PART 1. HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 555. NURSING FACILITY ADMINISTRATORS
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Title 26, Part 1, Chapter 555, Nursing Facility Administrators, amendments to §555.2, concerning Definitions, §555.11, concerning Application Requirements, §555.12, concerning Licensure Requirements, §555.13, concerning Internship Requirements, §555.18, concerning Examinations and Requirements to Take the Examinations, §555.32, concerning Provisional License, and §555.35, concerning Continuing Education Requirements for License Renewal.
BACKGROUND AND PURPOSE
The purpose of the proposal is to clarify requirements and provide additional options to qualify for nursing facility administrator (NFA) licensure. The proposal updates definitions and associated references for consistency with changes made by the National Association of Long Term Care Administrator Boards (NAB), regarding both educational domains for testing and the company conducting the NAB examination. The proposal also adds an additional option for persons to qualify for licensure, and a greater degree of flexibility for the administrator-in-training (AIT) internship. Other non-substantive changes are for clarification.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §555.2 revises definitions for NFA rules. Paragraph (8) updates the names and number of educational domains used by the NAB. Paragraph (12) clarifies that HHSC is responsible for NFA licensure in Texas. Paragraph (23) clarifies that NAB is the national authority on NFA licensure, credentialing, and regulation. Paragraph (28) removes extraneous language from the definition of the NFA advisory committee. Paragraph (30) removes the "professional examination services (PES)" name of the company that administers the NAB licensure exam and renumbers the paragraphs accordingly. Paragraph (35) revises the Texas Administrative Code citation for substandard quality of care.
The proposed amendment to §555.11 revises the requirements for an NFA licensure application. Subsection (a)(5) reduces the number of academic credits required for NFA candidates who hold a transcript with coursework in the updated NAB domains that is not reflected by the baccalaureate degree. Subsections (b) and (c) have non-substantive edits to update rule citations.
The proposed amendment to §555.12 provides additional options for licensure requirements. Subsection (a)(1)(A) reduces the number of academic credits in long-term care administration required for candidates who hold a baccalaureate degree that includes coursework in the updated NAB domains. Subsection (a)(2) updates the NAB domains referenced for applicants holding a baccalaureate degree in health administration, health services administration, health care administration, or nursing. Subsection (a)(3) provides an additional option for persons to qualify for NFA licensure: holding a baccalaureate degree with coursework in the NAB domains and one year of experience as assistant administration of record or administrator of record at a facility in another state. Subsection (a)(4) and (5) have non-substantive renumbering edits. Subsection (a)(6) describes an option for application for candidates with a license issued by another state.
The proposed amendment to §555.13 provides more flexibility for the AIT internship. Subsection (a)(2) removes the requirement for the internship to be completed in a facility with a minimum of 60 beds and instead allows the internship to be completed in a facility of any size. Subsection (a)(6) and (7) have non-substantive renumbering edits. Subsection (a)(8) requires the internship to be completed at the same facility at which the AIT's preceptor serves as NFA. Subsection (b)(2) updates the referenced rule.
The proposed amendment to §555.18 makes a minor editorial change, replacing the word "on-line" with "online" and removes a reference to the name of the company that administers the NAB examination.
The proposed amendment to §555.32 clarifies requirements for provisional NFA licenses. Subsection (a)(4)(A) removes equivocal language around "substantially similar" licensing requirements in other states. Subsection (e) stipulates that if internship hours in another state do not meet requirements in §555.13, the provisional licensee must complete the required internship hours under the supervision of an HHSC-licensed preceptor.
The proposed amendment to §555.35 makes non-substantive edits to clarify requirements for continuing education for license renewal. Subsection (a)(2) revises the number of NAB domains from five to four, which aligns with NAB consolidation of the domains. Subsection (a)(4) makes non-substantive edits to clarify that at least six hours of continuing education in ethics is required. Subsection (c) replaces "three-semester hour" with "three-semester-hour" in reference to a course requirement.
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 not create a new rule;
(6) the proposed rules will not expand, limit, or repeal an existing rule;
(7) the proposed rules will not change the number of individuals subject to the rule; 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 or micro-businesses, or rural communities.
A nursing facility is not a small business or micro-business but may be located in a rural community. The proposed rules are not expected to have an adverse economic effect on small businesses, micro-businesses, or rural communities because there are no requirements to alter current business practices, and there are no new fees or costs imposed on those required to comply.
LOCAL EMPLOYMENT IMPACT
The proposed rules will not affect a local economy.
COST TO REGULATED PERSONS
Texas Government Code §2001.0045 does not apply to these rules because the rules are necessary to protect the health, safety, and welfare of the residents of Texas, and do not impose a cost on regulated persons.
PUBLIC BENEFIT AND COSTS
Stephen Pahl, Deputy Executive Commissioner for Regulatory Services, has determined that for each year of the first five years the rules are in effect, the public will benefit from having current information from and regarding the national authority on NFAs, clarified requirements regarding NFA licensure, and a greater degree of flexibility should a person choose to enter the profession.
Trey Wood has also determined that for the first five years the rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules because any costs incurred by current or prospective NFAs under the proposed rules will be costs that would otherwise be incurred through the current NFA licensure process.
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 Caroline Sunshine, Policy Specialist, by email to HHSCLTCRRules@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 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 22R103" in the subject line.
SUBCHAPTER A. GENERAL INFORMATION
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; 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; Texas Human Resources Code §32.021, which provides that HHSC shall adopt necessary rules for the proper and efficient operation of the Medicaid program; and Texas Health and Safety Code §242.302, which grants HHSC the general authority to establish rules consistent with that subchapter, and directs HHSC to establish qualifications of applicants for licenses and renewal of licenses issued under that subchapter, as well as reasonable and necessary administration and implementation fees, and continuing education hours required to renew a license under that subchapter.
The amendment gives effect to Texas Government Code §531.0055 and §531.021; Texas Human Resources Code §32.021; and Texas Health and Safety Code §242.302.
§555.2.Definitions.
The words and terms in this chapter have the following meanings, unless the context clearly indicates otherwise:
(1) Abuse--Negligent or willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical or emotional harm or pain to a resident; or sexual abuse, including involuntary or nonconsensual sexual conduct that would constitute an offense under Texas Penal Code §21.08 (relating to Indecent Exposure) or Texas Penal Code Chapter 22 (relating to Assaultive Offenses), sexual harassment, sexual coercion, or sexual assault.
(2) Active duty--Current full-time military service in the armed forces of the United States or as a member of the Texas military forces, as defined in Texas Government Code §437.001, or similar military service of another state.
(3) Administrator-in-training (AIT)--[]A person undergoing an internship under a HHSC-approved certified preceptor.
(4) Administrator of Record--The individual who is listed as the facility's licensed nursing facility administrator with the HHSC Licensing and Credentialing Section.
(5) Applicant--A person applying for a Texas nursing facility administrator (NFA) license.
(6) Armed forces of the United States--The Army, Navy, Air Force, Coast Guard, Space Force, or Marine Corps of the United States, including reserve units of those military branches.
(7) Complaint--An allegation that an NFA violated one or more of the licensure rules or statutory requirements.
(8) Domains of the National Association of Long Term
Care Administrator Boards (NAB)--The four [five]
categories for education and continuing education of the NAB, which
are care, services, and supports; operations; environment and
quality; and leadership and strategy. [resident care and
quality of life; human resources; finance; physical environment and
atmosphere; and leadership and management.]
(9) Formal hearing--A hearing held by the State Office of Administrative Hearings to adjudicate a sanction taken by HHSC against an NFA.
(10) Good standing--In Texas an NFA is in good standing if the NFA is in compliance with the rules in this chapter and, if applicable, the terms of any sanction imposed by HHSC. An NFA licensed or registered in another state is in good standing if the NFA is in compliance with the NFA licensing or registration rules in the other state and, if applicable, the terms of any sanction imposed by the other state.
(11) Health services executive (HSE)--An individual
who has entry-level competencies in [of] a nursing
facility, assisted living community, or home and community-based service
provider in this state [jurisdiction] or another state [jurisdiction]. The HSE has met NAB's minimum
standards for qualification as an HSE.
(12) HHSC--The Texas Health and Human Services Commission. HHSC is responsible for NFA licensure in Texas.
(13) Internship--The training period in a nursing facility for an AIT. When HHSC accepts internship hours completed in another state, the hours must be completed in a facility that qualifies as a nursing facility or nursing home under the laws of the other state.
(14) License--An NFA license or provisional license.
(15) Licensee--A person licensed by HHSC as an NFA.
(16) Long-term Care Regulation--The department of HHSC responsible for long-term care regulation, including determining nursing facility compliance with licensure and certification requirements and the regulation of NFAs.
(17) Management experience--Full-time employment as a department head, assistant nursing facility administrator, or licensed professional supervising two or more employees in a nursing facility, including a nursing facility outside of Texas, or skilled nursing hospital unit.
(18) Military service member--A person who is on active duty.
(19) Military spouse--A person who is married to a military service member.
(20) Military veteran--A person who has served on active duty and who was discharged or released from active duty.
(21) Misappropriation of resident property--Taking, secretion, misapplication, deprivation, transfer, or attempted transfer to any person not entitled to receive any property, real or personal, or anything of value belonging to or under the legal control of a resident without the effective consent of the resident or other appropriate legal authority, or the taking of any action contrary to any duty imposed by federal or state law prescribing conduct relating to the custody or disposition of property of a resident.
(22) NAB examination--The national examination developed by NAB that applicants must pass in combination with the state licensure examination to be issued a license to practice nursing facility administration in Texas. The NAB examination consists of two modules: Core of Knowledge and Line of Service.
(23) National Association of Long Term Care Administrator
Boards (NAB)--The national authority on licensing, credentialing,
and regulating administration of organizations along the continuum
of long-term care. NAB sets the national standards and evaluation
requirements for NFAs. [State boards or agencies responsible
for the licensure of NFAs.]
(24) National Continuing Education Review Service (NCERS)--The part of NAB that approves and monitors continuing education activities for NFAs.
(25) Neglect--Failure to provide goods or services, including medical services, that are necessary to avoid physical or emotional harm, pain, or mental illness.
(26) Nursing facility--A facility licensed in accordance with THSC Chapter 242.
(27) Nursing Facility Administrator (NFA)--An individual licensed by HHSC to engage in the practice of nursing facility administration, regardless of whether the individual has an ownership interest in the facility.
(28) Nursing Facility Administrators Advisory Committee
(NFAAC)--The advisory committee established by THSC §242.303
[(the text of Subchapter I is effective until federal determination
of failure to comply with federal regulations)].
(29) Preceptor--An NFA certified by HHSC to provide supervision to an AIT.
[(30) Professional examination services
(PES)--The testing agency that administers the NAB and state examinations
to applicants seeking licensure as an NFA.]
(30) [(31)] Referral--A recommendation
made by Long-term Care Regulation staff to investigate an NFA's compliance
with licensure requirements when deficiencies or substandard quality
of care deficiencies are found in a nursing facility, as required
by Title 42 Code of Federal Regulations §488.325.
(31) [(32)] Sanctions--An adverse
licensure action against an NFA. In Texas, a sanction is one of the
actions listed in §555.57 of this chapter (relating to Schedule
of Sanctions).
(32) [(33)] Self-study course--A
NAB-approved education course that an individual pursues independently
to meet continuing education requirements for license renewal.
(33) [(34)] State examination--The
state licensure examination that applicants must pass, in combination
with the NAB examination, to be issued a license to practice nursing
facility administration in Texas.
(34) [(35)] Substandard quality
of care--For a Medicare- or Medicaid-certified facility, this term
has the meaning given in Title 42 Code of Federal Regulations §488.301.
For a licensed-only facility, this term has the meaning given in §554.101
of this title (relating to Definitions). [Texas Administrative
Code, Title 26, Part 1, §554.101(139).]
(35) [(36)] THSC--Texas Health and Safety Code.
(36) [(37)] Traditional business
hours--Monday through Friday from 8:00 a.m. until 5:00 p.m.
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 August 28, 2023.
TRD-202303170
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3161
26 TAC §§555.11 - 555.13, 555.18
STATUTORY AUTHORITY
The amendments are 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; 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; Texas Human Resources Code §32.021, which provides that HHSC shall adopt necessary rules for the proper and efficient operation of the Medicaid program; and Texas Health and Safety Code §242.302, which grants HHSC the general authority to establish rules consistent with that subchapter, and directs HHSC to establish qualifications of applicants for licenses and renewal of licenses issued under that subchapter, as well as reasonable and necessary administration and implementation fees, and continuing education hours required to renew a license under that subchapter.
The amendments give effect to Texas Government Code §531.0055 and §531.021; Texas Human Resources Code §32.021; and Texas Health and Safety Code §242.302.
§555.11.Application Requirements.
(a) Except as provided in subsections (b) and (c) of this section, an applicant seeking licensure must submit to the Texas Health and Human Services Commission (HHSC):
(1) a complete Nursing Facility Administrator's Application for Licensure form;
(2) the application fee;
(3) fingerprints for a Texas Department of Public Safety criminal background check;
(4) an official transcript reflecting a baccalaureate degree from a college or university accredited by an agency recognized by the Texas Higher Education Coordinating Board;
(5) if not a part of the transcript reflecting a baccalaureate
degree, another transcript reflecting 12 [15]
semester credit hours in long-term care administration, or its equivalent,
that include the four [five] domains of the
National Association of Long Term Care Administrator Boards; and
(6) proof of completing the minimum applicable internship that meets the internship requirements in §555.13 of this subchapter (relating to Internship Requirements).
(b) If an applicant has a health services executive
(HSE) qualification and is applying for a license under §555.12(a)(5)
[§555.12(a)(4)] of this subchapter (relating
to Licensure Requirements), the applicant must submit:
(1) a complete Nursing Facility Administrator's Application for Licensure form;
(2) the application fee;
(3) proof of the HSE qualification;
(4) fingerprints for a Texas Department of Public Safety criminal background check; and
(5) certification [proof] that
the applicant has not had a license revoked in any state.
(c) If an applicant has an NFA license issued by another
state and is applying for a license under §555.12(a)(6) [§555.12(a)(5)] of this subchapter, the applicant must
submit:
(1) a complete Reciprocity Licensure Questionnaire;
(2) the application fee;
(3) fingerprints for a Texas Department of Public Safety criminal background check; and
(4) proof of a license in good standing in another state.
(d) An application is valid for one year from the date the application fee is received.
(e) An applicant who does not meet the requirements for licensure within one year after HHSC receives the application must reapply for licensure as provided in this section.
(f) HHSC is not responsible for applications, forms, notices, and correspondence unless they are received by HHSC.
(g) HHSC is not responsible for mail it sends to a licensee or applicant if the licensee's or applicant's current address was not reported in writing to HHSC.
§555.12.Licensure Requirements.
(a) An applicant must meet one of the following groups of requirements to obtain a license as a nursing facility administrator (NFA).
(1) An applicant has a baccalaureate degree in any subject from a college or university accredited by an agency recognized by the Texas Higher Education Coordinating Board; and
(A) a minimum of 12 [15] semester
credit hours in long-term care administration, or its equivalent,
that includes courses in the four [five] domains
of the National Association of Long Term Care Administrator Boards (NAB);
(B) completed a 1,000-hour internship that meets the requirements in §555.13 of this subchapter (relating to Internship Requirements); and
(C) passed the state and NAB examinations described in §555.18 of this subchapter (relating to Examinations and Requirements to Take the Examinations).
(2) An applicant has a baccalaureate degree in health
administration, health services administration, health care administration,
or nursing that includes coursework encompassing the four [five] domains of the NAB; and
(A) three years of management experience;
(B) completed a 500-hour internship that meets the requirements in §555.13 of this subchapter; and
(C) passed the state and NAB examinations described in §555.18 of this subchapter.
(3) An applicant has a baccalaureate degree with coursework in the four domains of NAB and one year of experience as assistant administrator of record or administrator of record in another state; and
(A) completed a 500-hour internship that meets the requirements in §555.13 of this subchapter; and
(B) passed the state and NAB examinations described in §555.18 of this subchapter.
(4) [(3)] An applicant has a
master's degree in health administration, health services administration,
health care administration, or nursing that includes coursework encompassing
the four [five] domains of the NAB; and
(A) one year of management experience;
(B) completed a 500-hour internship that meets the requirements in §555.13; and
(C) passed the state and NAB examinations described in §555.18 of this subchapter.
(5) [(4)] An applicant has a
health services executive qualification; and
(A) has not had a license revoked in any state; and
(B) passed the state examination described in §555.18 of this subchapter.
(6) [(5)] An applicant has a
license issued by a state other than Texas and meets the requirements
for licensure in paragraphs (1), (2), (3), or (4) [(1),
(2), or (3)] of this subsection.
(b) HHSC accepts foreign university degrees and coursework that is counted as transfer credit by accredited universities recognized by the American Association of Collegiate Registrars and Admissions officers.
§555.13.Internship Requirements.
(a) Except as provided in subsection (b) or (c) of this section, an applicant must complete an internship that meets the following requirements.
(1) Before an applicant starts the internship, the applicant and the applicant's preceptor must complete a Texas Health and Human Services (HHSC) internship application.
(2) The internship must be in a nursing facility [that
has a minimum of 60 beds, unless HHSC grants an exception to the minimum
bed requirement. HHSC may consider an exception to the 60-bed requirement
on a case-by-case basis. To be considered, the facility with fewer
than 60 beds must be located in a rural area and more than 50 miles
away from a 60-bed facility. An applicant must submit to HHSC a written
request to complete an internship in a facility with fewer than 60
beds. HHSC will notify the applicant of the status of the applicant's request].
(3) A minimum of half of the internship hours must be during traditional business hours.
(4) The administrator-in-training (AIT) can train no more than 40 hours a week.
(5) If the internship is completed with a nursing facility administrator (NFA) not associated with a university as the preceptor, the AIT must complete a preceptor performance report. Additionally, the preceptor must complete an AIT final report.
(6) An AIT must complete an HHSC course in Infection Control and Personal Protective Equipment.
(7) [(6)] If the internship is
completed with an NFA associated with a university accredited by an
agency recognized by the Texas Higher Education Coordinating Board
as the preceptor, the AIT must submit an official transcript to HHSC.
(8) The internship must be completed at the same facility at which the AIT's preceptor serves as NFA.
(b) HHSC may accept an internship completed in another state if:
(1) the internship is part of a National Association of Long Term Care Administrator Boards-accredited program; or
(2) the internship is approved by the other state and
a minimum of 1,000 hours or a minimum of 500 hours if the requirements
listed in §555.12(a)(2), (3), or (4) [§555.12(a)(2)
or (3)] of this subchapter (relating to Licensure Requirements)
are met. An applicant who has completed fewer than 1,000 hours of
internship in another state that does not qualify for a 500-hour internship must [may] complete the remaining hours under a preceptor.
(c) As a substitute to meeting the internship requirements described in subsection (a) or (b) of this section, an applicant may submit to HHSC proof of a health services executive (HSE) qualification and certify that the applicant has not had a license or HSE qualification revoked in any state.
(d) The AIT must submit proof of completion of the internship or completion of HSE. HHSC will review the proof of completion and notify the applicant of the status of the applicant's request.
§555.18.Examinations and Requirements to Take the Examinations.
(a) Except as provided in subsection (b) of this section, an applicant seeking a license as a nursing facility administrator (NFA) from the Texas Health and Human Services Commission (HHSC) must pass the following examinations:
(1) the state examination on nursing facility requirements in Texas; and
(2) the NAB examinations.
(b) An applicant who meets the academic and internship requirements by presenting evidence of a health services executive (HSE) qualification must pass the state examination.
(c) An applicant registers for examination at the designated NAB website by:
(1) submitting an application for approval to take the examination; and
(2) paying the applicable state examination and NAB
examination fees online [on-line].
(d) HHSC sends an e-mail notifying an applicant of the applicant's eligibility to take the examinations.
(e) An applicant must not take any examination without HHSC approval.
(f) An applicant with a disability, including an applicant with dyslexia as defined in Texas Education Code §51.970 (relating to Instructional Material for Blind and Visually Impaired Students and Students with Dyslexia), may request a reasonable accommodation for the examination under the Americans with Disabilities Act.
(g) An applicant completes the online [on-line
] state and NAB examinations [at professional examination services].
(h) HHSC notifies an applicant of examination scores after receiving examination results.
(i) An applicant who fails an examination and wants to retake it must pay the appropriate state or NAB examination fee for each exam.
(j) An applicant who fails the state or NAB examination three consecutive times must complete an additional 1,000-hour administrator-in-training internship before retaking the examination.
(k) An applicant previously licensed as an NFA and whose license expired 365 or more days before the applicant reapplies for a license or who voluntarily surrendered the license must retake the state examination to obtain a new license.
(l) An applicant previously licensed as an NFA and whose license expired 365 or more days before the applicant reapplies for a license, or who voluntarily surrendered the license, must retake the NAB examination to obtain a new license if more than five years have passed since the applicant passed the NAB examination.
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 August 28, 2023.
TRD-202303171
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3161
STATUTORY AUTHORITY
The amendments are 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; 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; Texas Human Resources Code §32.021, which provides that HHSC shall adopt necessary rules for the proper and efficient operation of the Medicaid program; and Texas Health and Safety Code §242.302, which grants HHSC the general authority to establish rules consistent with that subchapter, and directs HHSC to establish qualifications of applicants for licenses and renewal of licenses issued under that subchapter, as well as reasonable and necessary administration and implementation fees, and continuing education hours required to renew a license under that subchapter.
The amendments give effect to Texas Government Code §531.0055 and §531.021; Texas Human Resources Code §32.021; and Texas Health and Safety Code §242.302.
§555.32.Provisional License.
(a) The Texas Health and Human Services Commission (HHSC) issues a provisional license to an applicant currently licensed or registered as a nursing facility administrator (NFA) in another state who submits the following to HHSC:
(1) complete and notarized Provisional Licensure Questionnaire and Nursing Facility Administrator License Application forms;
(2) the application fee;
(3) the provisional license fee; and
(4) proof of the following:
(A) a license and good standing status in another state
[with licensing requirements substantially equivalent to the
Texas licensure requirements];
(B) employment for at least one year as an administrator of record of a nursing facility in applicant's state;
(C) a passing score on the National Association of Long Term Care Administrator Boards examination and the state examination; and
(D) sponsorship by an NFA licensed by HHSC and who is in good standing, unless HHSC waives sponsorship based on a demonstrated hardship.
(b) A provisional license expires 180 days from the date of issue.
(c) HHSC issues an initial license certificate to a provisional license holder who satisfies the requirements for a license in §555.12 of this chapter (relating to Licensure Requirements) and §555.31 of this subchapter (relating to Initial license).
(d) HHSC may determine that a criminal conviction or sanction taken in another state is a basis for pending or denying a provisional license.
(e) If the internship hours completed in another state do not meet the requirements in §555.13 of this chapter (relating to Internship Requirements), then a provisional licensee must complete the required internship hours under the supervision of an HHSC-certified preceptor as described in §555.12 of this chapter.
§555.35.Continuing Education Requirements for License Renewal.
(a) The 40 hours of continuing education required for license renewal must:
(1) be completed during the previous two-year licensure period;
(2) include one or more of the four [five]
domains of the National Association of Long Term Care Administrator
Boards (NAB);
(3) include a Texas Health and Human Services Commission (HHSC) course in Infection Control and personal protective equipment;
(4) include at least six hours of continuing education in ethics; and
(5) be:
(A) approved by the National Continuing Education Review Service;
(B) a HHSC-sponsored event; or
(C) an upper-division semester credit course taken or taught at a post-secondary institution of higher education accredited by an agency recognized by the Texas Higher Education Coordinating Board.
(b) HHSC accepts NAB-approved self-study courses toward the required 40 hours of continuing education.
(c) HHSC waives, at a maximum, 20 of the 40 hours of
continuing education required of a licensee who completes one three-semester-hour
[three-semester hour] upper-division course taken
at a post-secondary institution of higher education.
(d) HHSC approves continuing education credit hours for the same course, seminar, workshop, or program only once per license renewal period.
(e) HHSC may perform an audit of continuing education courses, seminars, or workshops that the licensee has reported by requesting certificates of attendance.
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 August 28, 2023.
TRD-202303172
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3161
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes repeal of §749.2472, amendment to §749.2533; and new §§749.4401, 749.4411, 749.4413, 749.4415, 749.4417, 749.4419, 749.4421, 749.4423, 749.4425, 749.4427, 749.4429, 739.4431, 749.4433, 749.4451, 749.4453, 749.4455 in Title 26, Texas Administrative Code, Chapter 749, Minimum Standards for Child-Placing Agencies.
BACKGROUND AND PURPOSE
The rule changes implement Senate Bill 1896, 87th Legislature, Regular Session, 2021, as it relates to SECTION 21 of the bill.
SECTION 21 amended Texas Human Resources Code (HRC) to add §42.0538, which requires HHSC Child Care Regulation (CCR) to establish standards to allow a Child-Placing Agency (CPA) to issue a provisional foster home verification to a kinship provider who meets basic health and safety requirements identified in CCR rules. This statute cross-references Texas Family Code §264.851 for the definition of "kinship provider." This statute also requires CCR to establish the timeframe by which a foster home with a provisional kinship verification must meet all the requirements for a non-expiring verification. Accordingly, CCR is proposing rules that specify the requirements associated with the provisional verification of a kinship foster home.
SECTION-BY-SECTION SUMMARY
The proposed repeal of §749.2472 deletes the rule as no longer necessary because the content of the rule has been modified and moved to proposed new §749.4455.
The proposed amendment to §749.2533(1) updates the rule title and content to clarify that there are two scenarios in which a CPA may issue a provisional verification; (2) formats the rule into an introduction with two subdivisions; and (3) puts the new requirements for a kinship provider in subdivision (2). The requirements for a kinship provider (A) establish that a CPA may issue a provisional verification to a kinship provider in specific circumstances, and (B) clarify that rules for provisional kinship foster home verifications are located in proposed new Subchapter W, Division 2, Provisional Kinship Foster Home Verification, of this chapter.
Proposed new Subchapter W, Kinship Foster Homes, adds a new subchapter in Chapter 749 for rules related to kinship foster homes.
Proposed new Division 1, Definitions, in proposed new Subchapter W, contains definitions for words and terms used in Subchapter W.
Proposed new §749.4401 provides terms and definitions that are used throughout the subchapter. The rule (1) includes the terms "affinity" and "consanguinity," which are identical to the definitions found in Chapter 745, Licensing, Subchapter A §745.21; and (2) adds definitions for "kinship foster child," "kinship foster home," "kinship foster parent," and "provisional kinship foster home verification".
Proposed new Division 2, Provisional Kinship Foster Home Verification, in proposed new Subchapter W, contains rules relating the requirements for a provisional kinship foster home verification.
Proposed new §749.4411 establishes that a CPA must comply with rules in new proposed Subchapter W, Kinship Foster Homes, Division 2, Provisional Kinship Foster Home Verification (1) before issuing a provisional kinship foster home verification; and (2) while a provisional kinship foster home verification is in effect.
Proposed new §749.4413 requires a CPA to comply with all other rules in Chapter 749, Minimum Standards for Child-Placing Agencies, unless (1) the CPA waives a requirement as provided by a rule in proposed new Division 2, Provisional Kinship Foster Home Verification; or (2) a rule in Division 2, Provisional Kinship Foster Home Verification, replaces another rule in Chapter 749.
Proposed new §749.4415 establishes which orientation training requirements a CPA may waive for a provisional kinship foster home while a provisional kinship foster home verification is in effect. The rule allows a CPA to waive the orientation topic in §749.831(a)(3), which requires a prospective foster parent to receive training on the needs and characteristics of children in the home.
Proposed new §749.4417 establishes when a prospective kinship foster parent is exempt from pre-service experience requirements. The rule (1) exempts a prospective kinship foster parent from completing pre-service experience in §749.861(b) of Chapter 749 if the kinship foster child was living in the home when the prospective kinship foster home applied with the CPA; and (2) if a prospective foster parent does not meet the pre-service exemption criteria in proposed new §749.4417(a) and must complete pre-service experience, allows a CPA to limit the prescribed regime of child-care experience in §749.861(b) to observations and interactions with the kinship foster child in the prospective kinship foster parent's home or the child's current placement.
Proposed new §749.4419 establishes the timeframes within which a caregiver in a provisional kinship foster home must complete the pre-service training requirements required by §749.863. The rule requires a caregiver to complete (1) general pre-service training required in (a)(1) in Figure: 26 TAC §749.863(a) before the CPA issues a non-expiring foster home verification unless the CPA waives the requirement according to §749.868, which is a waiver option available to all foster homes; (2) normalcy training required in (a)(2) in Figure: 26 TAC §749.863(a) before the CPA issues a non-expiring foster home verification unless the agency waives the requirement according to §749.868, which is a waiver option available to all foster homes; (3) emergency behavior intervention (EBI) training required under (a)(3) in Figure: 26 TAC §749.863(a) before the CPA issues a non-expiring foster home verification if the CPA does not allow for the use of EBI unless (A) the caregiver is exempt because the caregiver cares exclusively for children receiving treatment services for primary medical needs, or (B) the CPA waives the training requirement according to §749.868; (4) EBI training according to the timeframes in (a)(4)(C) in Figure: 26 TAC §749.863(a) if the CPA allows for use of EBI unless (A) the caregiver is exempt because the caregiver cares exclusively for children receiving primary medical needs, or (B) the CPA waives the requirement according to §749.868, which is a waiver option available to all foster homes; (5) safe sleeping training required in (a)(5) in Figure: 26 TAC §749.863(a) according to timeframes in (a)(5)(C) in Figure: 26 TAC §749.863(a) if the kinship foster home will care for children younger than two years of age, which is consistent with the requirement for all foster homes; and (6) administration of psychotropic medication training required in (a)(3) in Figure: 26 TAC §749.863(a) before the caregiver administers psychotropic medication, which is consistent with the requirements for all foster homes.
Proposed new §749.4421 outlines the foster home screening requirements a CPA must complete before issuing a provisional kinship foster home verification. The rule requires a CPA to (1) meet the home screening requirements in Subchapter M, Foster Home: Screenings and Verifications, Division 2, Foster Home Screenings if the kinship foster child was not living in the home of the prospective kinship foster home on the date the kinship foster parent applied with the CPA; or (2) request a copy of the kinship home assessment completed by the Texas Department of Family and Protective Services (DFPS) or Single Source Continuum Contractor (SSCC) within 30 days after the date the home applied with the agency if the kinship foster child was living in the kinship foster home on the date the prospective kinship foster home applied with the CPA. The rule provides specific actions a CPA must complete before issuing a provisional foster home verification, depending on whether DFPS or SSCC provides the CPA with a kinship home assessment. The rule also provides that CPA management staff must review and approve the home screening or home screening addendum.
Proposed new §749.4423 outlines the information a CPA must obtain and document from a DFPS kinship development worker or SSCC equivalent for a foster home screening or an addendum to the kinship home assessment for a provisional kinship foster home verification. The rule requires the CPA to (1) gather and document, if a kinship development worker or SSCC equivalent is assigned to the home, if applicable, (A) any identified concerns impacting the health or safety of children and the steps taken to mitigate the concerns, (B) kinship home assessment evaluations completed for caregivers in the home, and (C) kinship development plans (KDP) put in place, the reason for the plan, and the outcome of the plan; and (2) create and document the CPA's plan to address and mitigate any concerns identified in the KDP. If the CPA is unable to obtain this information, the rule requires the CPA to (1) document diligent efforts to contact the DFPS kinship development worker or SSCC equivalent if the attempts to contact the DFPS kinship development worker or SSCC equivalent are unsuccessful; or (2) document if there is not a DFPS kinship development worker or SSCC equivalent assigned to the home.
Proposed new §749.4425 outlines the foster home verification requirements a CPA must meet before issuing a provisional kinship foster home verification. The rule (1) only allows a CPA to issue a provisional kinship foster home verification to a kinship foster home that provides, or will provide, care to kinship foster children in the conservatorship of DFPS; (2) allows a CPA to issue the provisional kinship foster home verification after the CPA (A) completes requirements in §749.2470(a)(3) - (6) and proposed new §749.4421, (B) complies with requirements in proposed new §749.4423, (C) documents and addresses with the kinship foster family any indicators of potential risk to children based on (i) the background information the CPA receives from the DFPS kinship development worker or SSCC equivalent and (ii) any screening and evaluation information the CPA has conducted; (D) the CPA's child placement management staff reviews and approves the provisional kinship foster home verification by dating and signing it; and (E) issues a verification certificate that includes the (i) total capacity of the kinship foster home, including any adopted children of the caregivers who live in the kinship foster home and any children for whom the family provides day care, (ii) kinship foster home's foster care capacity, (iii) names and ages of the kinship foster children for which the kinship foster home is verified to provide foster care, (iv) types of services the kinship home will provide, (v) CPA's main office or branch office issuing the provisional kinship foster home verification, and (vi) expiration date of the provisional kinship foster home verification. The rule also clarifies that a CPA may issue a provisional kinship foster home verification before kinship foster parents complete pre-service training in accordance with proposed new §749.4419.
Proposed new §749.4427 establishes the length of time for which a CPA may issue a provisional kinship foster home verification as a maximum six months from the date it is issued. The rule also (1) states that a provisional kinship foster home verification may not be renewed; and (2) clarifies that a provisional kinship foster home verification expires when a CPA issues a non-expiring foster home verification or closes the home.
Proposed new §749.4429 outlines the requirements a CPA must follow if a provisional kinship foster home will not meet the requirements for a non-expiring foster home verification before the provisional kinship foster home verification expires. The rule requires the CPA to (1) notify the parent as soon as the agency becomes aware that the home will not meet the requirements for a non-expiring verification; (2) close the kinship foster home by the date the provisional kinship foster home verification expires; and (3) complete a home closure summary as required by §749.2497.
Proposed new §739.4431 outlines the types of placements a CPA can make in a kinship foster home with a provisional kinship foster home verification. The rule (1) limits placements to kinship children; and (2) requires that if a CPA places additional kinship foster children in the kinship foster home while a provisional kinship foster home verification is in effect, the CPA must, by the date the agency places additional kinship children in the home, (A) determine and document in the home's record that the home is capable of providing care for the additional kinship foster children in accordance with rules in Chapter 749, (B) update the kinship foster home's provisional verification certificate to comply with requirements in §749.4425(b)(6), and (C) notify CCR of the change in verification as required by §749.2489. The rule also requires a CPA to, within 30 days after placing a kinship foster child in the home, (1) review and update with an addendum, if necessary, the foster home screening or the addendum to the kinship foster home assessment that was completed in accordance with §749.4421; and (2) ensure the kinship foster home meets all applicable requirements in Chapter 749. The rule further clarifies that placement of an additional kinship foster child in a kinship foster home with a provisional kinship foster home verification does not change the expiration date of the provisional verification.
Proposed new §749.4433 prohibits a CPA from using a kinship foster home with a provisional kinship foster home verification for respite care.
Proposed new Division 3, Non-Expiring Kinship Foster Home Verification, in proposed new Subchapter W, contains rules relating to requirements for issuing a non-expiring foster home verification to a kinship foster home.
Proposed new §749.4451 clarifies that a CPA may issue a kinship foster home a non-expiring foster home verification without having first issued a provisional kinship foster home verification.
Proposed new §749.4453 outlines the steps a CPA must take before issuing a non-expiring foster home verification to a kinship foster home with a provisional foster home verification. The rule requires a CPA to (1) ensure each caregiver is in compliance with all orientation, pre-service experience, and pre-service training requirements in Subchapter F; (2) meet all foster home verification requirements in §749.2470; and (3) notify CCR of the change in verification, as required in §749.2489.
Proposed new §749.4455 incorporates the content of proposed repealed §749.2472, relating to the requirement for a CPA to obtain a copy of the kinship home assessment completed by DFPS or SSCC, with updates to wording to clarify the rule applies if the CPA did not first issue a provisional kinship foster home verification.
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 new rules;
(6) the proposed rules will repeal and expand existing rules;
(7) the proposed rules will 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 because 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; and (3) are necessary to implement legislation that does not specifically state that §2001.0045 applies to the rules.
PUBLIC BENEFIT AND COSTS
Rachel Ashworth-Mazerolle, 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) greater flexibility for a CPA to verify a kinship foster home so that the CPA can provide the kinship foster home and children with additional support as the home works towards becoming fully verified; and (2) rules that comply with state law.
Trey Wood has also determined that for the first five years the rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules because there is no cost to comply with the proposed rules.
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 Aimee Belden by email at Aimee.Belden@hhs.texas.gov.
Written comments on the proposal may be submitted to Aimee Belden, Rules Writer, Child Care Regulation, Texas 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 22R116" in the subject line.
SUBCHAPTER M. FOSTER HOMES: SCREENINGS AND VERIFICATIONS
DIVISION 3. VERIFICATION OF FOSTER HOME
STATUTORY AUTHORITY
The repeal 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 §531.02011, which transferred the regulatory functions of the Texas Department of Family and Protective Services to HHSC. In addition, Texas Human Resources Code §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code, Chapter 42.
The repeal affects Texas Government Code §531.0055 and Texas Human Resources Code §42.042.
§749.2472.Are there any additional requirements to verify a foster home that is currently acting as a kinship home with the Child Protective Services (CPS) Division of the Department?
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 August 22, 2023.
TRD-202303087
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3269
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 §531.02011, which transferred the regulatory functions of the Texas Department of Family and Protective Services to HHSC. In addition, Texas Human Resources Code §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code, Chapter 42.
The amendment affects Texas Government Code §531.0055 and Texas Human Resources Code §42.042.
§749.2533.When may I issue [What
is the purpose of] a provisional verification?
You may issue a provisional verification to:
(1) Allow [The purpose of
a provisional verification is to permit] continued care of foster
children in a foster home that is transferring from one child-placing
agency to another, whether in the current residence or a new residence;
or[.]
(2) Allow a kinship provider to care for a kinship foster child in a kinship foster home when the kinship provider meets basic health and safety needs identified in Subchapter W, Division 2 of this chapter (relating to Provisional Kinship Foster Home Verification).
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 August 22, 2023.
TRD-202303088
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3269
DIVISION 1. DEFINITIONS
STATUTORY AUTHORITY
The new rule 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 §531.02011, which transferred the regulatory functions of the Texas Department of Family and Protective Services to HHSC. In addition, Texas Human Resources Code §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code, Chapter 42.
The new rule affects Texas Government Code §531.0055 and Texas Human Resources Code §42.042.
§749.4401.What do certain words mean in this subchapter?
These terms have the following meanings in this subchapter:
(1) Affinity--Related by marriage, as set forth in Texas Government Code §573.024 (relating to Determination of Affinity).
(2) Consanguinity--Two individuals are related to each other by consanguinity if one is a descendant of the other, or they share a common ancestor. An adopted child is related by consanguinity for this purpose. Consanguinity is defined in Texas Government Code §573.022 (relating to Determination of Consanguinity).
(3) Kinship foster child--A child in the care of a kinship foster home who:
(A) Is related to the kinship foster parents by consanguinity or affinity; or
(B) Has a longstanding and significant relationship with the kinship foster parent before living in the kinship foster home.
(4) Kinship foster home--A foster family home that has a kinship foster parent or parents.
(5) Kinship foster parent--A foster parent who:
(A) Is related to a foster child by consanguinity or affinity;
(B) Has a longstanding and significant relationship with the foster child before the child is placed in the kinship foster home; or
(C) Is the spouse of a foster parent who has a longstanding and significant relationship with the foster child before the child is placed in the kinship foster home.
(6) Provisional kinship foster home verification--A temporary foster home verification for a kinship foster home. A kinship foster home must meet certain requirements for a non-expiring foster home verification, as provided in this subchapter.
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 August 22, 2023.
TRD-202303089
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3269
STATUTORY AUTHORITY
The new rules are 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 §531.02011, which transferred the regulatory functions of the Texas Department of Family and Protective Services to HHSC. In addition, Texas Human Resources Code §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code, Chapter 42.
The new rules affect Texas Government Code §531.0055 and Texas Human Resources Code §42.042.
§749.4411.When must I comply with the rules in this division?
You must comply with the rules in this division before issuing a provisional kinship foster home verification and while a provisional kinship foster home verification is in effect.
§749.4413.In addition to rules in this division, what other rules in this chapter must I comply with while a provisional kinship foster home verification is in effect?
You must comply with all other rules in this chapter while a provisional kinship foster home verification is in effect, unless:
(1) You waive a requirement, as provided by in this division; or
(2) A rule in this division replaces another rule in this chapter.
§749.4415.Which orientation requirements may I waive for a kinship foster parent while a provisional kinship foster home verification is in effect?
You may waive the orientation requirement in §749.831(a)(3) of this chapter (relating to What is the orientation requirement for caregivers and employees?).
§749.4417.When is a prospective kinship foster parent exempt from pre-service experience requirements?
(a) A prospective kinship foster parent caring for a child who will receive treatment services is not required to meet the pre-service requirements in §749.861(b) of this chapter (relating to What are the pre-service experience requirements for caregivers?) if the kinship foster child was living in the home on the date the prospective kinship foster home applied to your agency.
(b) If the prospective kinship foster parent does not meet the exemption criteria in subsection (a) of this section, you may limit the regimen of specific child-care experience you prescribe in accordance with §749.861(b) to observations and interactions with the kinship foster child in the prospective kinship foster parent's residence or the child's current placement.
§749.4419.When must a caregiver in a provisional kinship foster home complete pre-service training?
If you issue a provisional kinship foster home verification, a caregiver must complete pre-service training required by §749.863 of this chapter (relating to What are the pre-service training requirements for a caregiver?) as provided in this chart:
Figure: 26 TAC §749.4419 (.pdf)
§749.4421.What are the foster home screening requirements for a provisional kinship foster home verification?
(a) If a kinship foster child was not living in the prospective kinship foster home on the date the prospective kinship foster parent applied with your agency, you must meet the home screening requirements in Subchapter M, Division 2 of this chapter (relating to Foster Home Screenings).
(b) If a kinship foster child was living in the prospective kinship foster home at the time the home applied with your agency, you must:
(1) Request a copy of the kinship home assessment from the Texas Department of Family and Protective Services (DFPS) or Single Source Continuum Contractor (SSCC) within 30 days after the date the home applied with your agency; and
(2) Meet the requirements in the following chart:
Figure: 26 TAC §749.4421(b)(2) (.pdf)
(c) Your child placement management staff must review and approve the home screening or home screening addendum completed in accordance with this section.
§749.4423.What information must I obtain from a Texas Department of Family and Protective Services (DFPS) kinship development worker or Single Source Continuum Contractor (SSCC) equivalent and document in a foster home screening for a provisional kinship foster home verification?
(a) If a DFPS kinship development worker or SSCC equivalent has been assigned to the home, you must contact the worker to obtain and document the following information as part of the home screening or addendum to the kinship home assessment required by §749.4421 of this division (relating to What are the foster home screening requirements for a provisional kinship foster home verification?):
(1) Any identified concerns impacting the health or safety of children and steps taken to mitigate the concerns;
(2) Kinship home assessment evaluations completed for caregivers in the home, if applicable; and
(3) Kinship developmental plans (KDP) put in place, the reason for the plan, and the outcome of the plan, if applicable.
(b) If the DFPS kinship development worker or SSCC equivalent indicates the kinship foster home is subject to a KDP, you must create a plan outlining steps you will take to address and mitigate any concerns identified in the KDP. You must document the plan in the home screening or addendum to the kinship home assessment.
(c) If your attempts to contact the DFPS kinship development worker or SSCC equivalent are unsuccessful, you must document your diligent efforts to make contact as part of home screening or addendum to the kinship home assessment, including the dates and methods by which you attempted contact.
(d) If there is no kinship development worker or SSCC equivalent assigned to the home, you must document this information in the foster home screening or foster home addendum.
§749.4425.What requirements must I meet before I issue a provisional kinship foster home verification?
(a) You may only issue a provisional kinship foster home verification to a kinship foster home that provides, or will provide, care to kinship foster children in the conservatorship of the Texas Department of Family and Protective Services (DFPS).
(b) You may only issue a provisional kinship foster home verification after:
(1) You complete the requirements in §749.2470(a)(3) - (6) of this chapter (relating to What must I do to verify a foster family home?);
(2) You complete the requirements for §749.4421 of this division (relating to What are the foster home screening requirements for a provisional kinship foster home verification?);
(3) You comply with requirements in §749.4423 of this division (relating to What information must I obtain from a Texas Department of Family and Protective Services (DFPS) kinship development worker or Single Source Continuum Contractor (SSCC) equivalent before I issue a provisional kinship foster home verification?);
(4) You document and address with the kinship foster family any indicators of potential risk to children based on:
(A) The background information you receive from the DFPS kinship development worker or SSCC equivalent as required by §749.4421 of this division and §749.4423 of this division, if applicable; and
(B) Any current screening and evaluation of information you have conducted;
(5) Your child placement management staff reviews and approves the provisional kinship verification by signing and dating it; and
(6) You issue a provisional kinship foster home verification certificate that includes:
(A) The total capacity of the kinship foster home, including the biological and adopted children of the caregivers who live in the kinship foster home, and any children for whom the family provides day care;
(B) The kinship foster home's foster care capacity, a subset of the total capacity, which includes only kinship foster children placed for foster care;
(C) The names and ages of kinship foster children for which the kinship foster home is verified to provide foster care;
(D) Types of services the kinship foster home will provide;
(E) The agency's main office or branch office that issued the verification; and
(F) The expiration date of the provisional kinship foster home verification.
(c) You can issue a provisional kinship foster home verification before the kinship foster parents complete pre-service training in accordance with §749.4419 of this division (relating to When must a caregiver in a provisional kinship foster home complete pre-service training?).
§749.4427.For what length of time may I issue a provisional kinship foster home verification?
(a) You may issue a provisional kinship foster home verification for six months from the date it is issued.
(b) You may not renew a provisional kinship foster home verification.
(c) A provisional kinship foster home verification is no longer valid when you issue a non-expiring foster home verification or close the home.
§749.4429.What must I do if a kinship foster home does not meet the requirements for a non-expiring verification before the provisional kinship foster home verification expires?
If a kinship foster home does not meet the requirements for a non-expiring foster home verification before the provisional kinship verification ends, you must:
(1) Notify the parent as soon as you become aware that the kinship foster home is not eligible for a non-expiring foster home verification and document the notification in the kinship foster home's file;
(2) Close the kinship foster home by the date the provisional kinship verification ends; and
(3) Complete a home closure summary that meets the requirements in §749.2497 of this chapter (relating to What requirements are there for a transfer or closing summary?).
§749.4431.What children may I place in a kinship foster home that has a provisional kinship foster home verification?
(a) You may only place kinship children in a kinship foster home that has a provisional kinship foster home verification.
(b) If you place additional kinship children in a home after you issue a provisional kinship foster home verification, you must:
(1) Do the following by the date you place the additional kinship foster children in the home:
(A) Determine the home is capable of providing care for the additional kinship foster child in accordance with the rules in this chapter and document your determination in the home's record;
(B) Update the kinship foster home's provisional verification certificate to be in compliance with §749.4425(b)(6) of this division (relating to What requirements must I meet before I issue a provisional kinship foster home verification?); and
(C) Notify Child Care Regulation of the change in verification, as required in §749.2489 of this chapter (relating to What information must I submit to Licensing about a foster home's verification status?); and
(2) Do the following within 30 days after the date you place the additional kinship foster child in the home:
(A) Review and update with an addendum, if necessary, the foster home screening or the addendum to the kinship home assessment you completed in accordance with §749.4421 of this division (relating to What are the foster home screening requirements for a provisional kinship foster home verification?); and
(B) Ensure the kinship foster home meets all applicable requirements in this chapter.
(c) The placement of additional kinship foster children in the home does not change the expiration date of the provisional verification.
§749.4433.May I use a home with a provisional kinship foster home verification for respite care?
You may not use a home with a provisional kinship foster home verification for respite care.
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 August 22, 2023.
TRD-202303090
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3269
26 TAC §§749.4451, 749.4453, 749.4455
STATUTORY AUTHORITY
The new rules are 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 §531.02011, which transferred the regulatory functions of the Texas Department of Family and Protective Services to HHSC. In addition, Texas Human Resources Code §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code, Chapter 42.
The new rules affect Texas Government Code §531.0055 and Texas Human Resources Code §42.042.
§749.4451.Must I issue a provisional kinship foster home verification before issuing a non-expiring foster home verification?
You are not required to issue a provisional kinship foster home verification if the home meets the requirements for a non-expiring foster home verification.
§749.4453.What must I do to issue a non-expiring foster home verification to a kinship foster home with a provisional foster home verification?
Before you may issue a non-expiring foster home verification to a kinship foster home with a provisional kinship foster home verification, you must:
(1) Ensure each caregiver is in compliance with all orientation, pre-service experience, and pre-service training requirements in Subchapter F of this chapter (relating to Training and Professional Development);
(2) Meet all foster home verification requirements in §749.2470 of this chapter (relating to What must I do to verify a foster family home?); and
(3) Notify Child Care Regulation of the change in verification, as required in §749.2489 of this chapter (relating to What information must I submit to Licensing about a foster home's verification status?).
§749.4455.If I did not issue a provisional kinship foster home verification, what additional requirements must I meet before issuing a non-expiring verification to a kinship foster home?
Before you may issue a non-expiring foster home verification to a kinship foster home for which you did not issue a provisional kinship foster home verification, you must obtain and review the kinship home assessment that the Texas Department of Family and Protective Services or the Single Source Continuum Contractor completed.
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 August 22, 2023.
TRD-202303091
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: October 8, 2023
For further information, please call: (512) 438-3269