Part 1. DEPARTMENT OF AGING AND DISABILITY SERVICES
Chapter 48. COMMUNITY CARE FOR AGED AND DISABLED
Subchapter H. ELIGIBILITY
The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), an amendment to §48.2906, concerning age requirements for Community Care for Aged and Disabled (CCAD) services, in Chapter 48, Community Care for Aged and Disabled.
Background and Purpose
The purpose of the amendment is to implement an age requirement for CCAD primary home care services (in-home unskilled attendant care for individuals who have a medical need for specific tasks, as provided under Title XIX of the Social Security Act). The rule currently states that there is no age requirement for CCAD primary home care services. However, in response to the settlement agreement in Alberto N., et al, vs. Albert Hawkins and James Hine, HHSC will offer personal care services (i.e., unskilled attendant care) to persons under 21 years of age. Upon implementation of HHSC's new personal care services program, DADS will make its CCAD primary home care services available only to persons who are 21 years of age or older. However, to provide continuity of care for individuals who would age out of HHSC's personal care services program within three months after the new program begins, the amendment allows a current consumer of CCAD primary home care services who is eligible for Texas Health Steps and who becomes 21 years of age during the three-month period, to continue receiving CCAD primary home care services.
Section-by-Section Summary
The amendment changes the structure of the current rule to make the requirements easier to understand. It states that a person 18 years of age or older, or an emancipated minor, may receive CCAD services, with several exceptions. The exceptions are for CCAD Medicaid-funded day activity and health services (for which there is no age requirement), for CCAD Medicaid-funded community attendant services (for which there is no age requirement for a person who is not eligible for the Texas Health Steps program), and for CCAD primary home care services (for which a person must be 21 years of age or older, except a current CCAD primary home care services consumer who is eligible for Texas Health Steps and who will become 21 years of age within three months after the effective date of the amendment). The amendment also provides a reference to the personal care services program at HHSC for an individual under the age of 21 who is eligible for Texas Health Steps.
Fiscal Note
Gordon Taylor, DADS Chief Financial Officer, has determined that, for the first five years the proposed amendment is in effect, enforcing or administering the amendment does not have foreseeable implications relating to costs or revenues of state or local governments.
Small Business and Micro-business Impact Analysis
DADS has determined that there is no adverse economic effect on small businesses or micro-businesses, or on businesses of any size, as a result of enforcing or administering the amendment, because the amendment applies to the eligibility of an individual for services and not to a business.
Public Benefit and Costs
Gary Jessee, DADS Assistant Commissioner for Access and Intake, has determined that, for each year of the first five years the amendment is in effect, the public benefit expected as a result of enforcing the amendment is that children under the age of 21 will have access to a greater array of personal care services and that Texas Health Steps-eligible children will have a better continuum of care in combination with skilled nursing services.
Mr. Jessee anticipates that there will not be an economic cost to persons who are required to comply with the amendment. The amendment will not affect a local economy.
Takings Impact Assessment
DADS has determined that this proposal 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 Texas Government Code, §2007.043.
Public Comment
Questions about the content of this proposal may be directed to Sharon Wallace at (512) 438-3729 in DADS' Access and Intake Local Procedure Development and Support Unit. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-027, Department of Aging and Disability Services W-615, P.O. Box 149030, Austin, Texas 78714-9030, or street address 701 West 51st St., Austin, TX 78751; faxed to (512) 438-5759; or e-mailed to rulescomments@dads.state.tx.us. To be considered, comments must be submitted no later than 30 days after the date of this issue of the Texas Register. The last day to submit comments falls on a Sunday; therefore, comments must be either (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered to DADS before 5:00 p.m. on DADS' last working day of the comment period; or (3) faxed or e-mailed by midnight on the last day of the comment period. When faxing or e-mailing comments, please indicate "Comments on Proposed Rule 027" in the subject line.
Statutory Authority
The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program.
The amendment affects Texas Government Code, §531.0055 and §531.021, and Texas Human Resources Code, §161.021.
§48.2906.Age.
(a) A person must be 18 years of age or older, or an emancipated minor, to receive Community Care for the Aged and Disabled (CCAD) services, except:
(1) a person of any age may receive CCAD Medicaid-funded day activity and health services;
(2) a person of any age who is not eligible for the Texas Health Steps program may receive CCAD Medicaid-funded community attendant services; and
(3) a person must be 21 years of age or older to receive CCAD primary home care services, except a current CCAD primary home care services consumer who is eligible for Texas Health Steps and who becomes 21 years of age within three months after the effective date of this section.
(b) A person under 21 years of age who is eligible for the Texas Health Steps program may be eligible for personal care services provided through the Texas Health and Human Services Commission.
[(a) Except as specified in subsections
(b) - (c) of this section, clients must be at least 18 to receive CCAD services.]
[(b) No age limits apply to CCAD
Medicaid services (primary home care and day activity and health services).]
[(c) Emancipated minors may receive
CCAD services without regard to age.]
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 March 30, 2007.
TRD-200701246
Kenneth L. Owens
General Counsel
Department of Aging and Disability Services
Earliest possible date of adoption: May 13, 2007
For further information, please call: (512) 438-4162