TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 47. CONTRACTING TO PROVIDE PRIMARY HOME CARE

The Texas Department of Human Services (DHS) adopts new §§47.1, 47.3, 47.5, 47.11, 47.21, 47.23, 47.25, 47.41, 47.43, 47.45, 47.47, 47.49, 47.61, 47.63, 47.65, 47.67, 47.69, 47.71, 47.73, 47.81, 47.83, 47.85, 47.87, 47.89, and 47.5902; and adopts the repeal of §§47.1901-47.1904, 47.2901-47.2905, 47.2908-47.2914, 47.3906-47.3908, 47.4902- 47.4905, 47.5902, and 47.6902.

New §§47.3, 47.41, and 47.45 are adopted with changes to the proposed text published in the February 6, 2004, issue of the Texas Register (29 TexReg 1169). New §§47.1, 47.5, 47.11, 47.21, 47.23, 47.25, 47.43, 47.47, 47.49, 47.61, 47.63, 47.65, 47.67, 47.69, 47.71, 47.73, 47.81, 47.83, 47.85, 47.87, 47.89, and 47.5902; and the repeals of §§47.1901-47.1904, 47.2901-47.2905, 47.2908-47.2914, 47.3906-47.3908, 47.4902- 47.4905, 47.5902, and 47.6902 are adopted without changes to the proposed text.

The new sections and repeals were undertaken as part of a DHS project to rewrite agency rules in plain English to make them easier for contractors and the public to use and understand. The addition of a rule concerning the interdisciplinary team was included to address any service delivery issues identified by the provider agency. In addition, language that duplicates licensure requirements was eliminated in order to reduce redundancy.

DHS received three written comments from the Texas Association for Home Care. A summary of the comments and DHS's responses follow.

Comment: Concerning §47.3(24), we suggest rewriting the definition for variable service schedules. The purpose of creating the flexible schedule was to allow for minor changes, which may routinely occur in delivering the services (the discussion began with the use of telephony). The service plan includes the service schedule as well as the total weekly hours authorized, and this is signed by the client. To force the schedule to equal authorized hours takes away the flexibility. An attendant who works a few minutes to a couple of hours per week less than the authorized hours should be able to be agreeable on the front end without the need for documentation at every instance. With your proposed language, a provider using telephony would have to document any time that the exact number of authorized hours were not delivered. This language would set us back from what had already been agreed to in policy for the flexible schedule and would make it impractical to utilize telephony.

Response: DHS agrees and changed the definition to read: "...A variable service schedule states the number of hours of services to be delivered per day or per week, not to exceed the authorized hours per week, and does not otherwise specify any certain days, times of day, or time periods for delivery of the services."

Comment: Concerning §47.3(25), we suggest adding language that initials are not an acceptable substitute for a signature "unless initials have been established as the person's official signature."

Response: DHS agrees and changed the section to include the requested wording.

Comment: Concerning §47.71(a)(4), we suggest expanding the definition of an institution to include a correctional facility, such as a prison or jail.

Response: DHS disagrees and did not change the section. DHS addresses this possibility in §47.71(a)(2). Primary home care, community attendant, and family care services cannot be provided in any setting or environment where other sources are available to provide care, as stated in §48.2911(b)(6) and §48.2918(b)(4).

In addition, DHS initiated a minor formatting change to the text of §47.41 and §47.45 to clarify the structure of the section.

Subchapter A. INTRODUCTION

40 TAC §§47.1, 47.3, 47.5

The new sections are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The new sections affect the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

§47.3.Definitions.

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

(1) Attendant--An employee of a provider agency who provides the authorized tasks to the client.

(2) Case manager--A Texas Department of Human Services (DHS) employee who is responsible for case management activities. Activities include eligibility determination, client registration, assessment and reassessment of client's need, service plan development, and intercession on the client's behalf.

(3) Client--A Community Care for Aged and Disabled (CCAD) client, as defined in Chapter 48 of this title (relating to Community Care for Aged and Disabled), who is eligible to receive services under this chapter. References in this chapter to "client" include the client's representative, unless the context indicates otherwise.

(4) Community attendant (CA) services--A service under the Primary Home Care Program providing in-home attendant services to clients. Clients receiving CA services must have a medical need for specific tasks. CA services (formerly known as §1929(b) or frail elderly) are provided under Title XIX of the federal Social Security Act (relating to Grants to States for Medical Assistance Programs) at 42 U.S.C. §1396t (relating to Home and community care for functionally disabled elderly individuals).

(5) Contract--The formal, written agreement between DHS and a provider agency to provide services to DHS clients eligible under this chapter in exchange for reimbursement.

(6) Contract manager--A DHS employee who is responsible for the overall management of the contract with the provider agency.

(7) Days--Any reference to days means calendar days, unless otherwise specified in the text. Calendar days include weekends and holidays.

(8) Family care (FC) services--A service under the Primary Home Care Program providing in- home attendant services to eligible adults. FC services are provided under Title XX of the federal Social Security Act (relating to Block Grants to States for Social Services) at 42 U.S.C. §1397 et seq.

(9) Imminent danger--An immediate, real threat to a person's safety.

(10) Medical need--A medical diagnosis that results in a need for assistance with activities of daily living. For purposes of this chapter, activities of daily living do not include services that must be provided or supervised by licensed personnel.

(11) Negotiated referral--A request from the case manager to a provider agency to evaluate a person for service delivery, in which the case manager determines that the person's needs require that services begin on a particular date.

(12) Non-priority--One of two types of eligibility status for service delivery determined by the case manager. The other type of eligibility status for service delivery is priority. A non-priority client does not meet the criteria described in §48.2918(f) of this title (relating to Eligibility for Primary Home Care). Services delivered to such a client may be referred to as non-priority services, and an attendant who serves such a client may be referred to as a non-priority attendant.

(13) Practitioner--A physician currently licensed in Texas, Louisiana, Arkansas, Oklahoma or New Mexico, a physician assistant currently licensed in Texas, or a registered nurse approved by the Texas State Board of Nurse Examiners to practice as an advanced practice nurse.

(14) Practitioner's statement--A document such as the DHS Practitioner's Statement of Medical Need form that includes:

(A) a statement signed by a practitioner that the client has a current medical need for assistance with personal care tasks and other activities of daily living; and

(B) certification that the provider agency verified with the United States' Centers for Medicare and Medicaid Services that the practitioner is not excluded from participation in Medicare or Medicaid.

(15) Practitioner's statement date--The practitioner's statement date is:

(A) the later of the following:

(i) the practitioner's signature date on the practitioner's statement; or

(ii) the date the provider agency receives the practitioner's statement. If the provider agency fails to stamp the receipt date on the form, the date of the practitioner's signature will be used to determine the practitioner's statement date; or

(B) the date of the practitioner's oral statement obtained for a negotiated referral. The provider agency must document the practitioner's oral statement date on the practitioner's written statement required in §47.47(c)(2) of this chapter (relating to Medical Need Determination).

(16) Primary Home Care Program--A DHS attendant care services program. Community attendant (CA), primary home care (PHC), and family care (FC) are the three types of services available under the Primary Home Care Program.

(17) Primary home care (PHC) services--A service under the Primary Home Care Program providing in-home attendant services to clients. Clients receiving PHC services must have a medical need for specific tasks. PHC services are provided under Title XIX of the federal Social Security Act, at 42 U.S.C. §1396a (relating to State plans for medical assistance).

(18) Priority--One of two types of eligibility status for service delivery determined by the case manager. The other type of eligibility status for service delivery is non-priority. A priority client meets the criteria described in §48.2918(f) of this title. Services delivered to such a client may be referred to as priority services, and an attendant who serves such a client may be referred to as a priority attendant.

(19) Provider agency--A home and community support services agency that contracts with DHS to provide services to clients in exchange for reimbursement.

(20) Reckless behavior--Acting with conscious indifference to the consequences.

(21) Regional nurse--A DHS employee who is responsible for authorizing a client to receive CA services.

(22) Representative--The client's spouse, other responsible party, or legal representative.

(23) Routine referral--A request from the case manager to a provider agency to evaluate a person for service delivery, in which the case manager determines that the person's needs do not require a negotiated referral.

(24) Service schedule--A schedule for delivering attendant services that is agreed upon and signed by the client. A fixed service schedule specifies certain days, times of day, or time periods for delivery of the services. A variable service schedule states the number of hours of services to be delivered per day or per week, not to exceed the authorized hours per week, and does not otherwise specify any certain days, times of day, or time periods for delivery of the services.

(25) Signature--A person's name written in longhand or a mark representing his or her name on a document to certify it is correct. Initials are not an acceptable substitute for a signature, unless initials have been established as the person's official signature.

(26) Supervisor--A provider agency employee who:

(A) coordinates the delivery of services in the client's service plan;

(B) supervises attendants; and

(C) meets the requirements found in §97.404 of this title (relating to Standards Specific to Agencies Licensed to Provide Personal Assistance Services).

(27) Unit of service--One hour of service delivered to a client.

(28) Working days--Days DHS is open for business.

(29) Written--Information recorded on paper or other legible document. Written information may be sent by mail or fax, or hand-delivered.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403143

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter B. PROVIDER AGENCY CONTRACTS

40 TAC §47.11

The new section is adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The new section affects the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403144

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter C. STAFF REQUIREMENTS

40 TAC §§47.21, 47.23, 47.25

The new sections are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The new sections affect the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403145

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter D. SERVICE PLAN DEVELOPMENT

40 TAC §§47.41, 47.43, 47.45, 47.47, 47.49

The new sections are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The new sections affect the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

§47.41.Allowable Tasks.

The Primary Home Care Program includes the following tasks:

(1) Personal care tasks related to the care of the client's physical health. These tasks include:

(A) bathing, which is:

(i) drawing water in sink, basin, or tub;

(ii) hauling or heating water;

(iii) laying out supplies;

(iv) assisting in or out of tub or shower;

(v) sponge bathing and drying;

(vi) bed bathing and drying;

(vii) tub bathing and drying; and

(viii) providing standby assistance for safety;

(B) dressing, which is:

(i) dressing the client;

(ii) undressing the client; and

(iii) laying out clothes;

(C) meal preparation, which is:

(i) cooking a full meal;

(ii) warming up prepared food;

(iii) planning meals;

(iv) helping prepare meals; and

(v) cutting client's food for eating;

(D) feeding/eating, which is:

(i) spoon-feeding;

(ii) bottle-feeding;

(iii) assisting with using eating and drinking utensils and adaptive devices. This does not include tube feeding; and

(iv) providing standby assistance or encouragement;

(E) exercise, which is walking with the client;

(F) grooming/shaving/oral care, which is:

(i) shaving;

(ii) brushing teeth;

(iii) shaving underarms and legs, when requested;

(iv) caring for nails; and

(v) laying out supplies;

(G) routine hair/skin care, which is:

(i) washing hair;

(ii) drying hair;

(iii) assisting with setting, rolling, or braiding hair. This does not include styling, cutting, or chemical processing of hair;

(iv) combing or brushing hair;

(v) applying nonprescription lotion to skin;

(vi) washing hands and face;

(vii) applying makeup; and

(viii) laying out supplies;

(H) assistance with self-administered medications. This means assistance with medication as defined in §97.2(10) of this title (relating to Definitions);

(I) toileting, which is:

(i) changing diapers;

(ii) changing colostomy bag or emptying catheter bag;

(iii) assisting on or off bedpan;

(iv) assisting with the use of a urinal;

(v) assisting with feminine hygiene needs;

(vi) assisting with clothing during toileting;

(vii) assisting with toilet hygiene, including the use of toilet paper and washing hands;

(viii) changing external catheter;

(ix) preparing toileting supplies and equipment. This does not include preparing catheter equipment; and

(x) providing standby assistance; and

(J) transfer/ambulation, which is:

(i) non-ambulatory movement from one stationary position to another (transfer). This does not include carrying;

(ii) adjusting or changing the client's position in a bed or chair (positioning);

(iii) assisting in rising from a sitting to a standing position;

(iv) assisting in positioning for use of a walking apparatus;

(v) assisting with putting on and removing leg braces and prostheses for ambulation;

(vi) assisting with ambulation or using steps;

(vii) assisting with wheelchair ambulation; and

(viii) providing standby assistance.

(2) Home management tasks that support the client's health and safety. These tasks include:

(A) cleaning, which is:

(i) cleaning up after the client's personal care tasks;

(ii) emptying and cleaning the client's bedside commode;

(iii) cleaning the client's bathroom;

(iv) changing the client's bed linens and making the client's bed;

(v) cleaning floor of living areas used by client;

(vi) dusting areas used by client;

(vii) carrying out the trash and setting out garbage for pick up;

(viii) cleaning stovetop and counters;

(ix) washing the client's dishes; and

(x) cleaning refrigerator and stove;

(B) laundry, which is:

(i) doing hand wash;

(ii) gathering and sorting;

(iii) loading and unloading machines in residence;

(iv) using Laundromat machines;

(v) hanging clothes to dry;

(vi) folding and putting away clothes; and

(C) shopping, which is:

(i) preparing a shopping list;

(ii) going to the store and purchasing or picking up items;

(iii) picking up medication; and

(iv) storing the client's purchased items.

(3) Escort. Escort includes the following:

(A) accompanying the client outside the home to support the client in living in the community;

(B) arranging for transportation. The provider agency may also choose to directly provide transportation; however, direct client transportation is not reimbursed under the Primary Home Care Program;

(C) accompanying the client to a clinic, doctor's office, or location for medical diagnosis or treatment; and

(D) waiting in the doctor's office or clinic with a client when necessary due to client's condition or distance from home.

§47.45.Pre-Initiation Activities.

(a) Pre-initiation activities. The supervisor must complete the following activities for each referral:

(1) Conduct an evaluation.

(A) The evaluation must be a single document that includes the person's self-report of:

(i) the dates and reasons for any hospitalization within the last three months; and

(ii) the assistance needed for the person to achieve activities of daily living, including any assistive devices or medical equipment used by the person.

(B) If the provider agency determines during the evaluation that the client exhibits reckless behavior that results in imminent danger to the health and safety of the client, the provider agency must convene an Interdisciplinary Team meeting as described in §47.49 of this chapter (relating to Interdisciplinary Team) to discuss the barriers to service delivery.

(2) Develop a service plan. The service plan must be a single document that:

(A) is agreed upon and signed by the client and the provider agency;

(B) indicates the location of service delivery. The provider agency must:

(i) make a reasonable effort to deliver services at a location outside the client's home, if requested by the client; and

(ii) maintain written justification if the client's request was not granted; and

(C) includes the following:

(i) the tasks the client will receive.

(I) The provider agency must ensure that at least one personal care task is authorized by the Texas Department of Human Services (DHS), scheduled, and provided.

(II) Recipients of family care services are not required to receive any personal care tasks.

(III) The provider agency must ensure the tasks the client will receive do not duplicate any services received from any other source;

(ii) the total weekly hours of service DHS authorizes the client to receive;

(iii) the service schedule;

(iv) frequency of supervisory visits; and

(v) a statement that:

(I) the Primary Home Care Program only provides the tasks allowable in the program as described in §47.41 of this chapter (relating to Allowable Tasks) and agreed to on the service plan; and

(II) the provider agency is not responsible for meeting the applicant's needs other than tasks allowed under the Primary Home Care Program.

(3) Obtain a practitioner's statement as described in §47.47 of this chapter (relating to Medical Need Determination). This paragraph does not apply to family care services.

(b) Service plan differences.

(1) The provider agency must orally notify the case manager when the initial service plan developed by the provider agency:

(A) has more hours than authorized on DHS's Authorization for Community Care Services form; or

(B) has no personal care tasks. This subparagraph does not apply to family care services.

(2) The provider agency must discuss the difference in the service plan with the case manager.

(3) The provider agency must provide services according to the existing service plan, until the provider agency receives a new DHS Authorization for Community Care Services form.

(4) The provider agency must maintain the following documentation regarding the service plan difference in the client file:

(A) the specific difference in the service plan; and

(B) the decision regarding the difference.

(c) Pre-initiation activities due date. The provider agency must complete the pre-initiation activities as follows:

(1) for routine referrals, within 14 days after one of the following dates, whichever is later:

(A) the referral date (Item 1) on DHS's Authorization for Community Care Services form; or

(B) the date the provider agency receives DHS's Authorization for Community Care Services form. If the provider agency fails to stamp the receipt date on the form, the referral date (Item 1) will be used to determine timeliness; and

(2) for negotiated referrals, by the service initiation date negotiated with the case manager.

(d) Delay in pre-initiation activities.

(1) The provider agency must document any failure to complete the pre-initiation activities for routine referrals by the due date, including:

(A) the reason for the delay, which must be beyond the control of the provider agency;

(B) either the date the provider agency anticipates it will complete the pre-initiation activities or specific reasons why the provider agency cannot anticipate a completion date; and

(C) a description of the provider agency's ongoing efforts to complete pre-initiation activities.

(2) The provider agency must orally notify the case manager of any failure to complete the pre- initiation activities for negotiated referrals before the negotiated service initiation date. Oral notice means directly speaking with the case manager and does not include a message left by voice mail. The case manager may refer the client to another provider agency.

(e) Documentation of pre-initiation activities.

(1) The provider agency may combine the evaluation and service plan into a single document, but each item must be clearly identifiable.

(2) The provider agency must maintain documentation of the pre-initiation activities in the client file.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403146

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter E. SERVICE REQUIREMENTS

40 TAC §§47.61, 47.63, 47.65, 47.67, 47.69, 47.71, 47.73

The new sections are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The new sections affect the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403147

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter F. CLAIMS PAYMENT AND DOCUMENTATION

40 TAC §§47.81, 47.83, 47.85, 47.87, 47.89, 47.5902

The new sections are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The new sections affect the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403148

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Chapter 47. PRIMARY HOME CARE

Subchapter A. GENERAL PROVISIONS AND SERVICES

40 TAC §§47.1901 - 47.1904

The repeals are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The repeals affect the Human Resources Code, §§22.0001-22.040 and §§32.001- 32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403149

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter B. SERVICE REQUIREMENTS

40 TAC §§47.2901 - 47.2905, 47.2908 - 47.2914

The repeals are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The repeals affect the Human Resources Code, §§22.0001-22.040 and §§32.001- 32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403150

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter C. CLAIMS PAYMENT

40 TAC §§47.3906 - 47.3908

The repeals are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The repeals affect the Human Resources Code, §§22.0001-22.040 and §§32.001- 32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403151

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter D. PROVIDER CONTRACTS

40 TAC §§47.4902 - 47.4905

The repeals are adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The repeals affect the Human Resources Code, §§22.0001-22.040 and §§32.001- 32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403152

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter E. SUPPORT DOCUMENTS

40 TAC §47.5902

The repeal is adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The repeal affects the Human Resources Code, §§22.0001-22.040 and §§32.001- 32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403153

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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


Subchapter F. SANCTIONS

40 TAC §47.6902

The repeal is adopted under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs, and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The repeal affects the Human Resources Code, §§22.0001-22.040 and §§32.001- 32.067.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 10, 2004.

TRD-200403154

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Effective date: June 1, 2004

Proposal publication date: February 6, 2004

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