boards (NAB) examination for Nursing Facility Administrators.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
26 TAC §555.3

OVERVIEW

BACKGROUND AND JUSTIFICATION

New 26 TAC §§555.11 – 555.18, describing requirements for licensure for Nursing Facility Administrators.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
26 TAC §§555.11 – 555.18

OVERVIEW

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §§555.1, 555.2, 555.31 – 555.42, 555.51 – 555.57 to update requirements for licensing and referrals, complaint procedures, and sanctions for Nursing Facility Administrators.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
26 TAC §§555.1, 555.2, 555.31 – 555.42, 555.51 – 555.57

OVERVIEW

BACKGROUND AND JUSTIFICATION

Texas State Board of Examiners of Professional Counselors

Adopted Rules Re:

Amending 22 TAC §681.41 to clarify a licensee’s duty to take reasonable action in response to actions by third-parties.

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

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §681.41, relating to General Ethical Requirements. Section 681.41 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3681) and will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rule clarifies a licensee’s duty to take reasonable action in response to actions by third-parties.

If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The rule pertains to the scope of practice, standards of care, or ethical practice for the practice of professional counseling. Therefore, this rule is covered by §507.153 of the Tex. Occ. Code.

The Texas State Board of Examiners of Professional Counselors, in accordance with §503.2015 of the Tex. Occ. Code, previously voted and, by a majority, approved to propose the adoption of this rule to the Executive Council. Therefore, the Executive Council has complied with Chapters 503 and 507 of the Tex. Occ. Code and may adopt this rule.

Amending 22 TAC §681.72 to ensure to ensure the regulatory standard for substantial equivalency comports with the underlying statutory requirement with regard to required application materials for Professional Counselors.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER C. APPLICATION AND LICENSING
22 TAC §681.72

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §681.72, relating to Required Application Materials. Section 681.72 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3684) and will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rule is necessary to ensure the regulatory standard for substantial equivalency comports with the underlying statutory requirement.

If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The rule pertains to the qualifications necessary to obtain a license to practice professional counseling. Therefore, this rule is covered by §507.153 of the Tex. Occ. Code.

Amending 22 TAC §681.73 to update application standards relating to Art Therapy Specialty Designation.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER C. APPLICATION AND LICENSING
22 TAC §681.73

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §681.73, relating to Application for Art Therapy Specialty Designation. Section 681.73 is adopted with changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3686). The rule will be republished.

BACKGROUND AND JUSTIFICATION

The amended rule is necessary because the agency has received information that the American Art Therapy Association is being replaced as an accrediting body. This amended rule will allow the agency to rely upon accreditation by its successor.

If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The rule pertains to the qualifications necessary to obtain a license to practice professional counseling. Therefore, this rule is covered by §507.153 of the Tex. Occ. Code.

Amending 22 TAC §681.82 to ensure the minimum degree requirement applies equally to counseling and counseling-related degrees.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER C. APPLICATION AND LICENSING
22 TAC §681.82

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §681.82, relating to Academic Requirements. Section 681.82 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3688). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rule is necessary to ensure the minimum degree requirement applies equally to counseling and counseling-related degrees. Additionally, the amended rule will streamline the application process for qualified out of state applicants.

If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The rule pertains to the qualifications necessary to obtain a license to practice professional counseling. Therefore, this rule is covered by §507.153 of the Tex. Occ. Code.

Amending 22 TAC §681.114 to update requirements relating to Licensing of Military Service Members, Military Veterans, and Military Spouses.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER C. APPLICATION AND LICENSING
22 TAC §681.114

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §681.114, relating to Licensing of Military Service Members, Military Veterans, and Military Spouses. Section 681.114 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3691) and will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rule is necessary to determine substantial equivalency for out of state licensees that are military service members, military veterans, and military spouses.

If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The rule pertains to the qualifications necessary to obtain a license to practice professional counseling. Therefore, this rule is covered by §507.153 of the Tex. Occ. Code.

Amending 22 TAC §681.205 to update requirements relating to schedule of sanctions and ensure consistency amongst other corresponding rule amendments.

CHAPTER 681. PROFESSIONAL COUNSELORS
SUBCHAPTER D. SCHEDULE OF SANCTIONS
22 TAC §681.205

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §681.205, relating to Schedule of Sanctions. Section 681.205 is adopted without changes to the proposed text as published in the June 18, 2021, issue of the Texas Register (46 Tex Reg 3693) and will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rule is necessary to match other corresponding rule amendments referenced in this rule.

If a rule will pertain to the qualifications necessary to obtain a license; the scope of practice, standards of care, or ethical practice for a profession; continuing education requirements; or a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The rule pertains to a schedule of sanctions. Therefore, this rule is covered by §507.153 of the Tex. Occ. Code.

Texas Behavioral Health Executive Council

Adopted Rules Re:

Amending 22 TAC §883.1 to modify the assessment of late fees related to renewal of a license.

CHAPTER 883. RENEWALS
SUBCHAPTER A. GENERAL PROVISIONS
22 TAC §883.1

OVERVIEW

The Texas Behavioral Health Executive Council adopts amendments to §883.1, relating to Renewal of a License. Section 883.1 is adopted without changes to the proposed text as published in the August 13, 2021, issue of the Texas Register (46 Tex Reg 4973). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amended rule modifies the assessment of late fees such that licensees need only pay a late renewal fee for late renewals, rather than a late fee in addition to the standard renewal fee.

Texas Board of Occupational Therapy Examiners

Adopted Rules Re:

Amending 40 TAC §364.5 to update requirements for licensure by allowing a military spouse to show proof of residency by submitting a permanent change of station order.

CHAPTER 364. REQUIREMENTS FOR LICENSURE
40 TAC §364.5

OVERVIEW

The Texas Board of Occupational Therapy Examiners adopts amendments to 40 TAC §364.5, concerning Recognition of Out-of-State License of Military Spouse. The amendments allow a military spouse to show proof of residency by submitting a permanent change of station order. The amendments also include adding that individuals update the Board of certain changes. The amendments are adopted without changes to the proposed text as published in the August 27, 2021, issue of the Texas Register (46 Tex Reg 5377). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

House Bill 139 of the 87th Regular Legislative Session, codified as Texas Occupations Code §55.004(d), provides that: “A state agency that issues a license that has a residency requirement for license eligibility shall adopt rules regarding documentation necessary for a military spouse applicant to establish residency for purposes of this subsection, including by providing to the agency a copy of the permanent change of station order for the military service member to whom the spouse is married.” The Bill took effect September 1, 2021. In accordance with HB 139, the amendment allows a permanent change of station order to serve as proof of residency for a military spouse requesting the authorization provided by the section.

An additional amendment concerns updating the Board of changes. Subsection (b)(2) of the section requires that a military spouse requesting the authorization submit proof of the military spouse’s residency in this state and a copy of the military spouse’s military identification card. The amendment adds the requirement that individuals who have received the authorization described by the section update the Board of any changes to information as specified under subsection (b)(2) within 30 days of such change(s). The change is adopted to enhance the Board’s ability to remain apprised of changes to the information submitted for the authorization.