Texas Register - November 19, 2021 Volume: 46 Number: 47

Texas Register Table of Contents

1 The Governor
- - 1.0.1 Proclamation 41-3864
    - 1.0.1.1 Governor issues Proclamation 41-3864 to renew the disaster proclamation for all counties in Texas in response to the ongoing COVID-19 pandemic.
2 Health and Human Services Commission
- - 2.0.1 Emergency Rules Re:
  - 2.0.2 Adopted Rules Re:
    - 2.0.2.1 New 1 TAC §355.8200, authorizing HHSC to set and collect an application fee for the Uncompensated Care (UC) program.
3 Texas Board of Nursing
- - 3.0.1 Adopted Rules Re:
4 Department of State Health Services
- - 4.0.1 Adopted Rules Re:
    - 4.0.1.1 Amending 25 TAC §181.2 to update rules for expediting a death certificate for religious purposes in certain counties.
    - 4.0.1.2 Amending 25 TAC §181.22 and §181.30 to update standards for obtaining and documenting vital records.
5 Department of Aging and Disability Services
- - 5.0.1 Adopted Rules Re:
    - 5.0.1.1 Repealing 40 TAC §§79.1801 – 79.1806 to remove outdated ethical standards.

The Governor

Proclamation 41-3864

Governor issues Proclamation 41-3864 to renew the disaster proclamation for all counties in Texas in response to the ongoing COVID-19 pandemic.

OVERVIEW

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

BACKGROUND AND JUSTIFICATION

Pursuant to Section 418.017, the Governor authorizes the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster.

Pursuant to Section 418.016, any regulatory statute prescribing the procedures for conduct of state business or any order or rule of a state agency that would in any way prevent, hinder, or delay necessary action in coping with this disaster shall be suspended upon written approval of the Office of the Governor. However, to the extent that the enforcement of any state statute or administrative rule regarding contracting or procurement would impede any state agency’s emergency response that is necessary to cope with this declared disaster, the Governor hereby suspends such statutes and rules for the duration of this declared disaster for that limited purpose.

Health and Human Services Commission

Emergency Rules Re:

Renewing 26 TAC §553.2004 to require assisted living facilities to track COVID-19 vaccinations of staff and residents.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER K. COVID-19 RESPONSE
26 TAC §553.2004

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §553.2004 for a 60-day period. The text of the emergency rule was originally published in the July 23, 2021, issue of the Texas Register (46 Tex Reg 4415).

HHSC is renewing an emergency rule to require assisted living facilities to accurately report COVID-19 vaccination data for staff and residents to HHSC in the format established by HHSC within 24 hours of completing a round of vaccinations. This rule is necessary to accurately track vaccinations of staff and residents in long-term care facilities in Texas.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing if it finds 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 for Assisted Living Facility COVID-19 Vaccination Data Reporting and Emergency Communication System Enrollment.

Renewing 26 TAC §554.2804 to require nursing facilities to accurately track and report COVID-19 vaccination data for staff and residents.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER CC. COVID-19 EMERGENCY RULE
26 TAC §554.2804

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §554.2804 for a 60-day period. The text of the emergency rule was originally published in the July 23, 2021, issue of the Texas Register (46 Tex Reg 4416).

HHSC is renewing an emergency rule to require nursing facilities to accurately report COVID-19 vaccination data for staff and residents to HHSC in the format established by HHSC within 24 hours of becoming aware of a staff or resident’s COVID-19 vaccination and to require the administrator and director of nurses to enroll in an emergency communication system. The rule is necessary to accurately track vaccinations of staff and residents in long-term care facilities in Texas and to facilitate timely emergency communications between HHSC and nursing facilities in Texas.

BACKGROUND AND JUSTIFICATION

As authorized by Government Code, §2001.034, the Commission may adopt an emergency rule without prior notice or hearing if it finds 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. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Nursing Facility COVID-19 Vaccination Data Reporting and Emergency Communication System Enrollment.

Renewing 26 TAC §745.115 to exempt from licensure and regulation by the HHSC programs that provides care exclusively to unlawfully present individuals.

CHAPTER 745. LICENSING
SUBCHAPTER C. OPERATIONS THAT ARE EXEMPT FROM REGULATION
DIVISION 2. EXEMPTIONS FROM REGULATION
26 TAC §745.115

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency amended §745.115 for a 60-day period. The text of the emergency rule was originally published in the July 23, 2021, issue of the Texas Register (46 Tex Reg 4417).

The emergency rule in §745.10301 provides that child-care programs that are exempt from licensure and regulation by HHSC must be operated separately from child-care operations that are licensed or certified by HHSC. The emergency amendment of §745.115 clarifies that a program that provides care exclusively to unlawfully present individuals, as defined in §745.10301, is exempt from licensure and regulation by HHSC.

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 comply with the Governor’s direction in the May 31, 2021, proclamation declaring a state of disaster in certain Texas counties and for affected state agencies. In this proclamation, the Governor directed HHSC to take all necessary steps to discontinue state licensing of certain child-care facilities that shelter or detain unlawful immigrants or other individuals not lawfully present in the United States. The Governor suspended §§42.046 and 42.048 of the Texas Human Resources Code and all other relevant laws to the extent necessary for HHSC to comply with this direction. Based on the disaster declaration, HHSC finds that the imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these emergency rules concerning child-care facility licensing.

Renewing 26 TAC §745.10301 to require that child-care programs that are exempt from licensure and regulation by HHSC be operated separately from child-care operations that are licensed or certified by HHSC.

CHAPTER 745. LICENSING
SUBCHAPTER X. EMERGENCY RULES
26 TAC §745.10301

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §745.10301 for a 60-day period. The text of the emergency rule was originally published in the July 23, 2021, issue of the Texas Register (46 Tex Reg 4418).

The new emergency rule in §745.10301 provides that child-care programs that are exempt from licensure and regulation by HHSC must be operated separately from child-care operations that are licensed or certified by HHSC. The emergency amendment of §745.115 clarifies that a program that provides care exclusively to unlawfully present individuals, as defined in §745.10301, is exempt from licensure and regulation by HHSC.

BACKGROUND AND JUSTIFICATION

Adopted Rules Re:

New 1 TAC §355.8200, authorizing HHSC to set and collect an application fee for the Uncompensated Care (UC) program.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 11. TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM REIMBURSEMENT
1 TAC §355.8200

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new §355.8200, concerning Retained Funds for the Uncompensated Care Program, in Texas Administrative Code, Title 1, Part 15, Chapter 355, Subchapter J, Division 11. Section 355.8200 is adopted without changes to the proposed text as published in the October 8, 2021, issue of the Texas Register (46 Tex Reg 6624). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The new rule authorizes HHSC to set and collect an application fee for the Uncompensated Care (UC) program currently valued at $3.9 billion annually, in accordance with 42 CFR §433.68(d)(1)(iv).

The rule is necessary to comply with Senate Bill (S.B.) 2138, 86th Legislature, Regular Session, 2019 and S.B. 1 (Article II, Texas Health and Human Services Commission, Rider 15), 87th Legislature, Regular Session, 2021. The establishment of a rule is critical to the ability to support the infrastructure needed to operate and safeguard the UC program operated under the Texas Healthcare Transformation and Quality Improvement Project 1115 waiver (THTQIP). The amount of the application fee will be determined based on the cost necessary to administer the program and the funds will be spent to assist in administering the UC program.

During the 86th Texas Legislative Session, the Texas legislature passed S.B. 2138, which gave HHSC the authority to retain certain funds. The bill established reporting requirements and limitations on the amount of funds that could be collected. The 87th Texas Legislature adopted a rider in S.B. 1 that has given HHSC the authority to increase the number of full-time equivalents for increased monitoring and oversight of the use of local funds and the administration of new programs. HHSC is now creating a monitoring plan to oversee the use of local funds in the Medicaid program.

The required application fee will be implemented beginning October 1, 2021.

Texas Board of Nursing

Adopted Rules Re:

Amending 22 TAC §213.28 to provide sectional clarity for rules relating to licensure of individuals with criminal history.

CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.28

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to §213.28, relating to Licensure of Individuals with Criminal History, without changes to the proposed text as published in the September 10, 2021, edition of the Texas Register (46 Tex Reg 5724). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments are adopted under the authority of the Occupations Code §301.151 and House Bills (HB) 375 and 757, both enacted during the 87th Legislative Session and both effective September 1, 2021. HB 375 amends the existing criminal offense found in the Texas Penal Code §21.02, Continuous Sexual Abuse of Young Child or Children, to include disabled individuals. This offense is currently specified in the enumerated list of crimes in the Occupations Code §301.4535 that mandates licensure revocation and denial and is included in the Board’s Disciplinary Guidelines for Criminal Conduct (Guidelines). The adopted amendments to the Guidelines, located at §213.28(c), amend the title of this criminal offense for consistency with the statutory change made by HB 375.

HB 757 prohibits a licensing agency from denying, suspending, or revoking a license based upon a deferred adjudication that has been successfully completed and dismissed, except in certain, specified circumstances. Under the terms of the bill, a successfully completed deferred adjudication may be considered by a licensing agency when issuing, renewing, denying, or revoking a license if the offense is listed in the Texas Code of Criminal Procedure Article 42A.054(a); is described by the Texas Code of Criminal Procedure Article 62.001(5) or (6); is committed under Texas Penal Code Chapter 21 or 43; or is related to the activity or conduct for which the individual seeks or holds the license. Further, an agency may also consider a completed deferred adjudication if the profession for which the individual holds or seeks a license involves direct contact with children in the normal course of official duties or duties for which the license is required.

The adopted amendments to §213.28 are necessary for consistency with these statutory directives. Board Rule 213.28 currently requires a criminal offense to be directly related to the practice of nursing in order for the Board to consider the offense in licensure decisions. As such, the Board finds the majority of Rule 213.28 already complies with the mandates of HB 757. The adopted amendments make minor changes to the rule text, however, to incorporate the additional exception permitted by HB 757 (Texas Code of Criminal Procedure Article 42A.111(d)(4)(B)) into the rule. The remaining adopted amendments make editorial changes for additional clarity.

Amending 22 TAC §213.33 to modernize rules relating to factors considered in the imposition of penalties and sanctions.

CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.33

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to 22 Texas Administrative Code §213.33, relating to Factors Considered for Imposition of Penalties/Sanctions, without changes to the proposed text published in the September 10, 2021, edition of the Texas Register (46 Tex Reg 5726). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments are being adopted under the authority of the Occupations Code §301.151 and House Bill (HB) 1434, effective September 1, 2021. HB 1434, enacted during the 87th Legislative Session, created a new disciplinary cause of action for practitioners who conduct pelvic examinations on unconscious or anesthetized patients without proper informed consent, where the procedure is not within the standard scope of a scheduled procedure or diagnostic examination, where the examination is not necessary for the diagnosis or treatment of the patient’s medical condition, or where the examination is not for the purpose of collecting evidence. The new disciplinary cause of action is located in the Occupations Code §301.452(b)(13). The adopted amendments to the Board’s Disciplinary Matrix (Matrix) are necessary for consistency with this statutory change.

DETAILS

First, the adopted amendments add a new subsection to the Matrix that corresponds to the new disciplinary cause of action. The adopted amendments also renumber existing §301.452(b)(13) accordingly. The adopted amendments also include a range of disciplinary sanctions applicable to the new violation and aggravating and mitigating factors that could apply to a violation of §301.452(b)(13). The adopted range of sanctions includes licensure suspension, including temporary suspension on an emergency basis under the Occupations Code §301.455; licensure revocation, or licensure denial. The Board has determined that these levels of discipline are appropriate given the seriousness of the conduct that would constitute a violation of §301.452(b)(13). Further, the aggravating factors include actual patient harm; impairment at the time of the incident; severity of patient harm; prior complaints or discipline for similar conduct; and patient vulnerability. These factors, if present in a given case, could justify a higher sanction. The adopted mitigating factors include mistaken consent or a good faith belief that a statutory exception applied. These factors, if present in a given case, could justify a lower sanction.

The remaining adopted amendments to the Matrix correct outdated references to website addresses; remove obsolete provisions; make editorial changes; and clarify sanctions that are not available as the result of a contested case proceeding. Specifically, the adopted amendments make clear that participation in a peer assistance program, such as the Texas Peer Assistance Program for Nurses (TPAPN), or participation in a targeted assessment and remediation program, such as the Knowledge, Skills, Training, Assessment, and Research Program (KSTAR), are not available as the result of a contested case hearing. Like a corrective action, participation in a targeted assessment and remediation program is only available as a condition of settlement. See 22 Texas Administrative Code §213.32(4) (relating to Corrective Action Proceedings and Schedule of Administrative Fines) and §213.35(k)(2) (relating to Targeted Assessment and Remediation Pilot Program). Likewise, participation in a peer assistance program must be voluntary, not forced, as the program contains rigorous requirements for the participant’s successful completion of the program. See 22 Texas Administrative Code §217.13 (relating to Peer Assistance Program). The adopted amendments clarify the applicability of these existing rules and policies of the Board as they apply to contested case proceedings. The remaining adopted amendments to §213.33 make editorial, non-substantive changes to the section.

Amending 22 TAC §214.4 to improve rules relating to vocational nursing education.

CHAPTER 214. VOCATIONAL NURSING EDUCATION
22 TAC §214.4

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to 22 Texas Administrative Code §214.4(c), relating to Approval, without changes to the proposed text published in the September 10, 2021, edition of the Texas Register (46 Tex Reg 5728) and will not be republished.

BACKGROUND AND JUSTIFICATION

House Bill (HB) 2426, enacted by the 80th Legislature, required the Board to identify national nursing accreditation agencies recognized by the United States Department of Education with standards equivalent to the Board’s ongoing approval standards. In order to implement the requirements of HB 2426, the Board conducted a comprehensive comparative review of national accreditation standards and identified two accreditation agencies with equivalent standards: the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Based upon these findings, the Board adopted Education Guideline 3.2.4.a, which provided guidance to accredited programs regarding their exemption from compliance with certain Board rules. This guidance was also included in Board Rule 214.4. However, the rule did not include a specific reference to ACEN or CCNE at that time. In October 2012, Board Rule 214.4(c)(8) was amended to specifically incorporate the title of Education Guideline 3.2.4.a. into the rule. The title of Education Guideline 3.2.4.a specifically referenced the names of the Board’s approved national nursing accreditation agencies, the ACEN and CCNE. These two accreditation agencies have remained the only accreditation agencies recognized by the Board until recently.

The National League for Nursing (NLN) launched a third nursing accreditation organization in 2013, and 115 education programs across 29 states representing all program types have been pre-accredited or accredited by the NLN Commission for Nursing Education Accreditation (CNEA). On May 25, 2021, the NLN CNEA was recognized by the United States Department of Education as a fully accrediting agency for an initial five-year period. At its July 2021 meeting, the Board voted to add the NLN CNEA to its list of approved accreditation agencies, recognized by the United States Department of Education, and determined to have standards equivalent to the Board’s ongoing approval standards for nursing education programs. Due to the addition of an additional accreditation agency, the title of Education Guideline 3.2.4.a was also amended to eliminate reference to the specific approved accreditation agencies. Instead, the title of the guideline was amended to refer more generically to Board-approved national nursing accreditation agencies.

The adopted amendments to §214.4(c)(8) are necessary for consistency with these recent changes made by the Board. The adopted amendments reference the newly amended title of Education Guideline 3.2.4.a by referring generically to Board-approved national nursing accreditation organizations instead of including specific reference to the ACEN and CCNE.

Amending 22 TAC §215.2 to define a professional nursing education program.

CHAPTER 215. PROFESSIONAL NURSING EDUCATION
22 TAC §215.2

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to §215.2, relating to Definitions, without changes to the proposed text published in the September 10, 2021, edition of the Texas Register (46 Tex Reg 5730) and will not be republished.

BACKGROUND AND JUSTIFICATION

22 Texas Administrative Code Chapter 215 relates to professional nursing education programs, not vocational nursing education programs. The adopted amendments are necessary to correct a typographical error in §215.2 from vocational to professional.

Amending 22 TAC §215.4 to update rules relating to approval for professional nursing education.

CHAPTER 215. PROFESSIONAL NURSING EDUCATION
22 TAC §215.4

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to §215.4(c), relating to Approval, without changes to the proposed text published in the September 10, 2021, edition of the Texas Register (46 Tex Reg 5731). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

House Bill (HB) 2426, enacted by the 80th Legislature, required the Board to identify national nursing accreditation agencies recognized by the United States Department of Education with standards equivalent to the Board’s ongoing approval standards. In order to implement the requirements of HB 2426, the Board conducted a comprehensive comparative review of national accreditation standards and identified two accreditation agencies with equivalent standards: the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Based upon these findings, the Board adopted Education Guideline 3.2.4.a, which provided guidance to accredited programs regarding their exemption from compliance with certain Board rules. This guidance was also included in Board Rule 215.4. However, the rule did not include a specific reference to ACEN or CCNE at that time. In October 2012, Board Rule 215.4(c)(8) was amended to specifically incorporate the title of Education Guideline 3.2.4.a. into the rule. The title of Education Guideline 3.2.4.a specifically referenced the names of the Board’s approved national nursing accreditation agencies, the ACEN and CCNE. These two accreditation agencies have remained the only accreditation agencies recognized by the Board until recently.

The adopted amendments to §215.4(c)(8) are necessary for consistency with these recent changes made by the Board. The adopted amendments reference the newly amended title of Education Guideline 3.2.4.a by referring generically to Board-approved national nursing accreditation organizations instead of including specific reference to the ACEN and CCNE.

Amending 22 TAC §217.24 to update rules related to the use of telemedicine services to treat certain chronic pain patients.

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE
22 TAC §217.24

OVERVIEW

The Texas Board of Nursing (Board) adopts amendments to §217.24(e), relating to Telemedicine Medical Service Prescriptions, with changes to the proposed text published in the August 13, 2021, issue of the Texas Register (46 Tex Reg 4971). The rule will be republished.

The Board received two joint comments on the proposal. In response to the written comments on the published proposal, the Board has made changes to §217.24(e)(1)(A)(i) and (iii) as adopted. These changes, however, do not materially alter issues raised in the proposal, introduce new subject matter, or affect persons other than those previously on notice. Further, the Board believes these changes address some of the commenters’ concerns.

BACKGROUND AND JUSTIFICATION

On March 13, 2020, the Governor of the State of Texas certified COVID-19 as posing an imminent threat of disaster to the public health and safety and declared a state of disaster in all counties of Texas. On March 23, 2020, the Office of the Governor granted a waiver of 22 Texas Administrative Code §217.24(e), which prohibits an advanced practice registered nurse (APRN) from treating chronic pain with scheduled drugs through the use of telemedicine medical services, unless otherwise permitted under federal and state law. The waiver, however, expired on June 6, 2020.

The Board held a public meeting on June 8, 2020, to consider the adoption of an emergency rule to permit APRNs to treat chronic pain with scheduled drugs through the use of telemedicine medical services under certain conditions during the COVID-19 pandemic. At the conclusion of the meeting, the Board voted to adopt emergency amendments to 22 Texas Administrative Code §217.24(e). Subsequently, the Board found that the continued effects of the COVID-19 pandemic necessitated the continuation of emergency amendments to §217.24(e) and re-adopted emergency amendments to the section several times, the last adoption taking effect on August 1, 2021. During its public meeting on July 30, 2021, the Board determined that permanent rule amendments to §217.24(e), consistent with those amendments adopted on an emergency basis during the pandemic, should also be considered due to the continuation of the pandemic and recent increases in the number of new COVID cases throughout the state. Further, the Board determined it would routinely evaluate the continued need for a permanent rule as the pandemic progresses to ensure ongoing compliance with state and federal law and to determine when, and if, the necessity of the permanent rule ceases to exist.

Department of State Health Services

Adopted Rules Re:

Amending 25 TAC §181.2 to update rules for expediting a death certificate for religious purposes in certain counties.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER A. MISCELLANEOUS PROVISIONS
25 TAC §181.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendments to §181.2, concerning Assuming Custody of Body. The amendment to §181.2 is adopted with changes to the proposed text as published in the September 10, 2021, issue of the Texas Register (46 Tex Reg 5733). This rule will be republished.

BACKGROUND AND JUSTIFICATION

The amendments are necessary to comply with House Bill (H.B.) 1011, Senate Bill (S.B.) 798, and H.B. 4048, 87th Legislature, Regular Session, 2021.

H.B. 1011 created new Texas Health and Safety Code §193.0025, requiring DSHS to establish a process for individuals to request an expedited death certificate for religious purposes in applicable counties. The amendment to §181.2 specifies how DSHS will provide technical support, as needed, to local offices who will fulfill these requests.

Additional amendments are adopted to update the name of the Vital Statistics Section and correct minor formatting inconsistencies.

Amending 25 TAC §181.22 and §181.30 to update standards for obtaining and documenting vital records.

CHAPTER 181. VITAL STATISTICS
SUBCHAPTER B. VITAL RECORDS
25 TAC §181.22, §181.30

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendments to §181.22, concerning Fees Charged for Vital Records Services; and §181.30, concerning Instructions and Requirements for Filing of Amendments to Medical Certification of Certificate of Death with a Local Registrar. The amendments to §181.22 and §181.30 are adopted without changes to the proposed text as published in the September 10, 2021, issue of the Texas Register (46 Tex Reg 5733), and therefore will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments are necessary to comply with House Bill (H.B.) 1011, Senate Bill (S.B.) 798, and H.B. 4048, 87th Legislature, Regular Session, 2021.

S.B. 798 created new Texas Health and Safety Code §191.00491, waiving the fee for issuing a certified copy of a person’s birth record to victims and the children of victims of family or dating violence. The amendment to §181.22 establishes a fee waiver for persons who meet all requirements as defined by statute and rule.

H.B. 4048 repealed Texas Health and Safety Code §193.005(a-1), thus allowing physician assistant or advanced practice resident nurse to complete the medical certification for a death certificate or a fetal death certificate in an expanded set of circumstances. The amendment to §181.30 removes the prior statutory limitations.

Additional amendments are adopted to update the name of the Vital Statistics Section and correct minor formatting inconsistencies.

Department of Aging and Disability Services

Adopted Rules Re:

Repealing 40 TAC §§79.1801 – 79.1806 to remove outdated ethical standards.

CHAPTER 79. LEGAL SERVICES
SUBCHAPTER S. CONTRACTING ETHICS
40 TAC §§79.1801 – 79.1806

OVERVIEW

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. Therefore, the Executive Commissioner of HHSC adopts the repeal of Subchapter S, concerning Contracting Ethics, which is comprised of §§79.1801 – 79.1806, in Title 40, Part 1, Chapter 79.

The repeal of Chapter 79, Subchapter S is adopted without changes to the proposed text as published in the August 20, 2021, issue of the Texas Register (46 Tex Reg 5165). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeal is necessary to remove obsolete rules in Chapter 79, Subchapter S, concerning Contracting Ethics, which were last updated in 1999, and do not reflect subsequent agency changes and consolidation, or statutory changes made to Texas Government Code Chapter 572, Personal Financial Disclosure, Standards of Conduct, and Conflict of Interest, and other ethics statutes. Ethical standards addressed by the subchapter proposed for repeal will continue to be addressed, including for contracts for goods and services for which DADS previously contracted, through:

HHSC rules in Title 1, Part 15, Chapter 391, Subchapter D, Standards of Conduct for Vendors and HHSC Procurement and Contracting Personnel;
self-implementation of longer standing and more recent statutory ethics provisions, particularly in Texas Government Code Chapter 572;
the Health and Human Services Ethics Policy; and
incorporation of applicable standards of conduct and restrictions into HHSC contracts.