Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 1.0.1 Proposed Rules Re:
- 1.0.1.1 Amending 1 TAC §372.354 to exclude the full amount of one prepaid burial insurance policy, funeral plan or funeral agreement for each household member as a resource when determining TANF eligibility.
- 1.0.1.2 Amending 1 TAC §372.1507 to expand the TANF supplemental grandparent payment to include aunts, uncles, and siblings.
- 1.0.1.3 Amending 26 TAC §§307.155, 307.163, 307.165, 307.167, 307.169, 307.175, repealing §307.157, and new §§307.157 and 307.159, concerning the timeline of outpatient competency restoration services for behavioral health programs.
- 1.0.2 Adopted Rules Re:
- 1.0.3 In Addition Re:
- 1.0.1 Proposed Rules Re:
- 2 Texas Department of Licensing and Regulation
- 3 Department of State Health Services
- 3.0.1 Proposed Rules Re:
- 3.0.1.1 Amending 25 TAC §117.41 and §117.45 to update emergency preparedness requirements and contingency operations plans for end stage renal disease (ESRD) facilities.
- 3.0.1.2 Amending 25 TAC §117.91 to include potable water requirements as part of an emergency contingency plan for end stage renal disease facilities.
- 3.0.2 In Addition Re:
- 3.0.1 Proposed Rules Re:
- 4 Texas Board of Nursing
Texas Health and Human Services Commission
Proposed Rules Re:
Amending 1 TAC §372.354 to exclude the full amount of one prepaid burial insurance policy, funeral plan or funeral agreement for each household member as a resource when determining TANF eligibility.
CHAPTER 372. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS
SUBCHAPTER B. ELIGIBILITY
1 TAC §372.354
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §372.354, concerning Treatment of Resources in TANF.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to align policy regarding the treatment of prepaid burial insurance, funeral plans and other funeral agreements for the Temporary Assistance for Needy Families (TANF) program with recently changed resource policy under the Supplemental Nutrition Assistance Program (SNAP). HHSC proposes to exclude the full amount of funeral agreements as a resource when determining eligibility for TANF.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §372.354 excludes the full amount of one prepaid burial insurance policy, funeral plan or funeral agreement for each household member as a resource when determining TANF eligibility.
Amending 1 TAC §372.1507 to expand the TANF supplemental grandparent payment to include aunts, uncles, and siblings.
CHAPTER 372. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS
SUBCHAPTER F. BENEFITS
1 TAC §372.1507
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §372.1507, concerning TANF Supplemental Grandparent Payment.
BACKGROUND AND JUSTIFICATION
The proposal is necessary to comply with Senate Bill (S.B.) 263, 87th Legislature, Regular Session, 2021, which requires HHSC to expand who may receive a one-time $1,000 TANF Supplemental Grandparent Payment from only grandparents to also include aunts, uncles, and siblings.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §372.1507 expands the one-time TANF Supplemental Grandparent Payment to include aunts, uncles and siblings. The proposed amendment also retitles the rule to “TANF Supplemental Relative Payment.” This amendment aligns the rule with the requirements of S.B. 263.
Amending 26 TAC §§307.155, 307.163, 307.165, 307.167, 307.169, 307.175, repealing §307.157, and new §§307.157 and 307.159, concerning the timeline of outpatient competency restoration services for behavioral health programs.
CHAPTER 307. BEHAVIORAL HEALTH PROGRAMS
SUBCHAPTER D. OUTPATIENT COMPETENCY RESTORATION
26 TAC §§307.155, 307.157, 307.159, 307.163, 307.165, 307.167, 307.169, 307.175
The Texas Health and Human Services Commission (HHSC) proposes amendments to §307.155, concerning Definitions; §307.163, concerning Assessment, Reassessment and Court Reporting; §307.165, concerning Discharge Requirements; §307.167, concerning Data; §307.169, concerning Written Policies and Procedures; §307.175, concerning Compliance with Statutes and Rules; the repeal of §307.157, concerning Criteria for Admission to an Outpatient Competency Restoration Program; §307.159, concerning Recommendation Regarding Outpatient Competency Restoration Program Admission; and new §307.157, concerning Recommendation Regarding Outpatient Competency Restoration Program Admission; and §307.159, concerning Admission to an Outpatient Competency Restoration Program.
BACKGROUND AND JUSTIFICATION
The proposal implements Senate Bill 49, 87th Legislature, Regular Session, 2021 which amended Texas Code of Criminal Procedure Article 46B relating to when competency restoration services begin and when an extension of the initial restoration period begins. In addition, HHSC proposes additional amendments to clarify statutory requirements and language for consistency and understanding, reorder requirements in the order in which processes occur, and update and add cross references.
SECTION-BY-SECTION SUMMARY
- Proposed amendment to §307.155 adds a definition for “extension” and deletes the definition of intellectual disability as the term is not used in this subchapter. Other definitions were renumbered accordingly.
- Proposed new §307.157 contains the requirements that were originally in §307.159 to reflect the order in which processes occur regarding criteria for assessing an individual, informing the court of the individual’s appropriateness for outpatient competency restoration (OCR) services, and treatment planning. The requirements have been updated to reflect current terminology and cross references.
- Proposed repeal of §307.157 deletes the rule language so it can be proposed in new §307.159 to reflect the order in which processes occur regarding court order of an individual’s participation in an OCR program.
- Proposed new §307.159 clarifies the procedures set forth in Code of Criminal Procedure Articles 46B.0711 and 46B.072 concerning court orders for outpatient competency restoration when an individual has been charged with a Class A or B misdemeanor or a felony. Proposed new §307.159(d) sets forth when the initial competency restoration period begins.
- Proposed repeal of §307.159 deletes the rule language so it can be proposed in new §307.157 to reflect the order in which processes occur regarding court order of an individual’s participation in an OCR program.
- Proposed amendment to §307.163 amends the section title; updates references; deletes “if the individual is active in the program” in §307.163(a)(2)(B); adds new §307.163(a)(4) regarding the deadline for notifying the court that the initial restoration period is to expire as required by Article 46B.079; and adds new §307.163(b) which states that the notification to the court may include a request for a 60-day extension of the initial restoration period for OCR services, and it must include an explanation for the request in accordance with Texas Code of Criminal Procedure, Article 46B.079(d).
- Proposed amendment to §307.165(a) establishes that discharge planning begins upon the individual’s admission into the OCR program; consolidates §307.165(a)(8) with §307.165(a)(2) deleting duplicative information; clarifies that the LMHA or LBHA in the individual’s county of residence coordinates ongoing services while the LIDDA responsible for coordination of ongoing services is based on the 5000 section of the LIDDA Handbook posted on HHSC’s website; and clarifies that the individual’s designated LIDDA facilitates service coordination in §307.165(b)(2).
- Proposed amendment to §307.167 updates language regarding the data an OCR provider must collect and report; and adds language that clarifies that the court determines whether an individual has not restored to competency at the conclusion of the court-ordered services.
- Proposed amendment to §307.169 revises the list of required written policies and procedures an OCR provider must develop and implement to outline processes; adds “to stand trial” in §307.169(11)(B); and adds a cross reference to Article 46B.077(c).
- Proposed amendment to §307.175 updates the other applicable statutes and rules for which an OCR provider must comply.
Adopted Rules Re:
CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER B. ADVISORY COMMITTEES
1 TAC §351.807
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts an amendment to Texas Administrative Code, Title 1, Part 15, Chapter 351, Subchapter B, §351.807 concerning the Behavioral Health Advisory Committee. The amendment to §351.807 is adopted without changes to the proposed text as published in the June 24, 2022, issue of the Texas Register (47 TexReg 3597), and therefore will not be republished.
BACKGROUND AND JUSTIFICATION
The amended rule revises the Behavioral Health Advisory Committee (BHAC) membership to align with federal best practices and accommodate current and future changes to the provision of behavioral health services. The amendment also aligns the format of §351.807 to follow agency guidelines.
Amending 26 TAC §331.17 to expand minimum qualifications for service coordinators.
CHAPTER 331. LIDDA SERVICE COORDINATION
26 TAC §331.17
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §331.17, concerning Minimum Qualifications. The amendment to §331.17 is adopted without changes to the proposed text as published in the July 22, 2022, issue of the Texas Register (47 TexReg 4252). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendment to §331.17 is necessary to change minimum qualifications for service coordinators. Local intellectual and developmental disability authorities (LIDDAs) across Texas are reporting workforce challenges, particularly among service coordinators, who previously needed at least a bachelor’s degree in a human services-related field of study, unless they met specific requirements in addition to having a high school diploma. Expanding the hiring qualifications for service coordinators will increase the pool of skilled applicants who may not have advanced degrees but are qualified to monitor services for people with intellectual and developmental disabilities based on previous unpaid or paid experiences. Expanding qualification requirements could have long-term positive effects for a vulnerable population that relies on LIDDA service coordinators to assist them in securing the services they need and achieving their desired outcomes and best quality of life.
HHSC also modified outdated references to mental retardation authority (MRA) with the current organizational title of local intellectual and developmental disability authority (LIDDA).
In Addition Re:
Correction of Error concerning the effective date of adopted amendments to 26 TAC §550.108.
OVERVIEW
The Texas Health and Human Services Commission adopted amendments to 26 TAC §550.108 in the October 7, 2022, issue of the Texas Register (47 TexReg 6588). Due to an error by the Texas Register, the effective date of the rulemaking was published incorrectly. The correct effective date is October 11, 2022.
Public Hearings for Home Health Supplies in Pharmacy
OVERVIEW
Public Notice: Value-Based Agreements for home health supplies, equipment, and appliances through the Pharmacy Benefit
The Texas Health and Human Services Commission (HHSC) announces its intent to submit transmittal number 22-0007 to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act.
BACKGROUND AND JUSTIFICATION
The purpose of this amendment is to allow certain home health supplies, equipment and appliances to be added to the pharmacy formulary. If the item is available in Texas Medicaid as a medical benefit, pharmacies will be reimbursed the same rates other providers are paid as listed in the Texas Medicaid fee schedule for medical benefits.
Some home health supplies, equipment, and appliances are only available through the pharmacy benefit with a prescription. This means the product will never be assigned a HCPCS code and will not have a reimbursement rate listed in the fee schedule for medical benefits. The amendment would apply the existing pharmacy reimbursement methodology listed in the Texas State Plan to home health supplies, equipment, and appliances covered under the pharmacy benefit when there is no corresponding rate under the medical benefit. This allows Texas to consider coverage of these products, improving access to care.
The amendment also incorporates language authorizing the state to negotiate supplemental and value-based purchasing arrangements with manufacturers of these products improving cost-effectiveness with the goal of improving health outcomes for Medicaid beneficiaries. The requested effective date for the proposed amendment is October 1, 2022.
The proposed amendment is estimated to have no fiscal impact. The amendment shifts utilization of current benefits from medical to pharmacy. Additionally, the amendment allows Texas to negotiate supplemental rebate agreements and value-based rebate agreements. Both rebate agreements generate revenue and do not increase federal expenses.
Texas Department of Licensing and Regulation
Proposed Rules Re:
Amending 16 TAC §114.29 to modify inspection requirements for orthotists and prosthetists.
CHAPTER 114. ORTHOTISTS AND PROSTHETISTS
16 TAC §114.29
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 114, §114.29, regarding the Orthotists and Prosthetists program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 114, implement Texas Occupations Code, Chapter 605, Orthotists and Prosthetists.
House Bill (HB) 1560, 87th Legislature, Regular Session (2021), the Sunset legislation for the Department, added new inspection provisions to Occupations Code, Chapter 51, the Department’s enabling statute (see HB 1560, Article 1, Section 1.05). HB 1560 added new §51.211 to Chapter 51, requiring the department to conduct risk-based inspections that prioritize inspections based on key risk factors. HB 1560 also repealed provisions from several program statutes that conflicted with this new provision.
The proposed rules remove periodic inspections from the Orthotists and Prosthetists program rules and are necessary to implement Texas Occupations Code §51.211.
SECTION-BY-SECTION SUMMARY
- The proposed rules amend §114.29(h) to remove periodic inspection requirements and to add language stating that facilities will be inspected in accordance with Chapter 51, Occupations Code, and new rules governing inspections within 16 TAC, Chapter 60, Subchapter H. The proposed rules also repeal former subsections (h)(1) through (h)(6) of §114.29, as that subject matter will be covered by the inspections rules contained in Chapter 60, Subchapter H.
- The proposed rules also change the title of §114.29 to “Accreditation and Inspection of Facilities” (emphasis added).
- The new rules regarding inspections under Chapter 60, Subchapter H, are also currently being proposed separately in this issue of the Texas Register. Those proposed rules provide, among other things, that: (1) the department may perform inspections with or without advance notice to ensure compliance with statute or rule, or as a result of a complaint; (2) inspections will be performed during the regular operating hours of the location being inspected; (3) upon completion of an inspection, the license holder, applicant, or representative will be provided with the results of the inspection in writing; (4) the department may use alternative inspection methods, including the use of videoconference technology, instead of conducting an in-person inspection; and (5) a license holder, applicant, or other person must cooperate in the performance of an inspection.
Department of State Health Services
Proposed Rules Re:
Amending 25 TAC §117.41 and §117.45 to update emergency preparedness requirements and contingency operations plans for end stage renal disease (ESRD) facilities.
CHAPTER 117. END STAGE RENAL DISEASE FACILITIES
SUBCHAPTER D. MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT
25 TAC §117.41, §117.45
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §117.41, concerning Governing Body; §117.45, concerning Provision and Coordination of Treatment and Services; and §117.91, concerning Fire Prevention, Protection, and Emergency Contingency Plan in Texas Administrative Code, Title 25, Part 1, Chapter 117, End Stage Renal Disease Facilities.
BACKGROUND AND JUSTIFICATION
The proposal is necessary to implement Senate Bill (S.B.) 1876, 87th Legislature, Regular Session, 2021, which, in part, added Texas Health and Safety Code (HSC) §251.016 and §251.017. S.B. 1876 requires an end stage renal disease (ESRD) facility to adopt a written emergency preparedness and contingency operations plan to address the provision of care during an emergency and an emergency contingency plan for the continuity of essential building systems during an emergency.
The proposal is also necessary to correct outdated information, improve readability, and update language to reflect the transition of regulatory authority from the Department of State Health Services (DSHS) to HHSC.
SECTION-BY-SECTION SUMMARY
- The proposed amendment to §117.41 improves readability and updates the reference to §117.45(b) for accuracy.
- The proposed amendment to §117.45 updates the emergency preparedness requirements in subsection (b) to ensure consistency with the S.B. 1876 provisions for the emergency preparedness and contingency operations plan, updates a reference from “department” to “HHSC” to reflect the transition of regulatory authority from DSHS to HHSC, and makes other non-substantive changes to increase clarity and readability.
Amending 25 TAC §117.91 to include potable water requirements as part of an emergency contingency plan for end stage renal disease facilities.
CHAPTER 117. END STAGE RENAL DISEASE FACILITIES
SUBCHAPTER D. MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT
25 TAC §117.91
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §117.41, concerning Governing Body; §117.45, concerning Provision and Coordination of Treatment and Services; and §117.91, concerning Fire Prevention, Protection, and Emergency Contingency Plan in Texas Administrative Code, Title 25, Part 1, Chapter 117, End Stage Renal Disease Facilities.
BACKGROUND AND JUSTIFICATION
The proposal is necessary to implement Senate Bill (S.B.) 1876, 87th Legislature, Regular Session, 2021, which, in part, added Texas Health and Safety Code (HSC) §251.016 and §251.017. S.B. 1876 requires an end stage renal disease (ESRD) facility to adopt a written emergency preparedness and contingency operations plan to address the provision of care during an emergency and an emergency contingency plan for the continuity of essential building systems during an emergency.
The proposal is also necessary to correct outdated information, improve readability, and update language to reflect the transition of regulatory authority from the Department of State Health Services (DSHS) to HHSC.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §117.91 defines, in new subsection (h), “emergency” and updates the emergency contingency plan for power and potable water requirements to ensure consistency with S.B. 1876. The proposed amendment also updates the contact information for submitting fire incident reports under subsection (a) and makes other non-substantive changes to clarify language and increase readability.
In Addition Re:
Order Placing Methoxetamine into Schedule I and Maintaining Serdexmethylphenidate in Schedule IV
For more information, please visit this week’s edition of the Texas Register at 47 Tex Reg 6903.
Texas Board of Nursing
Adopted Rules Re:
Amending 22 TAC §213.28 to update requirements concerning the licensing of individuals convicted of sexual or threatening offenses.
CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.28
OVERVIEW
The Board adopts amendments to §213.28, relating to Licensure of Individuals with Criminal History, without changes to the proposed text published in the August 19, 2022, edition of the Texas Register (47 TexReg 4929) and will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement the statutory requirements of House Bill (HB) 1899, enacted by the 86th Texas Legislature, effective September 1, 2019. HB 1899 added Subchapter B to the Occupations Code Chapter 108. Subchapter B applies to health care professionals, including nurses under the Occupations Code Chapter 301.
Pursuant to HB 1899, the Board is required to deny or revoke the license of an individual who: (1) is required to register as a sex offender under the Code of Criminal Procedure Chapter 62; (2) has been previously convicted of or placed on deferred adjudication community supervision for the commission of a felony offense involving the use or threat of force; or (3) has been previously convicted of or placed on deferred adjudication community supervision for the commission of an offense under the Penal Code §§22.011, 22.02, 22.021, or 22.04, or an offense under the laws of another state or federal law that is equivalent to an offense under one of those sections, committed in the course of providing services within the scope of the individual’s license and in which the victim of the offense was a patient of the individual. SB 1899 also simultaneously amended the Code of Criminal Procedure Article 42.0175 to require affirmative findings to be included in criminal judgments regarding whether an individual is required to register as a sex offender under Chapter 62; whether an individual used force or threat of force in the commission of the offense; and whether the victim of the offense was a patient of the individual and the offense was committed in the course of providing services within the scope of the individual’s license. HB 1899 also requires agencies like the Board to be notified of these disqualifying events by criminal trial courts and parole panels.
SECTION-BY-SECTION SUMMARY
- Adopted §213.28 (c) contains the Board’s Disciplinary Guidelines for Criminal Conduct (Guidelines). The adopted amendments to the Guidelines include a paragraph that references the requirements of the Occupations Code Chapter 108. Specifically, the adopted paragraph states that, in accordance with the Occupations Code Chapter 108, Subchapter B, the Board is required to deny or revoke, as applicable, the license of an individual who: (A) is required to register as a sex offender under the Code of Criminal Procedure Chapter 62; (B) has been previously convicted of or placed on deferred adjudication community supervision for the commission of a felony offense involving the use or threat of force; or (C) has been previously convicted of or placed on deferred adjudication community supervision for the commission of an offense: (i) under the Penal Code §§22.011, 22.02, 22.021, or 22.04 or an offense under the laws of another state or federal law that is equivalent to an offense under one of these sections; (ii) committed when the individual held a license as a health care professional in this state or another state and in the course of providing services within the scope of the individual’s license; and (iii) in which the victim of the offense was a patient of the individual. Further, the adopted paragraph states that an individual’s eligibility for reapplication or reinstatement of licensure will be governed by the Occupations Code Chapter 108, Subchapter B. These adopted provisions are consistent with the statutory requirements of Chapter 108.
- The adopted amendments to §213.28(k) add a paragraph to subsection (k) that also references the requirements in the Occupations Code Chapter 108. Specifically, the adopted paragraph states that, pursuant to the Occupations Code Chapter 108, Subchapter B, the Board is required to deny or revoke, as applicable, the license of an individual who is required to register as a sex offender under the Code of Criminal Procedure Chapter 62; has been previously convicted of or placed on deferred adjudication community supervision for the commission of a felony offense involving the use or threat of force; or has been previously convicted of or placed on deferred adjudication community supervision for the commission of an offense (i) under the Penal Code §§22.011, 22.02, 22.021, or 22.04 or an offense under the laws of another state or federal law that is equivalent to an offense under one of these sections; (ii) committed when the individual held a license as a health care professional in this state or another state and in the course of providing services within the scope of the individual’s license; and (iii) in which the victim of the offense was a patient of the individual. Further, the adopted paragraph states that an individual’s eligibility for reapplication or reinstatement of licensure is governed by the Occupations Code Chapter 108, Subchapter B. These adopted provisions are also consistent with the statutory requirements of Chapter 108.