Texas Register Table of Contents
- 1 Texas Board of Physical Therapy Examiners
- 2 Texas Health and Human Services Commission
- 2.0.1 Adopted Rules Re:
- 2.0.1.1 Adopting 1 TAC §§355.304, 355.306 – 355.308, 355.318, 355.320, to update references, change titles, and introduce the new PDPM LTC methodology.
- 2.0.1.2 Repealing 1 TAC §355.309, §355.314, to remove rules which no longer apply to nursing facility reimbursements.
- 2.0.1.3 Adopting 26 TAC §553.17, to describe the ability of an accreditation commission to conduct an on-site accreditation survey.
- 2.0.1.4 Adopting 26 TAC §§553.254, 553.255, 553.257, to add new training requirements for staff members who are not Alzheimer’s certified and to add a suspension requirement for reportable conduct.
- 2.0.1.5 Adopting 26 TAC §553.329, to remove the in-person complaint investigation requirement unless the abuse or neglect involves an unemancipated minor who has been inappropriately placed in a facility.
- 2.0.2 Proposed Rule Reviews Re:
- 2.0.3 Adopted Rule Reviews Re:
- 2.0.4 In Addition Re:
- 2.0.1 Adopted Rules Re:
- 3 Cancer Prevention and Research Institute of Texas
- 4 Texas Department of State Health Services
- 5 State Board of Dental Examiners
- 6 Department of Aging and Disability Services
Texas Board of Physical Therapy Examiners
Proposed Rules Re:
Amending 22 TAC §§343.1, 343.23, 343.24, 343.26 – 343.29, 343.35, 343.48, 343.50 – 343.53, 343.55, 343.56, to clarify the procedures for contested cases, update references, and conform to current rules.
CHAPTER 343. CONTESTED CASE PROCEDURE
22 TAC §§343.1, 343.23, 343.24, 343.26 – 343.29, 343.35, 343.48, 343.50 – 343.53, 343.55, 343.56
OVERVIEW
The Texas Board of Physical Therapy Examiners (board) proposes amending Chapter 343. Contested Case Procedures, Occupations Code. Specifically, the Board proposes amendments to §343.1. Definitions, §343.23. Hearings, §343.24. Payment of Costs for a Contested Case Hearing Resulting in the Discipline of a Licensee or the Denial of an Application for License, §343.26. Commutation of Time, §343.27. Probation, §343.28. Records Retention Schedule, §343.29. Failure To Appear at Informal Settlement Conference or Hearing, §343.35. Complaint Investigation and Disposition, §343.48. Dismissal of Complaint, §343.50. Application for Reinstatement of License, §343.51. Evaluation for Reinstatement, §343.52. Procedure upon Request for Reinstatement, §343.53. Board Action Possible upon Reinstatement of Revoked License, §343.55. Failure To Appear, and §343.56. Monitoring of Licensees. And proposes the repeal of §343.25. Continuance.
BACKGROUND INFORMATION
The amendments are proposed in order to provide clarity to the procedures for contested cases, to correct inaccurate and outdated references, and to conform the rules in Chapter 343 with the physical therapy provisions in Chapter 453, Occupations Code, with the administrative procedures in Chapter 2001, Government Code, and with Title 1 Texas Administrative Code. The repeal is proposed as the procedure is covered under the State Office of Administrative Hearings (SOAH) rules for hearings.
SECTION-BY-SECTION SUMMARY
Section 343.1. Definitions is amended to provide more accurate descriptions and references; to add definitions of Informal Settlement Conference (ISC), Investigation Committee, and Voluntary Surrender; and to reformat accordingly.
Section 343.23. Hearings is amended to correct references and eliminate redundancy of the sited sections of the Texas Government Code and the Texas Administrative Code.
Section 343.24. Payment of Costs for a Contested Case Hearing Resulting in the Discipline of a Licensee or the Denial of an Application for License is amended to correct the title to reflect that penalties not costs are assessed and that administrative penalties may be assessed if a licensee is found in violation of the Act and are payable in accordance with the final order.
Section 343.26. Commutation of Time is amended to correct the title as the section deals with computation of time.
Section 343.27. Probation is amended to correct grammatical errors.
Section 343.28. Records Retention Schedule is amended to align terminology with the current agency records retention schedule.
Section 343.29. Failure To Appear at Hearing is amended to add the procedure for failure to appear at an Informal Settlement Conference and clarify that failure to appear at a State Office of Administrative Hearings (SOAH) shall result in a default judgment against the respondent.
Section 343.35. Complaint Investigation and Disposition is amended to align terminology (a) with Definitions in §343.1. (1) and correct terminology in (b)(2).
Section 343.48. Dismissal of Complaint is amended to replace “respondent has left the state” with “unable to locate” as a reason for complaint dismissal and to correct grammatical errors.
Section 343.50. Application for Reinstatement of License is amended to replace “application” with “request” and to designate the Investigations Committee for consideration of a request for reinstatement.
Section 343.51. Evaluation for Reinstatement is amended to include licenses that have been voluntarily surrendered and to eliminate the requirement for a sworn notarized statement as attestation degree of rehabilitation attained.
Section 343.52. Procedure upon Request for Reinstatement to designate the Investigations Committee for appearance by requestor for reinstatement.
Section 343.53. Board Action Possible upon Reinstatement of Revoked License is amended to include licenses that have been voluntarily surrendered and to include completion of a pending Agreed Order as a requirement for reinstatement.
Section 343.55. Failure To Appear is amended to include licenses that have been voluntarily surrendered.
Section 343.56. Monitoring of Licensees is amended to designate the agency for monitoring of licensees to ensure compliance to board orders.
Repealing 22 TAC §343.25 to align procedures with the current rules.
CHAPTER 343. CONTESTED CASE PROCEDURE
22 TAC §343.25
OVERVIEW
The repeal is proposed under Texas Occupation Code §453.102, which authorizes the board to adopt rules necessary to implement chapter 453.
BACKGROUND INFORMATION
The amendments are proposed in order to provide clarity to the procedures for contested cases, to correct inaccurate and outdated references, and to conform the rules in Chapter 343 with the physical therapy provisions in Chapter 453, Occupations Code, with the administrative procedures in Chapter 2001, Government Code, and with Title 1 Texas Administrative Code. The repeal is proposed as the procedure is covered under the State Office of Administrative Hearings (SOAH) rules for hearings.
SECTION-BY-SECTION SUMMARY
Section 343.25. Continuance is repealed as the procedure is covered under SOAH administrative rules for hearings.
Texas Health and Human Services Commission
Adopted Rules Re:
Adopting 1 TAC §§355.304, 355.306 – 355.308, 355.318, 355.320, to update references, change titles, and introduce the new PDPM LTC methodology.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES
1 TAC §§355.304, 355.306 – 355.308, 355.318, 355.320
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts amendments to §355.304, concerning Direct Care Staff Spending Requirement on or after September 1, 2023; §355.306, concerning Cost Finding Methodology before September 1, 2025; §355.307, concerning Reimbursement Setting Methodology before September 1, 2025; and §355.308, concerning Direct Care Staff Rate Component before September 1, 2025; repeal of §355.309, concerning Performance-based Add-on Payment Methodology; and §355.314, concerning Supplemental Payments to Non-State Government-Owned Nursing Facilities; and adopts new §355.318, concerning Reimbursement Setting Methodology for Nursing Facilities on or after September 1, 2025; and §355.320, concerning Nursing Care Staff Rate Enhancement Program for Nursing Facilities on or after September 1, 2025.
The amendments to §§355.304, 355.306, 355.307, 355.308; the repeal of §355.309 and §355.314; and the new §355.318 are adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2859) These rules will not be republished.
New §355.320 is adopted with changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2859). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendments, new rules, and repeals are necessary to implement the 2024-25 General Appropriations Act (GAA), House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, HHSC, Rider 25). Rider 25 provides appropriations for HHSC to “develop and implement a Texas version of the Patient Driven Payment Model (PDPM) methodology for the reimbursement of long-term stay nursing facility services in the Medicaid program to achieve improved care for long-term stay nursing facility services, excluding services provided by a pediatric care facility or any state-owned facilities.”
The adoption amends §355.304, concerning Direct Care Staff Spending Requirement on or after September 1, 2023, to specify how the spending requirement will operate under PDPM Long-Term Care (LTC). The adoption amends the title of §355.306 to “Cost Finding Methodology before September 1, 2025,” and revises the rule text to replace “Rate Analysis Department” with “Provider Finance Department.” The title of §355.307 is amended to “Reimbursement Setting Methodology before September 1, 2025,” and the title of §355.308 is amended to “Direct Care Staff Rate Component before September 1, 2025.” The revised titles clarify that the rules are in effect until September 1, 2025, when the PDPM LTC methodology is implemented. The adoption repeals §355.309, concerning Performance-based Add-on Payment Methodology, and §355.314, concerning Supplemental Payments to Non-State Government-Owned Nursing Facilities, as these rules are no longer applicable to nursing facility reimbursement. Finally, the adoption adds new rules §355.318, concerning Reimbursement Setting Methodology for Nursing Facilities on or after September 1, 2025, and §355.320, concerning Nursing Care Staff Rate Enhancement Program for Nursing Facilities on or after September 1, 2025. The new rules operationalize the rider requirements, enabling HHSC to implement PDPM LTC.
Repealing 1 TAC §355.309, §355.314, to remove rules which no longer apply to nursing facility reimbursements.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES
1 TAC §355.309, §355.314
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts amendments to §355.304, concerning Direct Care Staff Spending Requirement on or after September 1, 2023; §355.306, concerning Cost Finding Methodology before September 1, 2025; §355.307, concerning Reimbursement Setting Methodology before September 1, 2025; and §355.308, concerning Direct Care Staff Rate Component before September 1, 2025; repeal of §355.309, concerning Performance-based Add-on Payment Methodology; and §355.314, concerning Supplemental Payments to Non-State Government-Owned Nursing Facilities; and adopts new §355.318, concerning Reimbursement Setting Methodology for Nursing Facilities on or after September 1, 2025; and §355.320, concerning Nursing Care Staff Rate Enhancement Program for Nursing Facilities on or after September 1, 2025.
The amendments to §§355.304, 355.306, 355.307, 355.308; the repeal of §355.309 and §355.314; and the new §355.318 are adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2859) These rules will not be republished.
New §355.320 is adopted with changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2859). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendments, new rules, and repeals are necessary to implement the 2024-25 General Appropriations Act (GAA), House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, HHSC, Rider 25). Rider 25 provides appropriations for HHSC to “develop and implement a Texas version of the Patient Driven Payment Model (PDPM) methodology for the reimbursement of long-term stay nursing facility services in the Medicaid program to achieve improved care for long-term stay nursing facility services, excluding services provided by a pediatric care facility or any state-owned facilities.”
The adoption amends §355.304, concerning Direct Care Staff Spending Requirement on or after September 1, 2023, to specify how the spending requirement will operate under PDPM Long-Term Care (LTC). The adoption amends the title of §355.306 to “Cost Finding Methodology before September 1, 2025,” and revises the rule text to replace “Rate Analysis Department” with “Provider Finance Department.” The title of §355.307 is amended to “Reimbursement Setting Methodology before September 1, 2025,” and the title of §355.308 is amended to “Direct Care Staff Rate Component before September 1, 2025.” The revised titles clarify that the rules are in effect until September 1, 2025, when the PDPM LTC methodology is implemented. The adoption repeals §355.309, concerning Performance-based Add-on Payment Methodology, and §355.314, concerning Supplemental Payments to Non-State Government-Owned Nursing Facilities, as these rules are no longer applicable to nursing facility reimbursement. Finally, the adoption adds new rules §355.318, concerning Reimbursement Setting Methodology for Nursing Facilities on or after September 1, 2025, and §355.320, concerning Nursing Care Staff Rate Enhancement Program for Nursing Facilities on or after September 1, 2025. The new rules operationalize the rider requirements, enabling HHSC to implement PDPM LTC.
Adopting 26 TAC §553.17, to describe the ability of an accreditation commission to conduct an on-site accreditation survey.
CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER B. LICENSING
26 TAC §553.17
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §553.17, concerning Criteria for Licensing; §553.255, concerning All Staff Policy for Residents with Alzheimer’s Disease or a Related Disorder; §553.257, concerning Human Resources; and §553.329, concerning HHSC Investigation of Allegations of Abuse, Neglect, or Exploitation; and new §553.254, concerning Training Requirements for Staff Providing Personal Care Services to a Resident With Alzheimer’s Disease or Related Disorder in a Facility that is Not an Alzheimer’s Certified Facility.
The amendments to §553.255 and §553.257 are adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2944). These rules will not be republished.
The amendments to §553.17 and §553.329, and new §553.254, are adopted with changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2944). These rules will be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the amended and new rules is to implement House Bill (H.B.) 1009, H.B. 1673, and H.B. 4696 from the 88th Legislature, Regular Session, 2023. H.B. 1009 requires a facility to suspend an employee who HHSC has determined has engaged in reportable conduct during any applicable appeals process. H.B. 1673 requires facilities that are not Alzheimer’s certified to nevertheless ensure all staff complete training specific to Alzheimer’s disease and related disorders. H.B. 4696 allows HHSC to conduct an offsite survey unless the investigation is for alleged abuse or neglect. The proposal also clarifies that an accreditation commission is able to conduct a life safety code survey of a facility based on the requirements in Subchapter D of Chapter 553, Facility Construction.
Adopting 26 TAC §§553.254, 553.255, 553.257, to add new training requirements for staff members who are not Alzheimer’s certified and to add a suspension requirement for reportable conduct.
CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER E. STANDARDS FOR LICENSURE
26 TAC §§553.254, 553.255, 553.257
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §553.17, concerning Criteria for Licensing; §553.255, concerning All Staff Policy for Residents with Alzheimer’s Disease or a Related Disorder; §553.257, concerning Human Resources; and §553.329, concerning HHSC Investigation of Allegations of Abuse, Neglect, or Exploitation; and new §553.254, concerning Training Requirements for Staff Providing Personal Care Services to a Resident With Alzheimer’s Disease or Related Disorder in a Facility that is Not an Alzheimer’s Certified Facility.
The amendments to §553.255 and §553.257 are adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2944). These rules will not be republished.
The amendments to §553.17 and §553.329, and new §553.254, are adopted with changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2944). These rules will be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the amended and new rules is to implement House Bill (H.B.) 1009, H.B. 1673, and H.B. 4696 from the 88th Legislature, Regular Session, 2023. H.B. 1009 requires a facility to suspend an employee who HHSC has determined has engaged in reportable conduct during any applicable appeals process. H.B. 1673 requires facilities that are not Alzheimer’s certified to nevertheless ensure all staff complete training specific to Alzheimer’s disease and related disorders. H.B. 4696 allows HHSC to conduct an offsite survey unless the investigation is for alleged abuse or neglect. The proposal also clarifies that an accreditation commission is able to conduct a life safety code survey of a facility based on the requirements in Subchapter D of Chapter 553, Facility Construction.
Adopting 26 TAC §553.329, to remove the in-person complaint investigation requirement unless the abuse or neglect involves an unemancipated minor who has been inappropriately placed in a facility.
CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER G. INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION
26 TAC §553.329
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §553.17, concerning Criteria for Licensing; §553.255, concerning All Staff Policy for Residents with Alzheimer’s Disease or a Related Disorder; §553.257, concerning Human Resources; and §553.329, concerning HHSC Investigation of Allegations of Abuse, Neglect, or Exploitation; and new §553.254, concerning Training Requirements for Staff Providing Personal Care Services to a Resident With Alzheimer’s Disease or Related Disorder in a Facility that is Not an Alzheimer’s Certified Facility.
The amendments to §553.255 and §553.257 are adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2944). These rules will not be republished.
The amendments to §553.17 and §553.329, and new §553.254, are adopted with changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2944). These rules will be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the amended and new rules is to implement House Bill (H.B.) 1009, H.B. 1673, and H.B. 4696 from the 88th Legislature, Regular Session, 2023. H.B. 1009 requires a facility to suspend an employee who HHSC has determined has engaged in reportable conduct during any applicable appeals process. H.B. 1673 requires facilities that are not Alzheimer’s certified to nevertheless ensure all staff complete training specific to Alzheimer’s disease and related disorders. H.B. 4696 allows HHSC to conduct an offsite survey unless the investigation is for alleged abuse or neglect. The proposal also clarifies that an accreditation commission is able to conduct a life safety code survey of a facility based on the requirements in Subchapter D of Chapter 553, Facility Construction.
Proposed Rule Reviews Re:
Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal of the chapter concerning Diagnostic Assessment.
The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 26, Part 1, of the Texas Administrative Code (TAC):
Chapter 304, Diagnostic Assessment
Adopted Rule Reviews Re:
Adopting Title 1, Part 15, concerning Coordinated Planning and Delivery of Health and Human Services.
The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 1, Part 15, of the Texas Administrative Code (TAC):
Chapter 351, Coordinated Planning and Delivery of Health and Human Services
Adopting Title 26, Part 1, concerning the Office of Deaf and Hard of Hearing Services.
The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code (TAC):
Chapter 360, Office of Deaf and Hard of Hearing Services
In Addition Re:
Notice of Public Hearing on Proposed Medicaid Rates for Nursing Facility Services, Effective September 1, 2025.
Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on October 1, 2024, at 9:00 a.m. (CDT) to receive public comments for nursing facility (NF) services. The proposed payment rates will support the implementation of the Patient Driven Payment Model Long-Term Care (PDPM LTC) methodology for NF services.
Cancer Prevention and Research Institute of Texas
Adopted Rules Re:
Adopting 25 TAC §701.11, to remove the requirement that CPRIT provide a hard copy of the Texas Cancer Plan.
CHAPTER 701. POLICIES AND PROCEDURES
25 TAC §701.11
OVERVIEW
The Cancer Prevention and Research Institute of Texas (“CPRIT” or “the Institute”) adopts the amendment to 25 Texas Administrative Code §701.11 without changes to the proposed amendment as published in the May 31, 2024, issue of the Texas Register (49 TexReg 3904); therefore, the rule will not be republished.
BACKGROUND AND JUSTIFICATION
Texas Health & Safety Code Chapter 102 charges CPRIT with the responsibility of facilitating the development of the Texas Cancer Plan, which aims to reduce the cancer burden across the state to improve the lives of Texans. CPRIT plans to present the next version of the Texas Cancer Plan as a fully online, dynamic resource available to the public. The proposed amendment removes the requirement that CPRIT provide a hard copy of the Texas Cancer Plan.
Texas Department of State Health Services
Proposed Rule Reviews Re:
Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal of the chapter concerning Retail Food Establishments.
The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code (TAC):
Chapter 228, Retail Food Establishments
Adopted Rule Reviews Re:
Adopting Title 25, Part 1, concerning Public Health Improvement Grants.
The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the review of the chapter below in Title 25, Part 1, of the Texas Administrative Code (TAC):
Chapter 83, Public Health Improvement Grants
State Board of Dental Examiners
Adopted Rule Reviews Re:
Adopting Title 22, Part 5, concerning Dental Board Procedures and Standards for Prescribing Controlled Substances and Dangerous Drugs.
The Texas State Board of Dental Examiners (Board) adopts the review of the chapters below in Title 22, Part 5, of the Texas Administrative Code (TAC):
Chapter 107, Dental Board Procedures; and
Chapter 111, Standards for Prescribing Controlled Substances and Dangerous Drugs.
Department of Aging and Disability Services
Adopted Rule Reviews Re:
Adopting Title 40, Part 1, concerning Intellectual Disability Services–Medicaid State Operating Agency Responsibilities.
The Texas Health and Human Services Commission (HHSC), as the successor agency of the Texas Department of Aging and Disability Services, adopts the review of the chapter below in Title 40, Part 1, of the Texas Administrative Code (TAC):
Chapter 9, Intellectual Disability Services–Medicaid State Operating Agency Responsibilities