TITLE 40. SOCIAL SERVICES AND ASSISTANCE

PART 1. DEPARTMENT OF AGING AND DISABILITY SERVICES

CHAPTER 90. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS

The Texas Health and Human Services Commission (HHSC), on behalf of the Department of Aging and Disability Services (DADS), proposes amendments to Chapter 90, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, §90.3, concerning Definitions; §90.50, concerning Emergency Preparedness and Response; §90.61, concerning Introduction, Application, and General Requirements for Facilities for Persons with an Intellectual Disability or Related Conditions; and §90.74, concerning Safety Operations.

BACKGROUND AND PURPOSE

The Centers for Medicare & Medicaid Services (CMS) adopted a rule that made the 2012 edition of two publications of the National Fire Protection Association (NFPA)-the Life Safety Code (NFPA 101) and the Health Care Facilities Code (NFPA 99)-apply to an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID). Therefore, the proposed amendments refer to the 2012 editions of those publications and make references to the publications consistent throughout the amended sections. Consistent with the CMS rule, the proposed amendments allow an existing small facility until July 5, 2019, to be in compliance with the NFPA provisions in Chapter 33 regarding sprinklers and heat detection systems in attics.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §90.3 clarifies that "Life Safety Code" is synonymous with NFPA 101 and adds a definition of the acronym "NFPA." Definitions of "NFPA 99" and "NFPA 101" are added to specify the edition of the codes adopted by CMS, and to explain how to obtain a copy of NFPA 99 and NFPA 101.

The proposed amendment to §90.50 replaces the term "Life Safety Code, 2000 Edition" with a reference to the newly defined term, "NFPA 101."The proposed amendment also adds a new requirement that a large facility's fire safety plan must include a provision concerning "emergency phone call to fire department." The 2012 edition of NFPA 101 added a requirement that a large facility's fire safety plan include a provision for calling a fire department, in addition to any automatic notification.

The proposed amendment to §90.61 deletes references to the "Life Safey Code," using the newly defined term "NFPA 101" in its place. The proposed amendment deletes references to the 2000 and 2001 edition NFPA publications. The proposed amendment deletes the definitions of several terms from subsection (c) because they are included in §90.3. The proposed amendment changes dates in the descriptions of "new construction" and an "existing facility" in new subsection (c) to establish that new construction is any construction work that began on or after July 5, 2016, and an existing facility is one that was operating with a license before November 1, 2016. These descriptions determine which chapters of the 2012 edition of NFPA 101 will apply to an ICF/IID. The amendment also requires an ICF/IID to comply with a Tentative Interim Amendment issued by the NFPA for any of the NFPA publications with which an ICF/IID is required to comply. The amendment includes a list of Tentative Interim Agreements that have been issued for NFPA 101 and NFPA 99. The amendment also corrects references to statutes.

The proposed amendment to §90.74 uses the acronym "NFPA" to refer to a publication, because the acronym is now a defined term. The proposed amendment also removes a reference to the 2000 edition of NFPA 101 to be consistent with the definition of "NFPA 101," which means the 2012 edition.

FISCAL NOTE

David Cook, DADS Chief Financial Officer, has determined that, for the first five years the proposed amendments are in effect, enforcing or administering the amendments does not have foreseeable implications relating to costs or revenues of state or local governments.

SMALL BUSINESS AND MICRO-BUSINESS IMPACT ANALYSIS

DADS has determined that the proposed amendments will not have an adverse economic effect on small businesses or micro-businesses.

PUBLIC BENEFIT AND COSTS

Mary T. Henderson, Assistant Commissioner, has determined that, for each year of the first five years the amendments are in effect, the public will benefit from updated rules that are designed to better protect residents of an ICF/IID from fire.

Ms. Henderson anticipates that ICF/IIDs will incur costs to comply with the rules that CMS adopted effective July 5, 2016. However, because all ICF/IIDs in Texas are federally certified, an ICF/IID would incur those costs, even if DADS did not update the licensing rules. The amendment will not affect a local economy.

TAKINGS IMPACT ASSESSMENT

DADS has determined that this 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 Barbie Blankenship at (512) 438-5502 in DADS Regulatory Services Division. Written comments on the proposal may be submitted to Barbie Blankenship at 701 West 51st Street, Austin, Texas 78751, Mail Code E-370; or via email to barbara.blankenship@dads.state.tx.us. To be considered, comments must be submitted no later than 30 days after the date of this issue of the Texas Register. The last day to submit comments falls on a Sunday; therefore, comments must be: (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered to DADS before 5:00 p.m. on DADS last working day of the comment period; or (3) faxed or e-mailed by midnight on the last day of the comment period. When faxing or e-mailing comments, please indicate "Comments on Proposed Rule 16R20" in the subject line.

SUBCHAPTER A. INTRODUCTION

40 TAC §90.3

STATUTORY AUTHORITY

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; 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; Texas Health and Safety Code, §252.033, which authorizes DADS to license ICF/IIDs; and Texas Health and Safety Code, §252.008, which requires the HHSC executive commissioner to adopt rules related to the administration and implementation of Chapter 252.

The amendment affects Texas Government Code, §531.0055 and §531.021; Texas Human Resources Code, §32.021; and Texas Health and Safety Code, §252.0332 and §252.008.

§90.3.Definitions.

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise. Individual subchapters may have definitions that are specific to the subchapter.

(1) - (34) (No change.)

(35) Life Safety Code [(also referred to as the Code or NFPA 101)]--NFPA 101 [The Code for Safety to Life from Fire in Buildings and Structures, Standard 101, of the National Fire Protection Association (NFPA)].

(36) - (41) (No change.)

(42) NFPA--The National Fire Protection Association. If the term is immediately followed by a number, it is a reference to a publication of NFPA, as referenced in NFPA 101.

(43) NFPA 99--NFPA 99, Health Care Facilities Code, 2012 Edition. A publication of the NFPA that provides minimum requirements for the installation, testing, maintenance, performance, and safe practices for health care facilities and for material, equipment, and appliances, used for patient care in health care facilities. The Centers for Medicare and Medicaid Services has incorporated NFPA 99, 2012 Edition, except Chapters 7, 8, 12, and 13, by reference as a Condition of Participation in the ICF/IID program for facilities that meet the definition of a health care occupancy. Copies of NFPA 99 may be obtained from NFPA, 1 Batterymarch Park, Quincy, MA 02169.

(44) NFPA 101--NFPA 101, Life Safety Code, 2012 Edition. A publication of the NFPA that provides minimum requirements, with due regard to function, for the design, operation, and maintenance of buildings and structures for safety to life from fire. The Centers for Medicare and Medicaid Services has incorporated NFPA 101, 2012 Edition, by reference as a Condition of Participation in the ICF/IID program. Copies of NFPA 101 may be obtained from NFPA, 1 Batterymarch Park, Quincy, MA 02169.

(45) [(42)] Oral medication--Medication administered by way or through the mouth and does not include sublingual or buccal.

(46) [(43)] Person--An individual, firm, partnership, corporation, association, or joint stock company, and any legal successor of those entities.

(47) [(44)] Personal hold--

(A) A manual method, except for physical guidance or prompting of brief duration, used to restrict:

(i) free movement or normal functioning of all or a portion of a resident's body; or

(ii) normal access by a resident to a portion of the resident's body.

(B) Physical guidance or prompting of brief duration becomes a restraint if the resident resists the guidance or prompting.

(48) [(45)] Qualified mental retardation professional (QMRP)--A person who has at least one year of experience working directly with persons with an intellectual disability or related conditions and is one of the following:

(49) [(46)] Quality-of-care monitor--A registered nurse, pharmacist, or dietitian, employed by DADS, who is trained and experienced in long-term care regulations, standards of practice in long-term care, and evaluation of resident care and functions independently of DADS Regulatory Services Division.

(50) [(47)] Registered nurse--A person licensed to practice professional nursing in accordance with Texas Occupations Code, Chapter 301.

(51) [(48)] Remodeling--The construction, removal, or relocation of walls and partitions, or construction of foundations, floors, or ceiling-roof assemblies, including expanding of safety systems (i.e., sprinkler systems, fire alarm systems), that will change the existing plan and use areas of the facility.

(52) [(49)] Renovation--The restoration to a former better state by cleaning, repairing, or rebuilding, e.g., routine maintenance, repairs, equipment replacement, painting.

(53) [(50)] Restraint--A manual method, or a physical or mechanical device, material, or equipment attached or adjacent to the resident's body that the resident cannot remove easily, that restricts freedom of movement or normal access to the resident's body. This term includes a personal hold.

(54) [(51)] Seclusion--The involuntary separation of a resident away from other residents and the placement of the resident alone in an area from which the resident is prevented from leaving.

(55) [(52)] Small facilities--Facilities with 16 or fewer resident beds.

(56) [(53)] Specialized staff--Personnel with expertise in developmental disabilities.

(57) [(54)] Standards--The minimum conditions, requirements, and criteria with which a facility will have to comply to be licensed under this chapter.

(58) [(55)] Topical medication--Medication applied to the skin but does not include medication administered in the eyes.

(59) [(56)] Universal precautions--The use of barrier precautions by facility personnel to prevent direct contact with blood or other body fluids that are visibly contaminated with blood.

(60) [(57)] Vaccine preventable diseases--The diseases included in the most current recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

(61) [(58)] Well-recognized church or religious denomination--An organization which has been granted a tax-exempt status as a religious association from the state or federal government.

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 March 16, 2017.

TRD-201701095

Lawrence Hornsby

General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: April 30, 2017

For further information, please call: (512) 438-5502


SUBCHAPTER C. STANDARDS FOR LICENSURE

40 TAC §90.50

STATUTORY AUTHORITY

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; 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; Texas Health and Safety Code, §252.033, which authorizes DADS to license ICF/IIDs; and Texas Health and Safety Code, §252.008, which requires the HHSC executive commissioner to adopt rules related to the administration and implementation of Chapter 252.

The amendment affects Texas Government Code, §531.0055 and §531.021; Texas Human Resources Code, §32.021; and Texas Health and Safety Code, §252.008 and §252.033.

§90.50.Emergency Preparedness and Response.

(a) - (e) (No change.)

(f) Fire Safety Plan. A facility's fire safety plan must:

(1) for a large facility, include the provisions described in the Operating Features section of [the] NFPA 101 [Life Safety Code, 2000 Edition], Chapter 18 (for new healthcare occupancies) and Chapter 19 (for existing healthcare occupancies) concerning:

(A) use of alarms;

(B) transmission of alarm to fire department;

(C) emergency phone call to fire department;

(D) [(C)] response to alarms;

(E) [(D)] isolation of fire;

(F) [(E)] evacuation of immediate area;

(G) [(F)] evacuation of smoke compartment;

(H) [(G)] preparation of floors and building for evacuation; and

(I) [(H)] extinguishment of fire;

(2) for a small facility, include the provisions described in the Operating Features section of [the] NFPA 101 [Life Safety Code, 2000 Edition], Chapter 32 (for new residential board and care occupancies) and Chapter 33 (for existing residential board and care occupancies) concerning:

(A) - (E) (No change.)

(3) (No change.)

(g) (No change.)

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 March 16, 2017.

TRD-201701096

Lawrence Hornsby

General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: April 30, 2017

For further information, please call: (512) 438-5502


SUBCHAPTER D. GENERAL REQUIREMENTS FOR FACILITY CONSTRUCTION

40 TAC §90.61, §90.74

STATUTORY AUTHORITY

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; 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; Texas Health and Safety Code, §252.033, which authorizes DADS to license ICF/IIDs; and Texas Health and Safety Code, §252.008, which requires the HHSC executive commissioner to adopt rules related to the administration and implementation of Chapter 252.

The amendment affects Texas Government Code, §531.0055 and §531.021; Texas Human Resources Code, §32.021; and Texas Health and Safety Code, §252.008 and §252.033.

§90.61.Introduction, Application, and General Requirements for Facilities for Persons with an Intellectual Disability or Related Conditions.

(a) Scope. The requirements of this section are applicable to both new and existing facilities unless stated otherwise.

(b) Purpose.

(1) The concept of requirements for fire safety with regard to the residents is based on evacuation capability as published in [by National Fire Protection Association (NFPA) in] NFPA 101 [Life Safety Code]. These standards are written with the premise that the residents will be capable of self-evacuation without continuous staff assistance. Residents that are not normally capable of self-evacuation nor capable of negotiating stairs unassisted shall not be housed above or below the floor of exit discharge unless the facility meets the construction requirements of NFPA 101, Chapter 18, [titled "]New Health Care Occupancies,["] or Chapter 19, [titled "]Existing Health Care Occupancies,["] for large facilities, or the "impractical" requirements for small facilities as found in NFPA 101, Chapter 32, [titled "]New Residential Board and Care Occupancies,["] or Chapter 33, [titled "]Existing Residential Board and Care Occupancies.["] Examples of residents who may not be capable of self-evacuation are as follows:

(A) - (C) (No change.)

(2) The method of determining the evacuation capability of residents under NFPA 101, Chapter 32 or 33, is by rating each resident and each staff member to determine an evacuation difficulty score (E-score). If the E-score is 1.5 or less, the evacuation capability of the facility is prompt, greater than 1.5 to five is slow, greater than five is impractical. The worksheets to be completed are located in NFPA 101A, Guide on Alternative Approaches to Life Safety, [2001 edition,] Chapter 6. Intermediate care facilities for persons with an intellectual disability (ICF/ID) with 16 beds or less must meet the evacuation requirement for their designated Chapter 32 or 33 rating. The ratings and their requirements follow:

(A) Impractical rating.

(i) - (v) (No change.)

(B) Slow rating.

(i) - (ix) (No change.)

(C) Prompt rating.

(i) - (ix) (No change.)

(3) The "E" score will determine which NFPA 101 features are to be installed and maintained in the facility. These features include construction, fire alarm systems, smoke detector systems, interior finish, sprinkler systems, separation of bedrooms, and egress from the building.

[(c) Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.]

[(1) Addition-The addition of floor space.]

[(2) Large facilities-Facilities with 17 or more resident beds.]

[(3) Life safety features-Fire safety components required by NFPA 101 such as building construction, fire alarm systems, smoke detection systems, interior finishes, sizes and thicknesses of doors, exits, emergency electrical systems, sprinkler systems, etc.]

[(4) Remodeling-The altering of the structure, e.g., removal or addition of walls or partitions, floors, ceiling, roof.]

[(5) Renovation-The restoration to a former better state by cleaning, repairing, or rebuilding, e.g., routine maintenance, repairs, equipment replacement, painting.]

[(6) Small facilities-Facilities with 16 or fewer resident beds.]

(c) [(d)] Construction.

(1) New construction is any construction work that began on or after July 5, 2016 [March 11, 2003]. The provisions of NFPA 101, Chapter 18 are applicable for large facilities, and Chapter 32 for small facilities.

(2) An existing facility is one that was operating with a license as a facility for persons with an intellectual disability and related conditions before November 1, 2016 [September 11, 2003], and has not subsequently become unlicensed. The provisions of NFPA 101, Chapter 19 are applicable for large facilities, and Chapter 33 for small facilities.

(3) - (8) (No change.)

(9) Each building must be classified as to the building construction type for fire resistance rating purposes in accordance with NFPA 220, Standard on Types of Building Construction, and NFPA 101.

(d) [(e)] Applicable codes and standards. Except as provided in paragraph (9) of this subsection, a facility [Facilities] must comply with [meet the requirements of] NFPA 101, NFPA 99, and a Tentative Interim Amendment (TIA) issued by the NFPA for NFPA 99 or NFPA 101, including the TIAs listed in paragraphs (1) and (2) of this subsection. A facility must also comply with other NFPA publications referenced in this chapter and a TIA issued for a publication referenced in this chapter, unless [2000 edition, and any other codes and standards of NFPA listed in this section, except as may be] otherwise approved or required by DADS.

(1) The following TIAs have been issued for NFPA 101:

(A) TIA 12-1 to NFPA 101, issued August 11, 2011;

(B) TIA 12-2 to NFPA 101, issued October 30, 2012;

(C) TIA 12-3 to NFPA 101, issued October 22, 2013; and

(D) TIA 12-4 to NFPA 101, issued October 22, 2013.

(2) The following TIAs have been issued for NFPA 99:

(A) TIA 12-2 to NFPA 99, issued August 11, 2011;

(B) TIA 12-3 to NFPA 99, issued August 9, 2012;

(C) TIA 12-4 to NFPA 99, issued March 7, 2013;

(D) TIA 12-5 to NFPA 99, issued August 1, 2013; and

(E) TIA 12-6 to NFPA 99, issued March 3, 2014.

(3) [(1)] If the municipality has a building code and a plumbing code, then those codes must govern in those areas of construction. Where local codes or ordinances are applicable, the most restrictive parts concerning the same subject item must apply unless otherwise determined by the authority having jurisdiction for local codes and DADS.

(4) [(2)] In the absence of such governing municipal codes, nationally recognized codes must be used, such as the Standard Building Code and the Standard Plumbing Code, both of the Southern Building Code Congress International, Inc. Such nationally recognized codes, when used, must all be publications of the same group or organization to assure the intended continuity.

(5) [(3)] Heating, ventilating, and air-conditioning systems must be designed and installed in accordance with NFPA 90A, Standard for the Installation of Air Conditioning and Ventilating Systems, and NFPA 90B, Standard for the Installation of Warm Air Heating and Air Conditioning Systems, as applicable, and the American Society of Heating, Ventilating, and Air-Conditioning Engineers (ASHRAE), except as may be modified in this subchapter.

(6) [(4)] Electrical and illumination system must be designed and installed in accordance with NFPA 70, National Electrical Code, and the Lighting Handbook of the Illuminating Engineering Society of North America (IES) except as may be modified in this subchapter.

(7) [(5)] The facility must meet all applicable provisions and requirements concerning accessibility for individuals with disabilities in the following laws and regulations: the Americans with Disabilities Act of 1990 ([Public Law 101-336;] Title 42, United States Code, Chapter 126); Title 28, Code of Federal Regulations, Part 35; Government Code, Chapter 469, Elimination of Architectural Barriers [Texas Civil Statutes, Article 9102]; and Title 16, Texas Administrative Code, Chapter 68. Plans for new construction, substantial renovations, modifications, and alterations must be submitted to the Texas Department of Licensing and Regulation (Attention: Elimination of Architectural Barriers Program) for accessibility approval under Chapter 469 [Article 9102].

(8) [(6)] A facility with a boiler must meet all applicable provisions and requirements of [All boilers not exempted by the] Texas Health and Safety Code, Chapter 755 [Annotated §755.022 shall be inspected and certified for operation by the Texas Department of Licensing and Regulation].

(9) A facility that is required to comply with NFPA 101, Chapter 33, must be in compliance with Chapter 33.2.3.5.7.1 or 33.2.3.5.7.2 by July 5, 2019.

(e) [(f)] General requirements.

(1) The facility must provide and maintain furnishings and decorations that meet the needs of the residents.

(2) The building, grounds, and equipment must be maintained in good repair, operational, sanitary, and free of hazards.

(3) There must be at least one telephone (other than a pay phone) in the facility, accessible to residents for use in making calls to summon help in case of emergency.

(4) The facility must have:

(A) floors that are free of irregularities and are substantially level (floor areas may be at different elevations with connecting stairs or ramps);

(B) floors that have a resilient, nonabrasive, and slip-resistant surface;

(C) nonabrasive carpeting, if the area used by residents is carpeted and serves residents who lie on the floor or ambulate with parts of their bodies, other than feet, touching the floor; and

(D) exposed floor surfaces and floor coverings that promote mobility in areas used by residents and promote maintenance of sanitary conditions.

(5) Walls and ceilings must be cleanable and in good repair.

(6) Walls and floors must be kept free of cracks. The joint between the walls and floors is to be maintained so as to be free of spaces which might harbor insects, rodents, or vermin.

(7) An adequate supply of hot water must be provided. The hot water system for resident use must be capable of being regulated to not exceed 110 degrees Fahrenheit at the fixtures.

(8) Draperies, curtains (including cubicle curtains), and other similar furnishings and decorations must be flame resistant in accordance with NFPA 701, Standard Methods of Fire Tests for Flame Resistant Textiles and Films. Documentation must be kept on file in the facility.

(9) Wastebaskets must be of noncombustible material.

(10) An initial pressure test of facility gas lines from the meter must be provided. Additional pressure tests will be required when the facility has major renovations or additions where the gas service is interrupted. All gas heating systems must be checked for proper operation and safety prior to the heating season. Any unsatisfactory conditions must be corrected promptly.

(11) The IES recommendations must be followed to achieve proper illumination characteristics and lighting levels throughout the facility. Minimum illumination must be 10 foot candles in resident rooms during the day and 20 foot candles in corridors, staff stations, dining rooms, lobbies, toilets, bathing facilities, laundries, stairways, and elevators during the day. Illumination requirements for these areas apply to lighting throughout the space and should be measured at approximately 30 inches above the floor anywhere in the room. Minimum illumination for medication preparation or storage areas, kitchens, and staff station desks must be 50 foot candles during the day. Illumination requirements for these areas apply to the task performed and should be measured on the tasks.

(12) In addition to the required illumination (normal and emergency), the facility must keep on hand and readily available to night staff, no less than one working flashlight.

(13) Combustible attic areas larger than 3,000 square feet must be divided into compartments not exceeding 3,000 square feet or the attic area must be sprinkled. The separating barrier must be at least one layer of 1/2-inch gypsum board on one side of support members.

§90.74.Safety Operations.

(a) The facility must have a program to inspect, test, and maintain the fire alarm system and must execute the program at least once every three months for large facilities and at least once every six months for small facilities.

(1) The facility must contract with a company that is registered by the State Fire Marshal's Office to execute the program.

(2) The person who performs a service under the contract must be licensed by the State Fire Marshal's Office to perform the service and must complete, sign, and date an inspection form similar to the inspection and testing form in NFPA [National Fire Protection Association (NFPA)] 72 for a service provided under the contract.

(3) - (5) (No change.)

(6) The facility must ensure that smoke dampers are inspected and tested in accordance with NFPA 101[, 2000 Edition].

(7) The facility must maintain onsite documentation of compliance with this subsection.

(b) The facility must have a program to inspect, test, and maintain the sprinkler system and must execute the program at least once every three months for large facilities and at least once every six months for small facilities.

(1) - (3) (No change.)

(4) The facility must ensure that sprinkler system components that require testing are tested in accordance with [the] NFPA 13, NFPA 13D, or NFPA 13R and in accordance with NFPA 25.

(5) - (7) (No change.)

(c) The facility must formulate, adopt, and enforce smoking policies.

(1) - (5) (No change.)

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 March 16, 2017.

TRD-201701097

Lawrence Hornsby

General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: April 30, 2017

For further information, please call: (512) 438-5502