PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES

SUBCHAPTER B. ADVISORY COMMITTEES

DIVISION 1. COMMITTEES

1 TAC §351.821

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §351.821, concerning the Value-Based Payment and Quality Improvement Advisory Committee.

BACKGROUND AND PURPOSE

The Value-Based Payment and Quality Improvement Advisory Committee (VBPQIAC) was established in 2016 by the HHSC Executive Commissioner, under the authority of Texas Government Code §531.012. This statute requires the HHSC Executive Commissioner to establish and maintain advisory committees; establish rules for the operation of advisory committees; and for advisory committees to provide recommendations to the HHSC Executive Commissioner and the Texas Legislature.

The VBPQIAC advises the HHSC Executive Commissioner and Texas Health and Human Services agencies (HHS agencies) on quality improvement and value-based payment initiatives for Medicaid, other publicly funded health services, and the wider health care system. The VBPQIAC consolidated the functions of the previous Medicaid and CHIP Quality Based Payment Advisory Committee and the Texas Institute of Health Care Quality and Efficiency. Members meet approximately four times a year in Austin.

In §351.821, the VBPQIAC is set to abolish on December 31, 2023. Abolition of the VBPQIAC would result in the loss of a primary source of public input for key Medicaid value-based and quality improvement programs, such as the state's Alternative Payment Models initiative. The VBPQIAC maintains strong participation from stakeholders.

The proposed amendment would extend the VBPQIAC by four years to December 31, 2027, update membership categories by removing "Regional Healthcare Partnerships" and align the rule with current HHSC advisory committee rule formatting and standards.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §351.821 adds "HHSC" in front of "Executive Commissioner" and uses the acronym "VBPQIAC" for the Value-Based Payment and Quality Improvement Advisory Committee.

The proposed amendment to §351.821 is revised in several places to ensure the rule conforms with HHSC's standards for its advisory committee rules. The proposed amendment adds new subsection (e), relating to Meetings, new subsection (h), relating to Required Training, and new subsection (i), relating to Travel Reimbursement. The language relating to abolition is moved to subsection (j) and the date of abolition is updated from December 31, 2023, to December 31, 2027.

The proposed amendment to subsection (a), relating to Statutory authority, adds a reference to §351.801. Language is added to subsection (b) to reference HHSC and the Executive Commissioner. A new paragraph (2) is added to subsection (c), relating to bylaws. Subsection (d), relating to Reporting Requirements, is updated to comply with HHSC's standards for its advisory committee rules. Subsection (f), relating to Membership, is updated to clarify terms relating to members and language related to "Regional Healthcare Partnerships" in (f)(1)(A)(ii) is deleted and the clauses are renumbered. Regional Healthcare Partnerships are now obsolete due to the end of the Delivery System Reform Incentive Payment program, commonly known as DSRI. Subsection (g), relating to Officers, is updated to clarify terms related to officers.

FISCAL NOTE

Trey Wood, HHSC Chief Financial Officer, has determined that for each year of the first five years that the rule will be in effect, enforcing or administering the rule does not have foreseeable implications relating to costs or revenues of state government because there is no change to state procedures or additional costs, and VBPQIAC members are not reimbursed for any committee participation-related expenses.

The rule does not have any fiscal implications to local governments because the rule does not apply to any local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

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

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

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

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

(5) the proposed rule will not create a new rule;

(6) the proposed rule will expand an existing rule;

(7) the proposed rule will not change the number of individuals subject to the rule; and

(8) the proposed rule 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 because the proposed amendment applies only to HHSC.

LOCAL EMPLOYMENT IMPACT

The proposed rule will not affect a local economy.

COSTS TO REGULATED PERSONS

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

PUBLIC BENEFIT AND COSTS

Stephanie Stephens, State Medicaid Director, has determined that for each year of the first five years the amended rule is in effect, the public benefit will be that the VBPQIAC will continue to advise HHS agencies on quality improvement and value-based payment initiatives for Medicaid, other publicly funded health services, and the wider health care system.

Trey Wood has also determined that for the first five years the amended rule is in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rule because the rule applies only to HHSC.

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 Jenn Hamilton at (512) 438-3214 in the HHSC Medicaid and CHIP Services Division, Office of Value-Based Initiatives.

Written comments on the proposal may be submitted to HHSC, Mail Code H250, P.O. Box 13247, Austin, Texas 78711-3247, or by email to HHSC_VBPQIAC@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 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 23R022" 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 operation and provision of services by the health and human services agencies, and Texas Government Code §531.012(c)(1), which requires the Executive Commissioner to adopt rules consistent with Texas Government Code Chapter 2110 to govern an advisory committee's report requirements.

The amendment affects Texas Government Code §531.0055 and Texas Government Code §531.012.

§351.821.Value-Based Payment and Quality Improvement Advisory Committee.

(a) Statutory authority. The Value-Based Payment and Quality Improvement Advisory Committee (VBPQIAC [Quality Committee]) is established under [in accordance with] Texas Government Code §531.012 and is subject to §351.801 of this division (relating to Authority and General Provisions).

(b) Purpose. The VBPQIAC advises the Texas Health and Human Services (HHSC) Executive Commissioner and Health and Human Services system agencies (HHS agencies) on [Quality Committee provides a forum to promote public-private, multi-stakeholder collaboration in support of] quality improvement and value-based payment initiatives for Medicaid, other publicly funded health services, and the wider health care system.

(c) Tasks. The VBPQIAC [Quality Committee] performs the following tasks:

(1) studies and makes recommendations regarding:

(A) value-based payment and quality improvement initiatives to promote better care, better outcomes, and lower costs for publicly funded health care services;

(B) core metrics and a data analytics framework to support value-based purchasing and quality improvement in Medicaid and CHIP [Medicaid/CHIP];

(C) HHSC and managed care organization incentive and disincentive programs based on value; and

(D) the strategic direction for Medicaid and CHIP [Medicaid/CHIP] value-based programs; and

(2) adopts bylaws to guide the operation of the committee; and

(3) [(2)] pursues other deliverables consistent with its purpose to improve quality and efficiency in state health care services as requested by the HHSC Executive Commissioner or adopted into the work plan or bylaws of the committee.

(d) Reporting Requirements [Reports].

(1) No later than [By] December 31st of each [fiscal] year, the VBPQIAC [Quality Committee] files an annual [a] written report with the HHSC Executive Commissioner covering [that covers] the meetings and activities in the immediately preceding [fiscal] year. The report includes:

(A) a list of [lists] the meeting dates;

(B) [provides] the members' attendance records;

(C) a brief description of the [briefly describes] actions taken by the VBPQIAC [committee];

(D) a description of [describes] how the committee [has] accomplished its tasks;

[(E) summarizes the status of any rules that the committee recommended to HHSC;]

(E) [(F)] a description of the [describes anticipated] activities the VBPQIAC [committee] anticipates undertaking [will undertake] in the next [fiscal] year;

(F) [(G)] recommended [recommends] amendments to this section[, as needed]; and

(G) [(H)] the costs related [identifies the costs related] to the VBPQIAC [committee ], including the cost of HHSC staff time spent supporting the VBPQIAC's [committee's] activities and the source of funds used to support the VBPQIAC's [committee's] activities.

(2) No later than [By] December 1st of each even-numbered year, the VBPQIAC [committee] submits a written report to the HHSC Executive Commissioner and Texas Legislature that:

(A) describes current trends and identifies best practices in health care for value-based payment and quality improvement; and

(B) provides recommendations consistent with the purposes of the VBPQIAC [Quality Committee].

(e) Meetings. [Date of abolition. The Quality Committee is abolished, and this section expires, on December 31, 2023.]

(1) Open meetings. The VBPQIAC complies with the requirements for open meetings under Texas Government Code Chapter 551, as if it were a governmental body.

(2) Frequency. The VBPQIAC will meet at least twice each year.

(3) Quorum. A majority of members constitutes a quorum for the purpose of transacting official business. (To calculate a majority for a committee with an even number of members, divide the membership by two and add one; for a committee with an odd number of members, divide the membership by two and round up to the next whole number.)

(f) Membership.

(1) The VBPQIAC [Quality Committee] is composed of 19 voting members and up to four non-voting ex officio members appointed by the HHSC Executive Commissioner. In selecting members to serve on the VBPQIAC, HHSC considers the applicants' qualifications, background, and interest in serving.

(A) The 19 [HHSC solicits] voting members represent [from] the following categories:

(i) Medicaid managed care organizations;

[(ii) Regional Healthcare Partnerships;]

(ii) [(iii)] hospitals;

(iii) [(iv)] physicians;

(iv) [(v)] nurses;

(v) [(vi)] pharmacies;

(vi) [(vii)] providers of long-term services and supports;

(vii) [(viii)] academic systems; and

(viii) [(ix)] [members from] other disciplines or organizations with expertise in health care finance, delivery, or quality improvement.

(B) Four non-voting, ex officio members may be appointed to the VBPQIAC as [The final composition of the committee is] determined by the HHSC Executive Commissioner.

[(C) The committee may include nonvoting, ex officio agency representatives as determined by the Executive Commissioner.]

(2) In selecting voting members, the Executive Commissioner considers ethnic and minority representation and geographic representation.

(3) Members are appointed for [to] staggered terms so that the terms of an equal or almost equal number of [approximately half the] members expire on December 31 [31st] of each [even-numbered] year. Regardless of the term limit, a member serves until his or her replacement has been appointed. This ensures sufficient, appropriate representation.

(A) If a vacancy occurs, the HHSC Executive Commissioner will appoint a person to serve the unexpired portion of that term.

(B) [(4)] Except as necessary to stagger terms, the term of each [voting] member is four years. A member may apply to serve one additional term.

(C) This subsection does not apply to ex officio members, who serve at the pleasure of the HHSC Executive Commissioner and do not have the authority to vote on items before the full committee.

(g) Officers. The VBPQIAC [Quality Committee] selects a chair and vice chair of the committee from among its members [a presiding officer and an assistant presiding officer].

(1) The chair [presiding officer] serves until December 31 [31st] of each odd-numbered year. The vice chair [assistant presiding officer] serves until December 31 [31st] of each even-numbered year.

(2) A member may serve up to two consecutive terms as chair or vice chair.

[(2) The presiding officer and the assistant presiding officer remain in their positions until the committee selects a successor; however, the individual may not remain in office past the individual's membership term.]

(3) A member is not eligible to serve in the role of chair or vice chair once another person has been appointed to fill the member's position on the VBPQIAC.

(h) Required Training. Each member must complete training on relevant statutes and rules, including this section, §351.801 of this division, Texas Government Code §531.012, Texas Government Code Chapters 551, 552, and 2110, the HHS Ethics Policy, and other relevant HHS policies. Training will be provided by HHSC.

(i) Travel Reimbursement. Unless permitted by the current General Appropriations Act, members of the VBPQIAC are not paid to participate in the VBPQIAC nor reimbursed for travel to and from meetings.

(j) Date of abolition. The VBPQIAC is abolished and this section expires on December 31, 2027.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 29, 2023.

TRD-202302358

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: August 13, 2023

For further information, please call: (512) 438-3214

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §351.823, concerning the e-Health Advisory Committee.

BACKGROUND AND PURPOSE

The e-Health Advisory Committee (eHAC) was established in 2016 by the HHSC Executive Commissioner, under the authority of Texas Government Code §531.012. This statute requires the HHSC Executive Commissioner to establish and maintain advisory committees; establish rules for the operation of advisory committees; and for advisory committees to provide recommendations to the executive commissioner and the Texas Legislature.

The eHAC advises the HHSC Executive Commissioner and Health and Human Services (HHS) agencies on strategic planning, policy, rules, and services related to the use of health information technology, health information exchange systems, telemedicine, telehealth, and home telemonitoring services. Members meet approximately four times per year in Austin, at the discretion of the eHAC Chair.

In §351.823(i), the eHAC is set for abolition on December 31, 2023. In an eHAC meeting held June 6, 2022, committee members voted to recommend amending the committee rule to extend the eHAC so the committee can continue to advise on issues related to health information technology and exchange systems, as well as teleservices. In response, HHSC proposes to amend §351.823 to extend this committee for two years , from December 31, 2023, to December 31, 2025.

The proposed amendment to §351.823 includes several revisions to ensure the rule meets the HHSC standards for its advisory committee rules.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §351.823 is revised in several places to add "HHSC" in front of "Executive Commissioner" for clarity.

The proposed amendment to §351.823 makes the following changes to ensure the rule conforms with HHSC's standards for its advisory committee rules. The proposed amendment adds a new paragraph (6) in subsection (c), relating to bylaws; amends subsection (f), relating to Membership, subsection (g), relating to Officers, and subsection (h), relating to Required Training; and adds a new subsection (i), relating to travel reimbursement.

The proposed amendment to §351.823(e) adds "as if it were a governmental body" to align the rule with §351.801(c) (relating to Authority and General Provisions) and to ensure the rule conforms with HHSC's standards for advisory committee rules. Additional language is added regarding frequency of meetings and quorum.

The proposed amendment to §351.823(f)(2) replaces "Texas Health Service Regions" with "Public Health Regions" because Texas Health and Safety Code §121.007 authorizes the Department of State Health Services (DSHS) to establish "Public Health Regions." The proposed amendment also removes the website in the rule in the event it might change in the future.

The proposed amendment to §351.823 renumbers subsection (i) as subsection (j) and extends the date of abolition of the eHAC from December 31, 2023, to December 31, 2025.

The proposed amendment to §351.823 includes minor edits to correct a reference in subsection (a) and renumber the rules in subsections (f) and (g).

FISCAL NOTE

Trey Wood, HHSC Chief Financial Officer, has determined that for each year of the first five years that the rule will be in effect, enforcing or administering the rule does not have foreseeable implications relating to costs or revenues of state government because there is no change to state procedures or additional costs, and eHAC members are not reimbursed for any eHAC participation-related expenses.

The rule does not have any fiscal implications to local governments because the rule does not apply to any local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

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

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

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

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

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

(5) the proposed rule will not create a new rule;

(6) the proposed rule will expand an existing rule;

(7) the proposed rule will not change the number of individuals subject to the rule; and

(8) the proposed rule 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 because the proposed amendment applies only to HHSC.

LOCAL EMPLOYMENT IMPACT

The proposed amendment will not affect a local economy.

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 AND COSTS

Stephanie Stephens, State Medicaid Director, has determined that for each year of the first five years the amended rule is in effect, the public benefit will be that the eHAC will continue to advise HHS agencies on strategic planning, policy, rules, and services related to the use of health information technology and exchange systems, telemedicine, telehealth, and home telemonitoring services in the interest of protecting the health, safety, and welfare of the residents of Texas.

Trey Wood has also determined that for the first five years the amended rule is in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rule because the rule applies only to HHSC.

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

Written comments on the proposal may be submitted to the HHSC Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 701 W. 51st Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@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 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 23R018" 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 operation and provision of services by the health and human services agencies, and Texas Government Code §531.012(c)(1), which requires the Executive Commissioner to adopt rules consistent with Texas Government Code Chapter 2110 to govern an advisory committee's report requirements.

The amendment affects Texas Government Code §531.0055 and Texas Government Code §531.012.

§351.823.e-Health Advisory Committee.

(a) Statutory authority. The e-Health Advisory Committee (committee) is established under Texas Government Code §531.012 and is subject to §351.801 of this division [subchapter ] (relating to Authority and General Provisions).

(b) Purpose. The committee advises the Texas Health and Human Services Commission (HHSC) Executive Commissioner and Health and Human Services system agencies (HHS agencies) on strategic planning, policy, rules, and services related to the use of health information technology, health information exchange systems, telemedicine, telehealth, and home telemonitoring services.

(c) Tasks. The committee:

(1) advises HHS agencies on the development, implementation, and long-range plans for health care information technology and health information exchange, including the use of electronic health records, computerized clinical support systems, health information exchange systems for exchanging clinical and other types of health information, and other methods of incorporating health information technology in pursuit of greater cost-effectiveness and better patient outcomes in health care and population health;

(2) advises HHS agencies on incentives for increasing health care provider adoption and usage of an electronic health record and health information exchange systems;

(3) advises HHS agencies on the development, use, and long-range plans for telemedicine, telehealth, and home telemonitoring services, including consultations, reimbursements, and new benefits for inclusion in Medicaid telemedicine, telehealth, and home telemonitoring programs;

(4) makes recommendations to HHS agencies through regularly scheduled meetings and verbal or written recommendations communicated to HHSC [Texas Health and Human Services Commission (HHSC)] staff assigned to the committee; [and]

(5) performs other tasks consistent with its purpose as requested by the Executive Commissioner; and[.]

(6) adopts bylaws to guide the operation of the committee.

(d) Reporting Requirements.

(1) No later than December 1 of each even-numbered year, the committee files a written report with the HHSC Executive Commissioner and the Texas Legislature covering the meetings and activities not covered in its most recent report filed with the HHSC Executive Commissioner and Texas Legislature through September 30 of the even-numbered year the report is due to be filed. The report includes:

(A) a list of the meeting dates;

(B) the members' attendance records;

(C) a brief description of actions taken by the committee;

(D) a description of how the committee accomplished its tasks;

(E) a summary of the status of any rules that the committee recommended to HHSC;

(F) a description of activities the committee anticipates undertaking in the next fiscal year;

(G) recommended amendments to this section;

(H) any policy recommendations; and

(I) the costs related to the committee, including the cost of HHSC staff time spent supporting the committee's activities and the source of funds used to support the committee's activities.

(2) No later than December 1 of each odd-numbered year, the committee submits to the HHSC Executive Commissioner an informational briefing memorandum describing the committee's costs, accomplishments, and areas of focus that covers October 1 of the preceding year through September 30 of the odd-numbered year the informational briefing memorandum is due to be filed.

(e) Meetings.

(1) Open meetings. The committee complies with the requirements for open meetings under Texas Government Code Chapter 551, as if it were a governmental body.

(2) Frequency. The committee will meet at least three times a year at the call of the presiding officer.

(3) Quorum. A majority of members constitutes a quorum.

(f) Membership.

(1) The committee is composed of no more than 24 members appointed by the HHSC Executive Commissioner. In selecting members to serve on the committee, HHSC considers the applicants' qualifications, background, and interest in serving.

(2) [(1)] The committee includes representatives of HHS agencies, other state agencies, and other health and human services stakeholders concerned with the use of health information technology, health information exchange systems, telemedicine, telehealth, and home telemonitoring services. The committee comprises the following voting and non-voting ex officio members[, including]:

(A) Voting members representing the following categories: [at least two non-voting ex officio representatives from HHSC;]

[(B)] [at least one non-voting ex officio representative from the Texas Department of State Health Services;]

(i) [(C)] at least one representative from the Texas Medical Board;

(ii) [(D)] at least one representative from the Texas Board of Nursing;

(iii) [(E)] at least one representative from the Texas State Board of Pharmacy;

(iv) [(F)] at least one representative from the Statewide Health Coordinating Council;

(v) [(G)] at least one representative of a managed care organization;

(vi) [(H)] at least one representative of the pharmaceutical industry;

(vii) [(I)] at least one representative of a health science center in Texas;

(viii) [(J)] at least one expert on telemedicine;

(ix) [(K)] at least one expert on home telemonitoring services;

(x) [(L)] at least one representative of consumers of health services provided through telemedicine;

(xi) [(M)] at least one Medicaid provider or child health plan program provider;

(xii) [(N)] at least one representative from the Texas Health Services Authority established under Texas Health and Safety Code Chapter 182;

(xiii) [(O)] at least one representative of a local or regional health information exchange; and

(xiv) [(P)] at least one representative with expertise related to the implementation of electronic health records, computerized clinical support systems, and health information exchange systems for exchanging clinical and other types of health information.

(B) Non-voting ex officio members representing the following categories:

(i) at least two non-voting ex officio representatives from HHSC; and

(ii) at least one non-voting ex officio representative from the Texas Department of State Health Services.

(3) [(2)] When appointing members, the HHSC Executive Commissioner considers [will consider] the cultural, ethnic, and geographic diversity of Texas, including representation from at least 6 of the 11 Public [Texas] Health [Service] Regions as defined by the Texas Department of State Health Services in accordance with Texas Health and Safety Code §121.007 [(www.dshs.state.tx.us/regions/state.shtm)].

[(3) Except as may be necessary to stagger terms, the term of office of each member is two years. Individuals will normally serve one term. An individual may apply and be appointed for a second two-year term, which may be served consecutively or nonconsecutively.]

(4) [(A)] Members are appointed for staggered terms so that the terms of half of the members expire on December 31st of each year. Regardless of the term limit, a member serves until the member's replacement has been appointed. This ensures sufficient, appropriate representation.

(A) [(B)] If a vacancy occurs, the HHSC Executive Commissioner appoints a person [is appointed ] to serve the unexpired portion of that term.

(B) Except as may be necessary to stagger terms, the term of each member is two years. A member may apply and be appointed for a second two-year term, which may be served consecutively or nonconsecutively.

(C) This section [paragraph] does not apply to non-voting ex officio members, who serve at the pleasure of the HHSC Executive Commissioner.

(g) Officers. The committee selects from its members the presiding officer and an assistant presiding officer.

(1) The presiding officer serves until July 1st of each even-numbered year. The assistant presiding officer serves until July 1 of each odd-numbered year.

(2) A member serves no more than two consecutive terms as presiding officer or assistant presiding officer.

(3) A member whose term has expired is not eligible to serve in the officer role of chair or vice chair once another person has been appointed to fill the member's position on the committee.

(h) Required Training. Each member must [shall ] complete [all] training on relevant statutes and rules, including this section; [and] §351.801 of this subchapter; [and] Texas Government Code §531.012; Texas Government Code[, and] Chapters 551, 552, and 2110; the HHS Ethics Policy, and other relevant HHS policies. Training will be provided by HHSC.

(i) Travel Reimbursement. Unless permitted by the current General Appropriations Act, members of the committee are not paid to participate in the committee nor reimbursed for travel to and from meetings.

(j) [(i)] Date of abolition. The committee is abolished[,] and this section expires[,] on December 31, 2025 [2023].

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on July 29, 2023.

TRD-202302357

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: August 13, 2023

For further information, please call: (512) 239-8300