AGENDA ITEM: 2.n - Texas Health and Human Services



00TO: Health and Human Services Commission Executive CouncilDATE:June 25, 2020 FROM:Dee Budgewater, Deputy Executive Commissioner for Health, Developmental and Independence ServicesAGENDA ITEM: 2.nSUBJECT: Human Trafficking Prevention Training RequirementsBACKGROUND: ? Federal ? Legislative ? Other: Program InitiativeThe purpose of the proposal is to establish the review, approval, and update process of the list of human trafficking prevention training courses approved by the Executive Commissioner, pursuant to Texas Occupations Code, §116.002. The proposed rule also defines key terms and the time prescribed for a health care practitioner to successfully complete a training course on human trafficking prevention. The proposal is necessary to comply with Texas Occupations Code, §§116.001, 116.002, and 116.003, which requires HHSC to approve, post, and update a list of human trafficking prevention training courses for certain health care practitioners. HHSC proposes the new rule as the result of House Bill (H.B.) 2059, 86th Legislature, Regular Session, 2019. H.B. 2059 requires the Executive Commissioner to approve training courses on human trafficking prevention, including at least one that is available without charge. It also requires the Executive Commissioner to post the list of approved training courses on the agency website and to update the list of approved trainings as necessary. The bill requires a Texas Health and Human Services Commission (HHSC) rule to define the time allowed for health care practitioners to successfully complete a training course from the approved list. ISSUES AND ALTERNATIVES:There are no known concerns, issues, or objections to the proposal. One comment from the Texas Medical Association was received during the informal comment period and no changes to the proposal were necessary as a result of the comment.STAKEHOLDER INVOLVEMENT:There was considerable stakeholder engagement during the development of the draft rule. The following entities were engaged for feedback and comment: Texas Medical Board, Texas Board of Nursing, Texas State Board of Pharmacy, Texas State Board of Dental Examiners, Texas Board of Chiropractic Examiners, Texas Optometry Board, Texas State Board of Examiners of Psychologists, Texas Board of Physical Therapy Examiners, Texas Board of Occupational Therapy Examiners, Texas Department of Licensing and Regulation, Texas Medical Association, Texas Nurses Association, and Texas Hospital Association.The draft rule was posted for informal comments on the HHS Rulemaking webpage from January 8-22, 2020. One comment was received from the Texas Medical Association. No changes were made to the rule based on the comment.FISCAL IMPACT:? None SERVICES IMPACT STATEMENT:The proposed rule will require all health care practitioners who provide direct patient care to complete a training course on human trafficking prevention. This will improve the awareness, response, prevention, and treatment options for survivors, vulnerable populations, and potential victims of human trafficking. RULE DEVELOPMENT SCHEDULE:June 25, 2020Present to HHSC Executive CouncilJune 2020Publish proposed rules in Texas RegisterAugust 2020Publish adopted rules in Texas RegisterSeptember 2020Effective dateTITLE 26HEALTH AND HUMAN SERVICESPART 1HEALTH AND HUMAN SERVICES COMMISSIONCHAPTER 370HUMAN TRAFFICKING RESOURCE CENTERPROPOSED PREAMBLEThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §370.1, concerning Human Trafficking Prevention Training Requirements.BACKGROUND AND PURPOSEThe purpose of the proposal is to establish the review, approval, and update process of the list of human trafficking prevention training courses approved by the Executive Commissioner, pursuant to Texas Occupations Code, §116.002. The proposed rule also defines key terms and the time prescribed for a health care practitioner to successfully complete a training course on human trafficking prevention. The proposal is necessary to comply with Texas Occupations Code, §§116.001, 116.002, and 116.003, which require HHSC to approve, post, and update a list of human trafficking prevention training courses for certain health care practitioners. HHSC proposes the new rule as the result of House Bill (H.B.) 2059, 86th Legislature, Regular Session, 2019. H.B. 2059 requires the Executive Commissioner to approve training courses on human trafficking prevention, including at least one that is available without charge. It also requires the Executive Commissioner to post the list of approved training courses on the agency website and to update the list of approved trainings as necessary. The bill requires an HHSC rule to define the time allowed for health care practitioners to successfully complete a training course from the approved list. SECTION-BY-SECTION SUMMARYProposed new §370.1(a) defines terms used in the section. Proposed new §370.1(b) establishes that a course must meet the human trafficking prevention training standards established by HHSC, in order to be approved by the Executive Commissioner. Proposed new §370.1(c) lists the categories of minimum standards that must be met for a training course to be approved. Proposed new §370.1(d) defines the time prescribed for a health care practitioner to complete an approved human trafficking prevention training course. It also confirms that at least one approved course will be available free of charge.Proposed new §370.1(e) states that the complete description of the human trafficking prevention training standards and approval process is posted on the HHSC website. FISCAL NOTETrey Wood, 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 or 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 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 create a new rule;(6) the proposed rule will not expand, limit, or repeal existing rules;(7) the proposed rule will not change the number of individuals subject to the rules; 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. The rule does not apply to small or micro-businesses, or rural communities.LOCAL EMPLOYMENT IMPACTThe 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 do not impose a cost on regulated persons.PUBLIC BENEFIT AND COSTSDee Budgewater, Deputy Executive Commissioner for Health, Developmental and Independence Services, has determined that for each year of the first five years the rule is in effect the public benefit will be that health care practitioners who provide direct patient care will be trained in human trafficking prevention efforts, which will increase the number of potential victims of human trafficking identified and treated throughout the state. This will decrease the overall incidence of human trafficking and improve the health and safety of the public. Trey Wood has also determined that for the first five years the rule is in effect, there could be anticipated economic costs to persons who are required to comply with the proposed rule. The proposed rule requires a completed course for each health care practitioner license renewal, as defined by each licensing entity, and at least one training to be available to practitioners free of charge. There is already a federally-approved course (SOAR) that is free. Practitioners also have the flexibility in choosing a course for completion, including SOAR, and any other free courses for future licensing renewals. HHSC does not have sufficient information to determine which courses health care practitioners will be required to take and potential licensing entity costs to add these requirements. As a result, HHSC does not have sufficient information to estimate costs to comply.TAKINGS IMPACT ASSESSMENTHHSC 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 Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4900 North Lamar Boulevard, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhsc.state.tx.us. 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 20R034” in the subject line.STATUTORY AUTHORITYThe new section 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 Occupations Code §§116.002, which directs the Executive Commissioner of HHSC to develop and approve required human trafficking training courses.This agency hereby certifies that this proposal has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.TITLE 26HEALTH AND HUMAN SERVICESPART 1HEALTH AND HUMAN SERVICES COMMISSIONCHAPTER 370HUMAN TRAFFICKING RESOURCE CENTER§370.1. Human Trafficking Prevention Training Requirements.(a) The following terms, when used in this chapter, have the following meanings unless the context clearly indicates otherwise:(1) Health care practitioner--An individual who holds a license, certificate, permit, or other authorization, issued under Title 3 of the Texas Occupations Code, to engage in a health care profession and provides direct patient care.(2) Direct patient care--The act of providing direct delivery of care and services to patients and clients in a health care setting described under Title 3 of the Texas Occupations Code.(b) For a human trafficking prevention training course to become approved by the Executive Commissioner, or designee, the course must meet the human trafficking training standards established by the Health and Human Services Commission. (c) The human trafficking prevention training course, at a minimum, must include: (1) types of human trafficking, including definitions; (2) vulnerability factors; (3) health impact; (4) identification; (5) assessment; (6) response; and (7) resources.(d) Health care practitioners must complete an approved human trafficking prevention training course for each license renewal, within the full license term as defined by each licensing entity. At least one approved course will be available without charge.(e) A complete description of the human trafficking prevention training standards and training approval process is posted on the HHSC website. ................
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