The Health and Human Services Commission (HHSC) proposes amendments to §97.2, concerning Definitions; §97.13, concerning Application Procedures for an Initial License; §97.17, concerning Application for Renewal License; and new §97.30, concerning Operation of an Inpatient Unit at Parent Agency.

BACKGROUND AND PURPOSE

The proposal amends Title 40, Chapter 97, Licensing Standards for Home and Community Support Services Agencies, by adding §97.30, which states the requirements that a home and community support services agency (HCSSA) or an applicant for a HCSSA license must meet to operate an inpatient unit at its parent agency. An inpatient unit is a facility where inpatient hospice services are provided. Current rules address operation of an inpatient unit at an alternate delivery site (ADS), but an ADS may not be a parent agency. Specifically, the proposed rules require a HCSSA or an applicant for a HCSSA license to notify HHSC of its intent to operate the inpatient unit; request and allow a Life Safety Code inspection; obtain verification from HHSC that the inpatient unit is in compliance with all requirements; and, unless the applicant is exempt from a health survey, request a health survey after providing services to one client. This new section is proposed in response to inquiries from HCSSAs about the requirements for operating an inpatient unit at a parent agency.

The proposal also amends definitions in §97.2, including the definition of "parent agency," a term currently used in Chapter 97 and proposed new §97.30. The proposal amends §97.13 and §97.17 to require an applicant for an initial or renewal license to comply with new §97.30 to operate an inpatient unit at its parent agency.

Other amendments to §§97.2, 97.13, and 97.17 are proposed to improve their accuracy and readability, and to use consistent terminology.

SECTION-BY-SECTION SUMMARY

The proposed amendment of §97.2, Definitions, changes "DADS," a reference to the Department of Aging and Disability Services, to "HHSC" and adds a definition of "HHSC." These changes reflect the transfer of functions relating to Chapter 97 from DADS to HHSC in accordance with Senate Bill 200, 84th Legislature, 2015. The proposed amendment changes the definition of "JCAHO" to reference the "Joint Commission," instead of the "Joint Commission on Accreditation of Healthcare Organizations." This change reflects the current name of the accrediting organization. The proposed amendment changes the definition of "parent agency," a term currently used in Chapter 97 and proposed new §97.30, to clarify that the term is synonymous with the term "principal place of business," which is removed from the definition of "ADS." The proposed amendment to the definition of "personal assistance services" removes the reference to a memorandum of understanding between the Board of Nursing and DADS because the statute requiring the memorandum has been repealed and health-related services that do not constitute the practice of professional nursing are described in Board of Nursing rules. The proposed amendment to the definition of "presurvey conference" more accurately describes the presurvey conference by stating that HHSC staff provide "information," not a "consultation."

The proposed amendment of §97.13, Application Procedures for an Initial License, requires an applicant for an initial HCSSA license to comply with new §97.30 to operate an inpatient unit at a parent agency. In addition, the proposed amendment specifies that an applicant for a license may not provide incorrect or false information on, or withhold information from, an application or attachment to an application. This change is made to clarify the context of the prohibition. The amendment provides that if an applicant provides false or incorrect information or withholds information, HHSC may deny the application as described in §97.21. The proposed amendment changes "DADS" to "HHSC" throughout the section and makes editing changes to improve the readability of the section.

The proposed amendment of §97.17, Application for a Renewal License, requires an applicant for license renewal to comply with §97.30 to operate an inpatient unit at a parent agency. In addition, the proposed amendment specifies that an applicant for a license renewal may not provide incorrect or false information on, or withhold information from, an application or attachment to an application. This change is made to clarify the context of the prohibition. The amendment provides that if an applicant provides false or incorrect information or withholds information, HHSC may deny the renewal application as described in §97.21, and assess an administrative penalty as described in §97.602(e)(5). The proposed amendment changes "DADS" to "HHSC" throughout the section and makes editing changes to improve the readability of the section and to use terminology consistent with other sections.

Proposed new §97.30, Operation of an Inpatient Unit at Parent Agency, sets forth the requirements for operating an inpatient unit at a parent agency. Specifically, a HCCSA or an applicant for a license must notify HHSC of its intent to operate an inpatient unit at a parent agency; request and receive a Life Safety Code inspection; receive verification of compliance with the requirements for a hospice inpatient unit; admit and provide hospice services to a client in the inpatient unit; and, unless the HCSSA is exempt from an initial health survey, submit a notification of readiness for an initial health survey, and be determined to be in substantial compliance with licensure requirements. The proposed new section provides that a HCSSA must not have proposed enforcement action pending against the license under which it would operate the inpatient unit at the time it notifies HHSC of its intent to operate the inpatient unit. The proposed new section also sets forth the requirements for being exempt from an initial health survey through accreditation and requires an agency operating an inpatient unit to comply with Texas Health and Safety Code, Chapter 142, and 40 TAC Chapter 97.

FISCAL NOTE

David Cook, Deputy Chief Financial Officer, has determined that for each year of the first five years that the sections will be in effect, there will be no fiscal implications to state or local governments as a result of enforcing and administering the sections as proposed.

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

David Cook has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities required to comply with the sections as proposed.

ECONOMIC COSTS TO PERSONS AND IMPACT ON LOCAL EMPLOYMENT

There are no anticipated economic costs to persons who are required to comply with the sections as proposed.

There is no anticipated negative impact on local employment.

COSTS TO REGULATED PERSONS

Texas Government Code, §2001.0045 does not apply to this rule because the rule is necessary to protect the health, safety, and welfare of the residents of Texas.

PUBLIC BENEFIT

Mary Henderson, Associate Commissioner, has determined that for each year of the first five years the sections are in effect, the public will benefit from adoption of the sections. The public benefit anticipated as a result of enforcing or administering the sections will be to improve the health and safety of clients who receive services in an inpatient hospice unit located at the parent agency of a HCSSA.

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 Government Code, §2007.043.

PUBLIC COMMENT

Written comments on the proposal may be submitted to the Rules Coordination Office, P.O. Box 149030, Mail Code H600, Austin, Texas 78714-9030, or street address 4900 North Lamar Boulevard, Austin, Texas 78751; or e-mailed to HHSRulesCoordinationOffice@hhsc.state.tx.us.

To be considered, comments must be submitted no later than 30 days after the date of this issue of the Texas Register. The last day to submit comments falls on a Sunday; therefore, 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) e-mailed by midnight on the last day of the comment period. When submitting comments, please indicate "Comments on Proposed Rule 16R19" in the subject line.

STATUTORY AUTHORITY

The amendment is proposed 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; and Texas Health and Safety Code, Chapter 142, which authorizes the HHSC executive commissioner to adopt rules regulating home and community support services agencies.

The amendment implements Texas Government Code, §531.0055 and Texas Health and Safety Code, §142.0011 and §142.012.