PART 1. HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §509.47, concerning Emergency Services.
The amendment to §509.47 is adopted without changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5302). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption is necessary to implement Senate Bill (S.B.) 1402, 88th Legislature, Regular Session, 2023.
S.B. 1402 amended Texas Health and Safety Code (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 the new training requirements in HSC §323.0045 and §323.0046 to the freestanding emergency medical care facility rules.
COMMENTS
The 31-day comment period ended August 19, 2024.
During this period, HHSC did not receive any comments regarding the proposed rule.
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 §254.101, which authorizes HHSC to adopt rules regarding freestanding emergency medical care facilities.
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-202405948
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: December 31, 2024
Proposal publication date: July 19, 2024
For further information, please call: (512) 834-4591
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §510.44, concerning Miscellaneous Policies and Protocols.
The amendment to §510.44 is adopted without changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5304). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption is necessary to implement Senate Bill (S.B.) 186, 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.
The adoption adds information regarding the new discharge requirements in HSC §256.003.
COMMENTS
The 31-day comment period ended August 19, 2024.
During this period, HHSC received comments regarding the proposed rule from two commenters, the Texas Association of Behavioral Health Systems (TABHS) and the Texas Hospital Association (THA). A summary of comments relating to the rule and HHSC responses follows.
Comment: Regarding §510.44(e), TABHS requested HHSC clarify how a psychiatric hospital should document whether a group facility is licensed at the time of planned discharge. TABHS asked whether hospitals would have access to a website to confirm licensure for group facilities and how often HHSC would update the licensing database. TABHS also asked what happens if a group facility loses its license after a hospital confirms the facility's license, but before patient discharge from the hospital occurs.
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. HHSC requires private psychiatric hospitals to comply with all applicable statutes and rules, including HSC §256.003.
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 §510.44(e), which implements HSC §256.003, may impact a psychiatric hospital's ability to timely discharge patients who no longer need inpatient psychiatric care. THA noted timely patient discharge is critical because there is a general lack of capacity for inpatient psychiatric care and limitations imposed by HSC §256.003 and §510.44(e) may have a significant impact on a psychiatric hospital's capacity.
Response: HHSC requires private psychiatric 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 §510.44(e), 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 §510.44(e). In situations where one of the exceptions in the rule does not apply, THA suggested HHSC consider factors including a psychiatric 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 private psychiatric 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 §577.010, which requires HHSC to adopt rules and standards necessary and appropriate to ensure the proper care and treatment of patients in a private mental hospital or mental health facility.
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-202405949
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: December 31, 2024
Proposal publication date: July 19, 2024
For further information, please call: (512) 834-4591
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §511.62, concerning Discharge Planning.
The amendment to §511.62 is adopted without changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5306). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption is necessary to implement Senate Bill (S.B.) 186, 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.
The adoption adds information regarding the new discharge requirements in HSC §256.003.
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 §511.62(m), which implements HSC §256.003, may impact the ability of a limited services rural hospital (LSRH) to timely discharge patients who no longer need hospital care. THA noted that surges of disease, such as COVID-19, strain capacity of the health care system and any factor that may cause discharge delays could further impact that capacity.
Response: HHSC requires LSRHs 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 §511.62(m), THA stated there are no resources available for a hospital to identify licensed or certified group homes, if any, in the LSRH'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 §511.62(m). In situations where one of the exceptions in the rule does not apply, THA suggested HHSC consider factors including an LSRH's need to maintain emergency treatment capacity or when there is not availability a licensed or certified group-facility when enforcing the rule.
Response: HHSC requires LSRHs 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 authorized by 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 §241.302(b), which provides that the Executive Commissioner of HHSC shall adopt rules to implement that section and establish minimum standards for LSRHs.
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-202405950
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: December 31, 2024
Proposal publication date: July 19, 2024
For further information, please call: (512) 834-4591