Texas Register October 8, 2021 Volume: 46 Number: 41

Texas Register Table of Contents

1 Governor
- - 1.0.1 Appointments Re:
    - 1.0.1.1 The Governor appointed seven individuals to the Texas Medical Board.
  - 1.0.2 Proclamation 41-3861
    - 1.0.2.1 Governor renews Proclamation 41-3861 in response to the continuing COVID-19 crisis.
2 Texas Health and Human Services Commission
- - 2.0.1 Emergency Rules Re:
  - 2.0.2 Proposed Rules Re:
3 Department of State Health Services
- - 3.0.1 Proposed Rules Re:
  - 3.0.2 In Addition Re:
    - 3.0.2.1 Order Placing Five Synthetic Cannabinoids, N-Ethylpentylone, and 4F-MDMB-BUTINACA into Schedule I, and Placing Lasmiditan in Schedule V.

Governor

Appointments Re:

The Governor appointed seven individuals to the Texas Medical Board.

Appointments for September 20, 2021

Appointed to the Texas Medical Board, for a term to expire April 13, 2027:

Ada L. Booth, M.D. of Corpus Christi, Texas (replacing Jeffrey L. Luna, M.D. of Livingston, whose term expired).
Michael E. Cokinos of Houston, Texas (Mr. Cokinos is being reappointed).
Kandace B. Farmer, D.O. of Southlake, Texas (Dr. Farmer is being reappointed).
LuAnn R. Morgan of Midland, Texas (Ms. Morgan is being reappointed).
Jayaram B. “Jay” Naidu, M.D. of Odessa, Texas (Dr. Naidu is being reappointed).
Ebony V. Todd of Fort Hood, Texas (replacing Linda G. Molina of San Antonio, whose term expired).
Sherif Zaafran, M.D. of Houston, Texas (Dr. Zaafran is being reappointed).

Proclamation 41-3861

Governor renews Proclamation 41-3861 in response to the continuing COVID-19 crisis.

OVERVIEW

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

BACKGROUND AND JUSTIFICATION

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

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

Texas Health and Human Services Commission

Emergency Rules Re:

New 26 TAC §500.20, allowing licensed End Stage Renal Disease (ESRD) facilities to apply to operate an off-site outpatient facility without obtaining a new license at certain locations.

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER B. END STAGE RENAL DISEASE FACILITIES
26 TAC §500.20

OVERVIEW

The Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 500 COVID-19 Emergency Health Care Facility Licensing, new §500.20, ESRD Off-Site Facilities During the COVID-19 Pandemic, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19. This emergency rule will allow end stage renal disease (ESRD) facilities to treat and train dialysis patients more effectively during the COVID-19 pandemic.

HHSC is adopting an emergency rule to allow a currently licensed ESRD facility to apply to operate an off-site outpatient facility without obtaining a new license at: (1) an ESRD facility that is no longer licensed that closed within the past 36 months; (2) a mobile, transportable, or relocatable medical unit; (3) a physician’s office; or (4) an ambulatory surgical center or freestanding emergency medical care facility that is no longer licensed that closed within the past 36 months.

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 exists and requires immediate adoption of this emergency rule for ESRD Off-Site Facilities During the COVID-19 Pandemic.

New 26 TAC §550.213, requiring prescribed pediatric extended care centers to develop and enforce policies and procedures for infection control.

CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER C. GENERAL PROVISIONS
DIVISION 1. OPERATIONS AND SAFETY PROVISIONS
26 TAC §550.213

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 550, Licensing Standards for Prescribed Pediatric Extended Care Centers, Subchapter C, General Provisions, Division 1, Operations and Safety Provisions, new §550.213, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.

HHSC is adopting an emergency rule to require prescribed pediatric extended care centers to develop and enforce policies and procedures for infection control.

BACKGROUND AND JUSTIFICATION

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Prescribed Pediatric Extended Care Center Response to COVID-19–Screening and Infection Control Policies and Procedures.

Renewing 26 TAC §554.2802 to require nursing facilities to take certain actions to reduce the risk of spreading COVID-19.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER CC. COVID-19 EMERGENCY RULE
26 TAC §554.2802

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §554.2802 for a 60-day period. The text of the emergency rule was originally published in the June 11, 2021, issue of the Texas Register (46 Tex Reg 3593).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 26 Texas Administrative Code, Chapter 554, Nursing Facility Requirements for Licensure and Medicaid Certification, new §554.2802. This emergency rule is adopted in response to COVID-19 and requires nursing facilities to take certain actions to reduce the risk of spreading COVID-19. The emergency rule also permits nursing facilities to request temporary increases in capacity and Medicaid bed allocations to aid in preventing the transmission of COVID-19 or caring for residents with COVID-19.

HHSC is renewing this emergency rule to mitigate and contain COVID-19 and to permit a nursing facility to request a temporary increase in capacity or Medicaid bed allocation as part of the facility’s response to COVID-19. The purpose of the new rule is to describe the requirements nursing facility providers must immediately put into place to mitigate and contain COVID-19 and the procedures and criteria for requesting a temporary capacity increase or a temporary Medicaid bed allocation increase.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

Renewing 26 TAC §554.2803 to describe requirements for limited indoor and outdoor visitation in a nursing facility.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER CC. COVID-19 EMERGENCY RULE
26 TAC §554.2803

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §554.2803 for a 60-day period. The text of the emergency rule was originally published in the June 11, 2021, issue of the Texas Register (46 Tex Reg 3596).

HHSC is renewing this new emergency rule to allow limited indoor and outdoor visitation in a nursing facility. The purpose of the new rule is to describe the requirements related to such visits.

BACKGROUND AND JUSTIFICATION

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. This emergency rulemaking reflects the continued reopening of the State of Texas as well as the new requirements for visitation of nursing facility residents provided by the Centers for Medicare & Medicaid Services (CMS) in Memorandum QSO-20-39-NH, as revised April 27, 2021. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Nursing Facility COVID-19 Response – Expansion of Reopening Visitation.

New 26 TAC §558.960, defining criteria for screening staff, clients, and household members for COVID-19.

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE
26 TAC §558.960

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 558, Licensing Standards for Home and Community Support Services Agencies, new §558.960, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.

HHSC is adopting an emergency rule to define criteria for screening staff, clients, and household members for COVID-19, to require that related documentation be made available to HHSC upon request, and to clarify that HCSSA staff must comply with a long-term care facility’s infection control protocols when entering to provide essential services.

BACKGROUND AND JUSTIFICATION

As authorized by Texas 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 for not longer than 60 days.

New 26 TAC §559.65, requiring day activity and health services providers to develop and enforce policies and procedures for infection control.

CHAPTER 559. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS
SUBCHAPTER D. LICENSURE AND PROGRAM REQUIREMENTS
26 TAC §559.65

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC or Commission) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 559, Day Activity and Health Services Requirements, new §559.65, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.

HHSC is adopting an emergency rule to require day activity and health services providers to develop and enforce policies and procedures for infection control.

BACKGROUND AND JUSTIFICATION

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Day Activity and Health Services Response to COVID-19 – Screening, Activities and Infection Control Policies and Procedures.

Proposed Rules Re:

Amending 1 TAC §353.1305 to extend the date for the Uniform Hospital Rate Increase Program (UHRIP).

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES
1 TAC §353.1305

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to 1 TAC §353.1305, concerning the Uniform Hospital Rate Increase Program for program periods before September 1, 2021.

BACKGROUND AND JUSTIFICATION

The purpose of the proposed amendment to §353.1305 is to extend the date for the Uniform Hospital Rate Increase Program (UHRIP) to apply to program periods before September 1, 2022 or as approved by the Centers for Medicare and Medicaid Services (CMS).

SECTION-BY-SECTION SUMMARY

The proposed amendment to §353.1305(a) replaces the date “September 1, 2021” with “September 1, 2022” and adds “or for the time period as approved by the Centers for Medicare and Medicaid Services” to extend the program an additional year or as approved by CMS. The date is deleted in the title of the rule. The acronym “MCO” is also spelled out.

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

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

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes a new rule §355.8200, concerning Retained Funds for the Uncompensated Care Program, in Texas Administrative Code, Title 1, Part 15, Chapter 355, Subchapter J, Division 11.

BACKGROUND AND JUSTIFICATION

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

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

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

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

SECTION-BY-SECTION SUMMARY

Proposed new §355.8200(a) provides the purpose and start date for the UC application fee.
Proposed new §355.8200(b) defines the term “non-public provider.”
Proposed new §355.8200(c) provides the scope of applicability.
Proposed new §355.8200(d) provides an explanation of the application fee, including use, total limitation, and effective time period.
Proposed new §355.8200(e) provides an explanation of the uses of the funds and limitations.

New 26 TAC §506.38, prohibiting a special care facility from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 506. SPECIAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §506.38

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §506.38 concerning, Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with House Bill (H.B.) 119, 87th Legislature, Regular Session, 2021, which requires HHSC to adopt rules prohibiting health care providers from discriminating against an organ transplant recipient based on a patient’s or client’s disabilities.

SECTION-BY-SECTION SUMMARY

The proposed new §506.38 adds language prohibiting a special care facility from discriminating against an organ transplant recipient based on the patient’s disability and requiring a special care facility to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

New 26 TAC §509.68, adding language to prohibit a freestanding emergency medical care facility (FEMC) from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §509.68

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §509.68, concerning Miscellaneous Polices and Protocols.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed new §509.68 adds language prohibiting a freestanding emergency medical care facility (FEMC) from discriminating against an organ transplant recipient based on the patient’s disability and requiring an FEMC to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Amending 26 TAC §510.44 to prohibit a private psychiatric hospital or crisis stabilization unit (CSU) from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §510.44

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to 26 TAC §510.44, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §510.44 adds language prohibiting a private psychiatric hospital or crisis stabilization unit (CSU) from discriminating against an organ transplant recipient based on the patient’s disability and requiring private psychiatric hospitals and CSUs to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Department of State Health Services

Proposed Rules Re:

New 25 TAC §117.49, prohibiting an end stage renal disease facility (ESRD) from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 117. END STAGE RENAL DISEASE FACILITIES
SUBCHAPTER D. MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT
25 TAC §117.49

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §117.49, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed new §117.49 adds language prohibiting an end stage renal disease facility (ESRD) from discriminating against an organ transplant recipient based on the patient’s disability and requiring an ESRD to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Amending 25 TAC §133.45 to add language prohibiting a hospital from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
25 TAC §133.45

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §133.45, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with House Bill (H.B.) 3721, 87th Legislature, Regular Session, 2021, which requires HHSC to adopt rules requiring abortion facilities and hospitals to comply with the human trafficking signage requirements required by Texas Health and Safety Code §245.025.

The proposal is also necessary to comply with H.B. 119, 87th Legislature, Regular Session, 2021, which requires HHSC to adopt rules prohibiting health care providers from discriminating against an organ transplant recipient based on a patient’s or client’s disabilities.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §133.45 adds language requiring hospitals to comply with Texas Health and Safety Code, Chapter 245.025, Human Trafficking Signs Required. This change is consistent with H.B. 3721’s provision requiring HHSC to adopt rules necessary to implement that bill.
The proposed amendment to §133.45 also adds language prohibiting a hospital from discriminating against an organ transplant recipient based on the patient’s disability and requiring a hospital to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

New 25 TAC §135.30, prohibiting an ambulatory surgical center (ASC) from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
25 TAC §135.30

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §135.30, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed new §135.30 adds language prohibiting an ambulatory surgical center (ASC) from discriminating against an organ transplant recipient based on the patient’s disability and requiring an ASC to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Amending 25 TAC §137.55 to add language prohibiting a birthing center from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 137. BIRTHING CENTERS
SUBCHAPTER D. OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES
25 TAC §137.55

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to 25 TAC §137.55, concerning Other State and Federal Compliance Requirements.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §137.55 adds language prohibiting a birthing center from discriminating against an organ transplant recipient based on the patient’s disability and requiring a birthing center to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Amending 25 TAC §139.60 to prohibit an abortion facility from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 139. ABORTION FACILITY REPORTING AND LICENSING
SUBCHAPTER D. MINIMUM STANDARDS FOR LICENSED ABORTION FACILITIES
25 TAC §139.60

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §139.60, concerning Other State and Federal Compliance Requirements.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with H.B. 119, 87th Legislature, Regular Session, 2021, which requires HHSC to adopt rules prohibiting health care providers from discriminating against an organ transplant recipient based on a patient’s or client’s disabilities.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §139.60 adds language requiring an abortion facility to comply with Texas Health and Safety Code, Chapter 245.025, Human Trafficking Signs Required. This change is consistent with H.B. 3721’s provision requiring HHSC to adopt rules necessary to implement that bill.
The proposed amendment to §139.60 adds language prohibiting an abortion facility from discriminating against an organ transplant recipient based on the patient’s disability and requiring an abortion facility to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

New 25 TAC §140.435, prohibiting a licensed chemical dependency counselor (LCDC), including a counselor intern (CI), from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 140. HEALTH PROFESSIONS REGULATION
SUBCHAPTER I. LICENSED CHEMICAL DEPENDENCY COUNSELORS
25 TAC §140.435

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §140.435, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed new §140.435 adds language prohibiting a licensed chemical dependency counselor (LCDC), including a counselor intern (CI), from discriminating against an organ transplant recipient based on the patient’s disability and requiring an LCDC to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Amending 25 TAC §229.144 to prohibit a narcotic treatment program (NTP) from discriminating against an organ transplant recipient based on the patient’s disability.

CHAPTER 229. FOOD AND DRUG
SUBCHAPTER J. MINIMUM STANDARDS FOR NARCOTIC TREATMENT PROGRAMS
25 TAC §229.144

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §229.144, concerning State and Federal Statutes and Regulations.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §229.144 adds language prohibiting a narcotic treatment program (NTP) from discriminating against an organ transplant recipient based on the patient’s disability and requiring an NTP to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a patient’s disability.

Amending 25 TAC §§289.252, 289.256, 289.257 to update licensing regulations related to medical use of radioactive material.

CHAPTER 289. RADIATION CONTROL
SUBCHAPTER F. LICENSE REGULATIONS
25 TAC §§289.252, 289.256, 289.257

OVERVIEW

The Executive Commissioner of the Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendments to §289.252, concerning Licensing of Radioactive Material; §289.256, concerning Medical and Veterinary Use of Radioactive Material; and §289.257, concerning Packaging and Transportation of Radioactive Material.

BACKGROUND AND JUSTIFICATION

The purpose of the amendments to §§289.252, 289.256, and 289.257 is to comply with compatibility requirements of the United States Nuclear Regulatory Commission (NRC), to which Texas is subject as an Agreement State. The amendments update NRC information and are the result of the NRC’s adoption of rules related to the reporting and notification requirements for a medical event for permanent implant brachytherapy and the training for radiation safety officers, associate radiation safety officers, authorized medical physicists, authorized nuclear pharmacists, teletherapy or medical physicists, authorized users, and nuclear pharmacists The amendments allow associate radiation safety officers to be named on a medical license and several clarifying amendments; and exempt certain board-certified individuals from certain training and experience requirements (i.e., “grandfather” these individuals).

Other amendments to §§289.252, 289.256, and 289.257 clarify terms and conditions of licenses for medical use of radioactive material, establish new definitions, update license application processes, and update facility radiation protection programs. The amendments also include changes to update, correct, improve, or clarify rule citation references, terminology, language and format consistency, grammar, and minor typographical and formatting errors.

A section-by-section summary of the amendments can be found in this week’s issue of the Texas Register at 46 Tex Reg 6779.

Amending 25 TAC §448.401 to exempt certain satellite locations or offices from the CDTF license requirement.

CHAPTER 448. STANDARD OF CARE
SUBCHAPTER D. FACILITY LICENSURE INFORMATION
25 TAC §448.401

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §448.401, concerning License Required.

BACKGROUND AND JUSTIFICATION

This proposal is necessary to comply with House Bill (H.B.) 4, 87th Legislature, Regular Session, 2021, which requires HHSC to adopt rules to permit a licensed chemical dependency treatment facility (CDTF) to provide outpatient treatment services to adult and adolescent clients using telecommunications or information technology. H.B. 4 also requires HHSC to adopt rules relating to the minimum standards for CDTFs to provide intakes, screenings, and assessments using telecommunications or information technology.

The proposal is also necessary to implement H.B. 4298, 86th Legislature, Regular Session, 2019, which exempted a satellite office or location operating under the supervision of a licensed outpatient CDTF and providing services within the scope of the outpatient CDTF’s license from the requirement to obtain a CDTF license under Texas Health and Safety Code Chapter 464.

The proposal is also necessary to ensure consistency with Texas Health and Safety Code §464.003 by updating the rule language to align with current statute. Senate Bill (S.B.) 219, 84th Legislature, Regular Session, 2015, and S.B. 1314, 85th Legislature, Regular Session, 2017, made non-substantive amendments to §464.003 to update the references for juvenile justice facilities and programs and licensed acute care facilities already exempt from licensure and to use person-first language.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §448.401, License Required, adds language to ensure consistency with Texas Health and Safety Code §464.003 by exempting certain satellite locations or offices from the CDTF license requirement and updates the language to ensure consistency with statute by correcting or outdated references to entities that no longer exist.

Amending 25 TAC §448.801 and §448.803 to update screening and assessment mechanisms for licensed chemical dependency treatment facilities (CDTF).

CHAPTER 448. STANDARD OF CARE
SUBCHAPTER H. SCREENING AND ASSESSMENT
25 TAC §448.801, §448.803

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §448.801, concerning Screening; and §448.803, concerning Assessment.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §448.801, Screening, adds language to implement H.B. 4, which amended Texas Health and Safety Code §462.025, by specifying a licensed facility may provide certain client screenings through electronic means and establishing requirements for conducting those screenings through electronic means.
The proposed amendment to §448.803, Assessment, adds language to implement H.B. 4, which amended Texas Health and Safety Code §462.025, by permitting a licensed facility to provide a client assessment through electronic means and establishing requirements for conducting those assessments through electronic means.

Amending 25 TAC §448.911 to allow a licensed CDTF to provide outpatient treatment services through electronic means to adults and adolescents.

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

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §448.911, concerning Treatment Services Provided by Electronic Means.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §448.911, Treatment Services Provided by Electronic Means, adds language to implement H.B. 4, which added new §462.015 to the Texas Health and Safety Code. The amendment also incorporates language from emergency rules HHSC adopted during the COVID-19 pandemic to allow a licensed CDTF to provide outpatient treatment services through electronic means to adults and adolescents.

New 25 TAC §448.912, prohibiting a chemical dependency treatment facility (CDTF) from discriminating against an organ transplant recipient based on the client’s disability.

CHAPTER 448. STANDARD OF CARE
SUBCHAPTER I. TREATMENT PROGRAM SERVICES
25 TAC §448.912

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §448.912, concerning Miscellaneous Policies and Protocols.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed new §448.912 adds language prohibiting a chemical dependency treatment facility (CDTF) from discriminating against an organ transplant recipient based on the client’s disability and requiring a CDTF to comply with Texas Health and Safety Code, Chapter 161, Subchapter S, Allocation of Kidneys and Other Organs Available for Transplant. This change is consistent with the provision in H.B. 119 requiring HHSC to adopt rules relating to prohibiting organ transplant recipient discrimination by health care providers based on a client’s disability.

In Addition Re:

Order Placing Five Synthetic Cannabinoids, N-Ethylpentylone, and 4F-MDMB-BUTINACA into Schedule I, and Placing Lasmiditan in Schedule V.

OVERVIEW

The Drug Enforcement Administration issued a final rule adopting an interim final rule placing lasmiditan (2,4,6-trifluoro-N-(6-(1-methylpiperidine-4- carbonyl)pyridine-2-yl-benzamide), including its salts, in schedule V of the Controlled Substances Act without change. This final rule was published in the May 24, 2021 issue of the Federal Register, Volume 86, Number 98, pages 27803-27806 and was effective May 24, 2021.

Complete details can be found at 46 Tex Reg 6990.