Part 1.
TEXAS DEPARTMENT OF HUMAN SERVICES
Chapter 19.
NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
The Texas Department of Human Services (DHS) adopts an amendment to §19.101,
concerning definitions, and §19.802, concerning comprehensive care plans,
in its Nursing Facility Requirements for Licensure and Medicaid Certification
chapter. The amendments are adopted without changes to the proposed text in
the March 23, 2001 issue of the
Texas Register
(26 TexReg 2329) and will not be republished.
Justification for the amendments is to allow providers the option of including
a palliative plan of care in the comprehensive care plan at the request of
residents of nursing facilities with terminal conditions, end stage diseases
or other conditions. This part of the plan of care may be developed when curative
care is no longer warranted.
The department received no comments regarding adoption of the amendments.
Subchapter B. DEFINITIONS
40 TAC §19.101
The amendment is adopted under the Health and Safety Code,
Chapter 242, which authorizes the department to license and regulate nursing
facilities.
The amendment implements the Health and Safety Code, 242.001- 242.268.
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 May 10, 2001.
TRD-200102627
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: June 1, 2001
Proposal publication date: March 23, 2001
For further information, please call: (512) 438-3108
40 TAC §19.802
The amendment is adopted under the Health and Safety Code,
Chapter 242, which authorizes the department to license and regulate nursing
facilities.
The amendment implements the Health and Safety Code, 242.001- 242.268.
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 May 10, 2001.
TRD-200102628
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: June 1, 2001
Proposal publication date: March 23, 2001
For further information, please call: (512) 438-3108
The Texas Department of Human Services (DHS) adopts amendments to §19.215,
concerning informal reconsideration; §19.403, concerning notice of rights
and services; §19.2008, concerning investigations of incidents and complaints; §19.2106,
concerning revocation of a license; and §19.2301; concerning conditions
for participation as a Medicaid-certified facility in its Nursing Facility
Licensure Application Process chapter. The amendments are adopted without
changes to the proposed text in the March 9, 2001, issue of the
Texas Register
(26 TexReg 2009) and will not be republished.
Justification for the amendments is to provide consistent requirements
in the rules governing the notice given to the license holder and facility
when DHS proposes to revoke or suspend a license or deny a license application.
The amendments also assure compliance with the notice requirement in §2001.054
of the Government Code. Since the conditions for a facility to participate
in the Medicaid program include a requirement that the facility is licensed,
it is not necessary to state this as an independent requirement in the rules.
References to a rule and statute in these rules were updated to cite the current
rule or statute.
The department received no comments regarding adoption of the amendments.
Subchapter C. NURSING FACILITY LICENSURE APPLICATION PROCESS
40 TAC §19.215
The amendment is adopted under the Human Resources Code, Title
2, Chapter 22, and the Health and Safety Code, Chapter 242, which authorizes
the department to license nursing facilities.
The amendment implements the Human Resources Code, §§22.001 -
22.030; Health and Safety Code, Chapter 242; and Government Code §2001.054
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 May 11, 2001.
TRD-200102649
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: July 1, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 438-3108
40 TAC §19.403
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.
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 May 11, 2001.
TRD-200102650
Paul Leche
General Counsel
Texas Department of Human Services
Effective date: July 1, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 438-3108
40 TAC §19.2008
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 Health and Safety Code, Chapter 242,
which authorizes the department to investigate nursing facilities.
The amendment implements the Human Resources Code, §§22.001-
22.030 and §§32.001-32.042; and Health and Safety Code, Chapter
242.
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 May 11, 2001.
TRD-200102651
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: July 1, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 438-3108
2.
LICENSING REMEDIES
40 TAC §19.2106
The amendment is adopted under the Human Resources Code, Title
2, Chapter 22; and the Health and Safety Code, Chapter 242, which authorizes
the department to license nursing facilities.
The amendment implements the Human Resources Code, §§22.001-
22.030; Health and Safety Code, Chapter 242; and Government Code §2001.054.
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 May 11, 2001.
TRD-200102652
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: July 1, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 438-3108
40 TAC §19.2301
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.
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 May 11, 2001.
TRD-200102653
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: July 1, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 438-3108
Chapter 159.
ADMINISTRATIVE RULES AND PROCEDURES
Subchapter A. GENERAL INFORMATION
40 TAC §159.6
The Texas Commission for the Blind adopts amendments to §159.6,
pertaining to rates for medical services with changes to the text proposed
in the November 24, 2000, issue of the
Texas Register
(25 TexReg 11639). This rule is adopted as amended to satisfy the
agency's statutory responsibility to adopt a rate schedule based on standards.
The Board is not adopting subparagraphs (G)-(Z) and (BB)-(CC) of (b)(6) of
the proposed text. The remaining paragraphs have been renumbered accordingly
in this adoption. The changes are being made because subsequent to the proposal,
rates already established by HCFA/Medicare were located for the services listed
in these proposed subparagraphs and there is no longer a need for the Commission
to establish a separate rate. The agency is also changing two rates that were
based on Medicare 2000 rates instead of 2001 rates. Instead of paying a rate
of $28 for "psychological service, group counseling, per hour, Ph.D. level
of academic training and current licensure in accordance with requirements
of the licensing entity" proposed in (b)(6)(DD), the rate has been corrected
to $30.85. Instead of paying a rate of $25 for "psychological service, group
counseling per hour, Master's level of academic training and current certification
in accordance with requirements of the certifying entity" the rate has been
corrected to $23.14.
The rate schedule as adopted contains the amounts the Commission will pay
for medical services purchased for consumers. Subsection (c) contains the
conditions under which payments for medical services may be negotiated. Subsection
(d) advises the public of the means by which to view a complete compilation
of all individual rates.
No comments were received on the proposal.
The amendments are adopted under the authority of Human Resources
Code, Title 5, Chapter 91, §91.029, which authorizes the Commission to
adopt rates the Commission will pay for medical services.
§159.6.Rates for Medical Services.
(a)
Pursuant to Human Resources Code §91.029, the following
rules and standards shall govern the rates the commission will pay for medical
services:
(1)
Subject to any limitations and exceptions specified in
this section, eye-medical and related services purchased by the commission
for consumers served by its various programs shall be paid for at rates not
to exceed rates established by Health Care Finance Administration's (HCFA)
relative value units (RVUs) adjusted by the Medicare conversion factor as
applied to the Current Procedural Terminology (CPT). Where no HCFA RVU exists,
a maximum payment shall be set that represents best value based upon factors
that include reasonable and customary industry standards for each specific
service. Subject to the same limitations and exceptions, noneye-medical and
related services shall be paid at the rates established by the Texas Rehabilitation
Commission.
(2)
Rates for eye-medical and related services shall be established
at a level adequate to insure availability of qualified providers in adequate
numbers to provide assessment and treatment within a geographic distribution
that mirrors consumer distribution.
(3)
Rates for eye-medical and related services shall be adopted
after comparing proposed rates to other cost-based rates for medical services,
including Medicaid and Medicare rates. The commission shall document the reasons
that any adopted rate exceeds the Medicaid or Medicare rate for the same service.
(4)
Rates for eye-medical and related services shall be administered
uniformly in all commission programs in accordance with federal regulations
governing payment for vocational rehabilitation services, which allows the
agency to establish and maintain written policies to govern the rates of payment
for all purchased services insofar as the schedule:
(A)
is not so low as to effectively deny an individual a necessary
service;
(B)
permits exceptions so that individual needs can be addressed;
and
(C)
takes into consideration the consumer's informed choice.
(5)
The Board shall review its rate schedule for eye-medical
and related services annually after a public hearing to consider whether adjustments
are necessary. If between annual reviews it becomes necessary to set the amount
of payment for a medical service because a payment rate is not established
in these rules or is not otherwise available, the Executive Director is authorized
to set the amount on an individual basis with the advice of the agency's medical
and optometric consultants. The interim amounts shall be presented to the
Board at the next scheduled annual review of all rates.
(6)
Until rates are adopted pursuant to this section, the commission
shall pay for medical services using amounts contained in the agency's Maximum
Affordable Payment Schedule (MAPS). The MAPS shall continue to be maintained
in its present form for public inspection at the commission's main office
at 4800 North Lamar, Austin, Texas, 78756, until superseded.
(b)
Rate schedule. Based on the standards set forth in subsection
(a) of this section, the Commission shall pay for medical services according
to the following:
(1)
The Commission shall pay for eye-medical and related services
according to the Health Care Financing Administration's (HCFA) Relative Value
Units (RVU) base rate adjusted by the Medicare conversion factor if a rate
for the service has been established.
(2)
When there are no HCFA RVU rates established for eye-prosthetics
and related items, the Commission shall pay the rates established by Medicare
for durable medical equipment, prosthetics, orthotics, and supplies, if a
rate for the service has been established.
(3)
When there is no HCFA RVU and no established Medicare rate
for eye-prosthetics and related items, the Commission shall pay the rates
established by Medicaid for durable medical equipment, prosthetics, orthotics,
and supplies, if a rate for the service has been established.
(4)
When there is no rate established by Medicare and Medicaid
for optical low-vision devices, the Commission shall purchase these from national
suppliers at the lowest available catalog price.
(5)
The Commission shall pay for noneye-medical and related
services that are not unique to persons with visual disabilities according
to the Texas Rehabilitation Commission's medical payment rates.
(6)
For services and items for which there is neither a rate
nor an industry standard that takes into consideration the unique needs of
persons with vision loss, the Commission shall pay according to the following:
(A)
Low vision evaluation: $226.92;
(B)
Hand-held and other nonspectacle-mounted optical low vision
devices: national supplier catalog price with an add-on of a 15% processing
fee when purchased through a low vision specialist;
(C)
Spectacle-mounted optical low vision devices: national
supplier catalog price, with an add-on of a 25% prescriptive/processing fee
when purchased through a low vision specialist;
(D)
Telescopic and other compound optical low vision device
systems, including distance vision telescopes, near vision telescopes and
compound microscopic lens systems: national supplier catalog price, with an
add-on of a 40% prescriptive processing fee when purchased through a low vision
specialist;
(E)
Poly carbon safety lens: base prescription, with a $15.32
per lens add-on;
(F)
Deluxe frames (heavy duty; to support optical low vision
lens(es), at or above plus or minus 8D, or spectacle mounted optical devices;
not for use with lens(es) of less than 8D): $100.00;
(G)
Psychological service, Comprehensive Vocational Evaluation
System (CVES) used as Vocational Evaluation: $500.00;
(H)
Psychological service, group counseling, per hour, Ph.D.
level of academic training and current licensure in accordance with requirements
of the licensing entity: $30.85;
(I)
Psychological service, group counseling, per hour, Master's
level of academic training and current certification in accordance with requirements
of the certifying entity: $23.14.
(c)
The executive director or the executive director's designee
may establish procedures for and may negotiate payments for medical services
under the following conditions:
(1)
when a consumer's eye-medical condition requires medical
services or a combination of eye-medical services unique to the consumer and
rates adopted under subsection (b) of this section are not applicable or do
not sufficiently describe the needed service; and
(2)
when the service or combination of services is not expected
to reoccur because of its uniqueness and adopting a standard rate serves no
useful future purpose.
(3)
when a new medical service or procedure has become FDA
approved or when a related service or procedure has become available, and
for which there are no established rates yet in any other payment systems.
(d)
Maximum Affordable Payment Schedule (MAPS). A compilation
of rates and detailed descriptions of the services are contained in the Maximum
Affordable Payment Schedule (MAPS), which is available for viewing according
to agency rules on access to public information. Because the compilation contains
copyrighted information, the MAPS may not be duplicated for public use.
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 May 7, 2001.
TRD-200102574
Terrell I. Murphy
Executive Director
Texas Commission for the Blind
Effective date: May 27, 2001
Proposal publication date: November 24, 2000
For further information, please call: (512) 377-0611
40 TAC §159.8
The Texas Commission for the Blind adopts new §159.8,
pertaining to Commission vehicle use without changes to the text published
in the February 23, 2001, issue of the
Texas Register
(26 TexReg 1685). The rule is adopted to satisfy the requirements
of Government Code §2171.1045 and is consistent with the General Services
Commission's State Vehicle Fleet management Plan. The adopted rules specifically
address the requirements that: (1) vehicles are assigned to the agency's motor
pool and may be available for checkout; and (2) the agency may assign a vehicle
to an individual administrative or executive employee on a regular or everyday
basis only if there is a documented finding that the assignment is critical
to the needs and mission of the agency.
No comments were received on the proposal.
The rule is adopted under Human Resources Code §91.011,
which authorizes the Commission to adopt rules prescribing the policies and
procedures followed by the commission in the administration of its programs,
as well as Texas Government Code §2171.1045, which requires the rule.
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 May 7, 2001.
TRD-200102573
Terrell I. Murphy
Executive Director
Texas Commission for the Blind
Effective date: May 27, 2001
Proposal publication date: February 23, 2001
For further information, please call: (512) 377-0611
Chapter 254.
OPERATION OF THE TEXAS DEPARTMENT ON AGING
40 TAC §254.24, §254.35
The Texas Department on Aging adopts new §254.24 and §254.35
concerning Agency Training Plan and Historically Underutilized Business Program.
Section 254.24 is adopted with non substantive changes to the proposed text
as published in the March 2, 2001, issue of the
Texas Register
(26 TexReg 1830). The text will be republished. Section
254.35 is adopted without changes to the proposed text as published in the
March 2, 2001, issue of the
Texas Register
(26 TexReg 1830) and will not be republished.
Section 254.24 is adopted in order to conform to Texas Government Code,
Chapter 656, Subchapter C, which directs state agencies to provide training
and educational opportunities to its employees.
Section 254.24 will become effective 20 days after the final adopted rule
was filed with
Texas Register
or on the day
the rule is approved by the Governor, whichever is later.
As identified in §254.24(c)(2)(B) (relating to eligibility), the department
may provide training for an employee if such training is directly related
to the employee's current job duty. This is to further enhance their job performance.
The requirement under §254.24(d)(1)(A) (relating to employee training),
is to encourage employees to acquire the full benefit of training they may
receive. Section 254.24(d)(1)(B) is included to provide the department administrative
control over employee training.
Section 254.35 is adopted in order to conform to Texas Government Code, §2161.003,
which directs state agencies to adopt the rules of the General Services Commission
(GSC) regarding historically underutilized businesses (HUBs) as the agency's
own rules. Those rules apply to the Board's purchase of goods and services
paid for with appropriated money. The GSC rules the Board will adopt by reference
provide for a policy and a purpose for the rules, definitions applicable to
the HUB rules, annual procurement HUB utilization goals, subcontracting requirements,
agency planning responsibilities, state agency reporting requirements, A HUB
certification process, protests from denial of HUB applications, a HUB recertification
process, revocation provisions, certification and compliance reviews, compilation
of a HUB directory, HUB graduation procedures, review and revision of GSC's
HUB program, a memorandum of understanding between GSC and the Texas Department
of Economic Development concerning technical assistance and budgeting for
the HUB program, HUB coordinator responsibilities, HUB forum programs for
state agencies, and a mentor-protégé program.
No comments were received regarding adoption of the new rules.
The new rules are adopted under Texas Government Code, §2161.003,
which provides the Texas Department on Aging with the authority to promulgate
rules governing the operation of the Department.
§254.24.Agency Training Plan.
(a)
Purpose. In accordance with the State Employees Training
Act, Government Code, Chapter 656, Subchapter C, it is the policy of the Texas
Department on Aging (TDoA) to provide training and educational opportunities
to its employees. This program is designed to help employees gain knowledge
about general subjects required by the agency and to allow employees to participate
in job related professional development opportunities that will increase an
employee's job potential. This subchapter prescribes the policies governing
employee eligibility for participation in TDoA's Staff Training and Development
program and the obligations of the employees upon receiving education.
(b)
Definitions. The following words and terms, when used in
this section shall have the following meanings, unless the context clearly
indicates otherwise.
(1)
Academic Training--Any subject offered through an accredited
college or university.
(2)
Department--The Texas Department on Aging.
(3)
Employee--An individual employed with TDoA in either a
full-time or part-time position, not including contract employees.
(4)
Hardship--A serious or catastrophic illness, family emergency,
or extenuating circumstance beyond the control of the student that precludes
the student from being reasonably expected to comply with the terms of an
education assistance agreement.
(5)
Institution of higher education--A public or private technical
institute, junior college, senior college, university, medical or dental unit,
or other institution offering an associate's, baccalaureate, master's, or
doctoral degree program.
(6)
Part-time employee--An individual employed with TDoA and
working less than 40 hours per week.
(7)
Professional development--Educational, academic or technical
training used to improve an employee's professional or technical knowledge
and skills or to maintain license requirements.
(8)
Reimburse--To repay monies spent for the cost of public
college or university's tuition fees and books.
(9)
TDoA--The Texas Department on Aging.
(10)
Training--Planned, structured activities designed to improve
employee job performance and job related skills by achieving specific, measurable,
and predetermined learning objectives.
(c)
Employee Training.
(1)
Purpose. TDoA provides employees with a program which allows
employees to gain knowledge about general subjects and encourages employees
to participate in job related professional development opportunities that
will help each employee to achieve his or her highest potential for the job
they hold. This section establishes eligibility criteria for employee participation
in TDoA training opportunities.
(2)
Eligibility. TDoA may provide training for an employee
if such training is:
(A)
designed to increase the employee's competency through
an objective, systematic program of teaching and/or self-study and is utilized
to improve an employee's professional or technical knowledge and skills, or
to maintain license requirements;
(B)
directly related to the employee's current job duties,
or for the purpose of upward mobility into a position currently available
within the employee's career path; or
(C)
designed to increase an employee's awareness of State or
Federal laws regarding equal opportunity, non-discrimination, Drug-Free workplace,
AIDS/HIV, workplace safety and other relevant topics.
(d)
Employee Training Obligations.
(1)
Obligation. Employee training under this section is conditional
upon:
(A)
the employee attending and satisfactorily completing the
training, including passing tests or other types of performance measures where
required; and
(B)
as required by the TDoA, the employee completing and filing
with TDoA, on forms prescribed by TDoA, an employee training agreement that
sets forth the terms and conditions of the training assistance.
(2)
Waiver. For training covered by Texas Government Code,
Chapter 656, Subchapter D, the Texas Board on Aging has the discretion to
waive an employee's obligation to abide by the terms of the agreement if the
Board finds that a waiver is in the best interest of TDoA or is warranted
because of an extreme personal hardship suffered by the employee.
(e)
Academic Training Program.
(1)
Purpose. The Texas Department on Aging (TDoA) encourages
employees to participate in job related professional development opportunities
that will help each employee to achieve his or her highest potential for the
job they hold or allow upward mobility into a position within their career
path. This section establishes eligibility criteria for participation in the
program.
(2)
Eligibility. To qualify for the academic training program,
the employee:
(A)
must currently meet or exceed performance standards in
job performance;
(B)
must not be on probation of any kind;
(C)
must seek enrollment in a field of study where:
(i)
course content is related to the employee's present job
duties, or the course is taken for the purpose of upward mobility into a position
available within the agency; and
(ii)
the course will equip the employee with skills and knowledge
needed to work efficiently and improve the employee's job effectiveness;
(3)
Type of Institution. An employee who participates in the
Academic Training Program must attend a public institution in the State of
Texas, unless:
(A)
no accredited public institution offers program courses
that can reasonably be attended by an employee;
(B)
a public institution does not offer the approved courses
or degree program;
(C)
the admission requirements of the public institution are
so restrictive as to preclude the employee's qualifications for the program;
(D)
the completion of the course at a private institution costs
less than a public institution; or
(E)
Waiver.
(i)
The Executive Director has the authority to approve a waiver
to allow an employee to attend a private institution to complete coursework
when similar coursework is offered in a public institution.
(ii)
The Department will provide financial assistance up to
the amount of what the coursework would cost in a public institution.
(4)
Eligible Expenses. Financial assistance may be awarded
for tuition fees and books.
(f)
Academic Training Program Obligations.
(1)
Obligation. Academic training under this section is conditional
upon:
(A)
the course must be taken after working hours or, if the
course is taken during working hours, accrued leave is taken to attend class;
(B)
the employee having continued employment in good standing
for the entirety of the course;
(C)
the employee completed the course with a grade of "C" or
above; and
(D)
as required by the Texas Department on Aging (TDoA), the
employee completing and filing with TDoA, on forms prescribed by TDoA, an
employee training agreement that sets forth the terms and conditions of the
training assistance.
(2)
Waiver. For training covered by Texas Government Code,
Chapter 656, Subchapter D, the Texas Board on Aging has the discretion to
waive an employee's obligation to abide by the terms of the agreement if the
Board finds that a waiver is in the best interest of TDoA or is warranted
because of an extreme personal hardship suffered by the employee.
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 May 14, 2001.
TRD-200102676
Gary Jessee
Aging Network Policy Coordinator
Texas Department on Aging
Effective date: June 3, 2001
Proposal publication date: March 2, 2001
For further information, please call: (512) 424-6857
Chapter 453.
HISTORICALLY UNDERUTILIZED BUSINESS PROGRAM
Subchapter I. RESIDENT ASSESSMENT
Chapter 19.
NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
Subchapter E. RESIDENT RIGHTS
Subchapter U. INSPECTIONS, SURVEYS, AND VISITS
Subchapter V. ENFORCEMENT
Subchapter X. REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES
Part 4.
TEXAS COMMISSION FOR THE BLIND
Part 9.
TEXAS DEPARTMENT ON AGING
Part 15.
TEXAS VETERANS COMMISSION