The Health and Human Services Commission (HHSC), on behalf of the Department of Aging and Disability Services (DADS), adopts amendments to §97.2, Definitions; §97.29, Application and Issuance of an Alternate Delivery Site License; §97.201, Applicability; §97.244, Administrator Qualifications and Conditions and Supervising Nurse Qualifications; §97.248, Volunteers; §97.257, Medicare Certification Optional; §97.288, Coordination of Services; §97.322, Standards for Alternate Delivery Sites; §97.602, Administrative Penalties; new §§97.801, 97.810 - 97.813, 97.820 - 97.823, 97.830 - 97.834; 97.840 - 97.846, 97.850 - 97.861, 97.870, 97.871, and 97.880 in new Subchapter H, concerning Standards Specific to Agencies Licensed to Provide Hospice Services; and the repeal of §97.403, Standards Specific to Agencies Licensed to Provide Hospice Services, in Chapter 97, Licensing Standards for Home and Community Support Services Agencies. The amendments to §§97.2, 97.29 and 97.602, and new §97.811 and §97.871 are adopted with changes to the proposed text published in the June 21, 2013, issue of the Texas Register (38 TexReg 3944). The amendments to §§97.201, 97.244, 97.248, 97.257, 97.288, and 97.322; new §§97.801, 97.810, 97.812, 97.813, 97.820 - 97.823, 97.830 - 97.834; 97.840 - 97.846, 97.850 - 97.861, 97.870, and 97.880; and the repeal of §97.403 are adopted without changes to the proposed text.

The Department of Aging and Disability Services (DADS) initiated this project in response to the Centers for Medicare and Medicaid Services' (CMS) revised hospice conditions of participation (CoPs) at 42 Code of Federal Regulations (CFR), Part 418, effective December 2, 2008. DADS also included amendments to recognize a boarding home facility as an independent living environment where a client may reside and receive HCSSA services.

The adoption includes repealing §97.403, Standards Specific to Agencies Licensed to Provide Hospice Services from Chapter 97, Subchapter D, and replacing it with a new Subchapter H to better organize the information in the sections. The rule sections in new Subchapter H are based on the federal hospice CoPs and on Texas state laws regulating services provided by hospice licensed staff and hospice aides.

In §§97.29, 97.602, 97.811, and 97.871 the agency changed references to time periods after a particular event to consistently use the phrase "within" a certain number of days, instead of "no later than" or "not later than."

DADS received written comments from the Texas New Mexico Hospice Organization. A summary of the comments and the responses follows.

Comment: The commenter recommended adding the word "Texas" before Occupations Code, in §97.2(83) to maintain consistency within the section.

Response: The agency agrees and has made the requested change.

Comment: The commenter recommended referencing the acronym "ADS" instead of "Alternate Delivery Site" §97.29(e)(1) and (k).

Response: The agency agrees that the acronym is appropriate in the subsections listed and has made the requested change.

Comment: The commenter noted that the tables in §97.602(h)(2)(D) and §97.602(h)(3)(E) do not identify the areas of change that were made to the administrative penalties. It appears that all the penalties are current rule language, which they are not.

Response: The agency agrees that the amendment to §97.602 updated rule cites listed on the administrative penalty tables. In accordance with Texas Register preference, proposed amendments to tables are not indicated by strikethrough or underline. For a copy of the proposal with changes shown in §97.602(h)(2)(D) and §97.602(h)(3)(E), contact the Policy, Rules, and Curriculum Development Unit in DADS Regulatory Services Division at 512-438-3161.

Comment: The commenter recommended spelling out the word "five" instead of using the numeral in §97.811(b).

Response: The agency agrees that numbers less than ten are usually spelled out in rule and has made the requested change.

The amendment is adopted under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Health and Safety Code §142.0011, which requires the adoption of rules related to the regulation of home and community support services agencies.