Texas Health and Human Services Digest: August 11, 2020

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Previous meetings have made alternative arrangements like phone-in capability or have been canceled. These meetings are on the calendar as of today.
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Proposed Rules
Formal Comments via the Texas Register
To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State. Interested parties then can review and comment on the proposed rule. The Secretary of State publishes a new issue of the Texas Register each Friday.

The Administrative Procedure Act (Texas Government Code, Chapter 2001) requires the notice published in the Texas Register to include a brief explanation of the proposed rule and a request for comments from any interested person. The notice also includes instructions for submitting comments regarding the rule to the agency, including the date by which comments must be submitted. Agencies must give interested persons “a reasonable opportunity” to submit comments. The public comment period begins on the day after the notice of a proposed rule is published in the Texas Register and lasts for a minimum of 30 calendar days.

Below is a list of proposed rules that have been published in the Texas Register. The proposed rules that are published in the Texas Register are open for public comment until the end of the comment period.

Project No.,
Comment End Date
Title 25, Chapter 37, Subchapter S, Newborn Hearing Screening#19R073: Newborn Hearing ScreeningDSHS Newborn Screening Unit9/8/20
Title 25, Chapter 73, Laboratories, and Title 25, Chapter 218, Subchapter A, Evaluation of Milk Laboratories, and Subchapter B, Evaluation of Shellfish Laboratories#19R014: Evaluation of Milk and Shellfish LaboratoriesDSHS Milk and
Dairy Unit
Title 1, Chapter 370, Subchapter G, Standards for CHIP Managed Care#19R057: CHIP Appeals ProcessHHS Rules Coordination Office8/24/20
Title 40, Chapter 51, Medically Dependent Children Program#18R006: Repeal of MDCP Rules in Title 40HHS Rules Coordination Office8/24/20
Title 25, Chapter 265, General Sanitation#19R043: Public Swimming Pools and SpasDSHS Consumer Protection Division8/24/20
Title 1, Chapter 354, Subchapter D, Division 8 DSRIP Program Demonstration Years 9-10#19R067: Delivery System Reform Incentive Payment (DSRIP) Program DY 9-10HHS Texas Healthcare Transformation and Quality Improvement Program8/17/20

Draft Rules Informal Comments

Informal opportunities to comment occur before a rule is published in the Texas Register. HHS staff may solicit informal public and stakeholder input by:

  • inviting stakeholders to submit comments on potential rule changes during rule development.
  • sharing a draft rule with stakeholders for review.
  • using existing HHS advisory committees to comment on rules.

There are currently no draft rules available for comment.

The Trump Administration today announced it is further transforming the nation’s rural health care system by unleashing innovation through new funding opportunities that will increase access and improve quality. The Community Health Access and Rural Transformation (CHART) Model delivers on President Trump’s Executive Order from last week on Improving Rural Health and Telehealth Access as well as the President’s Medicare Executive Order and CMS’s Rethinking Rural Health initiative.  Collectively, the Administration aims to ensure individuals in rural America have access to high quality, affordable health care.

Per the President’s Executive Order, the CHART Model also ties payment to value, increases choice and lowers costs for patients. CHART will empower rural communities to develop a system of care to deliver high quality care to their patients by providing support through new seed funding and payment structures, operational and regulatory flexibilities and technical and learning support.

Americans living in rural areas have worse health outcomes and higher rates of preventable diseases than the over 57 million Americans living in urban areas. Impediments such as transportation challenges disproportionately impact rural Americans and their access to care. Rural providers also experience challenges. For example, many rural healthcare facilities experience health care workforce shortages, and operate on thin margins and over 126 rural hospitals have closed since 2010 (1). Many rural hospitals also have difficulty recruiting and retain medical professionals to rural areas. Meanwhile, value-based payment models have accelerated nationally, though rural health care providers have been slow to adopt these models.

Providers interested in the CHART Model have two options for participation:

Community Transformation Track. The Trump Administration is investing up to $75 million in seed money to allow up to 15 rural communities to participate in the Community Transformation Track. The upfront investment empowers communities to implement care delivery reform, provide predictable capitated payments, and offer operational and regulatory flexibilities to build a sustainable system of care. Through these flexibilities, health care providers across the community will be able to pursue care transformation such as expanding telehealth to allow the beneficiary’s place of residence to be an originating site and waiving certain Medicare hospital conditions of participation to allow a rural outpatient department and emergency room to be paid as if they were classified as a hospital. The model also allows participant hospitals to waive cost-sharing for certain Part B services, provide transportation support, and gift cards for chronic disease management.

In September, CMS will select up to 15 rural communities to participate in this track, with the winners being announced in early 2021 and the model starting in Summer 2021.

Accountable Care Organization (ACO) Transformation Track. This track offers upfront investment to assist rural healthcare providers in improving outcomes and quality for rural beneficiaries. This track builds on the success of the ACO Investment Model (AIM), which has saved $382 million over three years. Providers participating in the ACO Transformation Track will enter into two-sided risk arrangements as part of the Medicare Shared Savings Program (MSSP) and may use all waivers available in the MSSP program. CMS anticipates releasing a Request for Applications in the Spring 2021 and selecting up to 20 rural ACOs to participate in this track starting in January 2022.

For more information, please visit: https://innovation.cms.gov/initiatives/chart-model/

Read the Fact Sheet.

Children wearing multifocal contact lenses had slower progression of their myopia, according to results from a clinical trial funded by the National Eye Institute, part of the National Institutes of Health. The findings support an option for controlling the condition, also called nearsightedness, which increases the risk of cataracts, glaucoma and retinal detachment later in life. Investigators of the Bifocal Lenses In Nearsighted Kids (BLINK) Study published the results August 11 in JAMA

Read the full release.

The U.S. Department of Health and Human Services (HHS) will continue to expand access to pre-exposure prophylaxis (PrEP) HIV prevention medications at no cost to eligible individuals without prescription drug coverage through a $4 million contract with TrialCard for one year with four one-year option periods.

Ready, Set, PrEP is a key component of the Ending the HIV Epidemic: A Plan for America (EHE) initiative. EHE aims to reduce the number of new HIV infections in the United States by 75% by 2025 and by 90% by 2030. Ready, Set, PrEP makes PrEP available to uninsured people who have a prescription for the medication.

Although more than 1 million people at risk for HIV in the United States could benefit from PrEP medications, only a small fraction of people get them. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force  recommend PrEP for individuals at risk of acquiring HIV. When taken as prescribed, PrEP is highly effective at reducing an individual’s risk of sexually acquiring HIV.

Read the full release.

The U.S. Department of Health and Human Services (HHS), through the Health and Resources and Services Administration (HRSA), awarded over $101 million to combat substance use disorders (SUD) and opioid use disorders (OUD). The awards support 116 organizations in 42 states and the District of Columbia, with many targeting high-risk rural communities.

HRSA’s Federal Office of Rural Health Policy awarded $89 million to 89 rural organizations across 38 states as part of the Rural Communities Opioid Response Program-Implementation (RCORP-Implementation). Each RCORP-Implementation grant recipient will use the funding to enhance and expand service delivery for SUD and OUD in rural communities. Awardees will work with rural communities to implement a set of core SUD and OUD prevention, treatment and recovery activities grounded in evidence-based or promising practice models which can be tailored to communities’ unique needs. These awards are part of HHS’ broader focus on rural health and human service issues through the Secretary’s Rural Health Task Force and build on the Administration’s commitment to support rural communities under an Executive Order released August 3, 2020.

In addition to the RCORP-Implementation investments, HRSA’s Bureau of Health Workforce awarded nearly $12.5 million to 28 organizations to expand access to behavioral health services for families affected by opioids and other substance use disorders. The Opioid-Impacted Family Support Program (OIFSP) aims to increase the number of training opportunities for behavioral health paraprofessionals working with families, and provides tuition assistance for trainees. Today’s awardees will recruit and train paraprofessionals to work with youth, including in high-need rural areas across the United States.
For a list of today’s RCORP-Implementation award recipients, visit: https://www.hrsa.gov/rural-health/rcorp/implementation/fy20-awards

For a list of today’s OIFSP award recipients, visit: https://bhw.hrsa.gov/grants/behavioral-health/opioid-impacted-family-support-fy20-awards

To learn about HRSA-supported resources, visit HRSA’s Opioid Crisis page.

The Department of State Health Services (DSHS) is seeking input on public health program funding for the 2022-2023 biennium Legislative Appropriations Request.

Included are programs for preventing, detecting and responding to infectious diseases; promoting healthy lifestyles through disease and injury prevention; reducing health risks and threats through consumer protection; developing evidence-based public health interventions through data analysis and science; and providing medical response during disasters and emergencies. Stakeholder input is a critical element of this process. You may submit written comments through August 14, 2020.

Please include the following in your comments:

  1. Your name or the name of your organization and a contact person.
  2. A clear, concise description of the recommendation.
  3. What need would be addressed by this recommendation and the expected impact or benefit to the state or the people we serve.

Send written comments by U.S. mail, fax, or e-mail to the appropriate address listed below:

 U.S. Mail
Attention: Carolyn Bivens
Mail Code 1911
P.O. Box 149347
Austin, TX 78714-9347
Attention: Carolyn Bivens