Texas Health and Human Services Digest: June 17, 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.

June 18, 2020

June 23, 2020

June 25, 2020

June 26, 2020

June 30, 2020

The Administrative Procedure Act (Texas Government Code, Chapter 2001(link is external)) 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.

The Administrative Procedure Act (Texas Government Code, Chapter 2001(link is external)) 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.

No rules are presently available for public comment.

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
Repeal of Title 40, Chapter 109, Subchapter C, Specialized Telecommunications Assistance Program, and new Title 26, Chapter 360, Subchapter C, Specialized Telecommunications Assistance Program#18R061Bryant Robinson6/18/207/2/20
Title 26, Chapter 744, 746, & 747 Minimum Standards for School Age and Before or After School Programs, Child-Care Centers, & Child-Care Homes#20R024HHSC Child Care Regulation6/17/207/1/20
Title 26, Chapter 742 Minimum Standards for Listed Family Homes#20R021HHSC Child Care Regulation6/15/206/29/20
Title 26, Chapter 303 Preadmission Screening and Resident Review (PASSR)#20R049Lisa Habbit6/12/206/26/20

 

Texas Health and Human Services is accepting comments from stakeholders on the following draft rules. The comment period ends July 1, 2020.

  • Texas Health and Human Services Commission Title 26, Chapter 744 Minimum Standards for School Age and Before or After School Programs. Comments can be emailed to HHSC Child Care Licensing.
  • Texas Health and Human Services Commission Title 26, Chapter 746 Minimum Standards for Child-Care Centers. Comments can be emailed to HHSC Child Care Licensing.
  • Texas Health and Human Services Commission Title 26, Chapter 747 Minimum Standards for Child-Care Homes. Comments can be emailed to HHSC Child Care Licensing.

Questions can be emailed to HHS Rules Coordination Office.  Visit the HHS Rulemaking website for more information.

Texas Health and Human Services is accepting comments from stakeholders on the following draft rules. The comment period ends June 29, 2020.

  • Texas Health and Human Services Commission Title 26, Chapter 742 Minimum Standards for Listed Family Homes. Comments can be emailed to HHSC Child Care Licensing.

Questions can be emailed to HHS Rules Coordination Office.
Visit the HHS Rulemaking website for more information.

DNA from uterine cells of women with endometriosis has different chemical modifications, compared to the DNA of women who do not have the condition, according to researchers funded by the National Institutes of Health. The changes involve DNA methylation — the binding of compounds known as methyl groups to DNA — which can alter gene activity. Moreover, the methylated DNA regions varied according to the stage, or severity, of endometriosis and responded differently to hormones involved in the menstrual cycle. Uterine responses to hormones influence pregnancy and other functions of uterine tissue.

The study was conducted by Linda C. Giudice, M.D., Ph.D., and colleagues at the University of California, San Francisco. It appears in PLOS Genetics. The study was funded by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Endometriosis is a disease in which tissue similar to the lining of the uterus grows in other places in the body, such as on the ovaries, fallopian tubes or the bowels and bladder. It affects from 5 to 10% of women in the United States. Its main symptoms include pain, especially during menstrual periods, and infertility. Endometriosis is classified into four stages, ranging from minimal (stage I) to severe (stage IV). The only definitive way to diagnose endometriosis is with a surgical procedure called a laparoscopy(link is external).

The researchers analyzed a type of cell known as an endometrial stromal fibroblast, which regulates cells in the lining of the uterus. They compared methylation across DNA regions and differences in gene functioning in cells from women who did not have endometriosis or any other gynecological disorders to those of women with stage I endometriosis and of women with stage IV endometriosis. They also observed methylation patterns and gene functioning after the cells were exposed to estradiol (a form of estrogen) alone, progesterone alone, and to a combination of the two hormones to mimic changes in the levels of these hormones that occur during the menstrual cycle.

DNA methylation patterns and gene functioning differed among all groups of cells before exposure to the hormones, with exposure to each individual hormone, and to the combination of the two. The differences in methylation and gene functioning between stage I and stage IV endometrial cells could mean that the two may be distinct subtypes of endometriosis, rather than different degrees of the condition.

HCS and TxHmL Stakeholders can now comment on proposed revisions to the HCS, TxHmL and CFC Billing Guidelines by July 20, 2020. A copy of the proposed billing guidelines and a summary of changes are at:

Email stakeholder comments to TxHmL Policy.

The Center for Medicare and Medicaid Innovation (Innovation Center) is announcing that if you did not submit a Letter of Intent (LOI) for the Direct Contracting Model you now have the opportunity to do so for participation beginning in the first Performance Year: https://app1.innovation.cms.gov/dc. Once a LOI is submitted, you will have access to the Performance Year 1 application portal for the Direct Contracting Model Professional and Global options. The portal is available at https://app1.innovation.cms.gov/dcrfa/dcrfaLogin.

Applications for Performance Year 1 are due by July 6th, at 11:59 PM EDT. The start date for Performance Year 1 will be April 1st, 2021. There will be a second cohort of the Direct Contracting Model Professional and Global options that starts on January 1, 2022. CMS expects that the application period for this cohort will begin in the first quarter of 2021. Please note: A LOI will not be required to access the 2022 application portal. CMS encourages interested parties to monitor the Direct Contracting Model website (https://innovation.cms.gov/innovation-models/direct-contracting-model-options) for future updates. Please contact our help desk with any questions/comments at DPC@cms.hhs.gov.