Texas Health and Human Services Digest: July 27, 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 27, 2020

July 28, 2020

July 29, 2020

July 30, 2020

July 31, 2020

August 4, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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.

Project No.,
Comment End Date
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
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

A new study, which analyzed 40 years of Framingham Heart Study data, found an association between lowered rates of hip fractures and decreases in smoking and heavy drinking.The rates of hip fractures in the United States have been declining over the past few decades. Although some experts attribute this change primarily to improved treatments for bone health, a new National Institutes of Health-supported study suggests other factors. These results indicate that modifiable lifestyle factors, along with treatments, may be beneficial to bone health. The findings appear July 27, 2020 in JAMA Internal Medicine.

Timothy Bhattacharyya, M.D., a researcher with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of NIH, led the analysis to determine what may be causing the drop in hip fracture rates. The research team included scientists from NIH’s National Cancer Institute, the Hinda and Arthur Marcus Institute for Aging Research, part of the Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, and Harvard Medical School, Boston.

The analysis included information from 4,918 men and 5,634 women who participated in the Framingham Study. These individuals were followed for a first hip fracture between Jan. 1, 1970, and Dec. 31, 2010. The rates for hip fractures, which were adjusted for age, dropped by 4.4% each year across the 40-year study period. The decrease was seen in both men and women.

In this group, the rate of smoking decreased from 38% in the 1970s to 15% in the period from 2006 to 2010. During the same period, heavy drinking (defined as three or more drinks per day) fell from 7% to 4.5%.  The rates of other risk factors for hip fracture, such as underweight and early menopause, did not change over the study period.

The Framingham Heart Study launched in 1948 to determine factors that contribute to cardiovascular disease. The National Heart, Lung, and Blood Institute, assumed responsibility for the project in 1949. Though many of the original participants have passed away, the study continues to examine another two generations of residents in and near Framingham, Massachusetts.

The study authors note that because the data was exclusively from white individuals, it is unclear whether other populations might show a similar correlation based on lifestyle factors. Another limiting factor was that Framingham participants had lower rates of obesity than the national average. Additionally, the study did not include measurements of bone mineral density, because such testing was not available until the 1990s.

The following Limited Data Set (LDS) files are now available to request:

  • 2019 MEDPAR Skilled Nursing Facility (SNF)
  • 2021 Ambulatory Surgical Center (ASC) Proposed

To request these files, please see the instructions on the CMS Data Use Agreement (DUA) website.

For more information about CMS LDS files, please see the LDS File Listing website.

The Texas Commission of Licensing and Regulation adopted amendments to the Midwives program rules (16 Texas Administrative Code, Chapter 115, §115.14 and §115.70). The adopted rules implement House Bill 2059, 86th Legislature, Regular Session (2019), which requires human trafficking prevention training for health care practitioners prior to the renewal of a license, and Senate Bill 1531, 86th Legislature, Regular Session (2019), which removes conviction of a “misdemeanor of moral turpitude or a felony” from the list of items authorizing discipline of a midwife or denial of an application for a midwife license or its renewal.

The adoption justification was published in the July 24, 2020, issue of the Texas Register (45 TexReg 5184). The updated rule chapter will be made available upon its effective date of August 1, 2020.

The Texas Commission of Licensing and Regulation adopts amendments to the Speech-Language Pathologists and Audiologists program rules at 16 Texas Administrative Code, Chapter 111, Subchapter B, §111.13; Subchapter C, §111.20 and §111.23; Subchapter D, §111.35 and §111.37; Subchapter E, §§111.41, 111.42, 111.45, and 111.47; Subchapter F, §§111.52, 111.55, and 111.57; Subchapter H, §111.75 and §111.77; Subchapter I, §§111.81, 111.85, and 111.87; Subchapter J, §§111.92, 111.95, and 111.97; Subchapter L, §111.115 and §111.117; Subchapter N, §§111.130 – 111.132; Subchapter P, §§111.150, 111.151, 111.154, and 111.155; Subchapter Q, §111.160; Subchapter R, §111.171; Subchapter T, §111.192; Subchapter U, §111.201; and Subchapter V, §111.212; new rules at Subchapter M, §§111.120 – 111.125; and Subchapter R, §§111.172 – 111.176; and repeal of existing rules at Subchapter S, §§111.180 – 111.183; and Subchapter U, §111.200. The adopted rules implement House Bill (HB) 1899, HB 2059, and HB 2847, Articles 7 and 10, 86th Legislature, Regular Session (2019) and HB 2680, Section 1, 79th Legislature, Regular Session (2005); implement recommended changes from the Licensing Workgroup; and make terminology and other clean-up changes.

The adoption justification was published in the July 24, 2020, issue of the Texas Register (45 TexReg 5172). The updated rule chapter will be made available upon its effective date of August 1, 2020.

The Texas Department of State Health Services (CHW) is sharing a survey link for community health workers (CHWs) at the request of UTHealth. DSHS will not collect or analyze any of the responses or data related to the study. UTHealth & the C3 Project researchers would like to ask you questions about how the COVID-19 pandemic response has impacted your work & professional quality of life. Your participation in this survey will contribute to the CHW profession in a very meaningful way! All information shared is anonymous & confidential. Upon completion of a short 15-20-minute online survey, participants will be randomly selected to receive incentives of $100 from a retailer such as Amazon or Wal-Mart! A summary of the survey results will also be shared with respondents who provide an email address. To take the survey, click ‘Take the survey’: Take the survey

The survey will be available Monday, July 13 to August 3, 2020.

Please direct any questions to Sogand Solgi at mch@uth.tmc.edu

Thank you for the critical work that you do and for your interest in advancing the CHW workforce through this research opportunity!

This service is provided to you at no charge by the Texas Department of State Health Services.

See the latest children who were added to or updated in the Texas Adoption Resource Exchange (TARE).