The Texas Health and Human Services Commission (HHSC) adopts, on behalf of the Department of Aging and Disability Services (DADS), an amendment to §90.3 and new §90.44 in Chapter 90, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, without changes to the proposed text as published in the January 8, 2016, issue of the Texas Register (41 TexReg 466).

The amendment and new section are adopted to implement House Bill 2789 of the 84th Legislature, Regular Session, 2015, which added new §161.088 to the Texas Human Resources Code. The adoption requires an intermediate care facility for individuals with an intellectual disability or related conditions to ensure that an employee who is hired on or after May 1, 2016, completes trauma-informed care training before working directly with a resident. The adoption provides that an employee works directly with a resident if the employee serves on a resident's interdisciplinary team or otherwise works with a resident to implement the resident's individual program plan. The adoption also updates the definition for "facility" and adds a definition for "individual program plan."

DADS received written comments from Providers Alliance for Community Services of Texas and one individual. A summary of the comments and the responses follows.

Comment: Two commenters requested more flexibility in the delivery of the trauma-informed care training. The commenters stated that accessing an online course may be burdensome for some facilities. The commenters requested curriculum that can be administered without a computer, and an option for more than one person to watch the online course in one sitting.

Response: The agency will make training content available in other formats for facilities to access. Specific information will be provided in a provider letter from the agency. The costs associated with these formats will be minimal because the agency will provide the content of the training. No changes were made in response to the comments.

The amended section 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; Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program; and Texas Human Resources Code, §32.021, which provides that HHSC shall adopt necessary rules for the proper and efficient operation of the Medicaid program.