Texas Register Table of Contents
- 1 Governor
- 2 Texas Department of Licensing and Regulation
- 3 Texas Department of State Health Services
- 3.0.1 Proposed Rule Reviews Re:
- 3.0.1.1 Proposed review of Title 25, Part 1, to review and consider for readoption, revision, or repeal the chapter covering communicable diseases.
- 3.0.1.2 Proposed Rule Review of Title 25, Part 1 to to review and consider for readoption, revision, or repeal the chapter the chapter addressing asbestos health protection.
- 3.0.1.3 Proposed Rule Review of Title 25, Part 1 to to review and consider for readoption, revision, or repeal the chapter the chapter coving indoor air quality for government buildings.
- 3.0.1 Proposed Rule Reviews Re:
- 4 Texas Health and Human Services Commission
- 4.0.1 Adopted Rule Reviews Re:
- 4.0.1.1 Adopting the Rule Review for Title 26, Part 1, related to Intermediate Care Facilities for Individuals with an Intellectual Disability or other related condition.
- 4.0.1.2 Adopting the Rule Review for Title 26, Part 1, to review the chapter covering the certification standards for the Texas Home Living (TxHmL) Programs and Community First Choice (CFC).
- 4.0.2 In Addition Re:
- 4.0.2.1 Public Notice – Amendments to the Texas State Plan for Medical Assistance and the Texas State Plan for the Children’s Health Insurance Program
- 4.0.2.2 Public Notice – CLASS EVV Amendment, to amend waiver applications for the Community Living Assistance and Support Services (CLASS) program regarding Electronic Visit Verification (EVV) requirements.
- 4.0.2.3 Public Notice – DBMD Amendment, to amend the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) program pertaining to the Electronic Visit Verification (EVV) requirements.
- 4.0.2.4 Public Notice – HCS Amendment, to to amend the Home and Community-based Services (HCS) waiver program specifically the Electronic Visit Verification (EVV) requirements.
- 4.0.2.5 Public Notice – MDCP Amendment, to amend the waiver application for the Medically Dependent Children Program (MDCP) program regarding the Electronic Visit Verification (EVV) requirements.
- 4.0.2.6 Revised TxHML Public Notice, to describe all of the services that will require Electronic Visit Verification (EVV) including home health services.
- 4.0.1 Adopted Rule Reviews Re:
Governor
Appointments Re:
The Governor appointed three individuals to the Texas State Board of Examiners of Marriage and Family Therapists.
Appointed to the Texas State Board of Examiners of Marriage and Family Therapists for a term to expire February 1, 2029:
- Barbara E. “Barbie” Ezell of Portland, Texas;
- Lisa V. Merchant, Ph.D. of Clyde, Texas; and
- Nicole M. Richardson of Westlake Hills, Texas
Texas Department of Licensing and Regulation
Proposed Rules Re:
Amending 16 TAC §115.80, to reduce the initial application fee for midwife licenses from $275 to $195 and reduce the renewal fee from $550 to $390.
CHAPTER 115. MIDWIVES
16 TAC §115.80
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to the existing rule at 16 Texas Administrative Code (TAC), Chapter 115, §115.80, regarding the Midwives program. These proposed changes are referred to as “proposed rule.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 115, implement Texas Occupations Code, Chapter 203, Midwives.
The proposed rule lowers the application fee for an initial midwife license from $275 to $195 and lowers the application fee for renewal of a midwife license from $550 to $390. The proposed rule is necessary to set fees in amounts reasonable and necessary to cover the costs of administering the Midwives program, as required by Texas Occupations Code §51.202. Department staff reviewed the costs of administering the Midwives program and determined that license application fees should be lowered so that the revenue from the fees does not exceed the costs of administering the program.
Advisory Board Recommendations
Due to time constraints, the proposed rule was not presented to the Midwives Advisory Board prior to publication of the proposed rule in the Texas Register. However, the proposed rule will be presented to the Advisory Board before being presented to the Texas Commission of Licensing and Regulation (Commission) for possible adoption.
SECTION-BY-SECTION SUMMARY
The proposed rule amends §115.80, Fees, by reducing the midwife license initial application fee in paragraph (1) from $275 to $195 and by reducing the midwife license renewal application fee in paragraph (2) from $550 to $390 for each two-year renewal period.
Texas Department of State Health Services
Proposed Rule Reviews Re:
Proposed review of Title 25, Part 1, to review and consider for readoption, revision, or repeal the chapter covering communicable diseases.
The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:
Chapter 97, Communicable Diseases
Subchapter A – Control of Communicable Diseases
Subchapter B – Immunization Requirements in Texas Elementary and Secondary Schools and Institutions of Higher Education
Subchapter C – Consent for Immunization
Subchapter D – Statewide Immunization of Children in Certain Facilities and by Hospitals, Physicians, and Other Health Care Providers
Subchapter E – Provision of Anti-Rabies Biologicals
Subchapter F – Sexually Transmitted Diseases Including Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV)
Subchapter G – Vaccination Stamps
Subchapter H – Tuberculosis Screening for Jails and Other Correctional Facilities
Subchapter I – Immunization Requirements for Residents of Texas Nursing Homes
Subchapter K – Respiratory Syncytial Virus
Proposed Rule Review of Title 25, Part 1 to to review and consider for readoption, revision, or repeal the chapter the chapter addressing asbestos health protection.
The Texas Health and Human Services Commission (HHSC), on behalf of Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:
Chapter 296, Texas Asbestos Health Protection
Subchapter A. General Provisions
Subchapter B. Definitions
Subchapter C. Standards of Conduct
Subchapter D. License and Registration
Subchapter E. Training Provider License and Training Courses
Subchapter F. License and Registration Fees
Subchapter G. State Licensing Examination
Subchapter H. License and Registration Provisions Related to Military Service Members, Military Veterans, and Military Spouses
Subchapter I. Accreditation
Subchapter J. Exemptions
Subchapter K. Asbestos Management in a Public Building, Commercial Building, or Facility
Subchapter L. General Requirements, and Practices and Procedures for Asbestos Abatement in a Public Building
Subchapter M. Alternative Asbestos Practices and Procedures in a Public Building
Subchapter N. Notifications
Subchapter O. Inspections and Investigations
Subchapter P. Recordkeeping
Subchapter Q. Compliance
Proposed Rule Review of Title 25, Part 1 to to review and consider for readoption, revision, or repeal the chapter the chapter coving indoor air quality for government buildings.
The Texas Health and Human Services Commission (HHSC), on behalf of Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:
Chapter 297, Indoor Air Quality
Subchapter A Government Buildings
Texas Health and Human Services Commission
Adopted Rule Reviews Re:
OVERVIEW
The Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code:
Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions
Subchapter A Introduction
Subchapter B Application Procedures
Subchapter C Standards for Licensure
Subchapter D General Requirements for Facility Construction
Subchapter F Inspections, Surveys, and Visits
Subchapter G Abuse, Neglect, and Exploitation; Complaint and Incident Reports and Investigations
Subchapter H Enforcement
Subchapter J Respite Care
Subchapter L Provisions Applicable to Facilities Generally
Adopting the Rule Review for Title 26, Part 1, to review the chapter covering the certification standards for the Texas Home Living (TxHmL) Programs and Community First Choice (CFC).
OVERVIEW
The Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code:
Chapter 566, Texas Home Living (TxHmL) Program and Community First Choice (CFC) Certification Standards
In Addition Re:
Public Notice – Amendments to the Texas State Plan for Medical Assistance and the Texas State Plan for the Children’s Health Insurance Program
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit the following amendments: Transmittal Number 23-0028 to amend the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act; and Transmittal Number 23-0029 to amend the Texas State Plan for the Children’s Health Insurance Program (CHIP) under Title XXI of the Social Security Act. The requested effective date of the proposed amendments is March 1, 2024.
The purpose of these amendments is to provide 12 months of continuous postpartum coverage to pregnant individuals who were enrolled under CHIP or Medicaid while pregnant. The 12-month postpartum period begins on the last day of a beneficiary’s pregnancy and extends through the end of the month in which the 12-month period ends.
Individuals who were enrolled in Medicaid or CHIP while pregnant and are still less than 12 months postpartum, but whose coverage was terminated prior to the effective date of these amendments, will be provided continuous eligibility for the remainder of their 12-month postpartum period provided they continue to be state residents.
Additionally, a previous amendment to the CHIP State Plan allowed 12-month continuous coverage for children under the age of nineteen effective January 1, 2022. This CHIP state plan amendment also reflects this coverage.
Public Notice – CLASS EVV Amendment, to amend waiver applications for the Community Living Assistance and Support Services (CLASS) program regarding Electronic Visit Verification (EVV) requirements.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Community Living Assistance and Support Services (CLASS) program. HHSC administers the CLASS Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the CLASS waiver application through August 31, 2024. The proposed effective date for this amendment is February 26, 2024.
The request proposes to amend Appendix I to change existing language regarding Electronic Visit Verification (EVV) requirements. HHSC currently requires program providers to use EVV for certain personal care services. This amendment addresses the requirement in §1903(l) of the Social Security Act (U.S.C. Title 42, §1396b(l)) to also use EVV for home health care services. The amendment references the state rules that describe all of the services for which the use of EVV is required instead of listing the specific services. These state rules do not currently include the home health services for which the use of EVV will be required but will include these services by January 2024. The personal care service for which the use EVV is currently required is in-home respite delivered by the provider or through the consumer directed services (CDS) option. The home health care services for which the use of EVV will be required effective January 1, 2024, are nursing services, occupational therapy services, and physical therapy services delivered by the provider or through the CDS option.
The CLASS waiver program provides community-based services and supports to individuals with a related condition who live in their own homes or in the home of another person, such as a family member. Services and supports are intended to enhance quality of life, functional independence, health and welfare, and to supplement, rather than replace, existing informal or formal supports and resources. Services in the CLASS waiver program are case management, prevocational services, residential habilitation, respite (in-home and out of home), supported employment, prescribed drugs, financial management services, support consultation, adaptive aids, auditory integration training/auditory enhancement training, behavioral support, cognitive rehabilitation therapy, continued family services, dental treatment, dietary, employment assistance, minor home modifications, nursing, occupational therapy services, physical therapy services, specialized therapies, speech and language pathology, support family services and transition assistance services.
Public Notice – DBMD Amendment, to amend the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) program pertaining to the Electronic Visit Verification (EVV) requirements.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) program. HHSC administers the DBMD Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the DBMD waiver application through February 29, 2028. The proposed effective date for this amendment is February 26, 2024.
The request proposes to amend Appendix I to change existing language regarding Electronic Visit Verification (EVV) requirements. HHSC currently requires program providers to use EVV for certain personal care services. This amendment addresses the requirement in §1903(l) of the Social Security Act (U.S.C. Title 42, §1396b(l)) to also use EVV for home health care services. The amendment references the state rules that describe all of the services for which the use of EVV is required instead of listing the specific services. These state rules do not currently include the home health services for which the use of EVV will be required but will include these services by January 2024. The personal care service for which the use EVV is currently required is in-home respite delivered by the provider or through the consumer directed services (CDS) option. The home health care services for which the use of EVV will be required effective January 1, 2024, are nursing services, occupational therapy services, and physical therapy services delivered by the provider.
The DBMD waiver program provides community-based services and supports to individuals with legal blindness, deafness, or a condition that leads to deaf blindness, and at least one additional disability that limits functional abilities and who live in their own homes or in the home of another person, such as a family member or in a small group home setting. Services and supports are intended to enhance quality of life, functional independence, health and welfare, and to supplement, rather than replace, existing informal or formal supports and resources. Services in the DBMD waiver program are case management, residential habilitation, respite (in-home and out of home), supported employment, prescribed medications, financial management services, support consultation, adaptive aids and medical supplies, assisted living, audiology services, behavioral support, chore services, dental treatment, dietary services, employment assistance, intervener, minor home modifications, nursing, occupational therapy services, orientation and mobility, physical therapy services, speech, hearing and language therapy, transition assistance services and individualized skills and socialization.
Public Notice – HCS Amendment, to to amend the Home and Community-based Services (HCS) waiver program specifically the Electronic Visit Verification (EVV) requirements.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the Home and Community-based Services (HCS) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the HCS waiver application through August 31, 2028. The proposed effective date for the amendment is February 26, 2024.
The request proposes to amend Appendix I to change existing language regarding Electronic Visit Verification (EVV) requirements. HHSC currently requires program providers to use EVV for certain personal care services. This amendment addresses the requirement in §1903(l) of the Social Security Act (U.S.C. Title 42, §1396b(l)) to also use EVV for home health care services. The amendment references the state rules that describe all of the services for which the use of EVV is required instead of listing the specific services. These state rules do not currently include the home health services for which the use of EVV will be required but will include these services by January 2024. The personal care services for which the use EVV are currently required are in-home respite delivered by the provider or through the consumer directed services (CDS) option and in-home individualized skills and socialization delivered by the provider. The home health care services for which the use of EVV will be required effective January 1, 2024, are nursing services delivered by the provider or through the consumer directed services (CDS) option, occupational therapy services delivered by the provider, and physical therapy services delivered by the provider.
Public Notice – MDCP Amendment, to amend the waiver application for the Medically Dependent Children Program (MDCP) program regarding the Electronic Visit Verification (EVV) requirements.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Medically Dependent Children Program (MDCP) program. HHSC administers the MDCP Program under the authority of Section 1915(c) of the Social Security Act. The proposed effective date for this amendment is February 26, 2024.
The request proposes to amend Appendix I to change existing language regarding Electronic Visit Verification (EVV) requirements. HHSC currently requires program providers to use EVV for certain personal care services. This amendment addresses the requirement in §1903(l) of the Social Security Act (U.S.C. Title 42, §1396b(l)) to also use EVV for home health care services. The amendment references the state rules that describe all of the services for which the use of EVV is required instead of listing the specific services. These state rules do not currently include the home health services for which the use of EVV will be required but will include these services by January 2024. The personal care services for which the use EVV is currently required are in-home respite provided by an attendant delivered by the provider or through the consumer directed services (CDS) option and flexible family support services provided by an attendant delivered by the provider or through the CDS option. The home health care services for which the use of EVV will be required effective January 1, 2024, are in-home respite provided by a nurse, and flexible family support services provided by a nurse delivered by the provider or through the CDS option.
The MDCP waiver program provides home and community-based services to medically fragile individuals from birth through age 20 who, without the waiver program, would require institutionalization in a nursing facility. Services in the MDCP waiver program include respite, adaptive aids, minor home modifications, employment assistance, supported employment, financial management services, transition assistance services, and flexible family support services. Texas uses the MDCP waiver program to provide services to Texans in the least restrictive environment possible. These environments include the individual’s or a family member’s home, or a Child Protective Services foster care home which can meet the individual’s complex medical needs.
Revised TxHML Public Notice, to describe all of the services that will require Electronic Visit Verification (EVV) including home health services.
OVERVIEW
This revised Public Notice of Intent (PNI) replaces the PNI that was issued on October 6, 2023. The revisions are in bold type or otherwise noted.
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Texas Home Living (TxHmL) program. HHSC administers the TxHmL Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the TxHmL waiver application through February 28, 2027.
The new proposed effective date for this amendment is February 26, 2024.
The request proposes to amend Appendix I to change existing language regarding Electronic Visit Verification (EVV) requirements. HHSC currently requires program providers to use EVV for certain personal care services. This amendment addresses the requirement in §1903(l) of the Social Security Act (U.S.C. Title 42, §1396b(l)) to also use EVV for home health care services. The amendment references the state rules that describe all of the services for which the use of EVV is required instead of listing the specific services. These state rules do not currently include the home health services for which the use of EVV will be required but will include these services by January 2024. The personal care services for which the use EVV are currently required are in-home respite and in-home individualized skills and socialization delivered by the provider or through the consumer directed services (CDS) option. The home health care services for which the use of EVV will be required effective January 1, 2024, are nursing services, occupational therapy services, and physical therapy services delivered by the provider or through the consumer directed services (CDS) option.