TITLE 25.HEALTH SERVICES

Part 1. TEXAS DEPARTMENT OF HEALTH

Chapter 56. FAMILY PLANNING

The Texas Department of Health (department) adopts new §§56.1 - 56.19 and the repeal of §§56.101 - 56.104, 56.201 - 56.209, 56.301 - 56.306, 56.401 - 56.404, 56.501 - 56.525, 56.601 - 56.607, 56.701 - 56.703, 56.801, 56.802, and 56.901 - 56.904, concerning the Family Planning Program. Sections 56.1, 56.4, 56.7, 56.9, 56.12, 56.14, 56.16, and 56.17 are adopted with changes to the proposed text as published in the August 23, 2002, issue of the Texas Register (27 TexReg 7733) as a result of comments received during the 30-day comment period. The repeals and new §§56.2, 56.3, 56.5, 56.6, 56.8, 56.10, 56.11, 56.13, 56.15, 56.18, and 56.19 are adopted without change, and therefore the sections will not be republished.

Specifically, the new sections concern applicability of family planning requirements; definitions; purposes; family planning advisory committee; maximum rates and specific codes; range of methods; abortion statement; requirements for reimbursement of family planning services; records retention; prompt service; freedom of choice; confidentiality; eligibility for family planning services; consent; family planning for adolescents; and civil rights.

Government Code, Chapter 2110 requires that each state agency adopt rules on advisory committees. The rules must state the purpose of the committee, describe the tasks of the committee, describe the manner in which the committee will report to the agency, and establish a date on which the committee will automatically be abolished unless the governing body of the agency affirmatively votes to continue the committee's existence.

In 1998, the board adopted §56.104 of this title (relating to Family Planning Advisory Committee). The committee has provided advice to the Texas Board of Health (board) and the department relating to comprehensive family planning services. Section 56.104 states that the committee will automatically be abolished on January 1, 2003. The board has now reviewed and evaluated the committee and has determined that the committee should continue in existence until January 1, 2007.

New §56.4 updates provisions relating to the operation of the committee. Specifically, the new section provides that the committee shall continue in existence until January 1, 2007; provides that the committee shall appoint the presiding officer; and establishes the Informational and Educational Subcommittee.

Government Code, §2001.039 also requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 56.101 - 56.104, 56.201 - 56.209, 56.301 - 56.306, 56.401 - 56.404, 56.501 - 56.525, 56.601 - 56.607, 56.701 - 56.703, 56.801, 56.802, and 56.901 - 56.904 have been reviewed and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed. However, all the existing rules in Chapter 56 are being repealed, and new rules are being proposed to make them more accessible, understandable, and usable.

The department published a Notice of Intention to Review the sections as required by Government Code §2001.039 in the Texas Register on May 19, 2000 (25 TexReg 4598). No comments were received.

The department is making the following minor changes to clarify the intent and improve the accuracy of the sections.

Change: Concerning §56.1, the erroneous reference to the "Title V Manual, September, 2002" has been corrected as "Title V Policies and Procedures Manual, September, 2002".

Change: Concerning §56.4(f)(2)(B)(vi), the reference to "one representative of client self support services from DHS" has been updated to "one representative from the DHS Texas Works Program".

Change: Concerning §56.4(n)(5), the paragraph has been amended to clarify that advisory committee members may neither exercise their official powers or duties in favor of or against another person in exchange for a benefit.

Change: Concerning §56.9, the erroneous reference to 1 Texas Administrative Code §354.1003 (relating to Medical Records) has been corrected as "1 Texas Administrative Code §354.1004 (relating to Medical Records)".

Change: Concerning §56.16, the word "must" was inadvertently omitted from the first sentence of the section as proposed, and has been added to clarify that all the provisions of §56.16 are intended to be mandatory.

Change: Concerning §56.17(a)(1), the department has restated the professional qualifications of a clinical geneticist serving as a genetic service agency provider's medical director more specifically.

The following comments were received concerning the proposed sections. Following each comment is the department's response and any resulting changes.

Comment: Concerning the chapter as a whole, several commenters stated that the rules should be amended to assure that family planning providers report sexual abuse and assault of minors as required by state law.

Response: The department agrees and has amended §56.12 to incorporate the essence of the commenters' suggested language. As a result of the amendment, the sentence concerning access to client records by department staff or their authorized representatives has been rephrased and added to §56.12(3) for clarity.

Comment: Concerning the chapter as a whole, one commenter stated that the rules should be amended to require family planning providers to document reports of abuse of minors in the clients' medical records.

Response: The department already requires all family planning providers by contract to document reports of abuse of minors, but not necessarily in clients' medical records. No change was made as a result of this comment.

Comment: Concerning the chapter as a whole, one commenter recommended that the rules be amended to prohibit family planning providers from advising a minor not to reveal the name or other identifying information concerning the client's sexual partner, or informing a client that a report must be made if there is reason to believe that a sexual assault or other abuse has occurred.

Response: The department disagrees because §56.12 as amended already requires providers to show a good faith effort to comply with all child abuse reporting guidelines and requirements in order to receive appropriated funds. Any activities by providers inconsistent with their obligations under §56.12 are therefore prohibited by law, regulation, or by contract without specific enumeration. No changes were made as a result of this comment.

Comment: Concerning the chapter as a whole, one commenter suggested that the rules should be amended to require that audits of family planning providers should include review of a representative sample of client files to confirm that the provider is complying with child abuse reporting requirements.

Response: The department currently conducts on-site monitoring of family planning providers to assure they are making a good faith effort to comply with all abuse reporting guidelines and requirements, as required by the providers' contracts with the department. Monitoring procedures include review of a random sample of all client records, as well as a targeted review of the records of all unmarried minors under the age of 14 who are pregnant or who have a confirmed sexually transmitted disease. No changes were made as a result of this comment.

Comment: Concerning §56.1, one commenter suggested that the Family Planning Program Policies Manual and Title V Manual should be identified by date.

Response: The department agrees and has amended the section accordingly.

Comment: Concerning §56.4(n), one commenter stated that bylaws for all the department's advisory committees should include clarification of members' responsibilities concerning conflict of interest and acceptance of benefits.

Response: The department agrees, and the addition of §56.4(n)(3) - (6) clarifies these member responsibilities.

Comment: Concerning §56.7, several commenters stated that the rules should be amended to clarify that state funds shall not be used to pay the direct or indirect costs of abortion procedures provided by contractors.

Response: The department agrees and has amended the section with clarifying language concerning the use of state funds for contractors that provide abortion procedures.

Comment: Concerning §56.7, one commenter stated that the department's financial audits of family planning providers should include a determination of whether state funds have been used to pay the direct or indirect costs of abortion procedures provided by department contractors.

Response: Department policy concerning audits of family planning contractors already includes review for compliance with state and federal regulations that prohibit funding of costs related to abortion procedures. No changes were made as a result of this comment.

Comment: Concerning §56.14, several commenters stated that the department should deny compensation for provision of family planning services to minors unless consent has been obtained pursuant to Chapter 32 of the Texas Family Code.

Response: Federal law does not authorize states to require the consent of a parent or another adult for provision of family planning services to minors eligible for Medicaid. Additionally, several federal courts have held that regulations concerning Title X of the Public Health Service Act prohibit state parental consent requirements for family planning services provided to minors. Section 56.14 has been amended to clarify that providers must obtain consent in accord with Chapter 32, Family Code, unless federal law or regulations provide otherwise, before a minor may receive family planning services.

The comments on the proposed rules received by the department during the comment period were submitted by the Office of the Governor of Texas, Representative Charlie Howard, Representative Leo Berman, Representative John Shields, Representative Sid Miller, Representative Arlene Wohlgemuth, Representative Phil King, Representative Joe Nixon, Representative Rick Green, the Texas Alliance for Life, department staff, and individuals. The comments were neither for nor against the rules in their entirety; however, they raised questions, offered comments for clarification purposes, and suggested clarifying language concerning specific provisions in the rules.

25 TAC §§56.1 - 56.19

The new sections are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

§56.1.Applicability of Family Planning Requirements.

The requirements in each section apply to Titles V, X, XIX (Medicaid), and XX family planning programs unless otherwise specified within the section. Family planning contractors are also required to observe all guidelines and operating procedures outlined in the Family Planning Program Policies Manual, February, 2003, and/or Title V Policies and Procedures Manual, September, 2002, as required by their contracts. In addition to the requirements set out in Chapter 56, Title XIX (Medicaid) providers must comply with the terms and conditions of the Provider Agreement signed by all providers as a condition of participation in the Texas Medical Assistance Program.

§56.4.Family Planning Advisory Committee.

(a) An advisory committee shall be appointed under and governed by this section.

(1) The name of the committee shall be the Family Planning Advisory Committee.

(2) The committee is established under the Health and Safety Code, §11.016 which allows the board to establish advisory committees.

(3) The committee shall comply with the requirements of 42 United States Code §300a-4, 42 Code of Federal Regulations §59.6, and the Title X Program Guidelines for Project Grants for Family Planning Services by appointment of a subcommittee to review and approve informational and educational materials developed or made available under Title X of the Public Health Service Act.

(b) Applicable law. The committee is subject to the Government Code, Chapter 2110, relating to state agency advisory committees.

(c) Purpose. The purpose of the committee is to provide advice to the board and program staff in the area of comprehensive family planning services. The committee process affords the opportunity for participation in the development, implementation, and evaluation of the program by persons broadly representative of all significant elements of the population to be served, and by persons in the community knowledgeable about the needs for family planning services.

(d) Tasks.

(1) The committee shall evaluate, on an ongoing basis, the family planning needs of the state and the family planning program; make recommendations for the program's improvement; and review and make recommendations regarding proposed rules, policy revision and development.

(2) The committee shall advise the board concerning rules relating to the family planning program.

(3) The committee shall carry out any other tasks given to the committee by the board.

(e) Committee abolished. By January 1, 2007, the board will initiate and complete a review of the committee to determine whether the committee should be continued, consolidated with another committee, or abolished. If the committee is not continued or consolidated, the committee shall be abolished on that date.

(f) Composition. The committee shall be composed of 15 members.

(1) The composition of the committee shall include five family planning consumer representatives and ten non-consumer representatives. The composition of the committee shall reflect the diversity of the state's citizens and consumers, with regard to ethnicity, race, age, gender, geographic location, and economic status. Each member shall represent all the citizens of the state in all the committee's deliberations and decisions.

(2) The members of the committee shall be appointed by the board as follows:

(A) five family planning consumers, with at least one male representative; and

(B) ten non-consumer members, including the following:

(i) two primary care physicians currently licensed by the Texas State Board of Medical Examiners and currently involved in the delivery of family planning services. One physician must be certified by the American College of Obstetricians and Gynecologists or its equivalent and one physician must have a practice that includes adolescents;

(ii) one women's health care nurse practitioner with family planning experience, currently licensed by the Board of Nurse Examiners for the State of Texas;

(iii) four family planning provider agency administrators;

(iv) one reproductive health educator;

(v) one presiding officer of the Regional Coordinating Chairpersons' Subcommittee;

(vi) one representative from the DHS Texas Works Program.

(g) Terms of office. The term of office of each member shall be six years, except for the presiding officer of the Regional Coordinating Chairpersons' Subcommittee, who shall be appointed for a two-year term.

(1) Members shall be appointed for staggered terms so that the terms of members shall expire on December 31st of each even-numbered year.

(2) If a vacancy occurs, a person shall be appointed to serve the unexpired portion of that term.

(h) Officers. The committee shall select from its members the presiding officer and assistant presiding officer.

(1) Each officer shall serve until December 31st of each even-numbered year. Each officer may holdover until his or her replacement is elected.

(2) The presiding officer shall preside at all committee meetings at which he or she is in attendance, call meetings in accordance with this section, appoint subcommittees of the committee as necessary, and cause proper reports to be made to the board. The presiding officer may serve as an ex-officio member of any subcommittee of the committee.

(3) The assistant presiding officer shall perform the duties of the presiding officer in case of the absence or disability of the presiding officer. If the office of presiding officer becomes vacant, the assistant presiding officer will serve until a successor is appointed to complete the unexpired portion of the term of the office of presiding officer.

(4) If the office of assistant presiding officer becomes vacant, it may be filled by vote of the committee.

(5) A member shall serve no more than two consecutive terms as presiding officer and/or assistant presiding officer.

(6) The committee may reference its officers by other terms, such as chairperson and vice-chairperson.

(i) Meetings. The committee shall meet at least semiannually to conduct committee business.

(1) A meeting may be called by agreement of department staff and either the presiding officer or at least three members of the committee.

(2) Meeting arrangements shall be made by department staff. Department staff shall contact committee members to determine availability for a meeting date and place.

(3) The committee is not a "governmental body" as defined in the Open Meetings Act. However, in order to promote public participation, each meeting of the committee shall be announced and conducted in accordance with the Open Meetings Act, Texas Government Code, Chapter 551, with the exception that the provisions allowing executive sessions shall not apply.

(4) Each member of the committee shall be informed of a committee meeting at least five working days before the meeting.

(5) A simple majority of the members of the committee shall constitute a quorum for the purpose of transacting official business.

(6) The committee is authorized to transact official business only when in a legally constituted meeting with a quorum present.

(7) The agenda for each committee meeting shall include an opportunity for any person to address the committee on matters relating to committee business. The presiding officer may establish procedures for such public comment, including a time limit on each comment.

(j) Attendance. Members shall attend committee meetings as scheduled. Members shall attend meetings of subcommittees to which the members are assigned.

(1) A member shall notify the presiding officer or appropriate department staff if he or she is unable to attend a scheduled meeting.

(2) It is grounds for removal from the committee if a member cannot discharge the member's duties for a substantial part of the term for which the member is appointed because of illness or disability, is absent from more than half of the committee and subcommittee meetings during a calendar year, or is absent from at least three consecutive committee meetings.

(3) The validity of an action of the committee is not affected by the fact that it is taken when a ground for removal of a member exists.

(k) Staff. Staff support for the committee and its subcommittees shall be provided by the department.

(l) Procedures. Roberts Rules of Order, Newly Revised, shall be the basis of parliamentary decisions except where otherwise provided by law or rule.

(1) Any action taken by the committee must be approved by a majority vote of the members present once a quorum is established.

(2) Each member shall have one vote.

(3) A member may not authorize another individual to represent the member by proxy.

(4) The committee shall make decisions in the discharge of its duties without discrimination based on any person's race, creed, gender, religion, national origin, age, physical condition, or economic status.

(5) Minutes of each committee meeting shall be taken by department staff.

(A) A draft of the minutes approved by the presiding officer shall be provided to the board and each member of the committee within 30 days of each meeting.

(B) After approval by the committee, the minutes shall be signed by the presiding officer.

(m) Subcommittees. The committee may establish subcommittees as necessary to assist the committee in carrying out its duties.

(1) The presiding officer shall appoint members of the committee to serve on subcommittees and to act as subcommittee chairpersons. The presiding officer may also appoint nonmembers of the committee to serve on subcommittees.

(2) Subcommittees shall meet when called by the subcommittee chairperson or when so directed by the committee.

(3) A subcommittee chairperson shall make regular reports to the advisory committee at each committee meeting or in interim written reports as needed. The reports shall include an executive summary or minutes of each subcommittee meeting.

(4) The committee shall have a standing subcommittee to coordinate the activities of family planning providers at a regional level. The Regional Coordinating Chairpersons' Subcommittee (RCCS) shall be comprised of chairpersons of the Regional Coordinating Committees (RCC). The regional committees shall be comprised of representatives from the family planning providers in the region.

(A) The RCCS shall elect a presiding officer (chairperson) and assistant presiding officer from its membership to serve a two-year term to begin serving on January 1 of each odd-numbered year. Each officer shall serve until December 31st of each even-numbered year.

(B) The presiding officer shall preside at all committee meetings at which he or she is in attendance, call meetings in accordance with this section, appoint workgroups of the committee as necessary, and cause proper reports to be made to the committee.

(C) The assistant presiding officer shall perform the duties of the presiding officer in case of the absence or disability of the presiding officer. If the office of the presiding officer becomes vacant, the assistant presiding officer will serve until a successor is elected to complete the unexpired portion of the term of the office of presiding officer.

(D) A member shall not serve consecutive terms as presiding officer and/or assistant presiding officer.

(E) RCCS members are elected from each of the Regional Coordinating Committees to serve two-year terms to begin serving on January 1 of each even-numbered year. Each member shall serve until December 31st of each even numbered year. A member shall serve no more than two consecutive terms.

(5) The committee shall appoint a standing subcommittee of five to nine members who are broadly representative of the state to review and approve prior to their distribution, as required by federal law, Title X informational and educational material developed or made available under the project. The subcommittee will be known as the Informational and Educational Subcommittee.

(A) The Reproductive Health Educator from the committee shall serve as the presiding officer.

(B) Members will serve two-year terms to begin serving on January 1 of each odd-numbered year. Each member shall serve until December 31st of each even-numbered year.

(C) A member shall serve no more than two consecutive terms. Any vacancies shall be filled by appointment of the committee.

(D) The Informational and Educational Subcommittee may delegate responsibility for the review of the factual, technical, and clinical accuracy to appropriate project staff. However, final approval of the Informational and Educational materials rests with the committee.

(6) The Informational and Educational Subcommittee must:

(A) consider the educational and cultural backgrounds of the individuals to whom the materials are addressed;

(B) consider the standards of the population or community to be served with respect to such materials;

(C) review the content of the material to assure that the information is factually correct;

(D) determine whether the material is suitable for the population or community to which it is to be made available; and

(E) establish a written record of its determinations.

(n) Statement by members.

(1) The board, the department, and the committee shall not be bound in any way by any statement or action on the part of any committee member except when a statement or action is in pursuit of specific instructions from the board, department, or committee.

(2) The committee and its members may not participate in legislative activity in the name of the board, the department, or the committee except with approval through the department's legislative process. Committee members are not prohibited from representing themselves or other entities in the legislative process.

(3) A committee member should not accept or solicit any benefit that might reasonably tend to influence the member in the discharge of the member's official duties.

(4) A committee member should not disclose confidential information acquired through his or her committee membership.

(5) A committee member should not knowingly solicit, accept, or agree to accept any benefit for having exercised the member's official powers or duties in favor of or against another person.

(6) A committee member who has a personal or private interest in a matter pending before the committee shall publicly disclose the fact in a committee meeting and may not vote or otherwise participate in the matter. The phrase "personal or private interest" means the committee member has a direct pecuniary interest in the matter but does not include the committee member's engagement in a profession, trade, or occupation when the member's interest is the same as all others similarly engaged in the profession, trade, or occupation.

(o) Reports to board. The committee shall file an annual written report with the board.

(1) The report shall list the meeting dates of the committee and any subcommittees, the attendance records of its members, a brief description of actions taken by the committee, a description of how the committee has accomplished the tasks given to the committee by the board, the status of any rules which were recommended by the committee to the board, and anticipated activities of the committee for the next year.

(2) The report shall identify the costs related to the committee's existence, including the cost of agency staff time spent in support of the committee's activities and the source of funds used to support the committee's activities.

(3) The report shall cover the meetings and activities in the immediately preceding 12 months and shall be filed with the board by January 31st of each year. It shall be signed by the presiding officer and appropriate department staff.

(p) Reimbursement for expenses. In accordance with the requirements set forth in the Government Code, Chapter 2110, a committee member may receive reimbursement for the member's expenses incurred for each day the member engages in official committee business if authorized by the General Appropriations Act or budget execution process and following the department requirements.

(1) No compensatory per diem shall be paid to committee members unless required by law.

(2) A committee member who is an employee of a state agency, other than the department, may not receive reimbursement for expenses from the department.

(3) A nonmember of the committee who is appointed to serve on a subcommittee may not receive reimbursement for expenses from the department.

(4) Each member who is to be reimbursed for expenses shall submit to staff the member's receipts for expenses and any required official forms no later than 14 days after each committee meeting.

(5) Requests for reimbursement of expenses shall be made on official state travel vouchers prepared by department staff.

§56.7.Abortion Statement.

Abortion is not considered a method of family planning and no state funds appropriated to the department shall be used to pay the direct or indirect costs (including overhead, rent, phones and utilities) of abortion procedures provided by contractors.

§56.9.Records Retention.

Providers must maintain for the time period specified by the department all records pertaining to client services, contracts, and payments. Title XIX (Medicaid) record retention requirements are found in 1 Texas Administrative Code §354.1004 (relating to Retention of Records). The department contractors must follow contract provisions and the department's Retention Schedule for Medical Records. All records relating to services must be accessible for examination at any reasonable time to representatives of the department and as required by law.

§56.12.Confidentiality.

The department and providers must ensure the safeguarding of client family planning information. Clients must give written permission prior to the release of any personally identifying information except reports of child abuse required by Chapter 261 of the Texas Family Code, and as required or authorized by other law. The department may distribute appropriated funds only to contractors that show good faith efforts to comply with all child abuse reporting guidelines and requirements.

(1) The provider must ensure client confidentiality and provide safeguards for clients against the invasion of personal privacy.

(2) All personnel (both paid and volunteer) must be informed during orientation of the importance of keeping information about a client confidential.

(3) Clients' records must be monitored to ensure access is limited to appropriate staff and to department staff or their authorized representatives.

(4) The client's preference of methods of follow-up contact must be documented in the client's record.

(5) Each client must receive verbal assurance of confidentiality and an explanation of what confidentiality means.

§56.14.Consent.

The department and providers may provide family planning services, including prescription drugs, without the consent of the minor's parent, managing conservator, or guardian only as authorized by Chapter 32 of the Texas Family Code or by federal law or regulations. A provider may not require consent for family planning services from the spouse of a married client.

§56.16.Civil Rights.

The department and providers must make family planning and genetic services available without regard to marital status, parenthood, handicap, age, color, religion, sex, ethnicity, or national origin. The provider must comply with Title VI of the Civil Rights Act of 1964 (Public Law 88-352); §504 of the Rehabilitation Act of 1973 (Public Law 93-112); The Americans with Disabilities Act of 1990 (Public Law 101-336), including all amendments to each; and all regulations issued pursuant to these Acts.

§56.17.Contract Requirements for the Title XIX (Medicaid) Family Planning Genetics Program.

(a) A genetic service agency provider may contract with the department for Title XIX reimbursement for family planning genetic diagnostic and counseling services under the following conditions.

(1) The medical director of the genetic services agency provider is a clinical geneticist (MD or DO). The clinical geneticist must be board eligible or board certified in clinical genetics by the American Board of Medical Geneticists (ABMG).

(2) A team of professionals provides the genetic diagnostic and counseling services. The team must consist of at least a clinical geneticist and at least one of the following: a nurse (RN), a genetic associate (MS), a social worker (MSW), a medical geneticist (PhD), or a genetic counselor (MS). The members of the team must meet the criteria established by ABMG or work under the direct supervision of a clinical geneticist. Administrative and support staff may also be involved.

(3) The agency provider's records must contain multiple indexing for easy retrieval of information (by client name, by client number, and by syndrome, according to the International Classification of Diseases (current edition) with Clinical Modifications), and must comply with the department's records requirements.

(4) The agency provider must arrange for full medical referral services since genetic disorders often encompass several health problems. Independent consultant, laboratory, and radiology services must be billed through the genetic services agency provider under contract with the department.

(5) Genetic counseling must be provided face-to-face by a clinical geneticist or under the direct supervision of a clinical geneticist.

(6) Services provided by a specialized genetics agency provider must be under a written subcontractual agreement with the prime contractor. The department has the right to approve all subcontractual agreements.

(7) Any applicable state licensure or certification requirements must be met.

(b) Clinical laboratories that are part of the genetic services agency provider and external clinical laboratories used by genetic services agency providers must be directed by a clinical laboratory geneticist as defined by the ABMG. In some cases, the department may approve selected laboratory tests to be conducted by regular clinical laboratories if these laboratories demonstrate the ability to perform these tests. All clinical laboratories must be certified by Title XVIII for services provided and further approved for participation in the Title XIX program.

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 January 24, 2003.

TRD-200300641

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Chapter 56. FAMILY PLANNING

Subchapter A. PROGRAM INFORMATION

25 TAC §§56.101 - 56.104

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300642

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter B. CLIENT RIGHTS AND ELIGIBILITY

25 TAC §§56.201 - 56.209

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300643

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter C. PROVIDER PROGRAM REQUIREMENTS

25 TAC §§56.301 - 56.306

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300644

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter D. PURCHASED SERVICES

25 TAC §§56.401 - 56.404

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300645

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter E. FAMILY PLANNING AGENCY STANDARDS TITLES V, X, XIX, AND XX

25 TAC §§56.501 - 56.525

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300646

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter F. ADMINISTRATIVE REQUIREMENTS FOR AGENCY PROVIDERS

25 TAC §§56.601 - 56.607

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300647

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter G. GENETIC SERVICES

25 TAC §§56.701 - 56.703

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300648

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter H. FAMILY PLANNING PROGRAM SERVICES PROVIDED BY TEXAS DEPARTMENT OF HEALTH DIRECT DELIVERY STAFF, FAMILY HEALTH SERVICES NURSES, AND CONTRACTED HEALTH PROVIDERS

25 TAC §56.801, §56.802

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300649

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Subchapter I. TEXAS DEPARTMENT OF HEALTH AIDS PREVENTION

25 TAC §§56.901 - 56.904

The repeals are adopted under Health and Safety Code, §12.001, that provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, the department, and the commissioner of health.

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 January 24, 2003.

TRD-200300650

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: February 13, 2003

Proposal publication date: August 23, 2002

For further information, please call: (512) 458-7236


Part 2. TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Chapter 411. STATE AUTHORITY RESPONSIBILITIES

Subchapter B. INTERAGENCY AGREEMENTS

25 TAC §411.56

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts the repeal of §411.56, governing memorandum of understanding (MOU) on coordinated services to children and youths of Chapter 411, Subchapter B, concerning interagency agreements, without changes to the proposal as published in the November 22, 2002, issue of the Texas Register (27 TexReg 10890).

Senate Bill 1468 (77th Legislative Session) repealed Family Code, §264.003, which required TDMHMR and seven other health and human services agencies to adopt by rule the Memorandum of Understanding for Coordinated Services to Children and Youths. In §411.56, TDMHMR adopted by reference the rule of the Texas Department of Protective and Regulatory Services (40 TAC §736.701), which included the Memorandum of Understanding for Coordinated Services to Children and Youths as required by the Texas Family Code, §264.003. The MOU remained in effect until the new MOU required by the Government Code, §531.055, (relating to Memorandum of Understanding on Services for Persons Needing Multiagency Services) was signed by the final party in early March 2002. The new MOU was distributed to interested parties as an attachment to a For Your Information document in September 2002.

Comments from the public were not received.

The repealed section is adopted under the Texas Health and Safety Code, §532.015, which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority, and Senate Bill 1468 (77th Legislative Session) that repealed Texas Family Code, §264.003, which required TDMHMR to adopt the MOU by 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 January 22, 2003.

TRD-200300347

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Effective date: February 11, 2003

Proposal publication date: November 22, 2002

For further information, please call: (512) 206-4516