TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 3. TEXAS WORKS

Subchapter LL. DISABILITY DETERMINATION

40 TAC §3.3801

The Texas Department of Human Services (DHS) adopts the repeal of §3.3801, and new §3.3801, in its Texas Works chapter. The repeal is adopted without changes to the proposed text published in the December 24, 1999, issue of the Texas Register (24 TexReg 11697). The new section is adopted with changes.

Justification for the new section is to streamline the process used to determine disability for Temporary Assistance for Needy Families (TANF) applicants and recipients, as well as eligibility for Medicaid under the Medically Needy programs for a parent.

The new section will function by allowing disability to be determined by the client's physician, resulting in a more efficient use of time for medical professionals involved in the copying and transmitting of medical information.

During the comment period, DHS received a comment from the Houston Welfare Rights Organization. A summary of the comment and DHS's response follows:

Comment: The commenter stated that when this item was presented at the December 2, 1999 Texas Works Advisory Council meeting, the department indicated that the disability could be physical or mental and the mental disability could be verified by a psychologist. The commenter pointed out that this is not indicated in the proposed rule.

Response: DHS agrees with the comments as they are consistent with the intent of the policy. The comments are incorporated in the adopted rule.

The repeal is adopted under the Human Resources Code, Title 2, Chapter 31, which provides the department with the authority to administer financial assistance programs.

The repeal implements the Human Resources Code, §§31.001-31.0325.

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 February 7, 2000.

TRD-200000939

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: February 27, 2000

Proposal publication date: December 24, 1999

For further information, please call: (512) 438-3108


The new section is adopted under the Human Resources Code, Title 2, Chapter 31, which authorizes the department to administer financial assistance programs.

The new section implements the Human Resources Code, §§31.001- 31.0325.

§3.3801.Basis for Disability Determination and Employment Services Program Exemptions.

(a)

TANF. The Texas Department of Human Services (DHS) considers a person incapacitated if he has a physical or mental disability which precludes him for substantial gainful employment or care for his children for a continuous period of at least 30 days. The physical or mental disability must be supported by a physician, a physician's assistant (under a physician's order), or a licensed or certified psychologist. A certification of RSDI, SSI, or VA disability is sufficient proof of incapacity.

(b)

Food Stamps. DHS allows disability determination for employment services as specified in 7 Code of Federal Regulations (CFR) §273.7(b)(ii).

Filed with the Office of the Secretary of State on February 7, 2000.

TRD-200000940

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: February 27, 2000

Proposal publication date: December 24, 1999

For further information, please call: (512) 438-3108


Chapter 15.
MEDICAID ELIGIBILITY

Subchapter D. RESOURCES

40 TAC §15.417

The Texas Department of Human Services (DHS) adopts an amendment to §15.417, without changes to the proposed text published in the December 24, 1999, issue of the Texas Register (24 TexReg 11698).

The amendment is justified to clarify the treatment of limited partnerships as a resource. The Omnibus Budget Reconciliation Act of 1993 (Public Law 103-66) established the treatment of trusts and similar financial arrangements in Medicaid eligibility policy. DHS Legal Services staff requested the addition of a specific rule for limited partnerships because of the increased use of limited partnerships as estate-planning devices.

The amendment will function by ensuring that long term care Medicaid eligibility policy will be applied correctly and consistently statewide.

The department received no comments regarding adoption of the amendment.

The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs, and under Texas Government Code §531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds.

The amendment implements the Human Resources Code, §§22.001-22.030 and §§32.001-32.042.

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 February 4, 2000

TRD-200000812

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: April 1, 2000

Proposal publication date: December 24, 1999

For further information, please call: (512) 438-3108


Chapter 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

Subchapter I. RESIDENT ASSESSMENT

40 TAC §19.804

The Texas Department of Human Services (DHS) adopts new §19.804, without changes to the proposed text published in the October 15, 1999, issue of the Texas Register (24 TexReg 8929).

The justification for the new section is to require nursing facilities to use a tool, the Capacity Assessment for Self Care and Financial Management, when asked by a court or when considering obtaining guardianship of a nursing facility patient. The Texas Health and Safety Code §533.044 requires DHS and the Texas Department of Mental Health and Mental Retardation to agree to develop rules relating to the use of this instrument in their respective facilities. The Texas Health and Safety Code also requires DHS to use this tool to provide probate courts with sufficient information to make informed decisions regarding a person's need for guardianship. This tool is designed to enable the facility or a court to assess whether a person needs a guardian.

The new section will function by ensuring that nursing facilities will have a uniform tool to assist the facility in determining whether or not a person needs a guardian. Nursing facilities may also benefit by discovering that an individual may be in need of guardianship.

During the comment period, DHS received a comment from the Houston Welfare Rights Organization. The commenter noted that DHS should add a definition regarding when a guardianship referral may be appropriate. One of the purposes of the tool is to assist the facility in determining if a guardianship referral is appropriate. DHS believes that each individual case is different and varies by setting. For example, in an intermediate care facility, a person could lack capacity to participate in care planning and have a non-responsible party participate in the care plan. This person may have his or her needs met by the use of surrogate decision makers, or for major medical decisions, by a surrogate decision making committee. These same protections would not be available in a community based setting. DHS feels that guidance to help nursing facilities determine when a guardianship is indicated should be covered in training materials. A referral for guardianship may be appropriate when (1) a resident lacks capacity to participate in care planning; (2) a resident has no presently appointed guardian; (3) no one is seeking guardianship for the resident; (4) there is no responsible party to participate in care planning; and (5) there is no agent under a medical power of attorney who is willing to participate in care planning. DHS will include these and other examples in the training materials it is preparing. In addition, DHS will be working with the Texas Rural Health Initiatives Agency to determine how to disseminate information regarding the Capacity Assessment Instrument to rural physicians. If a physician feels that a guardianship proceeding should be initiated on behalf of a patient, the physician may request that a nursing facility complete the assessment.

The new section is adopted under the Health and Safety Code §533.044, which provides the department with the authority to require facilities to use the instrument; and the Health and Safety Code Chapter 242, which provides the department with the authority to license nursing facilities.

The new section implements §533.044 of the Health and Safety 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 February 3, 2000.

TRD-200000771

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: March 15, 2000

Proposal publication date: October 15, 1999

For further information, please call: (512) 438-3108


Subchapter S. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES

40 TAC §19.1812

Senate Bill 30, §1.07, 75th Legislative Session transferred the responsibility for utilization review in the state Medicaid program from the Texas Department of Health and the Texas Department of Human Services to the Texas Health and Human Services Commission. In accordance with this transfer, Title 25, Part 1, §§41.101-41.105 and 41.107-41.113 concerning utilization review will become Title 1, Part 15, §§371.200-371.211, effective September 1, 1997. Title 40, Part 1, §§19.1812, 19.2411, and 19.2412 will become Title 1, Part 15, §§371.212-371.214, effective September 1, 1997. The rule conversion chart is published in the Tables and Graphic section.

Figure: 1 TAC Chapter 371.

§19.1812.Case Mix Classification System.


Subchapter Y. MEDICAL REVIEW AND RE-EVALUATION

40 TAC §19.2411, §19.2412

Senate Bill 30, §1.07, 75th Legislative Session transferred the responsibility for utilization review in the state Medicaid program from the Texas Department of Health and the Texas Department of Human Services to the Texas Health and Human Services Commission. In accordance with this transfer, Title 25, Part 1, §§41.101-41.105 and 41.107-41.113 concerning utilization review will become Title 1, Part 15, §§371.200-371.211, effective September 1, 1997. Title 40, Part 1, §§19.1812, 19.2411, and 19.2412 will become Title 1, Part 15, §§371.212-371.214, effective September 1, 1997. The rule conversion chart is published in the Tables and Graphic section.

Figure: 1 TAC Chapter 371.

§19.2411.Utilization Review and Control Activities Performed by Texas Department of Human Services (DHS).

§19.2412.Texas Index for Level of Effort (TILE) Assessments.


Part 8. CHILDREN'S TRUST FUND OF TEXAS COUNCIL

Chapter 201. COUNCIL ADMINISTRATION: POLICIES AND PROCEDURES

40 TAC §§201.1, 201.3, 201.6, 201.7

The Children's Trust Fund of Texas Council adopts the repeal of §§201.1, 201.3, 201.6, 201.7 without changes as published in the August 6, 1999, issue of the Texas Register (24 TexReg 6016).

The proposed repeal arose as a result of the Rule Review process mandated by the 1997 General Appropriations Act, Art. IX, sec. 167. In compliance with that rider, the Council reviewed its rules to determine whether the reasons the rules originally were adopted continued to exist, to determine whether the rules were consistent with current law, and to determine whether rules should be re-adopted with or without changes, or whether rules should be repealed.

Section 201.1 is repealed. The section is out-of-date and is repetitive of CTF's enabling legislation; therefore it is repetitive of agency statute and not an appropriate subject of an agency rule.

Section 201.3 is repealed. Subsection (a) largely tracks CTF's enabling legislation, therefore it is repetitive of agency statute and not an appropriate subject of an agency rule. Subsections (b) and (c) lack a proper statutory basis.

Section 201.6 is repealed. This section involves the internal organization of the agency and incorrectly states the law regarding the executive director's employment status.

Section 201.7 is repealed. This section is a restatement of CTF's enabling legislation, therefore it is repetitive of agency statute and not an appropriate subject of an agency rule.

No comments were received regarding adoption of the repeals.

The repeals are adopted under the authority of Texas Human Resources Code §74.003(a)(11) which directs the board to adopt rules to implement the council enabling statute, Texas Human Resources Code, Chapter 74.

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 February 3, 2000.

TRD-200000768

John Chacon

Executive Director

Children's Trust Fund of Texas Council

Effective date: February 23, 2000

Proposal publication date: August 6, 1999

For further information, please call: (512) 833-3440


40 TAC §§201.8 - 201.10

The Children's Trust Fund of Texas Council adopts the amendments to §§201.8, 201.9, and 201.10, without changes to the text as published in the August 6, 1999, issue of the Texas Register (24 TexReg 6016).

The rule amendments arise as a result of the Rule Review process mandated by the 1997 General Appropriations Act, Art. IX, §167. In compliance with that rider, the Council reviewed its rules to determine whether the reasons the rules originally were adopted continued to exist, to determine whether the rules were consistent with current law, and to determine whether rules should be re-adopted with or without changes, or whether rules should be repealed.

Section 201.8 is amended to reflect the correct reference to the Open Meetings Act (Government Code, Chapter 551). Subsections (a), (c), (g), (i), and (k) are deleted. These subsections mirror applicable statutory law. Also, subsection (d) is deleted. The Open Meetings Act, not a rule, determines when an agency is authorized to go into executive session.

Section 201.9 is retained but amended by adding a new paragraph (6) as follows: "adoption of substantive or procedural rules," to clarify to board members what actions required Council approvals.

Section 201.10(b) regarding amendments to and concerning Council Administration: Policies and Procedures is deleted because it is a restatement of existing law, therefore it is repetitive of agency statute and not an appropriate subject of an agency rule. Additionally the statutory citation is out-of-date.

No comments were received regarding adoption of the amendments.

The amendments are adopted under the authority of Texas Human Resources Code §74.003(a)(11) which directs the board to adopt rules to implement the council's enabling statute, Texas Human Resources Code, Chapter 74.

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 February 3, 2000.

TRD-200000769

John Chacon

Executive Director

Children's Trust Fund of Texas Council

Effective date: February 23, 2000

Proposal publication date: August 6, 1999

For further information, please call: (512) 833-3440


Chapter 202. FUNDED PROGRAM AWARDS AND CONTRACTS

40 TAC §§202.6, 202.8, 202.10

The Children's Trust Fund of Texas Council adopts the amendments §§202.6, 202.8, and 202.10, without changes to the text as published in the August 6, 1999, issue of the Texas Register at 24 TexReg 6016.

The rule amendments arise as a result of the Rule Review process mandated by the 1997 General Appropriations Act, Art. IX, §167. In compliance with that rider, the Council reviewed its rules to determine whether the reasons the rules originally were adopted continued to exist, to determine whether the rules were consistent with current law, and to determine whether rules should be re-adopted with or without changes, or whether rules should be repealed.

Section 202.6(a) is amended to delete a delivery address that is no longer available.

Section 202.8(f) is amended by including a description of the confidentiality guidelines that are referred to in the current rule. By adding the guidelines, applicants will have adequate guidance without going to another source.

Section 202.10 amends subsection (a) to reflect the amendment to Human Resources Code, §74.010, which authorizes more than two extensions under certain circumstances as determined by the Council and defines those circumstances.

No comments were received regarding adoption of the amendments.

The amendments are adopted under the authority of Texas Human Resources Code §74.003(a)(11) which directs the board to adopt rules to implement the council's enabling statute, Texas Human Resources Code, Chapter 74.

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 February 3, 2000.

TRD-200000766

John Chacon

Executive Director

Children's Trust Fund of Texas Council

Effective date: February 23, 2000

Proposal publication date: August 6, 1999

For further information, please call: (512) 833-3440


40 TAC §202.9

The Children's Trust Fund of Texas Council adopts the repeal of §202.9 without changes as published in the August 6, 1999, issue of the Texas Register (24 TexReg 6016).

The proposed repeal arose as a result of the Rule Review process mandated by the 1997 General Appropriations Act, Art. IX, §167. In compliance with that rider, the Council reviewed its rules to determine whether the reasons the rules originally were adopted continued to exist, to determine whether the rules were consistent with current law, and to determine whether rules should be re-adopted with or without changes, or whether rules should be repealed.

Section 202.9 is repealed because of the conflict of interest provisions concerning internal policies and are not the proper subject for rules. They will be transferred to the Policies and Procedures Manual.

No comments were received regarding adoption of the repeal.

The repeal is adopted under the authority of Texas Human Resources Code §74.0039(a)(11) which directs the board to adopt rules to implement the council enabling statute, Texas Human Resources Code, Chapter 74.

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 February 3, 2000.

TRD-200000767

John Chacon

Executive Director

Children's Trust Fund of Texas Council

Effective date: February 23, 2000

Proposal publication date: August 6, 1999

For further information, please call: (512) 833-3440


Chapter 203. ADVISORY COMMITTEES

40 TAC §§203.1 - 203.5

The Children's Trust Fund of Texas Council adopts the repeal of Chapter 203 §§203.1 - 203.5 without changes as published in the August 6, 1999, issue of the Texas Register (24 TexReg 6016).

The proposed repeal arose as a result of the Rule Review process mandated by the 1997 General Appropriations Act, Art. IX, §167. In compliance with that rider, the Council reviewed its rules to determine whether the rules originally were adopted continued to exist, to determine whether the rules were consistent with current law, and to determine whether rules should be re-adopted with or without changes, or whether rules should be repealed.

Chapter 203, §§203.1 - 203.5 concerning advisory committees is repealed, because both advisory committees addressed in the rules have expired; therefore the entire chapter is no longer necessary and is ineffective.

No comments were received regarding adoption of the repeal.

The repeal is adopted under the authority of Texas Human Resources Code §74.003(a)(11) which directs the board to adopt rules to implement the council enabling statute, Texas Human Resources Code, Chapter 74.

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 February 3, 2000.

TRD-200000765

John Chacon

Executive Director

Children's Trust Fund of Texas Council

Effective date: February 23, 2000

Proposal publication date: August 6, 1999

For further information, please call: (512) 833-3440


Part 19. TEXAS DEPARTMENT OF PROTECTIVE AND REGULATORY SERVICES

Chapter 700. CHILD PROTECTIVE SERVICES

Subchapter C. ELIGIBILITY FOR CHILD PROTECTIVE SERVICES

40 TAC §700.347

The Texas Department of Protective and Regulatory Services (TDPRS) adopts new §700.347, without changes to the proposed text published in the November 5, 1999, issue of the Texas Register (24 TexReg 9798).

The justification for the new section is to describe new situations in which a child who does not reside in the state that signed the state adoption assistance agreement can receive Texas Medicaid coverage. Receipt of medical assistance (Medicaid) from the state of residence versus the state signing the adoption assistance agreement will facilitate access to the coverage. Access to medical coverage is an essential part of the nationwide effort to promote and support adoption of children with special needs.

The new section will function by ensuring that children with special needs who are covered by adoption assistance agreements have access to medical assistance in the state of residence.

No comments were received regarding adoption of the new section.

The new section is adopted under the Texas Family Code, Chapter 162, Subchapter C, §§162.201 - 162.206, which provides the Texas Department of Protective and Regulatory Services with the authority to extend medical assistance to children with state adoption assistance agreements from member states; under Texas Human Resources Code §40.002(e), which authorizes the department to adopt rules necessary to conform with federal funding requirements; under Texas Government Code §531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds; and under the Memorandum of Understanding Between the Texas Health and Human Services Commission and the Texas Department of Protective and Regulatory Services Regarding Implementation of the Interstate Compact on Adoption and Medical Assistance and the Adoption and Safe Families Act of 1997.

The new section implements the Interstate Compact on Adoption and Medical Assistance, Texas Family Code §162.201, Art. VII and the Adoption and Safe Families Act of 1997, 42 U.S.C. §673b (b)(4) and 42 U.S.C. §1320a-9(a)(4).

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 February 4, 2000.

TRD-200000813

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2000

Proposal publication date: November 5, 1999

For further information, please call: (512) 438-3734