The proposed amendment to §748.937 (1) clarifies that a person may complete annual training through instructor-led training or self-instructional training; (2) deletes the exclusion for self-instructional annual emergency behavior intervention training and CPR training, because those issues are more accurately addressed in proposed new §748.941 and §748.911(b); (3) deletes the exclusion of self-instructional training for first aid training, because this is now allowed in proposed new §748.911(a); (4) deletes counting annual emergency behavior intervention training as annual training, because it is redundant; (5) increases, from 10 hours to 15 hours, the number of pre-service hours that a person may carry over and use as annual training hours; (6) increases, from 50 percent to 80 percent, the number of annual training hours that may come from self-instructional training; and (7) increases from 10 hours to 15 hours the number of annual training hours that a person may carry over to the next year.

The proposed amendment to §748.939 (1) deletes subsection (b) because it is already incorporated into the proposed amendment to §748.943; and (2) moves the requirements for instructor-led and self-instruction training in subsection (c) to new proposed §748.941(a) because this information is more germane to that rule.

The proposed repeal of §748.941 deletes the rule as no longer necessary because instructor requirements for certain annual training topics and the content of the rule relating to transportation safety training are being transferred to proposed new §748.941.

Proposed new §748.941 (1) adds requirements for instructor-led and self-instruction training from proposed amended §748.939; (2) clarifies that annual training for emergency behavior intervention and administering psychotropic medication must be instructor-led; (3) describes the requirements for annual emergency behavior intervention and administering psychotropic medication training instead of referring back to the pre-service requirements in §748.869; and (4) incorporates the content of the proposed repeal of §748.941 relating to transportation safety training.

Proposed new Division 8 creates a new division entitled Topics and Curriculum Components for Annual training for organization purposes.

The proposed amendment to §748.943 (1) clarifies what areas or topics are appropriate for caregivers and employees; (2) adds extra areas or topics for annual training appropriate for both caregivers and employees; (3) clarifies that annual topics for employees must be in areas appropriate to the needs of children for whom the GRO provides care; and (4) adds emergency behavior intervention as an appropriate area or topic for annual training for employees.

The proposed amendment to §748.944 updates the language of the rule to make it easier to understand.

The proposed repeal of §748.945 deletes the rule as no longer necessary because the content of the rule is being added to proposed new §748.945 with substantive modifications. The part of the proposed repeal of §748.945 that required a caregiver to take the annual administering psychotropic medication training no later than 12 months from the caregiver's previous training on the topic is not being included in proposed new §748.945.

Proposed new §748.945 incorporates part of the proposed repeal of §748.945 relating to the curriculum component for annual training for administering psychotropic medication.

The proposed amendment to §748.947 (1) updates the language of the rule to make it easier to understand; and (2) updates two citations.

The proposed repeal of Division 7 deletes the First-Aid and CPR Certification division as no longer necessary, because the content of the rules in this division are being added to proposed new Division 6, First Aid and CPR Certification, for organizational purposes.

The proposed repeal of §§748.981, 748.983, 748.985, and 748.987 deletes the rules as no longer necessary, because the content of the rules is being added to proposed new §748.911 and §748.913 with substantive modifications.

The proposed repeal of §748.989 deletes the rule as no longer necessary, because the content of the rule is being added to proposed new §748.915 with non-substantive modifications.

The proposed amendment to §748.1211 removes references to "sponsoring families."

The proposed amendment to §748.1217 adds the child's educational and behavioral level of functioning and any history of trauma to the list of things that an admission assessment must cover prior to a child's non-emergency admission.

The proposed amendment to §748.1303 (1) adds a requirement to notify a parent to request an Admission, Review, and Dismissal (ARD) or Individual Transitional Planning (ITP) meeting if needed; (2) adds a requirement for attending ARD or ITP meetings, if held; and (3) clarifies that the GRO should know the specifics of a child's Individual Education Plan (IEP) and support the school's efforts to implement the IEP, if applicable.

Proposed new §748.1553 (1) outlines what a caregiver must do when a child is injured or ill and requires immediate treatment by a health-care professional; and (2) clarifies that a caregiver must not be required to seek approval to contact emergency services or to take the child to the nearest emergency room.

The proposed repeal of §748.1937 deletes the rule as no longer necessary, because the content of the rule is being added to proposed new §748.1937 with some substantive changes.

Proposed new §748.1937 (1) incorporates the proposed repeal of §748.1937; (2) adds four situations when an adult in care may share a bedroom with a child in care: (A) when they are siblings; (B) when the adult is the child's parent; (C) when they are both non-ambulatory and receive treatment services for primary medical needs; and (D) when an adult in care shares a bedroom with a child in care is at least 16-years old and the age difference is not more than 24 months, which implements H.B. 700, Family Code §264.1214(c); (3) clarifies that the service planning team must complete and document an assessment determining that there is no known risk to the child sharing a room with an adult by looking at certain factors, except when the adult is the child's parent; (4) clarifies that the adult and child must not sleep in the same bed unless the adult is the child's parent and the child is between the ages of one year and 10 years old; and (5) includes an exception for traveling and camping situations.

The proposed amendment to §748.2009 clarifies procedures for ensuring a non-prescription medication or supplement is not contraindicated with any other medication prescribed to a child.

The proposed amendment to §748.2307 deletes "and verbal abuse" from subsection (4) because it is already covered under subsections (8) and (9).

The proposed amendment to §748.2507 adds a requirement to provide the parent with a copy of the PRN order within 72 hours of obtaining a PRN order for a personal restraint, emergency medication, or seclusion.

The proposed amendment to §748.2553 and §748.2801 clarifies that a prone or supine hold is meant to be transitional.

The proposed amendment to §748.2651 clarifies that a video camera may be used to continuously observe a child in seclusion, but that the GRO may not use a video camera in lieu of direct observation.

Proposed new §748.2857 adds requirements to notify the parent when the GRO has used an emergency behavior intervention, other than a short personal restraint, with the parent's child.

The proposed amendment to §748.2953 clarifies that a GRO must submit aggregate numbers of emergency behavior interventions to CCR no later than 15 days after the end of each quarter.

The proposed amendment to §748.3273 (1) deletes the requirement for cotton balls in a first-aid kit; and (2) amends the requirement for adhesive bandages in a first-aid kit so that they do not have to be multi-sized.

Proposed new §748.3281 describes an unsafe product as it is determined by the United States Consumer Product Safety Commission.

Proposed new §748.3283 outlines responsibilities for ensuring there are no unsafe products at the GRO and a notice is posted for parents and employees to inform them of unsafe products recalled by the United States Consumer Product Safety Commission.

The proposed amendment to §748.3301 (1) reorganizes the content of the rule; and (2) clarifies that buildings must not pose a risk to the health and safety of children.

The proposed amendment to §748.3361 updates the language of the rule for better readability and understanding.

The proposed repeal of §748.3363 deletes the rule as no longer necessary because the content of the rule is being added to proposed new §748.3363 with substantive changes.

Proposed new §748.3363 (1) incorporates the proposed repeal of §748.3363; (2) adds three situations when children of opposite gender may share a bedroom: (A) when they are siblings; (B) when the older child is the younger child's parent; and (C) when they are both non-ambulatory and receive treatment services for primary medical needs; (3) clarifies that the service planning team must complete and document an assessment determining there is no known risk to each child by looking at certain factors, except when the older child is the younger child's parent; and (4) clarifies the factors to be assessed include the children's behavior, compatibility, relationship, any history of possible sexual trauma or sexually inappropriate behavior, and any factors affecting the appropriateness of the children sharing a bedroom.

The proposed amendment to §748.3421 clarifies that poisonous and flammable materials must be stored in an area that is inaccessible to children.

The proposed amendment to §748.3443 clarifies that food must be refrigerated if it requires refrigeration.

The proposed amendment to §748.3601 deletes subsection (7), combines its substantive content with subsection (6), and renumbers the subsections accordingly.

The proposed amendment to §748.3603 (1) clarifies that a GRO is not required to have a pool lock on doors leading to the swimming pool area that an adult can open if the state or local fire authority determines that the height of the lock violates or would violate the fire code and the GRO keeps documentation from the fire authority on file; and (2) makes non-substantive changes for better understanding.

The proposed amendment to §748.3757 (1) clarifies that life jackets must be Coast Guard approved; (2) adds a subsection requiring a child under the age of 12, or a child of any age who cannot swim, to wear a Coast Guard-approved life jacket when swimming in other bodies of water such as ponds, rivers, lakes, and oceans; and (3) adds a subsection allowing the swimming ratios to not apply as long as child/caregiver ratios are met under §748.1003, (A) to children over 12 years of age who are competent swimmers, regardless of the type of body of water, and (B) to children of any age who are participating in sprinkler play or are playing in a splash pad or wading pool that has standing water less than two feet.

The proposed amendment to §748.3931 (1) clarifies that the GRO must develop and enforce a policy identifying specific precautions to ensure that a child does not have unsupervised access to weapons, firearms, explosive materials, or projectiles including specific storage requirements; (2) adds a subsection exempting firearms that are inoperable and solely ornamental from the storage requirements; (3) clarifies that a toy that explodes or shoots must be age appropriate to the child; (4) deletes "such as fireworks or BB guns" in subsection (a), so that fireworks and BB guns are not used as examples of toys that explode or shoot; and (5) reorganizes the rule content and makes other non-substantive changes.

The proposed amendment to §748.4001 deletes the broad requirement to ensure the safety of children during any transportation provided by the GRO because more specific rule requirements in Subchapter R ensure the safety of children during transportation.

FISCAL NOTE

Trey Wood, Chief Financial Officer, has determined that for each year of the first five years that the rules will be in effect, enforcing or administering the rules does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rules will be in effect:

(1) the proposed rules will not create or eliminate a government program;

(2) implementation of the proposed rules will not affect the number of HHSC employee positions;

(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;

(4) the proposed rules will not affect fees paid to HHSC;

(5) the proposed rules will create a new rule;

(6) the proposed rules will expand existing rules;

(7) the proposed rules will not increase the number of individuals subject to the rules; and

(8) the proposed rules will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Trey Wood has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. The rules do not impose any additional costs on small businesses, micro-businesses, or rural communities that are required to comply with the rules.

LOCAL EMPLOYMENT IMPACT

The proposed rules will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to these rules because the rules: (1) are necessary to protect the health, safety, and welfare of the residents of Texas; (2) do not impose a cost on regulated persons; (3) are amended to reduce the burden or responsibilities imposed on regulated persons by the rules; and (4) are necessary to implement legislation that does not specifically state that §2001.0045 applies to the rules.

PUBLIC BENEFIT AND COSTS

Jean Shaw, Associate Commissioner for Child Care Regulation, has determined that for each year of the first five years the rules are in effect, the public benefit will be: (1) an enhancement in child health and safety; (2) an improvement in quality of care; and (3) increased compliance with statutory requirements due to clearer wording and the streamlining of rules that will help providers' understanding.

Trey Wood has also determined that for the first five years the rules are in effect, persons who are required to comply with the proposed rules will not incur economic costs.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Questions about the content of this proposal may be directed to Ryan Malsbary by email at Ryan.Malsbary@hhs.texas.gov.

Written comments on the proposal may be submitted to Ryan Malsbary, Rules Writer, Child Care Regulation, Health and Human Services Commission, E-550, P.O. Box 149030, Austin, Texas 78714-9030; or by email to CCRRules@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 20R102" in the subject line.

STATUTORY AUTHORITY

The amendment is authorized by Texas Government Code §531.0055, which provides that the Executive Commissioner of HHSC shall adopt rules for the GRO and provision of services by the health and human services agencies, and Texas Government Code §531.02011, which transferred the regulatory functions of the Texas Department of Family and Protective Services to HHSC. In addition, HRC §42.042(a) requires HHSC to adopt rules to carry out the requirements of HRC Chapter 42, while subsection (b) requires HHSC to conduct a comprehensive review of these rules every six years.

The amendment affects Texas Government Code §531.0055, HRC §42.042, and Texas Family Code §264.1214.