Texas Register September 3, 2021 Volume: 46 Number: 36

Texas Register Table of Contents

Health and Human Services Commission

Emergency Rules Re:

Renewing 26 TAC §551.47 to describe requirements regarding limited outdoor and indoor visitation in Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions.

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
SUBCHAPTER C. STANDARDS FOR LICENSURE
26 TAC §551.47

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §551.47 for a 60-day period. The text of the emergency rule was originally published in the May 7, 2021, issue of the Texas Register (46 Tex Reg 2945).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 26, Part 1, Texas Administrative Code, Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID) or Related Conditions, new §551.47, concerning an emergency rule in response to COVID-19 describing requirements for limited indoor and outdoor visitation in ICF/IID.

HHSC is renewing a new emergency rule to require limited indoor and outdoor visitation in an intermediate care facility. The purpose of the new rule is to describe the requirements related to such visits.

BACKGROUND AND JUSTIFICATION

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

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. This emergency rulemaking reflects the continued reopening of the State of Texas. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Intermediate Care Facility COVID-19 Response–Expansion of Reopening Visitation.


New 26 TAC §553.2003, requiring limited indoor and outdoor visitation in an assisted living facility.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER K. COVID-19 EMERGENCY RULE
26 TAC §553.2003

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities, Subchapter K, COVID-19 Emergency Rule, new §553.2003, concerning an emergency rule in response to COVID-19 describing requirements for limited indoor and outdoor visitation in a facility.

HHSC is adopting an emergency rule to require limited indoor and outdoor visitation in an assisted living facility. The purpose of the new rule is to describe the requirements related to such visits.

BACKGROUND AND JUSTIFICATION

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

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Assisted Living Facility COVID-19 Response–Expansion of Reopening Visitation.


Renewing 26 TAC §558.950, to outline requirements that limit indoor and outdoor visitation in a hospice inpatient unit.

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE
26 TAC §558.950

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §558.950 for a 60-day period. The text of the emergency rule was originally published in the May 7, 2021, issue of the Texas Register (46 Tex Reg 2960).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 26, Texas Administrative Code, Chapter 558, Licensing Standards for Home and Community Support Services Agencies, Subchapter I, Response to COVID-19 and Pandemic-Level Communicable Disease, new §558.950, concerning an emergency rule in response to COVID-19 describing requirements for limited indoor and outdoor visitation in a hospice inpatient unit.

HHSC is renewing an emergency rule to require limited indoor and outdoor visitation in a hospice inpatient unit. The purpose of the new rule is to describe the requirements related to such visits.

BACKGROUND AND JUSTIFICATION

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

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


In Addition Re:

Public Notice – Texas State Plan for Medical Assistance Amendment Effective October 1, 2021

OVERVIEW

The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendment is effective October 1, 2021.

BACKGROUND AND JUSTIFICATION

The purpose of the amendment is to update the fee schedules in the current state plan by adjusting fees, rates, or charges for the following services:

  • Ambulatory Surgical Centers / Hospital Based Ambulatory Surgical Centers; and
  • Physicians and Other Practitioners.

HEARING DETAILS

A rate hearing was conducted online on May 25, 2021, at 9:00 a.m. Information about the proposed rate changes and the hearing were published in the May 7, 2021, issue of the Texas Register (46 Tex Reg 3057). The notice of hearing can be found at http://www.sos.state.tx.us/texreg/index.shtml.

Interested parties may obtain additional information and/or a free copy of the proposed amendment by contacting Kevin Niemeyer, State Plan Policy Advisor, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by telephone at (512) 487-3349; by facsimile at (512) 730-7472; or by e-mail at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us. Copies of the proposed amendment will be available for review at the local county offices of HHSC, (which were formerly the local offices of the Texas Department of Aging and Disability Services).


Department of Aging and Disability Services

Emergency Rules Re:

New 40 TAC §9.198 and §9.199, describing HCS program requirements relating to visitation, essential caregivers, and day habilitation in response to the ongoing pandemic.

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 §9.198, §9.199

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40, Part 1, Texas Administrative Code, Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities, new §9.198 and §9.199, concerning emergency rules in response to COVID-19.

HHSC is adopting emergency rules to reduce the risk of spreading COVID-19 to individuals in the HCS program. These new rules describe the requirements HCS program providers must immediately put into place and the requirements they must follow for visitation, essential caregivers, and day habilitation.

BACKGROUND AND JUSTIFICATION

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

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of these Emergency Rules for Program Provider Response to COVID-19 and Home and Community-based Services (HCS) Expansion of Reopening Visitation.


Texas Optometry Board

Proposed Rules Re:

Amending 22 TAC §273.4 to increase fees in response to additional agency costs and expenses.

CHAPTER 273. GENERAL RULES
22 TAC §273.4

The Texas Optometry Board proposes amendments of 22 TAC §273.4, Fees (Non-Refundable). The initial fees are increased by five dollars and the biennial fees are increased by five dollars for each year for a total of ten dollars each biennium. The fees are being increased because the agency will incur additional costs and expenses due to SB993 of the 87th Regular Legislative Session.


Amending 22 TAC §275.1 to modernize approval processes for continuing education courses and its providers.

CHAPTER 275. CONTINUING EDUCATION
22 TAC §275.1

The Texas Optometry Board (the “Board”) proposes amendments of 22 TAC §275.1 General Requirements. This amendment simply modernizes the way the agency approves continuing education course providers and courses. The Board reserves the right to review and approve providers that are not automatically granted approval through this amendment as stated in Paragraph C. The Board also reserves the right to reject any course. Finally, this amendment will increase agency efficiencies and improve customer service.


Texas Department of Insurance

Withdrawn Rules Re:

Withdrawing 28 TAC §21.2410 and §21.2412, which concerned mental health and substance use disorder parity requirements.

CHAPTER 21. TRADE PRACTICES
SUBCHAPTER P. MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY
DIVISION 1. GENERAL PROVISIONS AND PARITY REQUIREMENTS
28 TAC §21.2410, §21.2412

The Texas Department of Insurance withdraws the proposed new §21.2410 and §21.2412 which appeared in the February 19, 2021, issue of the Texas Register (46 Tex Reg 1191).


Withdrawing 28 TAC §21.2453, which involved autism spectrum disorder rules.

CHAPTER 21. TRADE PRACTICES
SUBCHAPTER P. MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY
DIVISION 4. AUTISM SPECTRUM DISORDER
28 TAC §21.2453

The Texas Department of Insurance withdraws the proposed new §21.2453 which appeared in the February 19, 2021, issue of the Texas Register (46 Tex Reg 1191).


Adopted Rules Re:

Repealing 28 TAC §§21.2401 – 21.2407, 21.4401 – 21.4404 relating to Mental Health Parity and Autism Spectrum Disorder Coverage.

CHAPTER 21. TRADE PRACTICES
28 TAC §§21.2401 – 21.2407, 21.4401 – 21.4404

OVERVIEW

The Commissioner of Insurance adopts the repeal of 28 TAC Chapter 21, Subchapter P, §§21.2401 – 21.2407, relating to Mental Health Parity, and 28 TAC Chapter 21, Subchapter JJ, §§21.4401 – 21.4404, relating to Autism Spectrum Disorder Coverage. The repealed rules will not be republished. The Commissioner also adopts new 28 TAC Chapter 21, Subchapter P, relating to Mental Health and Substance Use Disorder Parity, §§21.2401 – 21.2409, 21.2411, 21.2413, 21.2414, 21.2421 – 21.2427, 21.2431 – 21.2441, 21.2451, and 21.2452, concerning parity between medical/surgical benefits and mental health and substance use disorder (MH/SUD) benefits. The repeals and adoption implement House Bill 10, 85th Legislature, 2017. The repeals are adopted without changes to the proposal published in the February 19, 2021, issue of the Texas Register (46 Tex Reg 1191).

The Commissioner withdraws the proposal of new §§21.2410, 21.2412, and 21.2453.

BACKGROUND AND JUSTIFICATION

This rule is required to implement the legislature’s directives in HB 10 to health benefit plan issuers (issuers) and the Commissioner. Issuers are to provide benefits and coverage for MH/SUD under the same terms and conditions applicable to the plan’s medical/surgical benefits and coverage. An issuer may not impose quantitative or nonquantitative treatment limitations on benefits for a mental health condition or substance use disorder that are generally more restrictive than the limitations imposed on coverage of benefits for medical or surgical expenses. The Commissioner is required to enforce compliance with the legislature’s directive to issuers by evaluating the benefits and coverage offered by an issuer’s health benefit plan for quantitative and nonquantitative treatment limitations in several categories:

(1) in-network and out-of-network inpatient care,

(2) in-network and out-of-network outpatient care,

(3) emergency care, and

(4) prescription drugs.

This rule is designed to provide issuers guidance on compliance with the legislature’s directive and to collect information and require issuer analyses of data that will allow the Commissioner to enforce compliance.


New 28 TAC §§21.2401 – 21.2409, 21.2411, 21.2413, 21.2414, 21.2421 – 21.2427, 21.2431 – 21.2441, 21.2451, 21.2452, concerning parity between medical/surgical benefits and mental health and substance use disorder (MH/SUD) benefits.

CHAPTER 21. TRADE PRACTICES
28 TAC §§21.2401 – 21.2409, 21.2411, 21.2413, 21.2414, 21.2421 – 21.2427, 21.2431 – 21.2441, 21.2451, 21.2452

OVERVIEW

The Commissioner of Insurance adopts the repeal of 28 TAC Chapter 21, Subchapter P, §§21.2401 – 21.2407, relating to Mental Health Parity, and 28 TAC Chapter 21, Subchapter JJ, §§21.4401 – 21.4404, relating to Autism Spectrum Disorder Coverage. The repealed rules will not be republished. The Commissioner also adopts new 28 TAC Chapter 21, Subchapter P, relating to Mental Health and Substance Use Disorder Parity, §§21.2401 – 21.2409, 21.2411, 21.2413, 21.2414, 21.2421 – 21.2427, 21.2431 – 21.2441, 21.2451, and 21.2452, concerning parity between medical/surgical benefits and mental health and substance use disorder (MH/SUD) benefits. The repeals and adoption implement House Bill 10, 85th Legislature, 2017. The repeals are adopted without changes to the proposal published in the February 19, 2021, issue of the Texas Register (46 Tex Reg 1191).

The Commissioner withdraws the proposal of new §§21.2410, 21.2412, and 21.2453.

BACKGROUND AND JUSTIFICATION

This rule is required to implement the legislature’s directives in HB 10 to health benefit plan issuers (issuers) and the Commissioner. Issuers are to provide benefits and coverage for MH/SUD under the same terms and conditions applicable to the plan’s medical/surgical benefits and coverage. An issuer may not impose quantitative or nonquantitative treatment limitations on benefits for a mental health condition or substance use disorder that are generally more restrictive than the limitations imposed on coverage of benefits for medical or surgical expenses. The Commissioner is required to enforce compliance with the legislature’s directive to issuers by evaluating the benefits and coverage offered by an issuer’s health benefit plan for quantitative and nonquantitative treatment limitations in several categories:

(1) in-network and out-of-network inpatient care,

(2) in-network and out-of-network outpatient care,

(3) emergency care, and

(4) prescription drugs.

This rule is designed to provide issuers guidance on compliance with the legislature’s directive and to collect information and require issuer analyses of data that will allow the Commissioner to enforce compliance.


Texas State Board of Pharmacy

Adopted Rules Re:

Amending 22 TAC §283.4 to update internship hours requirements in accordance with the Accreditation Council for Pharmacy Education (ACPE).

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS
22 TAC §283.4

The Texas State Board of Pharmacy adopts amendments to §283.4, concerning Internship Requirements. These amendments are adopted without changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 Tex Reg 3810). The rule will not be republished.

The amendments update the internship hours requirement to reflect that the board requires the number of intern hours required by the Accreditation Council for Pharmacy Education (ACPE).


Amending 22 TAC §291.6 to increase pharmacy license fees.

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.6

The Texas State Board of Pharmacy adopts amendments to §291.6, concerning Pharmacy License Fees. These amendments are adopted with changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 Tex Reg 3813). The Board adjusted the amount of the fees based on updated information. The rule will be republished.

The amendments increase pharmacy license fees based on expected expenses.


Amending 22 TAC §291.76 to update requirements relating to medication distribution procedures.

CHAPTER 291. PHARMACIES
SUBCHAPTER D. INSTITUTIONAL PHARMACY (CLASS C)
22 TAC §291.76

The Texas State Board of Pharmacy adopts amendments to §291.76, concerning Class C Pharmacies Located in a Freestanding Ambulatory Surgical Center. These amendments are adopted with changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 Tex Reg 3814). The rule will be republished.

The amendments allow a licensed nurse who is authorized by the pharmacist to perform the loading of an automated medication supply system; update the time interval in which a pharmacist must verify a drug withdrawal; update the requirements for using a floor stock method of drug distribution; update records requirements; and correct grammatical errors.


Amending 22 TAC §291.121 to allow for certain remote pharmacy services through the use of an automated dispensing and delivery system.

CHAPTER 291. PHARMACIES
SUBCHAPTER G. SERVICES PROVIDED BY PHARMACIES
22 TAC §291.121

The Texas State Board of Pharmacy adopts amendments to §291.121, concerning Remote Pharmacy Services. These amendments are adopted without changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 Tex Reg 3823). The amended rule will not be republished.

The amendments authorize a Class A or Class C pharmacy to provide remote pharmacy services using an automated dispensing and delivery system and correct grammatical errors.


Amending 22 TAC §291.151 to update requirements relating to medication supply and distribution procedures.

CHAPTER 291. PHARMACIES
SUBCHAPTER H. OTHER CLASSES OF PHARMACY
22 TAC §291.151

The Texas State Board of Pharmacy adopts amendments to §291.151, concerning Pharmacies Located in a Freestanding Emergency Medical Care Facility (Class F). These amendments are adopted with changes to the proposed text as published in the June 25, 2021, issue of the Texas Register at (46 Tex Reg 3835). The rule will be republished.

The amendments allow a licensed nurse who is authorized by the pharmacist to perform the loading of an automated medication supply system; update the time interval in which a pharmacist must verify a drug withdrawal; update the requirements for using a floor stock method of drug distribution; update records requirements; update references to DEA 222 form requirements to be consistent with federal regulations; and correct grammatical errors.


Amending 22 TAC §295.5 to increase pharmacist license fees.

CHAPTER 295. PHARMACISTS
22 TAC §295.5

The Texas State Board of Pharmacy adopts amendments to §295.5, concerning Pharmacist License or Renewal Fees. These amendments are adopted with changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 Tex Reg 3844). The rule will be republished. The Board adjusted the amount of the fees based on updated information.

The amendments increase pharmacist license fees based on expected expenses.


Amending 22 TAC §297.4 to increase pharmacy technician and pharmacy technician trainee registration fees.

CHAPTER 297. PHARMACY TECHNICIANS AND PHARMACY TECHNICIAN TRAINEES
22 TAC §297.4

The Texas State Board of Pharmacy adopts amendments to §297.4, concerning Fees. These amendments are adopted without changes to the proposed text as published in the June 25, 2021, issue of the Texas Register (46 TexReg 3845). The rule will not be republished.

The amendments increase pharmacy technician and pharmacy technician trainee registration fees based on expected expenses.


Cancer Prevention and Research Institute of Texas

Adopted Rules Re:

Amending 25 TAC §703.26 to clarify and authorize reimbursement for certain expenses incurred by participants in a cancer clinical trial.

CHAPTER 703. GRANTS FOR CANCER PREVENTION AND RESEARCH
25 TAC §703.26

OVERVIEW

The Cancer Prevention and Research Institute of Texas (“CPRIT” or “the Institute”) adopts the amendment to 25 Texas Administrative Code (TAC) §703.26 without changes to the proposed text as published in the June 4, 2021, issue of the Texas Register (46 Tex Reg 3498); therefore, the rule will not be republished. The amendment clarifies that CPRIT may reimburse certain expenses incurred by participants in a cancer clinical trial pursuant to the authority provided by Texas Health and Safety Code Annotated, § 102.203(b).

BACKGROUND AND JUSTIFICATION

The amendment to §703.26 makes the Institute’s administrative rules consistent with a statutory change to Texas Health and Safety Code Chapter 102 made by the Legislature in 2019. The 86th Legislature amended CPRIT’s statute to authorize reimbursement for costs of participation incurred by cancer clinical trial participants, including transportation, lodging, and costs reimbursed under a program established pursuant to Texas Health and Safety Code Annotated, Chapter 50 “Cancer Clinical Trial Participation Program.”


Texas Board of Nursing

Review of Agency Rules Re:

Proposed Rule Review of Chapter 227 §§227.1 – 227.4, which relates to Pilot Programs for Innovative Applications to Vocational and Professional Nursing Education.

Title 22, Part 11

OVERVIEW

In accordance with the Government Code §2001.039, the Texas Board of Nursing (Board) files this notice of intention to review and consider for re-adoption, re-adoption with amendments, or repeal, the following chapter contained in Title 22, Part 11, of the Texas Administrative Code, pursuant to the 2019 rule review plan adopted by the Board at its July 2018 Board meeting.

Chapter 227. Pilot Programs for Innovative Applications to Vocational and Professional Nursing Education, §§227.1 – 227.4.

In conducting its review, the Board will assess whether the reasons for originally adopting this chapter continues to exist. Each section of this chapter will be reviewed to determine whether it is obsolete, whether it reflects current legal and policy considerations and current procedures and practices of the Board, and whether it is in compliance with Chapter 2001 of the Government Code (Administrative Procedure Act).

COMMENT DETAILS

The public has thirty (30) days from the publication of this rule review in the Texas Register to comment and submit any response or suggestions. Written comments may be submitted to James W. “Dusty” Johnston, General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701; by email to dusty.johnston@bon.texas.gov; or by fax to James W. “Dusty” Johnston at (512) 305-8101. Any proposed changes to this chapter as a result of this review will be published separately in the Proposed Rules section of the Texas Register and will be open for an additional comment period prior to the final adoption or repeal by the Board.


Department of State Health Services

In Addition Re:

Withdrawal of a Practice Serving a Medically Underserved Population.

OVERVIEW

The Texas Department of State Health Services (department) under Texas Occupations Code §157.051 may designate practices serving a medically underserved population. Under Texas Administrative Code Title 25, Part 1, Chapter 13, Subchapter C, §13.35, the department is required to verify a practice’s continued eligibility for designation as a practice serving a medically underserved population no more than two years after its initial designation and within each two-year period thereafter.

PediPlace, located at 7989 Beltline Road, Dallas, Texas 75248, was designated as a site serving a medically underserved population on February 10, 2016 due to its disproportionate number of clients eligible for federal, state, or locally funded health care programs. PediPlace, located at 7989 Beltline Road, Dallas, Texas 75248, no longer meets the eligibility for designation and the designation has been withdrawn.

COMMENT DETAILS

Oral and written comments on this withdrawal of designation may be directed to Anne Nordhaus, MA, Research Specialist, Health Professions Resource Center – Mail Code 1898, Center for Health Statistics, Texas Department of State Health Services, P.O. Box 149347, Austin, Texas 78714-9347; (512) 776-3862 (phone); (512) 776-7344 (fax); or hprc@dshs.texas.gov (email). Comments will be accepted for 30 days from the publication date of this notice.