Part 1.
TEXAS DEPARTMENT OF HEALTH
Chapter 3.
MEMORANDUMS OF UNDERSTANDING WITH OTHER STATE AGENCIES
25 TAC §3.21
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Department of Health or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Department of Health (department) proposes
the repeal of §3.21, concerning a memorandum of understanding between
the department and the Department of Protective and Regulatory Services (DPRS)
for elderly abuse.
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 §3.21 and has determined that the reason for adopting the
section no longer exists. Human Resources Code, §48.022, was renumbered
to §48.303 and no longer applies to the department because it places
the burden of any memorandum of understanding on DPRS instead of the department.
The former DPRS rule (40 TAC §736.506) pertaining to the Memorandum of
Understanding was repealed effective March 1, 2001, and was published in the
The department published a Notice of Intention to Review for §3.21
in the
Texas Register
on September 4, 1998
(23 TexReg 9077). No comments were received due to publication of this notice.
Susan K. Steeg, General Counsel, has determined that for each year of the
first five years the repeal of this section is in effect, there will be no
fiscal impact on state or local government.
Ms. Steeg has determined that for each year of the first five years the
repeal of §3.21 is in effect, the public benefit anticipated as a result
of the repeal will be to eliminate a rule that is unnecessary because there
is no statutory requirement for the rule. There will be no cost effects on
micro-businesses or small businesses. This was determined by interpretation
of the rules that micro-businesses or small businesses will not be required
to alter their business practices as a result of the proposed repeal of this
rule. There are no economic costs to persons who may be affected by the proposed
repeal of this rule. There is no anticipated impact on local employment.
Comments on the proposal may be submitted to Robin Carter, Legal Assistant,
Office of General Counsel, Texas Department of Health, 1100 West 49th Street,
Austin, Texas 78756, (512) 458-7236 or by email at the following address:
robin.carter@tdh.state.tx.us. Comments will be accepted for 30 days following
publication of this proposal in the
Texas Register
.
The repeal is proposed under Health and Safety Code, §12.001,
which provides the Texas Board of Health (board) with authority to adopt rules
to implement every duty imposed by law on the board, the department and the
commissioner.
The repeal of this section implements Government Code, §2001.039.
§3.21.Memorandum of Understanding with Department of Protective and Regulatory Services Concerning Elderly Abuse.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302858
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
Subchapter B. PROSTATE CANCER ADVISORY COMMITTEE
25 TAC §91.21
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Department of Health or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Department of Health (department) proposes
the repeal of §91.21, concerning the Prostate Cancer Advisory Committee
(committee). The committee has provided advice to the Texas Board of Health
(board) and the department on strategies for educating the public on the health
benefits of the early detection, prevention, and treatment of prostate cancer.
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 2002, the board established a rule relating to the Prostate Cancer Advisory
Committee. The rule states that the committee will automatically be abolished
on September 1, 2003. The board has now reviewed and evaluated the committee
and has determined that the committee should be abolished on that date. Issues
relating to the type of advice previously provided by the committee may be
better addressed through the establishment of ad hoc workgroups.
Jacquelyn McDonald, Director, Office of the Board of Health, has determined
that for each year of the first five years the repeal is in effect, there
will be no fiscal implications for state or local governments as a result
of enforcing or administering this section since the section will no longer
exist.
Ms. McDonald has also determined that for each year of the first five years
the repeal is in effect, the public benefit anticipated as a result of repealing
the section will be increased flexibility and breadth in obtaining input on
prostate cancer education. There will be no effect on micro-businesses or
small businesses. This was determined by interpretation of the rule that small
businesses and micro-businesses will not be required to alter their business
practices in order to comply with the repeal of the rule as proposed. There
is no economic costs to persons as a result of this repeal. There will be
no effect on local employment.
Comments may be submitted to Jacquelyn McDonald, Director, Office of the
Board of Health, Texas Department of Health, 1100 West 49th Street, Austin,
Texas 78756, (512) 458-7484. Comments on the proposed section will be accepted
for 30 days following publication in the
Texas Register
.
The repeal is proposed under the Health and Safety Code, §11.016,
which allows the board to establish advisory committees; the Government Code,
Chapter 2110, which sets standards for the evaluation of advisory committees
by the agencies for which they function; and the Health and Safety Code, §12.001,
which provides the board with authority to adopt rules for the performance
of every duty imposed by law upon the board, the department, and the commissioner
of health.
The proposed repeal affects the Health and Safety Code, Chapters 11, 12,
and 91; and the Government Code, Chapter 2110.
§91.21.The Prostate Cancer Advisory Committee.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302863
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
Subchapter C. TEXAS HIV MEDICATION PROGRAM
1.
GENERAL PROVISIONS
The Texas Department of Health (department) proposes amendments to §§98.101
- 98.106, repeal of §§98.107 - 98.117, and new §§98.107
- 98.119, concerning the Texas HIV Medication Program.
Specifically, the department is requesting the ability to implement cost
containment measures, outlined in the rules, as needed to address a substantial
budgetary shortfall in the program and to ensure that the department is able
to continue delivering program services to individuals infected with the human
immunodeficiency virus (HIV).
An amendment to §98.101 reflects minor changes in wording regarding
the purpose of the program. An amendment to §98.102 adds a definition
for Eligible Metropolitan Area and deletes a definition for the HIV H.O.P.E.
(Health Options to Promote Employment) Project. An amendment to §98.103
adds a provision that the program will not approve the dispensing of medication(s)
in excess of a 30-day supply. An amendment to §98.104 includes a minor
change for clarity. An amendment to §98.105 establishes the program's
priority to serve eligible women and infants, and to children younger than
18 years of age. An amendment to §98.106 outlines the general eligibility
criteria for participation in the program. New §98.107 establishes medical
eligibility criteria for the program. New §98.108 establishes residency
eligibility criteria for the program. New §98.109 establishes financial
eligibility criteria for the program. New §98.110 establishes the process
for applying to the program. New §98.111 establishes how the program
will maintain confidentiality of individuals who apply and receive services
from the program. New §98.112 establishes how the program will distribute
medications. New §98.113 establishes that the program will only deliver
services through pharmacies approved by the program. New §98.114 establishes
that pharmacies participating in the program may collect a co-payment for
each prescription dispensed and that the program will pay the dispensing fees
for Medicaid clients. New §98.115 establishes cost containment measures,
such as, cease enrollment of new clients who reside in eligible metropolitan
areas; cease enrollment of all new clients; implement medical criteria; charge
client fees; and/or have the lowest eligibility criteria not lower than 125%
of federal poverty level. New §98.116 establishes that the department
may impose charges on clients enrolled in the program using a sliding fee
scale and defines how the program will collect the fees. New §98.117
establishes the criteria for denial of applications to the program and termination
of client benefits. New §98.118 establishes appeal procedures when a
person wishes to dispute the program's decision concerning either eligibility
or funding. New §98.119 establishes that the department is not required
to offer an opportunity to dispute the decision to deny or terminate client
status when the department's actions result from the exhaustion of funds.
Government Code, §2001.039, requires that each state agency review
and consider for re-adoption each rule adopted by that agency pursuant to
Government Code, Chapter 2001 (Administrative Procedure Act). The section
numbers have been reviewed and the department has determined that reasons
for adopting the sections continue to exist; however, §§98.101 -
98.106 are being amended; §§98.107 - 98.117 are being repealed;
and §§98.107 - 98.119 are being proposed as new.
The department published a Notice of Intention to Review the sections as
required by Government Code, §2001.039, in the
Texas Register
on April 28, 2000, (25 TexReg 3801). No comments were
received due to the publication of this notice.
Janet D. Lawson, M.D., Acting Chief, Bureau of HIV and STD Prevention,
has determined that for each year of the first five years the sections are
in effect there will be fiscal implications as a result of administering the
rules as proposed. In the event that the temporary cost-containment measure
of cost-sharing premiums is initiated because of budget shortfalls, the effect
on state government will be an estimated increase in revenue to the state
of approximately $200,000 to $400,000 per year as a result of proposed cost
sharing premiums. It is estimated that costs to the state to administer the
new provisions will be $100,000 per year. Other revenue will be used to offset
the program costs; the net effect will be no fiscal impact to the state or
local government.
Janet D. Lawson, M.D., Acting Chief, Bureau of HIV and STD Prevention,
has also determined that for each year of the first five years the sections
are in effect, the public benefits anticipated as a result of enforcing or
administering the sections will maintain the delivery of the program to eligible
persons with HIV disease. There will be no effect on micro-businesses or small
businesses because they do not participate in any component of the program.
There are anticipated economic costs to clients enrolled in the program due
to the proposed cost sharing premiums. If the program ceases enrollment to
new clients or to clients living in Title I Eligible Metropolitan Area Planning
Bodies, costs may be incurred to local communities. There is no anticipated
impact on local employment.
Comments on the proposal my be submitted to Janet D. Lawson, M.D., Acting
Chief, Bureau of HIV and STD Prevention, Texas Department of Health, 1100
West 49th Street, Austin, Texas 78756-3199, (512) 490-2505. Comments will
be accepted for 30 days following publication of this proposal in the
25 TAC §§98.101 - 98.119
The amendments and new sections are proposed under the Health
and Safety Code, §85.063, which provides the board authority to adopt
rules necessary to establish eligibility guidelines to ensure the most appropriate
distribution of funds; and §12.001, which provides the Texas Board of
Health (board) with the authority to adopt rules for the performance of each
duty imposed by law on the board, the department, and the commissioner of
health.
The amendments and new sections affect the Health and Safety Code, Chapters
12 and 85.
§98.101.Purpose.
This subchapter establishes procedures and eligibility guidelines
for
[
§98.102.Definitions.
The following words and terms, when used in this subchapter, shall
have the following meanings, unless the context clearly indicates otherwise.
(1)-(5)
(No change.)
(6)
Eligible Metropolitan Area--a metropolitan
area that is eligible to receive direct federal funding as defined in 42 U.S.C.
300ff-17.
(7)
[
(8)
[
(9)
[
(10)
[
[(10)
Project--The HIV H.O.P.E. (Health Options
to Promote Employment) Project as outlined in Rider 54 to the Texas Department
of Health portion of the General Appropriations Act of the 75th Legislature.]
(11)-(12)
(No change.)
§98.103.Medication Coverage.
(a)
(No change.)
(b)
The program will not approve the dispensing
of medication(s) in excess of a 30-day supply.
(c)
[
§98.104.Nondiscrimination.
The department operates
this
[
§98.105.Priority.
The department shall give priority to participation in the program
to eligible women and infants, and to children below the age of
[
§98.106. General Eligibility Criteria .
A person is eligible to participate in the program if the person applying
to the program:
(1)
[
(2)
meets the
residency eligibility
criteria
in §98.108
[
(3)
meets the financial eligibility criteria in §98.109
of this title (relating to Financial Eligibility Criteria)
[
(4)
requests assistance in obtaining
only
medications
provided under
[
(5)
submits a completed application for assistance as
described in §98.110 of this title (relating to Application Process)
[
§98.107.Medical Eligibility Criteria.
(a)
A person is medically eligible to participate in the program
if the person applying to the program:
(1)
provides evidence that the applicant has a diagnosis from
a licensed physician of HIV disease; and
(2)
is under the care of a physician licensed to practice in
Texas who prescribes the medications(s).
(b)
Exceptions to the Medical Eligibility Criteria can be made
at the discretion of the Chief of the Bureau of HIV and STD Prevention.
§98.108.Residency Eligibility Criteria.
The program requires and the client must present documentation of Texas
residency during the program's review of the client's application for services.
Documents that may provide evidence of residency include:
(1)
documents issued by the state or federal government, e.g.,
driver's license or identification card issued by the Texas Department of
Public Safety; a motor vehicle registration or automobile registration form;
a current Texas voter registration card; or a current Texas Medicaid card;
(2)
documents relating to the applicant's income, e.g., a recent
payroll check; retirement or social security check; or disability check;
(3)
all documents must be in the name of the applicant unless
the applicant is a dependent minor or a ward. In that event, the documents
may be in the name of the legally responsible person; and
(4)
the program may verify residency periodically during the
receipt of services and if requested by the program, a client must provide
additional documentation.
§98.109.Financial Eligibility Criteria.
(a)
A person is financially eligible for the program if he
or she:
(1)
is not covered for approved program medication(s) under
the Texas Medicaid Program;
(2)
does not qualify for assistance under any State compensation
program, under an insurance policy unless the insurance company provides less
than full coverage for prescription medication, or under any other state or
federal health benefits program; and
(3)
has an annual gross income that does not exceed 200% of
the most recently published federal poverty income guidelines.
(b)
Annual gross income.
(1)
An applicant's annual gross income (if single), or the
combined annual gross income of the applicant and his or her spouse.
(2)
For a minor, the child's annual gross income if the child
is an emancipated minor or meets the criteria established in Family Code,
Chapter 32, §32.003, or the (combined) annual gross income of the parent(s).
The spouse or the parent must be living in the same household as the child
at the time of application.
§98.110.Application Process.
(a)
To request an application packet, call toll-free 1-800-255-1090
or write to: Texas Department of Health, Bureau of HIV and STD Prevention,
Texas HIV Medication Program, 1100 West 49th Street, Austin, Texas 78756-3199.
The program's client application for assistance is also available online at
the following URL: http://www.tdh.state.tx.us/hivstd/meds/document.htm.
(b)
Submit completed applications along with certification
forms to: Texas Department of Health, Bureau of HIV and STD Prevention, Texas
HIV Medication Program, 1100 West 49th Street, Austin, Texas 78756-3199.
§98.111.Confidentiality.
(a)
No information that could identify an individual applicant
will be released except as authorized by law and in accord with §1.501
of this title (relating to Privacy of Health Information). Applicants are
advised that, in addition to the department, their physician(s) and pharmacist(s)
will be aware of their diagnosis.
(b)
The department may use or disclose individual health information
to provide, coordinate, or manage health care or related services. This includes
referring the client to other health care resources. The department may contact
a program participant to discuss enrollment benefits, resources for treatment,
or other health-related information as necessary.
(c)
An individual may request a copy of the department's privacy
notice by writing to: Texas Department of Health, Privacy Officer, 1100 West
49th Street, Austin, Texas 78756. More information pertaining to the Health
Insurance and Portability and Accountability Act (HIPPA) is available online
from the department at the following URL: http://www.tdh.state.tx.us/hipaa/default.htm.
§98.112.Program Distribution of Medications.
(a)
The department will contract with a pharmaceutical wholesaler
for purchase of drugs. The Texas Department of Health, Pharmacy Division will
distribute drugs to pharmacies participating in the program and a mail order
pharmaceutical distributor for the dispensing of drugs directly to clients
who reside outside areas covered by participating pharmacies.
(b)
Program funds must be used as payor of last resort and
coordinated with other local, state, and federal funds, including Medicaid.
§98.113.Participating Pharmacy.
The program will only deliver services through pharmacies approved
by the program that have signed a Memorandum of Agreement with the department.
§98.114.Prescription Fees.
A copayment may be collected by a participating pharmacy for each prescription
dispensed in accordance with the existing Memorandum of Agreement with the
department. Medicaid clients will have their dispensing fees paid for by the
program.
§98.115.Program Budget.
(a)
To ensure the program's expenditures do not exceed the
program's budget, the department will analyze program expenditures as follows.
(1)
Determine the annual average cost per client using program
expenditures from the previous 12 months. The annual average cost per client
is calculated by dividing the total amount of funds expended during a 12-month
period into the total number of clients served during the same 12-month period.
(2)
Project the number of clients that may be served during
the next 12-month period using current budget. The projected number of clients
that may be served is calculated by dividing the program's total available
dollars by the annual average cost per client derived from paragraph (1) of
this subsection.
(b)
The department will perform an analysis of program expenditures
every month using the methodology in subsection (a) of this section to determine
if funds are sufficient to meet projected expenditures.
(c)
To insure that expenditures do not exceed the program's
budget, the department may implement the following temporary cost-containment
measures as necessary.
(1)
Cost-containment measures may be implemented in the following
order.
(A)
Medical criteria must meet the most recent Federal Department
of Health and Human Services Guidelines for the Use of Antiretroviral Agents
in HIV-infected adults and adolescents. Present medical criteria is a CD4
+T-cell count at or below 350 cells per cubic millimeter and/or an HIV viral
load greater than 30,000 copies per milliliter when using the branched DNA
test or more than 55,000 copies per milliliter when using the RT-PCR test.
(B)
Cease enrollment of new clients who reside in an eligible
metropolitan area.
(C)
Cease enrollment of all new clients.
(D)
Client fees as defined in §98.116 of this title (relating
to Client Charges, Sliding Fee Scale).
(E)
Lower eligibility criteria not lower than 125% of federal
poverty level.
(2)
As funds become available, the department will reverse
the cost-containment measures in the reverse order of which they were implemented.
§98.116.Client Charges, Sliding Fee Scale.
(a)
The department may impose charges on clients enrolled in
the program using the sliding fee scale described in this section. The collection
of client fees are authorized under 42 U.S.C. 300ff-27(c) and Health and Safety
Code, §85.065.
(b)
Individual client charges set by the program are assessed
using the gross annual income guidelines described in section §98.109
(relating to Financial Eligibility Criteria) of this title and are in accord
with the most current version of the federal poverty guidelines received by
the department.
(c)
The department will charge fees in the following amounts:
(1)
less than or equal to 100%, no fee charged;
(2)
101% - 125% client pays $20.00;
(3)
126% - 150% client pays $30.00;
(4)
151% - 175% client pays $40.00;
(5)
176% - 200% client pays $50.00;
(6)
201% - 250% client pays $60.00;
(7)
251% - 300% client pays $70.00; or
(8)
301% or greater client pays $100.00.
(d)
Cost sharing premiums paid by clients will be collected
on a monthly basis as defined by the program. Monies collected from client
cost sharing premiums will be put back in the program's budget for the purpose
of purchasing more medications.
§98.117.Denial of Application or Termination of Client Benefits.
(a)
Individuals already receiving services will have their
application denied or services terminated only for one or more of the following
reasons.
(1)
Services will be denied or terminated if:
(A)
the person is not a resident of the state as required in §98.108
of this title (relating to Residency Eligibility Criteria);
(B)
the annual gross income does not meet the criteria set
in §98.109 of this title (relating to Financial Eligibility Criteria);
(C)
the person does not provide evidence to meet the criteria
set in §98.107 of this title (relating to Medical Eligibility Criteria);
or
(D)
the client notifies the program in writing that he/she
no longer wants to receive services.
(2)
Services may be terminated if:
(A)
the applicant or client submits an application form or
any document required in support of the application which contains a misstatement
of fact which is material to determining program eligibility;
(B)
the client submits false claims to a participating pharmacy;
(C)
the client has not requested or used services during any
period of three consecutive months;
(D)
program funds are exhausted.
(b)
Denial, modification, suspension, or termination of services
to a client will be governed by the procedures required by §98.118 of
this title (relating to Appeal Procedures), and §98.119 of this title
(relating to Exceptions from Appeal Procedures).
§98.118.Appeal Procedures.
(a)
A person may initiate the appeal process by notifying the
department's Bureau of HIV and STD Prevention that the person wishes to dispute
the program's decision concerning either eligibility or funding. The written
notice must contain sufficient reasons for the appeal. The notice should be
addressed to the Texas Department of Health, Bureau of HIV and STD Prevention,
1100 West 49th Street, Austin, Texas, 78756-3199.
(b)
A department review panel will hear the appeal. The panel
shall consist of the Chief, Bureau of HIV and STD Prevention; the Director,
HIV/STD Clinical Resources Division; and the Program Manager, Texas HIV Medication
Program, and the Chief, Bureau of Communicable Disease Prevention and Control.
The appellant(s) may present the case in person before the panel. After hearing
all testimony, the panel will issue a written decision. The panel's decision
shall be final.
(c)
Written complaints are subject to the Open Records Act,
Government Code, Chapter 552.
§98.119.Exceptions from Appeal Procedures.
The department is not required to offer an opportunity to dispute the
decision to deny or terminate client status, if the department's actions result
from the exhaustion of funds appropriated to the department for the Health
and Safety Code, Chapter 85, Subchapter C, Texas HIV Medication Program.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 12, 2003.
TRD-200302956
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
25 TAC §§98.107 - 98.117
(Editor's note: The text of the following sections proposed for
repeal will not be published. The sections may be examined in the offices
of the Texas Department of Health or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The repeals are proposed under the Health and Safety
Code, §85.063, which provides the board authority to adopt rules necessary
to establish eligibility guidelines to ensure the most appropriate distribution
of funds; and §12.001, which provides the Texas Board of Health (board)
with the authority to adopt rules for the performance of each duty imposed
by law on the board, the department, and the commissioner of health.
The repeals affect the Health and Safety Code, Chapters 12 and 85.
§98.107.Criteria for Financial Eligibility.
§98.108.Application Process.
§98.109.Confidentiality.
§98.110.Payment for Approved Medication(s).
§98.111.Participating Pharmacy.
§98.112.Prescription Fees.
§98.113.Residency; Documentation of Residency.
§98.114.Denial of Application or Termination of Client Benefits.
§98.115.Appeal Procedures.
§98.116.Exceptions from Appeal Procedures.
§98.117.Public Complaints.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed
with the Office of the Secretary of State on May 12, 2003.
TRD-200302957
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
Subchapter H. LONG-TERM CARE SERVICES FOR THE ELDERLY
25 TAC §145.121
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Department of Health or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Department of Health (department) proposes
the repeal of §145.121, concerning a memorandum of understanding between
the department and the Texas Department on Aging, the Texas Department of
Human Services, and the Texas Mental Health and Mental Retardation for long
term care services for the elderly.
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 §145.121 and has determined that the reason for adopting
the section no longer exists. Human Resources Code, §101.031, provided
for a memorandum of understanding to define the responsibilities of each agency
for updating biennially the long-term care state plan for the elderly. Human
Resources Code, §101.031, was repealed in 1995, thus making the rule
obsolete.
The department published a Notice of Intention to Review for §145.121
in the
Texas Register
on February 12, 1999
(24 TexReg 1003). No comments were received due to publication of this notice.
Susan K. Steeg, General Counsel, has determined that for each year of the
first five years the repeal of this section is in effect, there will be no
fiscal impact on state or local government.
Ms. Steeg has also determined that for each year of the first five years
the repeal of §145.121 is in effect, the public benefit anticipated as
a result of the repeal will be to eliminate a rule that is unnecessary because
there is no statutory requirement for the rule. There will be no cost effects
on micro-businesses or small businesses. This was determined by interpretation
of the rules that micro-businesses or small businesses will not be required
to alter their business practices as a result of the proposed repeal of this
rule. There are no economic costs to persons who may be affected by the proposed
repeal of this rule. There is no anticipated impact on local employment.
Comments on the proposal may be submitted to Robin Carter, Legal Assistant,
Office of General Counsel, Texas Department of Health, 1100 West 49th Street,
Austin, Texas 78756, (512) 458-7236 or by email at the following address:
robin.carter@tdh.state.tx.us. Comments will be accepted for 30 days following
publication of this proposal in the
Texas Register
.
The repeal of this section is proposed under Health and Safety
Code, §12.001, which provides the Texas Board of Health (board) with
authority to adopt rules to implement every duty imposed by law on the board,
the department and the commissioner.
The repeal of this section implements Government Code, §2001.039.
§145.121.Memorandum of Understanding between Texas Department on Aging, the Texas Department of Human Services, the Texas Department of Health, and the Texas Mental Health and Mental Retardation Concerning Long-term Care Services for the Elderly.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302862
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
25 TAC §§146.1, 146.3 - 146.10
The Texas Department of Health (department) proposes amendments
to §§146.1 and 146.3-146.10, concerning the regulation of training
and certification of promotores(as) or community health workers. Specifically,
the sections cover definitions, applicability, application requirements and
procedures, application requirements and procedures for instructors, application
requirements and procedures for sponsoring institutions and training programs,
types of certificates and applicant eligibility, standards for approval of
curricula, certificate issuance and renewals, and continuing education requirements.
The amended language clarifies the rules and improves ability of promotores(as)
or community health workers to obtain the training and certification established
by Health and Safety Code, Chapter 48. The only section of these rules not
amended by this proposal is §146.2 concerning the Promotor(a) or Community
Health Worker Training and Certification Advisory Committee. Section 146.2
will be brought to the Board of Health (board) as a different agenda item.
Health and Safety Code, Chapter 48, requires the department to establish
a program designed to train and educate persons who act as promotoras or community
health workers. This chapter also requires minimum standards for the certification
of promotores(as) or community health workers. These rules are reasonable
and necessary to accomplish this legislative mandate.
Government Code, §2001.039, requires that each state agency review
and consider for readoption each rule adopted by that agency pursuant to Government
Code, Chapter 2001, (Administrative Procedure Act). The sections have been
reviewed and the department has determined that reasons for adopting the sections
continue to exist; however, §§146.1 and 146.3 - 146.10 are being
amended.
The department published a Notice of Intention to Review the sections in
regards to Government Code, §2001.039, in the May 2, 2003, issue of the
Cecilia Berrios, Community Health Promotion Specialist, Office of Public
Health Practice has determined that for each year of the first five years
that the sections will be in effect there will be no fiscal implications to
state or local governments as a result of enforcing or administering the sections
as proposed. There may be impacts on such entities to the extent they choose
to become involved as employers, sponsors, or education providers to promotores(as)
or community health workers, but such involvement is voluntary on their part.
Ms. Berrios has determined that for each year of the first five years the
proposed sections are in effect the public health benefit anticipated as a
result of these amendments is increased clarity of the rules, better conformance
to statute, and improved ability of promotores(as) or community health workers
to obtain the training and certification established by Health and Safety
Code, Chapter 48. There is no anticipated cost to small businesses or micro-businesses
nor to persons who are required to comply with the sections as proposed because
becoming a promotora or community health care worker or sponsor, or educator
is voluntary. Those who choose to become certified under these rules (or their
sponsors) will incur the cost of obtaining required education. This cost will
vary depending on where this education is obtained. There is no impact on
local employment.
Comments on the proposal may be submitted to Cecilia Berrios, Office of
Public Health Practice, Texas Department of Health, 1100 West 49th Street,
Austin, Texas 78756, telephone (512) 458-7770, or cecilia.berrios@tdh.state.tx.us.
Comments will be accepted for 30 days after publication in the
Texas Register
.
The amendments are proposed under the Health and Safety Code, §48.003,
which requires the board to adopt rules that provide minimum standards and
guidelines on training; §48.002, which allows the board to provide for
exemption from certification by rule; 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 amendments affect Health and Safety Code, Chapter 48; and implement
Government Code, §2001.039.
§146.1.Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings, unless the context clearly indicates otherwise.
(1)
Administrator--The department employee designated as the
administrator of regulatory activities authorized by the Health and Safety
Code
,
Chapter
48
[
(2)-(4)
(No change.)
(5)
Committee--The Promotor(a)
or
[
(6)
(No change.)
(7)
Health--The extent to which an individual or group is able
to realize aspirations and satisfy needs, and to change or cope with the environment.
Health is a resource for everyday life, not the objective of living; it is
a positive concept emphasizing social and personal resources as well as physical
capabilities.
This definition is from the World Health Organization,
"Ottawa Charter for Health Promotion, 1986," and is available at http://www.who.dk/AboutWHO/Policy/20010827_2
.
(8)-(12)
(No change.)
§146.3.Applicability.
(a)
The purpose of this section is to describe who is eligible
for this [
(b)
(No change.)
(c)
Participation in a training and education program
established under this section is voluntary for promotores(as) or community
health workers who provide services without receiving compensation, and mandatory
for promotores(as) or community health workers who provide services for compensation.
[
§146.4.Application Requirements and Procedures for Promotores(as) or Community Health Workers.
(a)-(b)
(No change.)
(c)
Required application materials. The application form shall
contain the following items:
(1)
(No change.)
(2)
a statement that the applicant understands the Health and
Safety
Code
, Chapter
48
[
(3)-(9)
(No change.)
(d)
(No change.)
(e)
Disapproved applications.
(1)-(4)
(No change.)
(5)
An applicant whose application
has been disapproved may appeal the disapproval under the fair hearing procedures
found in Chapter 1, Subchapter C of this title (relating to Fair Hearing Procedures).
(f)
Application processing. A written notice stating that the
application has been approved may be sent in lieu of the notice of acceptance
of a complete application. The following periods of time shall apply from
the date of receipt of an application until the date of issuance of a written
notice that the application is complete and accepted for filing or that the
application is deficient and additional specific information is required.
(1)
Letter of acceptance of application for certification -
90
[
(2)
Letter of application deficiency -
90
[
§146.5.Application Requirements and Procedures for Instructors.
(a)-(b)
(No change.)
(c)
Required application materials. The application form shall
contain the following items:
(1)
(No change.)
(2)
a statement that the applicant understands the Health and
Safety Code, Chapter
48
[
(3)-(9)
(No change.)
(d)
(No change.)
(e)
Disapproved applications.
(1)-(2)
(No change.)
(3)
The applicant whose application has been disapproved under
paragraph (1) of this subsection shall be permitted to reapply after a period
of not less than six months from the date of the disapproval and shall submit
a current application satisfactory to the department, of compliance with the
then current requirements of this chapter and the provisions of the Health
and Safety Code, Chapter
48
[
(4)
An applicant whose application
has been disapproved may appeal the disapproval under the fair hearing procedures
found in Chapter 1, Subchapter C of this title.
(f)
Application processing. A written notice stating that the
application has been approved may be sent in lieu of the notice of acceptance
of a complete application. The following periods of time shall apply from
the date of receipt of an application until the date of issuance of a written
notice that the application is complete and accepted for filing or that the
application is deficient and additional specific information is required.
(1)
Letter of acceptance of application for certification -
90
[
(2)
Letter of application deficiency -
90
[
§146.6.Application Requirements and Procedures for Sponsoring Institutions and Training Programs.
(a)-(b)
(No change.)
(c)
Required application materials. The application form shall
contain the following items:
(1)
specific organizational data, current and previous experience
with training or sponsoring training for promotores(as) or community health
workers, educational and training qualifications of staff, accrediting information,
curricula and collateral materials, workplace assurances, registration policies
and procedures for promotores(as) or community health workers.
Applicants
must meet the minimum eligibility requirements for sponsoring institutions
or training program certification as set forth in §146.7(f) of this title
(relating to Types of Certificates and Applicant Eligibility);
(2)
a statement that the applicant understands Health and Safety
Code, Chapter
48
[
(3)-(8)
(No change.)
(d)
(No change.)
(e)
Disapproved applications.
(1)-(3)
(No change.)
(4)
An applicant whose application
has been disapproved may appeal the disapproval under the fair hearing procedures
found in Chapter 1, Subchapter C of this title.
(f)
Application processing. A written notice stating that the
application has been approved may be sent in lieu of the notice of acceptance
of a complete application. The following periods of time shall apply from
the date of receipt of an application until the date of issuance of a written
notice that the application is complete and accepted for filing or that the
application is deficient and additional specific information is required.
(1)
Letter of acceptance of application for certification -
90
[
(2)
Letter of application deficiency -
90
[
§146.7.Types of Certificates and Applicant Eligibility.
(a)
Purpose. The purpose of this section is to set out the
types of certificates issued and the qualifications of applicants.
(1)
The Texas Department of Health (department) shall issue
promotor(a) or community health worker certificates of competence, instructor
certificates, and sponsoring institutions or training program certificates.
A certificate will recognize all those who have performed promotor(a) or community
health worker services
between July 1997 to December 2002
[
(2)-(7)
(No change.)
(b)
Special provisions for persons who have performed promotor(a)
or community health worker services
between July 1997 to December 2002
[
(c)
Special provisions for persons who are nationally certified
health education specialists in good standing, other licensed/certified healthcare
professionals including social workers in good standing who have acted as
instructors of promotores(as)
or community health workers
, and
for promotores(as) or community health workers who have acted as supervisors
or as trainers
and
[
(d)-(e)
(No change.)
(f)
Minimum eligibility requirements for sponsoring institution
or training program certification. The following requirements apply to all
institutions or programs applying for certification:
(1)
usage of an approved curriculum for promotor(a) or community
health worker training, instructor certification and/or for continuing education
of promotores(as) or community health workers and instructors that meets the
standards and guidelines established by the department and as set forth in §146.8
of this title; [
(2)
submission of a satisfactory completed application on a
form supplied by the department
; and
[
(3)
at least two years of experience
with training or sponsoring training for promotores(as) or community health
workers.
§146.8.Standards for the Approval of Curricula.
(a)
Purpose. The purpose of this section is to establish the
minimum standards for approval of curricula and programs to train persons
to perform promotor(a) or community health worker services and to
qualify
[
(b)
(No change.)
§146.9.Certificate Issuance and Renewals.
(a)-(b)
(No change.)
(c)
Certificate renewal. Each promotor(a) or community health
worker, instructor and sponsoring institution or training program shall renew
the certificate biennially.
(1)-(2)
(No change.)
(3)
The department may not renew the certificate of a promotor(a)
or community health worker, instructor or sponsoring institution or training
program who is in violation of
Health and Safety Code, Chapter 48
[
(d)-(e)
(No change.)
§146.10.Continuing Education Requirements.
(a)
(No change.)
(b)
General. Continuing education requirements for recertification
shall be fulfilled during each biennial renewal period. A promotor(a) or community
health worker must complete
20
[
(1)-(3)
(No change.)
(c)-(f)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302861
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
Subchapter O. LICENSING OF WHOLESALE DISTRIBUTORS OF DRUGS--INCLUDING GOOD MANUFACTURING PRACTICES
25 TAC §229.255
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Department of Health or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Department of Health (department) proposes
the repeal of §229.255, concerning the Wholesale Drug Distributors Advisory
Committee (committee). The committee has provided advice to the Texas Board
of Health (board) and the department in the area of licensing of wholesale
drug distributors.
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 2002, the board established a rule relating to the Wholesale Drug Distributors
Advisory Committee. The rule states that the committee will automatically
be abolished on September 1, 2003, and the board has determined that the committee
should be abolished on that date. Issues relating to the type of advice previously
provided by the committee are better addressed through the establishment of
ad hoc workgroups.
Jacquelyn McDonald, Director, Office of the Board of Health, has determined
that for each year of the first five years the repeal is in effect, there
will be no fiscal implications for state or local governments as a result
of enforcing or administering this section since the section will no longer
exist.
Ms. McDonald has also determined that for each year of the first five years
the repeal is in effect, the public benefit anticipated as a result of repealing
the section will be increased flexibility and breadth in obtaining specific
input on issues related to licensing of wholesale drug distributors. There
will be no effect on micro-businesses or small businesses. The repeal of the
rule will not require small businesses and micro-businesses to alter their
business practices. There are no economic costs to persons previously required
to comply with the section as a result of this repeal. There will be no effect
on local employment.
Comments may be submitted to Jacquelyn McDonald, Director, Office of the
Board of Health, Texas Department of Health, 1100 West 49th Street, Austin,
Texas 78756, (512) 458-7484. Comments on the proposed section will be accepted
for 30 days following publication in the
Texas Register
.
The repeal is proposed under the Health and Safety Code, §11.016,
which allows the board to establish advisory committees; the Government Code,
Chapter 2110, which sets standards for the evaluation of advisory committees
by the agencies for which they function; and the Health and Safety Code, §12.001,
which provides the board with authority to adopt rules for the performance
of every duty imposed by law upon the board, the department, and the commissioner
of health.
The proposed repeal affects the Health and Safety Code, Chapter 11; and
the Government Code, Chapter 2110.
§229.255.Wholesale Drug Distributors Advisory Committee.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302859
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
25 TAC §229.444
The Texas Department of Health (department) proposes an amendment
to §229.444, concerning the Device Distributors and Manufacturers Advisory
Committee (committee). The committee has provided advice to the Texas Board
of Health (board) and the department in the area of licensure of device distributors
and manufacturers. The committee is established under the Health and Safety
Code, §11.016, which allows the board to establish advisory committees;
and the Health and Safety Code, §431.275, which requires the establishment
of the committee. The committee is governed by the 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 §229.444 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 §229.444
in the
Texas Register
on September 28, 2001
(26 TexReg 7581). 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 Device Distributors
and Manufacturers Advisory Committee. The rule states that the committee will
automatically be abolished on September 1, 2003. The board has now reviewed
and evaluated the committee and has determined that the committee should continue
in existence until September 1, 2007.
This section amends provisions relating to the operation of the committee.
Specifically, language is revised to: continue the committee until September
1, 2007; include additional requirements regarding statements by members;
and clarify the components that the committee must include in an annual report
to the board.
Jacquelyn McDonald, Director of the Office of the Board of Health, has
determined that for each year of the first five years the section is in effect,
there will be no fiscal implications for state and local government as a result
of amending the section as proposed.
Ms. McDonald has also determined that for each year of the first five years
the section is in effect, the public benefit anticipated as a result of amending
the section will be to provide a continuance of the committee and continued
advice to the department on this important issue. There will be no costs to
small businesses or micro-businesses resulting from compliance with this section,
as this section addresses only continuance of the committee and statements
by members. There are no anticipated economic costs to persons who are required
to comply with the section as proposed. There is no anticipated impact on
local employment.
Comments may be submitted to Jacquelyn McDonald, Director, Office of the
Board of Health, Texas Department of Health, 1100 West 49th Street, Austin,
Texas 78756, (512) 458-7484. Comments on the proposed section will be accepted
for 30 days following publication in the
Texas Register
.
The amendment is proposed under Health and Safety Code, §§11.016,
which allows the board to establish advisory committees; 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; 431.275,
which requires the establishment of the committee; and Government Code, §2110.005,
which requires the department to adopt rules stating the purpose and tasks
of its advisory committees.
The proposed amendment affects the Health and Safety Code, Chapters 11,
12, and 431; the Government Code, Chapter 2110; and implements Government
Code, §2001.039.
§229.444.Device Distributors and Manufacturers Advisory Committee.
(a)-(d)
(No change.)
(e)
Review and duration. By September 1,
2007
[
(f)-(m)
(No change.)
(n)
Statement by members.
(1)-(2)
(No change.)
(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)
(No change.)
(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)
(No change.)
(p)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302864
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
Subchapter C. TEXAS ASBESTOS HEALTH PROTECTION
25 TAC §295.73
The Texas Department of Health (department) proposes an amendment
to §295.73, concerning the Asbestos Advisory Committee (committee). The
committee has provided advice to the Texas Board of Health (board) and the
department in the area of asbestos licensing and compliance. The committee
is established under the Health and Safety Code, §11.016, which allows
the board to establish advisory committees. The committee is governed by the
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 §295.73 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 §295.73 in
the
Texas Register
on May 12, 2000 (25 TexReg
4360). 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 1998, the board established a rule relating to the Asbestos Advisory
Committee. The rule states that the committee will automatically be abolished
on September 1, 2003. The board has now reviewed and evaluated the committee
and has determined that the committee should continue in existence until September
1, 2007.
This section amends provisions relating to the operation of the committee.
Specifically, language is revised to: continue the committee until September
1, 2007; reduce the membership from twelve to nine; change the process for
filling vacancies in the offices of presiding officer and assistant presiding
officer; add additional time requirements for staff to furnish rules to committee
members; clarify statements by members; and provide additional components
that the committee must include in an annual report to the board.
Jacquelyn McDonald, Director of the Office of the Board of Health, has
determined that for each year of the first five years the section is in effect,
there will be no fiscal implications for state and local government as a result
of amending the section as proposed.
Ms. McDonald has also determined that for each year of the first five years
the section is in effect, the public benefit anticipated as a result of amending
the section will be to provide a continuance of the committee and continued
advice to the department on this important issue. There will be no costs to
small businesses or micro-businesses resulting from compliance with this section,
as this section addresses only continuance of the committee terms of office,
and a revised statement of members. There are no anticipated economic costs
to persons who are required to comply with the section as proposed. There
is no anticipated impact on local employment.
Comments may be submitted to Jacquelyn McDonald, Director, Office of the
Board of Health, Texas Department of Health, 1100 West 49th Street, Austin,
Texas 78756, (512) 458-7484. Comments on the proposed section will be accepted
for 30 days following publication in the
Texas Register
.
The amendment is proposed under Health and Safety Code, §11.016,
which allows the board to establish advisory committees; §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 proposed amendment affects the Health and Safety Code, Chapters 11
and 12; and the Government Code, Chapter 2110; and implements Government Code, §2001.039.
§295.73.Asbestos Advisory Committee.
(a)-(d)
(No change.)
(e)
Review and duration. By September 1,
2007
[
(f)
Composition. The committee shall be composed of
nine
[
(1)
three
[
(2)
six
[
(g)
(No change.)
(h)
Officers. The
committee
[
(1)-(2)
(No change.)
(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 [
(4)
If the office of assistant presiding officer becomes vacant,
it may be filled [
(5)-(6)
(No change.)
[
(i)
Meetings. The committee shall meet only as necessary to
conduct committee business.
(1)-(3)
(No change.)
(4)
Each member of the committee shall be informed of a committee
meeting at least
ten
[
(5)-(7)
(No change.)
(j)-(m)
(No change.)
(n)
Statement by members.
(1)-(2)
(No change.)
(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)
(No change.)
(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)
(No change.)
(p)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 8, 2003.
TRD-200302860
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
25 TAC §§295.181 - 295.183
The Texas Department of Health (department) proposes amendments
to §§295.181-295.183, concerning the requirements for operators
of different types of facilities to provide information on hazardous chemicals
at their facilities to the department, local fire departments, and local emergency
planning committees (LEPCs) for the purposes of emergency planning and response
and the public's right to know about hazardous chemicals in their communities.
The proposed amendment to §295.181 concerns information that must be
provided by manufacturing facilities; the proposed amendment to §295.182
concerns information that must be provided by public employers; and the proposed
amendment to §295.183 concerns information that must be provided by non-manufacturing
facilities.
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 295.181-295.183
have been reviewed and the department has determined that reasons for adopting
the sections continue to exist. Revisions were necessary as described in this
preamble.
Specifically, the proposed amendments address the reporting of hazardous
chemicals (Tier Two forms and electronic Tier Two files), complaints and investigations,
assessment of administrative penalties, and fees required for filing reports
with the department. Sections 295.181 and 295.182 also address direct citizen
access to a facility's chemical information.
The proposed amendments to §§295.181-295.183 add three new definitions,
delete one definition, and amend two others to clarify the intent of the rules.
The amendments to §§295.181-295.183 also reflect a change in the
division name, provide the program's toll free telephone number, clarify that
an electronic Tier Two file may be maintained at the facility and submitted
to the department in lieu of a completed hard copy Tier Two form, and clarify
that the software and procedures for submitting electronic Tier Two files
must be approved by the department. In addition, the amendments to §§295.181-295.183
delete temporary standards for reporting locations of rural facilities on
the Tier Two form. The board recommended these temporary standards in November
1999 and the expiration date established in the rules has now passed. The
amendments to §§295.181-295.183 propose adoption of new latitude
and longitude reporting standards used in the current electronic Tier Two
software program that has been approved by the department. Since most of the
Global Positioning System (GPS) instruments currently used for taking latitude
and longitude measurements are capable of meeting the proposed standards and
free Internet programs are available to convert measurements from older GPS
instruments to meet these standards, these new requirements for reporting
latitude and longitude are reasonable. The standards are being proposed to
improve mapping accuracy of facility locations that are reported by latitude
and longitude measurements.
A notice of intention to review rules was published for §§295.181-295.183
in the April 4, 2003, issue of the
Texas Register
(28 TexReg 2959) for the state agency review of rules in regards to
Government Code, §2001.039. No comments were received following publication
of the notice.
Charles Branton, Director, Product Safety Division, has determined that
for each year of the first five years the sections are in effect, there will
be no fiscal implications to state or local government as a result of enforcing
or administering the sections as proposed.
Mr. Branton has also determined that for each year of the first five years
the sections are in effect, the public benefit anticipated as a result of
enforcing the sections will be increased safety for communities where hazardous
chemicals are stored or used due to improved accessibility to chemical data
and greater accuracy of mapping data. The proposed amendments are anticipated
to improve consistency in reporting forms and data formats. There are no changes
being proposed for the subsections in §§295.181-295.183 that are
related to Tier Two form filing fees or the number of Tier Two forms that
may be consolidated under a single filing fee. Therefore, there will be no
costs to micro-businesses or small businesses to comply with the sections
as proposed. There are no anticipated economic costs to persons who are required
to comply with the sections as proposed. There is no anticipated impact on
local employment.
Comments on the proposal may be submitted to Charles Branton, Product Safety
Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas,
78756, (512) 834-6773, extension 2260, fax (512) 834-6766. Comments will be
accepted for 30 days following publication of this proposal in the
Texas Register
. In addition, a public hearing on the proposed sections
will be held at 9:00 a.m., Wednesday, June 18, 2003, in the Texas Department
of Health Auditorium, Room K-100, 1100 West 49th Street, Austin, Texas.
The amendments are proposed under the Health and Safety Code, §§505.016,
506.017, and 507.013, which provide the Texas Board of Health (board) with
the authority to adopt necessary rules to administer and enforce Chapters
505, 506, and 507; 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 of health;
and implements Government Code, §2001.039.
The amendments affect the Health and Safety Code, Chapters 505, 506, and
507.
§295.181.Manufacturing Facility Community Right-to-Know.
(a)
(No change.)
(b)
Definitions. The following words and terms, when used in
this section, shall have the following meanings unless the context clearly
indicates otherwise.
(1)-(2)
(No change.)
(3)
Commissioner of health--The director of
the Texas Department of Health, as referenced in the Health and Safety Code, §505.004(6).
(4)
[
(5)
[
[(5)
Director--The commissioner of the department.]
(6)
Electronic Tier Two file--An electronic
data file that contains, at a minimum, all of the information required for
submission of a hard copy Tier Two form, and which provides the required Tier
Two information for each individual reportable chemical.
(7)
[
(8)
[
(9)
[
(10)
Facility chemical list--A chemical inventory
that provides information for all reportable hazardous chemicals and EHSs
present at a reporting facility, and which is submitted to the department
in the form of either a completed electronic Tier Two file or a completed
hard copy Tier Two form.
(11)
[
(12)
[
(13)
[
(14)
[
(15)
[
(16)
[
(17)
[
(18)
[
(19)
[
(20)
[
(21)
[
(A)
the most current version of the Texas Tier Two Cover Sheet
form and one or more copies of the most current version of the Texas Tier
Two Chemical Description Sheet form; or
(B)
the most current version of the Texas Tier Two Cover Sheet
form and one or more copies of the most current version of the federal Tier
Two Emergency and Hazardous Chemical Inventory form.
(22)
[
(c)
Responsibility for implementation of program. The
commissioner's
[
(d)
Facility chemical list.
(1)
A facility operator covered by this section shall compile
and maintain a facility chemical list in the format of
either
a
Texas Tier Two form
or an electronic Tier Two file
.
(2)
Completed hard copy
[
(3)-(9)
(No change.)
(10)
For purposes of electronic reporting, a facility operator
covered by this section may submit to the department an electronic
Tier
Two
file of the facility chemical list using software
and a submission
procedure
which has been approved by [
(11)
A facility operator must contact the fire chief for approval
to submit an electronic
Tier Two
file of the facility chemical
list in lieu of the paper copy of any required Tier Two form. If approved
by the fire chief, a facility operator may submit an electronic
Tier
Two
file of the facility chemical list and shall be in compliance with
paragraphs (5)(A), (7)(A), and (9)(A) of this subsection. A facility operator
must contact the chair of the LEPC for approval to submit an electronic
Tier Two
file of the facility chemical list in lieu of the paper copy
of any required Tier Two form. If approved by the LEPC chair, a facility operator
may submit an electronic
Tier Two
file of the facility chemical
list and shall be in compliance with paragraphs (5)(B), (7)(B), and (9)(B)
of this subsection.
(12)-(16)
(No change.)
(17)
In providing appropriate facility identifiers, a facility
operator shall provide under the Facility Identification sections of the Texas
Tier Two form one of the following descriptions:
(A)
(No change.)
[(B)
through December 31, 2000, for a facility
located in an area outside of a city's limits, the description must include
a written description which provides one of the following:]
[(i)
when a street address has been assigned for purposes of
emergency services, the street address and the name of the nearest city;]
[(ii)
if the facility is located at the intersection of two
roads, the names of the roads at the intersection and the name of the nearest
city; or]
[(iii)
if neither clause (i) or (ii) of this subparagraph apply
to the facility, the approximate straight line distance and direction of the
facility from the nearest city and the name of the nearest city.]
(B)
[
(e)
(No change.)
(f)
Complaints and investigations.
(1)
The
commissioner
[
(2)
Complaints are not necessary to conduct an inspection under
this section. The
commissioner
[
(3)
(No change.)
(4)
Upon request from a representative of the
commissioner
[
(g)
Administrative penalties.
(1)
Inspections may be conducted by the
commissioner
[
(2)
(No change.)
(3)
Penalties shall be due after an order is issued by the
commissioner
[
(4)-(11)
(No change.)
(h)
Fees.
(1)-(3)
(No change.)
(4)
Fees paid by mail must be paid by check or money order
(cash payments are not acceptable) to the Texas Department of Health and must
be addressed to: Texas Department of Health,
Product Safety
[
(5)-(6)
(No change.)
§295.182.Public Employer Community Right-To-Know.
(a)
(No change.)
(b)
Definitions. The following words and terms, when used in
this section, shall have the following meanings unless the context clearly
indicates otherwise.
(1)-(2)
(No change.)
(3)
Commissioner of health--The director of
the Texas Department of Health, as referenced in the Health and Safety Code, §506.004(6).
(4)
[
(5)
[
[(5)
Director--The commissioner of the department.]
(6)
Electronic Tier Two file--An electronic
data file that contains, at a minimum, all of the information required for
submission of a hard copy Tier Two form, and which provides the required Tier
Two information for each individual reportable chemical.
(7)
[
(8)
[
(9)
[
(10)
Facility chemical list--A chemical inventory
that provides information for all reportable hazardous chemicals and EHSs
present at a reporting facility, and which is submitted to the department
in the form of either a completed electronic Tier Two file or a completed
hard copy Tier Two form.
(11)
[
(12)
[
(13)
[
(14)
[
(15)
[
(16)
[
(17)
[
(18)
[
(19)
[
(20)
[
(21)
[
(A)
the most current version of the Texas Tier Two Cover Sheet
form and one or more copies of the most current version of the Texas Tier
Two Chemical Description Sheet form; or
(B)
the most current version of the Texas Tier Two Cover Sheet
form and one or more copies of the most current version of the federal Tier
Two Emergency and Hazardous Chemical Inventory form.
(22)
[
(c)
Responsibility for implementation of program. The
commissioner's
[
(d)
Facility chemical list.
(1)
A facility operator covered by this section shall compile
and maintain a facility chemical list in the format of
either
a
Texas Tier Two form
or an electronic Tier Two file
.
(2)
Completed hard copy
[
(3)-(9)
(No change.)
(10)
For purposes of electronic reporting, a facility operator
covered by this section may submit to the department an electronic
Tier
Two
file of the facility chemical list using software
and a submission
procedure
which has been approved by [
(11)
A facility operator must contact the fire chief for approval
to submit an electronic
Tier Two
file of the facility chemical
list in lieu of the paper copy of any required Tier Two form. If approved
by the fire chief, a facility operator may submit an electronic
Tier
Two
file of the facility chemical list and shall be in compliance with
paragraphs (5)(A), (7)(A), and (9)(A) of this subsection. A facility operator
must contact the chair of the LEPC for approval to submit an electronic
Tier Two
file of the facility chemical list in lieu of the paper copy
of any required Tier Two form. If approved by the LEPC chair, a facility operator
may submit an electronic
Tier Two
file of the facility chemical
list and shall be in compliance with paragraphs (5)(B), (7)(B), and (9)(B)
of this subsection.
(12)-(16)
(No change.)
(17)
In providing appropriate facility identifiers, a facility
operator shall provide under the Facility Identification sections of the Texas
Tier Two form one of the following descriptions:
(A)
(No change.)
[(B)
through December 31, 2000, for a facility
located in an area outside of a city's limits, the description must include
a written description which provides one of the following:]
[(i)
when a street address has been assigned for purposes of
emergency services, the street address and the name of the nearest city;]
[(ii)
if the facility is located at the intersection of two
roads, the names of the roads at the intersection and the name of the nearest
city; or]
[(iii)
if neither clause (i) or (ii) of this subparagraph apply
to the facility, the approximate straight line distance and direction of the
facility from the nearest city and the name of the nearest city.]
(B)
[
(e)
(No change.)
(f)
Complaints and investigations.
(1)
The
commissioner
[
(2)
Complaints are not necessary to conduct an inspection under
this section. The
commissioner
[
(3)
(No change.)
(4)
Upon request from a representative of the
commissioner
[
(g)
Administrative penalties.
(1)
Inspections may be conducted by the
commissioner
[
(2)
(No change.)
(3)
Penalties shall be due after an order is issued by the
commissioner
[
(4)-(8)
(No change.)
(h)
Fees.
(1)-(3)
(No change.)
(4)
Fees paid by mail must be paid by check or money order
(cash payments are not acceptable) to the Texas Department of Health and must
be addressed to: Texas Department of Health,
Product Safety
[
(5)-(6)
(No change.)
§295.183.Nonmanufacturing Facilities Community Right-To-Know.
(a)
(No change.)
(b)
Definitions. The following words and terms, when used in
this section, shall have the following meanings unless the context clearly
indicates otherwise.
(1)-(2)
(No change.)
(3)
Commissioner of health--The director of
the Texas Department of Health, as referenced in the Health and Safety Code, §507.004(6).
(4)
[
(5)
[
[(5)
Director--The commissioner of the department.]
(6)
Electronic Tier Two file--An electronic
data file that contains, at a minimum, all of the information required for
submission of a hard copy Tier Two form, and which provides the required Tier
Two information for each individual reportable chemical.
(7)
[
(8)
[
(9)
[
(10)
Facility chemical list--A chemical inventory
that provides information for all reportable hazardous chemicals and EHSs
present at a reporting facility, and which is submitted to the department
in the form of either a completed electronic Tier Two file or a completed
hard copy Tier Two form.
(11)
[
(12)
[
(13)
[
(14)
[
(15)
[
(16)
[
(17)
[
(18)
[
(19)
[
(20)
[
(21)
[
(22)
[
(A)
the most current version of the Texas Tier Two Cover Sheet
form and one or more copies of the most current version of the Texas Tier
Two Chemical Description Sheet form; or
(B)
the most current version of the Texas Tier Two Cover Sheet
form and one or more copies of the most current version of the federal Tier
Two Emergency and Hazardous Chemical Inventory form.
(c)
Responsibility for implementation of program. The
commissioner's
[
(d)
Facility chemical list.
(1)
A facility operator covered by this section shall compile
and maintain a facility chemical list using the most current version of
either a
[
(2)
Completed
[
(3)-(9)
(No change.)
(10)
For purposes of electronic reporting, a facility operator
covered by this section may submit to the department an electronic
Tier
Two
file of the facility chemical list using software
and a submission
procedure
which has been approved by [
(11)
A facility operator must contact the fire chief for approval
to submit an electronic
Tier Two
file of the facility chemical
list in lieu of the paper copy of any required Tier Two form. If approved
by the fire chief, a facility operator may submit an electronic
Tier
Two
file of the facility chemical list and shall be in compliance with
paragraphs (5)(A), (7)(A), and (9)(A) of this subsection. A facility operator
must contact the chair of the LEPC for approval to submit an electronic
Tier Two
file of the facility chemical list in lieu of the paper copy
of any required Tier Two form. If approved by the LEPC chair, a facility operator
may submit an electronic
Tier Two
file of the facility chemical
list and shall be in compliance with paragraphs (5)(B), (7)(B), and (9)(B)
of this subsection.
(12)-(16)
(No change.)
(17)
In providing appropriate facility identifiers, a facility
operator shall provide under the Facility Identification sections of the Texas
Tier Two form one of the following descriptions:
(A)
(No change.)
[(B)
through December 31, 2000, for a facility
located in an area outside of a city's limits, the description must include
a written description which provides one of the following:]
[(i)
when a street address has been assigned for purposes of
emergency services, the street address and the name of the nearest city;]
[(ii)
if the facility is located at the intersection of two
roads, the names of the roads at the intersection and the name of the nearest
city; or]
[(iii)
if neither clause (i) or (ii) of this subparagraph apply
to the facility:]
[(I)
the approximate straight line distance and direction of
the facility from the nearest city and the name of the nearest city;]
[(II)
the latitude and longitude for the facility; or]
[(III)
for SIC Code 13 facilities, the plat information, as
provided to the Texas Railroad Commission for the facility.]
(B)
[
(e)
Complaints and investigations.
(1)
The
commissioner
[
(2)
Complaints are not necessary to conduct an inspection under
this section. The
commissioner
[
(3)
(No change.)
(4)
Upon request from a representative of the
commissioner
[
(f)
Administrative penalties.
(1)
Inspections may be conducted by the
commissioner
[
(2)
(No change.)
(3)
Penalties shall be due after an order is issued by the
commissioner
[
(4)-(8)
(No change.)
(g)
Fees.
(1)-(3)
(No change.)
(4)
Fees paid by mail must be paid by check or money order
(cash payments are not acceptable) to the Texas Department of Health and must
be addressed to: Texas Department of Health,
Product Safety
[
(5)-(6)
(No change.)
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 9, 2003.
TRD-200302894
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 458-7236
Chapter 411.
STATE AUTHORITY RESPONSIBILITIES
Subchapter N. STANDARDS FOR SERVICES TO INDIVIDUALS WITH CO-OCCURRING PSYCHIATRIC AND SUBSTANCE USE DISORDERS (COPSD)
The Texas Department of Mental Health and Mental Retardation (TDMHMR)
proposes new §§411.651-411.662 of Chapter 411, Subchapter N, concerning
standards for services to individuals with co-occurring psychiatric and substance
use disorders (COPSD).
The proposed new rules seek to improve outcomes for individuals with co-occurring
psychiatric and substance use disorders by defining first, minimum competencies
for staff serving members of the priority population who have serious impairment
from co-occurring psychiatric and substance use disorders; and second, minimum
standards for assessing and providing services to this population. Additionally,
the proposed rules define access standards for individuals with co-occurring
psychiatric and substance use disorders who meet the priority population definitions.
These standards are intended to clarify the current performance contract requirement
that members of the priority population not be restricted from services due
to substance use disorders.
Cindy Brown, chief financial officer, has determined that for each year
of the first five years the proposed rules are in effect, enforcing or administering
the rules does not have implications relating to cost or revenue of the state
or local governments because the standards required by the new subchapter
will be met through the reallocation of existing resources.
A.J. Ernst, Ph.D., liaison between TDMHMR and the Texas Commission on Alcohol
and Drug Abuse, has determined that for each year of the first five years
the proposed new rules are in effect, the public benefit expected is the provision
of appropriate services to individuals with co-occurring psychiatric and substance
use disorders. It is anticipated that there will be no additional economic
cost to persons required to comply with the proposed rules because they do
not impose requirements on such persons that are more difficult or more expensive
to meet than existing standards.
It is anticipated that the proposed new rules will not affect a local economy
because the rules do not contain requirements related to employment or a local
economy.
It is anticipated that the proposed new rules will not have an adverse
economic effect on small businesses or microbusinesses because the rules do
not impose requirements on small businesses or microbusinesses that are more
difficult or more expensive to meet than existing standards.
Written comments on the proposal may be sent to Linda Logan, director,
Policy Development, Texas Department of Mental Health and Mental Retardation,
P.O. Box 12668, Austin, Texas 78711-2668, within 30 days of publication.
1.
GENERAL PROVISIONS
25 TAC §§411.651 - 411.656
These new rules are proposed under the Texas Health and Safety
Code, §532.015, which provides the Texas Mental Health and Mental Retardation
Board with broad rulemaking authority; §533.047 (Managed Care Organizations:
Medicaid Program), §534.052 (Rules and Standards), and §534.058
(Standards of Care).
These proposed rules affect the Texas Health and Safety Code, §532.015; §533.047
(Managed Care Organizations: Medicaid Program), §534.052 (Rules and Standards),
and §534.058 (Standards of Care).
§411.651.Purpose.
The purpose of this subchapter is to enhance existing mental health
services provided by the entities defined in §411.653 of this title (relating
to Definitions) by establishing standards to ensure the effective and coordinated
provision of services to individuals who require specialized support or treatment
due to co-occurring psychiatric and substance use disorders (COPSD).
§411.652.Application.
(a)
The provisions of this subchapter apply to entities defined
in §411.653 of this title (relating to Definitions).
(b)
The provisions of this subchapter are in addition to requirements
contained in other TDMHMR rules. This subchapter does not supercede other
TDMHMR rules that may also apply to the provision of services to individuals
as defined in §411.653 of this title (relating to Definitions).
§411.653.Definitions.
The following words and terms, when used in this subchapter, have the
following meanings, unless the context clearly indicates otherwise:
(1)
Access--An individual's ability to obtain the services
needed to achieve the outcomes as described in §411.659 of this title
(relating to Quality Management).
(2)
Adolescent--A person who is 13 through 17 years of age.
(3)
Adult--A person who is 18 years of age or older.
(4)
Child--A person who is 0 through 12 years of age.
(5)
Contract--A legally enforceable written agreement for the
purchase of services.
(6)
Co-occurring psychiatric and substance use disorders (COPSD)--The
co-occurring diagnoses of mental illness and substance use disorders.
(7)
Diagnostic and Statistical Manual
of Mental Disorders
(DSM)--The most recent edition of the American
Psychiatric Association's official classification of mental disorders.
(8)
Entity or entities--The terms used to refer to the following:
(A)
local mental health authorities (LMHAs);
(B)
Medicaid managed care organizations (MMCOs);
(C)
state mental health facilities (SMHF); and
(D)
Medicaid providers who are required to comply with Chapter
419, Subchapter L of this title, governing Medicaid Rehabilitative Services,
or Chapter 412, Subchapter J of this title, governing Service Coordination.
(9)
Family member--Anyone an individual identifies as being
involved in the individual's life (e.g., the individual's parent, spouse,
child, sibling, significant other, or friend).
(10)
Individual--
(A)
For an LMHA--An adult with COPSD, adolescent with COPSD,
or child with COPSD seeking or receiving services from or through the LMHA
or its provider.
(B)
For an MMCO--An enrolled adult with COPSD, adolescent with
COPSD, or child with COPSD seeking or receiving services from or through the
MMCO or its provider.
(C)
For an SMHF--An adult with COPSD, adolescent with COPSD,
or child with COPSD seeking or receiving services from or through the SMHF
or its provider.
(D)
For a provider of rehabilitative services or a provider
of service coordination reimbursed by Medicaid--An adult with COPSD, adolescent
with COPSD, or child with COPSD seeking or receiving rehabilitative services
or service coordination reimbursed by Medicaid.
(11)
Integrated assessment--An assessment of an individual
to gather both substance use and psychiatric information.
(12)
Legally authorized representative (LAR)--A person authorized
by law to act on behalf of an individual with regard to a matter (e.g., a
parent, guardian, or managing conservator of a child or adolescent, a guardian
of an adult, or a personal representative of a deceased individual).
(13)
Local mental health authority (LMHA)--A governmental entity
to which the Texas MHMR Board delegates its authority and responsibility for
any, all, or portions of planning, policy development, coordination, resource
development and allocation, and oversight of the delivery of mental health
services in a local service area.
(14)
Medicaid managed care organization (MMCO)--An entity that
has a current Texas Department of Insurance certificate of authority to operate
as a health maintenance organization (HMO) under Article 20A of the Texas
Insurance Code or as an approved nonprofit health corporation under Article
21.52F of the Texas Insurance Code and that provides mental health services
to Medicaid recipients.
(15)
Psychiatric disorder--
(A)
In an adult, a severe and persistent mental illness such
as schizophrenia, major depression, bipolar disorder, or other severely disabling
mental disorder; or
(B)
In a child or adolescent, a diagnosis of mental illness
in one who exhibits serious emotional, behavioral, or mental disorders and
who: has a serious functional impairment; is at risk of disruption of a preferred
living or child care environment due to psychiatric symptoms; or is enrolled
in a school system's special education program because of a serious emotional
disturbance.
(16)
Readiness to change--An individual's emotional and cognitive
awareness of the need to change, coupled with a commitment to change.
(17)
Services--Services provided to treat a psychiatric or
substance use disorder.
(18)
Staff--Full- or part-time employees, contractors, and
students of an entity.
(19)
Substance use disorder--The use of one or more drugs,
including alcohol, which significantly and negatively impacts one or more
major areas of life functioning and which meets criteria described in the
current
Diagnostic and Statistical Manual of Mental
Disorders
for substance abuse or substance dependence.
(20)
Support services--Services delivered to an individual,
legally authorized representative (LAR) or family member(s) to assist the
individual in functioning in the living, learning, working, and socializing
environments.
(21)
Treatment plan--A written document developed by the provider,
in consultation with the individual (and LAR on the individual's behalf),
that is based on assessments of the individual and which addresses the individual's
strengths, needs, goals, and preferences regarding service delivery as referenced
in §412.315 (relating to Assessment and Treatment Planning) of Chapter
412, Subchapter G of this title, governing Mental Health Community Services
Standards.
§411.654.Services to Individuals.
(a)
The services provided to an individual with COPSD must:
(1)
address both psychiatric and substance use disorders;
(2)
be provided within established practice guidelines for
this population; and;
(3)
facilitate individuals or LARs in accessing available services
they need and choose, including self-help groups.
(b)
The services provided to an individual with COPSD must
be provided:
(1)
by staff who are competent in the areas identified in §411.658
of this title (relating to Specialty Competencies of Staff Providing Services
to Individuals with COPSD);
(2)
in an individual or small group setting;
(3)
in an age, gender, and culturally appropriate manner; and
(4)
in accordance with the individual's treatment plan.
§411.655.Responsibility for Compliance.
(a)
Entities must comply with this subchapter.
(b)
LMHAs, MMCOs, and SMHFs must require providers, by contract,
to comply with §411.654 of this title (relating to Services to Individuals), §411.657
of this title (relating to Access to Services), §411.658 of this title
(relating to Specialty Competencies of Staff Providing Services to Individuals
with COPSD), and §411.660 of this title (relating to Screening, Assessment,
and Treatment Planning).
(c)
Entities must monitor staff who provide services to an
individual with COPSD and contract providers for compliance with the applicable
provisions of Divisions 2 and 3.
(d)
MMCOs must comply and must require staff to comply with
Chapter 404, Subchapter E of this title, governing Rights of Persons Receiving
Mental Health Services.
§411.656.TDMHMR Central Office Responsibilities.
(a)
TDMHMR Central Office must make available training resources
for the competencies identified in §411.658 of this title (relating to
Specialty Competencies of Staff Providing Services to Individuals with COPSD).
(b)
TDMHMR Central Office must require LMHAs and SMHFs to develop
quality management systems that ensure an appropriate integrated assessment
for each individual and the appropriate delivery of services.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on May 12, 2003.
TRD-200302969
Rudy Arredondo, Ed.D
Chairman, Texas MHMR Board
Texas Department of Mental Health and Mental Retardation
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 206-5283
25 TAC §§411.657 - 411.659
These new rules are proposed under the Texas Health and Safety
Code, §532.015, which provides the Texas Mental Health and Mental Retardation
Board with broad rulemaking authority; §533.047 (Managed Care Organizations:
Medicaid Program), §534.052 (Rules and Standards), and §534.058
(Standards of Care).
These proposed rules affect the Texas Health and Safety Code, §532.015; §533.047
(Managed Care Organizations: Medicaid Program), §534.052 (Rules and Standards),
and §534.058 (Standards of Care).
§411.657.Access to Services.
(a)
In determining an individual's initial and ongoing eligibility
for any service, an entity may not exclude an individual based on the following
factors:
(1)
the individual's past or present mental illness or substance
use diagnosis or services;
(2)
medications prescribed to the individual in the past or
present;
(3)
the presumption of the individual's inability to benefit
from treatment;
(4)
the specific substance used by the individual;
(5)
the individual's continued substance use; or
(6)
the individual's level of success in prior treatment episodes.
(b)
Entities must ensure that an individual's refusal of a
particular service does not preclude the individual from accessing other needed
mental health or substance abuse services.
(c)
The LMHAs, MMCOs, and SMHFs must ensure that individuals
have access to staff who meet specialty competencies described in §411.658
of this title (relating to Specialty Competencies of Staff Providing Services
to Individuals with COPSD).
(d)
Entities must establish and implement procedures to ensure
the continuity of screening, assessment, and treatment services provided to
individuals.
§411.658.Specialty Competencies of Staff Providing Services to Individuals with COPSD.
(a)
When providing services to children and adolescents, all
competencies listed in this section must be tailored to address the needs
of these individuals.
(b)
Entities must ensure that services to individuals are provided
by staff within their scope of practice who have the following minimum knowledge,
technical, and interpersonal competencies prior to providing services:
(1)
Knowledge competencies:
(A)
knowledge of the fact that psychiatric and substance use
disorders are potentially recurrent relapsing disorders, and that although
abstinence is the goal, relapses can be opportunities for learning and growth;
(B)
knowledge of the impact of substance use disorders on developmental,
social, and physical growth and development of children and adolescents;
(C)
knowledge of interpersonal and family dynamics and their
impact on individuals;
(D)
knowledge of the current
Diagnostic
and Statistical Manual of Mental Disorders
diagnostic criteria for
psychiatric disorders and substance use disorders and the relationship between
psychiatric disorders and substance use disorders;
(E)
knowledge regarding the increased risks of self-harm, suicide,
and violence in individuals;
(F)
knowledge of the elements of an integrated treatment plan
and community support plan for individuals;
(G)
basic knowledge of pharmacology as it relates to individuals;
(H)
basic understanding of the neurophysiology of addiction;
(I)
knowledge of the phases of recovery for individuals;
(J)
knowledge of the relationship between COPSD and Axis III
disorders; and
(K)
basic knowledge of self-help in recovery.
(2)
Technical competencies:
(A)
ability to perform age-appropriate assessments of individuals;
and
(B)
ability to formulate an individualized treatment plan and
community support plan for individuals.
(3)
Interpersonal competencies:
(A)
ability to tailor interventions to the process of recovery
for individuals;
(B)
ability to tailor interventions with readiness to change;
and
(C)
ability to support individuals who choose to participate
in 12-step recovery programs.
(c)
These competencies may be evidenced by compliance with
current licensure requirements of the governing or supervisory boards for
the respective disciplines involved in serving individuals with COPSD or by
documentation regarding the attainment of the competencies described in subsection
(b) of this section.
§411.659.Quality Management.
(a)
The LMHAs and MMCOs must develop and implement a plan for
quality management of services to individuals with COPSD as required in §412.313
(relating to Quality Management) of Chapter 412, Subchapter G of this title,
governing Mental Health Community Services Standards.
(b)
The SMHFs must develop and implement a plan for quality
management of services to individuals. The plan must be incorporated into
the Improving Organizational Performance System (IOPS) and must identify clinical
measures. The plan must describe the following:
(1)
activities for measuring, assessing, and improving processes
for delivering services in accordance with this subchapter; and
(2)
methods for evaluating and improving outcomes for individuals
receiving services.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed
with the Office of the Secretary of State on May 12, 2003.
TRD-200302968
Rudy Arredondo, Ed.D
Chairman, Texas MHMR Board
Texas Department of Mental Health and Mental Retardation
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 206-5283
25 TAC §411.660
The new rule is proposed under the Texas Health and Safety
Code, §532.015, which provides the Texas Mental Health and Mental Retardation
Board with broad rulemaking authority; §533.047 (Managed Care Organizations:
Medicaid Program), §534.052 (Rules and Standards), and §534.058
(Standards of Care).
The proposed rule affects the Texas Health and Safety Code, §532.015; §533.047
(Managed Care Organizations: Medicaid Program), §534.052 (Rules and Standards),
and §534.058 (Standards of Care).
§411.660.Screening, Assessment, and Treatment Planning.
(a)
Screening and assessment. When a screening determines an
assessment is necessary, an integrated assessment must be conducted to consider
relevant past and current medical, psychiatric, and substance use information,
including:
(1)
information from the individual (and LAR on the individual's
behalf) regarding the individual's strengths, needs, natural supports, responsiveness
to previous treatment, as well as preferences for and objections to specific
treatments;
(2)
the needs and desire of the individual for family member
involvement in treatment and services if the individual is an adult without
an LAR; and
(3)
recommendations and conclusions regarding treatment needs
and eligibility for services for individuals.
(b)
Treatment plan development.
(1)
The individual (and LAR on the individual's behalf, if
applicable) must be involved in all aspects of planning the individual's treatment.
If the individual has requested the involvement of a family member, then the
provider must involve the family member in all aspects of planning the individual's
treatment.
(2)
The treatment plan must identify services to be provided
and must include measurable outcomes that address COPSD.
(3)
The treatment plan must identify the LAR's or family members'
need for education and support services related to the individual's mental
illness and substance abuse and a method to facilitate the LAR's or family
members' receipt of the needed education and support services.
(4)
The individual, LAR, and, if requested, family member,
must be given a copy of the treatment plan.
(c)
Treatment plan review. Each individual's treatment plan
must be reviewed as clinically indicated, but at least once every 90 calendar
days, and the review must be documented.
(d)
Progress notes. The medical record notes must contain a
description of the individual's progress towards goals identified in the treatment
plan, as well as other clinically significant activities or events.
(e)
Episode of care summary. Upon discharge or transfer of
an individual from one entity to another, the individual's medical record
must identify the services provided according to this subchapter and the items
referenced in §412.315 (relating to Assessment and Treatment Planning)
of Chapter 412, Subchapter G of this title, governing Mental Health Community
Services Standards.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed
with the Office of the Secretary of State on May 12, 2003.
TRD-200302967
Rudy Arredondo, Ed.D
Chairman, Texas MHMR Board
Texas Department of Mental Health and Mental Retardation
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 206-5283
25 TAC §411.661, §411.662
These new rules are proposed under the Texas Health and Safety
Code, §532.015, which provides the Texas Mental Health and Mental Retardation
Board with broad rulemaking authority; §533.047 (Managed Care Organizations:
Medicaid Program), §534.052 (Rules and Standards), and §534.058
(Standards of Care).
These proposed rules affect the Texas Health and Safety Code, §532.015; §533.047
(Managed Care Organizations: Medicaid Program), §534.052 (Rules and Standards),
and §534.058 (Standards of Care).
§411.661.References.
The following rules and laws are referenced in this subchapter:
(1)
Chapter 404, Subchapter E of this title, governing Rights
of Persons Receiving Mental Health Services;
(2)
Chapter 412, Subchapter G of this title, governing Mental
Health Community Services Standards;
(3)
Chapter 412, Subchapter J of this title, governing Service
Coordination;
(4)
Chapter 419, Subchapter L of this title, governing Medicaid
Rehabilitative Services; and
(5)
Texas Code of Insurance, Articles 20A and 21.52F;
§411.662.Distribution.
(a)
This subchapter will be distributed to:
(1)
members of the Texas Mental Health and Mental Retardation
Board;
(2)
executive, management, and program staff of TDMHMR Central
Office;
(3)
executive staff of the Texas Commission on Alcohol and
Drug Abuse;
(4)
CEOs of all LMHAs, MMCOs, and SMHFs; and
(5)
advocacy organizations.
(b)
The CEO of each LMHA, MMCO, and SMHF shall disseminate
the information contained in this subchapter to appropriate staff members
and contract providers.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed
with the Office of the Secretary of State on May 12, 2003.
TRD-200302966
Rudy Arredondo, Ed.D
Chairman, Texas MHMR Board
Texas Department of Mental Health and Mental Retardation
Earliest possible date of adoption: June 22, 2003
For further information, please call: (512) 206-5283
Chapter 621.
EARLY CHILDHOOD INTERVENTION
Subchapter I. SYSTEM OF FEES
Chapter 91.
CANCER
Chapter 98.
HIV AND STD PREVENTION
These sections implement the provisions of
] the Texas
HIV Medication Program (program) as
required in the
[
authorized
by the Human Immunodeficiency Virus Services Act,
] Health and Safety
Code,
§85.063
[
§§85.061-85.066
]. The
program
, established under the authority of the Health and Safety Code,
Chapter 85, Subchapter C, HIV Medication Program, provides prescription drug
assistance to low-income individuals with HIV disease.
[
shall assist
]
Hospital
[
hospital
] districts, local health
departments, public or nonprofit hospitals and clinics,
and
nonprofit
community organizations
may request assistance from the program with
[
, and HIV-infected individuals in
] obtaining
public
health pricing for
medications
to treat individuals with HIV disease
[
that have been shown to be effective in reducing hospitalizations
due to HIV-related conditions and approved by the Texas Board of Health for
program coverage
].
(6)
] HIV--Human immunodeficiency
virus infection as defined by the Centers for Disease Control and Prevention.
(7)
] Legally responsible person--A
parent, managing conservator, or other person that is legally responsible
for the support of a minor, a ward, or himself/herself.
(8)
] Minor--A person who has not
reached his or her 18th birthday and who has not been emancipated by a court
or who is not married or recognized as an adult by the State of Texas.
(9)
] Program--The Texas HIV Medication
Program established under the Health and Safety Code, Chapter 85, Subchapter
C.
(b)
] A list of the approved medications
and specific eligibility criteria for them may be obtained from the Texas
Department of Health, Bureau of HIV and STD Prevention, Texas HIV Medication
Program, 1100 West 49th Street, Austin, Texas 78756-3199
or on the program's
website at: http://www.tdh.state.tx.us/hivstd/meds/document.htm
.
the
] program in
a manner that allows full participation of individuals regardless of their
race, color, national origin, or handicapping conditions. In addition and
for purposes of the program, discrimination on the basis of gender or sexual
orientation is prohibited.
The Texas HIV Medication Program will coordinate with the department's Bureau
of Chronically Ill and Disabled Children Services for the provision of HIV
medication for all applicants under
] 18
as specified in 42 U.S.C.
300ff-21, and Health and Safety Code §85.062
[
years of age
].
is diagnosed with HIV infection and
] meets
the [
drug-specific
]
medical
eligibility criteria
in §98.107 of this title (relating to Medical Eligibility Criteria)
[
established by the program
];
of §98.113
] of this title
(relating
to Residency Eligibility Criteria);
[
(relating to Residency; Documentation
of Residency).
]
is
under the care of a licensed physician who prescribes the medication(s)
];
covered by
] the program [
as described
in §98.103 of this title (relating to Medication Coverage)
]; and
meets the financial eligibility criteria of the program
].
Chapter 145.
NURSING FACILITIES AND RELATED INSTITUTIONS
Chapter 146.
TRAINING AND REGULATION OF PROMOTORES(AS) OR COMMUNITY HEALTH WORKERS
46
].
and
]
Community Health Worker Training and Certification Advisory Committee established
by §146.2 of this title.
voluntary
] training and certification program under the
Health and Safety Code, Chapter
48
[
46
].
Nothing in this chapter requires promotores(as) or community
health workers, instructors, sponsoring institutions or training programs
to participate in this voluntary training and certification program.
]
46
] and this chapter
and agrees to abide by them;
30
] days.
30
] days.
46
] and this chapter and agrees
to abide by them;
46
].
30
] days.
30
] days.
46
] and this chapter and agrees to
abide by them;
30
] days.
30
] days.
during the three-year period preceding the effective date of these rules
]
and not less than 1000 cumulative hours
between July 1997 to December
2002
[
during any 12 consecutive months
]. A certificate will
recognize all those who have successfully completed an entry-level training
and certification program.
during the three year period, preceding the effective date of
these rules
]. Upon submission of the application forms by the practicing
promotor(a) or community health worker and upon approval by the department,
the department shall issue a certificate of competence to a person who has
performed promotor(a) or community health worker services for not less than
1000 cumulative hours
between July 1997 to December 2002
[
during any 12 consecutive months
], as documented on form(s) prescribed
by the department.
,
] have experience in
instructing
or training promotores(as)
[
performing promotor(a)
] or community
health
workers
[
worker services
] for not less than 1000
cumulative hours
between July 1997 to December 2002
[
during
any 12 consecutive months, or have attended a competency-based training program
within the three years from the date these rules are final
]. Upon submission
of the application forms by an instructor, other licensed/certified healthcare
professional or certified health education specialist and upon approval by
the department, the department shall issue an instructor certificate to a
person who is certified by the National Commission for Health Education Credentialing,
Inc., or who is a licensed/certified healthcare professional and to a promotor(a)
or community health worker who meets the above qualifications.
and
]
.
]
quality
] for the certificate of competence.
the Act
] or this chapter at the time of renewal.
80
] contact hours of
continuing education acceptable to the department during each biennial renewal
period. An instructor must complete at a minimum
20
[
32
]
contact hours of continuing education acceptable to the department during
each biennial renewal period.
Chapter 229.
FOOD AND DRUG
Subchapter X. LICENSURE OF DEVICE DISTRIBUTORS AND MANUFACTURERS
2003
], 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.
Chapter 295.
OCCUPATIONAL HEALTH
2003
], 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.
12
] members appointed by the board. The composition of
the committee shall include:
four
] consumer representatives;
and
eight
] nonconsumer representatives.
chairman of the
board
] shall
select from its members the
[
appoint a
] presiding officer and an assistant presiding officer to begin serving
on September 1 of each odd-numbered year.
serve until a successor is appointed to
]
complete the unexpired portion of the term of the office of presiding officer.
temporarily
] by vote of the committee [
until a successor is appointed by the chairman of the board
].
(7)
The presiding officer and
assistant presiding officer serving on August 1, 1999, will continue to serve
until the chairman of the board appoints their successors.]
five
] working days before the
meeting.
Proposed rules shall be sent to the committee at least ten working
days before the meeting.
Subchapter H. HAZARDOUS CHEMICAL RIGHT-TO-KNOW
(3)
] Current Tier Two threshold--A
quantity which is assigned to a specific hazardous chemical or extremely hazardous
substance in the most recent version of Title 40 CFR, Part 370, and which
determines whether a specific hazardous chemical or extremely hazardous substance
must be included on the Tier Two form.
(4)
] Department--The Texas Department
of Health.
(6)
] EPCRA or SARA, Title III--The
federal Emergency Planning and Community Right-To-Know Act, also known as
the Superfund Amendments and Reauthorization Act of 1986, Title III, 42 USC,
Chapter 116 et seq., and regulations promulgated by the EPA in Title 40 CFR,
Parts 355-370.
(7)
] EHS or extremely hazardous
substance--Any substance as defined in EPCRA, §302, or listed by the
EPA in Title 40 CFR, Part 355, Appendices A and B.
(8)
] Facility--All buildings, equipment,
structures, and other stationary items that are located on a single site or
on contiguous or adjacent sites and that are owned or operated by the same
person or by any person who controls, is controlled by, or is under common
control with that person, and that is in Standard Industrial Classification
(SIC) Code 20-39.
(9)
] Facility operator--The person
who controls the day-to-day operations of the facility.
(10)
] Fire chief--The elected
or paid administrative head of the fire department having jurisdiction over
a facility.
(11)
] Headquarters facility--Either
the facility itself when the facility is staffed more than 20 hours per week,
or, for facilities which are staffed less than 20 hours per week, the headquarters
facility is an office which is staffed full time by the facility operator
and which serves as the central office for staff who are responsible for overseeing
the operations of the facility.
(12)
] Latitude and longitude--A
mapping coordinate system, designated in units of
decimal
degrees,
[
minutes, and seconds,
] which serves as a facility location description
on the Tier Two form in lieu of a street address.
(13)
] LEPC--
The
[
the
] Local Emergency Planning Committee, a group of individuals representing
a designated emergency planning district and whose membership on the committee
has been approved by the Texas State Emergency Response Commission as meeting
the requirements of EPCRA, §301.
(14)
] Research laboratory--A laboratory
that engages in only research or quality control operations. Chemical specialty
product manufacturing laboratories, full scale pilot plant operation laboratories
that produces products for sale, and service laboratories are not research
laboratories.
(15)
] Standard Industrial Classification
(SIC) Code--The four digit number which describes a facility's primary activity,
which is determined by its principal product or group of products produced.
For the purposes of the Act, the SIC Code is the one that is assigned to a
facility by the Texas Workforce Commission. If a facility does not have
a
[
an
] SIC Code assigned by the Texas Workforce Commission,
then the department must be consulted for assistance in determining the correct
code.
(16)
] Submission or required submission--The
facility chemical list information which is submitted to the department
in the form of either a completed hard copy Tier Two form or an electronic
Tier Two file
for a single facility to comply with subsection (d) of
this section. When facility chemical list information for multiple facilities
is submitted to the department on one Tier Two form for purposes of paperwork
reduction, as allowed by subsection (d)(15) of this section
, or as one
electronic Tier Two file
, then the Tier Two form
or electronic
file
shall be counted by the department as multiple required submissions
under subsections (h)(2) and (3) of this section.
(17)
] Technically qualified individual--An
individual with a professional education and background working in the research
or medical fields, such as a physician, a registered nurse, or an individual
holding a college bachelor's degree in science.
(18)
] Texas Tier Two Cover Sheet
form--A form developed by the department to collect general information about
each reporting facility which is submitting a facility chemical list.
(19)
] Tier Two form--A document
that provides information for all reportable hazardous chemicals and EHSs
present at a reporting facility. An "annual Tier Two form" provides the information
for all hazardous chemicals and EHSs present at a facility at any time during
the previous calendar year in quantities that met or exceeded the current
Tier Two thresholds. An "initial Tier Two form" is one that provides information
for hazardous chemicals or EHSs that meet or exceed the current Tier Two thresholds,
but which were not reported on a previously submitted annual Tier Two form.
An "updated Tier Two form" is one that provides significant new information
concerning an aspect of one or more hazardous chemicals or EHSs which were
previously reported on either the annual or first time Tier Two forms submitted
by a facility. A "modified Tier Two form" provides information for all hazardous
chemicals and EHSs that are present at a facility at a threshold of 500 pounds;
this type of report may be prepared in response to a request from a citizen
for information, in lieu of the workplace chemical list. The Tier Two form
is a set of completed reporting forms for submitting the information required
for the facility chemical list, which consists of one of the following sets
of forms:
(20)
] Workplace chemical list--A
list of hazardous chemicals developed under Title 29 CFR, §1910.1200(e)(1)(i).
director's
] responsibilities under the Act
are carried out through the Texas Department of Health,
Product Safety
[
Toxic Substances Control
] Division, Hazard Communication
Branch. Compliance documents and routine inquiries regarding this Act shall
be addressed, until further notice by the
commissioner
[
director
], to: Texas Department of Health,
Product Safety
[
Toxic Substances Control
] Division, Hazard Communication Branch, 1100
West 49th Street, Austin, Texas 78756
, at toll free telephone number
1-800-452-2791
.
The completed
]
Tier Two forms shall be typed or mechanically reproduced, subject to approval
of the department. The Texas Tier Two Cover Sheet submitted as a part of the
Tier Two form to the department shall bear an original signature of an authorized
representative of the facility operator and the date on which the form was
signed.
EPA or
] the department.
[
A Texas Tier Two Cover Sheet, which has been signed and dated by the
authorized representative of the facility operator, shall be submitted to
the department with the electronic file of the facility chemical list.
]
A copy of the completed versions of the electronic
Tier Two
file
and any other document required by the department
[
of the facility
chemical list and the Texas Tier Two Cover Sheet
] and the appropriate
filing fee as provided under subsections (h)(2) and (3) of this section shall
meet the requirements of this subsection and may be submitted to the department
to comply with this subsection.
(C)
] effective January 1,
2003
[
2001
], for a facility located in an area outside of
a city's limits, the description must include either a street address or the
latitude and longitude for the facility. Latitude and longitude values shall
be given in units of
decimal
degrees [
, minutes, and seconds
and be provided
] to
four decimal places
[
0.1 seconds
]. Latitude and longitude values shall be obtained using a Global Positioning
System instrument which has been calibrated to either the North American Datum
of 1983 or the World Geodesic System of 1984.
director
] or his
designated representative shall investigate in a timely manner a complaint
relating to an alleged violation of the Act. Such complaints do not have to
be submitted to the department in writing and may be anonymous. An inspection
based on a complaint is not limited to the specific allegations of the complaint.
A facility operator who refuses to allow such an investigation shall be in
violation of the Act.
director
] or his designated
representatives may enter a facility at reasonable times to conduct random
compliance inspections. A facility operator who refuses to allow such an inspection
shall be in violation of the Act.
director
], a facility operator shall make or allow photocopies
of documents to be made and permit the representative to take photographs
to verify the compliance status of the employer. Such requests may be made
during a compliance inspection or in a written Notice of Violation issued
by the department.
director
] or his designated representative to determine if persons are
in violation of the Act or the rules adopted by the Board of Health to enforce
the Act. Persons found to be in violation will be notified in writing of any
alleged violations.
director
]. With the exception of a case where
the written notice from the department documents that a violation involves
failure to make a good faith effort to comply with the Act, an order may be
issued on or after the 16th business day following the date that a written
notification of violations is received by the facility operator, unless the
department receives an acceptable written response which documents that each
violation has been corrected, an informal conference has been requested, or
that a formal hearing has been requested. If an informal conference is held,
the facility operator must respond within 10 business days after the facility
operator receives a summary letter following the informal conference. In a
case where the written notice from the department documents that a violation
involves failure to make a good faith effort to comply with the Act, an order
may be issued at any time.
Toxic Substances Control
] Division, Hazard Communication Branch, 1100
West 49th Street, Austin, Texas 78756.
(3)
] Current Tier Two threshold--A
quantity which is assigned to a specific hazardous chemical or extremely hazardous
substance in the most recent version of Title 40 CFR, Part 370, and which
determines whether a specific hazardous chemical or extremely hazardous substance
must be included on the Tier Two form.
(4)
] Department--The Texas Department
of Health.
(6)
] EPCRA or SARA, Title III--The
federal Emergency Planning and Community Right-To-Know Act, also known as
the Superfund Amendments and Reauthorization Act of 1986, Title III, 42 USC,
Chapter 116 et seq., and regulations promulgated by the EPA in Title 40 CFR,
Parts 355-370.
(7)
] EHS or extremely hazardous
substance--Any substance as defined in EPCRA, §302, or listed by the
EPA in Title 40 CFR, Part 355, Appendices A and B.
(8)
] Facility--All buildings, equipment,
structures, and other stationary items that are located on a single site or
on contiguous or adjacent sites and that are owned or operated by the same
person or by any person who controls, is controlled by, or is under common
control with that person, and that is operated by the state or a political
subdivision of the state.
(9)
] Facility operator--The person
who controls the day-to-day operations of the facility.
(10)
] Fire chief--The elected
or paid administrative head of the fire department having jurisdiction over
a facility.
(11)
] Headquarters facility--Either
the facility itself when the facility is staffed more than 20 hours per week,
or, for facilities which are staffed less than 20 hours per week, the headquarters
facility is an office which is staffed full time by the facility operator
and which serves as the central office for staff who are responsible for overseeing
the operations of the facility.
(12)
] Latitude and longitude--A
mapping coordinate system, designated in units of
decimal
degrees,
[
minutes, and seconds,
] which serves as a facility location description
on the Tier Two form in lieu of a street address.
(13)
] LEPC--
The
[
the
] Local Emergency Planning Committee, a group of individuals representing
a designated emergency planning district and whose membership on the committee
has been approved by the Texas State Emergency Response Commission as meeting
the requirements of EPCRA, §301.
(14)
] Research laboratory--A laboratory
that engages in only research or quality control operations. Chemical specialty
product manufacturing laboratories, full scale pilot plant operation laboratories
that produces products for sale, and service laboratories are not research
laboratories.
(15)
] Standard Industrial Classification
(SIC) Code--The four digit number which describes a facility's primary activity,
which is determined by its principal product or group of products produced.
For the purposes of the Act, the SIC Code is the one that is assigned to a
facility by the Texas Workforce Commission. If a facility does not have
a
[
an
] SIC Code assigned by the Texas Workforce Commission,
then the department must be consulted for assistance in determining the correct
code.
(16)
] Submission or required submission--The
facility chemical list information which is submitted to the department
in the form of either a completed hard copy Tier Two form or an electronic
Tier Two file
for a single facility to comply with subsection (d) of
this section. When facility chemical list information for multiple facilities
is submitted to the department on one Tier Two form for purposes of paperwork
reduction, as allowed by subsection (d)(15) of this section
, or as one
electronic Tier Two file
, then the Tier Two form
or electronic
file
shall be counted by the department as multiple required submissions
under subsections (h)(2) and (3) of this section.
(17)
] Technically qualified individual--An
individual with a professional education and background working in the research
or medical fields, such as a physician, a registered nurse, or an individual
holding a college bachelor's degree in science.
(18)
] Texas Tier Two Cover Sheet
form--A form developed by the department to collect general information about
each reporting facility which is submitting a facility chemical list.
(19)
] Tier Two form--A document
that provides information for all reportable hazardous chemicals and EHSs
present at a reporting facility. An "annual Tier Two form" provides the information
for all hazardous chemicals and EHSs present at a facility at any time during
the previous calendar year in quantities that met or exceeded the current
Tier Two thresholds. An "initial Tier Two form" is one that provides information
for hazardous chemicals or EHSs that meet or exceed the current Tier Two thresholds,
but which were not reported on a previously submitted annual Tier Two form.
An "updated Tier Two form" is one that provides significant new information
concerning an aspect of one or more hazardous chemicals or EHSs which were
previously reported on either the annual or first time Tier Two forms submitted
by a facility. A "modified Tier Two form" provides information for all hazardous
chemicals and EHSs that are present at a facility at a threshold of 500 pounds;
this type of report may be prepared in response to a request from a citizen
for information, in lieu of the workplace chemical list. The Tier Two form
is a set of completed reporting forms for submitting the information required
for the facility chemical list, which consists of one of the following sets
of forms:
(20)
] Workplace chemical list--A
list of hazardous chemicals developed under the Texas Hazard Communication
Act, §502.005(a).
director's
] responsibilities under the Act
are carried out through the Texas Department of Health,
Product Safety
[
Toxic Substances Control
] Division, Hazard Communication
Branch. Compliance documents and routine inquiries regarding this Act shall
be addressed, until further notice by the
commissioner
[
director
], to: Texas Department of Health,
Product Safety
[
Toxic Substances Control
] Division, Hazard Communication Branch, 1100
West 49th Street, Austin, Texas 78756
, at toll free telephone number
1-800-452-2791
.
The completed
]
Tier Two forms shall be typed or mechanically reproduced, subject to approval
of the department. The Texas Tier Two Cover Sheet submitted as a part of the
Tier Two form to the department shall bear an original signature of an authorized
representative of the facility operator and the date on which the form was
signed.
EPA or
] the department.
[
A Texas Tier Two Cover Sheet, which has been signed and dated by the
authorized representative of the facility operator, shall be submitted to
the department with the electronic file of the facility chemical list.
]
A copy of the completed versions of the electronic
Tier Two
file
and any other document required by the department
[
of the facility
chemical list and the Texas Tier Two Cover Sheet
] and the appropriate
filing fee as provided under subsections (h)(2) and (3) of this section shall
meet the requirements of this subsection and may be submitted to the department
to comply with this subsection.
(C)
] effective January 1,
2003
[
2001
], for a facility located in an area outside of
a city's limits, the description must include either a street address or the
latitude and longitude for the facility. Latitude and longitude values shall
be given in units of
decimal
degrees [
, minutes, and seconds
and be provided
] to
four decimal places
[
0.1 seconds
]. Latitude and longitude values shall be obtained using a Global Positioning
System instrument which has been calibrated to either the North American Datum
of 1983 or the World Geodesic System of 1984.
director
] or his
designated representative shall investigate in a timely manner a complaint
relating to an alleged violation of the Act. Such complaints do not have to
be submitted to the department in writing and may be anonymous. An inspection
based on a complaint is not limited to the specific allegations of the complaint.
A facility operator who refuses to allow such an investigation shall be in
violation of the Act.
director
] or his designated
representatives may enter a facility at reasonable times to conduct random
compliance inspections. A facility operator who refuses to allow such an inspection
shall be in violation of the Act.
director
], a facility operator shall make or allow photocopies
of documents to be made and permit the representative to take photographs
to verify the compliance status of the employer. Such requests may be made
during a compliance inspection or in a written Notice of Violation issued
by the department.
director
] or his designated representative to determine if persons are
in violation of the Act or the rules adopted by the Board of Health to enforce
the Act. Persons found to be in violation will be notified in writing of any
alleged violations.
director
]. An order may be issued on or after
the 16th business day following the date that a written notification of violations
is received by the facility operator, unless the department receives an acceptable
written response which documents that each violation has been corrected, an
informal conference has been requested, or that a formal hearing has been
requested. If an informal conference is held, the facility operator must respond
within 10 business days after the facility operator receives a summary letter
following the informal conference.
Toxic Substances Control
] Division, Hazard Communication Branch, 1100
West 49th Street, Austin, Texas 78756.
(3)
] Current Tier Two threshold--A
quantity which is assigned to a specific hazardous chemical or extremely hazardous
substance in the most recent version of Title 40 CFR, Part 370, and which
determines whether a specific hazardous chemical or extremely hazardous substance
must be included on the Tier Two form.
(4)
] Department--The Texas Department
of Health.
(6)
] EPCRA or SARA, Title III--The
federal Emergency Planning and Community Right-To-Know Act, also known as
the Superfund Amendments and Reauthorization Act of 1986, Title III, 42 USC,
Chapter 116 et seq., and regulations promulgated by the EPA in Title 40 CFR,
Parts 355-370.
(7)
] EHS or extremely hazardous
substance--Any substance as defined in EPCRA, §302, or listed by the
EPA in Title 40 CFR, Part 355, Appendices A and B.
(8)
] Facility--All buildings, equipment,
structures, and other stationary items that are located on a single site or
on contiguous or adjacent sites and that are owned or operated by the same
person or by any person who controls, is controlled by, or is under common
control with that person. The term does not include a facility subject to
Chapter 505 or 506.
(9)
] Facility operator--The person
who controls the day-to-day operations of the facility.
(10)
] Fire chief--The elected
or paid administrative head of the fire department having jurisdiction over
a facility
.
(11)
] Hazardous chemical category--A
group or class of hazardous chemicals with similar uses or production methods
in a specified industrial process or processes which are specifically approved
by the EPA to be reportable as a hazardous chemical. An example of such an
EPA-approved industrial process is oil and gas exploration and production
in Standard Industrial Classification Code 13 facilities.
(12)
] Headquarters facility--Either
the facility itself when the facility is staffed more than 20 hours per week,
or, for facilities which are staffed less than 20 hours per week, the headquarters
facility is
an office
which is staffed full time by the facility
operator and which serves as the central office for staff who are responsible
for overseeing the operations of the facility.
(13)
] Latitude and longitude--A
mapping coordinate system, designated in units of
decimal
degrees,
[
minutes, and seconds,
] which serves as a facility location description
on the Tier Two form in lieu of a street address.
(14)
] LEPC--
The
[
the
] Local Emergency Planning Committee, a group of individuals representing
a designated emergency planning district and whose membership on the committee
has been approved by the Texas State Emergency Response Commission as meeting
the requirements of EPCRA, §301.
(15)
] Research laboratory--A laboratory
that engages in only research or quality control operations. Chemical specialty
product manufacturing laboratories, full scale pilot plant operation laboratories
that produces products for sale, and service laboratories are not research
laboratories.
(16)
] Standard Industrial Classification
(SIC) Code--The four digit number which describes a facility's primary activity,
which is determined by its principal product or group of products [
being
distributed or sold at the wholesale or retail level or the principal service
being provided
]
produced
. For the purposes of the Act, the
SIC Code is the one that is assigned to a facility by the Texas Workforce
Commission. If a facility does not have
a
[
an
] SIC Code
assigned by the Texas Workforce Commission, then the department must be consulted
for assistance in determining the correct code.
(17)
] Submission or required submission--The
facility chemical list information which is submitted to the department
in the form of either a completed hard copy Tier Two form or an electronic
Tier Two file
for a single facility to comply with subsection (d) of
this section. When facility chemical list information for multiple facilities
is submitted to the department on one Tier Two form for purposes of paperwork
reduction, as allowed by subsection (d)(15) of this section
, or as one
electronic Tier Two file
, then the Tier Two form
or electronic
file
shall be counted by the department as multiple required submissions
under subsections (g)(2) and (3) of this section.
(18)
] Technically qualified individual--An
individual with a professional education and background working in the research
or medical fields, such as a physician, a registered nurse, or an individual
holding a college bachelor's degree in science.
(19)
] Texas Tier Two Cover Sheet
form--A form developed by the department to collect general information about
each reporting facility which is submitting a facility chemical list.
(20)
] Tier Two form--A document
that provides information for all reportable hazardous chemicals and EHSs
present at a reporting facility. An "annual Tier Two form" provides the information
for all hazardous chemicals and EHSs present at a facility at any time during
the previous calendar year in quantities that met or exceeded the current
Tier Two thresholds. An "initial Tier Two form" is one that provides information
for [
a facility which has
] hazardous chemicals or EHSs that meet
or exceed the current Tier Two thresholds, but which were not reported on
a previously submitted annual Tier Two form. An "updated Tier Two form" is
one that provides significant new information concerning an aspect of one
or more hazardous chemicals or EHSs which were previously reported on either
the annual or first time Tier Two forms submitted by a facility. The Tier
Two form is a set of completed reporting forms for submitting the information
required for the facility chemical list, which consists of one of the following
sets of forms:
director's
] responsibilities under the Act
are carried out through the Texas Department of Health,
Product Safety
[
Toxic Substances Control
] Division, Hazard Communication
Branch. Compliance documents and routine inquiries regarding this Act shall
be addressed, until further notice by the
commissioner
[
director
], to: Texas Department of Health,
Product Safety
[
Toxic Substances Control
] Division, Hazard Communication Branch, 1100
West 49th Street, Austin, Texas 78756
, at toll free telephone number
1-800-452-2791
.
the
] Texas Tier Two form
or an electronic
Tier Two file
. For purposes of reporting hazardous chemicals at oil
and gas exploration and production (SIC Code 13) facilities, the API Generic
Tier Two Inventory Form may be substituted for the federal Tier Two Emergency
and Hazardous Chemical Inventory Form. If the director of the EPA approves
a different generic Tier Two Inventory form, developed by another industry
or group of industries, the
commissioner
[
director
]
of the department may authorize specified industries to substitute that form
for the federal Tier Two Emergency and Hazardous Chemical Inventory Form.
The completed
]
hard
copy
Tier Two forms shall be typed or mechanically reproduced, subject
to approval of the department. The Texas Tier Two Cover Sheet submitted as
a part of the Tier Two form to the department shall bear an original signature
of an authorized representative of the facility operator and the date on which
the form was signed.
EPA or
] the department.
[
A Texas Tier Two Cover Sheet, which has been signed and dated by the
authorized representative of the facility operator, shall be submitted to
the department with the electronic file of the facility chemical list.
]
A copy of the completed versions of the electronic
Tier Two
file
and any other document required by the department
[
of the facility
chemical list and the Texas Tier Two Cover Sheet
] and the appropriate
filing fee as provided under subsections (g)(2) and (3) of this section shall
meet the requirements of this subsection and may be submitted to the department
to comply with this subsection.
(C)
] effective January 1,
2003
[
2001
], for a facility located in an area outside of
a city's limits, the description must include either a street address or the
latitude and longitude for the facility. Latitude and longitude values shall
be given in units of
decimal
degrees [
, minutes, and seconds
and be provided
] to
four decimal places
[
0.1 seconds
]. Latitude and longitude values shall be obtained using a Global Positioning
System instrument which has been calibrated to either the North American Datum
of 1983 or the World Geodesic System of 1984.
director
] or his
designated representative shall investigate in a timely manner a complaint
relating to an alleged violation of the Act. Such complaints do not have to
be submitted to the department in writing and may be anonymous. An inspection
based on a complaint is not limited to the specific allegations of the complaint.
A facility operator who refuses to allow such an investigation shall be in
violation of the Act.
director
] or his designated
representatives may enter a facility at reasonable times to conduct random
compliance inspections. A facility operator who refuses to allow such an inspection
shall be in violation of the Act.
director
], a facility operator shall make or allow photocopies
of documents to be made and permit the representative to take photographs
to verify the compliance status of the employer. Such requests may be made
during a compliance inspection or in a written Notice of Violation issued
by the department.
director
] or his designated representative to determine if persons are
in violation of the Act or the rules adopted by the Board of Health to enforce
the Act. Persons found to be in violation will be notified in writing of any
alleged violations.
director
].
With the exception of a case
where the written notice from the department documents that a violation involves
failure to make a good faith effort to comply with the Act, an
[
An
] order may be issued on or after the 16th business day following
the date that a written notification of violations is received by the facility
operator, unless the department receives an acceptable written response which
documents that each violation has been corrected, an informal conference has
been requested, or that a formal hearing has been requested. If an informal
conference is held, the facility operator must respond within 10 business
days after the facility operator receives a summary letter following the informal
conference. In a case where the written notice from the department documents
that a violation involves failure to make a good faith effort to comply with
the Act, an order may be issued at any time.
Toxic Substances Control
] Division, Hazard Communication Branch, 1100
West 49th Street, Austin, Texas 78756.
Part 2.
TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION
2.
ORGANIZATIONAL STANDARDS
3.
STANDARDS OF CARE
4.
REFERENCES AND DISTRIBUTION
Part 8.
INTERAGENCY COUNCIL ON EARLY CHILDHOOD INTERVENTION