PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §133.45, concerning Miscellaneous Policies and Protocols.
The amendment to §133.45 is adopted without changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5253). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption is necessary to implement Senate Bill (S.B.) 186 and S.B. 1402, 88th Legislature, Regular Session, 2023.
S.B. 186 added new Texas Health and Safety Code (HSC) §256.003, which prohibits a hospital or other health care facility from discharging or otherwise releasing a patient to a group home, boarding home facility, or similar group-centered facility, unless the person operating the group-centered facility holds a license or permit in accordance with applicable state law. New HSC §256.003 also contains provisions to allow a hospital or other health care facility to discharge a patient to a group-centered facility that does not hold an applicable license or permit under certain circumstances.
S.B. 1402 amended HSC §323.0045 and added new HSC §323.0046. Amended HSC §323.0045 requires a person who performs a forensic medical examination on a sexual assault survivor to complete at least two hours of basic forensic evidence collection training or equivalent education. Amended HSC §323.0045 also requires each health care facility with an emergency department that is not a sexual assault forensic exam-ready facility (SAFE-ready facility) to develop a written policy to require staff who perform forensic medical examinations on sexual assault survivors to complete at least two hours of basic forensic evidence collection training. New HSC §323.0046 requires each health care facility with an emergency department to provide at least one hour of basic sexual assault response training to certain facility employees and outlines the training content requirements. New HSC §323.0046 also requires each non-SAFE-ready health care facility with an emergency department to develop a written policy to ensure all appropriate facility personnel complete the basic sexual assault response training.
The adoption adds information regarding the new discharge requirements in HSC §256.003, new training requirements in HSC §323.0045 and §323.0046 to the general and special hospital rules, and more statutory language to further align the rule requirements for providing parents or caregivers of newborn infants with a resource pamphlet, as required by HSC §161.501.
COMMENTS
The 31-day comment period ended August 19, 2024.
During this period, HHSC received comments regarding the proposed rule from one commenter, Texas Hospital Association (THA). A summary of comments relating to the rule and HHSC responses follows.
Comment: While THA acknowledged the goal of protecting vulnerable patients and that HHSC has little flexibility in implementing HSC §256.003, THA expressed concern that §133.45(k), which implements HSC §256.003, may impact a hospital's ability to timely discharge patients who no longer need hospital care. THA noted that surges of disease, such as COVID-19, strain inpatient capacity and any factor that may cause discharge delays could further impact inpatient capacity.
Response: HHSC requires hospitals to comply with all applicable statutes and rules, including HSC §256.003. HHSC declines to revise the rule in response to this comment because the rule aligns with HSC §256.003.
Comment: Regarding §133.45(k), THA stated there are no resources available for a hospital to identify licensed or certified group homes, if any, in the hospital's county. THA requested HHSC establish, publish, and maintain a list of facilities to which hospitals may discharge patients.
Response: HHSC declines to create or publish a list or database of authorized facilities as the commenters requested because these facilities are regulated at the county or municipal level, if regulated at all, and the statute did not authorize HHSC to do so.
Comment: THA requested that HHSC use discretion when enforcing §133.45(k). In situations where one of the exceptions in the rule does not apply, THA suggested HHSC consider factors including a hospital's need to maintain inpatient capacity or when there is not availability a licensed or certified group-facility when enforcing the rule.
Response: HHSC requires hospitals to comply with all applicable statutes and rules, including HSC §256.003. HHSC declines to revise the rule in response to this comment because the rule aligns with HSC §256.003.
STATUTORY AUTHORITY
The amendment is adopted under Texas Government Code §531.0055, 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; and HSC §241.026, which requires HHSC to develop, establish, and enforce standards for the construction, maintenance, and operation of licensed hospitals.
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 December 10, 2024.
TRD-202405947
Karen Ray
Chief Counsel
Department of State Health Services
Effective date: December 31, 2024
Proposal publication date: July 19, 2024
For further information, please call: (512) 834-4591