TITLE 1.ADMINISTRATION

Part 5. TEXAS BUILDING AND PROCUREMENT COMMISSION

Chapter 111. EXECUTIVE ADMINISTRATION DIVISION

Subchapter B. HISTORICALLY UNDERUTILIZED BUSINESS PROGRAM

1 TAC §111.14

(Editor's note: The text of the following section proposed for repeal will not be published.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 Building and Procurement Commission or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Texas Building and Procurement Commission proposes the repeal of 1 TAC, Chapter 111, Subchapter B, §111.14, concerning subcontracting for Historically Underutilized Business Program (HUB). The section outlines the steps to be followed in determining whether subcontracting opportunities are probable under a contract, the good faith required in developing a HUB subcontracting plan, submission and review during contract performance, and contract compliance.

The repeal is necessary because this section is being replaced with a new §111.14 approved by the commissioners and published contemporaneously in this issue of the Texas Register . Repealing the rule allows for a new rule which will function more effectively because it more correctly reflects the statutes, will meet the objectives of the program, and addresses concerns raised by interested parties.

Cindy Reed, Deputy Executive Director, has determined for the first five year period the repeal is in effect, there will be no fiscal implication for the state or local governments as a result of the repeal of the rule.

Ms. Reed has also determined that for each year of the first five year period the repeal is in effect, the public benefit anticipated as a result of repealing the rule will be negligible. There will be no effect on large, small or micro-businesses. There is no anticipated economic cost to persons as a result of the repeal and there is no impact on local employment.

Comments on the proposal may be submitted to Cynthia de Roch, General Counsel, Texas Building and Procurement Commission, P.O. Box 13047, Austin, Texas 78711-3047. Comments may also be sent via e-mail to travis.langdon@tbpc.state.tx.us. Comments must be received no later than 15 days from the date of publication of the proposal in the Texas Register .

The repeal of §111.14 is proposed under the authority of the Texas Government Code, Title 10, Subtitle D, §§152.003, 2161.002, and 2161.253.

The following statute is affected by the repeal: Texas Government Code, Chapters 2161.

§111.14.Subcontracts.

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 January 22, 2004.

TRD-200400440

Cynthia de Roch

General Counsel

Texas Building and Procurement Commission

Earliest possible date of adoption: March 7, 2004

For further information, please call: (512) 463-4257


1 TAC §111.14

The Texas Building and Procurement Commission proposes new rules to Title 1, Texas Administrative Code, Chapter 111, Subchapter B, §111.14 concerning subcontracting for Historically Underutilized Business (HUB). The new rules will revise the current (HUB) program rules to bring the rules into alignment with statutory requirements, meet the objectives of the program without creating costly administrative requirements for the vendors and agencies which must comply with the rules, and address concerns raised by interested parties.

Ms. Cindy Reed, Deputy Executive Director, has determined for the first five year period the new rules are in effect there will be a decrease in the administrative costs required to respond to state contracting opportunities, as well as award state contracts when the expected value is $100,000 or more and the contracting agency has determined that subcontracting opportunities are probable.

Ms. Reed further determines that for each year of the first five year period the new rules are in effect, the public benefit anticipated as a result of enforcing the rules is compliance with the current statutory requirements of Texas Government Code, Chapter 2161, as they apply to HUB. Respondents to state contracting opportunities will experience moderate decreases in administrative costs with regard to responding to state contracting opportunities where the expected contract value is $100,000.00 or more and the contracting agency has determined that subcontracting opportunities are probable. There will be no adverse impact on large, small or micro-businesses. Ms. Reed has also determined that for each year of the first five year period after the new rules are in effect, there will be no effect on employment.

Comments on the proposals may be submitted to Cynthia de Roch, General Counsel, Texas Building and Procurement Commission, P.O. Box 13047, Austin, TX 78711-3047. Comments may also be sent via email to travis.langdon@tbpc.state.tx.us. All comments must be received no later than thirty (30) days from the date of publication of the proposal to the Texas Register .

The new rules in §111.14 are proposed under the authority of the Texas Government Code, Title 10, Subtitle D, §§2152.003, 2161.002, and 2161.253.

The following codes are affected by these rules: Texas Government Code, Chapters 2161.

§111.14.Subcontracting.

(a) General Provisions

(1) In accordance with Texas Government Code, Chapter 2161, Subchapter F, each state agency that considers entering into a contract with an expected value of $100,000 or more shall, before the agency solicits bids, proposals, offers, or other applicable expressions of interest, determine whether subcontracting opportunities are probable under the contract.

(A) State agencies shall use the following steps to determine if subcontracting opportunities are probable under the contract:

(i) Use the HUB participation goals in §111.13 of this title (relating to Annual Procurement Utilization Goals); and

(ii) Research the Centralized Master Bidders List, the HUB Directory, the Internet, and other directories, identified by the commission, for HUBs that may be available to perform the contract work.

(B) In addition determination of subcontracting opportunities may include, but is not limited to, the following:

(i) contacting other state and local agencies and institutions of higher education to obtain information regarding similar contracting and subcontracting opportunities; and

(ii) reviewing the history of similar agency purchasing transactions.

(2) If subcontracting opportunities are probable, each agency's invitation for bids, requests for proposals or other purchase solicitation documents for construction, professional services, other services, and commodities with an expected value of $100,000 or more shall state that probability and require a HUB subcontracting plan.

(A) The HUB subcontracting plan shall be submitted at the same time as the response (bid, proposal, offer, or other applicable expression of interest), except for construction contracts involving alternative delivery methods. For construction contracts involving alternative delivery methods, the HUB subcontracting plan may be submitted up to 24 hours following the date/time that responses are due provided that responses are not opened until the HUB subcontracting plan is received.

(B) Responses that do not include a completed HUB subcontracting plan in accordance with paragraph (3) of this section, shall be rejected due to material failure to comply with advertised specifications in accordance with §113.6 (a) of this title (relating to Bid Evaluation and Award).

(3) A state agency shall require a respondent to state whether it is a certified HUB. A state agency shall also require a respondent to state overall subcontracting and overall certified HUB subcontracting to be provided in the contract. Respondents shall follow procedures in subsection (a)(3)(A)(i), (a)(3)(A)(ii), and (a)(3)(A)(iii) of this section when developing the HUB subcontracting plan.

(A) The HUB subcontracting plan shall consist of completed forms prescribed by the Texas Building and Procurement Commission and shall include the following:

(i) certification that respondent has made a good faith effort to meet the requirements of this section,

(ii) identification of the subcontractors that will be used during the course of the contract,

(iii) the expected percentage of work to be subcontracted

(iv) and the approximate dollar value of that percentage of work. The plan shall include goals established pursuant to §111.13 of this title (relating to Annual Procurement Utilization Goals).

(B) The successful respondent shall provide all additional documentation required by the agency to demonstrate compliance with good faith effort requirements prior to contract award. If the successful respondent is unable to provide supporting documentation (phone logs, fax transmittals, electronic mail, etc.) within the timeframe specified by the agency to demonstrate compliance with this subsection prior to contract award, that respondent’s bid/proposal shall be rejected for material failure to comply with advertised specifications.

(b) Construction Contracts

(1) Evidence of good faith effort in developing a HUB subcontracting plan for construction contracts, including heavy construction, building construction, and special trade construction includes, but is not limited to, the following procedures:

(A) Divide the contract work into reasonable lots or portions to the extent consistent with prudent industry practices.

(B) Provide written justification of the selection process if a non HUB subcontractor is selected.

(C) Provide notice to minority or women trade organizations or development centers to assist in identifying HUBs by disseminating subcontracting opportunities to their membership/participants. The notice shall, in all instances, include the scope of work, information regarding location to review plans and specifications, information about bonding and insurance requirements, and identify a contact person. Respondent must provide notice to organizations or development centers no less than five (5) working days for construction contracts prior to submission of the response (bid, proposal, offer, or other applicable expression of interest).

(D) Notify HUBs of the subcontracting opportunities that the respondent intends to subcontract. The preferable method of notification shall be in writing. The notice shall, in all instances, include the scope of the work, information regarding the location to review plans and specifications, information about bonding and insurance requirements, and identify a contact person. The notice shall be provided to potential HUB subcontractors prior to submission of the respondent's response.

(2) The respondent shall provide potential HUB subcontractors reasonable time to respond to the respondent's notice. "Reasonable time to respond" in this context is no less than five (5) working days for construction contracts, including heavy construction, building construction, and special trade construction, from receipt of notice, unless circumstances require a different time period, which is determined by the agency and documented in the contract file.

(3) The respondent shall use the commission's Centralized Master Bidders List, the HUB Directory, Internet resources, and/or other directories as identified by the commission or agency when searching for HUB subcontractors. Respondents may rely on the services of minority, women, and community organizations contractor groups, local, state, and federal business assistance offices, and other organizations that provide assistance in identifying qualified applicants for the HUB program who are able to provide all or select elements of the HUB subcontracting plan.

(4) The respondent shall provide the notice described in this section to three or more HUBs per each subcontracting opportunity that provide the type of work required for each subcontracting opportunity identified in the contract specifications or any other subcontracting opportunity the respondent cannot complete with its own equipment, supplies, materials, and/or employees. If more than three subcontracting opportunities are identified the respondent shall contact a total minimum of nine (9) HUBs. The respondent must document the HUBs contacted on the forms prescribed by the Texas Building and Procurement Commission.

(c) Professional Services Contracts

(1) Evidence of good faith effort in developing a HUB subcontracting plan for professional services contracts is established if the prime contractor meets the following conditions and procedures:

(A) A HUB subcontracting plan for a professional services contract which meets or exceeds HUB participation goals in §111.13 of this title (relating to Annual Procurement Utilization Goals), constitutes good faith effort under this section, or

(B) Develop a HUB Subcontracting Plan under the following procedures:

(i) Divide the contract work into reasonable lots or portions to the extent consistent with prudent industry practices.

(ii) Notify HUBs of the subcontracting opportunities that the respondent intends to subcontract. The preferable method of notification shall be in writing. The notice shall, in all instances, include the scope of the work, required qualifications, and identify a contact person. The notice shall be provided to potential HUB subcontractors prior to submission of the respondent's response.

(2) The respondent shall provide potential HUB subcontractors reasonable time to respond to the respondent's notice. "Reasonable time to respond" in this context is no less than five (5) working days from receipt of notice, unless circumstances require a different time period, which is determined by the agency and documented in the contract file.

(3) The respondent shall use the commission's Centralized Master Bidders List, the HUB Directory, Internet resources, and/ or other directories as identified by the commission or agency when searching for HUB subcontractors. Respondents may rely on the services of minority, women, and community organizations, contractor groups, local, state, and federal business assistance offices, and other organizations that provide assistance in identifying qualified applicants for the HUB program who are able to provide all or select elements of the HUB subcontracting plan.

(4) The respondent shall provide the notice described in this section to three or more HUBs per each subcontracting opportunity that provide the type of work required for each subcontracting opportunity identified in the contract specifications or any other subcontracting opportunity the respondent cannot complete with its own equipment, supplies, materials, and/or employees. If more than three subcontracting opportunities are identified the respondent shall contact a total minimum of nine (9) HUBs. The respondent must document the HUBs contacted on the forms provided by the Texas Building and Procurement Commission.

(A) Provide written justification of the selection process if a non HUB subcontractor is selected.

(B) Provide notice to minority or women trade organizations or development centers to assist in identifying HUBs by disseminating subcontracting opportunities to their membership/participants. The notice shall, in all instances, include the scope of the work, required qualifications, and identify a contact person. Respondent must provide notice to organizations or development centers no less than five (5) working days prior to submission of response (bid, proposal, offer, or other applicable expression of interest).

(d) Commodities and Other Services Contracts

(1) Evidence of good faith effort in developing a HUB subcontracting plan for commodities and other services contracts includes, but is not limited to, the following procedures:

(A) Divide the contract work into reasonable lots or portions to the extent consistent with prudent industry practices.

(B) Notify HUBs of the subcontracting opportunities that the respondent intends to subcontract. The preferable method of notification shall be in writing. The notice shall, in all instances, include the scope of the work, specifications, and identify a contact person. The notice shall be provided to potential HUB subcontractors prior to submission of the respondent's response.

(i) The respondent shall provide potential HUB subcontractors reasonable time to respond to the respondent's notice. "Reasonable time to respond" in this context is no less than five working days from receipt of notice, unless circumstances require a different time period, which is determined by the agency and documented in the contract file.

(ii) The respondent shall use the commission's Centralized Master Bidders List, the HUB Directory, Internet resources, and/or other directories as identified by the commission or agency when searching for HUB subcontractors. Respondents rely on the services of minority, women, and community organizations, contractor groups, local, state, and federal business assistance offices, and other organizations that provide assistance in identifying qualified applicants for the HUB program who are able to provide all or select elements of the HUB subcontracting plan.

(iii) The respondent shall provide the notice described in this section to three or more HUBs per each subcontracting opportunity that provide the type of work required for each subcontracting opportunity identified in the contract specifications or any other subcontracting opportunity the respondent cannot complete with its own equipment, supplies, materials, and/or employees. If more than three subcontracting opportunities are identified the respondent shall contact a total minimum of nine (9) HUBs. The respondent must document the HUBs contacted on the forms provided by the Texas Building and Procurement Commission.

(C) Provide written justification of the selection process if a non HUB subcontractor is selected.

(D) Provide notice to minority or women trade organizations or development centers to assist in identifying HUBs by disseminating subcontracting opportunities to their membership/participants. The notice shall, in all instances, include the scope of the work, specifications, and identify a contact person. Respondent must provide notice to organizations or development centers no less than five (5) working days for construction contracts prior to submission of the response (bid, proposal, offer, or other applicable expression of interest).

(2) In making a determination if a good faith effort has been made in the development of the required HUB subcontracting plan, a state agency may require the respondent to submit supporting documentation explaining how the respondent has made a good faith effort according to each criterion listed in subsection (a)(3)(A)(i), (a)(3)(A)(ii), and (a)(3)(A)(iii). The documentation shall include at least the following:

(A) how the respondent divided the contract work into reasonable lots or portions consistent with prudent industry practices;

(B) how the respondent's notices contain adequate information about bonding, insurance, the availability of plans, the specifications, scope of work, required qualifications and other requirements of the contract to three or more certified HUBs per each identified subcontracting opportunity or a minimum of nine HUBs for contracts with more than three (3) identified subcontracting opportunities per contract allowing reasonable time for HUBs to participate effectively;

(C) how the respondent negotiated in good faith with qualified HUBs, not rejecting qualified HUBs who were also the best value responsive bidder;

(D) how the respondent provided notice to minority or women trade organizations or development centers to assist in identifying HUBs by disseminating subcontracting opportunities to their membership/participants;

(E) for contracts subject to (c)(1)(A), how the respondent plans to subcontract with certified HUBs in an effort to meet or exceed HUB participation goals in §111.13 of this title (relating to Annual Procurement Utilization Goals) for each identified subcontracting opportunity.

(3) A respondent's participation in a Mentor Protégé Program under the Texas Government Code §2161.065, and the submission of a protégé as a subcontractor in the HUB subcontracting plan constitutes a good faith effort for the particular area to be subcontracted with the protégé. When submitted, state agencies may accept a Mentor Protégé Agreement that has been entered into by the respondent (mentor) and a certified HUB (protégé). The agency shall consider the following in determining the respondent's good faith effort:

(A) if the respondent has entered into a fully executed Mentor Protégé Agreement that has been registered with the commission prior to submitting the plan, and

(B) if the respondent's HUB subcontracting plan identifies the areas of subcontracting that will be performed by the protégé.

(4) If the respondent is able to fulfill any of the potential subcontracting opportunities identified with its own equipment, supplies, materials and/or employees, respondent must sign an affidavit and provide a statement explaining how the respondent intends to fulfill each subcontracting opportunity. The respondent must agree to provide the following if requested by the agency:

(A) evidence of existing staffing to meet contract objectives,

(B) monthly payroll records showing company staff fully engaged in the contract, and

(C) on site reviews of company headquarters or work site where services are to be performed.

(D) documentation proving employment of qualified personnel holding the necessary licenses and certificates required to perform the work.

(5) The HUB subcontracting plan shall be reviewed and evaluated prior to contract award and, if accepted, shall become a provision of the agency's contract. Revisions necessary to clarify and enhance information submitted in the original HUB subcontracting plan may be made in an effort to determine good faith effort. State agencies shall review the documentation submitted by the respondent to determine if a good faith effort has been made in accordance with this section. If the agency determines that a submitted HUB subcontracting plan was not developed in good faith, the agency shall treat the lack of good faith as a material failure to comply with advertised specifications, and the subject response (bid, proposal, offer, or other applicable expression of interest) shall be rejected. The reasons for rejection shall be recorded in the procurement file.

(6) If the respondent is selected and decides to subcontract any part of the contract after the award, as a provision of the contract, the contractor/vendor must comply with provisions of this section relating to developing and submitting a subcontracting plan before any modifications or performance in the awarded contract involving subcontracting can be authorized by the state agency. If the selected contractor/vendor subcontracts any of the work without prior authorization and without complying with this section, the contractor/vendor would be deemed to have breached the contract and be subject to any remedial actions provided by Texas Government Code, Chapter 2161, state law and this section. Agencies may report nonperformance relative to its contracts to the commission in accordance with Chapter 113, Subchapter F of this title (relating to the Vendor Performance and Debarment Program).

(7) If at any time during the term of the contract, a contractor/vendor desires to make changes to the approved subcontracting plan, proposed changes must be received for prior review and approval by the state agency before changes will be effective under the contract. The contractor/vendor must comply with provisions of subsection (a), paragraph 3, relating to developing and submitting a subcontracting plan for substitution of work or of a subcontractor, prior to any alternatives being approved under the subcontracting plan. The state agency shall approve changes by amending the contract or by another form of written agency approval. The reasons for amendments or other written approval shall be recorded in the procurement file.

(8) If a state agency expands the original scope of work through a change order or contract amendment, including a contract renewal that expands the scope of work, the state agency shall determine if the additional scope of work contains additional probable subcontracting opportunities not identified in the initial solicitation. If the agency determines additional probable subcontracting opportunities exist, the agency will require the contractor/vendor to submit a HUB subcontracting plan/revised HUB subcontracting plan for the additional probable subcontracting opportunities.

(9) The HUB subcontracting plan/revised HUB subcontracting plan shall comply with the provisions of this section relating to development and submission of a subcontracting plan before any modifications or performance in the awarded contract involving the additional scope of work can be authorized by the agency. If the contractor/vendor subcontracts any of the additional subcontracting opportunities identified by the agency without prior authorization and without complying with this section, the contractor/vendor would be deemed to have breached the contract and be subject to any remedial actions provided by Texas Government Code, Chapter 2161, state law and this section. Agencies may report nonperformance relative to its contracts to the commission in accordance with Chapter 113, Subchapter F of this title (relating to the Vendor Performance and Debarment Program.)

(10) The contractor/vendor shall maintain business records documenting its compliance with the HUB subcontracting plan and shall submit a compliance report to the contracting agency monthly and in the format required by the Texas Building and Procurement Commission. The compliance report submission shall be required as a condition for payment.

(11) During the term of the contract, the state agency shall monitor the HUB subcontracting plan monthly to determine if the value of the subcontracts to HUBs meets or exceeds the HUB subcontracting provisions specified in the contract. Accordingly, state agencies shall audit and require a contractor/vendor to whom a contract has been awarded to report to the agency the identity and the amount paid to its subcontractors in accordance with §111.16(c) of this title (relating to State Agency Reporting Requirements). If the contractor/vendor is meeting or exceeding the provisions, the state agency shall maintain documentation of the contractor's/vendor's efforts in the contract file. If the contractor/vendor fails to meet the HUB subcontracting provisions specified in the contract, the state agency shall notify the contractor of any deficiencies. The state agency shall give the contractor/vendor an opportunity to submit documentation and explain to the state agency why the failure to fulfill the HUB subcontracting plan should not be attributed to a lack of good faith effort by the contractor/vendor.

(12) To determine if the contractor/vendor made the required good faith effort, the agency may not consider the success or failure of the contractor/vendor to subcontract with HUBs in any specific quantity. The agency's determination is restricted to considering factors indicating good faith effort including, but not limited to, the following:

(A) whether the contractor gave timely notice to the subcontractor regarding the time and place of the subcontracted work;

(B) whether the contractor facilitated access to the work site, electrical power, and other necessary utilities; and

(C) whether documentation or information was provided that included potential changes in the scope of contract work.

(13) If a determination is made that the contractor/vendor failed to implement the HUB subcontracting plan in good faith, the agency, in addition to any other remedies, may report nonperformance to the commission in accordance with Chapter 113, Subchapter F of this title (relating to Vendor Performance and Debarment Program). In addition, if the contractor/vendor failed to implement the subcontracting plan in good faith, the agency may revoke the contract for breach of contract and make a claim against the contractor/vendor.

(14) State agencies shall review their procurement procedures to ensure compliance with this section. In accordance with §111.26 of this title (relating to HUB coordinator responsibilities) the agency's HUB coordinator and contract administrators should facilitate institutional compliance with this section.

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 January 22, 2004.

TRD-200400443

Cynthia de Roch

General Counsel

Texas Building and Procurement Commission

Proposed date of adoption: March 17, 2004

For further information, please call: (512) 463-4257


Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 354. MEDICAID HEALTH SERVICES

Subchapter A. PURCHASED HEALTH SERVICES

32. DISEASE MANAGEMENT

1 TAC §354.1415

The Texas Health and Human Services Commission (HHSC) proposes to amend Chapter 354, Medicaid Health Services by adding a new division to the existing subchapters. HHSC adds Division 32, Disease Management §354.1415, concerning Conditions for Participation. Chapter 354 describes the benefits and provider requirements of the Texas medical assistance (Medicaid) program. The new division added at §354.1415, Conditions for Participation, outlines the requirements for entities that wish to contract with HHSC to provide disease management services to recipients of Medicaid. The proposed section is required to satisfy the requirements of House Bill 727, 78th Legislature, regular session (2003), which mandates that HHSC, by rule, shall prescribe the minimum requirements that a provider of a disease management program must meet to be eligible to receive a contract.

Tom Suehs, Deputy Commissioner for Financial Services, has determined that during the first five-year period the proposed rule is in effect there will be no fiscal impact to state government. The proposed rule will not result in any fiscal implications for local health and human services agencies. Local governments will not incur additional costs.

Mr. Suehs has also determined that there will be no effect on small businesses or micro businesses to comply with the new rule as proposed as they will not be required to alter their business practices as a result of the rule. There are no anticipated economic costs to persons who are required to comply with the proposed rule. There is no anticipated negative impact on local employment.

Dena Stoner, Associate Medicaid and CHIP director for Program Innovation, has determined that for each year of the first five years the section is in effect, the public will benefit from the adoption of the section. The anticipated public benefit, as a result of enforcing the section, will be the establishment of minimum program requirements for providers of disease management services, and to ensure Medicaid recipients obtain consistent, quality health service interventions.

HHSC has determined that the proposed rule is not a "major environmental rule" as defined by §2001.0225 of the Texas Government Code. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environment exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. The proposed rule is not specifically intended to protect the environment or reduce risks to human health from environment exposure.

HHSC has determined that the proposed rule does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under §2007.043 of the Government Code.

Written comments on the proposal may be submitted to Geri Willems, Program Analyst, at P.O. Box 13247 Mail Code H-100, Austin, Texas 78711-3247, by fax to 512-424-6665, or by e-mail to geri.willems@hhsc.state.tx.us within 30 days of publication of this proposal in the Texas Register . A public hearing is scheduled for February 17, 2004 from 9:00 a.m. to 11:00 a.m. (central time) in the Public Hearing Room of the Brown Heatly State Office Building, 4900 North Lamar, Austin, Texas. Persons requiring further information, special assistance, or accommodations should contact Linda Williams at (512) 424-6646.

The new rule is proposed under the Texas Government Code, §531.033, which provides the Commissioner of HHSC with broad rulemaking authority; the Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provides the Health and Human Services Commission (HHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas.

The proposed rule affects the Human Resources Code, Chapter 32, and the Texas Government Code, Chapter 531. No other statutes, articles, or codes are affected by the proposed new rule.

§354.1415.Conditions for Participation.

In addition to the general requirements for contractors listed in Chapter 391, Purchase of Goods and Services by Health and Human Services Agencies and Chapter 392, Procurements by the Health and Human Services Commission, disease management companies must meet all of the following program requirements to be considered for a contract with the state. Entities who wish to contract with the Health and Human Services Commission (HHSC) to provide disease management services must meet the following conditions:

(1) Have an appropriate method for using HHSC healthcare data to identify targeted disease populations;

(2) Have an evidence-based healthcare practice guideline with minimum standards of care and clinical outcomes for each targeted disease;

(3) Have collaborative healthcare practice models in place to include HHSC's contracted physicians, support service providers, and existing community resources;

(4) Ensure that a recipient's primary care physician (PCP) and other appropriate specialty physicians, or registered nurses, advance practice nurses, or physician assistants become directly involved in the disease management program through which the recipient receives services;

(5) Have patient self-care management education materials and methods appropriate to each targeted disease population that demonstrate cultural competency;

(6) Have service provider education materials and methods appropriate to each targeted disease population;

(7) Have process and outcome measurements, evaluations, and management systems based on standardized best practice guidelines;

(8) Have routine reporting processes that are proven to properly support disease management goals;

(9) Have demonstrable, measurable, and successful experience in disease management for the targeted disease populations;

(9) Provide access to 24 hour-a-day, seven days-per-week nurse call center;

(10) Have the ability to guarantee program savings; and

(11) Meet applicable federal and state laws and regulations governing the participation of providers in the Medicaid 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 January 27, 2004.

TRD-200400515

Steve Aragón

General Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: March 7, 2004

For further information, please call: (512) 424-6576


Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter G. TELEMEDICINE SERVICES AND OTHER COMMUNITY-BASED SERVICES

1 TAC §355.5902

The Texas Health and Human Services Commission (HHSC) proposes to amend §355.5902, concerning reimbursement methodology for Primary Home Care, in its Medicaid Reimbursement Rates chapter. The purpose of the amendment is to change the term for clients who receive a priority service break designation from "Priority 1" to "priority." The amendment also replaces the term "provider agency" with "contract," and the terms "contracted provider" and "provider" with "provider agency," as appropriate.

Tom Suehs, Deputy Executive Commissioner for Financial Services, has determined that for the first five-year period the proposed section is in effect, there are no fiscal implications for state government or local government as a result of enforcing or administering the section.

David Palmer, Director, Rate Analysis, has determined that for each year of the first five years the section is in effect, the public benefit anticipated as a result of enforcing the section is that the reimbursement methodology for the Primary Home Care Program will appropriately reflect the name change made by DHS for clients with a priority service designation and will more accurately describe the use of contracts in reimbursement determination. There is no adverse economic effect on small or micro businesses as a result of enforcing or administering the section, because the proposal is technical in nature and does not add any new requirements for businesses. There is no anticipated economic cost to persons who are required to comply with the proposed section. There is no anticipated effect on local employment in geographic areas affected by this section.

Questions about the content of this proposal may be directed to Carolyn Pratt at (512) 685- 3127 (fax: (512) 685-3104) in HHSC's Rate Analysis Department. Written comments on the proposal may be submitted to Ms. Pratt via fax or mailed to HHSC Rate Analysis, Mail Code H- 400, 1100 West 49th Street, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Under §2007.003(b) of the Government Code, HHSC has determined that Chapter 2007 of the Government Code does not apply to this rule. Accordingly, HHSC is not required to complete a takings impact assessment regarding this rule.

The amendment is proposed under the Government Code, §531.033, which authorizes the commissioner of HHSC to adopt rules necessary to carry out the commission's duties, and §531.021(b), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance payments under the Human Resources Code, Chapter 32.

The amendment implements the Government Code, §§531.033 and 531.021(b).

§355.5902.Reimbursement Methodology for Primary Home Care.

(a) (No change.)

(b) Cost reporting. Provider agencies [ Providers ] must follow the cost-reporting guidelines as specified in §355.105 of this title (relating to General Reporting and Documentation Requirements, Methods and Procedures).

(1) All provider agencies [ contracted providers ] must submit a cost report unless the number of days between the date the first Texas Department of Human Services client received services and the provider agency's [ provider's ] fiscal year end is 30 days or fewer. The provider agency may be excused from submitting a cost report if circumstances beyond the control of the provider agency make cost report completion impossible, such as the loss of records due to natural disasters or removal of records from the provider agency's [ provider's ] custody by any governmental entity. Requests to be excused from submitting a cost report must be received at the address specified in the letter mailed along with the cost report before the due date of the cost report.

(2) Provider agencies [ Providers ] are responsible for reporting only allowable costs on the cost report, except where cost report instructions indicate that other costs are to be reported in specific lines or sections. Only allowable cost information is used to determine recommended reimbursement. HHSC excludes from reimbursement determination unallowable expenses included in the cost report and makes the appropriate adjustments to expenses and other information reported by provider agencies [ providers ]. The purpose is to ensure that the database reflects costs and other information which are necessary for the provision of services and are consistent with federal and state regulations.

(A)-(B) (No change.)

(c) Reimbursement determination. Reimbursement is determined in the following manner.

(1) Cost determination by cost area. Allowable costs are combined into three cost areas, after allocating payroll taxes to each salary line item on the cost report on a pro rata basis based on the portion of that salary line item to the amount of total salary expense and after applying employee benefits directly to the corresponding salary line item.

(A) Service support cost area. This includes field supervisors' salaries and wages, benefits, and mileage reimbursement expenses. This also includes building, building equipment, and operation and maintenance costs; administration costs; and other service costs. Administration expenses equal to $0.18 per priority [ Priority 1 ] unit of service are allocated to priority [ Priority 1 ]. The administration costs remaining after this allocation are summed with the other service support costs.

(B) Non-priority [ Nonpriority ] attendants cost area. This includes non- priority [ nonpriority ] attendants' salaries and wages, benefits, and mileage reimbursement expenses. This cost area is calculated as specified in §355.112 of this title (relating to Attendant Compensation Rate Enhancement).

(C) Priority [ 1 ] attendants cost area. This includes priority [ Priority 1 ] attendants' salaries and wages, benefits, and mileage reimbursement expenses. This cost area is calculated as specified in §355.112 of this title [ (relating to Attendant Compensation Rate Enhancement) ].

(2) Recommended reimbursement by cost area. For the service support cost area described in paragraph (1)(A) of this subsection the following is calculated:

(A) Projected costs. Each contract's [ provider's ] total allowable costs, excluding depreciation and mortgage interest, per unit of service are projected from each contract's [ provider agency's ] reporting period to the next ensuing reimbursement period, as described in §355.108 of this title (relating to Determination of Inflation Indices) to calculate the projected expenses. Reimbursement may be adjusted where new legislation, regulations, or economic factors affect costs as specified in §355.109 of this title (relating to Adjusting Reimbursement When New Legislation, Regulations, or Economic Factors Affect Costs).

(B) Projected cost per unit of service. To determine the projected cost per unit of service for each contract [ provider agency ], the total projected allowable costs for the service support cost area are divided by total units of service, including non-priority [ nonpriority ] services, priority [ Priority 1 ] services, and STAR+PLUS services, in order to calculate the projected cost per unit of service.

(C) Projected cost arrays. Each contract's [ All provider agencies' ] projected allowable costs per unit of service are rank ordered from low to high, along with each contract's [ provider agency's ] corresponding [ total ] units of service for each cost area .

(D) Recommended reimbursement for the service support cost area. The total units of service for each contract [ provider agency ] are summed until the median hour of service is reached. The corresponding projected expense is the weighted median cost component. The weighted median cost component is multiplied by 1.044 to calculate the recommended reimbursement for the service support cost area. The service support cost area recommended reimbursement is limited, if necessary, to available appropriations.

(3) Total recommended reimbursement.

(A) For non-priority [ nonpriority ] clients. The recommended reimbursement is determined by summing the recommended reimbursement described in paragraph (2) of this subsection and the cost area component from paragraph (1)(B) of this subsection

(B) For priority [ Priority 1 ] clients. The recommended reimbursement is determined by summing the recommended reimbursement described in paragraph (2) of this subsection and the cost area component from paragraph (1)(C) of this subsection.

(d) Reimbursement determination authority. The reimbursement determination authority is specified in §355.101 of this title [ (relating to Introduction) ].

(e) Desk reviews and field audits of cost reports. Desk reviews or field audits are performed on cost reports for all provider agencies [ contracted providers ]. The frequency and nature of the field audits are determined by HHSC to ensure the fiscal integrity of the program. Desk reviews and field audits will be conducted in accordance with §355.106 of this title (relating to Basic Objectives and Criteria for Audit and Desk Review of Cost Reports), and provider agencies [ providers ] will be notified of the results of a desk review or an audit in accordance with §355.107 of this title (relating to Notification of Exclusions and Adjustments). Provider agencies [ Providers ] may request an informal review and, if necessary, an administrative hearing to dispute an action taken under §355.110 of this title (relating to Informal Reviews and Formal Appeals).

(f) Factors affecting allowable costs. Provider agencies [ Providers ] must follow the guidelines in determining whether a cost is allowable or unallowable as specified in §355.102 of this title (relating to General Principles of Allowable and Unallowable Costs) and §355.103 of this title (relating to Specifications for Allowable and Unallowable Costs).

(g) (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 January 22, 2004.

TRD-200400464

Steve Aragón

General Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: March 7, 2004

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