Texas Health and Human Services Digest: July 21, 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.

July 22, 2020

July 23, 2020

July 24, 2020

July 27, 2020

July 28, 2020

July 29, 2020

July 30, 2020

July 31, 2020

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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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.

TitleProject No.,
ContactComment End Date
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
Title 26, Chapter 567 Certificate of Public Advantage#20R041: Certificate of Public Advantage (COPA)HHS Health Care Regulation’s Policy, Rules, and Training8/10/20
Title 25, Chapter 98, Subchapter C, Division 2 Advisory Committee#20R052: Texas HIV Medication Advisory CommitteeDSHS HIV-STD Program8/10/20
Title 26, Chapter 746, Subchapter B, Division 2 Required Notification#20R025: Annual Reporting of Employees Leaving Child-Care CentersHHS Child Care Regulation8/10/20

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.

The following are draft rules on which HHS is accepting informal public or stakeholder input. All rules are posted in MS Word format unless otherwise noted.

TitleProject No.ContactComment Start DateComment End Date
Title 26, Chapter 745 Licensing, Subchapters A, C, D, and L, and Chapter 748 Minimum Standards for General Residential Operations#20R039HHS Child Care Regulation7/15/207/29/20
Title 25, Chapter 217, Subchapter A, Grade Specifications and Requirements for Milk, and Subchapter B, Grade A Raw Milk and Raw Milk Products#20R051DSHS Milk and Dairy Unit7/14/207/28/20
Repeal of Title 25, Chapter 289, Subchapter E, §289.233 Radiation Control Regulations for Radiation Machines Used in Veterinary Medicine and new §289.233#20R030DSHS Consumer Protection Division7/13/207/27/20
Figures for new Title 25, Chapter 289, Subchapter E, §289.233 Radiation Control Regulations for Radiation Machines Used in Veterinary Medicine#20R030DSHS Consumer Protection Division7/13/207/27/20


The Healthier Texas Summit is a collaboration between It’s Time Texas and The University of Texas System that brings together thought leaders and health champions from all sectors to advance a shared vision: transforming health in Texas.

As the only conference of its kind bringing together cross-sector thought leaders and local health champions to unite for a healthier Texas, the Summit will be offered as a free, digital series in 2020.

In weekly sessions running now through October, attendees will hear from experts on issues spanning social determinants of health, community health, cross-sector partnerships, health disparities, and health communication. Content for the series will also focus on community-level responses to COVID-19, including successful collaborations and novel approaches to addressing the social factors that influence health during a crisis.

For a schedule of events and to register, please visit: 

The Centers for Medicare & Medicaid Services (CMS) recently released a new Functional Assessment Standardized Items (FASI) V1.1, including a 508 Compliant version (please see attached). The FASI V1.1 includes minor grammatical changes and refinements to instructions.  The integrity, validity, and reliability of the item set remain unchanged.  Please also note recent FASI publications:

If you have any questions or would like assistance implementing FASI in your state or program, please contact HCBSMeasures@Lewin.com.

Administration for Community Living: 2019 Profile of Older Americans. The Profile of Older Americans is an annual summary of the available statistics related to the older population in the United States. Principal sources of data are the U.S. Census Bureau, the National Center for Health Statistics, and the Bureau of Labor Statistics.

The Profile illustrates the shifting demographics of Americans age 65 and older. It includes key topic areas such as income, living arrangements, education, health, and caregiving. This year’s report includes special sections on obesity as well as aerobic activity and muscle-strengthening activities.

View/download the Profile

In addition to the full report, individual charts/graphs are available as image files. Also on this page are Excel tables from this and past years, along with previous years’ profiles.

Select Highlights*

  • Between 2008 and 2018, the population age 65+ increased 35%. It is projected to reach 94.7 million in 2060.
  • The number of Americans age 45-64—who will reach age 65 during the next
    two decades—increased by 7% between 2008 and 2018.
  • Racial and ethnic minority populations have increased from 7.5 million in 2008
    to 12.3 million in 2018, and are projected to reach 27.7 million in 2040.
  • In 2019, 69% of older men and 47% of older women were married.
  • As of 2019, about 28% of older persons lived alone. Among women age 75+, 44% lived alone.
  • The median income of older persons in 2018 was $34,267 for men and
    $20,431 for women.
  • In 2018, the percentage of older adults age 85+ who needed help with personal care (21%) was more than twice the percentage for adults ages 75–84 (8%) and five times the percentage for adults ages 65–74 (4%).
  • The 85+ population is projected to more than double from 6.5 million in
    2018 to 14.4 million in 2040.

*The Profile incorporates the data available. Not all data are updated annually. A complete list of data sources appears at the end of the report.

TEP Nominations Open for Development of CKD and ESRD Cost Measures for Use in CMMI Model. The Centers for Medicare & Medicaid Services (CMS) has contracted with Acumen, LLC to seek nominations for a Technical Expert Panel (TEP) that will provide input on the development of 1-2 cost measures for the Kidney Care Choices (KCC) Model from the Center for Medicare and Medicaid Innovation with quality measures under the CMS Kidney Care First (KCF) Option. Acumen is looking for 12-15 individuals with experience and expertise in Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD) care, nephrology practice, and measure development to take part in the TEP. We are streamlining this process to limit demands on stakeholders’ time by meeting once via webinar in September 2020 and once in early 2021. For more information, please see the Call for TEP members posting on this CMS webpage.

Nominations close on August 7, 2020 at 11:59 p.m. Eastern Time. Interested individuals may submit their nomination through this online TEP nomination form. If you would like a 508-compliant PDF version of the nomination form for submission via email instead of the online form, please email kcf-cost-measures@acumenllc.com to receive a blank form. Please feel free to reach out if you have any questions about this TEP.

CMS opened the Physician Compare Preview Period on June 22, 2020, at 10 a.m. ET (7 a.m. PT). The 60-day Preview Period provides an opportunity for clinicians and groups to review their 2018 Quality Payment Program performance information before it is publicly reported on Physician Compare profile pages and in the Downloadable Database.

You can access the secured measure preview through the Quality Payment Program website.
Check out the resource below on how to preview your information:

For additional assistance with accessing the Quality Payment Program website, or obtaining your EIDM user role, contact the Quality Payment Program service center at QPP@cms.hhs.gov.

To learn more about the 2018 Quality Payment Program performance information that is available for preview as well as the 2017 clinician utilization data that will be added to the Downloadable Database, download these documents from the Physician Compare Initiative page:

The 60-day Preview Period will close on August 20, 2020 at 8 p.m. ET (5 p.m. PT).

If you have any questions about Physician Compare, public reporting, or the 60-day Preview Period, please contact us at PhysicianCompare-Helpdesk@AcumenLLC.com.

Suspension of enforcement activity was lifted as of June 1, 2020, according to Centers for Medicare and Medicaid Services letter QSO 20-31 (PDF). Enforcement template letters specific to Focused Infection Control surveys will no longer be issued. The Texas Health and Human Services Commission will issue its normal enforcement letters for all surveys with exit dates of June 1 and later. Providers that choose to dispute findings should ensure the Informal Dispute Resolution request is submitted within 10 days of receipt of the forms CMS 2567 and HHSC 3724.  Questions can be directed to your long-term care regulation regional office.

The DSHS Laboratory has  implemented the use of whole genome sequencing (WGS) for the identification and serotyping of some Salmonella spp. in human clinical specimens. WGS will be used on a limited number of Salmonella spp. surveillance samples to provide Organism ID and Serotype. This information will be included in the reports for selected clinical samples submitted on or after July 20, 2020.

  • This additional information cannot be provided for samples submitted previously.
  • All clinical samples submitted will be processed for surveillance purposes. Only a portion of these samples will be sequenced to provide this additional information.

There will be no changes to the specimen submission or reporting process. Please contact the DSHS Microbiology laboratory with any questions you have at Lab.Microbiology@dshs.texas.gov.

Schools should follow these guidelines for students to obtain visionhearing and spinal screenings that are receiving in person or online instructions.

  • Send a letter to parents notifying them in advance that screenings will be conducted on designated dates
  • Request parent to please bring student receiving online instructions to the school so screenings may be performed in accordance with the statutes
  • In lieu of the screening(s) provided by the school:
  1. parents or guardians may provide screening record signed by a licensed professional
  2. parents or guardians may provide signed statement that the vision, hearing or spinal screening conflicts with the tenets and practices of a church or religious denomination of which the affiant is an adherent or member