TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 3. TEXAS WORKS

Subchapter G. RESOURCES

40 TAC §3.704

The Texas Department of Human Services (DHS) proposes an amendment to §3.704, concerning types of resources, in its Texas Works chapter.

The purpose of the amendment is to exempt money in the Texas Tomorrow Fund as a resource for TANF and Medical Programs for Families and Children.

Eric M. Bost, commissioner, has determined that for the first five- year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section.

Mr. Bost also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be that families who save for their childrens' college education will not have to sacrifice those childrens' future access to post secondary education in order to have access to health care or temporary cash assistance during times of unemployment. There will be no effect on large, small, or micro businesses. There is no anticipated economic cost to persons who are required to comply with the proposed amendment.

Questions about the content of this proposal may be directed to Mary Haifley at (512) 438-2599 in DHS's Programs and Policy section. Written comments on the proposal may be submitted to Supervisor, Rules and Editing Unit-210, Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Under §2007.003(b) of the Texas Government Code, the department has determined that Chapter 2007 of the Government Code does not apply to these rules. Accordingly, the department is not required to complete a takings impact assessment regarding these rules.

The amendment is proposed under the Human Resources Code, Title 2, Chapter 31, which authorizes the department to administer financial 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, §§31.001- 31.0325 and §§32.001-32.042.

§3.704.Types of Resources.

(a)

Temporary Assistance for Needy Families (TANF). The following are countable resources in TANF:

(1)

Individual retirement accounts (IRAs). The Texas Department of Human Services (DHS) [ DHS ] counts IRAs as resources, even if there is a penalty for early withdrawal. DHS deducts the early withdrawal penalty and counts the remainder as a resource;

(2)-(6)

(No change.)

(b)

Temporary Assistance for Needy Families (TANF). Exclusions from resources in TANF are:

(1)-(16)

(No change.)

(17)

Texas Tomorrow Fund. DHS exempts money in the Texas Tomorrow Fund.

(c)-(d)

(No change.)

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

Filed with the Office of the Secretary of State, on May 4, 2000.

TRD-200003145

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 18, 2000

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


Chapter 4. MEDICAID PROGRAMS--CHILDREN AND PREGNANT WOMEN

Subchapter A. ELIGIBILITY REQUIREMENTS

40 TAC §4.1006

The Texas Department of Human Services (DHS) proposes an amendment to §4.1006, concerning requirements for application, in its Medicaid Programs-Children and Pregnant Women chapter.

The purpose of the amendment is to exempt money in the Texas Tomorrow Fund as a resource for TANF and Medical Programs for Families and Children.

Eric M. Bost, commissioner, has determined that for the first five- year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section.

Mr. Bost also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be that families who save for their childrens' college education will not have to sacrifice those childrens' future access to post secondary education in order to have access to health care or temporary cash assistance during times of unemployment. There will be no effect on large, small, or micro businesses. There is no anticipated economic cost to persons who are required to comply with the proposed amendment.

Questions about the content of this proposal may be directed to Mary Haifley at (512) 438-2599 in DHS's Programs and Policy section. Written comments on the proposal may be submitted to Supervisor, Rules and Editing Unit-210, Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Under §2007.003(b) of the Texas Government Code, the department has determined that Chapter 2007 of the Government Code does not apply to these rules. Accordingly, the department is not required to complete a takings impact assessment regarding these rules.

The amendment is proposed under the Human Resources Code, Title 2, Chapters 22, and 32, which authorize 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, §§31.001-31.0325, and §§32.001-32.042.

§4.1006.Requirements for Application.

To be eligible for the Medicaid Programs for Children and Pregnant Women (CPW) Program, clients must meet the following requirements.

(1)

Citizenship. Citizenship requirements for CPW applicants are the same as requirements for Temporary Assistance for Needy Families (TANF) applicants outlined in the Texas Department of Human Services' (DHS's) [ DHS's ] TANF rules in Chapter 3 of this title (relating to Income Assistance Services).

(2)

Resources. Resource limits and types of countable and exempt resources for CPW are the same as those outlined in DHS's TANF rules, with the following exceptions:

(A)

(No change.)

(B)

The food stamp resource policy for households with no members 60 or over is applied when determining eligibility for children under six and children six or older born on or after October 1, 1983. Exception: DHS follows the TANF resource policy for loans and Texas Tomorrow Funds .

(C)-(F)

(No change.)

(3)-(9)

(No change.)

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

Filed with the Office of the Secretary of State, on May 4, 2000.

TRD-200003146

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 18, 2000

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


Part 2. TEXAS REHABILITATION COMMISSION

Chapter 101. GENERAL RULES

40 TAC §101.19

The Texas Rehabilitation Commission (TRC) proposes an amendment to §101.19, concerning functions of the board. The section is being amended to conform to amendments to enabling legislation for the Health and Human Services Commission and the Texas Rehabilitation Commission.

Charles E. Harrison, Jr., Deputy Commissioner for Financial Services, has determined that for the first five-year period the section is in effect, there will be no fiscal implications for state or local government.

Mr. Harrison also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be to conform to amendments to enabling legislation for the Health and Human Services Commission and the Texas Rehabilitation Commission. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed.

Comments on the proposal may be submitted to Roger Darley, Assistant General Counsel, Texas Rehabilitation Commission, 4900 North Lamar Boulevard, Suite 7300, Austin, Texas 78751.

The amendment is proposed under the Texas Human Resources Code, Title 7, Chapter 111, §111.018 and §111.023, which provides the Texas Rehabilitation Commission with the authority to promulgate rules consistent with Title 7, Texas Human Resources Code.

No other statute, article, or code is affected by this proposal.

§101.19.Functions of the Board.

[ The function of the board is to decide policy for the commission. The board does not engage in the daily operations of the commission. The commissioner administers the daily operations of the commission. ]

(a)

The functions of the board include:

(1)

providing concurrence with employment of the TRC Commissioner by the Commissioner of Health and Human Services;

(2)

providing concurrence with discharge of the TRC Commissioner by the Commissioner of Health and Human Services;

(3)

exercising the authority provided by law to adopt policies and rules governing the delivery of services to persons who are served by the Commission and the rights and duties of persons who are served or regulated by the Commission;

(4)

delegating to the TRC Commissioner, or to a person acting as Commissioner in the Commissioner's absence, any power or duty imposed on the board or Commission by law except that the board may not delegate the power to adopt rules ; the delegation of any power or duty must be in writing, and must be adopted by the board in a public meeting;

(5)

developing and implementing policies that clearly separate the policymaking responsibilities of the board and the management responsibilities of the Commissioner and staff of the Commission;

(6)

entering into a memorandum of understanding with the Commissioner of Health and Human Services that clearly defines the policymaking authority of the board and the operational authority of the Commissioner of Health and Human Services;

(7)

defining jointly with the Commissioner of Health and Human Services, specific performance objectives to be fulfilled by the TRC Commissioner in accordance with §531.055, Government Code;

(8)

considering the evaluation of the TRC Commissioner in a meeting of the board and taking necessary action, if any, not later than 90 days after the date of receipt of the evaluation.

(b)

The board operates as a Committee of the Whole, except for the three member Audit Committee.

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

Filed with the Office of the Secretary of State, on May 8, 2000.

TRD-200003201

Charles Schiesser

Chief of Staff

Texas Rehabilitation Commission

Earliest possible date of adoption: June 18, 2000

For further information, please call: (512) 424-4050


Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Chapter 362. DEFINITIONS

40 TAC §362.1

The Texas Board of Occupational Therapy Examiners proposes an amendment to §362.1, concerning Definitions. The amendment will add definitions for terms which are used in the rules, but which are not defined.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be clarification of terms used in the OT rules. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas, 78701.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

§362.1.Definitions.

The following words and terms, when used in this part, shall have the following meanings, unless the context clearly indicates otherwise.

(1)-(9)

(No change.)

(10)

Complete Renewal--Contains renewal fee, [ continuing education record card (if applicable), ] home/work address(es) and phone number(s), jurisprudence examination with at least 70% of questions answered correctly and supervision log (if applicable).

(11)-(22)

(No change.)

(23)

Health Care Condition-See Medical Condition.

(24)

[ (23) ] Investigation Committee--Reviews and makes recommendations to the board concerning complaints and disciplinary actions regarding licensees and facilities.

(25)

[ (24) ] Investigator--The employee of the Executive Council who conducts all phases of an investigation into a complaint filed against a licensee, an applicant, or an entity regulated by the board.

(26)

[ (25) ] Jurisprudence Examination--An examination covering information contained in the Texas Occupational Therapy Practice Act and Texas Board of Occupational Therapy Examiners rules. This test is an open book examination [ with multiple choice or true-false questions ] made up of multiple choice and/or true-false questions . The passing score is 70%.

(27)

[ (26) ] License--Document issued by the Texas Board of Occupational Therapy Examiners which authorizes the practice of occupational therapy in Texas.

(28)

[ (27) ] Licensed Occupational Therapist (LOT)--A person who holds a valid regular or provisional license to practice or represent self as an occupational therapist in Texas.

(29)

[ (28) ] Licensed Occupational Therapy Assistant (LOTA)--A person who holds a valid regular or provisional license to practice or represent self as an occupational therapy assistant in Texas and who is required to practice under the general supervision of an OTR or LOT.

(30)

[ (29) ] Medical Condition--A condition of acute trauma, infection, disease process, psychiatric disorders, addictive disorders, or post surgical status Synonymous with the term health care condition [ where prudence and custom require the services of a physician ].

(31)

[ (30) ] Monitored Services--The checking on the status/condition of students, patients, clients, equipment, programs, services, and staff in order to make appropriate adjustments and recommendations. Minimum contact for the purpose of monitoring will be one time a month.

(32)

[ (31) ] NBCOT (formerly AOTCB)--National Board for Certification in Occupational Therapy (formerly American Occupational Therapy Certification Board).

(33)

[ (32) ] Non-Medical Condition--A condition where the ability to perform occupational roles is impaired by developmental disabilities, learning disabilities, the aging process, sensory impairment, psychosocial dysfunction, or other such conditions which does not require the routine intervention of a physician.

(34)

[ (33) ] Occupational Therapist (OT)--A person who holds a Temporary License to practice as an occupational therapist in the state of Texas, who is waiting to receive results of taking the first available Examination, and who is required to be under continuing supervision of an OTR or LOT.

(35)

[ (34) ] Occupational Therapist, Registered (OTR)--An alternate term for a Licensed Occupational Therapist. An individual who uses this term must hold a regular or provisional license to practice or represent self as an occupational therapist in Texas. An individual who uses this term is responsible for ensuring that he or she is otherwise qualified to use it.

(36)

[ (35) ] Occupational Therapy--The use of purposeful activity or intervention to achieve functional outcomes. Achieving functional outcomes means to develop or facilitate restoration of the highest possible level of independence in interaction with the environment. Occupational Therapy provides services to individuals limited by physical injury or illness, a dysfunctional condition, cognitive impairment, psychosocial dysfunction, mental illness, a developmental or learning disability or an adverse environmental condition, whether due to trauma, illness or condition present at birth. Occupational therapy services include but are not limited to:

(A)

The evaluation/assessment, treatment and education of or consultation with the individual, family or other persons;

(B)

interventions directed toward developing, improving or restoring daily living skills, work readiness or work performance, play skills or leisure capacities;

(C)

intervention methodologies to develop restore or maintain sensorimotor, oral-motor, perceptual or neuromuscular functioning; joint range of motion; emotional, motivational, cognitive or psychosocial components of performance.

(37)

[ (36) ] Occupational Therapy Assistant (OTA)--A person who holds a Temporary License to practice as an occupational therapy assistant in the state of Texas, who is waiting to receive results of taking the first available Examination, and who is required to be under continuing supervision of an OTR or LOT.

(38)

[ (37) ] Occupational Therapy Plan of Care--A written statement of the planned course of Occupational Therapy intervention for a patient/client. It must include goals, objectives and/or strategies, recommended frequency and duration, and may also include methodologies and/or recommended activities.

(39)

[ (38) ] OT Aide or OT Orderly--A person who aids in the practice of occupational therapy and whose activities require on-the-job training and close personal supervision by an OTR, LOT, COTA or LOTA.

[(39)

Physician--An individual licensed by the Texas State Board of Medical Examiners, e.g., Medical Doctors (M.D.) and Doctors of Osteopathy (D.O.).]

(40)-(47)

(No change.)

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

Filed with the Office of the Secretary of State, on May 5, 2000.

TRD-200003157

John P. Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: June 18, 2000

For further information, please call: (512) 305-6900


Chapter 367. CONTINUING EDUCATION

40 TAC §367.1

The Texas Board of Occupational Therapy Examiners proposes an amendment to §367.1, Continuing Education. The amendment will set a time frame for retention of proof of continuing education documentation

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be added assurance that as a result of enforcing the rule there will be greater administrative efficiency and a reduction in confusion in reference to the random audit process. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas, 78701.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

§367.1.Continuing Education

(a)

The Act, §5(A), mandates licensee participation in a continuing education program for license renewal. All continuing education must be directly relevant to the profession of occupational therapy. The licensee is solely responsible for keeping accurate documentation of all continuing education requirements. The Executive Council staff will conduct, at least yearly, an audit of a randomly drawn sample of licensees to determine compliance with continuing education rules. Failure to maintain accurate documentation, or failure to respond to a request to submit documentation for an audit, may result in disciplinary action by the board. The audit results will be reported to the board.

(1)

Licensees randomly selected for the audit must provide to TBOTE appropriate documentation within 30 days of notification.

(2)

Continuing Education Documentation must be maintained for two years from the date of the last renewal for auditing purposes.

(b)-(c)

(No change.)

(d)

Continuing education credit may be earned in the following manner:

(1)-(4)

(No change.)

(5)

Development of publications, media materials or research/grant activities. A request to receive credit for this category must be submitted in writing to the Coordinator of Occupational Therapy no later than 60 days before the current license expiration date. The request must include a description of the activity/course, the sponsoring group, its direct relevance to the occupational therapy profession, and the number of hours to complete it. (Any publication, media materials, or research or grant activities can be counted only once per licensee). 10 hours;

(6)-(7)

(No change.)

(e)

(No change.)

(f)

[ Definitions for continuing education rules. ] Continuing education documentation includes, but is not limited to, final official transcripts, AOTA self-study completion certificates, copies of official sign-in or attendance sheets, and official correspondence from the Executive Council or board approving requested credits.

(1)

The continuing education record card (blue card) will no longer be accepted as proof of continuing education activities effective December 1, 2001.

(2)

Documentation must identify the licensee by name and license number, and must include the date and title of the course, the signature of the authorized signer, and the number of CEUs or contact hours awarded for the course.

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

Filed with the Office of the Secretary of State, on May 5, 2000.

TRD-200003158

John P. Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: June 18, 2000

For further information, please call: (512) 305-6900


Chapter 372. PROVISIONS OF SERVICES

40 TAC §372.1

The Texas Board of Occupational Therapy Examiners proposes an amendment to §372.1, concerning Provision of Services. The amendment will reflect a change made to the Act, which allows OTRs and LOTs to accept referrals from all qualified health care providers.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be greater access to occupational therapy services. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas, 78701.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, this amended section affects Subchapter H, Chapter 454 of the Occupations Code.

§372.1.Provision of Services

(a)

Referral. Occupational therapists may accept referral from all qualified licensed health care professionals who within the scope of licensure are authorized to refer for healthcare services. This includes but is not limited to dentists, chiropractors, and podiatrists.

(1)

Consultation, monitored services, screening, and evaluation for need of services may be provided without a referral [ from a physician ].

(2)

Occupational therapy for non-medical conditions (refer to §362.1 of this title (relating to Definitions)) does not require a [ physician ] referral. However, a [ physician ] referral must be requested at any time during the evaluation or treatment process when necessary to insure the safety and welfare of the consumer.

(3)

The provision of direct treatment by an OTR, LOT, COTA or LOTA for medical conditions requires a referral [ from a physician licensed by the Texas State Board of Medical Examiners to practice in the state of Texas ]. A referral may be an oral or written order to initiate services. If an oral referral is received, it must be followed by a written order signed by the referral source [ physician ] requesting the services.

(4)

An oral referral for evaluation and/or treatment [ from a licensed physician ] must be received and documented by a licensed health care provider.

(5)

(No change.)

(b)-(f)

(No change.)

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

Filed with the Office of the Secretary of State, on May 5, 2000.

TRD-200003159

John P. Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: June 18, 2000

For further information, please call: (512) 305-6900