TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 15. MEDICAID ELIGIBILITY

The Texas Department of Human Services (DHS) proposes amendments to §15.100, concerning definitions; §15.450, concerning general principles concerning income; and §15.619, concerning administrative denials; and new §15.401, concerning fiduciary agent, in its Medicaid Eligibility chapter. The purpose of the amendments to §15.100 and §15.450 and new §15.401 is to clarify the treatment of a fiduciary (financial) agent. If the client is the agent for another person, the income and resources of that person are not countable to the client. If the client has a fiduciary agent, the client's income and resources are available to him, unless otherwise excludable. The purpose of the amendment to §15.619 is to clarify the time frame for rescheduling a missed appointment for an application interview. In the proposed rule, the eligibility specialist sends a notice scheduling a second appointment that is no earlier than seven days after the date of the second notice.

James R. Hine, Commissioner, has determined that for the first five-year period the proposed sections will be in effect, there will be no fiscal implications for state or local governments as a result of enforcing or administering the sections.

Mr. Hine also has determined that for each year of the first five years the sections are in effect, the public benefit anticipated as a result of adoption of the proposed rules will be to ensure that eligibility staff apply policy correctly and consistently, statewide. There will be no effect on small or micro businesses as a result of enforcing or administering the sections, because the policy applies only to the client's financial eligibility for Medicaid benefits, not to the operation of business. There is no anticipated economic cost to persons who are required to comply with the proposed sections. There is no anticipated effect on local employment in geographic areas affected by these sections.

Questions about the content of this proposal may be directed to Judy Coker at (512) 438-3227 in DHS's Medicaid Eligibility section. Written comments on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-047, 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.

Subchapter A. GENERAL INFORMATION

40 TAC §15.100

The amendment is proposed 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.

§15.100.Definitions.

The following words and terms, when used in this chapter, have the following meanings unless the context clearly indicates otherwise:

(1) - (42) (No change.)

(43) Fiduciary agent-- A person or organization acting on behalf of and/or with the authorization of another person. The term applies to anyone who acts in a financial capacity, whether formal or informal, regardless of his title, such as representative payee, guardian, or conservator [ An individual who has authority to manage another person's funds ].

(44) - (138) (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 February 22, 2002.

TRD-200201085

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: April 7, 2002

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


Subchapter D. RESOURCES

40 TAC §15.401

The new section is proposed 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 new section implements the Human Resources Code, §§22.001 - 22.030 and §§32.001 - 32.042.

§15.401.Fiduciary Agent.

(a) A fiduciary agent is a person or organization acting on behalf of and/or with the authorization of another person. The term applies to anyone who acts in a financial capacity, whether formal or informal, regardless of his title, such as representative payee, guardian, or conservator.

(b) An action by a fiduciary agent is the same as an action by the person for whom he acts.

(c) Assets held by a client in his capacity as fiduciary agent for someone else are not countable assets to the client. Assets held by a fiduciary agent for a client are considered as available to the client, unless otherwise excludable.

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 February 22, 2002.

TRD-200201086

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: April 7, 2002

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


Subchapter E. INCOME

40 TAC §15.450

The amendment is proposed 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.

§15.450.General Principles Concerning Income.

(a) - (h) (No change.)

(i) A fiduciary agent is a person or organization acting on behalf of and/or with the authorization of another person. The term applies to anyone who acts in a financial capacity, whether formal or informal, regardless of his title, such as representative payee, guardian, or conservator.

(1) An action by a fiduciary agent is the same as an action by the person for whom he acts.

(2) Monies received by a client in his capacity as a fiduciary agent for someone else are not income to the client, provided the client disburses the monies to or for the benefit of the other person. If the agent is authorized to keep part of the funds as compensation for services rendered, the fees, commissions, or contributions are unearned income to the client.

(3) Monies received by a fiduciary agent for a client are charged as income to the client when received by the agent.

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 February 22, 2002.

TRD-200201087

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: April 7, 2002

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


Subchapter G. APPLICATION FOR MEDICAID

40 TAC §15.619

The amendment is proposed 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.

§15.619.Administrative Denials.

(a) When a client or responsible party misses an appointment, the eligibility specialist sends a second notice scheduling a second appointment that is no earlier than seven days after the date of the second notice. [ When the Texas Department of Human Services eligibility specialist sends the client or responsible party a notice scheduling an appointment and the appointment is not kept, the eligibility specialist sends a follow-up second notice of appointment. ]

(b) If there is no response to the notice and the second appointment is missed [ by the end of the 10-day deadline given on the follow-up notice ], the application is denied. The application can be reopened under the original file date if the client or the responsible party provides a reasonable explanation for failing to respond to the appointment letter, such as hospitalization, language barrier, or the need for other assistance.

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 February 22, 2002.

TRD-200201088

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: April 7, 2002

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


Part 5. TEXAS VETERANS LAND BOARD

Chapter 175. GENERAL RULES OF THE VETERANS LAND BOARD

Subchapter A. GENERAL RULES AND CONTRACTING FINANCING

40 TAC §175.6, §175.21

The Veterans Land Board of the State of Texas (the "Board") proposes amendments to Title 40, Part 5, Chapter 175 of the Texas Administrative Code, §175.6, relating to Commitment by the Board and §175.21, relating to Prizes and Inducements of the General Rules of the Veteran Land Board. These amendments propose to clarify the amount the Board will invest in land to be purchased and resold by the Board and the amount of investment required of the Veteran. The proposed amendments will also correct some errors and clarify some language.

Section 161.222(a) of the Texas Natural Resources Code was amended in 1985 to authorize the Board to set the amount of the initial payment required from a purchaser. Section 161.233(a) and §161.283(b) of the Texas Natural Resources Code were amended in 1991 to limit the maximum amount of the Board's investment to $40,000. The proposed amendment to §175.6 would allow the Board to invest a maximum of $40,000 by adjusting the initial payment and any additional required down payment. The proposed amendment would still require that Veteran purchasers have at least 5.0% equity in the tract they purchase. To avoid confusion, the statutory "initial payment" and additional "down payment(s)" are combined and referred to as the "equity investment" in the proposed amendment.

The proposed amendment to §175.21(a) would change the incorrect reference to §161.333(a) of the Texas Natural Resources Code, to the correct reference to §161.233(a) of the Texas Natural Resources Code, and add a previously omitted reference to §161.283(b) of the Texas Natural Resources Code.

The proposed amendments also make minor non-substantive changes to both rules.

Douglas Oldmixon, Executive Secretary of the Veterans Land Board, has determined that for each year of the first five years that the rules will be in effect, there will be no significant fiscal implication to state or local government as a result of administering the rules as amended.

Douglas Oldmixon, Executive Secretary of the Veterans Land Board, has determined that for each year of the first five years that the rules will be in effect, the public will benefit because the proposed amendments will allow the Board to increase the amount it invests in a tract of land on behalf of a Veteran. The amendments will have no significant effect on small businesses and the anticipated impact on local employment will be insignificant during each year of the first five years the amended rules are in effect . The anticipated economic cost to persons who are required to comply with the rules will be insignificant. Persons who seek financing from the Board through the Program will pay the same fees to the Board, and costs to third parties, as previously required.

Comments may be submitted to Melinda Tracy, Legal Services Division, General Land Office of the State of Texas, 1700 North Congress Avenue, Austin Texas, by no later than 30 days after publication.

The amendments are proposed under the Natural Resources Code, Title 7, Chapter 161, §§161.001, 161.061, 161.063, 161.222, 161.233 and 161.283. These sections authorize the Board to adopt rules that it considers necessary and advisable for the Land Program.

Natural Resources Code §§161.222, 161.233 and 161.283 are affected by this rule making action.

§175.6.Commitment by the Board.

(a) After reviewing the appraisal, and any other relevant information, the board shall issue a commitment showing the amount it will invest in the land selected. The veteran and seller shall be notified of the commitment amount in writing. The board shall not invest more than the least of the following options: [ . ]

(1) 95% of the appraised value of the land;

(2) 95% of the final agreed purchase price; or

(3) $40,000.

(b) Except for certain Forfeited Land Sales, the board requires the veteran to have at least a 5.0% equity investment in the land. The equity investment is the difference between the commitment amount and the purchase price. The amount of equity required shall be the combination of the initial payment and the down payment(s), as applicable.

(c) [ (b) ] If the commitment amount is less than 95% of the purchase price, one of the following should be done:

(1) The veteran may pay to the board the difference between the purchase price and the commitment amount; [ amend the contract price to conform to the commitment amount; ]

(2) The parties may amend the purchase [ amend the contract ] price, with the veteran paying to the board the difference between the amended price and the commitment amount[ , if necessary ];

[(3) pay to the board the difference between the contract price and the commitment amount;]

(3) [ (4) ] The parties may amend the contract to increase the acreage to make up for the difference in value compared to price ; or

(4) [ (5) ] The veteran may cancel the loan application and purchase contract .

(d) In certain cases, special circumstances may require special loan conditions in the commitment terms. The following are two examples, but others may apply:

(1) If improvements on the land are considered by the board in determining the commitment amount, their value may be amortized over their lifetime as determined by the appraiser; and

(2) If the land is situated in an underground irrigation water area, the installments may be accelerated for the purpose of protecting the board's investment against the risk of any diminishment of the water reserve.

[(c) If improvements on the land are considered by the board in determining the commitment amount, their value will be amortized over their lifetime as determined by the appraiser. Similarly, when land is situated in an underground irrigation water area, the installments will be accelerated for the purpose of protecting the board's investment against the risk of any diminishment of the water reserve.]

§175.21.Prizes and Inducements.

(a) The Texas Natural Resources Code, §161.222(a) [ and §161.333(a), ] requires veterans to make an initial payment in an amount set by the board's rules. Section 161.233(a) and §161.283(b) require that Veterans make additional down payment(s) under certain circumstances. In order to carry out the intent of the [ this ] requirement that veterans have equity in any tract purchased through the program, it is the policy of the Veterans Land Board to approve no transaction, the net effect of which involves the seller, realtor, or any party to the transaction other than the veteran directly or indirectly paying the initial [ down ] payment or down payment(s) [ program fees ]. This includes inducements such as zero coupon bonds, savings bonds, etc.

(b) Subsection (a) of this section shall not be construed to prevent a veteran from contracting with the seller or any other party to a transaction for the payment of other expenses associated with closing the transaction such as survey costs, title examination, and attorney's fees.

(c) Subsection (a) of this section shall not be construed to prohibit privileges incidental to the ownership of land and available to all purchasers in the same subdivision and/or joint ownership of recreational areas such as parks, lakes, etc.

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 February 19, 2002.

TRD-200201006

Larry R. Soward

Chief Clerk, General Land Office

Texas Veterans Land Board

Earliest possible date of adoption: April 7, 2002

For further information, please call: (512) 305-9129


Part 6. TEXAS COMMISSION FOR THE DEAF AND HARD OF HEARING

Chapter 181. GENERAL RULES OF PRACTICE AND PROCEDURE

Subchapter A. GENERAL PROVISIONS

40 TAC §181.28

The Texas Commission for the Deaf and Hard of Hearing proposes amendment to §181.28. The amendment is proposed to implement an increase in the application fee for children applying for camp to help cover the rising cost of the program.

David W. Myers, Executive Director, has determined that for each year of the first five years the amendment to this section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the amendment.

Mr. Myers has also determined that for each year of the first five years the amendment is in effect the public benefit anticipated as a result of this amendment will be that the program will be able to cover the costs of running the program. There will be no effect on small businesses. There is no anticipated economic hardship to persons required to comply with the amendment as proposed.

Comments on this proposed amendment may be submitted to Ann Horn, Texas Commission for the Deaf and Hard of Hearing, P.O. Box 12904, Austin, Texas 78711-2904.

The amendment is proposed under the Texas Administrative Code, §81.006(b) (3), which provides the Texas Commission for the Deaf and Hard of Hearing with the authority to adopt rules for administration and programs.

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

§181.28. Camp SIGN.

(a) Description of Services. Camp SIGN is a learning environment for students who are deaf or hard of hearing which is free of communication barriers. The goal is to have all students who are deaf or hard of hearing regardless of their communication mode participate in the program.

(b) Eligibility. Camp is open to boys and girls who are deaf or hard of hearing between the ages of 8 and 17 and residents of Texas.

(c) Counselor in Training (CIT). A program that focuses on developing leadership skills to prepare boys and girls aged 16 and 17 to become future camp counselors and leaders.

(d) Staffing. Camp SIGN staff are chosen on the basis of criteria to accommodate the needs of the campers and to serve as role models for the campers. Staff are recruited from professionals working in the field with individuals who are deaf or hard of hearing. Staff must be able to communicate effectively with children who use American Sign Language, English or other modes of communication. Junior Counselor Staff must be at least 18 years old and Senior counselor staff must be at least 21 years old. Staff are hired by the contracted campsite based on recommendations of the Commission.

(e) Campsites. Any contracted campsite will be obtained through competitive bid or through donation. The campsite must be ADA accessible, and provide adequate facilities and a variety of learning experiences for the campers.

(f) Application Fee. A fee of $35 [ $25 ] is required to process an application for Camp SIGN. This fee is refundable only upon written request if the child is determined ineligible , or if camp space is filled to capacity. [ to attend camp, and refund is requested in writing ]

(g) Sliding Scale Fee. Upon receipt of the application the family economic status is reviewed and a sliding scale may be applied.

(h) Behavior Problems. Children that have behavior problems that constantly disrupt camp activities or threaten other campers or staff will be sent home and all fees forfeited.

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 February 25, 2002.

TRD-200201148

David Myers

Executive Director

Texas Commission for the Deaf and Hard of Hearing

Earliest possible date of adoption: April 7, 2002

For further information, please call: (512) 407-3250


Part 9. TEXAS DEPARTMENT ON AGING

Chapter 270. GENERAL SERVICE REQUIREMENTS

40 TAC §270.23

The Texas Department on Aging proposes new §270.23, concerning Respite Voucher Program. The new rule establishes the requirements for implementation by area agencies on aging of a respite voucher program.

Barbara Zimmerman, Chief Fiscal Officer has determined that for the first five-year period the new section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the new section.

Ms. Zimmerman 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 the implementation of a respite voucher program. There will be no effect on small businesses. There will be no effect to individuals required to comply with the section as proposed.

Comments on the new rule may be submitted to Gary Jessee, Director of the Office of AAA Support and Operations, Texas Department on Aging, P. O. Box 12786, Austin, Texas 78711. All comments must be written and delivered via mail, in person, or facsimile. E-mail and verbal comments cannot be accepted. All comments must be received within 30 calendar days following the date of publication of the proposed new rules in the Texas Register .

The new rule is proposed 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.

Texas Government Code, §2161.003 is affected and implemented by this proposed action.

§270.23.Respite Voucher Program.

(a) Purpose. This rule establishes the requirements for implementation by area agencies on aging of a respite voucher program. Each area agency on aging may establish a respite voucher program. The respite voucher program shall incorporate the necessary strategies and activities to meet the following goals.

(1) Provide area agencies on aging the flexibility to best meet the respite needs of older adults, their family members and/or their caregivers within their respective service areas; and

(2) Provide vouchers to enable caregivers to have the maximum flexibility in arranging for respite services that best meet the needs of the care receivers.

(b) Targeting. The area agency on aging shall target respite voucher program services to ensure:

(1) Priority is given to older individuals who meet the requirements of the Older Americans Act, §373(c).

(2) Recipients are not currently receiving a similar service under another program.

(c) Eligibility. Eligible participants in the respite voucher program shall include:

(1) Adults of any age who are providing primary care for older adults, age 60 and over. The older adult must have a deficit in at least two or more activities of daily living. Caregivers may include spouses, adult children, other relatives or friends;

(2) Adults age 60 and over who are providing primary care for children age 18 years or younger (priority given to those raising children with developmental disabilities or mental retardation). In accordance with the requirements of the National Family Caregiver Support Program, no more than 10% of an AAA's Title III-E allocation may be spent on this group for all allowable services.

(3) A caregiver that is paid to provide care-giving services is not eligible to participate in the respite voucher program.

(d) Level of Service. The area agency on aging shall manage the respite voucher program to best meet the needs of older adults and their caregivers.

(e) Application Process. Area agencies on aging will administer an application process whereby interested caregivers may apply for the respite voucher program. Area agencies on aging will process the application, including verification that a deficit in two activities of daily living exists, and shall notify the applicant of whether or not the application is or is not approved.

(f) Caregiver Responsibilities. The caregiver is the individual that is providing care on a regular, ongoing basis. The caregiver has the responsibility of:

(1) Interviewing potential respite provider(s);

(2) Discussing and setting an hourly, daily or weekly rate;

(3) Selecting and Hiring the Respite Provider. Caregivers may choose a family member, neighbor, friend, adult care center, private agency staff, or contact the area agency on aging for assistance in finding respite providers. Selected providers must be 18 years of age or older. The respite provider may not be the spouse or legal guardian of, and may not live in the same house as the care receiver;

(4) Asking for and checking references;

(5) Informing or training the provider of the specific needs of the care receiver;

(6) Ensuring proper payment for services by keeping track of the number of hours or days of respite used and the total amount claimed against the voucher;

(7) Ensuring that federal tax guidelines for household employees are followed in accordance with IRS Publication 926;

(8) Appealing the rejection of an application for a respite voucher in accordance with the established area agency on aging appeal procedures;

(9) Notifying the area agency on aging of any change of address;

(10) Monitoring the quality of the respite service provided;

(11) Notifying the area agency on aging if they are dissatisfied with a respite provider;

(g) Quality Standards for Services Provided. To assure the highest quality of services, area agency on aging access and assistance staff will monitor and follow-up on the services provided to care receivers in accordance with §260.3(o) of this title (relating to Care Coordination).

(h) Complaints. Complaints from caregivers about the respite voucher program should be directed to the area agency on aging administering the program in their area.

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 February 20, 2002.

TRD-200201032

Gary Jessee

Director of the Office of AAA Support and Operations

Texas Department of Aging

Earliest possible date of adoption: April 7, 2002

For further information, please call: (512) 424-6857