Part 3.
OFFICE OF THE ATTORNEY GENERAL
Chapter 55.
CHILD SUPPORT ENFORCEMENT
Subchapter H. LICENSE SUSPENSION
1 TAC §55.203
The Office of the Attorney General adopts amendments to §55.203,
Figure 55.203(a), Figure 55.203(b), and Figure 55.203(c), the promulgated
forms for the Notice of Filing of Petition to Suspend License, Petition to
Suspend License, and Request for Hearing, with changes. The changes to the
proposed text were published in the February 4, 2000 issue of the
Texas Register
(25 TexReg 647).
The amended forms are being adopted to clarify instructions regarding an
administrative license suspension action, and to comply with recent changes
in the Texas Family Code, Chapter 232. The changes to the Notice of Filing
of Petition to Suspend License clarify the administrative process by instructing
the obligor to retain all service papers to be used at a later hearing. The
notice also clarifies information needed on the return of service. Changes
to the Petition to Suspend License involve deleted language to reflect recent
changes to the Texas Family Code, §232.003. Changes to the Request for
Hearing clarify the administrative license suspension process by additional
language that instructs the obligor to retain all service documents for use
at a later hearing, and sets out in bold the location of in person hearings.
These forms affect the Texas Family Code, Section 232.
No comments were received regarding the adoption of this section.
The amended forms are adopted under the Family Code, Chapter
232, Suspension of License for Failure to Pay Child Support, §232.016,
which provides the Office of the Attorney General with the authority to prescribe
forms and procedures for the implementation of Chapter 232.
§55.203.Forms.
(a)
Notice of Filing of Petition to Suspend License. The notice
shall take the form as follows:
Figure: 1 TAC §55.203(a)
(b)
Petition to Suspend License. The petition shall take the
form as follows:
Figure: 1 TAC §55.203(b)
(c)
Request for Hearing. The request shall take the form as
follows:
Figure: 1 TAC §55.203(c)
(d)
Notification to Licensing Authority of Order Suspending
License.
Figure: 1 TAC §55.203(d) (No change)
(e)
Notification of Licensing Authority of Order Vacating or
Staying Order Suspending License.
Figure: 1 TAC §55.203(e) (No change)
(f)
Suggested model forms for use by the Courts.
Figure: 1 TAC §55.203(f) (No change)
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on April 7, 2000.
TRD-200002458
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 4, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §55.210, §55.211
The Office of the Attorney General adopts the repeal of §55.210
and §55.211, concerning license suspension for failure to pay child
support without changes to the proposal as published in the January 28, 2000,
issue of the
Texas Register
(25 TexReg 490).
Section 55.210 requires the administrative law judge to issue a proposal
for decision following a license suspension hearing. Section 55.211 gives
the adversely affected party an opportunity to file exceptions to the proposal
for decision for the Title IV-D Director's consideration prior to rendition
of a final decision.
These sections are no longer necessary because the agency official (the
administrative law judge) who conducts the hearing or reads the record will
render the final decision in contested cases pursuant to amended §55.212.
This eliminates the necessity of the proposal for decision required by Tex.Gov.Code §2001.062(a)(1)
in cases in which the government official rendering the final decision does
not hear the case or review the record. The requirement to provide the parties
an opportunity to file exceptions and briefs in accordance with Tex.Gov.Code §2001.062(a)(2)
is dispensed with as well. Any party desiring to challenge a final decision
retains the right to file a Request for Rehearing which may be granted or
denied by the administrative law judge as provided in Tex.Gov.Code §2001.145.
No comments were received regarding adoption of the repeals.
The repeals are adopted under the Family Code, Chapter 232, Suspension
of License for Failure to Pay Child Support or Comply with Subpoena, §232.004(d),
which provides that a proceeding in a case filed with the Title IV-D agency
under this chapter is governed by the contested case provisions of Chapter
2001, Government Code.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on April 7, 2000.
TRD-200002455
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: January 28, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
The Office of the Attorney General (OAG) adopts §§63.1,
63.3, 63.11, 63.13, 63.15, 63.17, 63.19, 63.31, 63.33, 63.35, 63.37, 63.39,
63.51, 63.53, 63.55, 63.57, 63.71, 63.73, 63.81, 63.83, 63.85, 63.87, 63.89,
63.91, 63.101, 63.103, 63.105, 63.107, 63.109, 63.111, 63.113, 63.115, 63.117,
63.119, 63.121, 63.123, 63.125, 63.127, 63.129, 63.131, 63.141, 63.143, 63.145,
63.147, 63.149, 63.151, 63.153, 63.155, 63.157, 63.159, 63.161, 63.163, 63.165,
63.167, 63.169, 63.171, 63.173, 63.175, 63.177, 63.179, 63.181, 63.183, 63.185,
63.191, 63.193 and 63.195 without changes to the proposed text as published
in the February 25, 2000, issue of the
Texas Register
(25 Tex Reg 1459)
relating to rules for administration of crime victims'
assistance grants (VAG) and will not be republished.
This chapter adopts implementation of new rules necessary to carry out
the provisions of Tex. Code Crim. Proc. Ann. art. 56.541(West 1999), which
provides funds for grants or contracts that support crime victim-related services
or assistance. Article 56.541 reflects the legislature's finding that it is
appropriate and necessary for the state to authorize a method for the appropriation
of excess money in the compensation to victims of crime fund for grants or
contracts supporting victim-related services or assistance. This adopted chapter
establishes a procedure by which attorneys who represent the state in criminal
cases and local law enforcement authorities may apply for and administer victim
assistance coordinator grants. It also establishes a procedure by which nonprofit
corporations may apply for and administer VAGs for statewide training programs
that benefit victims of sexual assault and grants to purchase forensic exam
equipment. Article 56.541 establishes joint authority of the OAG and the comptroller
to determine the proper allocation of the revenue in the compensation to victims
of crime fund for purposes of the article. Article 56.541(f) authorizes the
OAG to adopt rules necessary for the implementation of article 56.541. The
purpose of the regulatory scheme is to establish procedures for application
and administration of VAGs or contracts which support crime victim-related
services or assistance and therefore carry out the purpose of the statute.
The OAG may also adopt rules to carry out its own independent functions under
the statute. The adopted rules accomplish the objectives as set out below:
Subchapter A (General Provisions, §§63.1, 63.3) contains the
general provisions of Chapter 63, including definitions of terms, a description
of the statutory authority for the grant funds, the source of the grant funds,
the Constitutionally dedicated purpose of the funds, and prohibitions related
to the use of grant funds. These sections also contain a description of the
OAG's statutory authority to adopt rules reasonable and necessary to implement
article 56.541 of the Code Crim. Proc. Ann. art. 56.541(West 1999). Adopted §63.1
establishes the definitions of terms. Adopted §63.3 states the statutory
authority for the creation of the fund, recognizes the authority of the Attorney
General to administer the funds, and the purpose of the funds.
Subchapter B (Grants for Victim Assistance Coordinator or Crime Victim
Liaison, §§63.11, 63.13, 63.15, 63.17, and 63.19) describes permissible
uses for grant funds, the class of persons or entities eligible to apply for
such grant funds, the funding levels for grants awarded, the limitations of
use of grant funds awarded, and the duties of individuals who are employed
as a result of grant awards. Adopted §63.11 defines that grants awarded
may be used to defray all or part of the salary for establishing the positions
of victim assistance coordinator or crime victim liaison and the duties associated
with such positions. Adopted §63.13 defines the class of persons and
entities eligible to obtain crime victim assistance grants to fund positions
of victim assistance coordinator and crime victim liaison. Adopted §63.15
sets forth minimum and maximum amounts of funding that may be applied for
and permissible uses of VAG funds. Adopted §63.17 limits the use of grant
funds to payment of salaries only and stipulates that the grant funds may
not be used to pay fringe benefits, such as retirement, health insurance,
etc., nor office expenses or equipment expenses. Adopted §63.19 states
the requirement that individuals employed in positions funded by VAG funds
provide direct services to victims of crime.
Subchapter C (Grants for Statewide Training for Programs That Benefit Victims
of Sexual Assault and to Purchase Forensic Exam Equipment, §§63.31,
63.33, 63.35, 63.37, and 63.39) describes permissible uses, eligible applicants,
and minimum and maximum amounts of funding for grant funds applied for and
awarded for statewide training for programs that benefit victims of sexual
assault and to purchase forensic exam equipment for communities with certified
Sexual Assault Nurse Examiner programs. Adopted §63.31 describes the
purposes for which grant funds may be used. Adopted §63.33 defines entities
that may be eligible to apply for grant funding. Adopted §63.35 establishes
the minimum and maximum amounts for grant funding. Adopted §63.37 specifies
various conditions and requirements associated with grantee tasks and activities
such as the requirement that a grantee must provide volunteer services in
connection with a VAG-funded project. Adopted §63.39 sets forth the adopted
rule relating to the use of grant funds for travel expenses.
Subchapter D (Grant Application, Scope of Grant, Approval, §§63.51,
63.53, 63.55, and 63.57) describes the application process, including the
requirement of a timely-filed application, the OAG review criteria, and discretionary
determination of funding by the OAG. Adopted §63.51 establishes applicants
to complete and submit an Application Kit to the OAG Grant Coordinator and
requires one original and one duplicate to be filed by the first working day
in May of each year for consideration for the coming fiscal year. Adopted §63.53
requires the OAG to review and evaluate timely filed applications, establishes
full discretion in the OAG for all funding decisions, and establishes other
criteria for the OAG to consider in funding decisions. Adopted §63.55
establishes the grant funding period and criteria for awarding second-year
funding on first year performance. Adopted §63.57 addresses the ineligibility
of indirect costs as an expenditure of VAG funds.
Subchapter E (Funding of Grants, §§63.71, 63.73) provides for
project approval and funding outside of the annual grant cycle. This subchapter
also declares that the actual funding of approved new and existing grant projects
is contingent on the availability of funds. Adopted §63.71 provides for
approval of nonstandard grant funding outside of the annual grant cycle. Adopted §63.73
declares that actual funding of approved new and existing grant projects is
contingent on availability of funds.
Subchapter F (Grant Budget Requirements, §§63.81, 63.83, 63.85,
63.87, 63.89, and 63.91) sets forth rules governing the use of VAG funds and
documentation of such use relating to personnel. The subchapter also sets
forth requirements related to expenditures for professional and contractual
services, rules concerning transportation, travel, and training, and use of
VAG funds for equipment. The subchapter also addresses limitations on the
use of grant funds.
Adopted §63.81 governs salary for VAG-funded positions, requirements
concerning verification of personnel licenses and certifications, verification
of personnel time and project records, and related rules concerning grant
funds for personnel. Adopted §63.83 sets out prohibitions on dual compensation
and documentary requirements that a grantee must meet with regard to contracts,
travel allowances, reimbursements, related party transactions, and consistency
with OAG professional rate schedules.
Adopted §63.85 details rules applicable to grantees concerning transportation,
travel, and training expenditures and the documentation of same. Adopted §63.87
details rules applicable to grantees concerning the acquisition of equipment.
Adopted §63.89 sets forth necessary OAG approvals and rules governing
the use of and prohibitions regarding the use of VAG funds for supplies and
direct operating expenses. Adopted §63.91 prohibits the use of grant
funds for construction costs and land acquisition costs.
Subchapter G. (Special Conditions and Required Documents, §§63.101,
63.103, 63.105, 63.107, 63.109, 63.111, 63.113, 63.115, 63.117, 63.119, 63.121,
63.123, and 63.125) addresses documents which VAG applicants are required
to submit to the OAG for approval. All of these documents are necessary for
the OAG to determine that grant funds are being awarded to entities which
follow operating procedures consistent with state and federal law. Adopted §63.101
requires a current statistical report of anticipated productivity to be filed
with the application for grant. Adopted §63.103 requires that the application
for grant include a signed Equal Employment Opportunity Program Certification
under certain circumstances. Adopted §63.105 requires that the application
include an executed copy of a Certification Regarding Lobbying that no Victims
Assistance Grant Funds have been paid or will be paid to any person for purposes
of lobbying in connection with the grant. Adopted §63.107 requires that
the application include a signed copy of the Nonprocurement Debarment Certification.
Adopted §63.109 requires the application to include a signed copy of
a Drug-Free Workplace Certification. Adopted §63.111 requires the application
to include a signed copy of a Uniform Grants Management Standards Certification.
Adopted §63.113 requires the application to include a signed copy of
a Certified Assurances Certification. Adopted §63.115 requires the application
to include a signed copy of a Cooperative Working Agreement which shall include
statements that the project will be carried out in a significant part due
to the cooperation of outside organizations and stipulates parties who have
authority to execute such agreements. Adopted §63.117 requires pre-approval
of the OAG for grantees to use grant funds to purchase equipment with a cost
exceeding $25,000. In addition, adopted §63.117 establishes the process
and documentation necessary for submission for review and approval of equipment
purchases by the OAG. Adopted §63.119 requires that prior to execution
of any contract in excess of $25,000, the grantee must submit said contract
and documentation stipulated for review and approval by the OAG. In addition,
adopted §63.119 establishes criteria and processes for the consideration
of entering into contracts by grantees using grant funds. Adopted §63.121
requires that governmental entities and nonprofit organizations who submit
applications obtain a resolution from the governing body that Designates and
authorizes officials the power to accept, reject, or amend a grant. The resolution
must state that in the event of misuse of grant funds, a security bond will
be obtained and the funds will be returned in full. In addition, the resolution
must contain non-supplanting language. Adopted §63.123 requires an applicant
to submit a current organizational chart reflecting grant and non-grant funded
positions. Adopted §63.125 permits the OAG to award a grant conditioned
upon a post-award survey and establishes procedures for conducting the post-award
survey.
Subchapter H. (Award and Grant Acceptance, §§63.127, 63.129,
and 63.131) sets forth the process for the award and acceptance of grants.
Adopted§63.127 requires to applicant to accept or reject in writing a
grant award within 45 days of the grant award date and provides for deobligation
of funds in the event a timely response is not received. This section includes
the requirement that a grantee implement the VAG within 60 days of the designated
start date or face relinquishment of the grant award. The section also sets
forth the OAG's full discretion in approving project funding and determining
grantee compliance with OAG policies. Adopted d §63.129 outlines procedures
for (i) an applicant's accepting or rejecting a grant award and (ii) an applicant's
response to deficiencies in a filed application. Adopted §63.131 describes
the process that an applicant may pursue in the event that the OAG denies
an application or part of an application and sets forth the final decision-making
authority of the OAG.
Subchapter I (Administering Grants, §§63.141, 63.143, 63.145,
63.147, 63.149, 63.151, 63.153, 63.155, 63.157, 63.159, 63.161, 63.163, 63.165,
63.167, 63.169, 63.171, 63.173, 63.175, 63.177, 63.179, 63.181, 63.183, and
63.185) proposes rules for the administration of VAGs. The rules establish
duties and responsibilities for grant officials, requirements regarding records,
requests for funds procedures, grant adjustments, copyrights, procurement
procedures, and rules relating to property management, bonding, and insurance.
The subchapter addresses OAG authority to withhold funds or terminate a grant
under certain conditions and a grantee's ability to request a reconsideration
of a decision to withhold funds or terminate a grant project. Adopted Subchapter
G also contains procedures for grantee self- evaluation of a project, submission
of regular progress reports to the OAG, evaluation of third party contracts,
if any, and winding up a VAG administration.
Adopted §63.141 requires that each grantee designate three grant officials
whose duties are described in the section. Adopted §63.143 requires OAG
approval if grant funds are obligated prior to the start date or later than
the ending date of the grant period. Adopted §63.145 sets forth grant
records retention requirements for a period of five years and availability
of the records in an electronic format for purposes of audit. Adopted §63.147
requires the grantee to file financial expenditure reports each calendar quarter
on forms promulgated by the OAG and the consequences for filing to file a
timely report. Adopted §63.149 requires the grantee to maintain an inventory
report on file in the principal office of the grantee. Adopted §63.151
establishes time limits for the filing of the grantee's final request for
funds and the consequences of a grantee's failure to submit accurate reports
in a timely manner. Adopted §63.153 describes the procedure for a grantee
to follow in submitting a request for a grant adjustment. Adopted §63.155
establishes the OAG's claim to a license to use copyrighted material where
the purchase of such copyright was funded in any part by OAG funds. Adopted §63.157
governs procurement procedures, including OAG review and approval, to be used
by a grantee who purchases equipment or professional or consultant services
in excess of $25,000. §63.159 establishes the Uniform Grant Management
Standards published by the Governor's Office of Budget and Planning as the
governing property management standards for a grantee. Adopted §63.161
provides guidance regarding equipment disposition methods where a grantee
that has purchased equipment in whole or in part with OAG funds is no longer
funded by the OAG. Adopted §63.163 provides guidance regarding the transfer
of title to equipment and nonexpendable personal property acquired with grant
funds. Adopted §63.165 sets forth a grantee's bonding and insurance requirements.
Adopted §63.167 addresses the OAG's authority and discretion to withhold
funds from a specific project or from all projects operated by a grantee if
any of the enumerated conditions or situations occur and a grantee's ability
to request a reconsideration of a decision by the OAG to withhold funds. Adopted §63.169
outlines the procedures regarding cancellation or termination of a grant,
the consequences of such action, and a grantee's ability to request a reconsideration
of a decision by the OAG to terminate a grant project.
Adopted §63.171 sets for the requirements for de-obligation of grant
funds at the end of the funding period and provides for final expenditure
reports to be submitted within a certain time limit. Adopted §63.173
requires the grantee to obligate and expend all outstanding liabilities within
certain specified time frames. Adopted §63.175 requires the grantee and
its personnel to report immediately upon discovery to the OAG and the prosecuting
attorney's office any violation of the law appertaining to the use and expenditure
of grant funds. Adopted §63.177 contains a prohibition against behavior
constituting a conflict of interest on the part of any person affiliated with
the VAG project. Adopted §63.179 imposes contract monitoring and self-evaluation
requirements on a grantee. In this section, the OAG seeks to ensure that a
grantee takes a sustained, active role in assessing actual delivery of service
to victims of crime through the VAG project. Adopted §63.181 imposes
the requirement for the filing of timely and complete progress reports. Adopted §63.183
requires a grantee who uses grant funds to contract with a third party to
maintain proper records to ensure that the requirements of the contract are
met. Adopted §63.185 establishes the requirement for accuracy of grant
records and the recourse for providing false information.
Subchapter J (Program Monitoring and Audits, §§63.191, 63.193,
and 63.195) contains provisions concerning OAG monitoring activities, compliance
reviews, and auditing authority and standards as well as procedures for grantee
appeals of OAG decisions relating to audit findings.
Adopted §63.191 explains that OAG monitoring will attempt to ensure
that a grantee is achieving VAG performance goals and that grant awards are
used in accord with applicable laws, rules, and grant agreements. Adopted §63.193
requires a grantee to be required to file independent annual audits in accordance
with UGMS and GAAS. Adopted §63.195 contains guidance as to the substance
of OAG reviews and the substance of required annual audits.
No comments were received regarding adoption of these new sections.
Subchapter A. GENERAL PROVISIONS
1 TAC §63.1, §63.3
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on April 7, 2000.
TRD-200002494
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.11, 63.13, 63.15, 63.17, 63.19
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002495
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.31, 63.33, 63.35, 63.37, 63.39
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002496
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.51, 63.53, 63.55, 63.57
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002497
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §63.71, §63.73
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002498
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.81, 63.83, 63.85, 63.87, 63.89, 63.91
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002499
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.101, 63.103, 63.105, 63.107, 63.109, 63.111, 63.113, 63.115, 63.117, 63.119, 63.121, 63.123, 63.125
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002500
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.127, 63.129, 63.131
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002501
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.141, 63.143, 63.145, 63.147, 63.149, 63.151, 63.153, 63.155, 63.157, 63.159, 63.161, 63.163, 63.165, 63.167, 63.169, 63.171, 63.173, 63.175, 63.177, 63.179, 63.181, 63.183, 63.185
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002502
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
1 TAC §§63.191, 63.193, 63.195
The new rules are adopted under the Texas Code of Criminal
Procedure, Article 56.541, which the OAG interprets as authorizing the Office
of the Attorney General to adopt rules reasonable and necessary to implement
Chapter 56, and in order to provide funds for grants or contracts that support
crime victim-related services or assistance.
The new rules affect Texas Code of Criminal Procedure, Chapter 56.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002503
Elizabeth Robinson
Assistant Attorney General
Office of the Attorney General
Effective date: April 27, 2000
Proposal publication date: February 25, 2000
For further information, please call: A.G. Younger
at (512) 463-2110
Chapter 355.
MEDICAID REIMBURSEMENT RATES
Subchapter C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES
The Texas Health and Human Services Commission (HSSC) adopts the repeal
of §355.307; adopts an amendment to §355.306; and adopts new §355.307,
without changes to the proposed text published in the February 25, 2000, issue
of the
Texas Register
(25 TexReg 1474). New §355.308
is adopted with changes to the proposed text.
Justification of the amendment and new sections is to implement the Texas
Department of Human Services appropriations rider 38 regarding nursing facilities
passed by the 76th legislature. These rules were developed in consultation
with representatives of the legislature, representatives of provider organizations,
and individual providers.
The amendment and new sections implement the Texas Department of Human
Services (DHS) appropriations rider 38 regarding nursing facilities passed
by the 76th legislature. The amendment and new sections will function by establishing
procedures for providers to obtain additional funds for increased staffing
for registered nurses (RNs), licensed vocational nurses (LVNs), Medication
Aides, and nurse aides in nursing facilities. Providers receiving the additional
funds must demonstrate compliance with enhanced staffing requirements. Providers
who choose not to receive additional funds will have their direct care staff
rate increase each year limited to routine inflation. All providers must spend
85% of the revenues received for direct care staff compensation for RNs, LVNs,
Medication Aides, and nurse aides or funds intended for those purposes are
recouped by DHS. The proposal modifies the cost areas to separate the new
direct care staff cost center from the other resident care cost center and
separates the dietary cost center from the general and administrative cost
center.
A public hearing was held on March 9, 2000, in the Texas Department of
Human Services Board Room, 701 West 51st Street, Austin, Texas.
Comments were received from representatives of the following associations:
Texas Association of Homes and Services for the Aging and Texas Health Care
Association. Comments were also received from representatives of Texas Advocates
for Nursing Home Residents, the Senior Advocacy Coalition, and Advocates for
Nursing Home Reform.
General Comments: One commenter stated that the department should institute
staffing ratios for nurse aides.
Response: The purpose of these rules is to implement the Texas Department
of Human Services appropriations rider 38 regarding nursing facilities passed
by the 76th legislature. This rider directs the department to incentivize
increased direct care staffing and direct care wages and benefits in nursing
homes. Instituting staffing ratios would mandate increased direct care staffing
rather than incentivize it.
Comment concerning §355.308(j): All but one commenter stated that
this subsection should be broadened to include nurse aides. One commenter
stated that nurse aides should be included at a later date.
Response: Language has been added to include Medication Aides and nurse
aides (Certified Nurse Aides and nurse aides in training as per 40 TAC §94.4)
in the direct care staff enhancement.
Comment concerning §355.308(j): One commenter recommended that RN
and LVN minutes be combined based on weighted average minutes into a single
nursing staff time measure to allow providers greater flexibility in meeting
their direct care staff enhancement requirements.
Response: Language has been added to combine staff types into a single
staff time measure based on weighted average minutes. The language at §355.308(l)(1)-(3)
and §355.308(n) was also revised to combine staff types into a single
staff time measure.
Comment concerning §355.308(j)(1)(F): One commenter recommended that
facilities' minimum required staffing levels be lowered from 95% of the statewide
average adjusted for their case mix to 90% of the statewide average adjusted
for their case mix.
Response: Language at 355.308(j)(1) has been revised to reflect a more
logical calculation sequence. Data used to determine minimum required minutes
are adjusted to account for Medicare acuity and other factors at 355.308(j)(1)(A),
before minimum required minutes by category are calculated. These adjustments
at the beginning of the calculation process reduce statewide average minutes
by approximately six percent. Thus the five percent adjustment specified at
355.308(j)(1)(F) was eliminated.
Comment concerning §355.308(n)(2): One commenter recommended that
the department modify this paragraph to require annual recoupment rather than
quarterly recoupment for facilities failing to meet their agreed upon staffing
requirements.
Response: The language has been revised to require semi-annual recoupment
rather than quarterly recoupment for facilities failing to meet their agreed
upon staffing requirements. Recoupment only on an annual basis is not responsive
enough to make adjustments for facilities failing to meet their agreed upon
staffing requirements. As a result of this revision, rule provisions at §355.308(f)(1)
and (2), §355.308(j)(3), and §355.308(n)(2)-(6) adjusting staffing
levels upward during the rate period were eliminated.
Comment concerning §355.308(n): One commenter recommended that the
department modify this subsection to make allowances for providers that try
in good faith to meet their requirements and still fail.
Response: Participation in the direct care staff enhancement is voluntary.
Recoupment based upon failure to meet staffing requirements will be limited
to enhancement dollars paid to the facility specifically to hire or retain
staff. If the facility is unable to hire or retain the required staff, they
will not have incurred the additional costs the enhancement is intended to
pay for and the enhancement should be recouped by the department. HHSC is
adopting this subsection without change. HHSC is revising §355.308(j)(3)
to allow enhancements of providers failing to meet their staffing requirements
to continue to qualify as pre-existing enhancements for purposes of granting
staffing enhancements if the provider can demonstrate to the satisfaction
of the Department of Human Services (DHS) that the facility has been unable,
despite diligent efforts, to recruit appropriate personnel.
In addition to the changes detailed above, the department has made the
following changes.
The department has modified §355.308(a) to clarify that staff which
are to be included in the direct care staff cost center include Directors
of Nursing (DONs) and Assistant Directors of Nursing (ADONs).
The department has added §355.308(a)(5) to clarify that for facilities
receiving supplemental reimbursement for children with tracheostomies requiring
daily care, staff required by 40 TAC §19.901(14)(C)(iii) (relating to
Quality of Care) performing nursing-related duties for Medicaid contracted
beds are included in the direct care staff cost center.
The department has added §355.308(a)(6) to clarify that nursing facility
administrators are not included in the direct care staff cost center.
The department has modified §355.308(a)(3) to clarify that nurse aides
include Certified Nurse Aides and nurse aides in training as per 40 TAC §94.4(c)
(relating to Facility Requirements).
The department has modified §355.308(c) to change the standard open
enrollment period from June to July to move the enrollment period closer to
the rate year.
The department has modified §355.308(d) to allow for more flexibility
in applying vendor hold. The subsection now states, "Facilities failing to
submit an acceptable enrollment contract amendment by the end of the open
enrollment period may be placed on vendor hold until such time as an acceptable
enrollment contract amendment is received and processed by DHS."
The department has modified §355.308(d) and (g) to eliminate from
the rule the specificity of the information required in the enrollment contract
amendment, Six-Month Staffing Report and Annual Staffing and Compensation
Report. The data collected on these documents could change as data needs change.
The department has modified §355.308(f)(1) to change the due date
for the Annual Staffing and Compensation Report from within 30 days of the
end of the rate year to within 60 days of the end of the rate year to allow
more time to complete the forms.
The department has modified §355.308(f)(1)(A) to clarify the reporting
requirements for new owners when a facility changes ownership.
The department has modified 355.308(g) and (h) to have the titles of reports
match the titles of the reports as specified in 355.308(f)(1) and (2).
The department has modified §355.308(i) to clarify that a facility's
participation in the enhanced direct care staff rate will end when the facility
is removed from participation by DHS as described in §355.308(n)(3).
The department has modified §355.308(j) and (l) to incorporate staff
time requirements for Medicaid residents receiving supplemental payments for
ventilator or pediatric tracheostomy care into the calculation of minimum
staffing requirements because there are additional staff times associated
with these residents.
1 TAC §§355.306-355.308
The amendment and new sections are adopted under the Government
Code, §531.033, which authorizes the commissioner of the Health and Human
Services Commission to adopt rules necessary to carry out the commission's
duties, and §531.021(b), which establishes the commission as the agency
responsible for adopting reasonable rules governing the determination of fees,
charges, and rates for medical assistance payments under Chapter 32, Human
Resources Code.
The amendment and new sections implement the Government Code, §§531.033
and 531.021(b).
§355.308.Enhanced Direct Care Staff Rate.
(a)
Direct care staff cost center. This cost center will include
compensation for employee and contract labor Registered Nurses (RNs) including
Directors of Nursing (DONs) and Assistant Directors of Nursing (ADONs), Licensed
Vocational Nurses (LVNs) including DONs and ADONs, Medication Aides, and nurse
aides performing nursing-related duties for Medicaid contracted beds.
(1)
Compensation to be included for these employee staff types
is the allowable compensation defined in §355.103(b)(1) of this title
(relating to Specifications for Allowable and Unallowable Costs) that is
reported as either salaries and/or wages (including payroll taxes and workers'
compensation) or employee benefits. Benefits required by §355.103(b)(1)(A)(iii)
of this title (relating to Specifications for Allowable and Unallowable Costs)
to be reported as costs applicable to specific cost report line items are
not to be included in this cost center.
(2)
Direct care staff who also have administrative duties
not related to nursing must properly direct charge their compensation to each
type of function performed based upon daily time sheets maintained throughout
the entire reporting period.
(3)
Nurse aides must meet the qualifications enumerated
under 40 TAC §94.3 (relating to Facility Requirements) to be included
in this cost center. Nurse aides include Certified nurse aides and nurse aides
in training as per 40 TAC §94.4(c) (relating to Facility Requirements).
(4)
Contract labor refers to personnel for whom the contracted
provider is not responsible for the payment of payroll taxes (such as FICA,
Medicare, and federal and state unemployment insurance) and who perform tasks
routinely performed by employees. Allowable contract labor costs are defined
in §355.103(b)(2)(C) of this title (relating to Specifications for Allowable
and Unallowable Costs).
(5)
For facilities receiving supplemental reimbursement
for children with tracheostomies requiring daily care as described in §355.307(b)(3)(G)
of this title (relating to Reimbursement Setting Methodology), staff required
by 40 TAC §19.901(14)(C)(iii) (relating to Quality of Care) performing
nursing-related duties for Medicaid contracted beds are included in the direct
care staff cost center.
(6)
Nursing facility administrators are not included in
the direct care staff cost center.
(b)
Rate year. The standard rate year begins on the first day
of September and ends on the last day of August of the following year. An
implementation rate period will begin on May 1, 2000, and end on August 31,
2000. Except where otherwise noted, all the rules in this section apply to
the implementation rate period as well as the standard rate year.
(c)
Open enrollment. Implementation open enrollment begins
on April 1, 2000, and ends on April 14, 2000. Standard open enrollment begins
on the first day of July and ends on the last day of that same July preceding
the standard rate year for which payments are being determined.
(d)
Enrollment contract amendment. All contracted facilities
must submit an enrollment contract amendment during the open enrollment period.
On the enrollment contract amendment the provider must specify for each facility
its desire to participate or its desire not to participate. The provider also
must submit with the contract amendment all required documentation to the
Texas Department of Human Services (DHS), in a manner specified by DHS. Facilities
failing to submit an acceptable enrollment contract amendment by the end of
the open enrollment period may be placed on vendor hold until such time as
an acceptable enrollment contract amendment is received and processed by DHS.
(e)
New facilities. For purposes of this section, for each
rate year a new facility is defined as a facility delivering its first day
of service to a DHS recipient after the first day of the open enrollment period,
as defined in subsection (c) of this section, for that rate year. Facilities
that underwent an ownership change are not considered new facilities. New
facilities must complete the enrollment contract amendment specified in subsection
(d) of this section within 30 days of notification by DHS. Facilities failing
to submit an acceptable enrollment contract amendment within 30 days of notification
by DHS will be placed on vendor hold until such time as an acceptable enrollment
contract amendment is received and processed by DHS. Based on the enrollment
contract amendment information received, the facility's direct care staff
rate will be adjusted effective on the sixty-first day of the contract with
DHS. New facilities will receive the direct care staff rate associated with
minimum staffing requirements as determined in subsection (j)(1) of this section
for the first 60 days of their contract with DHS.
(f)
Staffing and Compensation Report submittal requirements.
Staffing and Compensation Reports must be submitted as follows:
(1)
All contracted facilities. All contracted facilities will
provide DHS, in a method specified by DHS, an Annual Staffing and Compensation
Report reflecting the activities of the facility while delivering contracted
services from the first day of the rate year through the last day of the rate
year. This report will be used as the basis for determining compliance with
the staffing requirements and recoupment amounts as described in subsection
(n) of this section for the last six months of the rate year for participants,
and as the basis for determining the spending requirements and recoupment
amounts as described in subsection (o) of this section for all facilities.
Facilities failing to submit an acceptable Annual Staffing and Compensation
Report within 60 days of the end of the rate year will be placed on vendor
hold until such time as an acceptable report is received and processed by
DHS. For the implementation rate period, a Staffing and Compensation Report
is required reflecting the activities of the facility while delivering contracted
services from June 1, 2000, through August 31, 2000.
(A)
When a facility changes ownership, the prior owner must
submit a Staffing and Compensation Report covering the period from the beginning
of the rate year to the date recognized by DHS as the ownership-change effective
date. This report will be used as the basis for determining any recoupment
amounts as described in subsections (n) and (o) of this section. The new owner
will be required to submit a Staffing and Compensation Report covering the
period from the day after the date recognized by DHS as the ownership-change
effective date to the end of the rate year.
(B)
Facilities whose contracts are terminated either voluntarily
or involuntarily must submit a Staffing and Compensation Report covering the
period from the beginning of the rate year to the date recognized by DHS as
the contract termination date. This report will be used as the basis for determining
any recoupment amounts as described in subsections (n) and (o) of this section.
(C)
Participating facilities who voluntarily withdraw from
participation as per subsection (r) of this section must submit a Staffing
and Compensation Report covering the period from the beginning of the rate
year to the date of withdrawal as determined by DHS. This report will be used
as the basis for determining any recoupment amounts as described in subsections
(n) and (o) of this section.
(2)
Participating facilities. Within 30 days of the
end of the first six months of the rate year, all participating facilities
will provide DHS, in a method specified by DHS, with a Six-Month Staffing
Report reflecting the activities of the facility while delivering contracted
services from the first day of the rate year through the last day of the sixth
month of the rate year. These reports will be used as the basis for determining
compliance with the staffing requirements and recoupment amounts as described
in subsection (n) of this section for the first six months of the rate year.
Facilities failing to submit an acceptable Six-Month Staffing Report within
30 days of the end of the sixth month of the rate year will be placed on vendor
hold until such time as an acceptable report is received and processed by
DHS.
(3)
Other reports. DHS may require other Staffing and
Compensation Reports from all facilities as needed.
(g)
Report contents. Annual Staffing and Compensation Reports
and Six- Month Staffing Reports will include any information required by DHS
to implement this enhanced direct care staff rate.
(h)
Completion of Reports. All Staffing and Compensation Reports
and Staffing Reports must be completed in accordance with the provisions of §§355.102-355.105
of this title (relating to General Principles of Allowable and Unallowable
Costs, Specifications for Allowable and Unallowable Costs, Revenues, and General
Reporting and Documentation Requirements, Methods, and Procedures) and may
be reviewed or audited in accordance with §355.106 of this title (relating
to Basic Objectives and Criteria for Audit and Desk Review of Cost Reports).
(i)
Enrollment. Facilities choosing to participate in the enhanced
direct care staff rate must submit to DHS a signed contract amendment as described
in subsection (d) of this section, before the end of the open enrollment period.
Participation will remain in effect, subject to availability of funds, until
the facility notifies DHS in accordance with subsection (r) of this section
that it no longer wishes to participate or the facility is removed from participation
as described in subsection (n)(3) of this section. Facilities voluntarily
withdrawing from participation will have their participation end effective
on the date of the withdrawal as determined by DHS.
(j)
Determination of staffing requirements for participants.
Facilities choosing to participate in the enhanced direct care staff rate
agree to maintain certain direct care staffing levels. In order to permit
facilities the flexibility to substitute RN, LVN and aide (Medication Aide
and nurse aide) staff resources and, at the same time, comply with an overall
nursing staff requirement, total nursing staff requirements are expressed
in terms of LVN equivalent minutes. Conversion factors to convert RN and aide
minutes into LVN equivalent minutes are based upon most recently available,
reliable relative compensation levels for the different staff types.
(1)
Minimum staffing levels. DHS determines, for each participating
facility, minimum LVN equivalent staffing levels as follows.
(A)
Determine minimum required LVN equivalent minutes per resident
day of service for various types of residents using time study data, cost
report information, and other appropriate data sources.
(i)
Determine LVN equivalent minutes associated with Medicare
residents based on the data sources from subparagraph (A) of this paragraph
adjusted for estimated acuity differences between Medicare and Medicaid residents.
(ii)
Determine minimum required LVN equivalent minutes per
resident day of service associated with each Texas Index for Level of Effort
(TILE) case mix group and additional minimum required minutes for residents
reimbursed under the TILE system who also qualify for supplemental reimbursement
for ventilator care or pediatric tracheostomy care as described in §355.307
of this title (relating to Reimbursement Setting Methodology) based on the
data sources from subparagraph (A) of this paragraph adjusted for acuity differences
between Medicare and Medicaid residents and other factors.
(B)
Based on most recently available, reliable utilization
data, determine for each facility the total days of service by TILE group,
days of service provided to TILE residents qualifying for Medicaid supplemental
reimbursement for ventilator or tracheostomy care, total days of service for
Medicare Part A residents, and total days of service for all other residents.
(C)
Multiply the minimum required LVN equivalent minutes for
each TILE group and supplemental TILE reimbursement group from subparagraph
(A) of this paragraph by the facility's Medicaid days of service in each TILE
group and supplemental TILE reimbursement group from subparagraph (B) of this
paragraph and sum the products.
(D)
Multiply the minimum required LVN equivalent minutes for
Medicare residents by the facility's Medicare Part A days of service.
(E)
Divide the sum from subparagraph (C) of this paragraph
by the facility's total Medicaid days of service, with a day of service for
a Medicaid TILE recipient who also qualifies for a supplemental TILE reimbursement
counted as one day of service, and multiply the result by the facility's other
resident days of service.
(F)
Sum the results of subparagraphs (C), (D) and (E) of this
paragraph, divide the sum by the facility's total days of service, with a
day of service for a Medicaid TILE recipient who also qualifies for a supplemental
TILE reimbursement counted as one day of service. The results of these calculations
are the minimum LVN equivalent minutes per resident day a participating facility
must provide.
(2)
Enhanced staffing levels. Participating facilities
desiring to staff above the minimum requirements from paragraph (1) of this
subsection may request staffing enhancements from an array of enhanced staffing
options and associated add-on payments during open enrollment.
(3)
Granting of staffing enhancements. DHS divides all
requested enhancements into two groups: pre-existing enhancements that facilities
request to carry over from the prior year and newly- requested enhancements.
Newly-requested enhancements may be enhancements requested by facilities that
were nonparticipants in the prior year or by facilities that were participants
in the prior year desiring to be granted additional enhancements. For the
granting of enhancements to be effective September 1, 2001, and thereafter,
for an enhancement to qualify as a pre-existing enhancement, a facility must
have actually met the enhancement's staffing requirements during the most
recent six month reporting period from which reliable data is available at
the time qualification is determined. Enhancements held by nursing facilities
whose staffing requirements were not met during the most recent six-month
reporting period from which reliable data is available will qualify as pre-existing
if the facility submitted, with that staffing report, documentation that demonstrates
to the satisfaction of DHS that the facility has been unable, despite diligent
efforts (including offering wages at the community prevailing rate for nursing
facilities), to recruit appropriate personnel. If the initial six-month report
from the subsequent rate year indicates that the staffing requirement was
again not met, the unmet staffing will no longer be considered pre-existing.
Using the process described herein, DHS first determines the distribution
of carry-over enhancements. If funds are available after the distribution
of carry-over enhancements, DHS then determines the distribution of newly-requested
enhancements.
(A)
DHS determines projected units of service for facilities
requesting each enhancement option and multiplies this number by the rate
add-on associated with that enhancement as determined in subsection (l) of
this section.
(B)
DHS compares the sum of the products from subparagraph
(A) of this paragraph to available funds.
(i)
If the product is less than or equal to available funds,
all requested enhancements are granted.
(ii)
If the product is greater than available funds, enhancements
are granted in a proportional manner. Based upon an examination of existing
staffing levels and staffing needs, DHS may grant certain enhancement options
priority for proportional distribution.
(4)
Notification of granting of enhancements.
Participating facilities are notified, in a manner determined by DHS, as to
the disposition of their request for staffing enhancements.
(k)
Determination of direct care staff rates for nonparticipating
facilities.
(1)
Determine the sum of recipient care costs from the direct
care staff cost center in subsection (a) of this section in all nursing facilities
included in the Texas Nursing Facility Cost Report database used to determine
the nursing facility rates in effect on January 1, 2000 (hereinafter referred
to as the initial database).
(2)
Adjust the sum from paragraph (1) of this subsection
in order to account for inflation utilizing the inflation factors used in
the determination of the nursing facility rates in effect January 1, 2000.
(3)
Divide the result from paragraph (2) of this subsection
by the sum of recipient days of service in all facilities in the initial database
and multiply the result by 1.07. The result is the average direct care staff
rate component for ineligible facilities.
(4)
To calculate the direct care staff per diem rate component
for nonparticipating facilities for each of the 11 TILE case mix groups and
for the default group, multiply each of the standardized statewide case mix
indices associated with the initial database by the average direct care staff
rate component from paragraph (3) of this subsection.
(5)
The direct care staff per diem rates will remain constant
except as follows. For rates effective September 1, 2000, the rate derived
in paragraph (3) of this subsection will be multiplied by 1.016. Effective
September 1, 2001, and thereafter, the direct care staff per diem rate will
remain constant except for adjustments necessitated by increases in the personal
consumption expenditures (PCE) chain-type price index.
(l)
Determination of direct care staff rates for participating
facilities. Direct care staff rates for participating facilities as defined
in subsection (i) will be determined as follows:
(1)
Determine the direct care staff rate associated with maintaining
LVN equivalent minutes at the minimum levels required for participation.
(A)
Determine the sum of recipient care costs from the direct
care staff cost center in subsection (a) in all nursing facilities as included
in the initial database from subsection (k)(1) of this section.
(B)
Adjust the sum from subparagraph (A) of this paragraph
as specified in §355.108 of this title (relating to Determination of
Inflation Indices) to inflate the costs to the prospective rate year.
(C)
Divide the result from subparagraph (B) of this paragraph
by the sum of recipient days of service in all facilities in the initial database
from subsection (k)(1) of this section and multiply the result by 1.07. The
result is the average direct care staff rate associated with maintaining LVN
equivalent minutes at the minimum levels required for participation.
(D)
Case mix adjustment of direct care staff per diem rate
component. To calculate the direct care staff per diem rate component associated
with maintaining LVN equivalent minutes at the minimum levels required for
participation for each of the 11 TILE case mix groups, for the default group
and for each supplemental reimbursement group, multiply each of the standardized
statewide case mix indices associated with the initial database from subsection
(k)(1) of this section by the average direct care staff rate component from
subparagraph (C) of this paragraph.
(E)
The initial database from subsection (k)(1) of this section
used in determining the direct care staff rates will not change, except for
adjustments for inflation from subparagraph (B) of this paragraph. DHS may
also recommend adjustments to the rates in accordance with §355.109 of
this title (relating to Adjusting Reimbursement When New Legislation, Regulations,
or Economic Factors Affect Costs).
(2)
Determine the direct care staff rate add-on associated
with each enhanced staffing level. Taking into consideration the most recently
available, reliable data relating to LVN equivalent compensation levels, DHS
will determine a per diem add-on payment for each enhanced staffing level.
(3)
Determine each participating facility's total direct
care staff rate. Each participating facility's direct care staff rate will
be equal to the direct care staff rate associated with maintaining LVN equivalent
minutes at the minimum levels required for participation from paragraph (1)
of this subsection plus any add-on payments associated with enhanced staffing
levels selected by and awarded to the facility during open enrollment.
(m)
Staffing requirements for participating facilities. Each
participating facility will be required to maintain LVN equivalent minutes
equal to those determined in subsection (j) of this section.
(n)
Staffing accountability. Participating facilities will
be responsible for maintaining the staffing levels determined in subsection
(j) of this section. Upon receipt of the six-month staffing information described
in subsections (f)(1) and (2) of this section, DHS will determine the LVN
equivalent minutes maintained by each facility during the six-month reporting
period.
(1)
Participating facilities that fail to maintain staffing
at their required LVN equivalent minutes will have their direct care staff
rates and staffing requirements adjusted to a level consistent with the highest
LVN equivalent minutes, as defined in subsection (j) of this section, that
they actually attained.
(2)
Determination of staffing levels will be made on a
six-month basis with adjustments to direct care staff rates and staffing requirements
made upon determination by DHS that a facility is failing to meet its staffing
requirement.
(3)
Participating facilities that fail to meet the minimum
direct care staff requirements for participation will be removed from participation.
(4)
DHS will recoup all direct care staff revenues associated
with unmet staffing goals from participating facilities that fail to meet
their staffing requirements during any particular six-month period.
(5)
During the first six months of any rate year, staffing
requirements as determined in subsection (j) of this section override any
prospective adjustments made to staffing requirements under paragraphs (1)-(4)
of this subsection.
(o)
Spending requirements for all facilities. All facilities,
participants and non-participants alike, are subject to a direct care staff
spending requirement with recoupment calculated as follows:
(1)
At the end of the facility's rate year (with the implementation
rate period being treated as a rate year), a spending floor will be calculated
by multiplying accrued Medicaid direct care staff revenues (net of revenues
recouped by DHS due to the failure of the facility to meet a staffing requirement
as per subsection (n)(4) of this section) by 0.85.
(2)
Accrued allowable Medicaid direct care staff expenses
for the rate year will be compared to the spending floor from paragraph (1)
of this subsection. DHS will recoup the difference between the spending floor
and accrued allowable Medicaid direct care staff expenses from facilities
whose Medicaid direct care staff spending is less than their spending floor.
(p)
Mitigation of recoupment. Recoupment of funds described
in subsection (o) of this section may be mitigated as follows.
(1)
Calculate dietary cost deficit. At the end of the facility's
rate year (with the implementation rate period being treated as a rate year),
accrued Medicaid dietary per diem revenues will be compared to accrued, allowable
Medicaid dietary per diem costs. If costs are greater than revenues, the dietary
per diem cost deficit will be equal to the difference between accrued, allowable
Medicaid dietary per diem costs and accrued Medicaid dietary per diem revenues.
If costs are less than revenues, the dietary cost deficit will be equal to
zero.
(2)
Calculate dietary revenue surplus. At the end of the
facility's rate year (with the implementation rate period being treated as
a rate year), accrued Medicaid dietary per diem revenues will be compared
to accrued, allowable Medicaid dietary per diem costs. If revenues are greater
than costs, the dietary per diem revenue surplus will be equal to the difference
between accrued Medicaid dietary per diem revenues and accrued, allowable
Medicaid dietary per diem costs. If revenues are less than costs, the dietary
revenue surplus will be equal to zero.
(3)
Calculate fixed capital cost deficit. At the end of
the facility's rate year (with the implementation rate period being treated
as a separate rate year), accrued Medicaid fixed capital per diem revenues
will be compared to accrued, allowable Medicaid fixed capital per diem costs
as defined in §355.306(a)(2)(B) of this title (relating to Cost Finding
Methodology). If costs are greater than revenues, the fixed capital cost per
diem deficit will be equal to the difference between accrued, allowable Medicaid
fixed capital per diem costs and accrued Medicaid fixed capital per diem revenues.
If costs are less than revenues, the fixed capital cost deficit will be equal
to zero. For purposes of this paragraph, fixed capital per diem costs of facilities
with occupancy rates below 85% are adjusted to the cost per diem the facility
would have accrued had it maintained an 85% occupancy rate throughout the
rate year.
(4)
Calculate fixed capital revenue surplus. At the end
of the facility's rate year (with the implementation rate period being treated
as a separate rate year), accrued Medicaid fixed capital per diem revenues
will be compared to accrued, allowable Medicaid fixed capital per diem costs
as defined in §355.306(a)(2)(B) of this title (relating to Cost Finding
Methodology). If revenues are greater than costs, the fixed capital revenue
per diem surplus will be equal to the difference between accrued Medicaid
fixed capital per diem revenues and accrued, allowable Medicaid fixed capital
per diem costs. If revenues are less than costs, the fixed capital revenue
surplus will be equal to zero. For purposes of this paragraph, fixed capital
per diem costs of facilities with occupancy rates below 85% are adjusted to
the cost per diem the facility would have accrued had it maintained an 85%
occupancy rate throughout the rate year.
(5)
Facilities with a dietary per diem cost deficit will
have their dietary per diem cost deficit reduced by their fixed capital per
diem revenue surplus, if any. Any remaining dietary per diem cost deficit
will be capped at $2.00 per diem.
(6)
Facilities with a fixed capital cost per diem deficit
will have their fixed capital cost per diem deficit reduced by their dietary
revenue per diem surplus, if any. Any remaining fixed capital per diem cost
deficit will be capped at $2.00 per diem.
(7)
Each facility's recoupment, as calculated in subsection
(o) of this section, will be reduced by the sum of that facility's dietary
per diem cost deficit as calculated in paragraph (5) of this subsection and
its fixed capital per diem cost deficit as calculated in paragraph (6) of
this subsection.
(q)
Adjusting staffing requirements. Facilities that determine
that they will not be able to meet their staffing requirements from subsection
(m) of this section may request a reduction in their staffing requirements
and associated rate add-on. These requests will be effective on the first
day of the quarter following approval of the request. This option is not available
during the implementation rate period.
(r)
Voluntary withdrawal. Facilities wishing to withdraw from
participation must notify DHS in writing by certified mail. Facilities voluntarily
withdrawing must remain nonparticipants for the remainder of the rate year.
(s)
Notification of recoupment based on Annual Staffing and
Compensation Report. Facilities will be notified, in a manner specified by
DHS, within 90 days of the due date of their Annual Staffing and Compensation
Report or within 90 days of the date the report is submitted, whichever is
later, of the amount to be repaid to DHS. If a subsequent review or audit
results in adjustments to the Annual Staffing and Compensation Report as described
in subsection (f)(1) of this section that changes the amount to be repaid
to DHS, the facility will be notified in writing of the adjustments and the
adjusted amount to be repaid to DHS. DHS will recoup any amount owed from
a facility's vendor payment(s) following the date of the notification letter.
(t)
Notification of recoupment from Quarterly Staffing and
Compensation Report. Facilities will be notified in a manner specified by
DHS within 60 days of the due date of their Quarterly Staffing and Compensation
Report or within 60 days of the date the report is submitted, whichever is
later, of the amount to be repaid to DHS. If a subsequent review or audit
results in adjustments to the Quarterly Staffing and Compensation Report as
described in subsection (f)(2) of this section that changes the amount to
be repaid to DHS, the facility will be notified in writing of the adjustments
and the adjusted amount to be repaid to DHS. DHS will recoup any amount owed
from a facility's vendor payment(s) following the date of the notification
letter.
(u)
Vendor hold. Facilities required to submit a Staffing and
Compensation Report due to any of the events described in subsection (f) of
this section will have a hold placed on their vendor payments from the date
they are notified by DHS until an acceptable Staffing and Compensation Report
is received by DHS and funds identified for recoupment from subsections (n)
or (o) of this section are repaid to DHS. Facilities required to submit a
Staffing and Compensation Report due to a change of ownership or contract
termination as described in subsection (f)(1)(A)-(B) of this section will
have funds held as per 40 TAC §19.2308(2) (relating to Change of Ownership)
until an acceptable Staffing and Compensation Report is received by DHS and
funds identified for recoupment from subsections (n) or (o) of this section
are repaid to DHS. DHS will recoup any amount owed from the facility's vendor
payments that are being held. In cases where funds identified for recoupment
cannot be repaid from the held vendor payments, the responsible entity from
subsection (y) of this section will be jointly and severally liable for any
additional payment due to DHS. Failure to repay the amount due or submit an
acceptable payment plan within 60 days of notification will result in placement
of a vendor hold on all DHS contracts controlled by the responsible entity
and will bar the responsible entity from enacting any new contracts with DHS
until repayment is made in full.
(v)
Failure to document spending. Undocumented direct care
staff and contract labor compensation costs will be disallowed and will not
be used in the determination of direct care staff costs per unit of service.
(w)
All other rate components. All other rate components will
be calculated as specified in §355.307 of this title (relating to Reimbursement
Setting Methodology) and will be uniform for all providers.
(x)
Appeals. Subject matter of informal reviews and formal
appeals is limited as per §355.110(a)(3)(B) of this title (relating to
Informal Reviews and Formal Appeals).
(y)
Responsible entities. The contracted provider, owner, or
legal entity that received the revenue to be recouped upon is responsible
for the repayment of any recoupment amount.
(z)
Change of ownership. Participation in the enhanced direct
care staff rate confers to the new owner as defined in 40 TAC §19.2308
(relating to Change of Ownership) when there is a change of ownership. The
new owner is responsible for the reporting requirements in subsection (f)
of this section for any reporting period days occurring after the change.
(aa)
Disclaimer. Nothing in these rules should be construed
as preventing facilities from adding direct care staff in addition to those
funded by the enhanced direct care staff rate.
(bb)
Effective date. All rules enumerated in this section are
effective as of May 1, 2000.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on April 7, 2000.
TRD-200002491
Marina Henderson
Executive Deputy Commissioner
Texas Health and Human Services Commission
Effective date: May 1, 2000
Proposal publication date: February 25, 2000
For further information, please call: (512) 438-3108
1 TAC §355.307
The repeal is adopted under the Government Code, §531.033,
which authorizes the commissioner of the Health and Human Services Commission
to adopt rules necessary to carry out the commission's duties, and §531.021(b),
which establishes the commission as the agency responsible for adopting reasonable
rules governing the determination of fees, charges, and rates for medical
assistance payments under Chapter 32, Human Resources Code.
The repeal implements the Government Code, §§531.033 and 531.021(b).
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on April 7, 2000.
TRD-200002490
Marina Henderson
Executive Deputy Commissioner
Texas Health and Human Services Commission
Effective date: May 1, 2000
Proposal publication date: February 25, 2000
For further information, please call: (512) 438-3108
Subchapter C. UTILIZATION REVIEW
Chapter 63.
VICTIMS' ASSISTANCE GRANTS
Subchapter B. GRANTS FOR VICTIM ASSISTANCE COORDINATOR OR CRIME VICTIM LIAISON
Subchapter C. GRANTS FOR STATEWIDE TRAINING FOR PROGRAMS THAT BENEFIT VICTIMS OF SEXUAL ASSAULT AND TO PURCHASE FORENSIC EXAM EQUIPMENT
Subchapter D. GRANT APPLICATION, SCOPE OF GRANT, APPROVAL
Subchapter E. FUNDING OF GRANTS
Subchapter F. GRANT BUDGET REQUIREMENTS
Subchapter G. SPECIAL CONDITIONS AND REQUIRED DOCUMENTS
Subchapter H. AWARD AND GRANT ACCEPTANCE
Subchapter I. ADMINISTERING GRANTS
Subchapter J. PROGRAM MONITORING AND AUDITS
Part 15.
TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 371.
MEDICAID FRAUD AND ABUSE PROGRAM INTEGRITY