TITLE 25.HEALTH SERVICES

Part 1. TEXAS DEPARTMENT OF HEALTH

Chapter 61. CHRONIC DISEASES

Subchapter D. OSTEOPOROSIS ADVISORY COMMITTEE

25 TAC §61.61

The Texas Department of Health (department) proposes an amendment to §61.61 concerning the Osteoporosis Advisory Committee (committee). The committee provides advice to the Texas Board of Health (board) concerning the rules relating to educating the public on the health benefits of the early detection, prevention, and treatment of osteoporosis.

In 1993, the Texas Legislature passed Senate Bill 383 (now codified in the Government Code, Chapter 2110), which requires that each state agency adopt rules on advisory committees. The rules must state the purpose and tasks of the committee, describe the manner in which the committee will report to the agency, and establish a date on which the committee will be automatically abolished unless the governing body of the agency affirmatively votes to continue the committee's existence.

In 1996, the board established a rule relating to the Osteoporosis Advisory Committee. The rule states that the committee will automatically be abolished on September 1, 2000. The board has now reviewed and evaluated the committee and has determined that the committee should continue in existence until September 1, 2004.

This section amends provisions relating to the operation of the committee. Specifically, language is revised to reference the Health and Safety Code, §11.016 and the Government Code; to continue the committee until September 1, 2004; to change the composition; to clarify that members holdover until their replacement is appointed; to state that the presiding and assistant presiding officers shall be appointed by the chairman of the board for a term of two years; to allow a temporary vacancy in the office of assistant presiding officer to be filled by vote of the committee until appointment by the chairman of the board occurs; to clarify that the committee is prohibited from holding an executive session (closed meeting) for any reason; to clarify that the committee and its members may not participate in legislative activity in the name of the board, the department, or the committee except with certain approval; to require the committee's annual report in September rather than January; and to reference reimbursement for a committee member's expenses if authorized by the General Appropriations Act or budget execution process. Other minor language changes were made for clarification. These changes will clarify procedures for the committee and emphasize the advisory nature of the committee.

Philip P. Huang, M. D., Chief, Bureau of Disease, Injury and Tobacco Prevention, has determined that for each year of the first five years the proposed section is in effect, there will be no fiscal implications for state or local governments as a result of enforcing or administering this section.

Dr. Huang also has determined that for each year of the first five years the section is in effect, the public benefit anticipated as a result of enforcing the section will be better information and advice provided to the board and the department on the issues addressed by the advisory committee and clarification of the role and procedures of the committee. There will be no effect on small businesses or micro-businesses since the rule only reflects requirements for the committee. There are no economic costs to persons who are required to comply with the section as proposed. There will be no effect on local employment.

Comments may be submitted to Elaine Braslow, Bureau of Disease, Injury and Tobacco Prevention, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756, 512-458- 7534. Comments on the proposed section will be accepted for 30 days following publication in the Texas Register .

The amendment is proposed under the Health and Safety Code, §90.003 which allows the appointment of an osteoporosis task force; Health and Safety Code, §11.016, which allows the board to establish advisory committees; the Government Code, Chapter 2110, which sets standards for the evaluation of advisory committees by the agencies for which they function; and the Health and Safety Code, §12.001, which provides the board with authority to adopt rules for the performance of every duty imposed by law upon the board, the department, and commissioner of health.

The amendment affects the Health and Safety Code, Chapters 11 and 90, and the Government Code, Chapter 2110.

§61.61.The Osteoporosis Advisory Committee

(a)

The committee. An advisory committee shall be appointed under and governed by this section.

(1)

The name of the advisory committee shall be the Osteoporosis Advisory Committee (committee).

(2)

The committee is authorized to be established by the Texas Board of Health (board) by Health and Safety Code, §90.003 and §11.016 .

(b)

Applicable law. The committee is subject to the Government Code, Chapter 2110 [ Texas Civil Statutes, Article 6252-33 ], concerning state agency advisory committees.

(c)

Purpose. The purpose of the committee is to provide advice to the board on strategies for educating the public on the health benefits of the early detection, prevention, and treatment of osteoporosis.

(d)

Tasks.

(1)

The committee shall advise the board concerning rules relating to educating the public on the health benefits of the early detection, prevention, and treatment of osteoporosis.

(2)

The committee shall carry out any other tasks given to the committee by the board.

(e)

Review and duration. By September 1, 2004 [ 2000 ], the board will initiate and complete a review of the committee to determine whether the committee should be continued, consolidated with another committee, or abolished. If the committee is not continued or consolidated, the committee shall be abolished on that date.

(f)

Composition. The committee shall be composed of 17 members appointed by the board. The composition of the committee shall include:

(1)

six [ five ] consumer representatives; and

(2)

11 [ 12 ] other representatives.

(g)

Terms of office. The term of office of each member shall be six years. Members shall serve after expiration of their term until a replacement is appointed.

(1)

Members shall be appointed for staggered terms so that the terms of a substantial equivalent number of members will expire on December 31st of each even-numbered year.

(2)

If a vacancy occurs, a person shall be appointed to serve the unexpired portion of that term.

(h)

Officers. The chairman of the board [ advisory committee ] shall appoint [ elect ] a presiding officer and an assistant presiding officer to begin serving on September 1 of each even -numbered [ at its first meeting after August 31st of each ] year.

(1)

Each officer shall serve until the next regular election of officers.

(2)

The presiding officer shall preside at all committee meetings at which he or she is in attendance, call meetings in accordance with this section, appoint subcommittees of the committee as necessary, and cause proper reports to be made to the board. The presiding officer may serve as an ex-officio member of any subcommittee of the advisory committee.

(3)

The assistant presiding officer shall perform the duties of the presiding officer in case of the absence or disability of the presiding officer. In case the office of presiding officer becomes vacant, the assistant presiding officer will serve until a successor is appointed [ elected ] to complete the unexpired portion of the term of the office of presiding officer.

(4)

If the office of assistant presiding officer becomes vacant, it [ A vacancy which occurs in the offices of presiding officer or assistant presiding officer ] may be filled temporarily by vote of the committee until a successor is appointed by the chairman of the board [ at the next committee meeting ].

(5)

A member shall serve no more than two consecutive terms as presiding officer and/or assistant presiding officer.

(6)

The committee may reference its officers by other terms, such as chairperson and vice-chairperson.

(7)

The presiding officer and assistant presiding officer serving on August 1, 2000, will continue to serve until the chairman of the board appoints their successor.

(i)

Meetings. The committee shall meet only as necessary to conduct committee business.

(1)

A meeting may be called by agreement of department staff and either the presiding officer or at least three members of the committee.

(2)

Meeting arrangements shall be made by department staff. Department staff shall contact committee members to determine availability for a meeting date and place.

(3)

The committee is not a "governmental body" as defined in the Open Meetings Act. However, in order to promote public participation, each [ Each ] meeting of the committee shall be announced and conducted in accordance with the Open Meetings Act, Texas Government Code, Chapter 551 , with the exception that the provisions allowing executive sessions shall not apply .

(4)

Each member of the committee shall be informed of a committee meeting at least five working days before the meeting.

(5)

A simple majority of the members of the committee shall constitute a quorum for the purpose of transacting official business.

(6)

The committee is authorized to transact official business only when in a legally constituted meeting with a quorum present.

(7)

The agenda for each committee meeting shall include an item entitled public comment under which any person will be allowed to address the committee on matters relating to committee business. The presiding officer may establish procedures for public comment, including a time limit on each comment.

(j)

Attendance. Members shall attend committee meetings as scheduled. Members shall attend meetings of subcommittees to which the member is assigned.

(1)

A member shall notify the presiding officer or appropriate department staff if he or she is unable to attend a scheduled meeting.

(2)

It is grounds for removal from the committee if a member cannot discharge the member's duties for a substantial part of the term for which the member is appointed because of illness or disability, is absent from more than half of the committee and subcommittee meetings during a calendar year, or is absent from at least three consecutive committee meetings.

(3)

The validity of an action of the committee is not affected by the fact that it is taken when a ground for removal of a member exists.

[ (4)

The attendance records of the members shall be reported to the board. The report shall include attendance at committee and subcommittee meetings. ]

(k)

Staff. Staff support for the committee shall be provided by the department.

(l)

Procedures. Roberts Rules of Order, Newly Revised, shall be the basis of parliamentary decisions except where otherwise provided by law or rule.

(1)

Any action taken by the committee must be approved by a majority vote of the members present once quorum is established.

(2)

Each member shall have one vote.

(3)

A member may not authorize another individual to represent the member by proxy.

(4)

The committee shall make decisions in the discharge of its duties without discrimination based on any person's race, creed, gender, religion, national origin, age, physical condition, or economic status.

(5)

Minutes of each committee meeting shall be taken by department staff.

(A)

A draft of the minutes approved by the presiding officer shall be provided to the board and each member of the committee within 30 days of each meeting.

(B)

After approval by the committee, the minutes shall be signed by the presiding officer.

(m)

Subcommittees. The committee may establish subcommittees as necessary to assist the advisory committee in carrying out its duties.

(1)

The presiding officer shall appoint members of the committee to serve on subcommittees and to act as subcommittee chairpersons. The presiding officer may also appoint nonmembers of the committee to serve on subcommittee.

(2)

Subcommittees shall meet when called by the subcommittee chairperson or when so directed by the committee.

(3)

A subcommittee chairperson shall make regular reports to the committee at each committee meeting or in interim written reports as needed. The reports shall include an executive summary or minutes of each subcommittee meeting.

(n)

Statement by members.

(1)

The board, the department, and the committee shall not be bound in any way by any statement or action on the part of any committee member except when a statement or action is in pursuit of specific instructions from the board, department, or committee.

(2)

The committee and its members may not participate in legislative activity in the name of the board, the department or the committee except with approval through the department's legislative process. Committee members are not prohibited from representing themselves or other entities in the legislative process.

(o)

Reports to board. The committee shall file an annual written report with the board.

(1)

The report shall list the meeting dates of the committee and any subcommittees, the attendance records of its members, a brief description of actions taken by the committee, a description of how the committee has accomplished the tasks given to the committee by the board, the status of any rules which were recommended by the committee to the board, and anticipated activities of the committee for the next year [ , and any amendments to this section requested by the committee ].

(2)

The report shall identify the costs related to the committee's existence, including the cost of department [ agency ] staff time spent in support of the committee's activities.

(3)

The report shall cover the meetings and activities in the immediate proceedings 12 months and shall be filed with the board each September [ January ]. It shall be signed by the presiding officer and appropriate department staff.

(p)

Reimbursement for expenses. Members of the advisory committee are not entitled to compensation, a per diem, or expense reimbursement for their service on the [ advisory ] committee.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on April 3, 2000.

TRD-200002396

Susan K. Steeg

General Counsel

Texas Department of Health

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 458-7236


Chapter 169. ZOONOSIS CONTROL

Subchapter E. DOG AND CAT STERILIZATION

25 TAC §169.101

The Texas Department of Health (department) proposes an amendment to §169.101 concerning the expiration date of the terms of office for the members of the Animal Friendly Advisory Committee. Specifically, the amendment to §169.101(g)(1) changes the expiration date from September 1 to January 31, making it conform with the statute which created the committee, Health and Safety Code, §828.015.

Jane C. Mahlow, DVM, MS, Director, Zoonosis Control Division, has determined that for the first five-year period the amended section is in effect, there will be no additional fiscal impact on state and local governments.

Jane C. Mahlow, DVM, MS, Director, Zoonosis Control Division, has determined that for the first five-year period the amended section is in effect, there will be no additional public benefit. There is no anticipated effect on small or micro businesses because no program activities are being added or deleted. There are no anticipated economic costs to persons who are required to comply with the amendment as proposed. There is no anticipated impact on local employment.

Comments on the proposal may be submitted to Jane C. Mahlow, DVM, MS, Director, Zoonosis Control Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3189, (512) 458-7255. Comments will be accepted for 30 days following the date of publication of this proposal in the Texas Register .

The amendment is proposed under the Health and Safety Code §828.015, which provides for the appointment of an Animal Friendly Advisory Committee; and §12.001, which provides the Texas Board of Health (board) with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

The amendment affects the Health and Safety Code, Chapter 828.

§169.101.Animal Friendly Advisory Committee.

(a) - (f)

(No change.)

(g)

Terms of office. The term of office of each member shall be two years.

(1)

Members shall be appointed for staggered terms so that the terms of four members expire on January 31 [ September 1 ] of each odd-numbered year and the terms of the remaining members expire on January 31 [ September 1 ] of each even-numbered year.

(2)

(No change.)

(h) - (p)

(No change.)

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on April 3, 2000.

TRD-200002395

Susan K. Steeg

General Counsel

Texas Department of Health

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 458-7236


Part 2. TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Chapter 409. MEDICAID PROGRAMS

The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes the repeal of §§409.1 - 409.3, 409.5, and 409.7 of Chapter 409, Subchapter A, concerning General Reimbursement Methodology for All Medical Assistance Programs; §409.213 of Chapter 409, Subchapter F, concerning Case Management Program Requirements; and §409.256 of Chapter 409, Subchapter G, concerning Case Management for Persons With Severe and Persistent Mental Illness.

Sections 409.1, 409.3, 409.5, and 409.7 are proposed for repeal because they are duplicative of 1 TAC §§355.701, 355.703, 355.705, and 355.707. Section 409.2 is proposed for repeal because it conflicts with 1 TAC §355.702, which was amended effective September 1, 1999. Section 409.213 and §409.256, both relating to Right to Appeal, are proposed for repeal because provisions regarding fair hearings for Medicaid recipients of service coordination (previously referred to as case management) are described in 25 TAC §412.464. The two sections were inadvertently omitted when TDMHMR repealed the subchapters concerning case management.

Bill Campbell, Chief Financial Officer, has determined that for each year of the first five years the proposed repeals are in effect, enforcing or administering the repeals does not have foreseeable implications relating to cost or revenue of the state or local governments.

Ernest McKenney, Director, Medicaid Administration, has determined that, for each year of the first five years the proposed repeals are in effect, the public benefit expected is the elimination of unnecessary rules and the promulgation of rules that are consistent with rules of the Health and Human Services Commission. It is anticipated that there would be no additional economic cost to persons required to comply with the proposed repeals.

It is anticipated that the proposed repeals will not affect a local economy.

It is anticipated that the proposed repeals will not have an adverse economic effect on small businesses or micro-businesses.

Written comments on the proposal may be sent to Linda Logan, Director, Policy Development, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas, 78711-2668, within 30 days of publication.

Subchapter A. GENERAL REIMBURSEMENT METHODOLOGY FOR ALL MEDICAL ASSISTANCE PROGRAMS

25 TAC §§409.1 - 409.3, 409.5, 409.7

(Editor's note: The text of the following sections proposed for repeal will not be published. The sections may be examined in the offices of the Texas Department of Mental Health and Mental Retardation or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

These sections are proposed for repeal under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of HHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Texas Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program.

These sections affect the Texas Human Resources Code, §32.012(c).

§409.1.Definitions and General Specifications.

§409.2.Method for Cost Determination.

§409.3.Basic Objectives and Criteria for Review of Cost Reports.

§409.5.Notification.

§409.7.Reviews and Administrative Hearings.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on March 29, 2000.

TRD-200002256

Charles Cooper

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 206-4516


Subchapter F. CASE MANAGEMENT PROGRAM REQUIREMENTS

25 TAC §409.213

(Editor's note: The text of the following section proposed for repeal will not be published. The section may be examined in the offices of the Texas Department of Mental Health and Mental Retardation or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The section is proposed for repeal under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of HHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Texas Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program.

The section affects the Texas Human Resources Code, §32.012(c).

§409.213.Right to Appeal.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on March 29, 2000.

TRD-200002257

Charles Cooper

Chairman, Texas MHMR Board

Texas Department Mental Health and Mental Retardation

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 206-4516


Subchapter G. CASE MANAGEMENT FOR PERSONS WITH SEVERE AND PERSISTENT MENTAL ILLNESS

25 TAC §409.256

(Editor's note: The text of the following section proposed for repeal will not be published. The section may be examined in the offices of the Texas Department of Mental Health and Mental Retardation or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The section is proposed for repeal under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of HHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Texas Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program.

The section affects the Texas Human Resources Code, §32.012(c).

§409.256.Right to Appeal.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on March 29, 2000.

TRD-200002258

Charles Cooper

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 206-4516


Chapter 419. MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES

Subchapter O. ENROLLMENT OF MEDICAID WAIVER PROGRAM PROVIDERS

25 TAC §419.709

(Editor's note: The text of the following section proposed for repeal will not be published. The section may be examined in the offices of the Texas Department of Mental Health and Mental Retardation or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes the repeal of existing §419.709 of Chapter 419, Subchapter O, governing Enrollment of Medicaid Waiver Program Providers. New §419.709 is contemporaneously proposed for adoption is this issue of the Texas Register .

At the January 2000 meeting of the TDMHMR board, amendments to Chapter 409, Subchapter L, §409.501 (relating to Description of the Mental Retardation Local Authority (MRLA) Program) were adopted. With the approval of the Health Care Financing Administration (HCFA), these amendments would allow TDMHMR to expand the MRLA program service area. The program expansion would require home and community-based services (HCS) and home and community-based services - OBRA (HCS-O) providers in these service areas to become MRLA providers. The provisions in Chapter 419, Subchapter O (governing Enrollment of Medicaid Waiver Program Providers) do not address the provisional certification or certification of HCS and HCS-O providers as MRLA providers. The proposed new §419.709 and the repeal of existing §419.709 would allow HCS and HCS-O providers to be provisionally certified or certified as MRLA providers in expanded service areas based on their status as provisionally certified or certified HCS or HCS-O providers.

William R. Campbell, chief financial officer, has determined that for each of the first five years the proposed repeal is in effect, enforcing or administering the proposed repeal does not have implications relating to costs or revenues for state or local government.

Ernest McKenney, director, Medicaid Administration, has determined that for each year of the first five years the section is in effect, the public benefit expected as a result of adopting the proposed repeal is the continuity of waiver program services for consumers in counties that become part of the MRLA program.

There is no probable economic cost to persons required to comply with the proposed section because no additional requirements were included in the proposed repeal. It is not anticipated that these sections will have an adverse economic effect on small businesses or micro-businesses because they do not impose additional requirements on such persons. It is not anticipated that the proposed repeal will affect a local economy because they do not impose additional requirements on such persons.

A public hearing will be held at 10:00 a.m. on Thursday, April 27, 2000, in Room 240 of the main TDMHMR Central Office building (Building 2), 909 West 45th Street, Austin, Texas, to accept oral and written testimony concerning the proposal. Persons needing an accommodation to attend the hearing and persons with special needs requiring assistance should contact the Office of Policy Development at least 72 hours prior to the hearing by calling (512) 206-4516. Persons with hearing impairments may also call TTY-Message - Texas Relay toll-free at (800) 735-2988.

Comments on the proposal may be submitted to Linda Logan, director, Policy Development, Texas Department Mental Health and Mental Retardation, P.O. Box 12668, Austin, TX 78711-2668, within 30 days of publication of this notice.

The repeal is proposed under the Texas Health and Safety Code, §532.015(a), which provides TDMHMR with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code §32.021(a), which provide the Texas Health and Human Services Commission (THHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Texas Legislature, Chapter 6, §1, which clarifies the authority of THHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program. THHSC has designated TDMHMR as the operating agency for selected Medicaid waiver programs, including the HCS, HCS-O, and MRLA programs.

The section affects the Health and Safety Code, §532.015, Human Resources Code, §32.021, and Government Code, §531.021.

§419.709. Deemed Provider Certification.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on April 3, 2000.

TRD-200002355

Charles Cooper

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 206-5153


Chapter 419. MEDICAID STATE OPERATING AGENCY

Subchapter O. ENROLLMENT OF MEDICAID WAIVER PROGRAM PROVIDERS

25 TAC §419.709

The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes new §419.709 of Chapter 419, Subchapter O, governing Enrollment of Medicaid Waiver Program Providers. Existing §419.709 is contemporaneously proposed for repeal in this issue of the Texas Register .

At the January 2000 meeting of the TDMHMR board, amendments to Chapter 409, Subchapter L, §409.501 (relating to Description of the Mental Retardation Local Authority (MRLA) Program) were adopted. With the approval of the Health Care Financing Administration (HCFA), these amendments would allow TDMHMR to expand the MRLA program service area. The program expansion would require home and community-based services (HCS) and home and community-based services - OBRA (HCS-O) providers in these service areas to become MRLA providers. The provisions in Chapter 419, Subchapter O (governing Enrollment of Medicaid Waiver Program Providers) do not address the provisional certification or certification of HCS and HCS-O providers as MRLA providers. The proposed new §419.709 would allow HCS and HCS-O providers to be provisionally certified or certified as MRLA providers in expanded service areas based on their status as provisionally certified or certified HCS or HCS-O providers.

Subsection (c) would be added to address the provisional certification of HCS or HCS-O providers as provisionally certified MRLA providers if the MRLA program expands into the county where HCS or HCS-O providers are providing services. Subsection (d) would be added to address the certification of HCS or HCS-O providers as certified MRLA providers -- without conducting a review -- if the MRLA program expands into the county where HCS or HCS-O providers are providing services. Language would be revised in subsections (a) and (b) consistent with subsections (c) and (d). Subsection (e) would be added to clarify that TDMHMR may, for good cause, not provisionally certify or certify an HCS or HCS-O provider and to list examples of good cause.

William R. Campbell, chief financial officer, has determined that for each of the first five years the proposed new section is in effect, enforcing or administering the proposed new section does not have implications relating to costs or revenues for state or local government.

Ernest McKenney, director, Medicaid Administration, has determined that for each year of the first five years the section is in effect, the public benefit expected as a result of adopting the proposed new section is the continuity of waiver program services for consumers in counties that become part of the MRLA program.

There is no probable economic cost to persons required to comply with these proposed new section because no additional requirements were included in the proposed section. It is not anticipated that these sections will have an adverse economic effect on small businesses or micro-businesses because they do not impose additional requirements on such persons. It is not anticipated that the proposed new section will affect a local economy because they do not impose additional requirements on such persons.

A public hearing will be held at 10:00 a.m. on Thursday, April 27, 2000, in Room 240 of the main TDMHMR Central Office building (Building 2), 909 West 45th Street, Austin, Texas, to accept oral and written testimony concerning the proposal. Persons needing an accommodation to attend the hearing and persons with special needs requiring assistance should contact the Office of Policy Development at least 72 hours prior to the hearing by calling (512) 206-4516. Persons with hearing impairments may also call TTY-Message - Texas Relay toll-free at (800) 735-2988.

Comments on the proposal may be submitted to Linda Logan, director, Policy Development, Texas Department Mental Health and Mental Retardation, P.O. Box 12668, Austin, TX 78711-2668, within 30 days of publication of this notice.

The new section is proposed under the Texas Health and Safety Code, §532.015(a), which provides TDMHMR with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code §32.021(a), which provide the Texas Health and Human Services Commission (THHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Texas Legislature, Chapter 6, §1, which clarifies the authority of THHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program. THHSC has designated TDMHMR as the operating agency for selected Medicaid waiver programs, including the HCS, HCS-O, and MRLA programs.

The section affects the Health and Safety Code, §532.015, Human Resources Code, §32.021, and Government Code, §531.021.

§419.709. Concurrent Provider Certification

(a)

Upon the request of a certified HCS provider, TDMHMR may provisionally certify the HCS provider as an HCS-O provider.

(b)

Upon the request of a certified HCS-O provider, TDMHMR may provisionally certify the HCS-O provider as an HCS provider.

(c)

TDMHMR may provisionally certify as an MRLA provider a provisionally certified HCS or HCS-O provider authorized to serve individuals residing in a county added to the service area of the MRLA program.

(d)

Without conducting a review, TDMHMR may certify as an MRLA provider a certified HCS or HCS-O provider authorized to serve individuals residing in a county added to the service area of the MRLA program.

(e)

TDMHMR may deny provisional certification or certification for good cause, which includes but is not limited to corrective actions or sanctions that are pending against the HCS or HCS-O provider.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on April 3, 2000.

TRD-200002356

Charles Cooper

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: May 14, 2000

For further information, please call: (512) 206-5153