TITLE 1. ADMINISTRATION
PART 2. TEXAS ETHICS COMMISSION
CHAPTER 8. ADVISORY OPINIONS
1 TAC §§8.3, 8.5, 8.11, 8.18, 8.21The Texas Ethics Commission (TEC) re-adopts chapter 8 of the Ethics Commission Rules, with amendments, as part of its comprehensive review with a review of the TEC's rules.
The amended rules are adopted with two changes to the proposed text as published in the January 24, 2025, issue of the Texas Register (50 TexReg 509). The amended rules will be republished. The only changes from the previously published rules was not substantive. The change includes the phrase "relating to the same issue of law as the advisory opinion request" at the end of amended §8.3(b), and the insertion of the word "section" in §8.11(b).
The TEC readopts without amendment §§8.1, 8.7, 8.9, 8.13, 8.15, and 8.19, as the reasons for originally adopting these rules still exists.
The adopted amendments to Chapter 8 include:
- Repealing parts of §8.3, which are unnecessary as they just repeat statute;
- Amending §8.5 to make clear that a person may not request an opinion about how the law relates to another person;
- Adding §8.11(e) to clearly authorize staff to ask the requestor to clarify a request;
- Adding §8.11(f) to clearly authorize staff to request comments on a pending advisory opinion request from experts or interested parties, similar to the practice of the Office of the Attorney General;
- Repealing §8.17 and §8.18(4), which purported to give staff the authority to answer an advisory opinion request with a non-binding letter from the executive director rather than providing an advisory opinion; and
- Amending §8.21 to require that advisory opinions adopted by the TEC be posted on the TEC's website rather than a "single reference document."
The amendments to chapter 8 are designed to more closely track statutory language and to provide more clarity and notice of the TEC's interpretations of the statutory requirements in Chapter 571 of the Government Code regarding advisory opinions.
State law requires state agencies to "review and consider for readoption each of its rules … not later than the fourth anniversary of the date on which the rule takes effect and every four years after that date." Tex. Gov't Code §2001.039. The law further requires agencies to "readopt, readopt with amendments, or repeal a rule as the result of reviewing the rule under this section." Id. The TEC is authorized to adopt rules to administer Chapter 571 of the Government Code. Tex. Gov't Code §§ 571.061, .062.
The TEC received several public comments from Ross Fischer. First, Mr. Fischer suggested adding the phrase "relating to the same issue of law as the advisory opinion request" to the end of §8.3(c), regarding Subject of an Advisory Opinion. Mr. Fischer suggested that without this change, the rule could read to allow the refusal of an advisory opinion request on a matter unrelated to a pending sworn complaint. The TEC adopted this clarifying language.
Mr. Fischer also suggested adding the following language to subsection 8.11(f): "in a manner that preserves a requestor's confidentiality," which would clarify that the rule does not permit the executive director to unilaterally waive a requestor's confidentiality in the process of seeking outside input. Although the TEC agrees that the TEC cannot reveal the identity of the requestor, the rule does not need to repeat that statutory requirement. The addition of the commenter's suggested language is surplusage because the law requires that the identity of a requestor remain confidential, unless the confidentiality is waived by the requestor. Section 8.11(f) does not and cannot change that legal requirement.
These amended rules are adopted under Texas Government Code §571.062, which authorizes the TEC to adopt rules to administer Chapter 571 of the Government Code.
The adopted amended rules affect Chapter 571 of the Texas Government Code.
§
8.3.
(a) The commission may not issue an advisory opinion that concerns the same or substantially similar facts of pending litigation known to the commission.
(b) For purposes of this section, the term litigation includes a sworn complaint proceeding before the commission if the request is made by a respondent or complainant or the agent of a respondent or complainant of pending sworn complaint relating to the same issue of law as the advisory opinion request.
(c) An advisory opinion cannot resolve a disputed question of fact.
§
8.11.
(a) Upon receipt of a written request for an advisory opinion, the executive director shall determine whether the request:
(1) pertains to the application of a law specified under §571.091, Gov't Code;
(2) meets the standing requirements of §8.5 of this chapter; and
(3) meets the form requirements of §8.7 of this chapter.
(b) If the executive director determines that a request for an opinion meets the requirements of this chapter as set forth in subsections (a)(1)-(3) of this section, the executive director shall assign an AOR number to the request. The executive director shall notify the person making the request of the AOR number and of the proposed wording of the question to be answered by the commission.
(c) If the executive director determines that a request for an opinion does not meet the requirements of this chapter as set forth in subsections (a)(1)-(3) of this section, the executive director shall notify the person making the request of the reason the person making the request is not entitled to an advisory opinion in response to the request.
(d) A person who requests an opinion may withdraw the request prior to its inclusion on a meeting agenda filed by the Commission pursuant to the Open Meetings Law. Once a request is included on such an agenda, it may not be withdrawn by the requestor.
(e) The executive director may submit written questions to the requestor to clarify the real or hypothetical facts submitted with the request.
(f) The executive director may invite comments regarding an advisory opinion request from individuals or entities that may have expertise or an interest in the subject of the request.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 10, 2025.
TRD-202501156
Jim Tinley
General Counsel
Texas Ethics Commission
Effective date: April 30, 2025
Proposal publication date: January 24, 2025
For further information, please call: (512) 463-5800
1 TAC §8.17
The Texas Ethics Commission (the TEC) adopts the repeal of Texas Ethics Commission rule §8.17 regarding Request Answered by Written Response. The repealed rule is adopted without change to the proposed text as published in the January 24, 2025, issue of the Texas Register (50 TexReg 510). The repealed rule will not be republished.
State law requires state agencies to "review and consider for readoption each of its rules … not later than the fourth anniversary of the date on which the rule takes effect and every four years after that date." Tex. Gov't Code §2001.039. The law further requires agencies to "readopt, readopt with amendments, or repeal a rule as the result of reviewing the rule under this section." Id . The TEC is authorized to adopt rules to administer Chapter 571 of the Government Code. Tex. Gov't Code §§ 571.061, .062.
The TEC is continuing its comprehensive review with a review of the TEC's rules regarding advisory opinions, which are codified in Chapter 8. The adoption of amendments to some rules and the repeal of one rule seeks to clarify the rules related to requests for advisory opinions.
Section 8.17 of the TEC rules authorized the executive director to issue a non-binding written letter if a question presented in an advisory opinion request is clearly answered by reference to a previous advisory opinion, statute, or rule. The option to issue a non-binding letter rather than an advisory opinion has not been exercised in recent years and is out-of-step with statute, which requires the TEC to issue an advisory opinion upon written request. After reviewing §8.17 the TEC determined the rule was not necessary and therefore adopts repeal of the rule.
No public comments were received on this repealed rule.
The repealed rule is adopted under Texas Government Code §571.062, which authorizes the Commission to adopt rules to administer Chapter 571 of the Government Code.
The adopted repealed rule affects Chapter 571 of the Government Code.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 10, 2025.
TRD-202501157
Jim Tinley
General Counsel
Texas Ethics Commission
Effective date: April 30, 2025
Proposal publication date: January 24, 2025
For further information, please call: (512) 463-5800
CHAPTER 13. REFERRALS TO PROSECUTORS
1 TAC §13.1The Texas Ethics Commission (the Commission) adopts new §13.1 in the Texas Ethics Commission Rules, regarding Referral to Prosecuting Attorney. The new rule is adopted without changes to the proposed text as published in the January 24, 2025, issue of the Texas Register (50 TexReg 511). The rule will not be republished.
This rule is being adopted in response to the CCA's recent decision in Ex Parte Charette , which held that a referral from the TEC is a jurisdictional prerequisite for a court to hear criminal charges against a person accused of violating title 15 of the Election Code. In re Charette , Nos. PD-0522-21, PD-0523-21, PD-0524-21, PD-0525-21, 2024 Tex. Crim. App. LEXIS 690 (Crim. App. Sep. 11, 2024). The purpose of this rule is to provide information regarding the TEC's procedures for making criminal referrals as authorized by Section 571.171(a) of the Texas Government Code. TEC adopted an identical emergency rule on September 25, 2024.
Section-by-Section Summary
Subsection (a) clarifies the TEC's exercise of authority granted under section 571.171(a) of the Texas Government Code to refer matters to an appropriate prosecuting attorney for criminal prosecution upon a vote of at least six commission members.
Subsection (b) restates the requirement in section 571.134 of the Texas Government Code that certain referrals shall be delayed until after an election.
The rule is necessary to provide notice that the TEC interprets Section 571.171 to allow for the TEC to refer a matter related to a sworn complaint to the appropriate prosecuting attorney at any time in the complaint process after accepting jurisdiction over the complaint. The rule also makes clear that regardless of when voted on by the commission, the actual referral to an appropriate prosecuting attorney must be delayed in accordance with Section 571.134 of the Government Code.
The Commission received two public comments on this new rule. Shane Suam, a Lago Vista city council member commented that he was concerned with the TEC's "new authority to initiate criminal referrals." The requestor appears to believe that the TEC is granting itself authority to initiate criminal referrals. That is not true. The rule does not create new authority for the TEC. It is an interpretive rule implementing authority granted to the TEC by Section 571.171.
The other public comment came from Ross Fischer, who suggested adding subsection (c) which would read "(c) If the referral is not delayed in accordance with section 571.134 of the Government Code, the commission shall dismiss the complaint at its following meeting."
The TEC also disagrees with the addition of Mr. Fischer's preferred language. It is not clear that dismissal of a sworn complaint for a referral made in violation of Section 571.134 is the proper remedy. Regardless, such a rule be a better fit structurally in Chapter 12 of the TEC rules.
This new rule is adopted under Texas Government Code §571.062, which authorizes the TEC to adopt rules to administer Chapter 571 of the Government Code.
The adopted new rule affects Chapter 571 of the Texas Government Code, including Section 571.062, and the laws placed under the civil enforcement jurisdiction of the TEC as identified in Section 571.061(a) of the Texas Government Code.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 10, 2025.
TRD-202501155
Jim Tinley
General Counsel
Texas Ethics Commission
Effective date: April 30, 2025
Proposal publication date: January 24, 2025
For further information, please call: (512) 463-5800
PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER
B.
DIVISION 1. COMMITTEES
1 TAC §351.847, §351.849The Texas Health and Human Services Commission (HHSC) adopts the repeal of §351.847, concerning Aging Texas Well Advisory Committee, and §351.849, concerning the Texas Respite Advisory Committee. HHSC also adopts new §351.847, concerning Aging Texas Well Advisory Committee, and §351.849, concerning the Texas Respite Advisory Committee.
The repeals and new §351.847 are adopted without changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8631). The rules will not be republished.
New §351.849 is adopted with changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8631). The rule will be republished.
BACKGROUND AND JUSTIFICATION
The Aging Texas Well Advisory Committee (ATWAC) is established under Executive Order Rick Perry (R.P.) 42 and by the executive commissioner in accordance with Texas Government Code §523.0201 and is subject to Texas Administrative Code §351.801. The committee advises the executive commissioner and HHSC on aging topics and issues and makes recommendations to HHSC and state leadership consistent with Executive Order R.P. 42.
The ATWAC is set to abolish on March 1, 2026. Abolition of the ATWAC would result in the loss of a primary source of public input for key aging programs and initiatives. New §351.847 updates the agency name from the Department of Aging and Disability Services (DADS) to HHSC, per Senate Bill (S.B.) 200, 84th Texas Legislature, Regular Session, 2015, extends the abolishment to March 1, 2032, and revises the rule in several places to ensure the rule conforms with HHSC's advisory committee rules standards.
The Texas Respite Advisory Committee (TRAC) is established under Texas Government Code §523.0201; Texas Government Code Chapter 2110; Texas Human Resources Code §161.079; The Lifespan Respite Care Act, 42 United States Code §300ii; and is subject to TAC §351.801. The committee advises the executive commissioner and the health and human services system on developing strategies to reduce barriers to accessing respite services; improving the quality of respite services; and providing training, education, and support to family caregivers.
The TRAC is set to abolish on March 1, 2026. Abolition of the TRAC would result in the loss of a primary source of public input for developing strategies to reduce barriers to accessing respite services and improve the quality of respite services in Texas.
New §351.849 updates the agency name from DADS to HHSC, per S.B. 200, extends the abolishment to March 1, 2028, and revises the rule in several places to ensure the rule conforms with HHSC's advisory committee rules standards.
Certain citations to the Texas Government Code as modified by House Bill (H.B.) 4611, 88th Legislature, Regular Session, 2023 are updated in both of the new sections. HB 4611 made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature's ongoing statutory revision program. The updated citations will become effective on April 1, 2025.
COMMENTS
The 31-day comment period ended Monday, December 2, 2024.
During this period, HHSC received a comment regarding the proposed rules from one organization - the Texas Medical Association (TMA). A summary of the comment relating to the rules and HHSC's responses follow.
Comment: TMA's comment on the proposed rules noted that neither the ATWAC nor the TRAC are required to include a physician member. TMA recommended that the proposed rules be amended to specifically include at least one physician member for both the ATWAC and the TRAC.
Response: HHSC did not revise the rules based on this comment. The current processes of TRAC and ATWAC enable medical professionals to apply under the existing categories and share their expertise. The TRAC committee currently includes a pediatrician and a dentist.
HHSC revised §351.849(f)(1) to align the rule with statute and Executive Order No. GA-55, issued January 31, 2025.
HHSC made a minor edit to §351.849(f)(1)(E) to correct the spelling of "respite."
STATUTORY AUTHORITY
The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees, Texas Human Resources Code §161.079, relating to informal caregiver services, and the Lifespan Respite Care Act, 42, United States Code §300ii.
The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501241
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
1 TAC §351.847, §351.849
STATUTORY AUTHORITY
The new rules are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees, Texas Human Resources Code §161.079, relating to informal caregiver services, and the Lifespan Respite Care Act, 42, United States Code §300ii.
§
351.849.
(a) Statutory Authority. The Texas Respite Advisory Committee (TRAC) is established under Texas Government Code §523.0201; Texas Government Code Chapter 2110; Texas Human Resources Code §161.079; The Lifespan Respite Care Act, 42 United States Code §300ii; and is subject to Texas Administrative Code §351.801 of this division (relating to Authority and General Provisions).
(b) Purpose. The committee advises the Texas Health and Human Services Commission (HHSC) executive commissioner and health and human services system (HHS) on developing strategies to reduce barriers to accessing respite services; improving the quality of respite services; and providing training, education, and support to family caregivers.
(c) Tasks. The committee performs the following tasks:
(1) assists HHSC to identify barriers and best practices for providing and coordinating respite services in Texas;
(2) responds to requests from HHSC for information about the respite needs of caregivers;
(3) advises HHSC about effective methods for expanding the availability of affordable respite services in Texas through the use of funds available from respite care programs;
(4) cooperates and shares resources and knowledge among community stakeholders to facilitate barrier free access for primary caregivers;
(5) educates the public on the need for community-based options for primary caregivers; and
(6) adopts bylaws to guide the operation of the committee.
(d) Reporting requirements. By July 1 of each year, the committee files an annual written report with the executive commissioner covering the meetings and activities in the immediately preceding fiscal year. The report includes:
(1) a list of the meeting dates;
(2) the members' attendance records;
(3) a brief description of actions taken by the committee;
(4) a description of how the committee accomplished its tasks;
(5) a description of activities the committee anticipates undertaking in the next fiscal year;
(6) recommended amendments to this section; and
(7) the costs related to the committee, including the cost of HHSC staff time spent supporting the committee's activities and the source of funds used to support the committee's activities.
(e) Meetings.
(1) Open meetings. In accordance with statute, the TRAC complies with the requirements for open meetings under Texas Government Code Chapter 551 as if it were a governmental body.
(2) Frequency. The TRAC will meet quarterly.
(3) Quorum. Eight of all members constitutes a quorum.
(f) Membership.
(1) The committee is composed of 15 members appointed by the executive commissioner. In selecting members to serve on the committee, HHSC considers the applicants' qualifications, background, interest in serving, and geographic location. Fifteen voting members representing the following categories:
(A) family caregivers;
(B) primary caregivers;
(C) providers of respite services;
(D) faith-based organizations;
(E) respite care advocacy organizations; and
(F) members of the general public interested in the issue of respite care.
(2) Members are appointed for staggered terms so that the terms of an equal or almost equal number of members expire on December 31 of each year. Regardless of the term limit, a member serves until his or her replacement has been appointed. This ensures sufficient, appropriate representation.
(A) If a vacancy occurs, the executive commissioner will appoint a person to serve the unexpired portion of that term.
(B) Except as may be necessary to stagger terms, the term of each member is three years. A member may apply to serve one additional term.
(g) Officers. The committee selects a chair and vice chair of the committee from among its members.
(1) The chair serves until January 1 of each even-numbered year. The vice chair serves until January 1 of each odd-numbered year.
(2) A member may serve up to two consecutive terms as chair or vice chair.
(h) Required Training. Each member must complete training on relevant statutes and rules, including this section and §351.801 of this division, Texas Government Code §523.0201, Texas Government Code Chapters 551, 552, and 2110, the HHS Ethics Policy, the Advisory Committee Member Code of Conduct, and other relevant HHS policies. Training will be provided by HHSC.
(i) Travel Reimbursement. To the extent permitted by the current General Appropriations Act, a member of the committee may be reimbursed for their travel to and from meetings if funds are appropriated and available and in accordance with the HHSC Travel Policy.
(j) Date of abolition. The committee is abolished and this section expires on March 1, 2028.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501242
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
CHAPTER 354. MEDICAID HEALTH SERVICES
SUBCHAPTER
A.
DIVISION 1. MEDICAID PROCEDURES FOR PROVIDERS
1 TAC §354.1006The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §354.1006, concerning Prohibition of Provider Discrimination Based on Immunization Status.
Section 354.1006 is adopted with changes to the proposed text as published in the December 20, 2024, issue of the Texas Register (49 TexReg 10171). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The new section is necessary to implement Texas Government Code §531.02119, added by House Bill 44, 88th Legislature, Regular Session, 2023, which requires HHSC to adopt rules necessary to prohibit Medicaid and Children's Health Insurance Program (CHIP) providers from discriminating against Medicaid recipients or CHIP members by refusing to provide health care services based solely on immunization status.
Texas Government Code §531.02119 outlines the requirements for the prohibition of discrimination based on immunization status, exceptions to this prohibition, requires HHSC or its designee to withhold payment from providers that violate the requirements until HHSC finds the provider is in compliance, and requires HHSC to establish administrative and judicial reviews for providers who are alleged to be in violation.
COMMENTS
The 31-day comment period ended January 20, 2025.
During this period, HHSC received comments regarding the proposed rules from three commenters: The Immunization Partnership, the Texas Medical Association, and the Texas Pediatric Society. A summary of comments relating to the rule and HHSC's responses follows.
Comment: One commenter commented how an individual may request an exemption is too broad and impacts the administration of physicians' offices and the physicians' patients. The commenter recommended HHSC: 1) allow providers to require a patient seeking an exemption to a provider's immunization policy document the request on a standardized form for retention in patient files; and 2) require immunization exemptions to be documented in ImmTrac2.
Response: HHSC disagrees with the comment and declines to revise the rule as recommended. Allowing providers to require a documented request from the patient using a standardized form would contradict Government Code §531.02119(a-1)(2), which requires providers to accept oral requests for an exemption. In addition, Government Code §531.02119 does not grant HHSC the authority to track exemption requests under this section.
Comment: Two commenters recommended HHSC amend the proposed rule to define that the specialists in oncology or organ transplant services that are exempt from the rule include: 1) any physician who is currently or was previously board certified in a medical specialty relevant to one of those areas of treatment; and 2) a provider whose clinical practice includes the care of patients who are immunocompromised from receiving or having received oncology or organ transplant services.
Response: HHSC disagrees with the comment and declines to revise §354.1006(c) as recommended. Expanding the exemption in §354.1006(c), which applies only to a provider who is a specialist in oncology or organ transplant services, would go beyond the scope of the exemption provided in Texas Government Code §531.02119(d).
Comment: Two commenters recommended HHSC revise the due process provisions to address how HHSC will: 1) determine the existence of an alleged violation; 2) provide notice to the provider; 3) provide an opportunity for the provider to demonstrate compliance; and 4) detail the process for requesting an administrative hearing and judicial review. The commenters also recommended HHSC include an informal resolution process, including the opportunity for an informal resolution meeting.
Response: HHSC revised §354.1006(d) to outline more clearly how HHSC determines if a provider violated the rule before withholding payments; added new paragraph §354.1006(d)(2) to set forth that a provider subject to an HHSC vendor hold has the right to notice of the alleged violation and the procedures for requesting an appeal; and renumbered the other paragraphs accordingly. However, HHSC declines to revise the rule to add specific timelines and an informal resolution process. The processes for requesting an administrative hearing and judicial review are already provided for under Texas Administrative Code Chapter 357, Subchapter I, and under Texas Government Code Chapter 2001.
A minor editorial change was made to renumbered §354.1006(d)(4) to reflect that the final decision is from an administrative appeal instead of an administrative review.
STATUTORY AUTHORITY
The new section is adopted under Texas Government Code §531.02119, which authorizes the executive commissioner of HHSC to adopt rules necessary to prohibit a Medicaid provider from refusing to provide health care services to a Medicaid recipient based solely on the recipient's immunization status; Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system; Texas Government Code §531.033, which directs the executive commissioner of HHSC to adopt rules as necessary to carry out the commission's duties; and Texas Human Resources Code §32.021 and Texas Government Code §532.0051, which authorize HHSC to administer the federal medical assistance (Medicaid) program.
§
354.1006.
(a) Pursuant to Texas Government Code §531.02119, a Medicaid provider may not refuse to provide health care services to a Medicaid recipient based solely on the recipient's refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease.
(b) Notwithstanding subsection (a) of this section, a provider is not in violation of this section if the provider:
(1) adopts a policy requiring some or all the provider's patients, including patients who are Medicaid recipients to be vaccinated or immunized against a particular infection or communicable disease to receive health care services from the provider; and
(2) provides an exemption to the policy described in paragraph (1) of this subsection and accepts an oral or written request from the Medicaid recipient or legally authorized representative, as defined by Texas Health and Safety Code §241.151, for an exemption from each required vaccination or immunization based on:
(A) a reason of conscience, including a sincerely held religious belief, observance, or practice, that is incompatible with the administration of the vaccination or immunization; or
(B) a recognized medical condition for which the vaccination or immunization is contraindicated.
(c) This section does not apply to a provider who is a specialist in:
(1) oncology; or
(2) organ transplant services.
(d) HHSC or its designee withholds payments to any Medicaid participating provider only if HHSC determines, after review of the evidence obtained, that the provider is in violation of this section.
(1) HHSC withholds payments for services to the provider until HHSC determines the provider corrected the circumstances resulting in the vendor hold.
(2) A provider subject to an HHSC vendor hold under this section has the right to notice of the alleged violation and the procedures for requesting an appeal.
(3) A provider has the right to appeal an HHSC vendor hold as provided by Chapter 357, Subchapter I of this title (relating to Hearings Under the Administrative Procedure Act).
(4) If the final decision in the administrative appeal is adverse to the appellant, the appellant may obtain a judicial review by filing for review with a district court in Travis County not later than the 30th day after the date of the notice of the final decision as provided under Texas Government Code Chapter 2001.
(e) Subsection (d) of this section applies only to an individual provider. HHSC or its designee may not refuse to reimburse a provider who did not violate this section based on the provider's membership in a provider group or medical organization with an individual provider who violated this section.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2025.
TRD-202501154
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 29, 2025
Proposal publication date: December 20, 2024
For further information, please call: (512) 438-2910
CHAPTER 381. GUARDIANSHIP SERVICES
The Texas Health and Human Services Commission (HHSC) adopts the repeal of Chapter 381, comprising of Subchapter A, §381.1, concerning Purpose; and §381.2, concerning Definitions; Subchapter B, §381.101, concerning Duties; §381.102, concerning Membership and Eligibility; and §381.103, concerning Officers and Meetings; Subchapter C, §381.201, concerning Eligible Projects; 381.202, concerning Eligible Applicants; §381.203, Application and Selection Process; §381.204, concerning Grant Period; §381.205, concerning Continuation Funding Policy; §381.206, concerning Grant Amounts; §381.207, concerning Notification of Award; §381.208, concerning Request for Reconsideration; §381.209, concerning Contract; §381.210, concerning Progress Reports; Subchapter D, §381.301, concerning Purpose; §381.303, concerning Applicability of Standards to Guardianship Programs; §381.305, concerning Ineligibility of Non-compliant Programs; §381.315, concerning Form of Entity; §381.317, concerning Fiscal Responsibility; §381.319, concerning Budget; §381.321, concerning Insurance; §381.323, concerning Fees for Services; §381.325, concerning Guardianship Bonds; §381.331, concerning Guardianship Accountability; §381.333, concerning Service Provider Employee Screening; §381.335, concerning Confidentiality; §381.337, concerning Supervision of Employees and Volunteers; §381.339, concerning Community Involvement; §381.345, concerning Less Restrictive Alternatives to Guardianship; §381.347, concerning Guardianship Program Service Levels, §381.349, concerning Role of Volunteers; §381.351, concerning Staffing Requirements; §381.353, concerning Training Requirements; §381.355, concerning Conflicts of Interest; §381.357, concerning Referral, Intake, and Assessments; §381.359, concerning Prioritization of Potential Clients on Waiting Lists; §381.361, concerning Responsibility for Burial or Cremation; §381.363, concerning Evaluation and Monitoring of Caseloads; §381.365, concerning Personal Care Plans for Guardianship Clients; and §381.367, concerning Financial Care Plans for Guardianship Clients.
The repeals are adopted without changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8640). The repeals will not be republished.
BACKGROUND AND JUSTIFICATION
The repeals are necessary because the authority for the HHSC Guardianship Advisory Board and related guardianship program grants and standards were transferred from HHSC to the Office of Court Administration by Senate Bill (S.B.) 966, 83rd Legislature, Regular Session, 2013. The governing statute for the HHSC Guardianship Advisory Board and related grants and standards, Texas Government Code Chapter 531, Subchapter D, was subsequently repealed by S.B. 200, 84th Legislature, Regular Session, in 2015.
COMMENTS
The 31-day comment period ended Monday, December 2, 2024.
During this period, HHSC did not receive any comments regarding the proposed repeals.
SUBCHAPTER
A.
STATUTORY AUTHORITY
The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501243
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
SUBCHAPTER
B.
The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501244
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
SUBCHAPTER
C.
The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501245
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
SUBCHAPTER
D.
DIVISION 1. GENERAL
1 TAC §§381.301, 381.303, 381.305The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501246
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
DIVISION 2. ADMINISTRATION AND FISCAL MANAGEMENT
1 TAC §§381.315, 381.317, 381.319, 381.321, 381.323, 381.325The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501247
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
DIVISION 3. PERSONNEL MANAGEMENT
1 TAC §§381.331, 381.333, 381.335, 381.337, 381.339The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501248
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536
DIVISION 4. GUARDIANSHIP PROGRAMS AND CLIENT SERVICES
1 TAC §§381.345, 381.347, 381.349, 381.351, 381.353, 381.355, 381.357, 381.359, 381.361, 381.363, 381.365, 381.367The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, Texas Government Code Chapter 2110, which establishes how a state agency may create an advisory committee, and Texas Government Code §523.0201, which provides that the executive commissioner of HHSC shall establish and maintain advisory committees.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 14, 2025.
TRD-202501249
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 4, 2025
Proposal publication date: November 1, 2024
For further information, please call: (512) 840-8536