Proposed Rules
TEXAS HEALTH AND HUMAN SERVICES COMMISSION
NURSE AIDES – 26 TAC §§556.2, 556.3, 556.5 – 556.13
- The Executive Commissioner of the Texas HHSC proposes amendments to TAC codes concerning Definitions; Nurse Aide Training and Competency Evaluation Program (NATCEP) Requirements; Program Director, Program Instructor, Supplemental Trainers, and Skills Examiner Requirements; Competency Evaluation Requirements; Review and Reapproval of a Nurse Aide Training and Competency Evaluation Program (NATCEP); Withdrawal of Approval of a Nurse Aide Training and Competency Evaluation Program (NATCEP); Nurse Aide Registry and Renewal; Expiration of Active Status; Waiver, Reciprocity, and Exemption Requirements; Findings and Inquiries; and Alternate Licensing Requirements for Military Service Personnel. The proposal aims to address the shortage of certified nurse aides by expanding the definition of a clinical site to allow certain health care facilities other than nursing facilities to serve as a NATCEP clinical site.
- The proposed amendments change the definition of “facility” to expand the meaning of a clinical training site to include assisted living facilities, intermediate care facilities for individuals with an intellectual disability or related condition, hospitals, and special hospitals with long-term care acute facilities. The amendments also update the definition of “nurse aide” to include the phrase “who has been issued a certificate of registration” to comply with SB 1103 and the definition of “nurse aide training and competency evaluation program (NATCEP) application” to include the word “nursing” to the facility type.
- The proposed amendments to include the requirement that a nursing facility must participate in Medicare, Medicaid, or both to apply for approval to be a NATCEP; require a clinical site to have all necessary equipment needed to practice and perform skills training; permit a NATCEP to offer clinical training hours in a laboratory setting under certain limited circumstances; and require that a clinical training provided by a NATCEP in a facility other than a nursing facility be provided under direct supervision of the NATCEP instructor and not delegated to other staff. The proposed amendments also permit a nursing facility to request a waiver of a NATCEP prohibition related to a civil money penalty from the Centers for Medicare and Medicaid Services (CMS). Other proposed amendments mostly include changing or adding language to distinguish facilities.
LICENSING - REQUESTING BACKGROUND CHECKS 26 TAC §§745.609, 745.611, 745.613, 745.615, 745.617
- The Executive Commissioner of the Texas HHSC proposes amendments concerning What types of background checks are required for persons at my operation; Which persons at my operation require either a fingerprint-based criminal history check or a name-based Texas criminal history check; Which persons at my operation must have an out-of-state criminal history check, and out-of-state child abuse and neglect registry check, and an out-of-state sex offender registry check; What types of background checks are required for persons at listed family homes that only provide care to related children, employer-based child care operations, and shelter care operations; and How do I submit a request for a background check. The proposal implements SB 1061, which amends Sections relating to Small Employer-Based Child Care (SEBCC) Operations and Shelter Care Operations. Currently, persons required to have a background check at these operation types are only required to have a name-based Texas criminal history check. The amendments will now require most persons at these operations to submit fingerprints so a fingerprint-based criminal history check may be conducted. The change will allow HHSC Child Care Regulation access to the FBI National Rap Back Service by receiving immediate notification of a change in a person’s criminal history. The amendments will also make the criminal history background check requirements for SEBCC Operations and Shelter Care Operations more consistent with the criminal history background check requirements for other operation types that CCR regulates.
- The proposed amendments (1) updates the rule so persons at SEBCC Operations and Shelter Care Operations will have background checks that are more consistent with the background checks required for other operation types that CCR regulates; (2) clarifies that persons at SEBCC Operations and Shelter Care Operations do not have to have a National Sex Offender Registry (NSOR) check (Note: A NSOR check is a name-based check that is different from the National Sex Offender Registry check that will be conducted through the fingerprint-based criminal history check.); and (3) updates a citation. The proposed amendment to §745.611 (1) clarifies that most persons at SEBCC Operations and Shelter Care Operations will be required to submit fingerprints, so a fingerprint-based criminal history check may be conducted; and (2) updates a citation.
- The proposed amendments: deletes a citation that is not necessary and is confusing; clarifies that this rule regarding name-based Texas criminal history checks no longer applies to SEBCC Operations and Shelter Care Operations, because most persons required to have a background check at these operations will be required to have a fingerprint-based criminal history check; (1) updates the figure name, (2) clarifies that for persons at SEBCC Operations and Shelter Care Operations, the operation must submit a request for a background check online through the operation’s Licensing account, and (3) defines acronyms to improve readability.
Emergency Rules
COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING – 26 TAC §500.20
- The Executive Commissioner of the HHSC adopts on an emergency basis an emergency rule that allows ESRD Off-Site Facilities During the COVID-19 Pandemic. This emergency rule will allow end stage renal disease (ESRD) facilities to treat and train dialysis patients more effectively during the COVID-19 pandemic. HHSC is adopting an emergency rule to allow a currently licensed ESRD facility to apply to operate an off-site outpatient facility without obtaining a new license at: (1) an ESRD facility that is no longer licensed that closed within the past 36 months; (2) a mobile, transportable, or relocatable medical unit; (3) a physician’s office; or (4) an ambulatory surgical center or freestanding emergency medical care facility that is no longer licensed that closed within the past 36 months. The section lists details on the Governor’s proclamation, the abilities of ESRD facilities that meet the requirements, and guidelines for these facilities.
LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS – OPERATIONS AND SAFETY PROVISIONS
26 TAC §550.213
- The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis an emergency rule on Licensing Standards for Prescribed Pediatric Extended Care Centers, Subchapter C, General Provisions, Division 1, Operations and Safety Provisions. To protect minors being served in a prescribed pediatric extended care center, HHSC is adopting an emergency rule to require prescribed pediatric extended care centers to develop and enforce policies and procedures for infection control. Details on requirements to prescribed pediatric extended services personnel are also detailed in the section.
NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION – 26 TAC §554.2802
- The Executive Commissioner of the Texas HHSC adopts on an emergency basis an emergency rule regarding Nursing Facility Requirements for Licensure and Medicaid Certification. The emergency rule also permits nursing facilities to request temporary increases in capacity and Medicaid bed allocations to aid in preventing the transmission of COVID-19 or caring for residents with COVID-19. HHSC is adopting an emergency rule to mitigate and contain COVID-19 and to permit a nursing facility to request a temporary increase in capacity or Medicaid bed allocation as part of the facility’s response to COVID-19. The purpose of the new rule is to describe the requirements nursing facility providers must immediately put into place to mitigate and contain COVID-19 and the procedures and criteria for requesting a temporary capacity increase or a temporary Medicaid bed allocation increase.
LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES – 26 TAC §558.960
26 TAC §558.961
- The Executive Commissioner of the Texas HHSC adopts on an emergency basis an emergency rule regarding Licensing Standards for Home and Community Support Services Agencies. To protect clients served by home and community support services agencies (HCSSAs), HHSC is adopting an emergency rule to define criteria for screening staff, clients, and household members for COVID-19, to require that related documentation be made available to HHSC upon request, and to clarify that HCSSA staff must comply with a long-term care facility’s infection control protocols when entering to provide essential services. The criteria for screening staff includes that an agency must develop and enforce policies and procedures for infection control, determine if a scheduled home visit requires essential services or non-essential services, and other measures to ensure agency efficiency and protection of public health.
DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS – 26 TAC §559.65
- The Executive Commissioner of the Texas HHSC or Commission adopts on an emergency basis an emergency rule regarding Day Activity and Health Services Requirements. To protect day activity and health services clients during the COVID-19 pandemic, HHSC is adopting an emergency rule to require day activity and health services providers to develop and enforce policies and procedures for infection control. The sections details definitions for providers of essential services, screening requirements, and volunteer management, among other measures.
Other Proposed Rules
COMPTROLLER OF PUBLIC ACCOUNTS
PREPAID HIGHER EDUCATION TUITION PROGRAM – 34 TAC §7.103 34 TAC §7.198
- The Comptroller of Public Accounts proposes amendments concerning tax benefits and securities laws exemptions. The amendments clarify that the plan manager will monitor the aggregate contributions rather than the account balance to determine whether an account has exceeded the amounts necessary to provide for the qualified higher education expenses of the beneficiary. These amendments include: (1) The maximum contribution limit for a savings trust account, with the sum computed then being rounded down to the nearest $5,000 increment; or a lesser amount determined by the board; The plan manager shall monitor contributions to each savings trust account that is in the manager’s custody; and the plan manager shall determine whether the beneficiary of a savings trust account is the beneficiary of any other qualified tuition program. The section details interest, savings plans, and other measures for clarification on Prepaid Higher Education Tuition Programs.