Texas Register September 16, 2022 Volume: 47 Number: 37

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Department of Licensing and Regulation
- - 2.0.1 Proposed Rules Re:
    - 2.0.1.1 Amending 16 TAC §114.50, adding the required human trafficking prevention training and completion of the jurisprudence examination to the list of acceptable sources of CE credit.
3 Department of Aging and Disability Services
- - 3.0.1 Proposed Rules Re:
4 Texas Behavioral Health Executive Council
- - 4.0.1 Adopted Rules Re:
5 Texas Department of State Health Services
- - 5.0.1 In Addition Re:
    - 5.0.1.1 Licensing Actions for Radioactive Materials
    - 5.0.1.2 Licensing Actions for Radioactive Materials

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §355.8212, §355.8214, concerning waiver payments to hospitals and physician group practices for uncompensated charity care.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
1 TAC §355.8212, §355.8214

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8212, concerning Waiver Payments to Hospitals for Uncompensated Charity Care, and §355.8214, concerning Waiver Payments to Physician Group Practices for Uncompensated Charity Care.

BACKGROUND AND JUSTIFICATION

The Uncompensated Care (UC) payments are made by HHSC to qualifying hospitals that serve a large number of Medicaid and uninsured individuals. Attachment H of the 1115 Waiver establishes rules and guidelines for the State to claim federal matching funds for UC payments to hospitals, clinics, and other provider types. The purpose of Texas Physician Uncompensated Care (TXPUC) is to determine the physician professional costs related to services provided to charity care patients by physician organizations that may be reimbursable from the Uncompensated Care pool. This proposal defines certain TXPUC provider classes and updates and makes other clarifying amendments.

This amendment updates the definition and the methodology used to allocate funds to physician groups. The current rule does not define the different classes of physician groups and allocates funds equally. The amended rule will add “State-owned” and “Non-State-owned” physician group classes and allow the application of different allocation methodologies to each newly defined class. “State-owned” physician groups will now have a different allocation methodology of funds while the “Non-State-owned” physician groups’ methodology remains unchanged. Minor grammatical and formatting edits were made to the rule text.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §355.8212(d) confirms the requirement that all transfers must meet applicable federal requirements.
The proposed amendment to §355.8212(f)(2) defines the physician group practice pool for demonstration years nine and after. Subparagraph (B)(i) and (ii) is added to subsection (f)(2) to define the physician group practice pool for demonstration years ten and after and to provide the physician group practice allocation for state-owned pool funds at an amount less than or equal to the total annual maximum uncompensated-care payment amount for these physicians. Subparagraph (C) is amended to define the physician group practice allocation for non-state-owned provider pools. Subparagraph (C)(i) is amended to define the applicability of the physician group practice non-state-owned provider pools to the applicable demonstration year. Subparagraph (C)(i)(II) is amended to clarify the use of physician’s charity-care costs used for the current demonstration year and charity-care costs used for the prior demonstration year for dental and ambulance. Subparagraph (C)(ii)(II) is amended to include “non-state-owned physician group.”

The proposed amendment to §355.8214(b)(1) defines the allocation amount for state-owned and non-state owned physician groups for demonstration years eleven and forward. New paragraph (9) defines “non-state-owned physician group.” New paragraph (12) defines “Service Delivery Area.” New paragraph (13) defines “state-owned physician group.”
The proposed amendment to §355.8214(d)(1) confirms the requirement that all transfers must meet applicable federal requirements.
The proposed amendment to §355.8214(f)(1) defines funding limitations for demonstration years nine and ten. Paragraph (2) is amended to define funding limitations for demonstration years eleven and forward.
The proposed amendment to §355.8214(g) adds paragraph (5) and (6) to define physician group service delivery area sub-pools. Old paragraph (6) is deleted.
Minor edits are made to §355.8214(h)(2)(B).
Grammatical and formatting edits are made to §355.8212 and §355.8214. Edits include spelling out abbreviated terms, adding lead-in phrases for consistency, and correcting formatting, references, and punctuation.

Amending 1 TAC §377.107, removing an outdated reference to the Internal Revenue Code relating to the HHSC contract with Texas Court Appointed Special Advocates (CASA).

CHAPTER 377. CHILDREN’S ADVOCACY PROGRAMS
SUBCHAPTER B. STANDARDS OF OPERATION FOR LOCAL COURT-APPOINTED VOLUNTEER ADVOCATE PROGRAMS
1 TAC §377.107

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §377.107, concerning Contract with Statewide Volunteer Advocate Organization.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with Senate Bill (S.B.) 1156, 87th Legislature, Regular Session, 2021, which requires HHSC to remove the requirement for the statewide organization for the volunteer advocate for children program to be designated as a supporting organization under §509(a)(3) of the Internal Revenue Code.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §377.107 removes an outdated reference to §509(a)(3) of the Internal Revenue Code as it relates to the HHSC contract with Texas Court Appointed Special Advocates (CASA), pursuant to SB 1156, 87th Legislature, Regular Session, 2021, as codified in Texas Family Code §264.603(a).

New 26 TAC §§260.5, 260.7, 260.9, defining terms used in the new chapter, describing the DBMD Program and CFC Option, and outlining excluded services.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER A. DEFINITIONS, DESCRIPTION OF SERVICES, AND EXCLUDED SERVICES
26 TAC §§260.5, 260.7, 260.9

OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in the Texas Administrative Code (TAC), Title 26, Part 1, new Chapter 260, Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC), comprised of §§260.5, 260.7, 260.9, 260.51, 260.53, 260.55, 260.57, 260.59, 260.61, 260.63, 260.65, 260.67, 260.69, 260.71, 260.73, 260.75, 260.77, 260.79, 260.81, 260.83, 260.85, 260.87, 260.89, 260.101, 260.103, 260.105, 260.107, 260.109, 260.111, 260.113, 260.151, 260.201, 260.203, 260.205, 260.207, 260.209, 260.211, 260.213, 260.215, 260.217, 260.219, 260.221, 260.223, 260.251, 260.253, 260.255, 260.257, 260.259, 260.261, 260.263, 260.265, 260.267, 260.269, 260.271, 260.301, 260.303, 260.305, 260.307, 260.309, 260.311, 260.313, 260.315, 260.317, 260.319, 260.321, 260.323, 260.325, 260.327, 260.329, 260.331, 260.333, 260.335, 260.337, 260.339, 260.341, 260.343, 260.345, 260.347, 260.349, 260.351, 260.353, 260.355, 260.357, 260.359, 260.401, 260.403, and 260.451.

BACKGROUND AND JUSTIFICATION

The Deaf Blind with Multiple Disabilities (DBMD) Program is a Medicaid waiver program approved by the Centers for Medicare & Medicaid Services (CMS) under §1915(c) of the Social Security Act. This waiver program provides community-based services and supports to eligible individuals as an alternative to services provided in an institutional setting. In the DBMD Program, an individual chooses a program provider who delivers both case management and direct services.

One purpose of the proposed new rules is to move the DBMD Program rules from 40 TAC, Chapter 42, to 26 TAC, Chapter 260. The repeal of 40 TAC, Chapter 42, is proposed elsewhere in this issue of the Texas Register.
Another purpose of the proposed new rules is to ensure that the DBMD Program complies with the requirements in Title 42, Code of Federal Regulations (42 CFR), Chapter IV, Subchapter C, Part 441, Subpart G, §441.301(c)(1) – (5). In 2014, CMS amended this regulation to establish new requirements for Home and Community-Based Services (HCBS) Medicaid programs, including requirements for HCBS program settings and person-centered planning. CMS has given states until March 2023 to be in full compliance with the requirements in §441.301(c)(1) – (5). The proposed new rules also ensure compliance with the requirements in 42 CFR, Chapter IV, Subchapter C, Part 441, Subpart K, §441.530, regarding Home and Community-Based Settings, and §441.540 regarding the Person-centered service plan, for Community First Choice (CFC) services because CFC services are available in the DBMD Program.

Additional purposes of the proposed new rules are described below.

A proposed new rule requires program providers to submit a translation of non-English documentation to HHSC. The purpose of the proposed new rule is to help ensure that HHSC’s reviews of documentation are efficient.
A proposed new rule provides that HHSC may allow program providers to use one or more of the exceptions specified in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. This provision is added to help ensure that providers are able to operate and provide services effectively during a disaster.

SECTION-BY-SECTION SUMMARY

New Subchapter A, Definitions, Description of Services, and Excluded Services
Proposed new §260.5, Definitions, defines terms used in the new chapter. The proposed rule is different from the current rule regarding definitions because the proposed new rule includes definitions of “agency foster home,” “enrollment IPP,” “hospital,” “inpatient chemical dependency treatment facility,” “in person or in-person,” “institution for mental diseases,” “Medicaid HCBS–Medicaid home and community-based services,” “mental health facility,” “nursing,” “person-centered planning process,” “renewal IPC,” “residential child-care facility,” “revised IPC,” “Texas Workforce Commission,” and “videoconferencing.”
Proposed new §260.7, Description of the DBMD Program and CFC Option, describes the DBMD Program, lists the services available to an individual in the DBMD Program, restricts a program provider to providing and billing for habilitation only if the activity provided is transportation, describes community first choice (CFC), and lists the CFC services available to an individual in the DBMD Program.
Proposed new §260.9, Excluded Services, describes services not provided through the DBMD Program.

New 26 TAC §260.51, §260.53, describing eligibility criteria for DBMD Program Services and how HHSC maintains a list of individuals interested in receiving services in the DBMD Program.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §260.51, §260.53

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in the Texas Administrative Code (TAC), Title 26, Part 1, new Chapter 260, Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC), comprised of §§260.5, 260.7, 260.9, 260.51, 260.53, 260.55, 260.57, 260.59, 260.61, 260.63, 260.65, 260.67, 260.69, 260.71, 260.73, 260.75, 260.77, 260.79, 260.81, 260.83, 260.85, 260.87, 260.89, 260.101, 260.103, 260.105, 260.107, 260.109, 260.111, 260.113, 260.151, 260.201, 260.203, 260.205, 260.207, 260.209, 260.211, 260.213, 260.215, 260.217, 260.219, 260.221, 260.223, 260.251, 260.253, 260.255, 260.257, 260.259, 260.261, 260.263, 260.265, 260.267, 260.269, 260.271, 260.301, 260.303, 260.305, 260.307, 260.309, 260.311, 260.313, 260.315, 260.317, 260.319, 260.321, 260.323, 260.325, 260.327, 260.329, 260.331, 260.333, 260.335, 260.337, 260.339, 260.341, 260.343, 260.345, 260.347, 260.349, 260.351, 260.353, 260.355, 260.357, 260.359, 260.401, 260.403, and 260.451.

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.51, Eligibility Criteria for DBMD Program Services and CFC Services, describes the eligibility criteria for an individual to qualify for DBMD Program services and CFC services.
Proposed new §260.53, DBMD Interest List, describes how HHSC maintains the interest list for individuals interested in receiving services in the DBMD Program. The proposed rule differs from the current rule in how HHSC assigns an interest list date to an individual after the individual’s name is removed from the interest list in accordance with subsection (f)(1) – (4) and the individual requests to be placed back on the list. In the current rule, if such an individual makes the request within 90 days after the individual’s name was removed from the list, HHSC adds the individual’s name to the DBMD interest list using the interest list date that was in effect at the time the individual’s name was removed from the list. In the proposed rule, HHSC adds the individual’s name to the DBMD interest list in this situation using the interest list date that was in effect at the time the individual’s name was removed, only if the request to be placed back on the list is the individual’s first request. Further, if the individual’s request to be placed back on the list is made more than 90 days after the individual’s name was removed from the list and the request is the individual’s first request, the proposed rule provides that HHSC adds the individual’s name to the interest list using the interest list date that was in effect at the time the individual’s name was removed from the list, if HHSC determines that extenuating circumstances exist. If a request to be placed back on an interest list by an individual in these situations is not the individual’s first request, the proposed rule provides that the individual’s name is added back using the date of the request as the interest list date. The reason for this change is to remove an incentive for an individual to repeatedly decline a written offer of DBMD Program services.

New 26 TAC §§260.55, 260.57, 260.59, 260.61, 260.63, 260.65, 260.67, 260.69, 260.71, describing the enrollment process for the DBMD program.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §§260.55, 260.57, 260.59, 260.61, 260.63, 260.65, 260.67, 260.69, 260.71

OVERVIEW

BACKGROUND AND JUSTIFICATION

Another purpose of the proposed new rules is to ensure that the DBMD Program complies with the requirements in Title 42, Code of Federal Regulations (42 CFR), Chapter IV, Subchapter C, Part 441, Subpart G, §441.301(c)(1) – (5). In 2014, CMS amended this regulation to establish new requirements for Home and Community-Based Services (HCBS) Medicaid programs, including requirements for HCBS program settings and person-centered planning. CMS has given states until March 2023 to be in full compliance with the requirements in §441.301(c)(1) – (5). The proposed new rules also ensure compliance with the requirements in 42 CFR, Chapter IV, Subchapter C, Part 441, Subpart K, §441.530, regarding Home and Community-Based Settings, and §441.540 regarding the Person-centered service plan, for Community First Choice (CFC) services because CFC services are available in the DBMD Program.

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.55, Written Offer of Enrollment in the DBMD Program, describes the process for offering an individual enrollment and what the individual or legally authorized representative (LAR) must do to accept the offer to enroll into the DBMD Program. The proposed rule also describes the reasons HHSC withdraws an offer of enrollment into the DBMD Program.
Proposed new §260.57, Person-Centered Planning Process, requires an individual’s service planning team to ensure the person-centered planning process is led by the individual to the maximum extent possible. The proposed rule requires the service planning team to use the person-centered planning process during enrollment and during renewals and revisions of an individual’s individual plan of care (IPC) using the forms listed in the Deaf Blind with Multiple Disabilities Program Manual. The proposed rule also describes the activities involved in the person-centered planning process.
Proposed new §260.59, Requirements for Service Settings, requires a program provider to ensure that a setting in which an individual receives DBMD Program and CFC services meet certain criteria, including that the setting is based on the individual’s preferences, and needs; supports the individual’s access to the greater community to the same degree as a person not enrolled in a Medicaid waiver program; ensures the individual’s rights of privacy, dignity, and respect; and optimizes an individual’s independence in making life choices. In addition, the proposed rule requires a program provider to ensure that a setting in which an individual receives a DBMD Program service or CFC service is not a setting presumed to have the qualities of an institution except that a DBMD Program service or a CFC service may be provided in a setting that is presumed to have the qualities of an institution if CMS determines through a heightened scrutiny review that the setting does not have the qualities of an institution and does have the qualities of home and community-based settings.
Proposed new §260.61, Process for Enrollment of an Individual, describes the process for offering an individual enrollment and enrolling an individual into the DBMD Program. The proposed new rule is different from the current rule regarding the process for enrollment because it includes a requirement for a case manager to provide an oral and written explanation to the individual and LAR or actively involved person about the use of electronic visit verifications as required by 1 TAC Chapter 354, Subchapter O.
Proposed new §260.63, Program Provider Cannot Ensure Individual’s Health and Welfare, describes requirements for a program provider and activities performed by HHSC if a program provider chosen by an individual or LAR is not willing to provide DBMD Program services or CFC services to the individual because it cannot ensure the individual’s health and welfare.
Proposed new §260.65, Development of an Enrollment IPP, describes the process for the development of an enrollment individual program plan (IPP).
Proposed new §260.67, Development of a Proposed Enrollment IPC, describes the process for the development of an enrollment IPC.
Proposed new §260.69, HHSC’s Review of Request for Enrollment, describes HHSC’s process for reviewing an IPC.
Proposed new §260.71, CDS Option, requires a case manager to perform specified activities including informing the applicant about the consumer directed services (CDS) option. The proposed rule also provides that if an applicant or individual chooses to receive a service through the CDS option, a program provider must perform specific activities including documenting the choice of a financial management services agency (FMSA). The proposed rule requires the case manager to provide an oral and written explanation of the CDS option using materials provided by HHSC if an individual or LAR chooses to participate in the CDS option.

New 26 TAC §§260.73, 260.75, 260.77, outlining required policies and procedures, the purpose of a utilization review, and the process for developing a renewal and revised IPP and IPC.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §§260.73, 260.75, 260.77

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.73, Tracking Annual Renewal of an ID/RC Assessment and an IPC, requires a program provider to have written policies and procedures to ensure compliance with proposed §260.77(b)(1) (relating to Renewal and Revision of an IPP and IPC) and that includes a written electronic tracking system that alerts the program provider to activities that must occur for the program provider to timely submit documentation to HHSC.
Proposed new §260.75, Utilization Review of an IPC by HHSC, describes the purpose of a utilization review of an IPC conducted by HHSC, requires a program provider to submit documentation supporting an IPC to HHSC if requested by HHSC and describes the processes that are followed if a review by HHSC results in a determination that a DBMD Program service or CFC service will be terminated, denied, or reduced.
Proposed new §260.77, Renewal and Revision of an IPP and IPC, describes the process for developing a renewal and revised IPP and IPC. The proposed rule is different from the current rule regarding renewal and revision of an IPP and IPC because it does not include the annual requirement for the case manager to obtain the signature of the individual or LAR on a Waiver Program Verification of Freedom of Choice form documenting the individual’s or LAR’s choice of the DBMD Program over the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Program because CMS requires this signature only at enrollment.

New 26 TAC §260.79, §260.81, describing the process for an individual to transfer to a different program and the process for personal leave days for individuals receiving licensed assisted living or licensed home health assisted living.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §260.79, §260.81

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.79, Coordination of Transfers, describes the process for an individual to transfer to a different program provider or FMSA.
Proposed new §260.81, Personal Leave for Individual Receiving Licensed Assisted Living or Licensed Home Health Assisted Living, allows an individual receiving licensed assisted living or licensed home health assisted living to take personal leave days, and describes how the program provider charges the individual for room and board and how the program provider bills HHSC when such leave is taken.

New 26 TAC §§260.83, 260.85, 260.87, 260.89, 260.101, 26.103, 260.105, 260.107, 260.109, describing denial, suspension, reduction, or termination of a DBMD Program Service and CFC Services.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §§260.83, 260.85, 260.87, 260.89, 260.101, 26.103, 260.105, 260.107, 260.109

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.83, Denial of Request for Enrollment in the DBMD Program or of a DBMD Program Services or a CFC Service, describes the basis and process for HHSC to deny an individual’s request for enrollment into the DBMD Program.
Proposed new §260.85, Suspension of DBMD Program Services and CFC Services, describes the basis and process for HHSC to suspend an individual’s DBMD Program services or CFC service. The proposed rule is different from the current rule about suspension of services because the proposed rule does not allow a program provider to request HHSC authorization to continue services when an individual is admitted to a facility. In addition, the proposed rule is different from the current rule because the proposed rule does not include a requirement for a case manager to be involved in facility discharge planning and related activities because case management would be suspended during the admission and the program provider cannot bill for case management provided during a suspension.
Proposed new §260.87, Reduction of a DBMD Program Service or a CFC Service, describes the basis and process for HHSC to reduce an individual’s DBMD Program service or CFC service.
Proposed new §260.89, Termination of DBMD Program Services and CFC Services with Advance Notice Due to Ineligibility or Leave from the State, describes the basis and process for HHSC to terminate an individual’s DBMD Program Services and CFC Services when advance notice of the termination is required because the individual does not meet eligibility criteria or leaves the state.
Proposed new §260.101, Termination of DBMD Program Services and CFC Services with Advance Notice Due to Non-Compliance with Mandatory Participation Requirements, describes the basis and process for HHSC to terminate an individual’s DBMD Program Services and CFC Services when advance notice is required because the individual did not comply with mandatory participation requirements.
Proposed new §260.103, Termination of DBMD Program Services and CFC Services without Advance Notice for Reasons Other Than Behavior Causing Immediate Jeopardy, describes the basis and process for HHSC to terminate an individual’s DBMD Program Services and CFC Services when advance notice is not required because of a reason other than behavior causing immediate jeopardy.
Proposed new §260.105, Termination of DBMD Program Services and CFC Services without Advance Notice Due to Behavior Causing Immediate Jeopardy, describes the basis and process for HHSC to terminate an individual’s DBMD Program Services and CFC Services when advance notice of the termination is not required because of behavior causing immediate jeopardy.
Proposed new §260.107, Offering Access to Other Services, requires the case manager to inform the individual of alternative services and supports in the community if HHSC terminates the individual’s DBMD Program and CFC services.
Proposed new §260.109, Individual Whose DBMD Program Services are Terminated May Request Name be Added to DBMD Interest List, provides that an individual may request that the individual’s name be placed on the DBMD interest list in accordance with proposed §260.53(b), relating to DBMD Interest List, if HHSC terminates an individual’s DBMD Program services.

New 26 TAC §260.111, §260.113, describing an individual’s right to a fair hearing and mandatory participation requirements of an individual.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §260.111, §260.113

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.111, Individual’s Right to a Fair Hearing, provides that an individual is entitled to a fair hearing in accordance with 1 TAC Chapter 357, Subchapter A (relating to Uniform Fair Hearing Rules).
Proposed new §260.113, Mandatory Participation Requirements of an Individual, describes the requirements an individual must comply with while receiving DBMD Program services and CFC services.

New 26 TAC §260.151, outlining certain rules program providers must comply with.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER C. COMPLIANCE WITH RULES
26 TAC §260.151

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.151, Program Provider Compliance with Rules, requires that a program provider comply with certain rules.

New 26 TAC §§260.201, 260.203, 260.205, 260.207, 265.209, 260.211, 260.213, 260.215, 260.217, 260.219, 260.221, 260.223, describing qualification and training requirements for program provider staff.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER D. ADDITIONAL PROGRAM PROVIDER PROVISIONS
26 TAC §§260.201, 260.203, 260.205, 260.207, 265.209, 260.211, 260.213, 260.215, 260.217, 260.219, 260.221, 260.223

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.201, Protection of Individual, requires a program provider to have written policies and procedures about specified topics to protect an individual. The proposed rule prohibits a program provider from using seclusion. The proposed rule requires a program provider to notify HHSC, in writing, of an individual’s death. The proposed rule requires a program provider to report critical incidents to HHSC. The proposed rule also requires a program provider to ensure that a program director who receives a copy of an HHSC initial intake report or a final investigative report from an FMSA sends a copy of the report to the individual’s case manager.
Proposed new §260.203, Qualification of Program Provider Staff, describes the required qualifications for a program director and service providers.
Proposed new §260.205, Training, describes the training requirements for program directors, case managers, and service providers. The proposed rule is different from the current rule on training because the proposed rule requires a program provider to ensure a case manager completes a comprehensive non-introductory person-centered planning training developed or approved by HHSC within six months after the case manager’s date of hire and requires a service provider whose duties include participating as a member of a service planning team to complete HHSC’s web-based Introductory Training within six months after assuming this duty.
Proposed new §260.207, Service Delivery, describes certain requirements for program providers regarding service delivery including a limitation on the number of individuals assigned to case managers, a requirement that a case manager have a monthly in-person or telephone contact with an individual, a requirement for a sufficient number of case managers to provide case management, and requirements when providing services to an individual while the individual is staying at a location outside the program provider’s contracted service delivery area.
Proposed new §260.209, Documentation of Services Delivered and Recordkeeping, describes the requirements for the documentation of services provided and the documentation that must be included in an individual’s record.
Proposed new §260.211, Quality Assurance, requires the program provider to conduct an annual survey of individuals, LARs, and persons actively involved in the individuals’ care to determine satisfaction with services provided. In addition, the proposed rule requires a program provider to annually review all final investigative reports from HHSC and critical incident data and identify program process improvements based on the review.
Proposed new §260.213, Service Backup Plans, describes the requirements for the development and revision of a service backup plan for each service identified as critical.
Proposed new §260.215, Protective Devices, describes the requirements regarding the use of a protective device for an individual.
Proposed new §260.217, Restraints, describes requirements regarding the use of restraints.
Proposed new §260.219, Reporting Allegations of Abuse, Neglect, or Exploitation of an Individual, requires a program provider, service provider, staff person, volunteer or controlling person who knows or suspects that an individual is being or has been abused, neglected, or exploited, to report the allegation of abuse, neglect, or exploitation.
Proposed new §260.221, Requirements Related to the Reporting of Abuse Neglect, and Exploitation of an Individual, describes the requirements related to a report and investigation of an allegation of abuse, neglect, or exploitation. In addition, the proposed rule prohibits a program provider from retaliating against a staff person, service provider, individual, or other person who files a complaint, presents a grievance, or otherwise provides good faith information relating to the possible abuse, neglect, or exploitation of an individual.
Proposed new §260.223, Requirement for Translation, requires a program provider who submits documentation to HHSC containing information that is not in English, to, at the same time, submit a translation of the information in English.

New 26 TAC §§260.251, 260.253, 260.255, 260.257, 260.259, 260.261, 260.263, 260.265, 260.267, 260.269, 260.271, describing personal fund management and establishing and describing a trust fund account.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER E. ASSISTANCE WITH PERSONAL FUNDS MANAGEMENT
26 TAC §§260.251, 260.253, 260.255, 260.257, 260.259, 260.261, 260.263, 260.265, 260.267, 260.269, 260.271

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.251, Request for Assistance with Personal Funds Management, describes requirements a program provider must comply with before accepting an individual’s personal funds or deposit in a trust fund account. In addition, the proposed rule prohibits a program provider from requiring an individual or LAR to request the program provider’s assistance with management of the individual’s personal funds.
Proposed new §260.253, Establishing a Trust Fund Account, describes the requirements a program provider must comply with in establishing a trust fund account when assisting an individual with personal funds management.
Proposed new §260.255, Maintaining a Trust Fund Account, describes requirements a program provider must comply with in maintaining an individual’s trust fund account.
Proposed new §260.257, Individual’s Access to Personal Funds, describes requirements a program provider must comply with when an individual whose personal funds are maintained in a trust fund account requests disbursement of a portion or all of the personal funds.
Proposed new §260.259, Petty Cash Fund, describes program provider requirements related to the maintenance of a petty cash fund.
Proposed new §260.261, Trust Fund Transactions, describes program provider requirements related to the maintenance of a trust fund ledger.
Proposed new §260.263, Recurring Payments, describes program provider requirements related to making recurring payments on behalf of an individual from a trust fund account if the individual or LAR submits a written authorization to the program provider.
Proposed new §260.265, Receipt for Direct Payment to Vendor from Trust Fund Account, describes program provider requirements related to obtaining a receipt from the vendor for an item or service authorized by the individual or LAR.
Proposed new §260.267, Trust Fund Documentation, describes program provider requirements related to trust fund documentation and making it accessible and retrievable for review.
Proposed new §260.269, Trust Fund Refund, requires the program provider to return the balance of the individual’s funds to the individual or LAR if the individual or LAR submits a written request for the balance.
Proposed new §260.271, Trust Fund Procedures for Individual Transfer and Termination, describes program provider requirements related to returning trust funds to an individual or LAR when an individual transfers or is terminated from the DBMD Program.

New 26 TAC §§260.301, 260.303, 260.305, 260.307, 260.309, 260.311, describing adaptive aids.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
26 TAC §§260.301, 260.303, 260.305, 260.307, 260.309, 260.311

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.301, Authorization Amount and Other Limits for Adaptive Aids, describes the adaptive aids that may be purchased in the DMBD Program, and the maximum amount HHSC will approve for adaptive aids. The proposed rule also requires a program provider to ensure that a purchased adaptive aid is the exclusive property and for the exclusive use of the individual for whom it is purchased; and a leased adaptive aid is for the exclusive use of the individual for whom it is leased.
Proposed new §260.303, Requirements for Authorization to Purchase or Lease and Adaptive Aid, describes the process to request authorization to purchase or lease an adaptive aid.
Proposed new §260.305, Requirements for Bids for an Adaptive Aid, requires a program provider to obtain bids for an adaptive aid that costs $500 or more and describes the process to obtain the bids.
Proposed new §260.307, Time Frames for Providing an Adaptive Aid, describes the required time frames that an individual must receive an adaptive aid from the program provider.
Proposed new §260.309, Cost Effective Delivery of Adaptive Aid, requires the program provider to ensure that, if an adaptive aid is delivered to an individual by a commercial carrier, the most cost-effective carrier is used. The proposed rule prohibits a program provider from using a commercial carrier to provide overnight delivery unless certain circumstances are met.
Proposed new §260.311, Requirements of Program Provider Following Provision of Adaptive Aid, describes the requirements a program provider must comply with after provision of an adaptive aid including that the individual, unpaid caregiver, and service providers are provided with appropriate orientation and training in the proper use of the adaptive aid.

New 26 TAC §§260.313, 260.315, 260.317, 260.319, 260.321, 260.323, 260.325, 260.327, 260.329, 260.331, describing the process and limits of minor home modification purchased in the DMDB Program.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
26 TAC §§260.313, 260.315, 260.317, 260.319, 260.321, 260.323, 260.325, 260.327, 260.329, 260.331

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.313, Items or Services Purchasable as a Minor Home Modification, describes the minor home modifications that may be purchased in the DMBD Program and also lists examples of modifications that may not be purchased.
Proposed new §260.315, Authorization Limit for Minor Home Modifications and Amount for Repair and Maintenance, describes the maximum amount HHSC approves as payment for minor home modifications. The proposed rule also addresses the process that must be used to request approval for repair and maintenance of a minor home modification.
Proposed new §260.317, Requesting Authorization to Purchase a Minor Home Modification that Costs Less than $1,000, describes the process a program provider must follow to obtain authorization of a minor home modification that costs less than $1,000.
Proposed new §260.319, Requesting Authorization to Purchase a Minor Home Modification that Costs $1,000 or More, describes the process a program provider and the service planning team must follow to obtain authorization of a minor home modification that costs $1,000 or more.
Proposed new §260.321, Specifications for a Minor Home Modification, describes program provider requirements regarding specifications for which HHSC has authorized payment.
Proposed new §260.323, Bid Requirements for a Minor Home Modification, requires a program to obtain bids for a minor home modification that costs $1,000 or more and describes the process to obtain the bids.
Proposed new §260.325, Time Frames for Completion of Minor Home Modification, describes the program provider requirements related to the completion of a minor home modification, including required time frames.
Proposed new §260.327, Inspection of a Minor Home Modification, describes program provider requirements related to an inspection of a minor home modification.
Proposed new §260.329, Repair or Replacement of a Minor Home Modification, describes when HHSC will authorize repair or maintenance of a minor home modification, when the program provider must repair or replace a minor home modification.
Proposed new §260.331, Individual’s Satisfaction with Minor Home Modification, describes the process for a program provider to determine whether the individual or LAR is satisfied with a minor home modification.

New 26 TAC §§260.333, 260.335, 260.337, 260.339, 260.341, 260.343, 260.345, 260.347, 260.349, 260.351, 260.353, 260.355, outlining requirements for DBMD Program Services.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
26 TAC §§260.333, 260.335, 260.337, 260.339, 260.341, 260.343, 260.345, 260.347, 260.349, 260.351, 260.353, 260.355

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.333, Behavioral Support, describes the program provider requirements related to the provision of behavioral support.
Proposed new §260.335, Chore Services, describes program provider requirements related to the provision of chore services.
Proposed new §260.337, Case Management, describes program provider requirements related to the provision of case management.
Proposed new §260.339, Dental Treatment, describes the program provider requirements related to the provision of dental treatment and includes the maximum amount HHSC will approve for an individual’s dental treatment.
Proposed new §260.341, Employment Services, describes program provider requirements related to the provision of employment services.
Proposed new §260.343, Day Habilitation, Residential Habilitation, and CFC PAS/HAB, describes program provider requirements related to the provision of day habilitation, residential habilitation, and CFC personal assistance services/habilitation.
Proposed new §260.345, Intervener, describes program provider requirements related to the provision of intervener services.
Proposed new §260.347, Nursing, describes program provider requirements related to the provision of nursing.
Proposed new §260.349, Orientation and Mobility, describes program provider requirements related to the provision of orientation and mobility.
Proposed new §260.351, Residential Services, describes program provider requirements related to the provision of residential services.
Proposed new §260.353, Respite, describes program provider requirements related to the provision of respite.
Proposed new §260.355, Therapies, describes program provider requirements related to the provision of therapies.

New 26 TAC §260.357, which provides a list of activities for which a program provider will not be reimbursed by HHSC.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
26 TAC §260.357

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.357, Non-Billable Time and Activities, provides a list of activities for which a program provider will not be reimbursed by HHSC.

New 26 TAC §260.359, describing program provider requirements related to provisions of Community First Choice emergency response services.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
26 TAC §260.359

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.359, CFC ERS, describes program provider requirements related to the provision of Community First Choice emergency response services.

New 26 TAC §260.401, 260.403, outlining residential agreements and requirements for program provider-owned residential settings.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER G. PROGRAM PROVIDER-OWNED RESIDENTIAL SETTINGS
26 TAC §260.401, 260.403

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.401, Residential Agreements, requires a program provider to have a residential agreement with an individual or LAR if the individual is receiving licensed assisted living from the program provider. In addition, the proposed rule describes the required contents of the residential agreement and requires the program provider to give the individual or LAR at least three calendar days to review, request changes, and sign the residential agreement; allows an individual to begin living in a residence in which licensed home health assisted living is provided before a residential agreement is fully executed because of an emergency; and requires a program provider to provide a copy of the residential agreement to the individual or LAR. The proposed rule also describes the requirements for a program provider if an individual or LAR is delinquent in payment of room and board and the program provider wants to evict the individual. Further, the proposed rule describes the criteria that must be met before a program provider proceeds to evict an individual. The proposed rule describes the requirements for a program provider and case manager after an individual is evicted. Also, the proposed rule describes the required actions for a program provider and case manager if the program provider determines that the provision in the residential agreement regarding decoration of the individual’s bedroom needs to be modified.
Proposed new §260.403, Requirements for Program Provider-Owned Residential Settings, requires a program provider to ensure that a setting in which licensed assisted living is provided meets certain criteria including that an individual has privacy in the individual’s bedroom, a choice of roommates, and that a lock is installed on the individual’s bedroom door with no cost to the individual. The proposed rule also describes requirements that must be met if the service planning team determines that a modification to the criteria is needed.

New 26 TAC §260.451, outlining exceptions to certain requirements during the declaration of a disaster.

CHAPTER 260. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER H. DECLARATION OF DISASTER
26 TAC §260.451

OVERVIEW

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

SECTION-BY-SECTION SUMMARY

Proposed new §260.451, Exceptions to Certain Requirements During Declaration of Disaster, provides that HHSC may allow program providers to use one or more of the exceptions described in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. The rule provides that HHSC notifies program providers if it allows an exception to be used and the date an allowed exception must no longer be used. The proposed rule also defines “disaster area.”

New 26 TAC §§262.1 – 262.9, describing the Texas Home Living (TxHmL) Program and the Community First Choice (CFC) Program.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §§262.1 – 262.9

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in the Texas Administrative Code (TAC), Title 26, Part 1, new Chapter 262, Texas Home Living (TxHmL) Program and Community First Choice (CFC), Subchapters A – I, comprised of §§262.1 – 262.9, 262.101 – 262.107, 262.201, 262.202, 262.301 – 262.304, 262.401, 262.501 – 262.508, 262.601, 262.602, 262.701, and 262.801.

BACKGROUND AND JUSTIFICATION

Additional purposes of the proposed new rules are described below.

The proposed new rules implement Texas Government Code §531.02161(b)(4) which requires HHSC to ensure that, if cost effective, clinically effective, and allowed by federal law, a Medicaid recipient has the option to receive certain services, including occupational therapy (OT), physical therapy (PT), and speech-language pathology as a telehealth service.

The proposed new rules require the initial TxHmL eligibility assessments to be conducted in person and the Community First Choice (CFC) personal assistance services/habilitation (PAS/HAB) assessment to be completed in person unless certain conditions exist, in which case the assessment may be completed by telehealth, telephone, or video conferencing. These requirements help ensure the assessments are thorough and accurate.
The proposed new rules include provisions regarding the denial, suspension, reduction, or termination of an individual’s TxHmL Program services to explain HHSC’s process in taking one of these actions. The proposed new rules change the existing service coordination monitoring requirement from 90 days to 30 days during an individual’s suspension.

The proposed new rules require a program provider and local intellectual and developmental disability authority (LIDDA) to submit a translation of non-English documentation submitted to HHSC. The purpose of the proposed new rule is to help ensure that HHSC’s reviews of documentation are efficient.

The proposed new rules require a registered nurse (RN) to complete a comprehensive nursing assessment of an individual in person under specified circumstances. This requirement is included so that the entire comprehensive nursing assessment is completed when necessary to help ensure the health and safety of an individual.
The proposed new rules codify current practice related to individuals transferring to another program provider or choosing a different service delivery option in the TxHmL Program.

The proposed new rules provide that HHSC may allow program providers and service coordinators to use one or more of the exceptions specified in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. This provision is added to help ensure that providers and service coordinators are able to provide services effectively during a disaster.

SECTION-BY-SECTION SUMMARY

Proposed new §262.1, Purpose, describes the purpose of the rules.
Proposed new §262.2, Application, describes the persons to whom Chapter 262 applies.
Proposed new §262.3, Definitions, defines the terms used in the new chapter including definitions for the following terms: “audio-only,” “comprehensive nursing assessment,” “delegated nursing task,” “DID–Determination of intellectual disability,” “DID report,” “EVV–Electronic visit verification,” “health maintenance activities,” “in person or in-person,” “platform,” “professional therapies,” “store and forward technology,” “synchronous audio-visual,” “TAC–Texas Administrative Code,” “telehealth service,” “transfer IPC,” and “videoconferencing.”
Proposed new §262.4, Description of the TxHmL Program and CFC, provides descriptions of the TxHmL Program and CFC including provisions about waiver contract areas and the consumer directed services option.
Proposed new §262.5, Description of TxHmL Program Services, provides a description of the TxHmL Program services available through the TxHmL Program.
Proposed new §262.6, Description of CFC Services, provides a description of the CFC services available through the TxHmL Program.
Proposed new §262.7, Requirement for Translation, requires program providers and local intellectual and developmental disability authorities to, when they submit documentation to HHSC containing information that is not in English, submit a translation of the information in English at the same time.
Proposed new §262.8, Comprehensive Nursing Assessment, requires an RN to complete the comprehensive nursing assessment for an applicant or individual who has nursing on their individual plan of care (IPC), using the HHSC Comprehensive Nursing Assessment form. The proposed new rule also specifies when a comprehensive nursing assessment must be completed in person, and when the comprehensive nursing assessment does not have to be completed in person.
Proposed new §262.9, Providing Physical Therapy, Occupational Therapy, and Speech and Language Pathology as a Telehealth Service, allows a service provider of PT, OT, or speech and language pathology to provide PT, OT, or speech and language pathology to an individual as a telehealth service unless the service is required to be provided in person in accordance with the Texas Medicaid Provider Procedures Manual. The proposed new rule describes the requirements for providing PT, OT, or speech and language pathology as a telehealth service, including obtaining the individual’s or LAR’s consent before the provision of the telehealth service. The proposed new rule also sets forth the PT, OT, or speech and language pathology services that must be provided to an individual in person.

New 26 TAC §§262.101 – 262.107, concerning eligibility criteria and the process for enrollment for TxHmL Program Services and CFC Services.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §§262.101 – 262.107

OVERVIEW

BACKGROUND AND JUSTIFICATION

The TxHmL Program is a Medicaid waiver program approved by the Centers for Medicare & Medicaid Services (CMS) under §1915(c) of the Social Security Act. This waiver program provides community-based services and supports to an eligible individual as an alternative to services provided in an institutional setting. One purpose of the proposal is to move certain TxHmL Program rules from 40 TAC Chapter 9, Subchapter N to 26 TAC Chapter 262. The repeal of §§9.551, 9.552, 9.554, 9.556, 9.558, 9.560 – 9.563, 9.566 – 9.568, 9.570, 9.571, 9.573- 9.575, 9.582, and 9.583 in 40 TAC Chapter 9, Subchapter N are proposed elsewhere in this issue of the Texas Register. In 2014, CMS amended this regulation to establish new requirements for Home and Community-Based Services (HCBS) Medicaid Programs, including requirements for HCBS Program settings and person-centered planning. CMS has given states until March 2023 to be in full compliance with the requirements in 42 CFR §441.301(c)(1) – (5). The proposed new rules will also ensure compliance with the requirements in 42 CFR Chapter IV, Subchapter C, Part 441, Subpart K, §441.530, regarding Home and Community-Based Setting, §441.535, regarding Assessment of functional need; and §441.540 regarding the Person-centered service plan, for Community First Choice (CFC) services because CFC services are available in the TxHmL Program.
Additional purposes of the proposed new rules are described below.
The proposed new rules implement Texas Government Code §531.02161(b)(4) which requires HHSC to ensure that, if cost effective, clinically effective, and allowed by federal law, a Medicaid recipient has the option to receive certain services, including occupational therapy (OT), physical therapy (PT), and speech-language pathology as a telehealth service.
The proposed new rules require the initial TxHmL eligibility assessments to be conducted in person and the Community First Choice (CFC) personal assistance services/habilitation (PAS/HAB) assessment to be completed in person unless certain conditions exist, in which case the assessment may be completed by telehealth, telephone, or video conferencing. These requirements help ensure the assessments are thorough and accurate.
The proposed new rules include provisions regarding the denial, suspension, reduction, or termination of an individual’s TxHmL Program services to explain HHSC’s process in taking one of these actions. The proposed new rules change the existing service coordination monitoring requirement from 90 days to 30 days during an individual’s suspension.
The proposed new rules require a program provider and local intellectual and developmental disability authority (LIDDA) to submit a translation of non-English documentation submitted to HHSC. The purpose of the proposed new rule is to help ensure that HHSC’s reviews of documentation are efficient.
The proposed new rules require a registered nurse (RN) to complete a comprehensive nursing assessment of an individual in person under specified circumstances. This requirement is included so that the entire comprehensive nursing assessment is completed when necessary to help ensure the health and safety of an individual.
The proposed new rules codify current practice related to individuals transferring to another program provider or choosing a different service delivery option in the TxHmL Program.
The proposed new rules provide that HHSC may allow program providers and service coordinators to use one or more of the exceptions specified in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. This provision is added to help ensure that providers and service coordinators are able to provide services effectively during a disaster.

SECTION-BY-SECTION SUMMARY

Proposed new §262.101, Eligibility Criteria for TxHmL Program Services and CFC Services, describes the eligibility criteria for TxHmL Program Services and CFC Services. The proposed rule is different from the current rule regarding eligibility criteria because the proposed rule specifically lists a hospital, an inpatient chemical dependency treatment facility, and a mental health facility as settings in which an individual cannot reside instead of using the phrase, “a facility licensed or subject to being licensed by the Department of State Health Services.” In addition, the proposed rule is different from the current rule because the proposed rule does not include, as a prohibited residential setting, a setting in which two or more dwellings create a distinguishable residential area. HHSC included provisions in proposed new §262.202, Requirements for Service Settings, that are consistent with 42 CFR §441.301(c)(5)(v) regarding settings that are presumed to have the qualities of an institution.
Proposed new §262.102, TxHmL Interest List, describes how HHSC maintains the interest list for individuals interested in receiving services in the TxHmL Program. The proposed rule is different from the current rule in how HHSC assigns an interest list date to an applicant after the applicant’s name is removed from the interest list in accordance with subsection (g)(1) – (4) and the applicant requests to be placed back on the list. In the current rule, if such an applicant makes the request within 90 days after their name was removed from the list, HHSC adds the applicant’s name to the TxHmL interest list using the interest list date that was in effect at the time the applicant’s name was removed from the list. In the proposed rule, HHSC adds the applicant’s name to the TxHmL interest list in this situation using the interest list date that was in effect at the time the applicant’s name was removed, only if the request to be placed back on the list is the applicant’s first request. Further, if the applicant’s request to be placed back on the list is made more than 90 days after their name was removed from the list and the request is the applicant’s first request, the proposed rule provides that HHSC adds the applicant’s name to the interest list using the interest list date that was in effect at the time the applicant’s name was removed from the list, if HHSC determines that extenuating circumstances exist. If a request to be placed back on the interest list by an applicant in these situations is not the applicant’s first request, the proposed rule provides that the applicant’s name is added back using the date of the request as the interest list date. The reason for this change is to remove an incentive for an applicant to repeatedly decline a written offer of TxHmL Program services.
Proposed new §262.103, Process for Enrollment of Applicants, describes the process for offering an applicant enrollment and enrolling an applicant into the TxHmL Program.
Proposed new §262.104, LOC Determination, describes the process for a LIDDA to request a level of care (LOC) from HHSC for an applicant and for a program provider to request an LOC from HHSC for an individual.
Proposed new §262.105, LON Assignment, describes the process for requesting a level of need (LON) from HHSC for an applicant and an individual and the LONs that may be assigned. The proposed rule also describes the criteria that must exist and process for an individual’s LON to be increased because of the individual’s dangerous behavior.
Proposed new §262.106, HHSC Review of LON, describes the process by which HHSC reviews an LON.
Proposed new §262.107, Reconsideration of LON Assignment, describes the process by which a LIDDA may request a reconsideration by HHSC of an LON assignment.

New 26 TAC §262.201, §262.202, detailing requirements for a service coordinator and service settings.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER C. PERSON-CENTERED PLANNING AND SERVICE SETTINGS
26 TAC §262.201, §262.202

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.201, Person-Centered Planning Process, requires a service coordinator and program provider to ensure the person-centered planning process is led by an individual to the maximum extent possible and that the person-centered planning process be used to develop a person directed plan (PDP), implementation plan, initial IPC, renewal IPC, revised IPC, service backup plan, and transportation plan. The proposed new rule also describes the activities involved in the person-centered planning process.
Proposed new §262.202, Requirements for Service Settings, requires a program provider to ensure that a setting in which the individual receives TxHmL Program and CFC services meets certain criteria, including that it’s based on the individual’s preferences and needs; it supports the individual’s access to the greater community to the same degree as a person not enrolled in a Medicaid waiver program; it ensures the individual’s rights of privacy, dignity, and respect; and it optimizes an individual’s independence in making life choices. In addition, the proposed rule requires that a setting in which an individual receives a TxHmL Program service is not located in a building that provides inpatient institutional treatment, or in a building on the grounds of or immediately adjacent to a public institution, or that has the effect of isolating individuals from the broader community of persons not receiving Medicaid HCBS, unless CMS determines through a heightened scrutiny review that the setting does not have the qualities of an institution and does have the qualities of home and community-based settings.

New 26 TAC §§262.301 – 262.304, concerning IPC requirements, renewal and revision of an IPC, and service limits.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER D. DEVELOPMENT AND REVIEW OF AN IPC
26 TAC §§262.301 – 262.304

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.301, IPC Requirements, describes the requirements of an IPC.
Proposed new §262.302, Renewal and Revision of an IPC, describes the process for developing a renewal IPC and a revision IPC. The proposed rule includes several requirements that are not part of the current rule regarding renewal IPCs and revision IPCs, including requiring the service coordinator to convene a meeting to update the PDP and develop a renewal IPC, or revised IPC if the addition, removal, or change of a service results in the addition, removal, or change to an outcome in the PDP. If the change made to an existing service does not require the addition, removal, or a change to an outcome in the PDP, the proposed rule requires the service coordinator to document the reasons for the IPC revision. The proposed rule requires the program provider to convene a meeting with the individual or LAR to develop the implementation plans the TxHmL Program services except for community support; CFC services except for CFC support management; and transportation plan. In addition, the proposed rule requires the service coordinator to send a copy of the updated PDP and HHSC HCS/TxHmL CFC PAS/HAB Assessment form to the program provider, the individual or LAR, and, if applicable, the financial management services agency (FMSA).
Proposed new §262.303, HHSC Review of an IPC, describes HHSC’s process for reviewing an IPC. The proposed rule provides that HHSC may review an IPC to determine if it meets the IPC requirements described in proposed §262.301, IPC Requirements, and to determine if the IPC exceeds the cost limit as described in §262.101(a)(4), Eligibility Criteria for TxHmL Program Services and CFC Services. In addition, the proposed rule codifies current practice that HHSC may deny or reduce a TxHmL or CFC service if an IPC does not meet requirements in §262.301 or the cost limits described in §262.101(a)(4).
Proposed new §262.304, Service Limits, lists the service limits for certain TxHmL Program services provided to an individual. The proposed rule allows an individual to use $300 per IPC year for maintenance of a minor home modification (MHM) before reaching the lifetime limit for MHM. Under the current policy, the lifetime limit of $7,500 must be exhausted prior to the use of the $300 maintenance fee. This change gives the individual flexibility to use the MHM funds for maintenance. The proposed rule also provides that a program provider may request authorization of a requisition fee for an adaptive aid, dental treatment, and MHM that is in addition to the service limits for these services to codify current practice.

New 26 TAC §262.401, describing how a program provider is reimbursed for services provided by the TxHmL Program.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER E. REIMBURSEMENT BY HHSC
26 TAC §262.401

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.401, Program Provider Reimbursement, describes how a program provider is reimbursed for services provided in the TxHmL Program. The proposed rule describes the basis for payment of service by HHSC to a program provider and requires a program provider to submit a service claim that meets certain requirements, including 40 TAC §49.311, Claims Payment, and the TxHmL Program Billing Requirements or the CFC Billing Requirements for HCS and TxHmL Program Providers. The proposed rule explains when a program provider may submit a claim for a service provided during the period of the individual’s suspension or after termination of the service. The proposed rule requires a claim submitted for an adaptive aid that costs $500 or more or for a minor home modification that costs $1,000 or more to be supported by a written assessment from a licensed professional. The proposed rule describes reasons that HHSC does not pay for or recoups payments for a service, including a program provider not complying with 40 TAC §49.305, Records, or providing CFC PAS/HAB, in-home day habilitation, or in-home respite and the service claim does not match the EVV visit transaction. The proposed rule provides that HHSC conducts fiscal compliance reviews and describes the actions HHSC may take as the result of a review.

New 26 TAC §§262.501 – 262.508, describing the process for transfers, denials, suspensions, reductions, and terminations of the TxHmL and CFC Services.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. TRANSFERS, DENIALS, SUSPENSIONS, REDUCTION AND TERMINATION
26 TAC §§262.501 – 262.508

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.501, Process for Individual to Transfer to a Different Program Provider or FMSA, describes the process for an individual to transfer to a different program provider or FMSA.
Proposed new §262.502, Process for Individual to Receive a Service Through the CDS Option that the Individual is Receiving from a Program Provider, describes the process for an individual to transfer services received through the consumer directed services (CDS) option to a program provider.
Proposed new §262.503, Denial of a Request for Enrollment into the TxHmL Program, describes the basis and process for HHSC to deny an individual’s request for enrollment into the TxHmL Program.
Proposed new §262.504, Denial of TxHmL Program Services or CFC Services, describes the basis and process for HHSC to deny an TxHmL Program Service or CFC Service.
Proposed new §262.505, Suspension of TxHmL Program Services and CFC Services, describes the basis and process for HHSC to suspend an individual’s TxHmL Program services and CFC service.
Proposed new §262.506, Reduction of TxHmL Program Services or CFC Services, describes the basis and process for HHSC to reduce an individual’s TxHmL Program service or CFC service.
Proposed new §262.507, Termination of TxHmL Program Services and CFC Services with Advance Notice, describes the basis and process for HHSC to terminate an individual’s TxHmL Program Services and CFC Services when advance notice of the termination is required.
Proposed new §262.508, Termination of TxHmL Program Services and CFC Services Without Advance Notice, describes the basis and process for HHSC to terminate an individual’s TxHmL Program Services and CFC Services when advance notice of the termination is not required.

New 26 TAC §262.601, §262.602, describing the fair hearing requirement and the program provider’s right to an administrative hearing.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER G. HEARINGS
26 TAC §262.601, §262.602

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.601, Fair Hearing, describes the requirement for applicants and individuals to receive a notice of the right to request a fair hearing in accordance with 1 TAC Chapter 357, Subchapter A, Uniform Fair Hearing Rules.
Proposed new §262.602, Program Provider’s Right to Administrative Hearing, describes when a program provider may request an administrative hearing.

New 26 TAC §262.701, regarding LIDDA requirements for providing service coordination in the TxHmL Program.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER H. LIDDA REQUIREMENTS
26 TAC §262.701

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.701, LIDDA Requirements for Providing Service Coordination in the TxHmL Program, describes requirements for the LIDDA in the provision of service coordination to applicants and individuals. The proposed rule includes several provisions that are not part of the current rule regarding LIDDA requirements. Specifically, the proposed rule changes the timeframe requirement for a service coordinator to complete a comprehensive non-introductory person-centered service planning training from two years to within six months after the service coordinator’s date of hire unless an extension of the six-month timeframe is granted by HHSC. The proposed rule requires the service coordinator to ensure that the updated finalized PDP is signed by the individual or LAR. In addition, the proposed rule requires the service coordinator to ensure the service planning team determines whether an individual who does not have a guardian would benefit from having a guardian or a less restrictive alternative to a guardian. The proposed rule also describes the requirements for a service coordinator to inform applicants and individuals about responsibilities related to EVV.

New 26 TAC §262.801, outlining exceptions to certain requirements during the declaration of a disaster.

CHAPTER 262. TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER I. DECLARATION OF DISASTER
26 TAC §262.801

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §262.801, Exceptions to Certain Requirements During Declaration of Disaster, provides that HHSC may allow program providers and service coordinators to use one or more of the exceptions described in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. The rule provides that HHSC notifies program providers and LIDDAs if it allows an exception to be used and the date an allowed exception must no longer be used. The proposed rule also defines “disaster area.”

New 26 TAC §§263.1 – 263.9, describing HCS and CFC services programs.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §§263.1 – 263.9

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in the Texas Administrative Code (TAC), Title 26, Part 1, new Chapter 263, Home and Community-based Services (HCS) Program and Community First Choice (CFC), Subchapters A – K, comprised of §§263.1 – 263.9; 263.101 – 263.108; 263.201; 263.301 – 263.304; 263.401; 263.501 – 263.503; 263.601; 263.701 – 263.708; 263.801; 263.802; 263.901 – 263.903; and 263.1000.

BACKGROUND AND JUSTIFICATION

The HCS Program is a Medicaid waiver program approved by the Centers for Medicare & Medicaid Services (CMS) under §1915(c) of the Social Security Act. This waiver program provides community-based services and supports to an eligible individual as an alternative to services provided in an institutional setting. One purpose of the proposal is to move certain HCS Program rules from 40 TAC Chapter 9, Subchapter D to 26 TAC Chapter 263. The repeals of §§9.151, 9.152, 9.154 – 9.170, 9.186, and 9.189 – 9.192 in 40 TAC Chapter 9, Subchapter D, are proposed elsewhere in this issue of the Texas Register.
This rule proposal does not include program provider certification principles that are currently in §§9.173 – 9.180, and §§9.181 – 9.183 and reviewed through the survey process. Rules containing the certification standards for the HCS Program will be proposed in 26 TAC Chapter 565 in a future issue of the Texas Register.
Another purpose of the proposed new rules is to ensure that the HCS Program complies with the requirements in Title 42, Code of Federal Regulations (CFR), Chapter IV, Subchapter C, Part 441, Subpart G, §441.301(c)(1) – (5). In 2014, CMS amended this regulation to establish new requirements for Home and Community-based Services (HCBS) Medicaid Programs, including requirements for HCBS Program settings and person-centered planning. CMS has given states until March 2023 to be in full compliance with the requirements in 42 CFR §441.301(c)(1) – (5). The proposed new rules will also ensure compliance with the requirements in 42 CFR Chapter IV, Subchapter C, Part 441, Subpart K, §441.530, regarding Home and Community-Based Setting; §441.535, regarding Assessment of functional need; and §441.540, regarding the Person-centered service plan, for Community First Choice (CFC) services because CFC services are available in the HCS Program.
Additional purposes of the proposed new rules are described below.
The proposed new rules implement Texas Government Code §531.02161(b)(4) which requires HHSC to ensure that, if cost effective, clinically effective, and allowed by federal law, a Medicaid recipient has the option to receive certain services, including occupational therapy (OT), physical therapy (PT), and speech-language pathology as a telehealth service.
The proposed new rules require the initial HCS eligibility assessments to be conducted in person and the Community First Choice (CFC) personal assistance services/habilitation (PAS/HAB) assessment to be completed in person unless certain conditions exist in which case the assessment may be completed by telehealth, telephone, or video conferencing. These requirements help ensure the assessments are thorough and accurate.
The proposed new rules include provisions regarding the denial, suspension, reduction, or termination of an individual’s HCS Program services to explain HHSC’s process in taking one of these actions. The proposed new rules change the existing service coordination monitoring requirement from 90 days to 30 days during an individual’s suspension.
The proposed new rules require a program provider and local intellectual and developmental disability authority (LIDDA) to submit a translation of non-English documentation submitted to HHSC. The purpose of the proposed new rule is to help ensure that HHSC’s reviews of documentation are efficient.
The proposed new rules require a registered nurse (RN) to complete a comprehensive nursing assessment of an individual in person under specified circumstances. This requirement is included so that the entire comprehensive nursing assessment is completed when necessary to help ensure the health and safety of an individual.
The proposed new rules codify HHSC’s current practice of increasing a level of need (LON) 1, 5, or 8 to the next LON because of an individual’s high medical needs if the individual meets certain criteria. The proposed new rule also codifies current practice related to individuals transferring to another program provider or choosing a different service delivery option in the HCS Program.
The proposed new rules provide that HHSC may allow program providers and service coordinators to use one or more of the exceptions specified in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. This provision is added to help ensure that providers and service coordinators are able to provide services effectively during a disaster.

SECTION-BY-SECTION SUMMARY

Proposed new §263.1, Purpose, describes the purpose of the rules.
Proposed new §263.2, Application, describes the persons to whom Chapter 263 applies.
Proposed new §263.3, Definitions, defines the terms used in the new chapter including definitions for the following terms: “audio-only,” “comprehensive nursing assessment,” “delegated nursing task,” “DID–Determination of intellectual disability,” “DID report,” “EVV–Electronic visit verification,” “health maintenance activities,” “in person or in-person,” “platform,” “professional therapies,” “store and forward technology,” “Supported Decision-Making Agreement,” “synchronous audio-visual,” “TAC–Texas Administrative Code,” “telehealth service,” “transfer IPC,” and “videoconferencing.”
Proposed new §263.4, Description of the HCS Program and CFC, provides descriptions of the HCS Program and CFC including provisions about waiver contract areas and the consumer directed services option.
Proposed new §263.5, Description of HCS Program Services, provides a description of the HCS Program services available through the HCS Program.
Proposed new §263.6, Description of CFC Services, provides a description of the CFC services available through the HCS Program and explains that individuals receiving host home/companion care, supervised living, or residential support may not receive a CFC service.
Proposed new §263.7, Requirement for Translation, requires program providers and LIDDAs to, when they submit documentation to HHSC containing information that is not in English, submit a translation of the information in English at the same time.
Proposed new §263.8, Comprehensive Nursing Assessment, requires an RN to complete the comprehensive nursing assessment for an applicant or individual who has nursing on their individual plan of care (IPC), using the HHSC Comprehensive Nursing Assessment form. The proposed new rule also specifies when a comprehensive nursing assessment must be completed in person, and when the comprehensive nursing assessment does not have to be completed in person.
Proposed new §263.9, Providing Physical Therapy, Occupational Therapy, and Speech and Language Pathology as a Telehealth Service, allows a service provider of PT, OT, or speech and language pathology to provide PT, OT, or speech and language pathology to an individual as a telehealth service except for certain activities that must be performed in person in accordance with the Texas Medicaid Provider Procedures Manual. The proposed new rule also describes the requirements for providing PT, OT, or speech and language pathology as a telehealth service, including obtaining the individual’s or legally authorized representative’s (LAR) consent before the provision of the telehealth service.

New 26 TAC §§263.101 – 263.108, describing the eligibility criteria for HCS Programs Services and CFC Services and enrollment processes.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
26 TAC §§263.101 – 263.108

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.101, Eligibility Criteria for HCS Program Services and CFC Services, describes the eligibility criteria for HCS Program Services and CFC Services. The proposed rule is different from the current rule regarding eligibility criteria because the proposed rule specifically lists a hospital, an inpatient chemical dependency treatment facility, and a mental health facility as settings in which an individual cannot reside instead of using the phrase, “a facility licensed or subject to being licensed by the Department of State Health Services.” In addition, the proposed rule is different from the current rule because the proposed rule does not include as a prohibited residential setting, a setting in which two or more dwellings create a distinguishable residential area. This restriction is included in proposed new §263.501, Requirements for Service Settings.
Proposed new §263.102, Calculation of Co-payment, describes the method for determining an individual’s or couple’s co-payment for sharing in the cost of HCS Program services because their income exceeds the maximum personal needs allowance.
Proposed new §263.103, HCS Interest List, describes how HHSC maintains the interest list for individuals interested in receiving services in the HCS Program. The proposed rule is different from the current rule in how HHSC assigns an interest list date to an applicant after the applicant’s name is removed from the interest list in accordance with subsection (g)(1) – (4) and the applicant requests to be placed back on the list. In the current rule, if such an applicant makes the request within 90 days after their name was removed from the list, HHSC adds the applicant’s name to the HCS interest list using the interest list date that was in effect at the time the applicant’s name was removed from the list. In the proposed rule, HHSC adds the applicant’s name to the HCS interest list in this situation using the interest list date that was in effect at the time the applicant’s name was removed, only if the request to be placed back on the list is the applicant’s first request. Further, if the applicant’s request to be placed back on the list is made more than 90 days after their name was removed from the list and the request is the applicant’s first request, the proposed rule provides that HHSC adds the applicant’s name to the interest list using the interest list date that was in effect at the time the applicant’s name was removed from the list, if HHSC determines that extenuating circumstances exist. If a request to be placed back on an interest by an applicant in these situations is not the applicant’s first request, the proposed rule provides that the applicant’s name is added back using the date of the request as the interest list date. The reason for these changes is to remove an incentive for an applicant to repeatedly decline a written offer of HCS Program services.
Proposed new §263.104, Process for Enrollment of Applicants, describes the process for offering an applicant enrollment and enrolling an applicant into the HCS Program.
Proposed new §263.105, LOC Determination, describes the process for a LIDDA to request a level of care (LOC) from HHSC for an applicant and for a program provider to request an LOC from HHSC for an individual.
Proposed new §263.106, LON Assignment, describes the process for requesting a level of need (LON) from HHSC for an applicant and an individual and the LONs that may be assigned. The proposed rule also describes the criteria that must exist and the process for an individual’s LON to be increased because of the individual’s dangerous behavior or high medical needs.
Proposed new §263.107, HHSC Review of LON, describes the process by which HHSC reviews an LON.
Proposed new §263.108, Reconsideration of LON Assignment, describes the process by which a program provider may request a reconsideration by HHSC of an LON assignment, if the program provider disagrees with an LON assignment.

New 26 TAC §263.201, which requires a service coordinator and program provider to ensure the person-centered planning process is led by an individual as much as possible.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER C. PERSON-CENTERED PLANNING
26 TAC §263.201

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.201, Person-Centered Planning Process, requires a service coordinator and program provider to ensure the person-centered planning process is led by an individual to the maximum extent possible and that the person-centered planning process be used to develop a person directed plan (PDP), implementation plan, initial IPC, renewal IPC, revised IPC, service backup plan, and transportation plan. The proposed new rule also describes the activities involved in the person-centered planning process.

New 26 TAC §§263.301 – 263.304, describing IPC requirements, renewals, and revisions as well as service limits for HCS Program services.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER D. DEVELOPMENT AND REVIEW OF AN IPC
26 TAC §§263.301 – 263.304

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.301, IPC Requirements, describes the requirements of an IPC.
Proposed new §263.302, Renewal and Revision of an IPC, describes the process for developing a renewal IPC and a revision IPC. The proposed rule includes several requirements that are not part of the current rule regarding renewal IPCs and revision IPCs. Specifically, the proposed rule requires the service planning team to complete the HHSC HCS/TxHmL CFC PAS/HAB Assessment form when revising the IPC to add CFC PAS/HAB or update the HHSC HCS/TxHmL CFC PAS/HAB Assessment form when revising the IPC to change the amount of CFC PAS/HAB. This requirement helps ensure a consistent method for determining the number of CFC PAS/HAB hours during an IPC revision. The proposed rule requires that the service planning team convene a meeting to update the PDP and develop a revised IPC if the addition, removal or change of a service results in the addition, removal, or change to an outcome in the PDP. If the change made to an existing service does not require the addition, removal, or a change to an outcome in the PDP, the proposed rule requires the service coordinator to document the reasons for the IPC revision. The proposed rule also requires the program provider to convene a meeting with the individual or LAR to revise the implementation plans for HCS Program services, and CFC services and transportation plan. The proposed rule requires the service coordinator to send a copy of the updated PDP and HHSC HCS/TxHmL CFC PAS/HAB Assessment form to the program provider, the individual or LAR and, if applicable, the financial management services agency (FMSA). The proposed rule provides that, for an individual who is receiving all service through the consumer directed services (CDS) option, the service coordinator is not required to comply with the requirement to review and agree or disagree with the IPC information entered in the HHSC data system.
Proposed new §263.303, HHSC Review of an IPC, describes HHSC’s process for reviewing an IPC. The proposed rule provides that HHSC may review an IPC to determine if it meets the IPC requirements described in proposed §263.301(c), relating to IPC Requirements. In addition, the proposed rule codifies current practice that HHSC may deny or reduce an HCS or CFC service if an IPC does not meet requirements in §263.301(c).
Proposed new §263.304, Service Limits, lists the service limits for certain HCS Program services provided to an individual. The proposed rule includes several provisions that are not part of the current rule regarding service limits. Specifically, the proposed rule allows an individual to use $300 per IPC year for maintenance of a minor home modification (MHM) before reaching the lifetime limit for MHM. Under the current rule, the lifetime limit of $7,500 must be exhausted prior to the use of the $300 maintenance fee. This change gives the individual flexibility to use the MHM funds for maintenance. The proposed rule provides that the service limit is for respite and in-home respite combined. The proposed rule provides that the limit for day habilitation and in-home day habilitation is combined to clarify existing policy. The proposed rule also provides that a program provider may request authorization of a requisition fee for an adaptive aid that is in addition to the $10,000 service limit to codify current practice.

New 26 TAC §263.401, describing the specified activities for service coordinators and informing an applicant about the CDS option.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER E. CDS OPTION
26 TAC §263.401

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.401, CDS Option, provides that if certain services are on an applicant’s PDP, a service coordinator must perform specified activities including informing the applicant about the CDS option. The proposed rule also provides that if an applicant or individual chooses to receive a service through the CDS option, a service coordinator must perform specific activities including documenting the choice of FMSA. The proposed rule requires the service coordinator to provide information about the CDS option to individuals annually. The proposed rule describes the requirements regarding a recommendation by the service coordinator that HHSC terminate an individual’s participation in the CDS option.

New 26 TAC §§263.501 – 236.503, describing requirements for service settings, program provider owned or controlled residential settings, and residential agreements.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER F. REQUIREMENTS FOR SERVICE SETTINGS AND PROGRAM PROVIDER OWNED OR CONTROLLED RESIDENTIAL SETTINGS
26 TAC §§263.501 – 236.503

OVERVIEW

BACKGROUND AND JUSTIFICATION

This rule proposal does not include program provider certification principles that are currently in §§9.173 – 9.180, and §§9.181 – 9.183 and reviewed through the survey process. Rules containing the certification standards for the HCS Program will be proposed in 26 TAC Chapter 565 in a future issue of the Texas Register.

Another purpose of the proposed new rules is to ensure that the HCS Program complies with the requirements in Title 42, Code of Federal Regulations (CFR), Chapter IV, Subchapter C, Part 441, Subpart G, §441.301(c)(1) – (5). In 2014, CMS amended this regulation to establish new requirements for Home and Community-based Services (HCBS) Medicaid Programs, including requirements for HCBS Program settings and person-centered planning. CMS has given states until March 2023 to be in full compliance with the requirements in 42 CFR §441.301(c)(1) – (5). The proposed new rules will also ensure compliance with the requirements in 42 CFR Chapter IV, Subchapter C, Part 441, Subpart K, §441.530, regarding Home and Community-Based Setting; §441.535, regarding Assessment of functional need; and §441.540, regarding the Person-centered service plan, for Community First Choice (CFC) services because CFC services are available in the HCS Program.

Additional purposes of the proposed new rules are described below.
The proposed new rules implement Texas Government Code §531.02161(b)(4) which requires HHSC to ensure that, if cost effective, clinically effective, and allowed by federal law, a Medicaid recipient has the option to receive certain services, including occupational therapy (OT), physical therapy (PT), and speech-language pathology as a telehealth service.
The proposed new rules require the initial HCS eligibility assessments to be conducted in person and the Community First Choice (CFC) personal assistance services/habilitation (PAS/HAB) assessment to be completed in person unless certain conditions exist in which case the assessment may be completed by telehealth, telephone, or video conferencing. These requirements help ensure the assessments are thorough and accurate.
The proposed new rules include provisions regarding the denial, suspension, reduction, or termination of an individual’s HCS Program services to explain HHSC’s process in taking one of these actions. The proposed new rules change the existing service coordination monitoring requirement from 90 days to 30 days during an individual’s suspension.
The proposed new rules require a program provider and local intellectual and developmental disability authority (LIDDA) to submit a translation of non-English documentation submitted to HHSC. The purpose of the proposed new rule is to help ensure that HHSC’s reviews of documentation are efficient.
The proposed new rules require a registered nurse (RN) to complete a comprehensive nursing assessment of an individual in person under specified circumstances. This requirement is included so that the entire comprehensive nursing assessment is completed when necessary to help ensure the health and safety of an individual.
The proposed new rules codify HHSC’s current practice of increasing a level of need (LON) 1, 5, or 8 to the next LON because of an individual’s high medical needs if the individual meets certain criteria. The proposed new rule also codifies current practice related to individuals transferring to another program provider or choosing a different service delivery option in the HCS Program.
The proposed new rules provide that HHSC may allow program providers and service coordinators to use one or more of the exceptions specified in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. This provision is added to help ensure that providers and service coordinators are able to provide services effectively during a disaster.

SECTION-BY-SECTION SUMMARY

Proposed new §263.501, Requirements for Service Settings, requires a program provider to ensure that a setting in which individual receives HCS Program and CFC services meet certain criteria including that it’s based on the individual’s preferences, and needs; it supports the individual’s access to the greater community to the same degree as a person not enrolled in a Medicaid waiver program; it ensures the individual’s rights of privacy, dignity and respect, and it optimizes an individual’s independence in making life choices. In addition, the proposed rule requires that a setting in which an individual receives an HCS Program service or CFC service is not a setting presumed to have the qualities of an institution except that an HCS Program service or a CFC service may be provided in a setting that is presumed to have the qualities of an institution if CMS determines through a heightened scrutiny review that the setting does not have the qualities of an institution and does have the qualities of home and community-based settings.
Proposed new §263.502, Requirements for Program Provider Owned or Controlled Residential Settings, requires the program provider to ensure certain criteria in each residence in which residential support, supervised living, or host home/companion care is provided, including that an individual has privacy in the individual’s bedroom, has an operable lock on an individual’s bedroom door at no cost to the individual, and has the freedom and support to control the individual’s schedule and activities that are not part of the implementation plan. The proposed rule also requires the program provider to notify the service coordinator if the program provider becomes aware that a modification to the criteria is needed and requires a service coordinator given such notification to convene a service planning team meeting to update the PDP.
Proposed new §263.503, Residential Agreements, requires a program provider to have a residential agreement with an individual or LAR if the individual is living in a three-person residence or four-person residence, and to ensure that the individual or LAR has a residential agreement with the service provider of host home/companion care if the individual is living in a residence in which host home/companion care is provided. In addition, the proposed rule describes the required contents of the residential agreement and requires the program provider to give the individual or LAR at least three calendar days to review, request changes, and sign the residential agreement; and to provide a copy of the residential agreement to the individual or LAR. The proposed rule also describes the requirements for a program provider and service coordinator if an individual or LAR is delinquent in payment of room or board and the program provider wants to evict the individual. Further, the proposed rule describes the criteria that must exist before a program provider proceeds to evict an individual. The proposed rule describes the requirements for a program provider and service coordinator after an individual is evicted. Also, the proposed rule describes the required actions for a program provider or service coordinator if the program provider determines that the provision in the residential agreement regarding decoration of the individual’s bedroom needs to be modified.

New 26 TAC §263.601, concerning program provider reimbursement.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER G. REIMBURSEMENT BY HHSC
26 TAC §263.601

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.601, Program Provider Reimbursement, describes how a program provider is reimbursed for services provided in the HCS Program. The proposed rule describes the basis for payment of service by HHSC to a program provider and requires a program provider to submit a service claim that meets certain requirements including 40 TAC §49.311, relating to Claims Payment, and the HCS Program Billing Requirements or the CFC Billing Requirements for HCS and TxHmL Program Providers. The proposed rule explains when a program provider may submit a claim for a service provided during the period of the individual’s suspension or after termination of the service. The proposed rule requires a claim submitted for an adaptive aid that costs $500 or more or for a minor home modification that costs $1,000 or more to be supported by a written assessment from a licensed professional. The proposed rule describes reasons that HHSC does not pay for or recoups payments for a service, including a program provider not complying with 40 TAC §49.305, relating to Records; providing CFC PAS/HAB or in-home day habilitation to an individual with a residential type of “own/family home” or providing in-home respite and the service claim does not match the electronic visit verification (EVV) visit transaction. The proposed rule provides that HHSC conducts fiscal compliance reviews and describes the actions HHSC may take as a result of a review.

New 26 TAC §§263.701 – 263.708, concerning transfers, denials, suspensions, reductions, and terminations of the HCS and CFC Programs.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER H. TRANSFER, DENIALS, SUSPENSION, REDUCTION, AND TERMINATION
26 TAC §§263.701 – 263.708

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.701, Process for Individual to Transfer to a Different Program Provider or FMSA, describes the process for an individual to transfer to a different program provider or FMSA.
Proposed new §263.702, Process for Individual to Receive a Service Through the CDS Option that the Individual is Receiving from a Program Provider, describes the process for an individual to transfer services received through the CDS option to a program provider.
Proposed new §263.703, Denial of a Request for Enrollment into the HCS Program, describes the basis and process for HHSC to deny an individual’s request for enrollment into the HCS Program.
Proposed new §263.704, Denial of HCS Program Services or CFC Services, describes the basis and process for HHSC to deny an HCS Program Service or CFC Service.
Proposed new §263.705, Suspension of HCS Program Services and CFC Services, describes the basis and process for HHSC to suspend an individual’s HCS Program services and CFC services.
Proposed new §263.706, Reduction of HCS Program Services or CFC Services, describes the basis and process for HHSC to reduce an individual’s HCS Program service or CFC service.
Proposed new §263.707, Termination of HCS Program Services and CFC Services with Advance Notice, describes the basis and process for HHSC to terminate an individual’s HCS Program Services and CFC Services when advance notice of the termination is required.
Proposed new §263.708, Termination of HCS Program Services and CFC Services Without Advance Notice, describes the basis and process for HHSC to terminate an individual’s HCS Program Services and CFC Services when advance notice of the termination is not required.

New 26 TAC §263.801, §263.802, concerning fair hearings and a program provider’s right to an administrative hearing.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER I. HEARINGS
26 TAC §263.801, §263.802

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.801, Fair Hearing, describes the requirement for applicants and individuals to receive a notice of the right to request a fair hearing in accordance with 1 TAC Chapter 357, Subchapter A, relating to Uniform Fair Hearing Rules.
Proposed new §263.802, Program Provider’s Right to Administrative Hearing, describes when a program provider may request an administrative hearing and that the program provider may receive an administrative hearing for a dispute involving a LON assignment only if reconsideration was requested by the program provider in accordance with proposed new §263.108.

New 26 TAC §§263.901 – 263.903, regarding LIDDA requirements for providing service coordination.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER J. LIDDA REQUIREMENTS
26 TAC §§263.901 – 263.903

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.901, LIDDA Requirements for Providing Service Coordination in the HCS Program, describes requirements for the LIDDA in the provision of service coordination to applicants and individuals. The proposed rule includes several provisions that are not part of the current rule regarding LIDDA requirements. Specifically, the proposed rule changes the timeframe requirement for a service coordinator to complete a comprehensive non-introductory person-centered service planning training from two years to within six months after the service coordinator’s date of hire unless an extension of the six-month timeframe is granted by HHSC. The proposed rule describes when the service coordinator is required to provide an individual, LAR, or family member with the Your Rights In the Home and Community-based Services (HCS) Program booklet, and the HHSC HCS Rights Addendum form, and an oral explanation of the rights in the booklet and the form. The proposed rule requires the service coordinator to ensure that the updated finalized PDP is signed by the individual or LAR. In addition, the proposed rule requires the service coordinator to ensure the service planning team determines whether an individual who does not have a guardian would benefit from having a guardian or a less restrictive alternative to a guardian. Further, the proposed rule requires the service coordinator to update an individual’s PDP with specific information described in the rule, if a service coordinator is notified by the program provider that a modification to a program provider owned or controlled residential setting requirement is needed based on a specific assessed need of an individual. The proposed rule also describes the requirements for a service coordinator to inform applicants and individuals about responsibilities related to EVV.
Proposed new §263.902, Permanency Planning, describes the required activities a LIDDA must perform regarding permanency planning for an applicant under 22 years of age moving from a family setting and requesting supervised living or residential support.
Proposed new §263.903, Referral from HHSC to DFPS, provides that if HHSC is unable to locate a parent or LAR of an individual, HHSC refers the case to the Department of Family and Protective Services (DFPS).

New 26 TAC §263.1000, outlining exceptions to certain requirements during the declaration of a disaster.

CHAPTER 263. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER K. DECLARATION OF DISASTER
26 TAC §263.1000

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §263.1000, Exceptions to Certain Requirements During Declaration of Disaster, provides that HHSC may allow program providers and service coordinators to use one or more of the exceptions described in the rule while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. The rule provides that HHSC notifies program providers and LIDDAs if it allows an exception to be used and the date an allowed exception must no longer be used. The proposed rule also defines “disaster area.”

New 26 TAC §§272.1, 272.3, 272.5, 272.7, replacing references to “DADS” with “HHSC.”

CHAPTER 272. TRANSITION ASSISTANCE SERVICES
SUBCHAPTER A. INTRODUCTION
26 TAC §§272.1, 272.3, 272.5, 272.7

OVERVIEW

The Texas Health and Human Services Commission (HHSC) proposes amendments to §272.1, concerning Purpose; §272.3, concerning Definitions; §272.5, concerning Service Description; §272.7, concerning TAS in the HCS Program; §272.11, concerning Contracting Requirements; §272.33, concerning Service Delivery; and §272.41, concerning Record Keeping.

BACKGROUND AND JUSTIFICATION

The purpose of the proposed amendments is to replace the reference to the Department of Aging and Disability Services (DADS) with the Texas Health and Human Services Commission (HHSC), revise references to program rules, and make minor editorial changes for clarity.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §272.1 replaces “DADS” with “HHSC,” spells out acronyms used in the section and removes language about waiver programs that is addressed in the definitions of the programs.
The proposed amendment to §272.3 spells out acronyms used in the section. The proposed amendment adds definitions for “HHSC” and “Texas Administrative Code (TAC),” removes the definition of “DADS,” and replaces “DADS” with “HHSC.” The proposed amendment updates rule references, including rule titles, and replaces a reference to a DADS website with a reference to the HHSC website. The proposed amendment reformats the definition of “facility” and revises the definition of “general residential operation (GRO)” to reference Texas Human Resources Code, §42.002 instead of including the entire definition in §272.3.
The proposed amendment to §272.5 replaces “DADS” with “HHSC.”
The proposed amendment to §272.7 revises a rule reference, including the title of the rule.

New 26 TAC §272.11, revising a rule reference related to Transition Assistance Services.

CHAPTER 272. TRANSITION ASSISTANCE SERVICES
SUBCHAPTER B. TAS PROVIDER REQUIREMENTS
26 TAC §272.11

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §272.11 revises a rule reference.

New 26 TAC §272.33, replacing “DADS” to “HHSC.”

CHAPTER 272. TRANSITION ASSISTANCE SERVICES
SUBCHAPTER D. SERVICE DELIVERY REQUIREMENTS
26 TAC §272.33

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §272.33 replaces “DADS” to “HHSC.”

New 26 TAC §272.41, revising rule references.

SUBCHAPTER E. CLAIM PAYMENTS AND DOCUMENTATION
26 TAC §272.41

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §272.41 revises rule references.

New 26 TAC §550.209, updating references from the Department of Aging and Disability Services to HHSC.

CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER C. GENERAL PROVISIONS
26 TAC §550.209

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §550.209, concerning Emergency Preparedness Planning and Implementation.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires a prescribed pediatric extended care center (PPECC or center) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC. The proposal also reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §550.209 updates a reference in subsection (c), updates the agency name in subsections (d) and (f) to reflect the transfer of functions from the Department of Aging and Disability Services to HHSC, and improves readability in subsection (d). The proposed new subsection (g) requires the center administrator and alternate administrator to enroll in an emergency communication system in accordance with instructions from HHSC. Subsection (g) also requires the center to respond to requests for information received through the emergency communication system.

New 26 TAC §551.50, concerning improved readability and responses to requests for information received through emergency communication systems.

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
SUBCHAPTER C. STANDARDS FOR LICENSURE
26 TAC §551.50

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §551.50, concerning Emergency Preparedness and Response.

BACKGROUND AND JUSTIFICATION

The purpose of proposal is to implement a new procedure that requires an intermediate care facility for individuals with an intellectual disability or related conditions (facility) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §551.50 spells out an acronym in subsection (d)(3)(F)(iii) to improve readability and adds new subsection (h) to require the facility administrator and alternate administrator to enroll in an emergency communication system in accordance with instructions from HHSC. The subsection also requires the facility to respond to requests for information received through the emergency communication system.

Amending 26 TAC §553.275, updating references and requiring a facility manager and alternate designee to enroll in an emergency communication system.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER E. STANDARDS FOR LICENSURE
26 TAC §553.275

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §553.275, concerning Emergency Preparedness and Response.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires an assisted living facility (facility) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC. The proposal also reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §553.275 updates references in subsection (c) and adds new subsection (p) to require the facility manager and alternate designee to enroll in an emergency communication system in accordance with instructions from HHSC. The subsection also requires the facility to respond to requests for information received through the emergency communication system.

Amending 26 TAC §554.1914, updating references to reflect the transfer from the Department of Aging and Disability Services to HHSC.

CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER T. ADMINISTRATION

26 TAC §554.1914

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §554.1914, concerning Emergency Preparedness and Response.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires the nursing facility to assign a designee to enroll in and respond to requests through the emergency communication system in the format established by HHSC. The proposal also updates a cross-reference and reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §554.1914 updates a reference in subsection (c), updates subsections (d) and (f) to reflect the transfer of functions from the Department of Aging and Disability Services to HHSC, and adds a new subsection (g). The proposed new subsection (g) requires the facility administrator and director of nursing to enroll in an emergency communication system in accordance with instructions from HHSC. The subsection also requires the facility to respond to requests for information received through the emergency communication system.

Amending 26 TAC §558.256, to improve readability and require enrollment in an emergency communication system in accordance with instructions from HHSC.

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER C. MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
26 TAC §558.256

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §558.256, concerning Emergency Preparedness Planning and Implementation.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires a home and community support services agency (agency) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC. The proposal also reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §558.256 improves readability in subsections (g) and (o) and adds new subsection (q) to require the agency administrator and alternate administrator to enroll in an emergency communication system in accordance with instructions from HHSC. Subsection (q) also requires the agency to respond to requests for information received through the emergency communication system.

Amending 26 TAC §559.64, updating subsections to reflect the transfer of functions from the Department of Aging and Disability Services to HHSC.

CHAPTER 559. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS
SUBCHAPTER D. LICENSURE AND PROGRAM REQUIREMENTS
26 TAC §559.64

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §559.64, concerning Emergency Preparedness and Response.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires a day activity and health services facility (facility) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC. The proposed amendment also reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §559.64 updates subsections (d) and (e) to reflect the transfer of functions from the Department of Aging and Disability Services to HHSC. The proposed new subsection (g) requires the facility director and designees to enroll in an emergency communication system in accordance with instructions from HHSC. The subsection also requires the facility to respond to requests for information received through the emergency communication system. Edits throughout the section improve readability and understanding.

New 26 TAC §565.1, requiring the program provider designee to enroll in an emergency communication system in accordance with instructions from HHSC.

CHAPTER 565. HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS
26 TAC §565.1

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §565.1, concerning Emergency Response System, in Title 26, Part 1, new Chapter 565, Home and Community-based Services (HCS) Program and Community First Choice (CFC) Certification Standards.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires a home and community-based services program provider (program provider) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC. The proposed amendment also reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

Proposed new §565.1 requires the program provider designee to enroll in an emergency communication system in accordance with instructions from HHSC. The section also requires the program provider designee to respond to requests for information received through the emergency communication system.

New 26 TAC §566.1, requiring the program provider designee to enroll in an emergency communication system in accordance with instructions from HHSC.

CHAPTER 566. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS
26 TAC §566.1

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §566.1, concerning Emergency Response System, in Title 26, Part 1, new Chapter 566, Texas Home Living (TXHML) Program and Community First Choice (CFC) Certification Standards.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to implement a new procedure that requires a Texas home living program provider (program provider) to assign a designee to enroll and respond to requests through the emergency communication system in the format established by HHSC. The proposed amendment also reflects the transfer of functions from the Department of Aging and Disability Services to HHSC.

SECTION-BY-SECTION SUMMARY

Proposed new §566.1 requires the program provider designee to enroll in an emergency communication system in accordance with instructions from HHSC. The subsection also requires the program provider designee to respond to requests for information received through the emergency communication system.

New 26 TAC §§965.1 – 965.9, outlining general information about electronic monitoring in an individual’s bedroom in a state supported living center.

CHAPTER 965. ELECTRONIC MONITORING IN AN INDIVIDUAL’S BEDROOM IN A STATE SUPPORTED LIVING CENTER
26 TAC §§965.1 – 965.9

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Chapter 965, Electronic Monitoring in an Individual’s Bedroom in a State Supported Living Center, in Texas Administrative Code (TAC) which comprises of §§965.1, concerning Definitions; 965.2, concerning Electronic Monitoring; 965.3, concerning Information Regarding Electronic Monitoring; 965.4, concerning Request to Conduct Electronic Monitoring; 965.5, concerning Annual Consent by a Roommate; 965.6, concerning Capacity to Request or Consent to Electronic Monitoring; 965.7, concerning Conducting Electronic Monitoring; 965.8, concerning Required Facility Notice and Accommodation; and 965.9, concerning Reporting Abuse, Neglect, or Exploitation.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to place HHSC rules in 40 TAC Chapter 3, Subchapter G regarding Electronic Monitoring rules in 26 TAC. The repeal of 40 TAC Chapter 3, Subchapter G is being proposed elsewhere in this issue of the Texas Register.

SECTION-BY-SECTION

Proposed new §965.1 defines terms used in this chapter.
Proposed new §965.2 provides when a facility must allow electronic monitoring.
Proposed new §965.3 provides information regarding electronic monitoring.
Proposed new §965.4 provides information on how to request to conduct electronic monitoring.
Proposed new §965.5 describes when annual consent by a roommate is needed.
Proposed new §965.6 provides information about capacity to request or consent to electronic monitoring.
Proposed new §965.7 describes how electronic monitoring is conducted.
Proposed new §965.8 provides when a facility is requested to provide notice and accommodation.
Proposed new §965.9 provides information about reporting abuse, neglect, or exploitation.

New 26 TAC §§985.1 – 985.6, outlining the general provisions regarding human immunodeficiency virus prevention and treatment in state supported living centers.

CHAPTER 985. HUMAN IMMUNODEFICIENCY VIRUS PREVENTION AND TREATMENT IN STATE SUPPORTED LIVING CENTERS
26 TAC §§985.1 – 985.6

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new Chapter 985, Human Immunodeficiency Virus Prevention and Treatment in State Supported Living Centers, comprising §§985.1, concerning Purpose; 985.2, concerning Application; 985.3, concerning Definitions; 985.4, concerning Education; 985.5, concerning Counseling; and 985.6, concerning Limitation of an Individual’s Activity, in the Texas Administrative Code (TAC).

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to transfer HHSC rules regarding Human Immunodeficiency Virus (HIV) prevention, testing, and treatment from 40 TAC Chapter 8, Subchapter L to 26 TAC Chapter 985. The new rules simplify and consolidate requirements for the state supported living centers regarding the prevention, testing, and treatment of human immunodeficiency virus for individuals served, and workplace guidelines for contractors providing services to individuals served by the SSLCs. The repeal of 40 TAC Chapter 8, Subchapter L is proposed simultaneously elsewhere in this issue of the Texas Register.

SECTION-BY-SECTION SUMMARY

Proposed new §985.1 provides that the purpose of the chapter is to describe efforts to prevent and treat HIV for people receiving services from SSLCs.
Proposed new §985.2 provides that the chapter applies to all SSLCs and contractors providing services to individuals served by the SSLCs.
Proposed new §985.3 defines certain terms used in the chapter.
Proposed new §985.4 describes when HIV and acquired immune deficiency syndrome education is provided and when contractors must adopt model workplace guidelines.
Proposed new §985.5 describes when counseling is provided.
Proposed new §985.6 describes when an individual’s activity can be limited.

Adopted Rules Re:

Amending 1 TAC §§354.1031, 354.1035, 354.1037, 354.1039, 354.1040, 354.1043, to outline rules relating to the expansion of the healthcare workforce during the COVID-19 pandemic.

CHAPTER 354. MEDICAID HEALTH SERVICES
SUBCHAPTER A. PURCHASED HEALTH SERVICES
1 TAC §§354.1031, 354.1035, 354.1037, 354.1039, 354.1040, 354.1043

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §354.1031, concerning General; §354.1035, concerning Recipient Qualifications for Home Health Services; §354.1037, concerning Written Plan of Care; §354.1039, Home Health Services Benefits and Limitations; §354.1040, concerning Requirements for Wheeled Mobility Systems; and §354.1043, concerning Competitive Procurement of Durable Medical Equipment (DME) and Supplies.

The amendments to §354.1031, §354.1035, §354.1037, §354.1039, §354.1040, and §354.1043 are adopted without changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3361). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The purpose of the adoption is in response to recent federal legislation that prompted the Centers for Medicare & Medicaid Services (CMS) to issue interim final rule, CMS-5531-IFC (Interim Final Rule with Comment), to expand the healthcare workforce during the COVID-19 pandemic. CMS-5531-IFC is a permanent federal regulation that is not subject to the COVID-19 Public Health Emergency and became effective on May 8, 2020, with a retroactive application date of March 1, 2020.

To align the Medicaid home health services rules with CMS-5531-IFC, this adoption changes the requirement that a plan of care for covered Medicaid home health services can only be recommended, signed, and dated by a recipient’s physician and allows a physician assistant (PA) or an advanced practice registered nurse who is licensed as a certified nurse practitioner (CNP) or clinical nurse specialist (CNS) to order home health services as described in the adopted rules.

In Addition Re:

Public Notice: Texas State Plan Amendment

OVERVIEW

The Texas Health and Human Services Commission (HHSC) announces its intent to submit transmittal number 22-0027 to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act.

BACKGROUND AND JUSTIFICATION

Senate Bill (S.B.) 1921, 87th Texas Legislature, Regular Session, 2021, requires the Texas Health and Human Services Commission (HHSC) to provide fee-for-service (FFS) Medicaid reimbursement to qualified public and private providers of behavioral health services. Section 1915(g)(1) of the Social Security Act is currently invoked to limit the providers of targeted case management services to local mental health authority and local behavioral health authority (LMHA/LBHA: public providers). The proposed amendment would remove limitations on FFS reimbursement for non-LMHA/non-LBHA (private providers) providers of mental health targeted case management. An amendment to the state plan provisions regarding state plan rehabilitative services is not needed because the state plan currently allows public and private providers to be reimbursed for mental health rehabilitative services. The proposed amendment is effective September 1, 2022.

Texas Medicaid already reimburses public providers of targeted case management services through the FFS delivery model. Allowing private providers to also be reimbursed via FFS for these services would likely only shift utilization between the public and private providers. A significant increase in utilization is not anticipated because the LMHA/LBHA already provides these services. Therefore, the fiscal impact for this SPA would likely be insignificant.

Public Notice – YES Waiver April 1, 2023 Renewal

OVERVIEW

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) for the renewal of the waiver application for the Youth Empowerment Services (YES) Program. HHSC administers the YES Program under the authority of Section 1915(c) of the Social Security Act. CMS has approved the YES waiver application through March 31, 2023. The proposed effective date for the renewal is April 1, 2023.

BACKGROUND AND JUSTIFICATION

The YES Program is designed to provide home and community-based services to children and youth with serious emotional disturbances and their families, with a goal of reducing or preventing children’s inpatient psychiatric treatment and the consequent removal from their families. The program currently serves eligible children who are at least three years of age and under 19 years of age.

The renewal request proposes to make the following changes:

Corrects acronyms, unit names, references to the Department of Family and Protective Services (DFPS) to HHSC where applicable, and terminology to ensure accurate terms are used.

Updates the unduplicated number of participants, reserve capacity group numbers, as well as the service projections, and projections for annual average per capita Medicaid costs for all non-waiver institutional services (Factor G), and other Medicaid costs for the institutional population (Factor G’) for all five waiver years in Appendices B, and J.

Revises Texas Administrative Code (TAC) references, based on updated titles and chapters.

Texas Department of Licensing and Regulation

Proposed Rules Re:

Amending 16 TAC §114.50, adding the required human trafficking prevention training and completion of the jurisprudence examination to the list of acceptable sources of CE credit.

CHAPTER 114. ORTHOTISTS AND PROSTHETISTS
16 TAC §114.50

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 114, §114.50, regarding the Orthotists and Prosthetists program. These proposed changes are referred to as the “proposed rule.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC, Chapter 114, implement Texas Occupations Code, Chapter 605, Orthotists and Prosthetists.

The proposed rule permits licensed orthotists and prosthetists to claim continuing education (CE) credit for completing the human trafficking prevention training required by Occupations Code, Chapter 116, and the jurisprudence examination required for initial licensure by Department rules. The proposed rule is necessary to expand the categories of CE credit in the existing Continuing Education rule. The changes are a result of recommendations from the Orthotists and Prosthetists Advisory Board workgroup and staff and were recommended by the full advisory board.

Advisory Board Recommendations

The proposed rule was presented to and discussed by the Orthotists and Prosthetists Advisory Board at its meeting on February 28, 2022. The Advisory Board did not make any changes to the proposed rule. The Advisory Board voted and recommended that the proposed rule be published in the Texas Register for public comment.

SECTION-BY-SECTION SUMMARY

The proposed rule amends §114.50, Continuing Education, by adding two new paragraphs in subsection (i) and making conforming edits to the punctuation of that subsection.
New §114.50(i)(8) adds the human trafficking prevention training required by Occupations Code, Chapter 116, to the list of acceptable sources of CE credit. No more than one hour of CE credit may be claimed by a licensee for completion of the human trafficking prevention training during a CE reporting period.
New §114.50(i)(9) adds completion of the jurisprudence examination to the list of acceptable sources of CE credit. Current Department rules in Chapter 114 do not require completion of the jurisprudence examination after initial licensure. The addition of this new paragraph permits a licensee to complete the examination for a one-hour CE credit in a CE reporting period even though the examination is not a requirement for renewal of a license.

Department of Aging and Disability Services

Proposed Rules Re:

Repealing 40 TAC §§3.701 – 3.708, regarding electronic monitoring.

CHAPTER 3. RESPONSIBILITIES OF STATE FACILITIES
SUBCHAPTER G. ELECTRONIC MONITORING
40 TAC §§3.701 – 3.708

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Texas Administrative Code (TAC) Title 40, Part 1, and will be repealed or administratively transferred to 26 TAC, Health and Human Services, as appropriate. Until such action is taken, the rules in 40 TAC, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in 40 TAC Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of 40 TAC Chapter 3, Subchapter G, Electronic Monitoring, which comprises of §3.701, concerning Electronic Monitoring; §3.702, concerning Information Regarding Electronic Monitoring; §3.703, concerning Request to Conduct Electronic Monitoring; §3.704, concerning Annual Consent of Other Individuals; §3.705, concerning Capacity to Request or Consent to Electronic Monitoring; §3.706, concerning Conducting Electronic Monitoring; §3.707, concerning Required Facility Notice and Accommodation; and §3.708, concerning Reporting Abuse, Neglect, or Exploitation.

BACKGROUND AND JUSTIFICATION

The proposed repeal of 40 TAC Chapter 3, Subchapter G deletes the rules as no longer necessary because content of the rules is being proposed in 26 TAC Chapter 965, Electronic Monitoring In An Individual’s Bedroom In A State Supported Living Center, simultaneously in this issue of the Texas Register.

SECTION-BY-SECTION

The rules in 40 TAC Chapter 3, Subchapter G are no longer necessary and is repealed. New rules regarding electronic monitoring are proposed in 26 TAC Chapter 965.

Repealing 40 TAC §§8.281 – 8.297, regarding HIV prevention and treatment in state sponsored living centers.

CHAPTER 8. CLIENT CARE–INTELLECTUAL DISABILITY SERVICES
SUBCHAPTER L. HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVENTION, TESTING, AND TREATMENT
40 TAC §§8.281 – 8.297

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Texas Administrative Code (TAC) Title 40, Part 1, and will be repealed or administratively transferred to 26 TAC, Health and Human Services, as appropriate. Until such action is taken, the rules in 40 TAC Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055 requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in 40 TAC Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of 40 TAC Chapter 8, Subchapter L, Human Immunodeficiency Virus (HIV) Prevention, Testing, and Treatment, which comprises of §8.281, concerning Purpose; §8.282, concerning Application; §8.283, concerning Definitions; §8.284, concerning Policy Overview; §8.285, concerning Education; §8.286, concerning Screening for HIV Antibody; §8.287, concerning Counseling; §8.288, concerning Confidentiality of Test Results; §8.289, concerning Documentation of Test Results; §8.290, concerning Required Reporting of Test Results; §8.291, concerning Management of Exposure to Blood/Body Substances; §8.292, concerning Limitation of Client Activity; §8.293, concerning Personnel Issues; §8.294, concerning Responsibility and Resources; §8.295, concerning Exhibits; §8.296, concerning Reference; and 8.297, concerning Distribution.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to repeal HHSC rules from 40 TAC Chapter 8, Subchapter L. The proposed repeals delete the rules as no longer necessary because content of the rules have been added to proposed new rules in 26 TAC Chapter 985, Human Immunodeficiency Virus Prevention and Treatment in State Supported Living Centers. The new rules are proposed elsewhere in this issue of the Texas Register.

SECTION-BY-SECTION SUMMARY

The rules in 40 TAC Chapter 8, Subchapter L are no longer necessary and is repealed. New rules regarding HIV prevention and treatment in State Supported Living Centers are proposed in 26 TAC Chapter 985.

Repealing 40 TAC §§9.151, 9.152, 9.154 – 9.170, 9.186, 9.189 – 9.192, concerning rules covering topics addressed in the new proposed rule.

CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER D. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
40 TAC §§9.151, 9.152, 9.154 – 9.170, 9.186, 9.189 – 9.192

OVERVIEW

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to repeal obsolete rules for the HCS Program, a Medicaid waiver program authorized under §1915(c) of the Social Security Act that provides services to individuals with intellectual disabilities. The rules in 40 TAC Chapter 9, Subchapter D govern the provision of HCS Program services. HHSC is proposing new rules regarding the HCS Program in 26 TAC Chapter 263 elsewhere in this issue of the Texas Register. The proposed rules address certain aspects of the HCS Program, including eligibility criteria; the maintenance of the HCS interest list; the process for the enrollment of applicants in the HCS Program; renewal and revision of an individual plan of care; requirements for reimbursement of a program provider; and requirements for a local intellectual and developmental disability authority in providing service coordination; and permanency planning requirements. Therefore, the rules in 40 TAC Chapter 9, Subchapter D that address the topics covered by the proposed new rules in 26 TAC Chapter 263 are no longer needed.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §§9.151, 9.152, 9.154 – 9.170, 9.186, and 9.189 – 9.192 removes rules covering topics that are addressed in new proposed rules.

Repealing 40 TAC §§9.551, 9.552, 9.554, 9.556, 9.558, 9.560 – 9.563, 9.566 – 9.568, 9.570, 9.571, 9.573 – 9.575, 9.582, 9.583, to remove rules that concern a Medicaid waiver program because they are covered in the new rules.

SUBCHAPTER N. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
40 TAC §§9.551, 9.552, 9.554, 9.556, 9.558, 9.560 – 9.563, 9.566 – 9.568, 9.570, 9.571, 9.573 – 9.575, 9.582, 9.583

OVERVIEW

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to repeal obsolete rules for the TxHmL Program, a Medicaid waiver program authorized under §1915(c) of the Social Security Act that provides services to individuals with intellectual disabilities. The rules in 40 TAC Chapter 9, Subchapter N govern the provision of TxHmL Program services. HHSC is proposing new rules regarding the TxHmL Program in 26 TAC Chapter 262 elsewhere in this issue of the Texas Register. The proposed rules address certain aspects of the TxHmL Program, including eligibility criteria; the maintenance of the TxHmL interest list; the process for the enrollment of applicants in the TxHmL Program; renewal and revision of an individual plan of care; requirements for reimbursement of a program provider; and requirements for a local intellectual and developmental disability authority in providing service coordination; and permanency planning requirements. Therefore, the rules in 40 TAC Chapter 9, Subchapter N that address the topics covered by the proposed new rules in 26 TAC Chapter 262 are no longer needed.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §§9.551, 9.552, 9.554, 9.556, 9.558, 9.560 – 9.563, 9.566 – 9.568, 9.570, 9.571, 9.573 – 9.575, 9.582 and 9.583 removes rules covering topics that are addressed in the proposed new rules in 26 TAC Chapter 262.

Repealing 40 TAC §§42.101 – 42.105 to remove the general rules governing the DBMD program.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER A. INTRODUCTION
40 TAC §§42.101 – 42.105

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to repeal all of the rules in 40 TAC Chapter 42. These rules govern the provision of DBMD Program services. The DBMD Program is a Medicaid waiver program authorized under §1915(c) of the Social Security Act. HHSC is proposing new rules governing the DBMD Program in 26 TAC Chapter 260 elsewhere in this issue of the Texas Register.

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.201, §42.202, which concerned eligibility, enrollment, and review of DBMD Programs and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §42.201, §42.202

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.201, §42.202, which related to eligibility of DBMD Programs and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §§42.211 – 42.217

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.220, 42.221, 42.223, which concerned review of DBMD Programs and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §§42.220, 42.221, 42.223

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.231, §42.232, which concerned the transfer between program providers in DBMD Programs and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §42.231, §42.232

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.241 – 42.249, to remove rules concerning denials, suspensions, reductions, and terminations of DBMD Programs and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §§42.241 – 42.249

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.251, §42.252, to eliminate rules concerning rights and responsibilities of an individual.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER B. ELIGIBILITY, ENROLLMENT, AND REVIEW
40 TAC §42.251, §42.252

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.301, which concerned program provider enrollment for DBMD and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER C. PROGRAM PROVIDER ENROLLMENT
40 TAC §42.301

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.401 – 42.411, concerning additional program provider provisions for DBMD and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER D. ADDITIONAL PROGRAM PROVIDER PROVISIONS
40 TAC §§42.401 – 42.411

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.501 – 42.511, concerning assistance with personal fund management in DBMD and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER E. ASSISTANCE WITH PERSONAL FUNDS MANAGEMENT
40 TAC §§42.501 – 42.511

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.601 – 42.606, concerning service descriptions and requirements for DBMD and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
40 TAC §§42.601 – 42.606

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.611 – 42.620, concerning service descriptions and requirements for DBMD and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
40 TAC §§42.611 – 42.620

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §§42.621 – 42.632, concerning service descriptions and requirements for DBMD and CFC Services.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
40 TAC §§42.621 – 42.632

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.641, concerning service descriptions and requirements for DBMD and CFC Services replaced in the new rule.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
40 TAC §42.641

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Repealing 40 TAC §42.651, concerning service descriptions and requirements for DBMD and CFC Services replaced in the new rule.

CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
40 TAC §42.651

OVERVIEW

As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to the Texas Health and Human Services Commission (HHSC) in accordance with Texas Government Code §531.0201 and §531.02011. Rules of the former DADS are codified in Title 40, Part 1, and will be repealed or administratively transferred to Title 26, Health and Human Services, as appropriate. Until such action is taken, the rules in Title 40, Part 1 govern functions previously performed by DADS that have transferred to HHSC. Texas Government Code §531.0055, requires the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by the health and human services system, including rules in Title 40, Part 1. Therefore, the Executive Commissioner of HHSC proposes the repeal of §§42.101 – 42.105, 42.201, 42.202, 42.211 – 42.217, 42.220, 42.221, 42.223, 42.231, 42.232, 42.241 – 42.249, 42.251, 42.252, 42.301, 42.401 – 42.411, 42.501 – 42.511, 42.601 – 42.606, 42.611 – 42.632, 42.641, and 42.651 in Texas Administrative Code Title 40 (40 TAC), Part 1, Chapter 42, concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services.

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed repeal of 40 TAC, Chapter 42 removes rules governing the DBMD Program. New rules governing the DBMD Program are being proposed in 26 TAC Chapter 260.

Texas Behavioral Health Executive Council

Adopted Rules Re:

Amending 22 TAC §882.2 to reflect the agency’s ability to receive digitally certified self-query reports from the NPDB, rather than continuing to rely exclusively on self-query reports submitted by mail.

CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER A. LICENSE APPLICATIONS
22 TAC §882.2

OVERVIEW

The Texas Behavioral Health Executive Council adopts amended §882.2, relating to General Application File Requirements. Section 882.2 is adopted without changes to the proposed text as published in the April 22, 2022, issue of the Texas Register (47 TexReg 2103) and will not be republished.

BACKGROUND AND JUSTIFICATION

Amending 22 TAC §882.22 to reflect the agency’s ability to receive digitally certified self-query reports from the NPDB and to clarify that only a full license can be reinstated while a transitory license used to obtain required experience for full licensure cannot.

CHAPTER 882. APPLICATIONS AND LICENSING
SUBCHAPTER B. LICENSE
22 TAC §882.22

OVERVIEW

The Texas Behavioral Health Executive Council adopts amended §882.22, relating to Reinstatement of a License. Section 882.22 is adopted without changes to the proposed text as published in the April 22, 2022, issue of the Texas Register (47 TexReg 2104) and will not be republished.

BACKGROUND AND JUSTIFICATION

The adopted change is necessary to reflect the agency’s ability to receive digitally certified self-query reports from the NPDB, rather than continuing to rely exclusively on self-query reports submitted by mail. The adopted change also clarifies that only a full license can be reinstated, and a transitory license used to obtain required experience for full licensure cannot.

Amending 22 TAC §884.20 to correct a typographic error relating to Disciplinary Guidelines and General Schedule of Sanctions.

SUBCHAPTER C. DISCIPLINARY GUIDELINES AND SCHEDULE OF SANCTIONS
22 TAC §884.20

OVERVIEW

The Texas Behavioral Health Executive Council adopts amended §884.20, relating to Disciplinary Guidelines and General Schedule of Sanctions. Section 884.20 is adopted without changes to the proposed text as published in the April 22, 2022, issue of the Texas Register (47 TexReg 2105) and will not be republished.

BACKGROUND AND JUSTIFICATION

The adopted amendment is necessary to correct a typographical error in subsection (a)(4) of the rule.

Texas Department of State Health Services

In Addition Re:

Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 47 Tex Reg 5884.

Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 47 Tex Reg 5891.