Texas Health and Human Services Digest: September 2, 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.

September 8, 2020

September 9, 2020

September 10, 2020

September 11, 2020

September 14, 2020

September 15, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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 25, Chapter 37, Maternal and Infant Health#19R012: Texas School Health Advisory CommitteeDSHS School Health9/28/20
Title 25, Chapter 85, Local Public Health#20R003: Data Request Process for Public Health Practice PurposesDSHS Center for Health Policy and Performance9/28/20
Title 25, Chapter 221, Meat Safety Assurance#20R013: Low-Volume Livestock Processing EstablishmentsDSHS PSQA Meat Compliance Unit9/28/20
Title 1, Chapter 355, Reimbursement Rates#20R054: HCS and TxHmL Respite and Day Habilitation ReimbursementHHS Rate Analysis Department9/21/20
Title 26, Part 1, Chapter 370, Human Trafficking Resource Center#20R034: Human Trafficking Prevention Training RequirementsHHS Rules Coordination Office9/14/20
Title 25, Chapter 37, Subchapter S, Newborn Hearing Screening#19R073: Newborn Hearing ScreeningDSHS Newborn Screening Unit9/8/20


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.
TitleProject No.ContactComment Start DateComment Start Date
Title 25, Chapters 133, 135, 139, 506, and 510, relating to Facility Surveys and Investigations#20R012Lindsay Reed8/31/209/4/20
Repeal of Title 25, Chapter 131, Subchapters A – E, Freestanding Emergency Medical Care Facilities, and new Title 26, Chapter 509, Freestanding Emergency Medical Care Facilities#20R009HHSC Policy, Rules and Training8/31/209/4/20


Introduction to the Long-Term Care Hospital Quality Reporting Program Web-Based Training. NEW TRAINING EVENT – Introduction to the Long-Term Care Hospital Quality Reporting Program Web-Based Training

Can be accessed via the LTCH Quality Reporting Program Training webpage.

Introduction to the Home Health Quality Reporting Program Web-Based Training. NEW TRAINING EVENT – Introduction to the Home Health Quality Reporting Program Web-Based Training

Can be accessed via the Home Health Quality Reporting Training webpage.

CMS Approves TxHmL Waiver Amendment 6. The Centers for Medicare and Medicaid Services approved the Texas Home Living Services Waiver Amendment 6.

Please see the HHS Waiver Applications page for a copy of the approved TxHmL amendment and email txhmlpolicy@hhsc.state.tx.us with any questions.

Supporting Family and Older Relative Caregivers: The Family Caregiving Advisory Council Marks One Year of Progress. By Greg Link, Director, Office of Supportive and Caregiver Services, ACL.  In the U.S., nearly 55 million caregivers, most of whom are family members, face new situations and challenges on a daily basis. A typical day often includes a bit of uncertainty topped with moments of elation and gratitude. Whether assisting with navigating the intricacies of the health care system or providing complex medical care themselves, family caregivers often need information, training, and other services and supports to help them manage their roles.

Regardless of the unique circumstances and challenges each caregiver faces, those of us who provide care and support to others share many similarities. When we need information about our caregiving situation, it must be reliable, current and from trusted sources. Because it can be confusing to understand the array of supports that are available, we might need someone we can turn to for assistance navigating the system. Sometimes, however, we just need a break. Having access to affordable, quality and flexible respite options can give us the respite we need to look after our own emotional, physical and spiritual wellbeing.

Too often, family caregivers don’t know where to turn for help and do not feel their voices are heard, much less understood. Because caregiving is the foundation of our nation’s system of long-term supports and services, families facing these challenges must be supported, empowered and heard.

One year ago, The Administration for Community Living first convened the Family Caregiving Advisory Council as part of its responsibility for implementing the requirements of the Recognize, Assist, Include, Support and Engage Family Caregivers Act, commonly known by its acronym, RAISE. Guided by the principles of respect for diversity and inclusion, person- and family-centered philosophies, and ensuring the autonomy, choice and empowerment of caregivers, the Council’s efforts have included:

  • Proactively seeking the input of caregivers, key stakeholders and others in advance of preparing a report and National Caregiving Strategy that reflects the voices and preferences of the families we are seeking to recognize and support;
  • Conducting substantive deliberations and work in five open meetings and public forums; and
  • Surveying the federal landscape to identify programs and initiatives already in place that can support caregivers and identify opportunities to strengthen collaboration and reduce duplication of such efforts.

Throughout this journey, both the Family Caregiving Advisory Council and ACL have been fortunate to collaborate with the National Academy for State Health Policy’s RAISE Family Caregiver Resource and Dissemination Center. Funded by The John A. Hartford Foundation, the Center is developing family caregiving resources for state and federal policymakers and other stakeholders; providing support to the council and its subcommittee member as they develop policy recommendations; convening experts and thought leaders to provide perspectives and expertise to the council; and supporting states as they develop policies to address family caregiver issues.

In the coming months, the Family Caregiving Advisory Council will deliver its initial Report to HHS Secretary Azar, who will review the findings and submit it to Congress. Through this process, a spotlight will be focused on the specific needs and concerns of caregivers and the recommendations of the Council will form the basis of America’s National Caregiving Strategy, to address the complex needs of caregivers.

State Health Insurance Assistance Program Technical Assistance Center Awarded. The Administration for Community Living (ACL) awarded the State Health Insurance Assistance Program Technical Assistance Center (SHIP TA Center) to the Northeast Iowa Area Agency on Aging (NEI3A).

ACL’s Office of Healthcare Information and Counseling manages the State Health Insurance Assistance (SHIP) program. The SHIP mission is to empower, educate, and assist Medicare-eligible individuals, their families, and caregivers through objective outreach, counseling, and training, to make informed health insurance decisions that optimize access to care and benefits. The SHIP vision is to be the known and trusted community resource for Medicare information.

The award is a five year cooperative agreement (from September 1, 2020, to August 31, 2025), totaling $1,350,000 this fiscal year. With this award NEI3A will:

  • Increase public awareness of SHIPs;
  • Increase SHIP knowledge of Medicare and related health benefits;
  • Increase SHIP knowledge of successful, innovative practices;
  • Increase SHIP abilities and accuracy using the national SHIP data system and performance measures;
  • Support SHIP implementation of policies for volunteer risk and program management (VRPM); and
  • Provide SHIPs nationally available, relevant resources that support their professional well-being and ability to meet the program mission.

Visit ACL’s website to learn more about the State Health Insurance Assistance program.

All of Us Selects Vibrent Health to Support Participant Technologies. The All of Us Research Program has awarded an initial $39 million to Vibrent Health, of Fairfax, Virginia, through a new award to continue leading the program’s Participant Technology Systems Center. With this funding, Vibrent Health will develop digital technologies to make it easy for people nationwide to take part in the program.  View Announcement.

Treatments Linked to Drop in Lung Cancer Deaths: At a Glance

  • Deaths from the most common lung cancer, non-small cell lung cancer, declined sharply after 2013, faster than the drop in new cases of the disease.
  • Treatments that target specific genetic alterations in lung cancer cells were likely responsible for the improvements in mortality.

Read the full release.

Factors that affect depression risk: At a Glance

  • Researchers screened more than 100 diverse factors in people’s daily lives for links to depression.
  • The findings suggest that getting enough social support and limiting how much media you use may help prevent depression.

Read the full release.

Effective Sept. 1, 2020: Revision of HCS, TxHmL and CFC Billing Guidelines for HCS and TxHmL Program Providers. The HCS, TxHml, and CFC billing guidelines have been updated effective September 1, 2020. A summary of the revisions can be found on:

Send questions about the billing guidelines to HCS.TxHml.BPR@hhsc.state.tx.us

HHSC Kicks Off Construction of New San Antonio State Hospital. The Texas Health and Human Services Commission announced today construction is underway for a new 300-bed hospital to replace the current facility at San Antonio State Hospital.

The Texas Legislature and Gov. Greg Abbott approved $205 million in funding for the design and initial construction of the hospital to replace the outdated buildings at San Antonio State Hospital. HHSC is partnering with UT Health San Antonio to construct the new hospital.

The design of the replacement hospital incorporates a layout that ensures a patient-first model, with private rooms for all patients and a floor plan that includes more open areas and natural light throughout the building. The design of the hospital also includes a special vantage point with improved sightlines for nursing staff to monitor multiple hallways from one spot.

The construction is part of the $745 million Texas has invested to revitalize and transform state psychiatric hospitals in Austin, Kerrville, Rusk and San Antonio, as well as a new hospital in Houston.

The three-story, 476,000 square-foot building is expected to open in January 2024, pending legislative approval of additional funding. The total cost budgeted for the new hospital is approximately $357 million.

Construction crews are also renovating an existing, vacant building on campus that is expected to be completed in January 2021. The $11.5 million project will add 40 beds to the hospital and more than 100 new jobs will be created to support the recommissioned building. Those jobs include psychiatric nursing assistants, nurses, psychiatrists, psychologists, social workers and support service positions for the kitchen, laundry, maintenance, and security areas.

Read the full release.

Vendor Drug Program Updates

Expansion of Pharmacy Benefit for Pharmacist Reimbursable Services Begins Sept. 1. On Sept. 1, 2020, HHSC will expand the Medicaid and CHIP benefit to allow pharmacists to administer certain medications in a pharmacy setting, including the administration of certain long-acting anti-psychotics, opiate dependence treatments and emergency treatment for known or suspected opioid overdoses, and flu vaccines.

Refer to the Vendor Drug Program website for more information, including claim submission instructions.

Managed Care Resources Update. Updates to the Pharmacy MCO Assistance Chart and other MCO resource documents are now available.

Meeting Materials Available from 8/14/20 Provider Finance Stakeholder Meeting. NOTE: The HHSC Rate Analysis Department (RAD) has rebranded as the HHSC Provider Finance Department as of September 1, 2020

The HHSC Provider Finance Department held a stakeholder meeting on August 14th, 2020. Materials from this meeting (listed below) are now available on the HHS Provider Finance Department Communications webpage.

  • 8-14-2020 Webinar Presentation (pdf)
  • 8-14-2020 Webinar Frequently Asked Questions (pdf)
  • 8-14-2020 Webinar Video Recording (wmv)

Visit this page to access these materials, and check back often to access future department-wide announcements and notifications, meeting information, GovDelivery archives, and additional resources.

DFPS publishes a series of reports on or before September 1:

  1. PEI Progress Report on Implementation of Five-Year Strategic Plan – This is the fourth annual progress report on the five-year plan on child abuse prevention and early intervention.
  2. Foster Parent Resources Study – This report evaluates whether DFPS provides foster parents with adequate resources to ensure they are able to comply with all the regulations relating to providing care for a child in state conservatorship.
  3. Relative and Other Designated Caregiver Placement Program Report – This report provides data on permanency outcomes for children placed with relatives or other designated caregivers.
  4. Contract Performance FY 2020 Reports – These reports present quarterly quality metrics for purchased client services in family-based safety Services, post-adoption services, and post-permanency services. (Note: the FY 2020 Q1 report was updated, and the Q2 and Q3 reports are new.)
  5. Family First Prevention Services Act Strategic Plan – This plan provides information on existing programs affected by the act and as well as options to improve services.
  6. Adult Protective Services Q3 Performance Report FY 2020 – This is a quarterly performance review for Adult Protective Services.
  7. Rider 30 Placement Process & Capacity Tracking – This report provides information on the process and capacity for placement of youth in DFPS conservatorship.
  8. Rider 36 Caseworker and Management Ratio – This report covers management to caseworker ratios in the Child Protective Services and Adult Protective Services programs.

Policy Updates for September 1, 2020. DFPS’s Child Protective Services (CPS) program updated its policy handbook today. The handbook includes new information about:

  • Runaway, missing, and trafficked children
  • Runaway prevention

For more information, please review the Child Protective Services Handbook’s revision memo.

An Audit Report on Licensing and Enforcement at the Board of Chiropractic Examiners. The Board of Chiropractic Examiners (Agency) had adequate processes to help ensure that it conducted most licensing and enforcement functions in accordance with applicable requirements. However, to ensure consistent compliance with requirements, the Agency should obtain required documents and necessary approvals, and retain required documentation. The Agency also should regularly update its internal policies and Texas Administrative Code rules to align with its processes and Texas Occupations Code requirements.

The Agency also had weaknesses in its controls to protect confidential data and other general controls related to data availability. To minimize security risks, auditors communicated details about the identified weaknesses separately to the Agency’s management in writing.