Texas Register November 6, 2020 Volume: 45 Number: 45

Governor

 

Appointments

Governor appoints three new members to the Texas State Board of Examiners of Marriage and Family Therapists

Appointments for October 21, 2020Appointed to the Texas State Board of Examiners of Marriage and Family Therapists, for terms to expire February 1, 2025: Russell F. “Russ” Bartee, Ph.D. of Fort Worth, Texas (replacing Keith Rosenbaum, Ph.D. of Joshua, whose term expired;Daniel W. Parrish of DeSoto, Texas (replacing Michael R. “Mike” Miller of Belton, whose term expired);Jeanene L. Smith of Austin, Texas (replacing Jennifer R. Smothermon of Abilene, whose term expired).

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Governor

Appointments

Governor designates Lisa V. Merchant, Ph.D., as presiding officer of the Texas State Board of Examiners of Marriage and Family Therapists

Appointments for October 21, 2020Designated as presiding officer of the Texas State Board of Examiners of Marriage and Family Therapists, for a term to expire at the pleasure of the Governor, Lisa V. Merchant, Ph.D. of Clyde, Texas (Dr. Merchant is replacing Jennifer R. Smothermon of Abilene).

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Governor

Appointments

Governor appoints Steven W. Hallbauer as presiding officer of the Texas State Board of Examiners of Professional Counselors

Appointments for October 21, 2020Designated as presiding officer of the Texas State Board of Examiners of Professional Counselors, for a term to expire at the pleasure of the Governor, Steven W. Hallbauer of Rockwall, Texas (Mr. Hallbauer is replacing Steven Douglas Christopherson of Pasadena as presiding officer).

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Governor

Appointments

Governor appoints three new members to the Texas State Board of Examiners of Professional Counselors

Appointments for October 21, 2020Appointed to the Texas State Board of Examiners of Professional Counselors, for terms to expire February 1, 2025: Jodie L. Elder, Ph.D. of Dallas, Texas (replacing Steven Douglas Christopherson of Pasadena, whose term expired);Vanessa Hall of Tomball, Texas (replacing Sarah T. Abraham of Sugar Land, whose term expired);Garrett A. Nerren of Dallas, Texas (replacing Leslie F. Pohl of Austin, whose term expired).

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Texas Health and Human Services Commission

Emergency Rule

Renewing emergency amendment to 26 TAC §303.303 to establish revised training requirements for new staff conducting PASRR evaluations or resident reviews at LIDDAs, LMHAs, and LBHAs

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)SUBCHAPTER C. RESPONSIBILITIES26 TAC §303.303OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency amended §303.303 for a 60-day period. The text of the emergency rule was originally published in the July 10, 2020, issue of the Texas Register (45 TexReg 4599).HHSC is renewing the emergency amendment to 26 TAC §303.303 to allow new new staff conducting a PE or resident review at a LIDDA, LMHA, or LBHA to meet revised training requirements before conducting PASRR evaluations and resident reviews, providing habilitation coordination, or providing service coordination for transition planning. Rather than attend HHSC in-person PASRR trainings, which are suspended during the COVID-19 pandemic to comply with social distancing requirements, new staff conducting a PE or resident review must complete HHSC computer-based training and local training from the LIDDA, LMHA, or LBHA. LIDDAs also currently do not have access to HHSC-approved person-centered thinking trainings. For new staff conducting a PE or resident review who have not attended HHSC-developed in-person PASRR trainings or HHSC-approved person-centered thinking training, the LIDDA, LMHA, or LBHA must ensure a supervisor, team lead, or quality monitoring staff person who has successfully completed the training reviews and signs off on the employee’s work.DURATIONAs authorized by Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that COVID-19 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 political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of emergency amendments in 26 TAC Chapter 303, Subchapters C, E, and G.

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Texas Health and Human Services Commission

Emergency Rule

Renewing emergency amendment to 26 TAC §303.502 to establish revised training requirements for new habilitation coordinators at LIDDAs, LMHAs, and LBHAs

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)SUBCHAPTER E. HABILITATION COORDINATION26 TAC §303.502OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency amended §303.502 for a 60-day period. The text of the emergency rule was originally published in the July 10, 2020, issue of the Texas Register (45 TexReg 4599).HHSC is adopting the emergency amendment to 26 TAC §303.502 to allow new habilitation coordinators at a LIDDA, LMHA, or LBHA to meet revised training requirements before conducting PASRR evaluations and resident reviews, providing habilitation coordination, or providing service coordination for transition planning. Rather than attend HHSC in-person PASRR trainings, which are suspended during the COVID-19 pandemic to comply with social distancing requirements, new habilitation coordinators must complete HHSC computer-based training and local training from the LIDDA, LMHA, or LBHA. LIDDAs also currently do not have access to HHSC-approved person-centered thinking trainings. For new habilitation coordinators who have not attended HHSC-developed in-person PASRR trainings or HHSC-approved person-centered thinking training, the LIDDA, LMHA, or LBHA must ensure a supervisor, team lead, or quality monitoring staff person who has successfully completed the training reviews and signs off on the employee’s work.DURATIONAs authorized by Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that COVID-19 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 political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of emergency amendments in 26 TAC Chapter 303, Subchapters C, E, and G.

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Texas Health and Human Services Commission

Emergency Rule

Renewing emergency amendment to 26 TAC §303.703 to establish revised training requirements for new transition planning coordinators at LIDDAs, LMHAs, and LBHAs

CHAPTER 303. PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)SUBCHAPTER G. TRANSITION PLANNING26 TAC §303.703OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency amended §303.703 for a 60-day period. The text of the emergency rule was originally published in the July 10, 2020, issue of the Texas Register (45 TexReg 4599).HHSC is renewing the emergency amendment 26 TAC §303.703 to allow new transition planning coordinators at a LIDDA, LMHA, or LBHA to meet revised training requirements before conducting PASRR evaluations and resident reviews, providing habilitation coordination, or providing service coordination for transition planning. Rather than attend HHSC in-person PASRR trainings, which are suspended during the COVID-19 pandemic to comply with social distancing requirements, new transition planning coordinators must complete HHSC computer-based training and local training from the LIDDA, LMHA, or LBHA. LIDDAs also currently do not have access to HHSC-approved person-centered thinking trainings. For new transition planning coordinators who have not attended HHSC-developed in-person PASRR trainings or HHSC-approved person-centered thinking training, the LIDDA, LMHA, or LBHA must ensure a supervisor, team lead, or quality monitoring staff person who has successfully completed the training reviews and signs off on the employee’s work.DURATIONAs authorized by Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.BACKGROUND AND JUSTIFICATIONThe purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that COVID-19 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 political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of emergency amendments in 26 TAC Chapter 303, Subchapters C, E, and G.

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Texas Health and Human Services Commission

Emergency Rule

Renewing emergency rule 26 TAC §745.10003 to impose heightened safety measures as a condition of licensing for certain day care operations

CHAPTER 745. LICENSINGSUBCHAPTER X. EMERGENCY RULESDIVISION 1. RULES FOR CERTAIN DAY CARE OPERATIONS IN RESPONSE TO COVID-1926 TAC §745.10003OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §745.10003 for a 60-day period. The text of the emergency rule was originally published in the July 3, 2020, issue of the Texas Register (45 TexReg 4433).HHSC is renewing this emergency rule to: (1) require compliance with CDC requirements for child care programs; (2) require caregiver training related to COVID-19; (3) require screening of persons and children entering an operation and explicitly deny entry to persons or children that meet a screening criteria;(4) require a pick-up and drop-off plan for children; (5) require stricter standards when changing diapers and when clothes get contaminated; (6) adjust the HVAC system; (7) limit the use of cloth toys; (8) require the posting of handwashing posters; (9) limit the use of food preparation sinks; (10) not allow the serving of family style meals; and (11) clarify that a more restrictive rule or executive order controls.BACKGROUND AND JUSTIFICATION As authorized by Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed once for not longer than 60 days.The purpose of the emergency rulemaking is to support: (1) the Governor’s continuing 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; and (2) the minimum standard health protocols that the Governor’s Strike Force to Open Texas created to help protect the health and safety of employees and children in child care centers during COVID-19. In the Governor’s proclamation, he authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule with Ongoing Requirements for Certain Day Care Operations in Response to COVID-19.

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Texas Department on Aging and Disability Services

Emergency Rule

Amending 40 TAC §47.25 to allow Primary Home Care (PHC), Community Attendant Services (CAS), and Family Care (FC) programs to conduct attendant orientation virtually during the COVID-19 pandemic

CHAPTER 47. PRIMARY HOME CARE, COMMUNITY ATTENDANT SERVICES, AND FAMILY CARE PROGRAMSSUBCHAPTER C. STAFF REQUIREMENTS40 TAC §47.25OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40 Texas Administrative Code, Chapter 47 Primary Home Care, Community Attendant Services, and Family Care Programs, amendments to §47.25, concerning emergency rules in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect individuals receiving attendant services in the Primary Home Care (PHC), Community Attendant Services (CAS), and Family Care (FC) Programs and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency amendment in §47.25(b)(C) to allow a supervisor to conduct an attendant’s orientation by telephone or videoconferencing at the discretion of the supervisor at any location with or without the participation of the individual receiving attendant services.BACKGROUND AND JUSTIFICATIONAs 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 these emergency amendments to §47.25, Attendant Orientation, and §47.65, Supervisory Visits.

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Texas Health and Human Services Commission

Emergency Rule

Amending 40 TAC §47.65 to allow Primary Home Care (PHC), Community Attendant Services (CAS), and Family Care (FC) program supervisors to virtually conduct supervisory visits during the COVID-19 pandemic

CHAPTER 47. PRIMARY HOME CARE, COMMUNITY ATTENDANT SERVICES, AND FAMILY CARE PROGRAMSSUBCHAPTER E. SERVICE REQUIREMENTS40 TAC §47.65OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40 Texas Administrative Code, Chapter 47 Primary Home Care, Community Attendant Services, and Family Care Programs, amendments to §47.65, concerning emergency rules in response to COVID-19 in order to reduce the risk of transmission of COVID-19. To protect individuals receiving attendant services in the Primary Home Care (PHC), Community Attendant Services (CAS), and Family Care (FC) Programs and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting this emergency amendment in §47.65(e) so that a supervisor is not required to conduct in-person supervisory visits. The emergency amendment allows a supervisor to conduct a supervisory visit by telephone or videoconference.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 these emergency amendments to §47.25, Attendant Orientation, and §47.65, Supervisory Visits.

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Texas Health and Human Services Commission

Proposed Rules

Amending 1 TAC §355.8201 to update and clarify the secondary reconciliation process and subsequent repayment to hospitals for Uncompensated Care

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER J. PURCHASED HEALTH SERVICESDIVISION 11. TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM REIMBURSEMENT1 TAC §355.8201OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8201, concerning Waiver Payments to Hospitals for Uncompensated Care.SECTION-BY-SECTION SUMMARYThe proposed amendment to §355.8201(i)(3) revises the secondary reconciliation process applied to hospitals that requested an adjustment to their interim HSL in demonstration years 6 through 8. The proposed amendment also includes other clarifying changes to indicate which demonstration years are subject to the secondary reconciliation process.The proposed amendment to §355.8201(k) adds new language to describe the methodology HHSC will use to redistribute recouped funds. The previous language contained in subsection (k) is moved to new §355.8201(l).BACKGROUND AND JUSTIFICATIONThe purpose of the proposal is to revise the secondary reconciliation process applied to hospitals that requested an adjustment to their interim hospital-specific limit (HSL) for purposes of calculating uncompensated care (UC) payments in demonstration years 6 through 8 (October 1, 2016 to September 30, 2019), and to describe the methodology HHSC will use to redistribute recouped funds. The amendment to the secondary reconciliation process is in response to a petition for rulemaking.Further explanation regarding secondary reconciliation and redistribution of recouped funds is included in this week’s edition of the Texas Register (45 Tex Reg 7812).  

State Board of Dental Examiners

Proposed Rules

Amending 22 TAC §104.1 to require training on human trafficking prevention as a condition of licensure

CHAPTER 104. CONTINUING EDUCATION22 TAC §104.1The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §104.1, concerning continuing education. The proposed rule is necessary to implement the requirements of House Bill 2059 of the 86th Texas Legislature, Regular Session (2019), and the Texas Occupations Code Chapter 116, requiring human trafficking prevention training for health care practitioners prior to the renewal of a license.

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State Board of Dental Examiners

Proposed Rules

New 22 TAC §111.5, establishing requirements for a controlled-substance prescriber to receive an Electronic Prescribing Waiver

CHAPTER 111. STANDARDS FOR PRESCRIBING CONTROLLED SUBSTANCES AND DANGEROUS DRUGS22 TAC §111.5The State Board of Dental Examiners (Board) proposes new rule 22 TAC §111.5 concerning Electronic Prescribing Waivers. The new rule is proposed to comply with the requirements of HB 2174 (86th Regular Legislative Session), which requires practitioners to electronically prescribe all controlled substances. The law allows for prescriber waivers which may be renewed annually, if the prescriber is experiencing: 1) economic hardship; 2) technological limitations not reasonably within the control of the prescriber; or 3) other exceptional circumstances demonstrated by the prescriber.

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State Board of Dental Examiners

Proposed Rules

Amending 22 TAC §114.12 to require dental assistants to participate in training on human trafficking prevention

CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS22 TAC §114.12The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §114.12, concerning continuing education for certificate holders. The proposed rule is necessary to implement the requirements of House Bill 2059 of the 86th Texas Legislature, Regular Session (2019), and the Texas Occupations Code Chapter 116, requiring human trafficking prevention training for health care practitioners prior to the renewal of a license.

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Texas Medical Board

Proposed Rules

New 22 TAC §161.11, establishing the Memorandum of Understanding between Texas Medical Board (TMB) and Texas Physician Health Program (TXPHP)

CHAPTER 161. GENERAL PROVISIONS22 TAC §161.11OVERVIEWThe Texas Medical Board (Board or TMB) proposes new rule 22 TAC §161.11, entitled Memorandum of Understanding between Texas Medical Board (TMB) and Texas Physician Health Program (TXPHP).BACKGROUND AND JUSTIFICATION The proposed rule §161.11 would adopt the Memorandum of Understanding entered into by the Texas Medical Board (TMB) and the Texas Physician Health Program (TXPHP), pursuant to H.B. 1504 (86th Legislature TMB Sunset Bill (2019)). H.B. 1504 added provision Texas Occupations Code §167.012 directing the TMB and TXPHP to enter into a memorandum of understanding to establish performance measures for the TXPHP, include a list of services provided by TMB to TXPHP, and require an internal audit of TXPHP to be completed once every three years.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §180.4 to remove an erroneous fee increase within the Texas Physician Health Program

CHAPTER 180. TEXAS PHYSICIAN HEALTH PROGRAM22 TAC §180.4OVERVIEWThe Texas Medical Board (Board or TMB) proposes amendments to 22 TAC §180.4 concerning Operation of Program.BACKGROUND AND JUSTIFICATION The proposed §180.4 would correct an error in the rule and is necessary to ensure that the rules are consistent with Texas Occupations Code Section 153.051(d)(10). The erroneous fee increase was implemented for a period of two weeks only and all fees received in excess of the statutory cap have been reimbursed or prorated.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §183.20 to require acupuncturists to complete training on human trafficking prevention as a condition of licensure

CHAPTER 183. ACUPUNCTURE22 TAC §183.20OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §183.20, concerning Continuing Acupuncture Education.BACKGROUND AND JUSTIFICATION The proposed amendments to §183.20, relating to Continuing Acupuncture Education, proposes amendments to implement new continuing education requirements set forth by H.B. 2059, passed by the 86th Legislature, Regular Session (2019). The new language requires that acupuncturists complete a course in the topic of human trafficking prevention, as part of the course hours required each biennial registration period. Carry forward hours will not apply to the new course. Other changes proposed to §183.20 are made to reorganize and format the rule.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §184.4 to remove the requirement that surgical assistants attest to good moral character as a condition of licensure

CHAPTER 184. SURGICAL ASSISTANTS22 TAC §184.4OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §184.4, concerning Qualifications for Licensure.BACKGROUND AND JUSTIFICATIONThe proposed amendments to §184.4, relating to Qualifications for Licensure, proposes to repeal language requiring an applicant for a surgical assistant license to attest to good moral character in order to obtain a license, pursuant to H.B. 1504 (86th Legislature (2019).

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Texas Medical Board

Proposed Rules

Amending 22 TAC §184.25 to require surgical assistants to complete training on human trafficking prevention as a condition of licensure

CHAPTER 184. SURGICAL ASSISTANTS22 TAC §184.25OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §184.25, concerning Continuing Education.BACKGROUND AND JUSTIFICATIONAmendments are proposed for §184.25, relating to Continuing Education, to implement new continuing education requirements set forth by H.B. 2059 (86th Leg.). The new language requires that licensed surgical assistants complete a course in the topic of human trafficking prevention, as part of the course hours required each biennial registration period. Carry forward hours will not apply to the new course requirement. Other changes proposed to 184.25 remove references to annual requirements, as the hours are required on a biennial basis. Remaining changes reorganize and format the rule.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §185.6 to require physician assistants to complete training on human trafficking prevention as a condition of biennial license renewal

CHAPTER 185. PHYSICIAN ASSISTANTS22 TAC §185.6OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §185.6, concerning Biennial Renewal of License.BACKGROUND AND JUSTIFICATION The proposed amendments to §185.6, relating to Biennial Renewal of License, proposes amendments to implement new continuing education requirements set forth by H.B. 2059 passed by the 86th Legislature, Regular Session (2019). The new language requires that physician assistants complete a course in the topic of human trafficking prevention. The new courses are to be completed as part of the formal course hours required each biennial registration period. Carry forwards will not be allowed toward the new requirements. Other changes are proposed to §185.6 are made to reorganize and format the rule.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §186.10 to require respiratory care practitioners to complete training on human trafficking prevention as a condition of licensure

CHAPTER 186. RESPIRATORY CARE PRACTITIONERS22 TAC §186.10OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §186.10, concerning Continuing Education Requirements.BACKGROUND AND JUSTIFICATIONThe proposed amendments to §186.10, relating to Continuing Education Requirements, propose amendments to implement new continuing education requirements set forth by H.B. 2059, passed by the 86th Legislature, Regular Session (2019). The new language requires that respiratory care practitioners complete a course in the topic of human trafficking prevention, as part of the course hours required each biennial registration period. Other changes proposed to 186.10 are made to reorganize and format the rule.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §187.9 to allow the Board to issue multiple remedial plans in response to complaints against licensees

CHAPTER 187. PROCEDURAL RULESSUBCHAPTER A. GENERAL PROVISIONS AND DEFINITIONS22 TAC §187.9OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §187.9, concerning Board Actions.BACKGROUND AND JUSTIFICATIONThe proposed amendments to §187.9 propose to repeal language limiting the board’s authority to issue more than one remedial plan to resolve complaints of violations of laws by licensees, pursuant to H.B. 1504 (86th Legislature TMB Sunset Bill (2019)). H.B. 1504 changed Texas Occupations Code §164.0015 so that the board is permitted to issue remedial plans to address minor law violations if the licensee has not received a remedial plan in the preceding five years. Remaining amendments delete language related to non-disciplinary orders, a type of order that the board has had no authority to issue since approximately 2009. Finally, the amendments delete an unnecessary reference to chapter 175 of the board rules.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §187.35 to update requirements for proposal presentation during a formal Board proceeding

CHAPTER 187. PROCEDURAL RULESSUBCHAPTER D. FORMAL BOARD PROCEEDINGS22 TAC §187.35OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §187.35, concerning Presentation of Proposal for Decision.BACKGROUND AND JUSTIFICATIONProposed amendments are made to §187.35, Presentation of Proposal for Decision, and §187.37, Final Decisions and Orders; pursuant to Texas Occupations Code Section 164.0072, added by H.B.1504 (86th Legislature TMB Sunset Bill (2019)).

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Texas Medical Board

Proposed Rules

Amending 22 TAC §187.37 to update procedure for the issuance of final decisions and orders in formal Board proceedings

CHAPTER 187. PROCEDURAL RULESSUBCHAPTER D. FORMAL BOARD PROCEEDINGS22 TAC §187.37OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §187.37, concerning Final Decisions and Orders. BACKGROUND AND JUSTIFICATIONProposed amendments are made to §187.35, Presentation of Proposal for Decision, and §187.37, Final Decisions and Orders; pursuant to Texas Occupations Code Section 164.0072, added by H.B.1504 (86th Legislature TMB Sunset Bill (2019)).

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Texas Medical Board

Proposed Rules

Repealing 22 TAC §187.38 to eliminate duplicative language regarding motions for rehearing in formal Board proceedings

CHAPTER 187. PROCEDURAL RULESSUBCHAPTER D. FORMAL BOARD PROCEEDINGS22 TAC §187.38OVERVIEWThe Texas Medical Board (Board) proposes the repeal of 22 TAC §187.38, concerning Motions for Rehearing.BACKGROUND AND JUSTIFICATIONSection 187.38, pertaining to Motions for Rehearing, is proposed for repeal, as Texas Government Code Chapter 2001 provides for a specific and clear process requiring no regulatory clarification.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §188.24 to require perfusionists to complete training on human trafficking prevention as a condition of licensure

CHAPTER 188. PERFUSIONISTS22 TAC §188.24OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §188.24, concerning Continuing Education.BACKGROUND AND JUSTIFICATION The proposed amendments to §188.24, relating to Continuing Education, proposes amendments to implement new continuing education requirements set forth by H.B. 2059, passed by the 86th Legislature, Regular Session (2019). The new language requires that perfusionists complete a course in the topic of human trafficking prevention, as part of the course hours required each biennial registration period. Other changes proposed to §188.24 are made to make language consistent with requirements being on a biennial basis, remove outdated language, and otherwise to reorganize and format the rule.

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Texas Medical Board

Proposed Rules

Amending 22 TAC §194.7 to require radiologist assistants, medical radiologic technologists, and non-certified technicians to complete training on human trafficking prevention as a condition of biennial license renewal

CHAPTER 194. MEDICAL RADIOLOGIC TECHNOLOGYSUBCHAPTER A. CERTIFICATE HOLDERS, NON-CERTIFIED TECHNICIANS, AND OTHER AUTHORIZED INDIVIDUALS OR ENTITIES22 TAC §194.7OVERVIEWThe Texas Medical Board (Board) proposes amendments to 22 TAC §194.7, concerning Biennial Renewal of Certificate or Placement on the Board’s Non-Certified Technician Registry.BACKGROUND AND JUSTIFICATIONThe proposed amendments to §194.7, relating to Biennial Renewal of Certificate or Placement on the Board’s Non-Certified Technician Registry, proposes amendments to implement new continuing education requirements set forth by H.B. 2059, passed by the 86th Legislature, Regular Session (2019). The new language requires that radiologist assistants, medical radiologic technologists, and non-certified technicians complete a course in the topic of human trafficking prevention, as part of the course hours required each biennial registration period. Carry forward hours will not apply to the new course requirement. For radiologist assistants, the course will be required in addition to the formal course hours. Other changes proposed to 194.7 reorganize and format the rule.

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Texas Department of State Health Services

Proposed Rules

Repealing 45 TAC, Chapter 404, Subchapter E (Rights of Persons Receiving Mental Health Services) to transition governance of the issue to HHSC

CHAPTER 404. PROTECTION OF CLIENTS AND STAFF–MENTAL HEALTH SERVICESSUBCHAPTER E. RIGHTS OF PERSONS RECEIVING MENTAL HEALTH SERVICES25 TAC §§404.151 – 404.169OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of 25 TAC, Chapter 404 (Protection of Clients and Staff – Mental Health Services), Subchapter E (Rights of Persons Receiving Mental Health Services) in its entirety. The proposed repeal of §§404.151 – 404.169 allows substantially similar new rules to be proposed in Title 26, Chapter 320, Subchapter A.BACKGROUND AND JUSTIFICATION The purpose of this proposal is to repeal rules no longer implemented by the Department of State Health Services in Texas Administrative Code (TAC) Title 25, Part 1, Chapter 404, Subchapter E, due to the consolidation of the Health and Human Services System by Senate Bill 200, 84th legislature, Regular Session, 2015. Rules that address the rights of individuals receiving mental health services are being proposed in Title 26, Part 1, Health and Human Services Commission, Chapter 320, Subchapter A. The new rules are proposed simultaneously elsewhere in this issue of the Texas Register.

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Texas Health and Human Services Commission

Proposed Rules

New 26 TAC, Chapter 320, Subchapter A (Rights of Individuals Receiving Mental Health Services), transferring governance on this issue from DSHS to HHSC

CHAPTER 320. RIGHTS OF INDIVIDUALSSUBCHAPTER A. RIGHTS OF INDIVIDUALS RECEIVING MENTAL HEALTH SERVICES26 TAC §§320.1 – 320.15OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Chapter 320, Rights of Individuals, Subchapter A, Rights of Individuals Receiving Mental Health Services. SECTION-BY-SECTION SUMMARYProposed new Subchapter A consists of the following sections: §320.1, which establishes the purpose of the subchapter.§320.2, which establishes to whom the subchapter applies.§320.3, which provides terminology used in the subchapter.§320.4, which establishes a right to freedom from abuse, neglect, and exploitation.§320.5, which establishes the rights which may not be restricted of individuals receiving mental health services.§320.6, which establishes the rights of individuals receiving mental health services.§320.7, which establishes the rights of individuals receiving inpatient services.§320.8, which establishes the rights of individuals at HHSC facilities, local mental health authorities, and local behavioral health authorities.§320.9, which establishes the right to request discharge.§320.10, which establishes the rights of individuals under age 18.§320.11, which establishes when rights can be restricted.§320.12, which describes the rights handbooks for individuals receiving mental health services.§320.13, which describes the communication of rights to individuals receiving mental health services.§320.14, which establishes a rights protection officer.§320.15, which establishes the rights of a legally authorized representative.BACKGROUND AND JUSTIFICATION The purpose of the proposal is to move rules previously implemented by the Department of State Health Services in Texas Administrative Code (TAC) Title 25, Part 1, Chapter 404, Subchapter E, to 26 TAC, Part 1, Health and Human Services Commission, due to the consolidation of the Health and Human Services System by Senate Bill 200, 84th legislature, Regular Session, 2015. Staff took this opportunity to update and reorganize the rules with a focus on incorporating plain language. The repeal of 25 TAC Chapter 404, Subchapter E is proposed simultaneously elsewhere in this issue of the Texas Register.The new rules outline the rights of individuals receiving mental health services and stipulates when rights may be restricted.

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Texas Department of Insurance

Proposed Rules

Amending 28 TAC §3.9901 to update the valuation manual for life, accident, and health insurance and annuities

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER RR. VALUATION MANUAL28 TAC §3.9901OVERVIEWThe Texas Department of Insurance (TDI) proposes to amend 28 TAC §3.9901, relating to the adoption of a valuation manual for reserving and related requirements.In addition to clarifying existing provisions, the 2021 valuation manual includes changes to:directly reference the interest rate used in the definition of life insurance under the Tax Code as the floor for the life nonforfeiture interest rate;allow for a transition from using the London Inter-bank Offered Rate because that rate standard is being eliminated;allow companies to use different credibility methods for different blocks of the life principle-based reserving business; andprovide that reserving must reflect risks due to policy conversions and be included in reporting requirements.The adopted changes to the valuation manual can be viewed at content.naic.org/sites/default/files/pbr_data_valuation_manual_future_edition_redline.pdf.BACKGROUND AND JUSTIFICATION Insurance Code §425.073 requires the Commissioner to adopt a valuation manual that is substantially similar to the valuation manual adopted by the National Association of Insurance Commissioners (NAIC). The valuation manual adopted by the NAIC may be viewed at the following website: content.naic.org/sites/default/files/pbr_data_valuation_manual_future_edition.pdf.TDI amends §3.9901 by striking the date on which the NAIC adopted its previous valuation manual and inserting the date on which the NAIC adopted its current valuation manual, changing it from August 6, 2019, to August 14, 2020.This proposal includes provisions related to NAIC rules, regulations, directives, or standards. Under Insurance Code §36.004, TDI must consider whether authority exists to enforce or adopt it. Additionally, under Insurance Code §36.007, an agreement that infringes on the authority of this state to regulate the business of insurance in this state has no effect unless the agreement is approved by the Texas Legislature. TDI has determined that neither §36.004 nor §36.007 prohibit the proposed rule, because Insurance Code §425.073 requires TDI to adopt a valuation manual that is substantially similar to the valuation manual approved by NAIC, and §425.073(c) expressly requires TDI to adopt changes to the valuation manual that are substantially similar to changes adopted by the NAIC.

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Texas Health and Human Services Commission

Withdrawn Rule

Withdrawing emergency rules 26 TAC §§567.1 – 567.4, which created the Certificate of Public Advantage for certain hospitals in low-population counties

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER A. GENERAL PROVISIONS26 TAC §§567.1 – 567.4The Health and Human Services Commission withdraws the emergency adoption of new §§567.1 – 567.4, which appeared in the June 12, 2020, issue of the Texas Register (45 TexReg 3951).

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Texas Health and Human Services Commission

Withdrawn Rule

Withdrawing emergency rules 26 TAC §§567.21 – 567.26, which outlined the application process for a Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER B. APPLICATION OF PUBLIC ADVANTAGE26 TAC §§567.21 – 567.26The Health and Human Services Commission withdraws the emergency adoption of new §§567.21 – 567.26, which appeared in the June 12, 2020, issue of the Texas Register (45 TexReg 3951).

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Texas Health and Human Services Commission

Withdrawn Rule

Withdrawing emergency rules 26 TAC §§567.31 – 567.33, which outlined operational requirements for a Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER C. OPERATIONAL REQUIREMENTS26 TAC §§567.31 – 567.33The Health and Human Services Commission withdraws the emergency adoption of new §§567.31 – 567.33, which appeared in the June 12, 2020, issue of the Texas Register (45 TexReg 3951).

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Texas Health and Human Services Commission

Withdrawn Rule

Withdrawing emergency rule 26 TAC §567.41, which outlined rate review requirements for a Certificate of Public Advantage hospital

Withdrawn Rule

Withdrawing emergency rules 26 TAC §§567.51 – 567.54, which outlined compliance and enforcement procedure for a Certificate of Public Advantage hospital

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER E. RATE REVIEW26 TAC §§567.51 – 567.54The Health and Human Services Commission withdraws the emergency adoption of new §§567.51 – 567.54, which appeared in the June 12, 2020, issue of the Texas Register (45 TexReg 3951).

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Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Amendment to §355.8201, relating to Waiver Payments to Hospitals for Uncompensated Care

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 17, 2020, at 2:00 p.m., to receive comment on proposed amendment to §355.8201, relating to Waiver Payments to Hospitals for Uncompensated Care.HHSC proposes to amend §355.8201, relating to Waiver Payments to Hospitals for Uncompensated Care. The proposed amendment is published in this week’s edition of the Texas Register (45 Tex Reg 7812). The purpose of the proposal is to revise the secondary reconciliation process applied to hospitals that requested an adjustment to their interim hospital-specific limit (HSL) for purposes of calculating uncompensated care (UC) payments in demonstration years 6 through 8 (October 1, 2016 to September 30, 2019), and to describe the methodology HHSC will use to redistribute recouped funds. The amendment to the secondary reconciliation process is in response to a petition for rulemaking.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only. No physical entry to the hearing will be permitted.Please register for the HHSC Public Hearing for Proposed Amendment to Waiver Payments to Hospitals for Uncompensated Care to be held on November 17, 2020, 2:00 p.m. CST at:https://attendee.gotowebinar.com/register/1916956052650995469. After registering, you will receive a confirmation email containing information about joining the webinar.HHSC will broadcast the public hearing. The broadcast will be archived for access on demand and can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings.PUBLIC COMMENT Written comments regarding the proposal may be sent by U.S. mail to HHSC, Mail Code H400, P.O. Box 13247, Austin, Texas 78711-3247, or by e-mail to RAD_1115_Waiver_Finance@hhsc.state.tx.us.To be considered, comments must be (1) postmarked or shipped before December 7, 2020; (2) hand-delivered before 5:00 p.m. on December 7, 2020; or (3) e-mailed before midnight on December 7, 2020. When e-mailing comments, please indicate “Comments on Proposed Rule 21R012” in the subject line.

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Texas Health and Human Services Commission

In Addition

HSC will request an amendment to the Healthy Texas Women (HTW) Waiver for additional funding to cover certain postpartum care services

OVERVIEWThe Health and Human Services Commission (HHSC) plans to submit a request to the Centers for Medicare & Medicaid Services (CMS) for an amendment to the Healthy Texas Women (HTW) waiver under section 1115 of the Social Security Act. CMS has approved this waiver through December 31, 2024.The amendment seeks to draw down federal funding for postpartum care services to treat major health conditions recognized as contributing to maternal morbidity and mortality in Texas, including: Postpartum depression and other mental health conditionsCardiovascular and coronary conditionsSubstance use disordersDiabetesAsthmaIf approved by CMS, the waiver amendment proposed by HHSC will provide federal matching funds for postpartum care services for women enrolled in HTW, with an effective date of April 1, 2021.BACKGROUND AND JUSTIFICATION This amendment is being requested to comply with Texas Health and Safety Code, Section 32.102, as added by Senate Bill (S.B.) 750, 86th Legislature, Regular Session, 2019. Section 32.102 requires HHSC to evaluate postpartum care services provided to women enrolled in the HTW program after the first 60 days of the postpartum period and, based on the evaluation, develop enhanced, cost-effective, and limited postpartum care services for women enrolled in the program. HHSC launched the enhanced postpartum care services package, called HTW Plus, for eligible women enrolled in HTW on September 1, 2020, using state general revenue funds. S.B. 750 directs HHSC to seek an amendment to the Section 1115 Demonstration Waiver to obtain CMS approval to draw down federal funds for the postpartum care services.PUBLIC COMMENT An individual may obtain a free copy of the proposed waiver amendment, ask questions, obtain additional information, or submit comments regarding this amendment by contacting Amanda Sablan by U.S. mail, telephone, or email. Those addresses are listed in this week’s edition of the Texas Register (45 Tex Reg 8055). 

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Texas Health and Human Services Commission

In Addition

HHSC will request an amendment to the Medically Dependent Children Program (MDCP) Waiver to temporarily extend the Request for Evidentiary Information report submission deadline

OVERVIEWHHSC has requested approval to extend the Request for Evidentiary Information (REI) report submission deadline by 60 days from November 30, 2020, to January 29, 2021. The REI demonstrates the state’s use of performance measures to collect home and community-based (HCBS) waiver program data and addresses how the state conducts discovery, remediation, and quality improvement activities.HHSC has requested approval to implement the change until no later than the end of the public health emergency. The effective date for this amendment is March 13, 2020.PUBLIC COMMENT An individual may obtain a free copy of the waiver amendment, ask questions, or obtain additional information regarding this amendment by contacting Luis Solorio by U.S. mail, telephone, fax, or email. Those addresses are listed in this week’s edition of the Texas Register (45 Tex Reg 8056). 

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Texas Department of Insurance

In Addition

TDI will hold a public hearing to consider the adoption of new chemical dependency treatment standards

OVERVIEWThe Department of Insurance will hold a public hearing to consider the repeal of 28 TAC §§3.8001 – 3.8030, relating to chemical dependency treatment standards, and the adoption of the new 28 TAC §3.8001, relating to the regulation of chemical dependency treatment standards, published in the Texas Register on September 25, 2020 (45 TexReg 6684).HEARING DETAILSTo avoid the risk of transmission of COVID-19, the hearing will take place remotely. It will begin at 11:00 a.m., Central time, November 24, 2020. TDI’s website has instructions on how to register for and participate in the hearing. This information is available at www.tdi.texas.gov/alert/event/2020/11/docket-2824.If you plan to speak, you should register on or before noon, Central time, on November 20, 2020. Please make certain you register for Docket No. 2824. You will be called by name when it is your turn to speak.PUBLIC COMMENT The period to submit written comments on this rule proposal closed at 5:00 p.m., Central time, on Monday, October 26, 2020, and all written comments received during the comment period will be taken into consideration in preparation of the adoption order. TDI will also consider oral comments made during this public hearing.

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Texas Department of Insurance

In Addition

TDI will hold a public hearing to consider the Provider Network Exam and Directories rule

OVERVIEWThe Department of Insurance will hold a public hearing to consider the Provider Network Exam and Directories rule, concerning amendments to 28 TAC §§3.3701, 3.3702, 3.3705, 3.3709, 3.3720 – 3.3723, and the repeal of §3.9208, published in the Texas Register on September 25, 2020 (45 TexReg 6673).HEARING DETAILSTo avoid the risk of transmission of COVID-19, the hearing will take place remotely. It will begin at 10:00 a.m., Central Time, on November 23, 2020. TDI’s website has instructions on how to register for and participate in the hearing. This information is available at www.tdi.texas.gov/alert/event/2020/11/docket-2823.If you plan to speak, you should register on or before noon, Central Time, on November 19, 2020. Please make certain you register for Docket No. 2823. You will be called by name when it is your turn to speak.PUBLIC COMMENT The period to submit written comments on this rule proposal closed at 5:00 p.m., Central Time, on Monday, October 26, 2020, and all written comments received during the comment period will be taken into consideration in preparation of the adoption order. TDI will also consider oral comments made during this public hearing.

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