TITLE 25.HEALTH SERVICES

Part 1. TEXAS DEPARTMENT OF HEALTH

Chapter 13. HEALTH PLANNING AND RESOURCE DEVELOPMENT

Subchapter A. WAIVER OF VISA RECOMMENDATION FOR PHYSICIANS

25 TAC §§13.1 - 13.8

The Texas Department of Health (department) adopts new §§13.1 - 13.8, concerning the waiver of visa rules for physicians serving in health professional shortage areas, who apply to the J-1 visa waiver program. Sections 13.1 - 13.8 are adopted with changes to the proposed text as published in the March 14, 2003, issue of the Texas Register (28 TexReg 2216).

Federal law (8 USC §§1182(e) and 1184(l)) allows state departments of health to recommend waivers of visa rules in certain cases involving physicians, and this is known as the J-1 visa waiver program. These recommendations are also addressed by Texas Education Code, §51.949, which is expected to be repealed and recodified under the Health and Safety Code, §12.0127, effective September 1, 2003. The Health and Safety Code, §12.031 and §12.032, allows the Texas Board of Health (board) to set public health service fees for administrative services by rule. The purpose of these rules is to establish the criteria the department will use to make the recommendations and establish the fee allowed by these laws. These rules will facilitate the service of foreign physicians in underserved areas and therefore benefit public health.

The following comments were received concerning the proposed rules.

Comment: Concerning proposed §13.1(3), renumbered as §13.1(4), one commenter suggested adding the words "graduate medical" in the following sentence: "Removal of the requirement that a J-1 visa holder must return to their country of origin for two years at the end of his/her graduate medical training".

Response: The department agrees. The suggested change was made to the paragraph.

Comment: Concerning proposed §13.1(7), renumbered as §13.1(8), one commenter suggested adding "psychiatry" to the definition.

Response: The issue of psychiatry and the qualified areas in which a psychiatrist may be recommended is addressed in §13.2(3). No changes were made as a result of this comment.

Comment: Concerning §13.2(1), one commenter suggested to add the wording "fully served" to describe areas no longer available due to previous waiver recommendations. Another commenter suggested defining fully served and eligible areas more specifically.

Response: The term "fully served" was added to the definitions as §13.1(2) and is also included in §13.2(1). The definition of an eligible area is more specific for §13.2(1), (2), and (3).

Comment: Concerning §13.2(4), one commenter suggested removing the term service area and including the terms HPSA or MUA.

Response: The department agrees. The changes were made as a result of this comment.

Comment: Concerning §13.2(1), one commenter suggested listing the criteria required to have an area to be designated as a Medically Underserved Area.

Response: The designation criteria are a separate issue and these rules are not the appropriate place to list them. No changes were made as a result of this comment.

Comment: Concerning §13.2(2), a comment was received concerning the rotation of pediatric subspecialist physicians at Driscoll Children's Hospital in Corpus Christi, and their regional clinics in McAllen, Brownsville, Harlingen, Victoria and Laredo.

Response: It is permissible for a visa waiver physician to split their time between more than one location. However, each site must reside in a Health Professional Shortage Area, or a Medically Underserved Area with a current shortage of physicians. No changes were made as a result of this comment.

Comment: Concerning §13.2(2), a comment was received concerning the designation of all freestanding, nonprofit children's hospitals as facility Health Professional Shortage Areas.

Response: The designation eligibility includes Health Professional Shortage Areas and Medically Underserved Areas with a current shortage of providers. Facilities with Health Professional Shortage Area designation are not eligible. No changes were made as a result of this comment.

Comment: Concerning §13.2(5), one commenter suggested adding the words "Bureau of Citizenship and Immigration Services".

Response: The department agrees. The language "Bureau of Citizenship and Immigrations Services" was added to §13.2(5). Also, the words "Bureau of Citizenship and Immigrations Services" were added to §13.6 and §13.7, and the words "Immigration and Naturalization Services" were deleted.

Comment: Concerning §13.3(b), one commenter suggested clarification or removal of the term "acquaintance."

Response: The department agrees, and has deleted the words "or acquaintance".

Comment: Concerning §13.4(b), one commenter suggested being more specific on the number of letters of support.

Response: The department agrees, and added the words "up to 6" for the letters of support.

Comment: Concerning §13.5(a), one commenter suggested that the contract include the wage and that a copy of the prevailing wage be included in the visa waiver application.

Response: The department agrees. The changes were made as a result of this comment.

Comment: Concerning §13.5(c)(1), (2), (3), (4) and (5), one commenter suggested that the list of items to be included in the contract should be more specific.

Response: The department agrees. The changes were made as a result of this comment.

Comment: Concerning §13.6(a), two comments were received suggesting that the 90 day notification to the Department of State and the Bureau of Citizenship and Immigration Services rule be removed. Another commenter suggested clarifying that the 90-day period begins upon receipt of the waiver.

Response: This is a Department of State rule and must be followed by state health departments; therefore the 90-day notification is not removed. The department agrees with the clarification that the 90 days begins upon receipt of the waiver and added the word "receiving" in front of the word "waiver".

Comment: Concerning §13.6(b), one commenter suggested including the language "in writing within ten days" to the section.

Response: The department agrees. The changes were made as a result of this comment.

Comment: Concerning §13.6(c) (1), (2), and (3), one commenter suggested that the section should be more specific regarding the department's verification activities.

Response: The department agrees. The changes were made as a result of this comment.

Comment: Concerning §13.8, one commenter suggested specific citation of the federal laws that apply to this program and removal of the requirement for letters of support for other waiver programs.

Response: The department agrees. The changes were made as a result of this comment.

Change: There were minor changes made due to department staff comments, which included changing upper case letters to lower case letters in several sections.

The comments were from institutions and were in favor of the rules and made recommendations. The commenters are two law offices, Pinchak & Associates, P.C., and Pederson & Freedman, L.L.P.; one hospital, Driscoll Children's Hospital, and department staff.

The new rules are adopted under Health and Safety Code, §12.032, which allows the board to set fees by rule for public health services; and §12.001, which 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.

§13.1.Definition of Terms.

The following words and terms when used in these sections, shall have the following meaning.

(1) Employer--A director of a health care facility where the physician will practice.

(2) Fully Served--An area with a population to provider ratio of 3000:1 or more physicians per capita.

(3) HPSA--Health Professional Shortage Area.

(4) J-1 Visa Waiver--Removal of the requirement that a J-1 visa holder must return to their country of origin for two years at the end of his/her graduate medical training. The waiver allows the J-1 visa holder to remain in the United States if they agree to practice in an underserved area.

(5) MUA--Medically Underserved Area.

(6) NHSC--National Health Service Corps.

(7) Operational--Providing health care services to patients.

(8) Primary Care Specialist--A physician who has a degree and specialization in internal medicine, general practice, family practice, pediatrics, or obstetrics/gynecology.

(9) Provider--A physician requesting a J-1 visa waiver.

§13.2.J-1 Visa Waiver Rules.

The following apply to faculty and non-faculty waivers.

(1) The Texas Department of Health (department) will consider a recommendation for a J-1 visa waiver in the area or areas designated by the Secretary of Health and Human Services as a HPSA or a MUA and are not fully served by J-1, NHSC or other primary care physicians. The HPSA or MUA must have a population to physician ratio of 3000:1 or fewer physicians per capita.

(2) Primary care specialists will be considered eligible to apply to areas designated as Primary Care HPSAs or MUAs.

(3) Psychiatrists will be considered eligible to apply to areas designated as Mental Health HPSAs or MUAs.

(4) The department will consider J-1 visa waivers for physicians who are non-primary care specialists when additional documentation is submitted supporting the need for the services of the specialist and the shortage of that specialty in the HPSA or MUA.

(5) The first 30 complete applications that meet federal and state requirements will be considered for recommendation. The submission of a complete waiver application to the department does not ensure that the department will recommend a waiver to the United States Department of State and the Bureau of Citizenship and Immigration Services.

(6) The employer or the employer's representative must submit the J-1 waiver request application to the department.

§13.3.Employer Rules.

(a) The department will not accept requests from employers who are physicians currently fulfilling their waiver obligation.

(b) The department will not recommend a waiver for a relative of the employer.

§13.4.Site Requirements.

(a) The health care facility named as the site of service in the application must be operational at the time of application.

(b) A waiver request must include up to 6 letters of support from community leaders, local physicians, hospital administrators, and/or the local health department, where applicable.

§13.5.Contract.

(a) The contract must include the wage to be paid over the contract period. Documentation that the wage meets the prevailing wage for the specialty for the area of practice must be included with the application packet. An example of a "prevailing wage" can be found at the United States Department of Labor web site at: http://www.workforcesecurity.doleta.gov/foreign/wages.asp.

(b) The contract must state that the employer and the provider agree that termination can be only for cause and not by mutual agreement.

(c) The contract must contain the following information:

(1) list of benefits, insurance to be provided to the provider;

(2) field of practice of the provider;

(3) practice site name, address and telephone number of the health care facility where the provider will work;

(4) hours of work;

(5) amount of leave; and

(6) statements that amendments shall adhere to state and federal J-1 visa waiver requirements.

(d) If applying under Education Code, §51.949, the applicant must demonstrate compliance with its provisions.

§13.6.Verification.

(a) The Department of State and the Bureau of Citizenship and Immigration Services shall be notified if the physician fails to begin practicing within 90 days of receiving waiver, or is found to not be practicing 40 hours at the site approved for waiver.

(b) The employer and/or the J-1 physician must notify the department in writing within 10 days if the contract is breached or terminated.

(c) The department will verify the following:

(1) compliance with subsection (a) of this section; and

(2) other information that supports the program goal of improving access to health care in underserved areas.

§13.7.Application Fee.

The department shall collect a fee of $2000 from each applicant who is granted a waiver of the two-year home residency requirement from the Bureau of Citizenship and Immigration Services. The fee shall be submitted to the department at the time of application. Part of the fees may be returned under the following circumstances:

(1) if the department recommends the waiver, and the Bureau of Citizenship and Immigration Services denies it, $1500 will be returned to the applicant; or

(2) if the applicant withdrawals the application before a recommendation is submitted by the department, $1700 will be returned to the applicant; or

(3) if at the time the application is received by the department, all 30 slots have been used for the fiscal year, $2000 will be returned to the applicant.

§13.8.Other Federal or State Requirements.

All waiver request applications must meet federal laws 8 USC §1182 and §1184. All waiver request applications for faculty physicians must meet applicable state laws (Texas Education Code, §51.949).

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 June 13, 2003.

TRD-200303573

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: March 14, 2003

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


Chapter 14. COUNTY INDIGENT HEALTH CARE PROGRAM

Subchapter F. ADVISORY COMMITTEE

25 TAC §14.501

The Texas Department of Health (department) adopts an amendment to §14.501, concerning the Indigent Health Care Advisory Committee (committee). The section is adopted with one change to the proposed text as published in the April 18, 2003, issue of the Texas Register (28 TexReg 3190).

The committee has provided advice to the Texas Board of Health (board) and the department in the area of the Indigent Health Care Program. The committee is established under the Health and Safety Code, §11.016, which allows the board to establish advisory committees. The committee is subject to Government Code, Chapter 2110, concerning state agency advisory committees.

Government Code, §2001.039, 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). The department has reviewed §14.501 and has determined that reasons for adopting the section continue to exist; however, changes were necessary as described in this preamble.

The department published a Notice of Intention to Review for §14.501 in the Texas Register on September 4, 1998 (23 TexReg 9077). No comments were received due to publication of this notice.

In 1993, the Texas Legislature passed Senate Bill 383 (now codified in the Government Code, Chapter 2110), which 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 be automatically abolished unless the governing body of the agency affirmatively votes to continue the committee's existence.

In 1999, the board established a rule relating to the Indigent Health Care Advisory Committee. The rule states that the committee will automatically be abolished on July 1, 2003. The board has now reviewed and evaluated the committee and has determined that the committee should continue in existence until July 1, 2007.

This section amends provisions relating to the operation of the committee. Specifically, language is revised to: continue the committee until July 1, 2007; specify that the committee appoints its presiding and assistant presiding officers; include additional requirements regarding statements by members; and clarify the components that the committee must include in an annual report to the board.

No public comments were received during the comment period for the rule. However, the department has made the following minor change due to a staff comment in order to provide consistency throughout the rule.

Change: Concerning §14.501(o)(2), the word "agency" was replaced with the word "department".

The amendment is adopted under Health and Safety Code, §12.001, which 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; and Government Code, §2110.005, which requires the department to adopt rules stating the purpose and tasks of its advisory committees. The review of this rule implements Government Code, §2001.039.

§14.501.Indigent Health Care Advisory Committee.

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

(1) The name of the committee shall be the Indigent Health Care Advisory Committee.

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

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

(c) Purpose. The purpose of the committee is to provide advice to the board in the area of the Indigent Health Care Program.

(d) Tasks.

(1) The committee shall advise the board concerning rules relating to the Indigent Health Care Program.

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

(e) Review and duration. By July 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 11 members consisting of four consumer and seven other representatives appointed by the board.

(g) Terms of office. The term of office of each member shall be six years. Members shall serve after expiration of their terms until a replacement is appointed.

(1) Members shall be appointed for staggered terms so that the terms of a substantial equivalent number of members will expire on August 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 an assistant presiding officer to begin serving on July 1 of each odd-numbered year.

(1) Each officer shall serve until June 30th of each odd-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. In case the office of presiding officer becomes vacant, the assistant presiding officer will 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 only as necessary 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 quorum present.

(7) The agenda for each committee meeting shall include an item entitled public comment under which any person will be allowed to address the committee on matters relating to committee business. The presiding officer may establish procedures for 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 member is 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 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 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.

(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 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 department 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 immediate preceding 12 months and shall be filed with the board each July. 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.

(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.

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 June 13, 2003.

TRD-200303566

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: April 18, 2003

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


Chapter 27. CASE MANAGEMENT FOR CHILDREN AND PREGNANT WOMEN

25 TAC §§27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13, 27.15

The Texas Department of Health (department) adopts new §§27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13 and 27.15, concerning case management for children and pregnant women with changes to the proposed text as published in the April 4, 2003, issue of the Texas Register (28 TexReg 2851).

Specifically, these new sections cover definitions; eligible recipients; case management service provisions; service limitations; applicant and provider qualifications; application process; case management provider review; and monitoring processes.

The adopted new rules for Case Management for Children and Pregnant Women will provide case management services to Medicaid eligible women of all ages who have a high risk pregnancy and to children from birth to 21 years of age with a health condition/health risk. Two programs, Medicaid Case Management for High Risk Pregnant Women and High Risk Infants (TCM/PWI) and Texas Health Steps Medical Case Management (THSteps MCM), will become one program due to the adopted repeal of §§32.301 - 32.305, 32.307, 33.501 - 33.506, and 37.81 - 37.86 of this title, and the adopted new Chapter 27. The new program will provide a greater continuity of services for all eligible recipients by allowing easier transition and coordination among services for family members.

The sections include changes made in response to comments, with the objective of clarifying the requirements of the program. Particular concerns and suggestions by stakeholders regarding issues such as the prior authorization requirement, the cessation of the intake as a reimbursed contact for providers, and the restrictions regarding solicitation of clients were raised during the public comment period and are addressed in this preamble.

Many comments were positive, with commenters in favor of merging the two programs. Several commenters felt the merged system would be beneficial for both providers and clients.

The most common questions and comments concerned the issues of prior authorization, the elimination of the intake as a reimbursable contact and the restrictions against the solicitation of clients. Many commenters stated that the prior authorization requirement will be too burdensome for providers and place a barrier on services for clients. Several commenters stated that they believed state resources are not sufficient to implement the new program. However, in the interest of quality management, the assurance of non-duplication and enrollment of only eligible clients, the department upheld the prior authorization requirement.

Many commenters were concerned with eliminating the Targeted Case Management for Pregnant Women and Infants intake as a reimbursed contact. These commenters felt that the intake requires such a significant amount of time to complete that without reimbursement, providers would have to cut services or lay off staff. However, automatically reimbursing all intakes mean that a Targeted Case Management for Pregnant Women and Infants provider who performed an intake would always receive reimbursement--even if the recipient was ultimately determined ineligible for the service. As a result, the intake has historically been an over billed and misused contact.

Several comments indicated that changes to limit client solicitation would inhibit the case managers from informing interested recipients about the program and thus, eliminate client choice. However, the prohibitions will in fact protect client choice and will not prohibit case managers from informing interested recipients about the program. In most cases, it is the recipient that contacts the case manager to learn more information about the program; therefore, there should be no inhibition of case managers informing interested program participants.

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

Change: Concerning proposed §27.1(1), a semi-colon was added after the term "facility operation" for proper format and style.

Change: Concerning proposed §27.1(2), "subchapter" was changed to "chapter" to reflect the proper terminology.

Change: Concerning proposed §27.1(6), the words "Case Management Provider" were changed to lower case for proper format and style.

Change: Concerning proposed §27.1(7), the word "Services" was changed to lower case for proper format and style.

Change: Concerning proposed §27.1(9), the word "same" was added between the terms "healthy" and "age" for clarity.

Change: Concerning proposed §27.1(12), a comma was inserted between the words "Diagnosis" and "and" to reflect the proper punctuation in the program name.

Change: Concerning proposed §27.1(13), the word "own" was changed to "biological" and the statement "a person or persons acting as the family of an individual; a foster family or identifiable support person or persons" was changed to "a person or persons acting as an individual's family, foster family or identifiable support person or persons" for clarity.

Change: Concerning proposed §27.1(15), the hyphen in "high-risk" was deleted for consistency.

Change: Concerning proposed §27.1(18), a definition for the term "prior authorization," was added, and the remaining definitions were renumbered accordingly.

Change: Concerning proposed §27.1(20), now renumbered as §27.1(21), the words "the name of" were inserted between the term "In Texas" and "the federal program" and the words ", is called Texas Health Steps" was deleted for clarity.

Change: Concerning proposed §27.3, "subchapter" was changed to "chapter" to reflect the proper title, and the hyphen in "high-risk" was deleted for consistency.

Change: Concerning proposed §27.3, "birth through age 20" was added for clarity.

Change: Concerning the title of proposed §27.5, the words "Service Provisions" were added to the title so that it now reads, "Case Management for Children and Pregnant Women Service Provisions" for clarity.

Change: Concerning proposed §27.5, the term "Case Management for Children and Pregnant Women's" was changed to "Case Management for Children and Pregnant Women" for proper format and style. The word "services" was added for clarity and "over utilization," was changed to "over-utilization" in the first paragraph of this section to reflect proper punctuation of this term.

Change: Concerning proposed §27.5(1)(A)(ii)(IV), the word "and" was added after "confidentiality;" to ensure proper format and style.

Change: Concerning proposed §27.5(1)(B), the statement "during which the" was added and the period and "The" deleted to combine the first and second sentence for clarity and the term "post partum" was changed to "post-partum" to reflect proper punctuation of this term.

Change: Concerning proposed §27.5(1)(B)(i), the word "the" was inserted between the words "of" and "complete" for clarity.

Change: Concerning proposed §27.7(b), the word "a" was inserted between the terms "for" and "billable", and "contact" was inserted following the word "billable." The term "Case Management for Children and Pregnant Women services" was deleted; the term "Comprehensive Visits and Follow up" was deleted and replaced with "billable." All of these changes were made to ensure clarity.

Change: Concerning proposed §27.7(c), the words "a billable" was inserted between "for" and "Case" to ensure clear and proper grammar.

Change: Concerning proposed §27.9(a)(3), the word "and" was deleted at the end of this paragraph to ensure proper format and style.

Change: Concerning proposed §27.9(a)(4)(B), the period at the end of this subparagraph was deleted and replaced with a semi-colon to ensure proper format and style.

Change: Concerning proposed §27.9(c), the term "Federal Government" was changed to lower case for proper format and style.

Change: Concerning the first line of proposed §27.11, the term "Case Management Provider" was changed to lower case for proper format and style.

Change: Concerning proposed §27.11(3)(F), now renumbered as §27.11(3)(E), the term "claims" was changed to "contacts" for accuracy and clarity.

Change: Concerning proposed §27.11(3)(G)(vi), now renumbered as §27.11(3)(F)(vi), the period at the end of this clause was deleted and replaced with a semi-colon to reflect proper format and style and punctuation.

Change: Concerning proposed §27.11(4), the statement "(relating to applicant qualifications and case management provider requirements)" was deleted for clarity.

Change: Concerning proposed §27.11(5), the word "TDH-" was changed to "department-" for clarity.

Change: Concerning proposed §27.11(5)(F)(ii), the statement "involvement in resolving case management problems" was moved to new §27.11(5)(F)(iii) and the period at the end of this clause was deleted and replaced with a semi-colon to reflect proper format and style.

Change: Concerning proposed §27.13(c), the term "subchapter" was deleted and replaced with "chapter" to ensure accuracy.

Change: Concerning proposed §27.13, new subsection (f) was added for clarity. That section reads, "Applications which do not meet department requirements will be denied," and the remainder of the subsections were renumbered accordingly.

Change: Concerning proposed §27.15(b), the term "Case Management Providers" were changed to lower case to ensure proper format and style.

The following comments were received concerning the rules. After each comment are the department's responses and any resulting change(s).

Comment: Concerning the chapter as a whole, many commenters stated they support the merger of TCM/PWI and THSteps MCM into one program.

Response: The department acknowledges the commenters' support. No changes were made as the result of these comments.

Comment: Concerning the chapter as a whole, many commenters stated their concern that the proposed rule changes would be harmful to children and pregnant women by making it harder to get case management services.

Response: The department disagrees. The rules will not make it more difficult for children and pregnant women to receive case management services. Rather, the rules will assure appropriate enrollment of eligible clients and non-duplication of services. No changes were made as a result of these comments.

Comment: Concerning the chapter as a whole, several commenters stated their concern that the proposed rule changes would lead to an increase in state spending because clients would not be able to access community organizations and appropriate medical care.

Response: The department disagrees. The rules will assure appropriate enrollment of eligible clients and non-duplication of services; they will not inhibit eligible clients in accessing needed services. No changes were made as a result of these comments.

Comment: Concerning the chapter as a whole, several commenters stated providers should be able to choose which population group they wish to serve rather than automatically having to provide services to both the TCM/PWI and THSteps MCM population.

Response: The department disagrees. Providers can in fact "choose" to limit the age ranges of clients served, although they must specify this in their application. No changes were made as the result of these comments.

Comment: Concerning the chapter as a whole, several commenters stated small case management providers will be more adversely affected by the proposed rules than will larger case management providers.

Response: The department disagrees. There is little disparity in the way the rules affect a small or a large case management provider. Any potential loss to the provider resulting from the elimination of the intake as a reimbursed service should be fairly minimal, regardless of provider size. No changes were made as the result of these comments.

Comment: Concerning the chapter as a whole, several commenters suggested withdrawing the proposed rules and continuing reimbursement for intake, replacing prior authorization with client registry and continuing reimbursement for first five visits without need for prior authorization.

Response: The department disagrees. The rules are being implemented to address the quality concerns and duplication of services currently at issue in the TCM/PWI and THSteps MCM services. No changes were made as the result of these comments.

Comment: Concerning the chapter as a whole, one commenter stated that the rules should be changed to include a statement that a qualified case manager must complete all documentation of services.

Response: The department agrees that a qualified case manager must document all billable contacts. As the rules require such documentation, no changes were made as the result of these comments.

Comment: Concerning the chapter as a whole, one commenter wondered if the program would allow independent contractors to serve as case managers.

Response: Currently, the program allows independently-enrolled case managers to serve as case management providers. The adoption of these rules would not result in any alteration of the ability of independent contractors to serve as case managers. This issue is not addressed in the rules and is a decision providers must make on their own. No change was made as a result of this comment.

Comment: Concerning the chapter as whole, one commenter asked if providers would have to re-apply when the programs merged.

Response: Providers will not have to re-apply when the programs merge. No change was made to the rules as a result of this comment.

Comment: Concerning the chapter as a whole, one commenter stated performing provider numbers should be issued to all case managers.

Response: The department is currently pursuing such an implementation. No change however was made to the rules as a result of this comment because such an issue does not need to be addressed in these rules.

Comment: Concerning the chapter as a whole, one commenter stated that language which requires the documentation of the client's continuing eligibility be added.

Response: The department agrees. Proposed §27.1(4) was changed to include the language "that continues to support eligibility of a" and "with an eligible" was deleted to address the change.

Comment: Concerning the chapter as a whole, one commenter stated that language be added to define how providers show documentation of justification of billing for more than one client in a family.

Response: The department disagrees. Eligibility criteria for individual clients is defined in the rule in §27.3. Each client within a family must meet the eligibility criteria defined. No changes were made as a result of this comment.

Comment: Concerning the chapter as a whole, one commenter asked that "should" be replaced by "must" in every section of the rules referring to documentation.

Response: The department agrees. The word "should" was replaced by "must" in §27.5(1)(A)(i) and (B) and the word "includes" was replaced by "must include" in §27.5(1)(A)(ii)(V).

Comment: Concerning proposed §27.1(9) and §27.3, one commenter asked that the term "at risk" be eliminated from eligibility criteria and that eligibility language be changed to include "medically fragile children" or "children with special health care needs."

Response: The department disagrees. The language, "with a health condition/health risk," covers a broader population than the terms "medically fragile children," and "children with special health care needs," to ensure that more children are potentially eligible for this service. No change was made as a result of this comment.

Comment: Concerning proposed §27.5(2), many commenters stated that the elimination of the intake as a reimbursable service will inhibit the case manager/client relationship and serve as a barrier to service provision.

Response: The department disagrees. The elimination of the intake as a reimbursable service will not inhibit the case manager/client relationship or serve as a barrier to service provision. The information collected for the purpose of the intake is needed to determine eligibility. Client/case manager rapport may be further developed during the comprehensive visit. No changes were made as a result of these comments.

Comment: Concerning proposed §27.5(2), some commenters stated that the elimination of the intake as a reimbursable service will reduce the number of participating providers.

Response: The department disagrees. No other component of the Texas Health Steps Comprehensive Care Program (CCP) allows for the reimbursement of the intake. By making this change through the combination of the programs, the department will be in line with the rest of CCP. No changes were made as a result of these comments.

Comment: Concerning proposed §27.5(2), some commenters stated that the elimination of the intake as a reimbursable service will result in providers potentially providing hours of intake services only to eventually discover the recipient is ineligible for case management services which will result in the provider performing significant amounts of services without pay.

Response: The department disagrees. The intake normally takes about five to ten minutes to complete and can be completed by telephone. Thus, it should not result in case managers providing hours of unpaid work if it is ultimately determined that the client is ineligible for case management services. No changes were made as a result of these comments.

Comment: Concerning proposed §27.7, many commenters stated that requiring prior authorization of all services will greatly increase the amount of paperwork they will be required to submit.

Response: The department disagrees. The paperwork that must be submitted will be minimal. No changes were made as the result of these comments.

Comment: Concerning proposed §27.7, many commenters stated that requiring prior authorization of all services will result in delayed and less frequent service provision to clients.

Response: The department disagrees. Clients will be approved for contacts based on their level of medical and psychosocial need. The prior authorization process will not delay service provision; if an emergency request is submitted, it must be processed quickly. Currently, medical case management is the only CCP service that does not require prior authorization for all of its services. With the adoption of these rules, case management procedures will be consistent with that of the other CCP services. No changes were made as the result of these comments.

Comment: Concerning proposed §27.7, many commenters stated the department case management program lacks sufficient staff to implement the prior authorization of services required by the proposed rules.

Response: The department disagrees. The staffing issue has been acknowledged and was included in the cost estimate. No changes were made as the result of these comments.

Comment: Concerning proposed §27.7, some commenters stated the department should change the prior authorization system to pay for an initial contact and then prior authorize the remaining contacts based on information on the needs assessment and service plan.

Response: The department disagrees. Prior authorization of all services is now a requirement, pursuant to these rules, in order to ensure only eligible clients are enrolled in the Case Management for Children and Pregnant Women program and receive program services. No changes were made as a result of these comments.

Comment: Concerning proposed §27.7, some commenters stated that the information included in the intake is insufficient for department staff to appropriately determine client eligibility and service needs.

Response: The department disagrees. The intake will be revised to require information regarding the medical and psychosocial needs of the client. The intake contains enough information to determine client eligibility and the amount of client contacts necessary to implement services. No changes were made as the result of these comments.

Comment: Concerning proposed §27.7, some commenters felt that the implementation of prior authorization through the adoption of the rules will result in a client's inability to receive a monthly contact.

Response: The department disagrees. Clients will be approved for contacts based on their level of medical and psychosocial need. If a client's needs warrant a monthly contact, sufficient documentation should be submitted to authorize these services. No changes were made as the result of these comments.

Comment: Concerning proposed §27.7, one commenter was curious about the type of the department program staff that will be reviewing prior authorization requests.

Response: Prior authorizations will be reviewed by case management program specialists. No changes were made to the rules as a result of this comment.

Comment: Concerning proposed §27.7, one commenter wanted to know if there would be a process available to appeal the denial of prior authorization requests.

Response: Under state and federal law, any request for Medicaid services that is denied may be appealed through the fair hearing process. This process is currently in place and will continue to be available for appealing any denial of Medicaid service. No changes were made to the rules as a result of this comment.

Comment: Concerning proposed §27.9, several commenters stated the new case manager qualifications are "unfair."

Response: The department disagrees. Applicants are now required to have more years of experience, which will ensure better quality of service provision. This should not affect our current case managers because current case managers lacking the required experience can still participate as case managers. No changes were made as the result of these comments.

Comment: Concerning proposed §27.9, several commenters stated case managers currently providing services but lacking the new qualification requirements of proposed §27.9, should be grandfathered in so that they can continue to provide services.

Response: The department agrees. Section 27.9(b) has been amended to delete the requirement that case managers approved as providers and providing services before the implementation date of these rules can continue to provide case management services only as long as that case manager does not leave the employ of that agency. This requirement has been replaced by the words, "if the case manager presents a certificate issued by the department attesting that the case manager possesses experience providing services for an approved Targeted Case Management for Pregnant Women and Infants or Texas Health Steps Medical Case Management agency before the implementation date of these rules." The statement "is eligible to" was changed to "may" and the statement "to provide" was changed to "providing" for clarity.

Comment: Concerning §27.9(b), one commenter stated that case managers with a temporary or provisional license should not be included in the clause allowing previous case managers to continue to provide services.

Response: The department agrees. The term "licensure" was deleted from §27.9(b) so that case managers currently providing either TCM/PWI or THSteps MCM services must meet the licensure requirements of this chapter in order to continue to be eligible case managers.

Comment: Concerning proposed §27.11(3)(C), one commenter stated the requirement of a comprehensive resource directory was too difficult to produce.

Response: The department agrees. This requirement has been deleted since referral directories are available from resources in local communities, and the remainder of the paragraphs was renumbered accordingly.

Comment: Concerning proposed §27.11(3)(F), now renumbered as §27.11(3)(E), one commenter asked if a provider could contract out the provider's accounts receivable system.

Response: A provider may contract out their accounts receivable system, but the provider is still responsible for the implementation of this component. No changes were made to the rules as a result of this comment.

Comment: Concerning proposed §27.11(3)(G), now renumbered as §27.11(3)(F), many commenters stated this section's prohibitions on client solicitation will inhibit case managers from telling interested recipients about the program and thus, eliminate client choice.

Response: The department disagrees. The prohibitions will not prohibit case managers from informing interested recipients of the case management program. In most cases, a recipient contacts the case manager to learn more information about the program; therefore, there should be no such inhibition. The client will continue to have choice of providers. No changes were made as a result of these comments.

Comment: Concerning proposed §27.11(3)(G)(ii), now renumbered as §27.11(3)(F)(ii), many commenters expressed dissatisfaction with certain rule language. In particular, commenters felt that the terms "can reasonably be interpreted as intended to market the provider's services" were both overbroad and vague.

Response: The department agrees. The statement "can reasonably be interpreted as intended to market the provider's services" was changed to "impede client choice" for clarity.

Comment: Concerning proposed §27.11(3)(G)(iii), now renumbered as §27.11(3)(F)(iii), many commenters expressed dissatisfaction with certain rule language. In particular, commenters felt that the terms "materially misleading materials" were both overbroad and vague.

Response: The department agrees. The word "materially" was deleted from "materially misleading materials" for clarity.

Comment: Concerning proposed §27.11(3)(G)(vi), now renumbered as §27.11(3)(F)(vi), several commenters stated that prohibiting providers from entering into exclusive relationships with referral sources is unfair.

Response: The department disagrees. Such prohibitions are consistent with state and federal law; moreover, any provider currently engaging in such actions should immediately cease this behavior. No changes were made as a result of these comments.

Comment: Concerning proposed §27.13(g), now renumbered as §27.13(h), one commenter asked about application approval guidelines.

Response: New criteria has been added to the rules to address this issue. The rules have been amended accordingly. The new language may be found in new §27.13(f) which states that applications which do not meet department requirements will be denied. The rest of the subsections were renumbered accordingly.

Comment: Concerning proposed §27.13(g), now renumbered as §27.13(h), one commenter asked about the rationale behind requiring rejected applicants to wait six months before resubmitting a revised application for review.

Response: The rational for the six month wait period is to ensure case management staff have adequate time to review all application documentation. Often, when an application is submitted, additional documentation may be sent by the applicant several months after filing the application. No change was made as a result of this comment.

The following commenters were in favor of the merger of the two programs, but had concerns or questions about the rules, which they generally did not support: Community Outreach Referral, The Family Plan and Bona Healthy Start.

The following commenters had concerns, questions, and/or suggestions regarding the rules, which they generally did not support: ReNas Family Services, Bexar County Case Management Coalition, Rio Health Steps, Child Study Clinic, TLCare, Catholic Charities, New Life Perinatal Health Care Services, Moving Ahead Family Services, Catholic Charities, Empowerment Now, Guardian Angel, ACCESS, Family Advocacy Case Management Services, Family Empowerment, Bienestar Case Management for Children and Pregnant Women, and Medical Social Services.

The department adopts the repeal of §§32.301 - 32.305 and §32.307, concerning case management for high risk pregnant women and high risk infants. Specifically, these sections cover definitions; eligible individuals; case management services; service limitations; provider qualifications and the right to appeal. These sections are repealed as they were repeated in §§37.81 - 37.86. Sections 32.301 - 32.305 and §32.307 were not repealed when §§37.81 - 37.86 were adopted.

The department further adopts the repeal of Early and Periodic Screening, Diagnosis, and Treatment, Subchapter J, Texas Health Steps Medical Case Management, §§33.501 - 33.506. Specifically, these sections cover definitions; eligible recipients; THSteps Medical Case Management Services; service limitations; applicant and provider qualifications; application, review and monitoring process. These sections are being repealed in an effort to integrate services to the eligible population for case management services: children with a health condition/health risk birth to 21 years and/or high risk pregnant women of all ages.

The department at the same time adopts the repeal of §§37.81 - 37.86, concerning Medicaid case management for high risk pregnant women and high risk infants. Specifically, these sections cover introduction; definitions; case management services; provider qualifications; application and review process; and documents adopted by reference.

The department provides health services to women and children in Texas under the authority of the Health and Safety Code, Chapter 32; the State Appropriations Act; and the Social Security Act, Title V. The Targeted Case Management Program for High Risk Pregnant Women and High Risk Infants was established under the authority of the Social Security Act, Title XIX, §1915(g), authorizing states to provide case management as a distinct service to targeted populations, through a waiver from the Health Care Financing Administration (HCFA). HCFA is now known as the Center for Medicare and Medicaid Services (CMS). The Health and Human Services Commission (HHSC) provides authority to the department to propose rules to administer certain Medicaid program services in Texas.

The new sections are adopted under the Health and Safety Code, §12.001, which provides the Board of Health (board) with the authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health; the Health and Safety Code, Chapter 32, which provides the board with the authority to establish maternal and infant health improvement services programs in the department to serve eligible recipients; the Human Resources Code, Chapter 32, which enables the state to provide medical assistance; and the Government Code, §531.021, which provides the Health and Human Services Commission (HHSC) with the authority to propose rules to administer the state's medical assistance program, and are submitted by the Texas Department of Health under its agreement with HHSC to operate the EPSDT program, and as authorized under §1.07 of the Acts of the 72nd Legislature, First Called Session (1991), Chapter 15, as amended by the Acts of the 73rd Legislature, Chapter 747, §2.

§27.1.Definition of Terms.

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

(1) Access--The ability of an eligible recipient to obtain health and health-related services, as determined by factors such as: the availability of THSteps services; service acceptability to the eligible child, family, and/or pregnant woman; the location of health care facilities and other resources; transportation; hours of facility operation; and length of time available to see the healthcare provider.

(2) Applicant--An agency, organization, or individual who submits an application to the department to provide Case Management for Children and Pregnant Women under this chapter and who meets the applicant qualifications and requirements as stated in §27.9 and §27.11 of this title (relating to Applicant Qualifications and Case Management Provider Requirements).

(3) Application process--Submission of an application to provide Case Management for Children and Pregnant Women and the department's ensuing review and disposition of the application.

(4) Billable contact--A documented Comprehensive Visit or Follow-up contact that continues to support eligibility of a recipient, by an approved case manager who provides an eligible case management service, as defined in §27.5 of this title (relating to Case Management and Pregnant Women).

(5) Board--The Texas Board of Health.

(6) Case manager--An individual who provides Case Management for Children and Pregnant Women services either independently or as an employee of a case management provider.

(7) Case management provider--An agency or individual approved by the department to provide Case Management for Children and Pregnant Women services and enrolled as a Medicaid provider.

(8) Case Management for Children and Pregnant Women--The federal enhancement service which assists eligible recipients in gaining access to medically necessary medical, social, educational, and other services.

(9) Children with a health condition/health risk--Children who have or are at risk for a medical condition, illness, injury, or disability that results in limitation of function, activities or social roles in comparison with healthy same age peers in the general areas of physical, cognitive, emotional, or social growth and development.

(10) Continuity of care--The degree to which: the care of a child is provided by the same medical home or primary care provider; the system of care remains stable and services are consistent, unduplicated and uninterrupted.

(11) Department--The Texas Department of Health.

(12) EPSDT--Early and Periodic Screening, Diagnosis, and Treatment program. All states participating in the Medicaid program must offer EPSDT to children under age 21 who qualify for Medicaid. EPSDT provides medical and dental services to Medicaid and Texas Health Steps clients under age 21 years. In Texas, EPSDT is known as Texas Health Steps (THSteps).

(13) Family--A basic unit in society having at its nucleus: one or more adults living together and cooperating in the care and rearing of their biological or adopted children; a person or persons acting as an individual's family, foster family or identifiable support person or persons.

(14) Health and health-related services--Services which are provided to meet the comprehensive (preventive, primary, tertiary and specialty) health needs of the eligible recipient, including but not limited to, well care and dental check ups, immunizations, acute care visits, pediatric specialty consultations, physical therapy, occupational therapy, audiology, speech language services, mental health professional services, pharmaceuticals, medical supplies, prenatal care, family planning, adolescent preventive health, durable medical equipment, nutritional supplements, prosthetics, eye glasses, and hearing aids.

(15) High risk pregnant women--Women who are pregnant and have one or more high risk medical and/or personal/psychosocial condition(s) during pregnancy.

(16) Preventive services--Services that include health counseling and education, immunizations, wellness care, nutritional supplementation, family planning and screening aimed at avoiding illness and/or disability.

(17) Primary services--Services that include care for minor illnesses, injuries and abnormalities discovered through screenings.

(18) Prior authorization--A condition for reimbursement, the prior authorization process requires all providers of Case Management for Children and Pregnant Women services to submit documentation of the requested services for approval before such services may be authorized for payment.

(19) State--The State of Texas.

(20) Tertiary services--Services that include care for major illnesses and injuries, and chronic or disabling conditions.

(21) Texas Health Steps Program (THSteps)--In Texas, the name of the federal program known as EPSDT, which is required of states participating in the Medicaid program.

§27.3.Eligible Recipients.

Clients eligible for case management services under this chapter must be either children birth through age 20 with a health condition/health risk or high risk pregnant women who are:

(1) Medicaid eligible in Texas;

(2) in need of services to prevent illness(es) or medical condition(s), to maintain function or slow further deterioration; and

(3) desire case management.

§27.5.Case Management for Children and Pregnant Women Service Provisions.

Case Management for Children and Pregnant Women services, as defined in §27.1 of this title (relating to Definitions), are services provided to assist eligible recipients in gaining access to medically necessary medical, social, educational and other services for which federal financial participation is available in order to: encourage the use of cost-effective health and health-related care; make referrals to appropriate community resources; discourage over-utilization or duplication of services; and reduce morbidity and mortality. Case Management for Children and Pregnant Women is not a "gatekeeper" function.

(1) The following contacts are billable:

(A) Comprehensive Visit--a face-to-face visit that includes the development of:

(i) Family Needs Assessment--a written evaluation of all issues that impact the short and long term health and well being of the eligible recipient and his/her family. Together, the case manager and family shall assess the medical, social, educational and other medically necessary service needs of the eligible recipient. Documentation of the Family Needs Assessment must include, at a minimum:

(I) the assessment of the medical, social/family, nutritional, educational, vocational, developmental and health care transportation needs;

(II) individualized assessment of the client; and

(III) the case manager's dated signature.

(ii) Service Plan--the written summary which:

(I) documents the services to be accessed;

(II) identifies the individual responsible for contacting the appropriate health and human service providers;

(III) designates the time frame within which the eligible recipient should access services;

(IV) may be sent to the medical provider or others as appropriate in accordance with the limits of confidentiality; and

(V) must include, at a minimum: the interventions and referrals for addressing needs identified in the Family Needs Assessment; the time frame for the client to access services; the client/parent/guardian's and case manager's dated signatures.

(B) Follow-up contact--a face-to-face or telephone contact with the eligible recipient and his/her family during which the case manager and the client/family review and reassess the client/family's needs, determine what referrals and services specified in the Service Plan have been received by the client/family, and develop appropriate modifications to the Service Plan. The Follow-up contact includes the review of the referrals that have occurred or are still needed to complete the Service Plan and meet the client/family's needs. Follow-up contacts for children should occur as needed. Follow-up contacts for pregnant women should occur as needed through the 59th day post-partum. Documentation of the Follow-up contacts must include, at a minimum:

(i) a review of the complete Service Plan;

(ii) efforts to ascertain on an ongoing basis which needs specified in the Service Plan have been addressed with appropriate referrals provided and services accessed; and

(iii) evidence of problem solving with client/parent/guardian when needs are not addressed or referrals not accessed.

(2) Case Management for Children and Pregnant Women services will include a non-billable intake with each client/family. The intake will include the collection of demographic information and determination of the client's eligibility.

(3) Only one billable contact per client shall be billed per day.

§27.7.Service Limitations.

(a) Case Management for Children and Pregnant Women services are not reimbursable if they are duplicative of other billed, comprehensive Medicaid case management services.

(b) Following intake completion, the initial prior authorization request for a billable contact must be supported by required documentation and submitted to the department for review and disposition. The amount of billable contacts that are prior authorized will be based on the client's level of need, level of medical involvement and complicating psychosocial factors.

(c) Any additional requests for a billable Case Management for Children and Pregnant Women services must also be prior authorized. Required documentation must be submitted to the department for review and disposition before any additional services may be prior authorized.

§27.9.Applicant Qualifications.

(a) The minimum qualifications for a Case Management for Children and Pregnant Women applicant are:

(1) completion and approval of an application for Case Management for Children and Pregnant Women as defined in §27.1 of this title (relating to Definitions);

(2) agreeing to comply with the department rules, policies and procedures on Case Management for Children and Pregnant Women and the applicable statutory provisions;

(3) agreeing to comply with applicable state and federal laws governing participation of providers in the Medicaid program;

(4) employment of case managers with the following qualifications:

(A) Registered nurse (with a diploma, an associate's, bachelor's or advanced degree) or Social Worker (with bachelor's or advanced degree), currently licensed by the respective Texas licensure board and whose license is not temporary or provisional in nature; and

(B) possessing two years of cumulative paid full-time work experience or two years of supervised, full-time educational internship/practicum experience in the past ten years with children, up to age 21, and/or pregnant women. Experience must include assessing the psychosocial and health needs of and making community referrals for these populations;

(5) agreeing to comply with all licensure requirements of the case manager(s) respective state licensure/examining boards including the obligation to report all suspected child abuse/neglect; and

(6) knowledge of and coordination with providers of health and health-related services and other active community resources.

(b) A case manager employed in an approved Targeted Case Management for Pregnant Women and Infants or Texas Health Steps Medical Case Management agency at the time of implementation of these rules but who does not meet the educational and/or experience requirements outlined in subsection (a)(4)(A) and (B) of this section, may continue providing case management services, if the case manager presents a certificate issued by the department attesting that the case manager possesses experience providing services for an approved Targeted Case Management for Pregnant Women and Infants or Texas Health Steps Medical Case Management agency before the implementation date of these rules.

(c) An applicant under investigation or being sanctioned by the department or any other State of Texas or federal governmental agency will not be approved as a case management provider.

§27.11.Case Management Provider Requirements.

In order to remain a case management provider, an individual or agency must:

(1) comply with applicable state and federal laws and regulations governing participation of providers in the Medicaid program;

(2) maintain provider status with the department;

(3) develop and maintain a system for Case Management for Children and Pregnant Women services incorporating the following elements:

(A) case Management for Children and Pregnant Women services in locations convenient for the eligible recipient to facilitate face-to-face contact;

(B) provision of Case Management for Children and Pregnant Women services in order to assist eligible recipients in accessing necessary medical, social, educational, and other services;

(C) an internal quality assurance plan that includes, but is not limited to, chart reviews and staff observation;

(D) a current list of opened and closed client records;

(E) an accounts receivable system through which billed contacts will be tracked and matched with paid claims and client records to assure claims are billed and paid for correct dates of service, were billed with appropriate procedure codes and are not duplicative of other claims for the same client;

(F) outreach activities that assure individualized referrals. The following activities may impede client choice and therefore are prohibited:

(i) door to door, telephone or other cold-call marketing or solicitation of clients by providers;

(ii) the distribution of materials to Case Management for Children and Pregnant Women recipients that impede client choice;

(iii) the distribution of any false or misleading materials to Case Management for Children and Pregnant Women recipients;

(iv) obtaining lists of Medicaid clients without a specific referral;

(v) offering incentives for enrollment into case management services; and/or

(vi) entering into exclusive referral relationships with referral sources;

(4) assure Case Management for Children and Pregnant Women services will be provided by approved case managers who meet the qualifications defined in §27.9 and §27.11 of this title;

(5) assure that approved case managers:

(A) have received department-approved education and training regarding Case Management for Children and Pregnant Women;

(B) have the opportunity to participate in appropriate Medicaid, case management and THSteps workshops, seminars, and training;

(C) assume responsibility for all Case Management for Children and Pregnant Women services they provide to eligible recipients, including services by their designated support staff;

(D) participate in relevant motion or cost studies;

(E) agree to permit the department or its designee access to the Case Management for Children and Pregnant Women provider's records, and permit direct observation of case management activities for the purpose of determining the provider's suitability to continue participation as a Case Management for Children and Pregnant Women provider; and

(F) participate in local and/or regional case management systems/coalitions in accordance with program policies to assure cooperation and coordination with local health departments, the department's public health region(s), school districts and other Medicaid-approved case management providers as evidenced by:

(i) participation in community coalition meetings in accordance with program policy;

(ii) collaboration in planning case management delivery systems; and

(iii) involvement in resolving case management problems;

(6) share information, within the limits of confidentiality, with the department and collaborating agencies to facilitate referral and monitoring of eligible recipients; and

(7) comply in a timely manner with all department data collection and reporting requirements.

§27.13.Application Process.

(a) Applications to become a Case Management for Children and Pregnant Women provider may be obtained by contacting the department or by accessing the department website.

(b) Applicants must include copies of documentation of all agency licenses, contracts and/or written agreements with their application.

(c) Applications must be typed and accompanied by all required supporting documentation set out in this chapter. An original must be sent to the appropriate department regional office and one copy of the application must be submitted to the department central office.

(d) All applications shall be reviewed by the department staff. The review process shall be completed within 20 working days following receipt of an application.

(e) Incomplete applications shall not be approved and shall be returned to the applicant for completion.

(f) Applications which do not meet department requirements will be denied.

(g) Applicants will be notified in writing of approval or non-approval by the department. Applicants must still enroll as Medicaid providers through Medicaid provider enrollment.

(h) Applicants who have submitted complete applications and who are not approved by the department to provide case management services must wait, at a minimum, 6 months before resubmission of a new application.

§27.15.Case Management Provider Review and Monitoring Process.

(a) Approved providers will be monitored on an as-needed basis for compliance with rules and policies.

(b) Case managers or case management providers who do not comply with program requirements may be terminated, placed on probationary status, referred to appropriate professional licensure entities for review, and/or referred for fraud and abuse investigation as described in department policies and procedures.

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 June 16, 2003.

TRD-200303690

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: September 1, 2003

Proposal publication date: April 4, 2003

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


Chapter 32. CASE MANAGEMENT

Subchapter C. CASE MANAGEMENT FOR HIGH-RISK PREGNANT WOMEN AND HIGH-RISK INFANTS

25 TAC §§32.301 - 32.305, 32.307

The Texas Department of Health (department) adopts the repeal of §§32.301 - 32.305 and §32.307, concerning case management for high-risk pregnant women and high-risk infants. The repeal is adopted without changes to the proposed repeal as published in the April 4, 2003, issue of the Texas Register (28 TexReg 2855) and, therefore, the repeal will not be republished.

Government Code, §2001.039, requires that each agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). The department has reviewed §§32.301 - 32.305 and §32.307 and determined that reasons for repealing these sections exist; however, new rules are adopted in a new chapter as described in this preamble.

The department published a Notice of Intention to Review the sections in the Texas Register (24 TexReg 10378) on November 19, 1999. No comments have been received.

The repeal of §§32.301 - 32.305 and §32.307 will allow the combination of the affected sections in new Chapter 27, entitled Case Management for Children and Pregnant Women, of this title. Combining these sections in this new chapter will ensure integration of services to the eligible population for case management services: children with a health condition/health risk, birth to 21 years, and/or high-risk pregnant women of all ages. Specifically, the repealed sections cover definitions; eligible individuals; case management services; service limitations; provider qualifications, and the right to appeal. The purpose of the new chapter is to continue to make available medically necessary Texas Health Steps ("THSteps") medical case management mandated by the federal Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program and case management services for other eligible women and children.

No comments were received regarding the proposal to repeal this subchapter.

The department also adopts the repeal of Early and Periodic Screening, Diagnosis, and Treatment, Subchapter J, Texas Health Steps Medical Case Management, §§33.501 - 33.506, under a separate publication. Specifically, these repealed sections cover definitions; eligible recipients; THSteps Medical Case Management Services; service limitations; applicant and provider qualifications, and application, review and monitoring process. The sections will be integrated in new Chapter 27.

The department at the same time is adopting the repeal of §§37.81 - 37.86 of this title, concerning Medicaid case management for high risk pregnant women and high risk infants, under a separate publication. Specifically, these sections cover introduction; definitions; case management services; provider qualifications; application and review process, and documents adopted by reference. These sections will be integrated in the new Chapter 27 of this title.

The department also adopts new Chapter 27, Case Management for Children and Pregnant Women, §§27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13 and 27.15, under a separate publication. The new sections combine case management programs to meet the needs of pregnant women of all ages and children with a health condition/health risk, birth to 21 years. Specifically, these new sections cover definitions; eligible recipients; case management service provisions; service limitations; applicant and provider qualifications; and application, review and monitoring processes.

The adopted new rules for Case Management for Children and Pregnant Women will provide case management services to Medicaid eligible women of all ages who have a high risk pregnancy and to children from birth to 21 years of age with a health condition/health risk. Two programs, Medicaid Case Management for High Risk Pregnant Women and High Risk Infants and the Texas Health Steps Medical Case Management were combined into one program in the new Chapter 27 upon the repeal of §§32.301 - 32.305, 32.307, 33.501 - 33.506 and 37.81 - 37.86. The new program will provide a greater continuity of services for all eligible recipients.

The repeals are adopted under the Health and Safety Code, §12.001, which provides the Board of Health (board) with the authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health; the Health and Safety Code, Chapter 32, which provides the board with the authority to establish maternal and infant health improvement services programs in the department to serve eligible recipients; the Human Resources Code, Chapter 32, which enables the state to provide medical assistance; and the Government Code, §531.021, which provides the Health and Human Services Commission (HHSC) with the authority to propose rules to administer the state's medical assistance program, and are submitted by the Texas Department of Health under its agreement with HHSC to operate the EPSDT program, and as authorized under §1.07 of the Acts of the 72nd Legislature, First Called Session (1991), Chapter 15, as amended by the Acts of the 73rd Legislature, Chapter 747, §2.

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 June 16, 2003.

TRD-200303688

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: September 1, 2003

Proposal publication date: April 4, 2003

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


Chapter 33. EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT

Subchapter J. TEXAS HEALTH STEPS MEDICAL CASE MANAGEMENT

25 TAC §§33.501 - 33.506

The Texas Department of Health (department) adopts the repeal of §§33.501 - 33.506, concerning the Texas Health Steps Medical Case Management. The repeal is adopted without changes to the proposed repeal as published in the April 4, 2003, issue of the Texas Register (28 TexReg 2869) and, therefore, the repeal will not be republished.

Government Code, §2001.039, requires that each agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). The department has reviewed §§33.501 - 33.506 and determined that reasons for repealing these sections exist; however, new rules are adopted in a new chapter as described in this preamble.

The department published a Notice of Intention to Review the sections in the Texas Register (24 TexReg 11129) on December 10, 1999. No comments have been received.

The repeal of §§33.501 - 33.506 will allow the combination of the affected sections in new Chapter 27, entitled Case Management for Children and Pregnant Women, of this title. Combining these sections in a new chapter will ensure integration of services to the eligible population for case management services: children with a health condition/health risk, birth to 21 years, and/or high-risk pregnant women of all ages. Specifically, the repealed sections cover definitions; eligible recipients; THSteps Medical Case Management services, services limitations, applicant and provider qualifications; and application, review and monitoring processes. The purpose of the new chapter is to continue to make available medically necessary Texas Health Steps ("THSteps") medical case management mandated by the federal Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program and case management services for other eligible women and children.

No comments were received regarding the proposal to repeal this subchapter.

The department also adopts the repeal of §§32.301 - 32.305 and §32.307 of this title, concerning case management for high-risk pregnant women and high-risk infants, under a separate publication. Specifically, these sections cover definitions; eligible individuals; case management services; service limitations; provider qualifications and the right to appeal. These sections are adopted for repeal as they were repeated in §§37.81 - 37.86. Sections 32.301 - 32.305 and §32.307 were not repealed when §§37.81 - 37.86 were adopted. The sections are integrated in new Chapter 27.

The department at the same time is adopting the repeal of §§37.81 - 37.86 of this title, concerning Medicaid case management for high risk pregnant women and high risk infants, under a separate publication. Specifically, these sections cover introduction; definitions; case management services; provider qualifications; application and review process, and documents adopted by reference. These sections are integrated in the new Chapter 27 of this title.

The department also adopts new Chapter 27, Case Management for Children and Pregnant Women, §§27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13 and 27.15, under a separate publication. The new sections combine case management programs to meet the needs of pregnant women of all ages and children with a health condition/health risk, birth to 21 years. Specifically, these new sections cover definitions; eligible recipients; case management service provisions; service limitations; applicant and provider qualifications; and application, review and monitoring processes.

The adopted new rules for Case Management for Children and Pregnant Women will provide case management services to Medicaid eligible women of all ages who have a high risk pregnancy and to children from birth to 21 years of age with a health condition/health risk. Two programs, Medicaid Case Management for High Risk Pregnant Women and High Risk Infants and the Texas Health Steps Medical Case Management were combined into one program in the new Chapter 27 upon the repeal of §§32.301 - 32.305, 32.307, 33.501 - 33.506, and 37.81 - 37.86. The new program will provide a greater continuity of services for all eligible recipients.

The repeals are adopted under the Health and Safety Code, §12.001, which provides the Board of Health (board) with the authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health; and under the Health and Safety Code, Chapter 32, which provides the board with the authority to establish maternal and infant health improvement services programs in the department to serve eligible recipients; the Human Resources Code, Chapter 32, which enables the state to provide medical assistance; and the Government Code, §531.021, which provides the Health and Human Services Commission (HHSC) with the authority to propose rules to administer the state's medical assistance program and are submitted by the Texas Department of Health under its agreement with HHSC to operate the EPSDT program, and as authorized under §1.07 of the Acts of the 72nd Legislature, First Called Session (1991), Chapter 15, as amended by the Acts of the 73rd Legislature, Chapter 747, §2.

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 June 16, 2003.

TRD-200303687

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: September 1, 2003

Proposal publication date: April 4, 2003

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


Chapter 37. MATERNAL AND INFANT HEALTH SERVICES

Subchapter E. MEDICAID CASE MANAGEMENT SERVICES FOR HIGH RISK PREGNANT WOMEN AND HIGH RISK INFANTS

25 TAC §§37.81 - 37.86

The Texas Department of Health (department) adopts the repeal of §§37.81 - 37.86, concerning case management for high-risk pregnant women and high-risk infants. The repeal is adopted without changes to the proposed repeal as published in the April 4, 2003, issue of the Texas Register (28 TexReg 2871) and, therefore, the repeal will not be republished.

Government Code, §2001.039, requires that each agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). The department has reviewed §§37.81 - 37.86 and determined that reasons for repealing these sections exist; however, new rules are adopted in a new chapter as described in this preamble.

The department published a Notice of Intention to Review the sections in the Texas Register (25 TexReg 602) on January 28, 2000. No comments have been received.

The repeal of §§37.81 - 37.86 will allow the combination of the affected sections in new Chapter 27, entitled Case Management for Children and Pregnant Women, of this title. Combining these sections in this new chapter will ensure integration of services to the eligible population for case management services: children with a health condition/health risk, birth to 21 years, and/or high-risk pregnant women of all ages. Specifically, the repealed sections cover introductions, definitions, case management services, provider qualifications, application and review process, and documents adopted by reference. The purpose of the new chapter is to continue to make available medically necessary Texas Health Steps ("THSteps") medical case management mandated by the federal Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program and case management services for other eligible women and children.

No comments were received regarding the proposal to repeal this subchapter.

The department also adopts repeal of §§32.301 - 32.305 and §32.307, of this title, concerning case management for high-risk pregnant women and high-risk infants, under a separate publication. Specifically, these sections cover definitions; eligible individuals; case management services; service limitations; provider qualifications, and the right to appeal. These sections are adopted for repeal as they were repeated in Chapter 37, §§37.81 - 37.86. Sections 32.301 - 32.305 and §32.307 were not repealed when §§37.81 - 37.86 were adopted. The repeal is also necessary in order to combine the affected sections in a new chapter entitled Chapter 27, Case Management for Children and Pregnant Women.

The department at the same time is adopting the repeal of Early and Periodic Screening, Diagnosis and Treatment, Subchapter J, THSteps Medical Case Management Services, §§33.501 - 33.506, under a separate publication. The repeal is necessary in order to combine these sections in new Chapter 27, Case Management for Children and Pregnant Women. Specifically, these sections cover definitions; eligible recipients; THSteps Medical Case Management services; service limitations; applicant and provider qualifications, and application, review and monitoring processes.

The department also adopts new Chapter 27, Case Management for Children and Pregnant Women, §§27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13 and 27.15, under a separate publication. The new sections combine case management programs to meet the needs of pregnant women of all ages and children with a health condition/health risk, birth to 21 years. Specifically, these new sections cover definitions; eligible recipients; case management service provisions; service limitations; applicant and provider qualifications; and application, review and monitoring processes.

The adopted new rules for Case Management for Children and Pregnant Women will provide case management services to Medicaid eligible women of all ages who have a high risk pregnancy and to children from birth to 21 years of age with a health condition/health risk. Two programs, Medicaid Case Management for High Risk Pregnant Women and High Risk Infants and the Texas Health Steps Medical Case Management were combined into one program in the new Chapter 27 upon the repeal of §§32.301 - 32.305, 32.307, 33.501 - 33.506, and 37.81 - 37.86. The new program will provide a greater continuity of services for all eligible recipients.

The repeals are adopted under the Health and Safety Code, §12.001, which provides the Board of Health (board) with the authority to adopt rules to implement every duty imposed by law on the board, the department and the commissioner of health; the Health and Safety Code, Chapter 32, which provides the board with the authority to establish maternal and infant health improvement services programs in the department to serve eligible recipients; the Human Resources Code, Chapter 32, which enables the state to provide medical assistance; and the Government Code, §531.021, which provides the Health and Human Services Commission (HHSC) with the authority to propose rules to administer the state's medical assistance program, and are submitted by the Texas Department of Health under its agreement with HHSC to operate the EPSDT program, and as authorized under §1.07 of the Acts of the 72nd Legislature, First Called Session (1991), Chapter 15, as amended by the Acts of the 73rd Legislature, Chapter 747, §2.

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 June 16, 2003.

TRD-200303689

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: September 1, 2003

Proposal publication date: April 4, 2003

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


Chapter 181. VITAL STATISTICS

The Texas Department of Health (department) adopts amendments to §§181.1-181.11, 181.13 - 181.14, 181.21, 181.23 - 181.26, 181.28 - 181.32, and 181.41 - 181.47; repeal of §§181.22, 181.27, 181.48 - 181.49; and new §§181.22 and 181.27, concerning administrative procedures, issuance of vital records events and statistical information, and the Central Adoption Registry of the Bureau of Vital Statistics. Sections 181.1, 181.26, and 181.44 are adopted with changes to the proposed text as published in the January 31, 2003, issue of the Texas Register (28 TexReg 889). The amendments to §181.2 - 181.11, 181.13 - 181.14, 181.21, 181.23 - 181.25, 181.28 -181.32, 181.41 - 181.43, 181.45 - 181.47, repeal of §§181.22, 181.27, and 181.48 -181.49, and new §§181.22 and 181.27 are adopted without changes and will not be republished.

Specifically, the amendments cover the following: Subchapter A clarifies key vital statistics words and terms; provides instructions and requirements for the preservation, transportation, and final disposition of dead bodies; set requirements regarding access, confidentiality and filing of supplemental birth certificates, fetal death certificates, and requests for personal data; and defines the form and content of birth, death, and fetal death certificates. Subchapter B provides instructions, sets requirements, and fees for issuance of certified copies, and registration of birth and death records; defines who can prescribe the form and context of the marriage application form; sets minimum requirements for adoption reporting and index access; and establishes notification, maintenance, and preservation requirements for out-of-business child-placing agencies' records. Subchapter C establishes rules for notifying adoptive parents about the Central/Voluntary Adoption Registry; defines the duties, responsibilities and fees associated with the voluntary adoption registries; and provides guidelines pertaining to the confidentiality, notification and the release of information. The repeals cover Confidentiality of Records Maintained by Each Registry and Fee Requirement for the Central Adoption Registry. The new sections cover Fees Charged for Vital Records Services and Memorandum of Understanding with the Texas Funeral Service Commission.

The Government Code, §2001.039, requires state agencies to review and consider for readoption each rule adopted by that agency, pursuant to the Government Code, Chapter 2001 (Administrative Procedures Act). Sections §§181.1 - 181.11, 181.13 - 181.14, 181.21 - 181.32 and 181.41 - 181.49 have been reviewed, and the department has determined that the rules should continue to exist; however, changes were necessary.

A Notice of Intention to Review for §§181.1 - 181.11, 181.13 - 181.14; 181.21 - 181.32; and 181.41 - 181.49 was published in the November 17, 2000, issue of the Texas Register (25 TexReg 11528). No comments were received as a result of the publication of this notice.

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

Comment: Concerning §181.1(5), the definition of "certified copy," a commenter stated that the phrase "seal of the State of Texas" should be changed to "state seal." The term "state seal" is used by the legislature, the secretary of state, and to the best of the commenter's knowledge, all other state agencies. If the bureau wishes to be specific about the precise design of the state seal, then the commenter suggested a reference to Title I, Texas Administrative Code, §72.50(1), which is the standard design for the state seal.

Response: The department agrees with the commenter, and has corrected the wording in this paragraph.

Comment: Concerning §181.7(a), (b), and (2), a commenter stated that when a stillbirth or fetal death occurs at the gestation of 20 completed weeks or more, the certificate filed should continue to be referred to as a Certificate of Stillbirth. Furthermore, Texas should consider giving the mother of a stillborn baby a "Certificate of Birth Resulting in Stillbirth."

Response: After consulting with the department's Office of General Council, it was determined that no changes be made as a result of the comment based on the following reasons: There was no live birth, hence no birth certificate should be issued; and issuing a certificate of stillbirth would still require a certificate of fetal death to be issued for the same event.

The comments received were neither for nor against the rules in their entirety; however, the commenters were individuals and raised questions and offered suggestions for changes.

The department has made the following editorial changes due to staff comments to correct punctuation.

Change: Concerning §181.26(d)(5), a semicolon was added after the word "card".

Change: Concerning §181.44(a), a comma was added after the word "(CAR)".

Subchapter A. MISCELLANEOUS PROVISIONS

25 TAC §§181.1 - 181.11, 181.13, 181.14

The amendments are adopted under authority of the Health and Safety Code, §191.003, which provides the Board of Health with authority to adopt necessary rules for collecting, recording, transcribing, compiling, and preserving vital statistics; and §12.001, which provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, department and the Commissioner of Health. The review of these rules implements Government Code, §2001.039.

§181.1.Definitions.

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

(1) Applicant--A person who requests a service pertaining to a record of birth or death, verification of marriage or divorce, or release of personal data. (Also, see definition for properly qualified applicant).

(2) Birth records--Records governing births filed pursuant to the Texas Vital Statistics Act, the Health and Safety Code, Title 3.

(3) Bureau of Vital Statistics (Bureau)--The office within the Texas Department of Health charged with the implementation of the Texas Vital Statistics Act.

(4) Certification--A certified statement, form, or letter, of the facts stated on the form or document as filed in the Bureau of Vital Statistics, certified by the state registrar or duly appointed designee, over the respective signature and may bear the seal of the Bureau of Vital Statistics.

(5) Certified copy--An abstract or photocopy of the original record issued as filed with the Bureau of Vital Statistics, and issued on a designated form or security paper which shall bear the "state seal", the Texas Department of Health-Bureau of Vital Statistics or the seal of their office, and the facsimile signature of the State Registrar or the local registration official.

(6) Dead body--A lifeless human body or such parts of the human body or the bones thereof from the state of which it may be reasonably concluded that death occurred.

(7) Disinterment--To exhume, unbury, or take out of the grave.

(8) Death records--Records governing deaths and fetal deaths filed pursuant to the Texas Vital Statistics Act.

(9) Department--The Texas Department of Health.

(10) Embalming--The act of disinfecting or preserving a human dead body, entire or in part, by the use of chemical substances, fluids, or gases in the body; or by the introduction of the same into the body by vascular or hypodermic injection; or by direct application into the organs or cavities; or by any other method intended to disinfect or preserve a dead body or restore body tissues and structures.

(11) Fetal death (stillbirth)--Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation, the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.

(12) Genealogist--An individual who traces the descent of persons or families. He or she may be an individual family member or a person hired by the family to trace a family tree or do family research.

(13) Identification of applicant--Each applicant must present a current form of government issued photo identification along with his or her application. If the applicant is unable to present a current form of photo identification, two valid supporting forms of identification may be presented, one of which bears the applicant's signature.

(14) Immediate family member--The registrant, a member of his or her immediate family either by blood, marriage or adoption, his or her guardian, or his or her legal agent or representative.

(15) Indexes--An index to or listing of birth records, death records, applications for marriage licenses, and reports of divorce or annulment of marriage.

(A) Consolidated indexes--These indexes are vital records consisting of more than one event year. Consolidated indexes may be prepared for any vital event at the discretion of the State Registrar in the form prescribed.

(B) General birth and death indexes--These indexes are maintained or established by the bureau of vital statistics or a local registration official which shall be prepared by event year, in alphabetical order by surname of the registrant, followed by any given names or initials, the date of the event, the county of occurrence, the state or local file number, the name of the father, the maiden name of the mother, and sex of the registrant.

(C) Summary birth and death index--These indexes are maintained or established by the Bureau of Vital Statistics or a local registration official which shall be prepared by event year, in alphabetical order by surname of the registrant, followed by any given names or initials, the date of the event, the county of occurrence, and sex of the registrant.

(16) Interment--Burial or the act of placing in a grave.

(17) Legal representative (personal representative or agent)--An attorney in fact, a funeral director, or any other person designated by affidavit, contract, or court order acting on behalf and for the benefit of the registrant or his or her immediate family. In order to determine the need for protection for personal property rights when the legal representative is acting on behalf and for the benefit of the registrant or the registrant's immediate family or other entity having a direct and tangible interest in the record, the state registrar, local registrar, or county clerk shall require a designation document or an attested statement to that effect.

(18) Live birth--The complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after such separation, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered live born.

(19) Local registration official--A county clerk or person authorized by the Vital Statistics Act to maintain a duplicate system of records for each birth, death, or fetal death that occurs in the person's jurisdiction.

(20) Non-institutional Birth--A birth occurring outside a hospital or birthing center licensed by the Texas Department of Health.

(21) Person in charge of interment--Any person who places or causes to be placed a fetus, dead body or the ashes, after cremation, in a grave, vault, urn, or other receptacle, or otherwise disposes thereof.

(22) Properly qualified applicant (qualified applicant)--The registrant, or immediate family member either by blood, marriage or adoption, his or her guardian, or his or her legal agent or representative. Local, state and federal law enforcement or governmental agencies and other persons may be designated as properly qualified applicants by demonstrating a direct and tangible interest in the record when the information in the record is necessary to implement a statutory provision or to protect a personal legal property right. A properly qualified applicant may also be a person who has submitted an application for a request to release personal information and has been approved as outlined in §181.11 of this title (relating to Requests for Personal Data).

(23) Registrant--The individual named on the certificate of birth, death, or fetal death; application for marriage license; or report of divorce or annulment of marriage.

(24) Research copy--A plain paper noncertified reproduction of the complete original document or a portion of the original document.

(25) Search--The act of examining the files and/or indexes maintained by the Bureau of Vital Statistics for a specific record or information.

(26) Signature--The name of a person written with his or her own hand; or by an electronic process approved by the State Registrar.

(27) State Registrar--The Chief, Bureau of Vital Statistics, Texas Department of Health.

(28) Supplemental Birth Certificate--A new birth certificate prepared and filed by the Bureau, which is based upon a paternity determination, or adoption. This new birth certificate replaces the original certificate of birth.

(29) Birth Verification--A noncertified statement only of the registrant's name, date of birth, and place of birth as it appears on the birth index filed with the Bureau of Vital Statistics.

(30) Death Verification--A noncertified statement only of the registrant's name, date of death, and place of death as it appears on the death index filed with the Bureau of Vital Statistics.

(31) Fetal Death Verification--A noncertified statement only of the registrant's name, date of delivery, and place of delivery as it appears on the fetal death index filed with the Bureau of Vital Statistics.

(32) Marriage Verification--A noncertified statement only of the registrant's name, date of marriage, and place of marriage as it appears on the application for marriage license index filed with the Bureau of Vital Statistics.

(33) Report of Divorce or Annulment of Marriage Verification--A noncertified statement only of the registrant's name, date of divorce, and place of divorce as it appears on the report of divorce or annulment of marriage index as it appears on the birth index filed with the Bureau of Vital Statistics.

(34) Vital statistics--The registration, preparation, transcription, collection, compilation, distribution and preservation of data pertaining to births, adoptions, paternity determinations, deaths, fetal deaths, suits affecting parent child relationship, court of continuing jurisdiction, marital status, and such other data as deemed necessary by the department.

(35) Vital Statistics Act--The Health and Safety Code, Title 3.

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 June 13, 2003.

TRD-200303600

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


Subchapter B. VITAL RECORDS

25 TAC §§181.21 - 181.32

The amendments and new rules are adopted under authority of the Health and Safety Code, §191.003, which provides the Board of Health with authority to adopt necessary rules for collecting, recording, transcribing, compiling, and preserving vital statistics; and §12.001 which provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, department and the Commissioner of Health. The review of these rules implements Government Code, §2001.039.

§181.26.Filing of Birth Certificates for Infants Born Outside of a Licensed Institution.

(a) All certificates of birth shall be filed as required by the Health and Safety Code, §192.001.

(1) Births occurring in a licensed institution shall be filed as required by the Health and Safety Code, §192.003. Licensed institutions include hospitals and birthing centers licensed by the department.

(2) Births occurring outside licensed institutions shall be filed as described in this section.

(b) The signature on the certificate of the registered, certified, or documented health care provider shall serve as prima facie evidence of the essential elements of proof required in subsection (c) of this section. The local registrar may accept certificates by mail when the signature of the registered, certified, or documented health care provider is on file with that registrar's office.

(c) The essential elements to register a noninstitutional birth are:

(1) proof of pregnancy in the following order of preference:

(A) an affidavit from a licensed, registered, or certified health care provider who is qualified to determine pregnancy as part of the scope of his/her license or registration, or certification; or

(B) an affidavit from one person, other than the parents, having knowledge of the pregnancy/birth.

(2) that there was an infant born alive;

(3) proof of the mother's presence in the registration district on the date of the birth if the birth occurred outside the locale of the mother's primary place of residence. Such proof shall consist of an affidavit from a person having knowledge of the mother's presence in the registration district in which the birth occurred on the date of the birth. If the birth occurred in the mother's primary place of residence, proof shall be presented in the following order of preference:

(A) a utility, telephone, or other bill which includes the mother's name and address;

(B) a rent receipt or agreement which includes the mother's name and address, and the printed name, address, and signature of the mother's landlord;

(C) a driver's license, or state issued identification card, which includes the mother's current residence on the face of the license/card;

(D) an envelope addressed to the mother at her place of residence, and postmarked prior to the date of the birth; or

(E) an affidavit attesting to the mother's place of residence from a person, other than the father, who was either living with the mother at the time of the alleged birth, or has other knowledge of the mother's residency; and

(4) the infant's birth occurred on the date stated.

(d) A birth as described in subsection (c) of this section shall only be filed upon personal presentation of the following evidence by the individual responsible for the preparation and registering of the certificate. An identifying document, with photograph, shall be presented in the following order of preference:

(1) a passport or certificate of naturalization;

(2) a military service or military dependent identification card;

(3) a United States government identification card, or national identification card issued by another country;

(4) a current driver's license or other state identification card;

(5) an alien registration receipt card; or

(6) an employee or student identification card, with photograph.

(e) At the discretion of the local registrar, the requirements contained in this section may be supplemented with any additional requirements which may be needed to verify the circumstances of the birth. Such additional requirements may include, but are not limited to, one or more of the following:

(1) an unannounced visit to the mother's residence or the place of the alleged birth by a public health nurse, other health professional, registrar staff, or other person including city, county, state, or federal law enforcement officer, prior to registering the alleged birth. This paragraph does not permit nor give authority to enter these premises unless permission is obtained from the occupant at the time of the visit;

(2) multiple forms of identifying documents, with or without photographs, when the documents described in this section are unavailable;

(3) personal appearance of both parents, either together or separately; or

(4) personal appearance of the infant whose birth certificate the parents are attempting to file.

(f) If the required or supplemental evidence described in this section is not available and the registrar is otherwise unable to verify the circumstances of the birth, the birth may only be filed upon order of a court of competent jurisdiction.

(g) A certificate of birth concerning a child who is between one and four years of age may only be filed by the state registrar. The state registrar shall require the same proof and documentation as previously mentioned in this section and, in addition, an affidavit of the parents and the attendant, if any, as to why the certificate was not timely filed. If the proof and documentation are not available, the certificate may only be filed as prescribed by the Health and Safety Code, §192.027.

(h) Each local registrar shall notify the state registrar's office of any suspicious documents or records submitted or filed with his/her office.

(i) Blank birth certificate forms shall only be issued to licensed institutions, certified nurse midwives, documented midwives, and individuals by the local registrar or the state registrar in reasonable amounts. No blank birth certificate forms shall be distributed by mail to any one other than a registered, certified, or documented health care provider.

(j) Each local registrar shall maintain a record of the number of blank birth certificate forms and their control number issued to each individual. The local registrar shall submit a copy of this record to the state registrar on a monthly basis.

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 June 13, 2003.

TRD-200303601

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


25 TAC §181.22, §181.27

The repeals are adopted under authority of the Health and Safety Code, §191.003, which provides the Board of Health with authority to adopt necessary rules for collecting, recording, transcribing, compiling, and preserving vital statistics; and §12.001 which provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, department and the Commissioner of Health. The review of these rules implements Government Code, §2001.039.

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 June 13, 2003.

TRD-200303602

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


Subchapter C. CENTRAL ADOPTION REGISTRY

25 TAC §§181.41 - 181.47

The amendments are adopted under authority of the Health and Safety Code, §191.003, which provides the Board of Health with authority to adopt necessary rules for collecting, recording, transcribing, compiling, and preserving vital statistics; and §12.001 which provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, department and the Commissioner of Health. The review of these rules implements Government Code, §2001.039.

§181.44.Inquiry through the Central Index.

(a) The bureau charges a fee of $5.00 to determine if a child-placing agency that operates its own registry was involved in a specified adoption. The person may send the inquiry, along with the appropriate fee and proof of age and identity to the Central Adoption Registry (CAR), P.O. Box 140123, Austin, Texas 78714-0123 or may inquire in person at the Bureau of Vital Statistics, 1100 West 49th Street, Austin, Texas.

(b) Proof of age and identity is a copy of the requestor's driver's license or other photo identification and a copy of the birth certificate, if the requestor's name has changed due to marriage. If the name has been legally changed through a court order, a certified copy of the order shall accompany the request.

(c) The department shall provide the child-placing agency's name, address, telephone number, and E-mail address, if appropriate, if that agency operates its own registry to which a person may apply. If the CAR finds inconclusive information to determine which agency handled the adoption, the person is entitled to apply only to the CAR.

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 June 13, 2003.

TRD-200303603

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


25 TAC §181.48, §181.49

The repeals are adopted under authority of the Health and Safety Code, §191.003, which provides the Board of Health with authority to adopt necessary rules for collecting, recording, transcribing, compiling, and preserving vital statistics; and §12.001 which provides the board with the authority to adopt rules for the performance of every duty imposed by law on the board, department and the Commissioner of Health. The review of these rules implements Government Code, §2001.039.

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 June 13, 2003.

TRD-200303604

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


Chapter 229. FOOD AND DRUG

The Texas Department of Health (department) adopts amendments to §§229.81, 229.82, 229.84, 229.85, 229.87 - 229.91, the repeal of §§229.83 and 229.86, and new §§229.83 and 229.86, concerning the production, processing, and distribution of bottled and vended drinking water. The amended §§229.81, 229.85 and 229.88, and new §229.86 are adopted with changes to the proposed text as published in the January 31, 2003, issue of the Texas Register (28 TexReg 901). Repeals §§229.83 and 229.86, amendments §§229.82, 229.84, 229.87, and 229.89 - 229.91, and new §229.83 are adopted without changes, and will not be republished.

An amendment to §229.81 adds definitions for clarification of the regulation. Duplicative language was deleted in §229.82. New §229.83 inserts the reference to the Texas Commission on Environmental Quality regulations on water hauling. An amendment to §229.84 updates the section title name. An amendment to §229.85 updates examples for labeling and advertising. New §229.86 reorganizes the section for clarity and adds a requirement for submission of sample results to the department. An amendment to §229.87 updates the reference to the Texas Commission on Environmental Quality. An amendment to §229.88 clarifies oversight of bottling and vending operations by a certified individual. An amendment to §229.89 adds a timeline for completing the bottled and vended water certificate examination within a limited time frame. An amendment to §229.90 updates the section title for clarification. Amendments to §229.91 update references to the department's hearing procedures and correct spellings to be consistent within the regulation.

Government Code, §2001.039, requires each state agency to review and consider for readoption each rule adopted by that agency. The current rules have been reviewed and the department has determined that reasons for adopting the sections continue to exist; however the rules need revisions as described in the preamble. Sections 229.83 and 229.86 are repealed, and new sections are adopted.

The department published a Notice of Intention to Review for §§229.81 - 229.91 in the Texas Register on March 22, 2002, (27 TexReg 2265). No comments were received as a result of the publication of this notice. Over 300 stakeholders were subsequently notified by mail that these rules were under review. Comments were submitted as a result of this mailing and were taken into consideration when drafting the proposed rules.

The following comments were received by the department during the official comment period concerning the proposed sections. Following each comment is the department's response and any resulting change.

Comment: Concerning §229.81(c)(14)(B), several commenters stated that deleting the word "unit" in the definition of "vended water" changes the meaning to include all sorts of waters.

Response: The department disagrees with these comments. The department feels the terms "unit" and "servings" are redundant, therefore "unit" was deleted in the proposed rules. No change was made as a result of these comments.

Comment: Concerning Section §229.81(c)(16), several commenters stated that definition of "water dispensing device" expands bureaucracy and is too vague. One commenter added, "What is your purpose?"

Response: The department disagrees with these comments. This definition was only added to provide some clarity on requirements for vending machines and bottled water stores. Under the current rules, requirements for both vending machines and bottled water stores were combined in §229.86. This section can be confusing because some of the requirements only apply to vending machines, not the store facilities. Since not all the requirements applied to vended water stores, the term "water dispensing device" was created, and §229.86 was divided into §§229.86(a) and 229.86(b) to provide better differentiation on requirements between the two types of facilities. No additional regulatory requirements were added on bottled water stores or vending machines due to the addition of this definition. No change was made as a result of these comments.

Comment: Concerning §229.83, several commenters recommended the removal of the wording that places jurisdiction of water hauled for bottled water from the Texas Commission on Environmental Quality's (TCEQ) jurisdiction as the department has sole jurisdiction over the production of food products including bottled water. The commenters also asserted that bulk hauled water is not drinking water and that deletion of this rule will not adversely impact health or safety.

Response: The department disagrees with these comments. The TCEQ regulates drinking water from its source to the point of the plant or dispensing device. As all water used in bottled and vended water must be from an approved source, the water at the point of source must be treated and therefore already meets the TCEQ's requirements for drinking water. While it is true that the department regulates food and beverages and their ingredients from the point of production through to the consumer, there is already a TCEQ regulation in place for hauling drinking water. The department feels there is no reason to create an additional or conflicting regulation. This department rule complements and does not conflict with the TCEQ rules. The deletion of this wording would remove any regulation of the tankers transporting water destined for bottled and vended water facilities. The department feels this could cause confusion and would have an impact on health and safety. The department does agree that there is confusion on the definition of "drinking water." A definition of "drinking water" has been added in §229.81(c)(6).

Comment: Concerning §229.83, several commenters stated that microbiological standards stated in §229.84 allow for flexibility on disinfection methods for transport. These commenters also stated that §229.83 is in direct conflict with federal regulations governing disinfection byproducts in bottled water and deletion would remove the requirement to test for disinfection byproducts in the source water.

Response: The department disagrees with these comments. Section 229.84 states, "Bottled and vended water production including transporting... shall be conducted under such conditions and controls as are necessary to minimize the potential for microbiological contamination... These conditions and controls shall include the following. (1) bottled and vended water shall be subject to effective germicidal treatment...". The commenters are requesting the removal of the treatment for the hauling of the water prior to plant production. Section 229.84 does allow for flexibility; however, this flexibility does not allow for no treatment and, as stated in the comment, would conflict with rules already in place for the transportation of drinking water. TCEQ regulation 30 TAC §290.42(b)(1) already requires disinfection of water at the source in order to obtain source approval. The reference to TCEQ water hauling regulations ensures disinfection residual through transportation. As the disinfection begins at the source, the requirement for testing disinfection byproducts of source water would not be eliminated by removing this section. There are methods during the processing of bottled and vended water to reduce the chlorine to an acceptable level in the finished product. Therefore, this rule is not in direct conflict with federal regulations. No changes were made as a result of these comments.

Comment: Concerning §229.84(2) and (3), several commenters recommended a change to this section allowing water to be filled in lines used for other beverages. The comments include the addition of a requirement for a Clean in Place (CIP) system or the equivalent to sanitize the lines prior to use for bottled water. The commenters assert with this change that firms prepare and follow a Hazard Analysis Critical Control Point Plan (HACCP).

Response: The department disagrees with these comments. The current rules do not require HACCP for bottled water facilities. To require such a system to be put in place at this time would require extensive start-up and training expenses for bottled water facilities. Since the requirement for dedicated lines has been the regulation in Texas for the past 15 years, industry in Texas is in general compliance at this time. No changes were made as a result of these comments.

Comment: Concerning §229.85(b), a commenter stated, "It should be specified that this subsection (b) applies to bottled water only since vending machine owners do not necessarily have control over the bottles being provided for use at the machine."

Response: The department disagrees with this comment. Labeling is only required for food in packaged form. Since vending machines do not sell water already in packaged form, there is no requirement for labeling, therefore this section does not apply. No change was made as a result of this comment.

Comment: Concerning §229.85(b), several commenters request the deletion of the source labeling requirement. These commenters assert this is in violation of the Federal Food, Drug and Cosmetic Act (FFDCA) 403A, and the Commerce Clause of the U.S Constitution and, as such, is preempted.

Response: The department disagrees with these comments. Federal preemption requirements described in FFDCA 403A do not apply to geographic source labeling. Section 403(A)(1) of the FFDCA preempts the states and locals on the name of the food if it has a "standard of identity." FFDCA 403(A)(1) only preempts the names of these waters and what they stand for. That is what a "standard of identity" means. As long as the "standards of identity" for the various types of waters are in conformance (i.e. "Deionized Water," "Distilled Water," "Purified Water," etc.), states are permitted to have other types of labeling requirements for these waters, including source labeling. Requiring manufacturers to label the source of the product has nothing to do with a "standard of identity." The Commerce Clause of the U.S. Constitution does not apply in the matter of source labeling. Source labeling is required only for manufacturers of bottled water in the State of Texas. Manufacturers of bottled water in other states do not have to comply with these requirements. No change was made as a result of these comments.

Comment: Concerning §229.86(b)(3), two commenters did not agree that vending machines should be equipped with self-closing, tight-fitting doors. A commenter understood why this could be required for outdoor machines, but not for the machines kept indoors. The commenter suggested that a sneeze guard should be adequate indoors. Another commenter stated that machines with dispensing nozzles that are inaccessible when the machine in not dispensing water should be allowed.

Response: The department partially agrees with these comments. First, the purpose of this section of the regulation is to protect the dispenser from environmental contamination. Even if a vending machine is placed indoors, it may be in an area with high traffic or where it is exposed to handling or cross drafts. Therefore, the department believes the reason for the protective door requirement remains. The department does not believe a sneeze guard meets this requirement. Second, the department considers vending machines that have a design such that the dispensing nozzle is protected by a mechanism that isolates the dispenser by an internal door when not in use, to be in compliance with this portion of the regulation. No change was made as result of these comments.

Comment: Concerning §229.86(c)(2), a commenter recommended that if the water used in the vending machine is from an approved source per state and local government agencies, why should the language, "...and if required by the department, shall also be analyzed for other physical, chemical, or microbiological parameters..." be added.

Response: The department disagrees with this comment. The department recognizes that approved sources are required to maintain certain physical, chemical, or microbiological test results. The department includes this language in the regulation to allow the department to do testing in cases where water from a particular facility is believed to be contaminated. In the case of vended water, this language does not require any additional routine testing other than the monthly bacteriology testing. No change was made as a result of this comment.

Comment: Concerning §229.86(c)(2)(A), a commenter recommended that the "testing lab or agency should be responsible for reporting POSITIVE TEST results to Austin rather than the vendor."

Response: The department disagrees with this comment. The vendor is responsible for testing the water and ensuring it is safe to distribute to the public. The department feels it is the vendor's responsibility to notify the department if water from their facility tests positive. In addition, the department does not have statutory authority to require private laboratories to submit sample results. No change was made as result of this comment.

Comment: Concerning §229.86(c)(2)(A), a commenter suggested that positive tests results be e-mailed in place of faxing.

Response: The department agrees with this comment. An option for e-mailing the positive test results has been added to this section.

Comment: Concerning §229.86(c)(2)(B), several commenters requested deletion of this section.

Response: The department disagrees with these comments. The department was approached during the rulemaking process to reduce the sampling interval on water dispensing devices. The department does not have enough data to determine the public health impact of this request. This section was added with the intent of requiring vendors to submit all sample results for the period of one year from the date of the rule implementation to obtain the needed data. After one year, the requirement to submit negative sample results to the department will be removed. No change was made as a result of these comments.

Comment: Concerning §229.86(c)(2)(B), a commenter suggests that a single, complete file of results be e-mailed within five business days of the end of each month.

Response: The department agrees with this comment. The section has been changed to allow negative sample results for one month to be sent in bulk within ten calendar days of the last day of the month. In addition, an option was added for e-mailing the test results.

Comment: Concerning §229.86(c)(5)(A), a commenter suggested that if the water sample is positive for coliforms, the machine should be disinfected and then a second sample taken. Also, the commenter recommended changing the verbiage "...one sample per day during a four consecutive-day period..." to three days later after disinfecting based on the assumption that the vending machine is using a reverse osmosis membrane in the purifying process. If the water is not processed by reverse osmosis, then the original rule would apply. The commenter stated, "Where can E-coli come from in these machines?" Another commenter recommended a single retest within 24 hours of notification of a positive coliform, without shutting the machine down. Should the retest be positive, the machine must be shut down, the "entire" machine sanitized, then a sample of the vended water and the source water be submitted. Both samples must be coliform negative in order to allow the machine to return to operation. Another commenter stated, "The four consecutive-day requirement is difficult to achieve without significant and unnecessary down time. For example, if we are notified of a positive sample on a Wednesday, in order to meet the four consecutive-day requirement, we would have to wait to begin repeat sampling until the following Monday." The commenter suggested that the repeat sampling should be completed on the same day.

Response: The department agrees with these comments. Regarding §229.86(c)(5)(A) - (C), subparagraphs (A) and (B) were amended, and subparagraph (C) was added to reflect the wording recommended by the Association of Food and Drug Officials model regulation for vended water.

Comment: Concerning §229.86(c)(5)(B), one commenter suggested eliminating this section or changing it to state, "GO GET ANOTHER SAMPLE as long as it is in the time frame required, i.e. monthly." Another commenter recommended deleting this section. The commenter stated, "A repeat test from water vending machines that have initially tested positive for coliform bacteria is an appropriate monitor of sample collection techniques."

Response: The department agrees with these comments. Regarding §229.86(c)(5)(A) - (C), subparagraphs (A) and (B) were amended, and subparagraph (C) was added to reflect the wording recommended by the Association of Food and Drug Officials model regulation for vended water.

Comment: Concerning §229.86(c)(2), several comments were received regarding bacteriological sampling of each water dispensing device. The commenters stated that this is very costly, and if the source of the water is the same for each dispensing device, why have to test each device?

Response: The department agrees with these comments in that the wording in the definition for a water dispensing device is not clear. The definition has been changed in §229.81(c)(17) to specify a water dispensing device as each unit that filters and disinfects the water for dispensing. The department did not intend for the definition to include each faucet in the case of a vended water store. However, each vending machine is a separate water dispensing device.

Comment: Concerning §229.88(a) and (b), a commenter recommended clarifying this section. The commenter stated that "§229.88(a) seems to require a vended water operator to hold a certificate...; however, (b) appears to allow an operator to run a system as long as he/she is being guided by someone who holds a certificate..."

Response: The department disagrees with this comment. The rule actually states the opposite. Section 229.88(a) requires that a bottled water facility have full-time supervision by a certified bottled water operator. The record keeping and sampling requirement for bottled water are more involved than vending. Section 229.88(b) requires that vending operations have a certified bottled and vended water operator guide the operation and be available whenever there are problems. No change was made as a result of this comment.

Comment: Concerning §§229.88 - 229.89, several commenters requested the expansion of this section to include acceptance of the International Bottled Water Association's (IBWA) Certified Plant Operator Program. The commenters also requested that the department standardize its program to follow the IBWA's certifying program.

Response: The department disagrees with these comments. The Texas Health and Safety Code, Chapter 441, Regulation of Bottled and Vended Drinking Water requires the department to provide for the testing of the applicant and issue a certificate of competency. It does not give the department the authority to allow for third party testing or reciprocity of third party certifications. No change was made as a result of these comments.

Comment: Concerning §§229.88 - 229.89, a commenter requested a change in the section to include two separate tests, one for water vending operators and a second for bottled water operators.

Response: The department disagrees with the comment at this time. However, we are studying the issue for future consideration. No change was made as a result of this comment.

Comment: Concerning the legend for the proposed rules, one commenter stated, "A new legend hidden in the text before paragraph §229.83 is a violation of order, common sense, standard procedure, and usual purpose. Why publish proposed changes if they are going to be camouflaged?"

Response: The department disagrees with this comment. A department copy of the proposed rules was forwarded to the commenter which included a legend to determine the underlining of new rule text, brackets for rule text being deleted, and (No change.) for rule text not being changed. The legend is department format which is almost identical to the Texas Register's weekly publication of rules that explains and utilizes the underlining, brackets, and (No change.) language at the beginning of proposed rules. No change was made as a result of this comment.

The commenters were: Culligan Store Solutions, Danone Waters of North America, Glacier Water, International Bottled Water Association, National Automatic Merchandising Association. In addition, numerous individuals commented. All commenters were not against the rules in their entirety, however, expressed concerns, asked questions, and suggested recommendations for change as discussed in the summary of comments.

The department is making the following changes due to staff comments.

Change: Concerning §229.88, a period was added at the end of the first sentence of the rule text.

Change: Concerning §229.85(b), a statement was added to clarify that water processed by deionization, distillation, or reverse osmosis that renders the water "purified" as defined by §229.81(c)(11) are not required to declare the source of the water.

Subchapter F. PRODUCTION, PROCESSING, AND DISTRIBUTION OF BOTTLED AND VENDED DRINKING WATER USE

25 TAC §§229.81 - 229.91

The amendments and new rules are adopted under the Health and Safety Code, §431.241, which provides the department with the authority to adopt necessary regulations pursuant to the enforcement of Chapter 431; and §12.001, which provides the Texas Board of Health (board) with the authority to adopt rules for the performance of every duty imposed by law on the board, department, and the commissioner of health. The review of these rules implements Government Code, §2001.039.

§229.81.General Provisions.

(a) Purpose. These sections establish definitions and standards for the processing and bottling of drinking and vended water. The sections also will supplement §§229.181-229.184 of this title (relating to Licensure of Manufacturers of Food and Wholesale Distributors of Food - Including Good Manufacturing Practices) and federal regulations in Title 21, Code of Federal Regulations, Part 165 concerning standards of quality, and Part 129 concerning processing and bottling of bottled drinking water.

(b) Requirements for specific standardized beverages. The department adopts by reference Title 21 Code of Federal Regulations, §165.110 concerning the identity, nomenclature, other label statements and label declarations for both bottled and vended water, except as modified by the Texas Board of Health in §229.85(b) of this title (relating to Labeling and Advertising).

(c) Definitions. The following words and terms, when used in this chapter, shall pertain to both bottled and vended water and shall have the following meanings unless the context clearly indicates otherwise.

(1) Approved source (when used in reference to a plant's product water or operations water)--A source of water and the water therefrom, whether it be from a spring, artesian well, drilled well, municipal water supply, or any other source, that has been inspected and the water sampled, analyzed, and found to be of a safe and sanitary quality according to applicable laws and regulations of State and local government agencies having jurisdiction. The presence in the plant of current certificates or notifications of approval from the government agency or agencies having jurisdiction constitutes approval of the source and the water supply.

(2) Artesian water--Water from a well tapping a confined aquifer in which the water level stands at some height above the top of the aquifer is "artesian water" or "artesian well water."

(3) Bottled water--Water that is intended for human consumption and that is sealed in bottled or other containers with no added ingredients except that it may optionally contain safe and suitable antimicrobial agents.

(4) Department--Texas Department of Health.

(5) Distilled water--Water which has been produced by a process of distillation and meets the definition of purified water in the United States Pharmacopeia, 23rd revision, January 1, 1995, which the department adopts by reference. (Copies may be obtained from the United States Pharmacopial Convention, Inc., 12601 Twinbrook Parkway, Rockville, MD 20852).

(6) Drinking water--All water from the point of the approved source intended for the purpose of human consumption or which may be used in the preparation of foods or beverages.

(7) Fluoridated water--Water containing added fluoride.

(8) Ground water--Water from a subsurface saturated zone that is under a pressure equal to or greater than atmospheric pressure.

(9) Mineral water--Water containing not less than 250 parts per million (ppm) total dissolved solids (TDS), coming from a source tapped at one or more bore holes or springs, originating from a geologically or physically protected underground water source.

(10) Person--Includes individual, partnership, corporation, or association.

(11) Purified water--Water that has been produced by distillation, deionization, reverse osmosis, or other suitable processes and that meets the definition of "purified water" in the United States Pharmacopoeia, 23rd revision, January 1, 1995, which the department adopts by reference. (Copies may be obtained from the United States Pharmacopial Convention, Inc., 12601 Twinbrook Parkway, Rockville, MD 20852).

(12) Sparkling bottled water--Water that after treatment and possible replacement of carbon dioxide, contains the same amount of carbon dioxide that it had at emergence from the source.

(13) Spring water--Water derived from an underground formation from which water flows naturally to the surface of the earth.

(14) Sterile water or sterilized water--Water that meets requirements under "Sterility Tests" in the United States Pharmacopeia, 23rd revision, January 1, 1995, which the department adopts by reference. (Copies may be obtained from the United States Pharmacopial Convention, Inc., 12601 Twinbrook Parkway, Rockville, MD 20852).

(15) Vended water--Vended water is:

(A) water dispensed from any vending machine; or

(B) servings of water dispensed in bulk by any operator or consumer from any water dispensing device.

(16) Vending machine--Any self-service device which upon insertion of a coin, coins, or token, or upon receipt of payment by other means, dispenses servings of water in bulk, without the necessity of refilling the machine between each operation.

(17) Water dispensing device--Any water unit that dispenses water in bulk without the necessity of refilling the machine between operations. This term includes stores that are manned by an operator at all times in which consumers bring containers to be filled by the operator, facilities that are not manned by an operator and where consumers dispense their own water, and vending machines. A water dispensing device may have several dispensing faucets in the case of a store. However, each vending machine is considered a separate water dispensing device.

(18) Well water--Water taken from a hole bored, drilled, or otherwise constructed in the ground which taps the water of an aquifer.

(d) Other requirements for specific standardized beverages.

(1) Artesian water may be collected with the assistance of external force to enhance the natural underground pressure. On request, a bottler or vendor shall demonstrate to the department that the water level stands at some height above the top of the aquifer.

(2) For bottled water or drinking water, fluoride may be optionally added within the limitations established in 21 Code of Federal Regulations (CFR) Part 165.110(b)(4)(ii). Bottled water may be used as an ingredient in beverages (e.g., diluted juices, flavored bottled waters). It does not include those food ingredients that are declared in ingredient labeling as "water," "carbonated water," "disinfected water," "filtered water," "seltzer water," "soda water," "sparkling water," and "tonic water." The processing and bottling of bottled water shall comply with applicable regulations in 21 CFR, Part 129.

(3) For fluoridated water, the total fluoride content levels cannot exceed levels contained in 21 CFR 165.110(b)(4)(ii).

(4) Ground water must not be under the direct influence of surface water as defined in 40 CFR 141.2.

(5) Mineral water shall be distinguished from other types of water by its constant level and relative proportions of minerals and trace elements at the point of emergence from the source, due account being taken of the cycles of natural fluctuations. No minerals may be added to this water.

(6) Water processed by demineralization that meets the purified water definition may alternatively be called "demineralized water." Alternatively, water that has been processed by deionization may be called "deionized water," and water processed by distillation may be called "distilled water," and water that has been processed by reverse osmosis may be called "reverse osmosis water." Also, if the water has been processed by either of the previously listed methods the water may be called "(blank) drinking water," with the blank being filled in with one of the defined terms describing the method of processing.

(7) Spring water shall be collected only at the spring or through a bore hole tapping the underground formation feeding the spring. There shall be a natural force causing the water to flow to the surface through a natural orifice. The location of the spring shall be identified. Spring water collected with the use of an external force shall be from the same underground stratum as the spring, as shown be a measurable hydraulic connection using a hydrogeologically valid method between the bore hole and the natural spring, and shall have all the physical properties, before treatment, and be of the same composition and quality, as the water that flows naturally to the surface of the earth. If spring water is collected with the use of an external force, water must continue to flow naturally to the surface of the earth through the spring's natural orifice.

§229.85.Labeling and Advertising.

(a) Claims of medicinal and health-giving properties shall not be placed on labels and references shall not be made to bacterial purity or to laboratory examinations which may have been made by department laboratories.

(b) The label must state the source of all artesian water, spring water, mineral water, well water, or drinking water sold. Source refers to the point of origin. Examples: Singing Hollow Spring Water from Buck Hollow, Arkansas; drinking water obtained from Austin municipal water supply, Austin, Texas; well water from Bandera, Texas. Except that water processed by distillation, deionization, reverse osmosis, or other suitable process that alters the water's physical properties enabling it to meet the definition of purified as defined in §229.81(c)(11) of this title (relating to General Provisions) is not required to state the source. This exception only applies if all the water used in the finished product is processed to meet the definition of purified.

(c) Other label statements.

(1) If the Total Dissolved Solids (TDS) content of Mineral water is below 500 ppm, or if it is greater than 1,500 ppm, the statement "low mineral content" or the statement "high mineral content," respectively, shall appear on the principal display panel following the statement of identity in type size at least one-half the size of the statement of identity but in no case less that one-sixteenth of an inch. If the TDS of mineral water is between 500 and 1,500 ppm, no additional statement need appear.

(2) When the label or labeling of a bottled water product states or implies (e.g., through label statements or vignettes with reference to infants) that the bottled water is for use in feeding infants, and the product is not commercially sterile, the product label shall bear conspicuously and on the principal display panel the statement "Not sterile. Use as directed by physician or by labeling directions for use of infant formula."

§229.86.Processing of Vended Water.

(a) Water dispensing device requirements are as follows.

(1) Any device from which any operator or consumer dispenses servings of water in bulk shall comply with Title 21, Code of Federal Regulations (CFR), §129.40, Equipment and Procedures, and §165.110, Requirements for Specific Standardized Beverages. Except §129.40, the provision pertaining to the cleaning, sanitizing, filling, and capping or sealing of containers shall not apply to containers furnished by the consumer.

(2) Water dispensing devices shall:

(A) be designed and constructed to permit thorough cleaning, sanitization, and maintenance of all exterior and interior surfaces and component parts;

(B) have all parts and surfaces that come into contact with the water constructed of corrosion-resistant, and nonabsorbent material acceptable to the department and capable of withstanding repeated cleaning and sanitizing treatment;

(C) be designed so all treatment of the water by distillation, ion-exchange, filtration, ultraviolet light, reverse osmosis, mineral addition, or any other acceptable process is done in an effective manner;

(D) have an effective system of collection and handling of drip, spillage, and overflow of water;

(E) have a backflow prevention device approved by the department or local authority for all connections with the water supply;

(F) disinfect water by ultraviolet light or other method approved by the department immediately prior to delivery into the customer's container;

(G) comply with the American Water Works Association (AWWA) specifications for granular activated carbon if used in the treatment of potable water (AWWA B604-74);

(H) be maintained in a clean and sanitary condition; and

(I) be free from dirt and vermin.

(b) Vending machines, in addition to requirements in subsection (a) of this section, shall:

(1) have a recessed or guarded corrosion-resistant dispensing spout;

(2) be equipped with monitoring devices designed to shut down operation of the machine when the disinfection unit fails to function;

(3) be equipped with a self-closing, tight-fitting door on the vending compartment;

(4) be located in an area that can be maintained in clean condition and in a manner that avoids insect and rodent harborage; and

(5) display in a position clearly visible to customers, the following information:

(A) the name and address of the operator;

(B) a statement to the effect that the water is obtained from an approved source; and

(C) a local or toll-free telephone number that may be called for further information, service, or complaints.

(c) Service, sampling and records shall meet the following requirements.

(1) All parts and surfaces of the water dispensing device shall be maintained in clean condition by the vended water operator. The dispensing chamber and dispensing nozzle shall be cleaned and sanitized each time the device is serviced; whereas, all surfaces in contact with the vended water shall be maintained as a deposit free, visibly clean system. A record of cleaning and maintenance operations shall be kept by the operator for each water dispensing device for a period of two years and be available for inspection upon request.

(2) The vended water from each water dispensing device shall have a bacteriological analysis conducted a minimum of once every month and if required by the department, shall also be analyzed for other physical, chemical, or microbiological parameters.

(A) Sample results reported as coliform positive or unsuitable for analysis shall be submitted by facsimile to the department within 24 hours of receipt of the sample results from a laboratory acceptable to the department. The person shall submit the results to the Manufactured Foods Division by facsimile at (512) 719-0263, or by e-mail at Feedback.MFD@tdh.state.tx.us.

(B) Sample results reported as coliform negative shall be submitted to the department within ten calendar days of the last day of each month in which the sample(s) were taken. The person shall send the results to the department via mail to the following address: Manufactured Foods Division, Bottled and Vended Water Program, 1100 West 49th Street, Austin, Texas 78756, or via e-mail to Feedback.MFD@tdh.state.tx.us.

(C) The person operating a water dispensing device shall maintain the original of all sample results for a period of two years. The analyses shall be performed by a laboratory acceptable to the department to perform drinking water analyses, and a copy of the analysis shall be available for review and copying during inspections.

(3) Each person operating a water dispensing device shall maintain a written maintenance program. The written maintenance program shall include written servicing instructions for the operator; technical manuals for the machine and water treatment appurtenances involved; and records of service. The written maintenance program shall be available for inspection by the department.

(4) The vended water operator shall clean and perform servicing of the water vending machine a minimum of once per month.

(A) More frequent cleaning and servicing may be required to maintain sanitation or as required by the manufacturer of the equipment.

(B) Sampling results of positive coliform or unsuitable for analysis are indications that servicing of machine may be required at a higher frequency than once per month as detailed in paragraph (5) of this subsection.

(5) Methods of testing for maximum contaminant levels (MCLs) for microbiological contaminants in water dispensed from water dispensing devices shall be performed as follows:

(A) if any sample collected from a water dispensing device is determined to be unsatisfactory for any reason (i.e. coliform positive or unsuitable for analysis), the operator shall notify the department in accordance with paragraph (2)(A) of this subsection; and

(B) the water dispensing device shall be cleaned, sanitized and resampled immediately. Until the sample results are known the machine shall remain out of service; and

(C) if after being cleaned and sanitized, the vended water is determined to be unsatisfactory, the machine shall remain out of service until the source of the contamination has been located and corrected and a negative sample obtained. The negative sample result shall be maintained in accordance with paragraph (2)(C) of this subsection.

§229.88.Certificates of Competency.

A person may not furnish bottled or vended water to the public or for distribution to the public unless the bottled or vended water operator holds a certificate of competency under this chapter.

(1) A person may not furnish bottled water to the public or for distribution to the public unless the processing, bottling, and distribution of the bottled water is performed by or under the full-time supervision of a bottled and vended water operator who holds a certificate of competency under this chapter.

(2) A person may not furnish vended water to the public or for distribution to the public unless the processing, bottling, and distribution of the vended water is performed by or under the guidance and control of a bottled and vended water operator who holds a certificate of competency under this chapter.

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 June 13, 2003.

TRD-200303571

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


Subchapter F. PRODUCTION, PROCESSING, AND DISTRIBUTION OF BOTTLED AND VENDED DRINKING WATER

25 TAC §229.83, §229.86

The repeals are adopted under the Health and Safety Code, §431.241, which provides the department with the authority to adopt necessary regulations pursuant to the enforcement of Chapter 431; and §12.001, which provides the Texas Board of Health (board) with the authority to adopt rules for the performance of every duty imposed by law on the board, department, and the commissioner of health. The review of these rules implements Government Code, §2001.039.

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 June 13, 2003.

TRD-200303572

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: January 31, 2003

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


Chapter 295. OCCUPATIONAL HEALTH

Subchapter A. HAZARD COMMUNICATION

25 TAC §§295.1 - 295.9, 295.11 - 295.13

The Texas Department of Health (department) adopts amendments to §§295.1-295.9 and 295.11-295.13, concerning the requirements for public employers (tax base-supported employers and agencies created by state law) to take actions to protect their employees from hazardous chemicals. Section 295.12 is adopted with changes to the proposed text as published in the March 14, 2003, issue of the Texas Register (28 TexReg 2242). Sections 295.1-295.9, 295.11, and 295.13 are adopted without changes and, therefore, the sections will not be republished.

Government Code, §2001.039, 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 295.1-295.9 and 295.11-295.13 have been reviewed and the department has determined that reasons for adopting the sections continue to exist.

A notice of intention to review rules was published for §§295.1-295.9 and 295.11-295.13 in the January 24, 2003, issue of the Texas Register (28 TexReg 761) for the state agency review of rules in accordance with Government Code, §2001.039. No comments were received by the department on these sections.

The sections ensure that public employers will have access to new compliance assistance documents that have been developed by the department and more timely access to hazardous chemical information contained in material safety data sheets. In addition, the sections clarify responsibilities of employers under the Health and Safety Code, Chapter 502, and clarify how the department will enforce the Chapter.

The amendment to §295.1 eliminates an outdated effective date established in the previous rule. The amendments to §295.2 add one new definition, delete one definition, and amend five others to clarify the intent of the rules. The amendments to §295.3 reflect a change in the Division name and provide the program's toll free telephone number. The amendments to §295.4 clarify that a model workplace chemical form is now available to employers from the department. The amendment to §295.5 reduces the amount of time that a hazardous chemical manufacturer or distributor will have to provide a material safety data sheet (MSDS) to an employer after receipt of the employer's written request for this document. The amendments to §295.6 specify the federal citation for the standard that manufacturers and distributors of hazardous chemicals must meet in providing container labels and clarify that employers are responsible for re-labeling a hazardous chemical container when the label is missing. The amendments to §295.7 notify employers of the availability of a model written hazard communication program from the department and clarify that this model is a recommended format. The amendments to §295.8 clarify that an employer's refusal to allow an inspection is a violation of both the Health and Safety Code, Chapter 502, and the rules. The amendments to §295.9 reflect the change in the Division name. The amendments to §295.11 clarify that an employer's written response to the department's written notice of proposed administrative penalties must conform to at least one of the options listed in the written notice. The amendments to §295.11 also clarify that a hazardous chemical manufacturer's or distributor's failure to provide an MSDS within three business days of an employer's written request is an example of a severe violation of Chapter 502. The amendments to §295.12 notify employers of the availability of the department's electronic and Spanish versions of the workplace notice. The amendments to §295.13 clarify that nurses, as well as physicians, may obtain trade secret information for a hazardous chemical when that information is needed for medical treatment during an emergency.

No comments were received on the proposal during the comment period; however, the department is making the following minor change due to staff comments to clarify the intent and improve the accuracy of the section.

Change: Concerning §295.12(a), the wording of the workplace notice was inadvertently omitted in the proposed amendments. The department is providing an updated version of the workplace notice that provides the new program mailing address.

The amendments are adopted under the Health and Safety Code, §502.019, which provides the Texas Board of Health (board) with the authority to adopt necessary rules to administer and enforce Chapter 502; and §12.001, which 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. The review of these rules implements Government Code, §2001.039.

§295.12.Employee Notice; Rights of Employees.

(a) Employers covered by the Act must post and maintain workplace notices specified in this section. The wording of the required workplace notice may be changed by the commissioner as needed.

Figure: 25 TAC §295.12(a) (.pdf format)

(b) The workplace notice shall measure at least 8-1/2 by 11 inches and be typed, typeset, or mechanically produced with lettering that is clearly legible. The letters shall not be smaller than 12 characters per inch. The words "NOTICE TO EMPLOYEES" shall be in bold capital letters at least 1/2 inch high. Other words spelled in capital letters in the sample notice shall be reproduced in capital letters.

(c) A current version of the workplace notice shall be clearly posted and unobstructed at all locations in the workplace where notices are normally posted, and at least one location in each workplace.

(d) An employer may add information to the workplace notice as long as the wording required by this section is included. Employers may add the name and telephone number of the employer's safety or environmental health officer to the bottom of the workplace notice in order to facilitate communication within the workplace.

(e) To assist employers in providing the workplace notice information, the department shall make original copies of the workplace notice available for photocopying by employers. The department shall also make an electronic version of the workplace notice available to employers. A Spanish translation of the workplace notice is available from the department.

(f) Employees have guaranteed rights to accessing the workplace chemical list and MSDSs and to receive training under the Act.

(g) Employees have a guaranteed right to receive appropriate personal protective equipment (PPE) from their employer. Employers shall provide appropriate PPE to employees who may be exposed to hazardous chemicals in their workplace. The employer shall provide training to employees regarding how to maintain and store PPE appropriately to ensure that contamination does not occur.

(h) An employee shall not be disciplined, harassed, or discriminated against by an employer for filing complaints, assisting inspectors of the department, participating in proceedings related to the Act, or exercising any rights under the Act.

(i) Employees cannot waive their rights under the Act. A request or requirement for such a waiver by an employer violates the Act.

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 June 13, 2003.

TRD-200303578

Susan K. Steeg

General Counsel

Texas Department of Health

Effective date: July 3, 2003

Proposal publication date: March 14, 2003

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


Part 16. TEXAS HEALTH CARE INFORMATION COUNCIL

Chapter 1301. HEALTH CARE INFORMATION

Subchapter A. COLLECTION AND RELEASE OF HOSPITAL DISCHARGE DATA

25 TAC §§1301.11, 1301.12, 1301.14 - 1301.19

The Texas Health Care Information Council (Council) adopts the review of §§1301.11-1301.20, pursuant to the Government Code, §2001.039, which is being published elsewhere in this issue of the Texas Register . The proposed review was published in the February 21, 2003 issue of the Texas Register (28 TexReg 1663). The Council also adopts amendments to §§1301.11, 1301.12, 1301.14, 1301.15, 1301.16, 1301.17, 1301.18, and 1301.19 as published in March 21, 2003 issue of the Texas Register (28 TexReg 2451) relating to the change in billing claim format as required by the Public Law 104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA), and providing access to more Public Use Data elements regarding external causes of injury, charges, service utilization, and to clarify language.

Sections 1301.11, 1301.12, 1301.14, 1301.15, 1301.16, 1301.17, and 1301.18, are adopted without changes to the proposed text published in the March 21, 2003, issue of the Texas Register (28 TexReg 2451) and will not be republished. Section 1301.19 is adopted with changes to the proposed text.

In §1301.19(c)(1) the proposed data segment for the race code has been modified, by removing the "-3" because it is not appropriate for the ANSI 837 Institutional Guide format translator used at Texas Health Information Network (THIN). The DMG05 segment will continue to be the location for the race code. Also the five-digit codes for race are withdrawn and the previous one-digit codes will be used.

In §1301.19(c)(2) the proposed five-digit ethnicity codes are withdrawn.

In §1301.19(e)(1-4 and 6-11) the word "in" and the proposed American National Standards Institute's Accredited Standards Committee X12N Form 837 Health Care Institutional Claims Guide (ANSI 837 Institutional Guide) data location language (Loop and Data segment) are removed.

In §1301.19(e)(5) the word "reported" replaces "placed in," and the proposed ANSI 837 Institutional Guide data location language (Loop and Data segment) is removed.

The Council received no comments relating to the rule review. The Council received comments from the Texas Hospital Association (THA) and the Dallas-Fort Worth Hospital Council (DFWHC) regarding the proposed amendments.

The agency's reason for adopting the rules contained in this chapter continues to exist.

TEXAS HOSPITAL ASSOCIATION'S AND DALLAS FORT WORTH HOSPITAL COUNCIL'S COMMENTS AND THE COUNCIL'S RESPONSES TO THE PROPOSED AMENDMENTS PUBLISHED IN THE MARCH 21, 2003 ISSUE OF THE TEXAS REGISTER (28 TexReg 2451).

PREAMBLE

Each commenter said the cost estimates in the preamble were substantially lower than hospitals reported they would expend to comply with Council rule requirements. The Council cost estimates are based on the anticipated additional costs to hospitals' billing systems. Some hospitals have indicated they would elect to create data extract systems rather than modify their billing systems. If they choose this option the costs will likely be significantly higher. The Council's estimates are based on the belief that all hospitals required to report are required to comply with HIPAA for billing claims, therefore the hospital must have a process to collect and submit claims from their internal system and it must be in the format of ANSI ASC X12N Form 837 Institutional Guide and then they must modify their systems to capture and submit Race and Ethnicity. The submission of additional E-codes in the ANSI Institutional Guide format only requires submitting the additional data elements with the proper qualifying code. Section §§2001.024 (a)(4)(A) and 2001.024 (a)(5)(B), Government Code requires that the fiscal note estimate additional costs associated with implementing the proposed amendments and the probable economic cost to persons required to comply with the rule. The fiscal note is not required to anticipate costs for providing optional features based on the amendments, such as building a separate data system to submit data to the Council.

§1301.19(a)

One commenter stated, "It needs to be clear in the documentation that THCIC will take the HIPAA 4010 with the additional Race/Ethnicity and E-Codes, and ignore additional data." The Council disagrees and believes that §§1301.19(a) and (c) clearly indicates the correct format and additional data elements and location of those elements to submit data to the Council.

The same commenter also made the following recommendation that "THCIC consider following the Federal Government and CMS timelines for changing file specifications. Language needs to be added to rules to reflect the timelines that THCIC would be following in regards to file specifications." The Council disagrees with the commenter in that following that recommendation would require the hospitals to be submitting in the THCIC compliant version of the ANSI 837 Institutional data format on October 16, 2003 and it is preferable for the Council to initiate changes on a calendar quarter basis so that data for the full year is in the same format.

§1301.19(c)(3)

One commenter stated and recommended the following statement; "E codes are not collected and reported in a standard format by hospitals, and likely to have data integrity issues for reporting quality and patient safety. We recommend that additional E codes not be included in the minimum dataset." The Council disagrees with the commenter's recommendation. E-codes are currently collected by hospitals and reported in standard formats. A review of the fourth quarter 2001 and first quarter 2002 Public Use Data Files showed that for each quarter more than 330 different reporting facilities submitted a total of more than 51,000 discharges with one or more E-codes. Therefore the Council believes that hospitals are collecting and reporting E-codes in a standard format. The Council cannot adequately address hospital inter-reliability of reporting.

§1301.19(e)

One commenter stated and recommended the following, "The rules are tightly tied to data specifications, we suggest either moving away from this language and listing the minimum data required to be in compliance". The Council agrees with the commenter and has removed the ANSI X12N Institutional Guide terminology loops and data segments and data elements and clarified the language regarding §1301.19(e).

Timeline for Transition

The Council received comments from both commenters regarding the transition timeline even though the Council did address the transition timeline from the UB92 to the ANSI 837 Institutional Guide in the proposed amendments.

The amendments are adopted under the Health and Safety Code, §§108.006 and 108.009. The Council interprets §108.006 as authorizing it to adopt rules necessary to carry out Chapter 108, including rules concerning data dissemination requirements. The Council interprets §108.009 as authorizing the Council to adopt rules regarding the collection of data from hospitals in uniform submission formats so incoming data will be substantially valid, consistent, compatible and manageable.

Health and Safety Code, §§108.006, 108.009, 108.011, 108.012, and 108.013 are affected by these amendments.

§1301.19.Discharge Reports--Records, Data Fields and Codes.

(a) Hospitals that have not obtained an exemption letter authorized by §1301.15 of this title (relating to Exemptions from Filing) shall submit discharge reports, electronically in the file format for inpatient hospital bills defined by the American National Standards Institute (ANSI), commonly known as the ANSI ASC X12N form 837 Health Care Claims (ANSI 837 Institutional Guide) transaction for institutional claims and/or encounters. ANSI updates this format from time to time by issuing new versions.

(b) The Council will make detailed specifications for these data elements available to submitters and to the public.

(c) In addition to the data elements contained in the ANSI 837 Institutional Guide, the Council has defined the following data elements shown in this subsection and as defined the location in the ANSI 837 Institutional Guide where each element is to be reported. Data element content, format and locations may change as federal and state legislative requirements change in regards to Public Law 104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA) is implemented.

(1) Patient race - This data element shall be reported at Loop 2010BA or 2010CA in the segment DMG05 as a numeric value. Acceptable codes are 1 = American Indian/Eskimo/ Aleut, 2 = Asian or, Pacific Islander, 3 =Black , 4 = White and 5 = Other Race. In order to obtain this data, the hospital staff retrieves the patient's response from a written form or asks the patient, or the person speaking for the patient to classify the patient. If the patient, or person speaking for the patient, declines to answer, the hospital staff is to use its best judgment to make the correct classification based on available data.

(2) Patient ethnicity - This data element shall be reported at Loop 2300 in the segment NTE02 as a numeric value. Acceptable codes are 1 = Hispanic or Latino Origin and 2 = Not of Hispanic or Latino Origin. In order to obtain this data, the hospital staff retrieves the patient's response from a written form or asks the patient, or the person speaking for the patient to classify the patient. If the patient, or person speaking for the patient, declines to answer, the hospital staff is to use its best judgment to make the correct classification based on available data.

(3) Other E-codes - These additional E-codes (maximum of nine (9)) shall be reported in the following ANSI X12N Form 837 locations: Loop 2300, segments, HI05-2, HI06-2, HI07-2, HI08-2, HI09-2, HI10-2, HI11-2 and HI12-2. (The first E-code is reported in Loop 2300 segment HI04-2).

(4) THCIC Identification Number - This data element shall be submitted in data segment REF02 of Loop 2010AA or Loop 2010AB (in the Pay-to provider reported provided the services), or Loop 2310E (if the Service Facility Provider is submitted).

(d) Hospitals shall submit the required minimum data set for all patients for which a discharge claim is required by this title. The required minimum data set includes the following data elements as listed in this subsection:

(1) Patient Name

(A) Patient Last Name

(B) Patient First Name

(C) Patient Middle Initial

(2) Patient Address

(A) Patient Address Line 1

(B) Patient Address Line 2 (if applicable)

(C) Patient City

(D) Patient State

(E) Patient ZIP

(F) Patient Country (if address is not in United States of America, or one of its territories)

(3) Patient Birth Date

(4) Patient Sex

(5) Patient Race

(6) Patient Ethnicity

(7) Patient Social Security Number

(8) Patient Account Number

(9) Patient Medical Record Number

(10) Claim Filing Indicator Code (Payer Source - primary and secondary (if applicable for secondary payer source)

(11) Payer Name - Primary and secondary (if applicable, for both)

(12) National Plan Identifier - for primary and secondary (if applicable) payers (National Health Plan Identification number, if applicable and when assigned by the Federal Government)

(13) Type of Bill

(14) Statement Dates (replaces Statement From and Statement Thru dates)

(15) Admission / Start of Care

(A) Admission / Start of Care Date

(B) Admission / Start of Care Hour

(16) Admission Type

(17) Admission Source

(18) Patient (Discharge) Status

(19) Patient Discharge Hour

(20) Principal Diagnosis

(21) Admitting Diagnosis

(22) Principle External Cause of Injury (E-Code)

(23) Other Diagnosis Codes - up to 24 occurrences (all applicable)

(24) External Cause Of Injury (E-Code) - up to 9 occurrences (if applicable)

(25) Principal Procedure Code (if applicable)

(26) Principal Procedure Date (if applicable)

(27) Other Procedure Codes - up to 24 occurrences (if applicable)

(28) Other Procedure Dates - up to 24 occurrences (if applicable)

(29) Occurrence Span Code - up to 24 occurrences (if applicable)

(30) Occurrence Span Code Associated Date - up to 24 occurrences (if applicable)

(31) Occurrence Code - up to 24 occurrences (if applicable)

(32) Occurrence Code Associated Date - up to 24 occurrences (if applicable)

(33) Value Code - up to 24 occurrences (if applicable)

(34) Value Code Associated Amount - up to 24 occurrences (if applicable)

(35) Condition Code - up to 24 occurrences (if applicable)

(36) Attending Physician or Attending Practitioner Name

(A) Attending Practitioner Last Name

(B) Attending Practitioner First Name

(C) Attending Practitioner Middle Initial

(37) Attending Practitioner Primary Identifier (National Provider Identifier, when HIPAA rule is implemented)

(38) Attending Practitioner Secondary Identifier (Texas state license number or UPIN)

(39) Operating Physician or Other Practitioner Name (if applicable)

(A) Operating Physician or Other Practitioner Last Name

(B) Operating Physician or Other Practitioner First Name

(C) Operating Physician or Other Practitioner Middle Initial

(40) Operating Physician or Other Practitioner Primary Identifier (National Provider Identifier, when HIPAA rule is implemented)

(41) Operating Physician or Other Practitioner Secondary Identifier (Texas state license number or UPIN)

(42) Total Claim Charges

(43) Revenue Service Line Details (up to 999 service lines) (all applicable)

(A) Revenue Code

(B) Procedure Code

(C) HCPCS/HIPPS Procedure Modifier 1

(D) HCPCS/HIPPS Procedure Modifier 2

(E) HCPCS/HIPPS Procedure Modifier 3

(F) HCPCS/HIPPS Procedure Modifier 4

(G) Charge Amount

(H) Unit Code

(I) Unit Quantity

(J) Unit Rate

(K) Non-covered Charge Amount

(44) Service Provider Name

(45) Service Provider Primary Identifier - Provider Federal Tax ID (EIN) or National Provider Identifier (when HIPAA rule is implemented)

(46) Service Provider Address

(A) Service Provider Address Line 1

(B) Service Provider Address Line 2 (if applicable)

(C) Service Provider City

(D) Service Provider State

(E) Service Provider ZIP

(47) Service Provider Secondary Identifier - THCIC 6-digit Hospital ID assigned to each facility

(e) For patients which are covered by 42 USC 290dd-2 and 42 CFR Part 2.1, the hospital shall submit the following patient identifying information or default values in the specified Record and Field locations as required by subsection (a) of this section:

(1) Patient Account Number - This alphanumeric patient control number shall be reported. This number is unique to the institution and episode of care and will be used by the hospital to review and certify data.

(2) Last Name - The patient's last name shall be removed and replaced with "Doe".

(3) First Name - The patient's first name shall be removed and replaced with "Jane" if female, or "John" if male, and can include a sequential number (e.g., John1, John2, John3... etc.).

(4) Middle Initial - The patient's middle initial shall be removed and left blank (space filled).

(5) Date of Birth - The patient's date of birth shall be reported.

(6) Address - The patient's residence address shall be removed and replaced with the hospital's street address.

(7) City - The patient's city of residence shall be reported.

(8) State - The patient's state of residence shall be reported.

(9) ZIP Code - The patient's ZIP code of residence shall be reported.

(10) Medical Record Number - The patient's medical record number shall be removed and replaced with "99999" and reported.

(11) Social Security Number - The patient's Social Security Number shall be removed and replaced with "999999999".

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 June 16, 2003.

TRD-200303673

Jim Loyd

Executive Director

Texas Health Care Information Council

Effective date: July 6, 2003

Proposal publication date: March 21, 2003

For further information, please call: (512) 482-3320