I”m not going to dig thru the rules but regarding the ‘opt out’ I think the internet option made it easier for anyone to apply. As I understand the process you had to go personally to the location and pick up a form that had the correct seal on it. The internet allowed for the securing of the form via an internet request rather than a personal visit. I maybe wrong in that understanding.
I posted a link to all the rules upthread, and also summarized the process. It was never true that a person had to apply in person. The application could be made via mail, fax, or in person. It is correct that the form has to have the correct seal. That is true now, and Perry did nothing to change that. Otherwise, your understanding is correct - the internet application process makes it easier to get the ball rolling.
The health depart also requires a opt-outer to opt-out each two years. The form expires. The legislature does not require an expiration, this is something that "Perry added" (I'm sure he didn't do it personally, but it's part of an administrative rule under the control of the executive (and the rule was promulgated under Perry's watch), not part of legislation).