Adopted Sections An agency may take final action on a section 30 days after a proposal has been published in the Texas Register. The section becomes effective 20 days after the agency files the correct document with the Texas Register, unless a later date is specified or unless a federal statute or regulation requires implementation of the action on shorter notice. If an agency adopts the section without any changes to the proposed text, only the preamble of the notice and statement of legal authority will be published. If an agency adopts the section with changes to the proposed text, the proposal will be republished with the changes. TITLE 7. BANKING AND SECURITIES Part VI. Credit Union Department Chapter 91. Chartering, Operations, Mergers, Liquidations Organization Procedures 7 TAC sec.91.211 The Credit Union Commission adopts an amendment to sec.91.211 concerning organization procedures, without changes to the proposed text as published in the October 1, 1991, issue of the Texas Register (16 TexReg 5376). The change requires all out-of-state credit unions operating branch offices in Texas to have federal deposit insurance by June 30, 1993. The rule is necessary for providing greater insurance protection for credit union members' savings. State-chartered credit unions headquartered in other states and seeking permits to operate branch offices in Texas will be required to have federal deposit insurance. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 2461-11.07, which provides the Credit Union Commission with the authority to adopt reasonable rules necessary for the administration of the Texas Credit Union Act. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115092 John R. Hale Commissioner Credit Union Department Effective date: December 24, 1991 Proposal publication date: September 23, 1991 For further information, please call: (512) 837-9236 TITLE 19. EDUCATION Part II. Texas Education Agency Chapter 75. Curriculum Subchapter B. Essential Elements Prekindergarten-Grade Six 19 TAC sec.sec.75.21-75.32 The Texas Education Agency adopts new sec.sec.75.21-75.32, concerning the essential prekindergarten grade six. Section 75.30 is adopted with changes to the proposed text as published in the October 25, 1991, issue of the Texas Register (16 TexReg 5957). Sections 75.21-75.29, 75.31, and 75.32 are adopted without changes and will not be republished. The sections are a result of the five-year curriculum review process, preliminary discussions with the State Board of Education, and changes in content that were included in Proclamations 68, 1991, and 1992. The former sections are being repealed in a separate submission. Justification for the new sections will be the revision of curriculum essential elements to reflect content changes made in Textbook Proclamations 68, 1991, and 1992. The new sections will function by allowing school districts sufficient time to update curriculum guides and materials and to plan staff development programs for implementing new textbooks based on the reviewed essential elements, assist publishers in developing teacher editions with references to the revised essential elements, and assist textbook reviewers in reviewing coverage of the revised essential elements in the textbooks. Comments were received regarding adoption of the new sections from the State Board of Education. The board directed the agency to implement the following changes as a result of these comments. Section 75.30(j)(1)(B),(C), and (D) were changed and new subparagraphs (E) and (F) were added to include additional opportunities for students in health-related fitness development. Section 75. 30(h)(2)(B)(iv) was changed and new subparagraph (C) was added to include additional elements relating to motor skills. Section 75.30(h)(4)(B) and (C) were changed and new subparagraph (D) was added to include additional skills relating to games and sports for physical education, grade one. Section 75.30(i) (1)(B)-(D) were changed and new subparagraphs (E) and (F) were added to include additional opportunities for students in improving the quality of life through health-related fitness development. Section 75.30(i)(2)(B)(i)-(iii) were changed and new clause (iv) was added to include additional elements relating to perceptual awareness skills. Section 75.30(i)(4)(B) and (C) were changed and new subparagraph (D) was added to include additional skills relating to games and sports for physical education, grade two. Section 75.30(j)(1)(B)-(D) were changed and new subparagraphs (E) and (F) were added to include additional elements relating to physical education, grade three. Section 75.30(j)(3)(B) was changed to eliminate the specificity of folk dances for student participation. Students would participate in all dances that develop multicultural heritage. Section 75.30(j)(4)(B)-(E) were changed to eliminate subparagraph (B) regarding participating in lead-up and modified games for physical education, grade three, and to insert the clarification in former subparagraph (C) that they will participate in modified games. Section 75.30(j)(5) was changed to add a new subparagraph (A) regarding students participation in sequential gymnastics, and the former subparagraphs (A)-(C) were redesignated as subparagraphs (B)-(D). Section 75.30(k)(1)(A)-(D) was changed to move the phrase "(sustained at the recommended duration of 20 minutes of activity in the personal target heart rate zone)" from subparagraph (B) to (A). New subparagraphs (E) and (F) were also added to include additional opportunities for health-related fitness development in physical education, grade four. Section 75.30(k)(3)(B) was changed to eliminate the specificity of folk dances for student participation. Section 75. 30(k)(4)(A)-(E) were changed to eliminate subparagraph (A) regarding students participating in lead-up and modified games. Section 75.30(k)(5)(A)-(C) was modified to include a new subparagraph (A) regarding students participating in sequential gymnastics and tumbling activities that develop coordination, strength, flexibility, and kinesthetic awareness. Section 75.30(1)(1)(A)-(D) was changed to move the phrase "(sustained at the recommended duration of 20 minutes of activity in the personal target heart rate zone)" from subparagraph (B) to (A) . New subparagraphs (E) and (F) were also added to include additional opportunities for health-related fitness development in physical education, grade five. Section 75.30(1)(3)(C) was changed to eliminate dance making from the rhythmic activities for physical education, grade five. Section 75.30(1)(5) (A)-(C) was modified to include a new subparagraph (A) regarding students participating in sequential gymnastics and tumbling activities that develop coordination, strength, flexibility, and kinesthetic awareness. Section 75.30(m) (1)(A) and (B) was changed to move the phrase "(sustained at the recommended duration of 20 minutes of activity in the personal target heart rate zone)" from subparagraph (B) to (A). Subparagraph (I) was also changed editorially to replace the term "components" with "fitness." Section 75.30(m)(3)(A)-(C) was changed to amend subparagraph (A) to include "self-created activities for endurance." A new subparagraph (B) was added to include multicultural and teacher choreographed dances to the elements for physical education, grade six. Section 75.30(m)(4)(B)-(C) was changed to add a new subparagraph (D) allowing the opportunity for the student to participate in contests and relays. Section 75.30(m)(5)(B)-(C) was changed to include a new subparagraph (C) that includes the opportunity for the student to explore, develop, and perform in a patterned sequence in gymnastics and tumbling. The new sections are adopted under the Texas Education Code, sec.21.101, which provides the State Board of Education with the authority to adopt rules designating the essential elements for a well-balanced curriculum for state school districts. sec.75.30. Physical Education. (a) Physical education, kindergarten. Essential elements described in this subsection for physical education, kindergarten, shall be superseded by the essential elements described in sec.75.22(d) of this title (relating to Kindergarten Education) effective September 1995. Physical education, kindergarten, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to participate in developmental activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) acquire fundamental movement skills: (i) locomotor (walking, running, jumping, hopping, etc.); (ii) nonlocomotor (bending and stretching, pushing and pulling, twisting and turning, etc.); (iii) manipulative (working with bean bags, large balls, ropes, etc.); and (iv) posture and body mechanics (standing, sitting, falling safely, etc.); (B) develop perceptual awareness skills: (i) body awareness (an awareness of name, location, and relationship of body parts); (ii) spatial and directional awareness (an awareness of how much space the body occupies and where to move); (iii) coordination (eye-hand, eye-foot, rhythm); and (iv) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) fundamental skills; (B) creative rhythms; and (C) singing games. (4) Skills related to games and sports. The students shall be provided opportunities to: (A) participate in skills common to games and sports (starting, stopping, dodging, throwing, kicking, catching, etc.); (B) participate in low-organizational games; and (C) develop and practice behavior reflective of good sportsmanship and safety. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) develop gross motor skills: (i) orientation of one's body in space; (ii) balance; (iii) eye-body coordination; (iv) upper body development; and (B) participate in creeping, crawling, rolling, balancing, climbing, lifting one' body. (b) Physical education, grade one. Essential elements described in this subsection for physical education, grade one, shall be superseded by the essential elements described in subsection (h) of this section effective September 1993. Physical education, grade one, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to participate in developmental activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) acquire fundamental movement skills: (i) locomotor (walking, running, jumping, hopping, skipping, etc.); (ii) nonlocomotor (bending and stretching, pushing and pulling, twisting and turning, etc.); (iii) manipulative (working with bean bags, large balls, ropes, etc.); and (iv) posture and body mechanics (standing, sitting, falling safely, etc.); (B) develop perceptual awareness skills: (i) body awareness (an awareness of name, location, and relationship of body parts); (ii) spatial and directional awareness (an awareness of how much space the body occupies and where to move); (iii) coordination (eye-hand, eye-foot, rhythm); and (iv) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) fundamental skills; (B) creative rhythms; and (C) singing games. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in skills common to games and sports (starting, stopping, dodging, throwing, kicking, catching, etc.); (B) participate in games (low-organizational, creative, and cooperative); and (C) develop and practice behavior reflective of good sportsmanship and safety. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) develop gross motor skills: (i) orientation of one's body in space; (ii) balance; (iii) eye-body coordination; and (iv) upper body development; (B) participate in creeping, crawling, rolling, balancing, climbing, lifting one's body. (c) Physical education, grade two. Essential elements described in this subsection for physical education, grade two, shall be superseded by the essential elements described in subsection (i) of this section effective September 1993. Physical education, grade two, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to participate in developmental activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) acquire fundamental movement skills: (i) locomotor (walking, running, jumping, skipping, etc.); (ii) nonlocomotor (bending and stretching, pushing and pulling, twisting and turning, etc.); (iii) manipulative (working with bean bags, large balls, ropes, etc.); and (iv) posture and body mechanics (standing, sitting, falling, safely, etc.); (B) develop perceptual awareness skills: (i) body awareness (an awareness of name, location, and relationship of body parts); (ii) spatial and directional awareness (an awareness of how much space the body occupies and where to move); (iii) coordination (eye-hand, eye-foot, rhythm); and (iv) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) fundamental skills; (B) creative rhythms; and (C) singing games. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in skills common to games and sports (starting, stopping, dodging, throwing, kicking, catching, etc.); (B) participate in games (low-organizational, creative, and cooperative); and (C) develop and practice behavior reflective of good sportsmanship and safety. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) develop gross motor skills; (i) orientation of one's body in space; (ii) balance; (iii) eye-body coordination; and (iv) upper body development; (B) participate in creeping, crawling, rolling, balancing, lifting one's body. (d) Physical education, grade three. Essential elements described in this subsection for physical education, grade three, shall be superseded by the essential elements described in subsection (j) of this section effective September 1993. Physical education, grade three, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance; and (B) participate in developmental activities for power, agility, speed, coordination, reaction, and balance. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using balls and other equipment; (B) continue development of perceptual awareness skills; (i) coordination (eye-hand, eye-foot, rhythm); and (ii) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) rhythmic activities for endurance; and (B) folk dance. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in games (low-organizational, creative, and cooperative); (B) participate in lead-up and modified games; (C) develop and practice behavior; and (D) participate in contests and relays. (5) Sequential gymnastics and tumbling skills. The student shall be provided opportunities to participate in gymnastics and tumbling. (e) Physical education, grade four. Essential elements described in this subsection for physical education, grade four, shall be superseded by the essential elements described in subsection (k) of this section effective September 1993. Physical education, grade four, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in development activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance; (B) participate in developmental activities for power, agility, speed, coordination, reaction, and balance; and (C) benefit from physical fitness testing and appraisal. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using balls and other equipment; (B) continue development of perceptual awareness skills: (i) coordination (eye-hand, eye-foot, rhythm); and (ii) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) rhythmic activities for endurance; and (B) folk dance. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in lead-up and modified games; (B) participate in individual, team, and recreational games; (C) develop and practice behavior reflective of good sportsmanship and safety; and (D) participate in contests and relays. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to participate in gymnastics and tumbling. (f) Physical education, grade five. Essential elements described in this subsection for physical education, grade five, shall be superseded by the essential elements described in subsection (1) of this section effective September 1993. Physical education, grade five, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance; (B) participate in developmental activities for power, agility, speed, coordination, reaction, and balance; and (C) benefit from physical fitness testing and appraisal. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using balls and other equipment. (B) continue development of perceptual awareness skills: (i) coordination (eye-hand, eye-foot, rhythm); and (ii) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) rhythmic activities for endurance; and (B) folk dance. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in lead-up and modified games; (B) participate in individual, team, and recreational games; (C) participate in individual, dual, and modified team sports; (D) develop and practice behavior reflective of good sportsmanship and safety; and (E) participate in contests and relays. (5) Sequential gymnastics and tumbling skills. The student shall be provided opportunities to participate in gymnastics and tumbling. (g) Physical education, grade six. Essential elements described in this subsection for physical education, grade six, shall be superseded by the essential elements described in subsection (m) of this section effective September 1993. Physical education, grade six, shall include the following essential elements. (1) Physical fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in development activities related to muscular strength and endurance, flexibility, and cardiorespiratory endurance; (B) participate in development activities for power, agility, speed, coordination, reaction and balance; and (C) benefit from physical fitness testing and appraisal. (2) Motor skills that develop positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using balls and other equipment; (B) continue development of perceptual awareness skills: (i) coordination (eye-hand, eye-foot, rhythm); and (ii) balance. (3) Rhythmic activities that develop coordination, self-expression, creativity, and endurance. The student shall be provided opportunities to participate in rhythmic activities: (A) rhythmic activities for endurance; and (B) folk dance. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in individual, dual, and modified team sports; (B) develop and practice behavior reflective of good sportsmanship and safety; and (C) participate in contests and relays. (5) Sequential gymnastics and tumbling skills. The student shall be provided opportunities to participate in gymnastics and tumbling. (h) Physical education, grade one. Essential elements for physical education, grade one, as described in this subsection shall be effective September 1993. Physical education, grade one, shall include the following essential elements. (1) Health-related fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, cardiorespiratory endurance, body composition, nutrition, health-related fitness concepts and behaviors, and lifestyle problem- solving skills; (B) participate in a cognitive and/or psychomotor appraisal of personal health fitness through activities that measure cardiorespiratory fitness, flexibility, and abdominal strength; (C) participate in activities that address the three components of fitness training (frequency, intensity, and duration) required to develop and maintain desired levels of fitness (e.g., jump rope, power walk, jog, vigorous games and activities); (D) develop and exhibit positive safety practices (warm-up and cool-down); (E) participate in flexibility and stretching exercises; and (F) demonstrate cognitive understanding of the benefits of the components of health-related fitness. (2) Motor skills that contribute to positive body image and confidence. The student shall be provided opportunities to: (A) develop fundamental movement skills using space, time, and energy through problem solving strategies: (i) locomotor (e.g., walking, running, jumping, hopping, skipping); (ii) nonlocomotor (e.g., bending and stretching, pushing and pulling, twisting and turning); (iii) manipulative (e.g., working with bean bags, large balls, ropes); (iv) posture and body mechanics (e.g., standing, sitting, falling safely,); and (v) combined movement experiences (e.g., walking and twisting, running and throwing, walking and swinging); (B) develop perceptual awareness skills through movement analysis, including: (i) body awareness (awareness of name, location, and relationship of body parts); (ii) spatial and directional awareness (awareness of how much space the body occupies and where to move); (iii) coordination (e.g., eye-hand, eye-foot, rhythm); and (iv) balance and agility; (C) exhibit safety practices. (3) Rhythmic activities using exploration and performance (with or without manipulatives) that develop self-expression, creativity, and skilled movement. The student shall be provided opportunities to: (A) participate in simple multicultural dances; (B) participate in creative rhythms; and (C) participate in rhythmic activities requiring music. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in games of low organization and/or games that children develop using basic skills (e.g., starting, stopping, dodging, throwing, kicking, catching); (B) participate in games (creative and cooperative); (C) develop and exhibit positive sportsmanship and safety practices; and (D) participate in contests and relays. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) develop balance, body coordination, agility, and upper body strength using apparatus; (B) participate in creeping, crawling, rolling, balancing, climbing, lifting one's body; and (C) exhibit safety practices. (i) Physical education, grade two. Essential elements for physical education, grade two, as described in this subsection shall be effective September 1993. Physical education, grade two, shall include the following essential elements. (1) Health-related fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, cardiorespiratory endurance, body composition, nutrition, health-related fitness concepts and behaviors, and lifestyle problem- solving skills; (B) participate in a cognitive and/or psychomotor appraisal of personal health fitness through activities that measure cardiorespiratory fitness, flexibility, and abdominal strength; (C) participate in activities that address the three components of fitness training (frequency, intensity, and duration) required to develop and maintain desired levels of fitness (e.g., jump rope, power walk, jog, vigorous games and activities); (D) develop and exhibit positive safety practices (warm-up and cool-down); (E) participate in flexibility and stretching exercises; and (F) demonstrate cognitive understanding of the benefits of the components of health-related fitness. (2) Motor skills that contribute to positive body image and confidence. The student shall be provided opportunities to: (A) develop fundamental movement skills using space, time, and energy through problem solving strategies: (i) locomotor (e.g., walking, running, jumping, skipping); (ii) nonlocomotor (e.g. , bending and stretching, pushing and pulling, twisting and turning); (iii) manipulative (e.g., working with bean bags, large balls, ropes); (iv) posture and body echanics (e.g., standing, sitting, falling, safely); and (v) combined movement experiences (e.g., walking and twisting, running and throwing, walking and swinging); (B) develop perceptual awareness skills through movement analysis, including: (i) body awareness (awareness of name, location, and relationship of body parts); (ii) spatial and directional awareness (awareness of how much space the body occupies and where to move); (iii) coordination (e.g., eye-hand, eye-foot, rhythm); and (iv) balance and agility; (C) exhibit safety practices. (3) Rhythmic activities using exploration and performance (with or without manipulatives) that develop coordination, self-expression, creativity, and skilled movement. The student shall be provided opportunities to: (A) participate in simple multicultural dances; (B) participate in creative rhythms; and (C) participate in rhythmic activities requiring music. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in games of low organization using basic skills (e.g., starting, stopping, dodging, throwing, kicking, catching); (B) participate in games (creative and cooperative); (C) develop and exhibit positive sportsmanship and safety practices; and (D) participate in contests and relays. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) develop balance, body coordination, agility, and upper body strength using apparatus; (B) participate in creeping, crawling, rolling, balancing, lifting one's body; and (C) exhibit safety practices. (j) Physical education, grade three. Essential elements for physical education, grade three, as described in this subsection shall be effective September 1993. Physical education, grade three, shall include the following essential elements. (1) Health-related fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, cardiorespiratory endurance, body composition, nutrition, health related fitness concepts and behaviors, and lifestyle problem- solving skills; (B) participate in a cognitive and/or psychomotor appraisal of personal health fitness through activities that measure cardiorespiratory fitness, flexibility, and abdominal strength; (C) participate in sustained and continuous activities that address the three components of fitness training (frequency, intensity, and duration) required to develop and maintain desired levels of fitness (e.g., jump rope, power walk, jog); (D) develop and exhibit positive safety practices (warm-up and cool-down); (E) participate in flexibility and stretching activities; and (F) demonstrate cognitive understanding of the benefits of the components of health-related fitness. (2) Motor skills that contribute to positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using space, time, and energy through problem solving strategies with balls and other equipment; (B) continue development of perceptual awareness skills through movement analysis, including; (i) coordination (e.g., eye-hand, eye-foot, rhythm); (ii) balance; and (iii) agility; (C) exhibit safety practices. (3) Rhythmic activities using exploration and performance (with or without manipulatives) that develop coordination, self-expression, creativity, and skilled movement. The student shall be provided opportunities to: (A) participate in rhythmic activities for endurance; (B) participate in dances that develop multicultural heritage; and (C) participate in creative activities. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in games (low-organizational, creative, and cooperative); (B) participate in lead-up modified individual, team, and recreational games; (C) develop and exhibit positive sportsmanship and safety practices; and (D) participate in contests and relays. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) participate in sequential gymnastics and tumbling activities that develop coordination, strength, flexibility, and kinesthetic awareness; (B) develop balance, body coordination, agility, and upper body strength using apparatus; (C) explore, develop, and perform in a patterned sequence; and (D) exhibit safety practices. (k) Physical education, grade four. Essential elements for physical education, grade four, as described in this subsection shall be effective September 1993. Physical education, grade four, shall include the following essential elements. (1) Health-related fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, cardiorespiratory endurance (sustained at the recommended duration of 20 minutes of activity in the personal target heart rate zone), body composition, nutrition, health-related fitness concepts and behaviors, and lifestyle problem-solving skills; (B) participate in a cognitive and/or psychomotor assessment of health-related fitness that measures cardiorespiratory fitness, flexibility, and abdominal strength at the recommended twice per school year; (C) participate in sustained and continuous activities that address the three components of fitness training (frequency, intensity, and duration) required to develop and maintain desired levels of fitness; (D) develop and exhibit positive safety practices (warm-up and cool-down); (E) participate in flexibility and stretching exercises; and (F) demonstrate cognitive understanding of the benefits of the components of health-related fitness. (2) Motor skills that contribute to positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using space, time, and energy through problem solving strategies with balls and other equipment; (B) continue development of perceptual awareness skills through movement analysis, including: (i) coordination (e.g., eye-hand, eye-foot, rhythm); (ii) balance; and (iii) agility; (C) exhibit safety practices. (3) Rhythmic activities using exploration and performance (with or without manipulatives) that develop coordination, self-expression, and creativity. The student shall be provided opportunities to: (A) participate in rhythmic activities for endurance; (B) participate in dances that develop multicultural heritage; and (C) participate in creative movement experiences. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) participate in individual, team, and modified recreational games; (B) participate in contests and relays; (C) develop and exhibit positive sportsmanship and safety practices; and (D) participate in games (creative and cooperative). (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) participate in sequential gymnastics and tumbling activities that develop coordination, strength, flexibility, and kinesthetic awareness; (B) demonstrate skills using apparatus and floor activities; (C) explore, develop, and perform in a patterned sequence; and (D) exhibit safety practices. (l) Physical education, grade five. Essential elements for physical education, grade five, as described in this subsection shall be effective September 1993. Physical education, grade five, shall include the following essential elements. (1) Health-related fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance, flexibility, cardiorespiratory endurance (sustained at the recommended duration of 20 minutes of activity in the personal target heart zone), body composition, nutrition, health-related fitness concepts and behaviors, and lifestyle problem-solving skills; (B) participate in a cognitive and/or psychomotor assessment of health-related fitness that measures cardiorespiratory fitness, flexibility, and abdominal strength at the recommended twice per school year; (C) participate in sustained and continuous activities that address the three components of fitness training (frequency, intensity, and duration) required to develop and maintain desired levels of fitness; (D) develop and exhibit positive safety practices (warm-up and cool-down); (E) participate in flexibility and stretching exercises; and (F) demonstrate cognitive understanding of the benefits of the components of health-related fitness. (2) Motor skills that contribute to positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using space, time and energy through problem solving strategies with balls and other equipment; (B) continue development of perceptual awareness skills through movement analysis, including: (i) coordination (e.g., eye-hand, eye-foot, rhythm); (ii) balance; and (iii) agility; (C) exhibit safety practices. (3) Rhythmic activities using exploration and performance (with or without manipulatives) that develop coordination, self-expression, and creativity. The student shall be provided opportunities to: (A) participate in rhythmic activities for endurance; (B) participate in folk dances that develop multicultural heritage; and (C) participate in creative movement experiences: (i) vary time, space, energy, and flow; and (ii) express ideas, feelings, and design through movement images. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) develop skills and participate in individual, dual, recreational leisure activities, and modified team sports; (B) develop and exhibit positive sportsmanship and safety practices; (C) participate in contests and relays; and (D) participate in games (creative and cooperative). (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to participate in gymnastics and tumbling: (A) participate in sequential gymnastics and tumbling activities that develop coordination, strength, flexibility, and kinesthetic awareness; (B) demonstrate skills using apparatus and floor activities; (C) explore, develop, and perform in a patterned sequence; and (D) exhibit safety practices. (m) Physical education, grade six. Essential elements for physical education, grade six, as described in this subsection shall be effective September 1993. Physical education, grade six, shall include the following essential elements. (1) Health-related fitness development to improve the quality of life. The student shall be provided opportunities to: (A) participate in developmental activities related to muscular strength and endurance (sustained at the recommended duration of 20 minutes of activity in the personal target heart rate zone), flexibility, cardiorespiratory endurance, body composition, nutrition, health-related fitness concepts and behaviors, and lifestyle problem-solving skills; (B) participate in a cognitive and/or psychomotor assessment of health-related fitness that measures cardiorespiratory fitness, flexibility, and abdominal strength at the recommended twice per school year; (C) participate in sustained and continuous activities that address the three components of fitness training (frequency, intensity, and duration) required to develop and maintain desired levels of fitness; (D) continue to exhibit positive safety practices (warm-up and cool-down); (E) participate in activities that address specificity, overload, and progression of benefits of exercise; (F) understand the concepts of fatigue and the benefits of exercise; (G) participate in flexibility and stretching activities; (H) understand and participate in activities that reduce stress; and (I) demonstrate cognitive understanding of the benefits of the components of health-related fitness. (2) Motor skills that contribute to positive body image and confidence. The student shall be provided opportunities to: (A) continue development of a combination of fundamental movement skills using space, time, and energy through problem solving strategies with balls and other equipment; (B) continue development of perceptual awareness skills through movement analysis, including: (i) coordination (e.g., eye-hand, eye-foot, rhythm); (ii) balance; and (iii) agility; (C) exhibit safety practices. (3) Rhythmic activities that develop coordination, self-expression, creativity, and skilled movement. The student shall be provided opportunities to: (A) explore and develop self-created activities for endurance; (B) perform multicultural and teacher choregraphed dances; and (C) observe, describe, and analyze rhythmic activities. (4) Skills related to games and sports. The student shall be provided opportunities to: (A) develop skills and participate in individual, dual, recreational leisure activities, and modified team sports; (B) develop and exhibit sportsmanship and safety practices; (C) participate in games (creative and cooperative); and (D) participate in contests and relays. (5) Sequential gymnastic and tumbling skills. The student shall be provided opportunities to: (A) participate in sequential gymnastics and tumbling activities that develop coordination, strength, flexibility, and kinesthetic awareness; (B) demonstrate skills using apparatus and floor activities; This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on November 21, 1991. TRD-9114990 Criss Cloudt Director, Planning Coordination Texas Education Agency Effective date: December 23, 1991 Proposal publication date: October 22, 1991 For further information, please call: (512) 463-9701 TITLE 22. EXAMINING BOARD Part IV. Texas Cosmetology Commission Chapter 83. Sanitary Rulings 22 TAC sec.sec.83.1-83.3, 83.5, 83.6, 83.13, 83.27, 83.30 The Texas Cosmetology Commission adopts amendments to sec. sec.83.1-83.3, 83.5, 83.6, 83.13, 83.27, and 83.30, concerning sanitation, without changes to the proposed text as published in the October 18, 1991, issue of the Texas Register (16 TexReg 5803). The amendments are adopted to update the language of the sections in keeping with the times. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 8451a, which provide the Texas Cosmetology Commission with the authority to issue rules and regulations consistent with the Act that are needed to protect the public's health and welfare. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 2, 1991. TRD-9115140 Ron Resech Executive Director Texas Cosmetology Commission Effective date: December 25, 1991 Proposal publication date: October 18, 1991 For further information, please call: (512) 454-4674 22 TAC sec.83.12 The Texas Cosmetology Commission adopts the repeal of sec.83.12, concerning neck brushes and dusters, without changes to the proposed text as published in the October 18, 1991, issue of the Texas Register (16 TexReg 5804). The repeal is adopted because neck brushes and dusters may be used. No comments were received regarding adoption of the repeal. The repeal is adopted under Texas Civil Statutes, Article 8451a, which provide the Texas Cosmetology Commission with the authority to issue rules and regulations consistent with the Act that are needed to protect the public's health and welfare. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 2, 1991. TRD-9115139 Ron Resech Executive Director Texas Cosmetology Commission Effective date: December 25, 1991 Proposal publication date: October 18, 1991 For further information, please call: (512) 454-4674 Chapter 89. General Rules and Regulations 22 TAC sec.sec.89.2-89.4, 89.6, 89.10, 89.11, 89.13, 89.15, 89.17, 89.19-89.22, 89.24, 89.26, 89.28-89.31, 89.39, 89.41, 89.44, 89.47, 89.49, 89.53, 89.69, 89.70, 89.72, 89.75, 89.76 The Texas Cosmetology Commission adopts amendments to sec. sec.89.2-89.4, 89.6, 89.10, 89.11, 89.13, 89.15, 89.17, 89.20, 89.22, 89.24, 89.28, 89.30, 89.31, 89. 39, 89.41, 89.44, 89.47, 89.49, 89.53, 89.54, 89.69, 89.70, 89.72, 89.75, and 89. 76 and new sec.sec.89.19, 89.21, 89.26, and 89.29 concerning general rules and regulations. Sections 89.17, 89.20, 89.21, 89.24, 89.29, 89.31, 89.47, 89.49, 89. 53, 89.54, 89.70, 89.75, and 89.76 are adopted with changes to the proposed text as published in the October 18, 1991, issue of the Texas Register (16 TexReg 5804). Sections 89.2-89.4, 89.6, 89.10, 89.11, 89.13, 89.15, 89.19, 89.22, 89.26, 89.28, 89.30, 89.39, 89.41, 89.44, 89.69, and 89.72 are adopted without changes and will not be republished. The amendments update and clarify the language of existing section. The new sections reflect new legislation passed in the 1991 regular session of the Texas Legislature. The amendments were made to update the language of the existing section to be in keeping with the times and to clarify existing language. The new sections reflect legislation that was passed in the 1991 Regular Session of the Texas Legislature. The Texas Independent Contractors Association opposed some of the language in sec.89.54 and changes were made in the adoption. The agency did not disagree with the comments made and made changes in the adopted version of the section to reflect the comments made. The amendments and new section are adopted under Texas Civil Statutes, Article 8451a, which provides the Texas Cosmetology Commission with the authority to issue rules and regulations consistent with the Act that are needed to protect the public's health and welfare. sec.89.17. Instructor Applicants. The student instructor must have a valid operator's license before re-entering a cosmetology school to complete 750 hours in cosmetology courses and methods of teaching, and must provide a high school diploma or a GED equivalent along with a properly completed registration form prior to entering school. To receive credit for hours for the instructor course, a person holding a current operator license from this state or any other state who can verify two years of operator experience in a licensed beauty salon may also qualify for the instructor exam provided they enroll in an instructor course and complete 250 hours of student instructor training in an approved school and meet the other instructor requirements. sec.89.20. Length of Courses. (a) Instructor. An Instructor course shall be 750 hours in an approved school or two years of licensed operator experience in this state or any other state plus 250 hours of instructor training in an approved school. (b)-(d) (No change.) (e) Facial specialist. A facial specialist course shall be for 600 hours in an approved school. (f) (No change.) (g) Manicurist. The manicuring course shall be for 250 in an approved school. (h) Hours. Once hours are accrued they will be valid for 48 months after withdrawal or graduation. sec.89.21. Student Loan Defaults. Licensees that are in default on a loan guaranteed by the Texas Guaranteed Student Loan Corporation, or any other loan made soley for the purpose of paying tuition and fees, may not renew that license unless timely payments are being made on that loan prior to license renewal. sec.89.24. General Provisions Regarding Transfer of Hours. (a) (No change.) (b) A student transferring to a school who desires to claim hours and practical applications earned must inform the school transferred to prior to enrollment of his/her prior attendance and must furnish to that school and the executive director a record of hours claimed and practical applications completed. This record may be in the form of a transcript from the prior school or an extract from records of the commission. The school must provide this information within 10 working days. (c) The commission, through the executive director, shall evaluate the transcript generated upon withdrawal from the prior school, and provided that the agreed tuition and fees have been tendered according to sec.23 of the Cosmetology Statutes shall certify in writing to the student and the school that the stated hours and practical applications have been completed. sec.89.29. Practical Applications of the Curriculum. (a) Each student in a school of cosmetology in the operator course enrolling after January 1, 1992, must complete practical applications of the curriculum according to the school's published rules on minimum practical applications, or the following schedule, whichever is greater. (1) Sanitation-175. (2) Facials 30 (a minimum of five services in each category) (A) skin analysis and care; (B) manipulation, massage (C) skin care; (D) removal of hair by the use of wax, tweezers, or depilatories; (E) make-up and brow arch. (3) Hairdressing-300 (minimum of 20 services in each category): (A) arranging, cutting, dressing; (B) shampooing, curling, pressing, fingerwaving. (4) Scalp and hair treatments-30. (5) Haircoloring-80 (a minimum of eight services in each category): (A) temporary, semi-permanent; (B) permanent, bleaching, and dimensional, coloring, color mixing. (6) Chemical hair services-80 (a minimum of 15 services in each category): (A) restructuring, permanent waving; (B) straightening and relaxing. (7) Patron protection-10. (8) Manicuring-30. (b) The above practical applications may be performed on a mannequin, a student or a patron, and mock applications may be used where appropriate and necessary. It shall be the responsibility of the student to keep a record of the number of practical applications performed, but shall be verified by an instructor signature. (c) The Cosmetology Commission inspector as part of their normal duties, will discontinue monitoring hours and hour reports, but will instead check a portion of the student's practical applications. The practical applications will be maintained as a part of the student's file after they graduate or withdraw. (c) When a student graduates the school must certify that the student has completed the 1,500 hour course and that all practical applications have been completed. sec.89.31. Examination. (a)-(d) (No change.) (e) The Cosmetology Commission may issue a temporary work permit to students who wish to work in a licensed beauty salon prior to taking the operator examination. To obtain a work permit the following guidelines will apply. (1) On a application furnished by the commission the school must apply 30 days prior to graduation that the student wishes to apply for a temporary work permit. The application must be accompanied by a $10 money order. (2) Upon receipt the commission will mail a two part work permit to the school, upon graduation the school must certify the completion of the 1,500 hour course and all practical applications and give the work permit to the student, the student then takes the work permit to the salon and the salon owner signs and returns to the commission in Austin. The second part is posted in the salon where the student will be working. (3) The temporary work permit will be valid for 45 days from the date that the school certified completion of the operator course and practical applications. The school will still send in the exam application and companion health certificate as always, but care must be exercised so that the student paper work is filed timely, otherwise the student must stop working. (4) The temporary work permit must be turned in when the student appears on the exam floor, or the Commission may stamp the work permit on exam day and allow the applicant to work for 15 more days while they wait for their result letter and mail in their money order for licensing. (5) If a student fails or does not appear for the exam, the work permit is voided and the salon owner notified. sec.89.47. Definition of a Facial Speciality Salon. (a)-(f) (No change.) (g) Only those specialities may be practiced in a speciality salon for which the salon is licensed, meets the equipment requirements, and has the services performed by the appropriate licensed specialist, a licensed operator, or a licensed instructor. sec.89.49. Definition of a Manicuring Specialty Salon. A manicuring salon is defined as an establishment where only manicuring and pedicuring is practiced. Only those specialities may be practiced in a speciality salon for which the salon is licensed, meets the equipment requirements, and has the services performed by the appropriate licensed specialist, a licensed operator, or a licensed instructor. sec.89.53. Minimum Requirements For Both Private and Public Cosmetology Schools. (a) The following are the requirements for a private cosmetology school as authorized by the Texas Cosmetology Commission as approved on June 1, 1985. (1) A building to house a cosmetology school must be fireproof and of permanent type of construction, and contain a minimum of 3,500 square feet of floor space, with separate restrooms for male and female students. The building must be divided into three separate areas: one for instruction of theory, one for practice work of seniors, and one for practice work of juniors. (2)-(9) (No change.) (10) The equipment in a cosmetology school shall not be changed after approval without notifying the Texas Cosmetology Commission. (11) All equipment in a cosmetology school shall be of professional type in good and sanitary condition. (12)-(14) (No change.) (15) On or after September 1, 1993, all schools of cosmetology must use a computer time clock using the month and date format. The appropriate person must note the correct year in ink. Safeguards must be in place so that an inspector can determine if the clock has been changed, Any school opening after September 1, 1990, must use the computer time clock. (b) The following are the requirements for a public school cosmetology program. (1) (No change.) (2) The classroom must be separated from the laboratory area and equipped with the following: (A)-(E) (No change.) (F) visual aid equipment. (3)-(6) (No change.) (7) On or after September 1, 1993, all schools of cosmetology must use a computer time clock using the month and date format. The appropriate person must note the correct year in ink. Safeguards must be in place so that an inspector can determine if the clock has been changed, Any school opening after September 1, 1990, must use the computer time clock. sec.89.70. New Private Cosmetology School. An applicant for a private cosmetology school must submit, at least 45 days prior to the tentative opening date, the following: (1)-(5) (No change.) (6) inspection report of fire marshal and electrical inspector available in or before the inspection; and (7) copy of the curriculum for each course offered; (8) proof of financial stability by providing a certified financial statement of the owner or owners; (9) On January 1, each year each private cosmetology school will contribute $200 in a special fund to protect the student if the school closes or ceases operation before the course is completed. When the tuition protection fund reaches $200,000 the contributions will cease until a portion of the fund is used, then the contributions will again be implemented to bring the fund up to capacity. sec.89.75. Field Trips. Field trips are permitted under the following conditions for students enrolled in the following courses. The following guidelines are to be strictly adhered to. (1) A maximum of 40 hours out of the 1,500 hours is permitted per student: (A) a maximum of eight hours for the manicure course; (B) a maximum of 20 hours for the facial course; (C) a maximum of 20 hours for students taking the 750 hour student instructor course; (D) a maximum of eight hours for students taking the 250 hour student instructor course; (E) field trips will not be allowed for other speciality courses. (2) Students must be under the supervision of a licensed instructor at all times during the field trip. The instructor-student ratio required in a school is required on a field trip. (3)-(6) (No change.) sec.89.76. Minimum Requirements For Cosmetology School Separate Facility. (a) A separate facility is an extension of a licensed or certified cosmetology school. It is a supplemental training space located within 500 feet of the main facility. Its purpose is to provide adequate space to train an overflow of students who cannot be accommodated at the main facility. It is located within close proximity to the main facility so as to assure immediate supervision by the main facility. (b)-(c) (No change.) (d) The practical work area shall contain the following: (1)-(7) (No change.) (8) one computer time clock; (9)-(24) (No change.) (e)-(m) (No change.) (n) A cosmetology school shall be responsible and accountable to the commission for its separate facility. (o) (No change. ) (p) The separate facility shall bear the same name as the licensed or certified cosmetology school. (q) To be approved for continued operation on a current license or certificate, facilities shall be inspected and approved. A cosmetology school adding a separate facility will submit, at least 45 days prior to the tentative opening date of the separate facility, the following; (1)-(6) (No change.) (r) (No change.) This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 2, 1991. TRD-9115141 Ron Resech Executive Director Texas Cosmetology Commission Effective date: December 25, 1991 Proposal publication date: October 18, 1991 For further information, please call: (512) 454-4674 22 TAC sec.89.19 The Texas Cosmetology Commission adopts the repeal of sec.89.19, without changes to the proposed text as published in the October 18, 1991, issue of the Texas Register (16 TexReg 5808). Legislation enacted in the 1991 Regular session of the Texas Legislature did away with the $5,000 Surety Bond requirement for private cosmetology schools. Legislation enacted in the 1991 regular session of the Texas Legislature made this section obsolete. No comments were received regarding adoption of the repeal. The repeal is adopted under Texas Civil Statutes, Article 8451a, which provides the Texas Cosmetology Commission with the authority to issue rules and regulations consistent with the Act that are needed to protect the public's health and welfare. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 2, 1991. TRD-9115138 Ron Resech Executive Director Texas Cosmetology Commission Effective date: December 25, 1991 Proposal publication date: October 18, 1991 For further information, please call: (512) 454-4674 Part XIII. Texas Board of Licensure for Nursing Home Administrators Chapter 243. Application 22 TAC sec.243.1 The Texas Board of Licensure for Nursing Home Administrators adopts an amendment to sec.243.1, without changes to the proposed text as published in the September 20, 1991, issue of the Texas Register (16 TexReg 5175). This amendment validates proof of actual experience as a nursing home administrator. Applicants for partial endorsement must evidence in writing at least one year's experience functioning as an administrator of record of a nursing home in another state. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 4442d, sec.8, which provides the Texas Board of Licensing for Nursing Home Administrators with the authority to make rules and regulations not inconsistent with law as may be necessary or proper for the performance of its duties, and to take such other actions as may be necessary to enable the state to meet the requirements set forth in sec.1908 of the Social Security Act (42 USCA S1396g), the federal rules and regulations promulgated thereunder, and other pertinent federal authority; provided, however, that no rule shall be promulgated, altered or abolished without the approval of a two-thirds majority of the board. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on November 17, 1991. TRD-9115078 Kim M. Foutz Administrative Technician III Texas Board of Licensure for Nursing Home Administrators Effective date: December 24, 1991 Proposal publication date: September 20, 1991 For further information, please call: (512) 458-1955 TITLE 28. INSURANCE Part II. Texas Workers' Compensation Commission Chapter 134. Benefits-Guidelines for Medical Services, Charges and Payments Subchapter G. Treatments and Services Required Pre-Authorization 28 TAC sec.134.600 The Texas Workers' Compensation Commission adopts new sec.134.600, concerning establishment by the commission of medical services that will be subject to advance approval ("pre-authorization") by workers' compensation insurance carriers in order for the medical health care provider to be paid for the service, with changes to the proposed text as published in the June 4, 1991, issue of the Texas Register (16 TexReg 3029). The new section lists 16 different categories of services and procedures that must be approved in advance by the insurance carrier, in order for the health care provider to be paid. In addition to listing the procedures, the section makes clear that the carrier must pay for medical emergency treatment or treatment ordered by the commission. The section requires the carrier to designate a telephone or facsimile number for conveying requests for pre- authorization, and the section further provides that response from the carrier must be conveyed by either means within three working days. The section provides that if the carrier denies authorization, that such notice must be sent to designated persons no later than 24 hours after denial is made. The carrier is charged with keeping accurate records of its preauthorization requests and decisions. Any dispute over pre-authorization is adjudicated as set out in the Texas Workers' Compensation Act, Article 8308-8.26, and in accordance with sec.133.305 of this title (relating to Request for Medical Dispute Resolution). Concerning the proposed section, one commentor asked that repeat diagnostic studies, surface electromyogram, video fluroscopy, all of which directly affect the chiropractic profession, be deleted from the list. Concerning the proposed section, one commentor noted that preauthorization of repeat diagnostic studies, surface electromyograms, and video fluoroscopy directly affected the chiropractic profession. The commentor would like these items deleted from the list of procedures subject to pre-authorization. The commission disagrees with the comments; as to repeat diagnostic studies, the commission has added the clarification that repeat "baseline" diagnostic studies are subject to pre-authorization, noting that sec.133.2 of this title (relating to Sharing Medical Reports and Test Results) provides for sharing of previously performed diagnostic test results, which should provide information that would generally preclude the need for repeating tests. As to the comment regarding surface electromyograms and video fluorscopy, the commission believes that such procedures should be reviewed prior to performance, to ensure that these treatments are medically necessary and related to the specific injury. Another commentor noted that the proposed section was unclear in that the treating doctor who was assigned responsibility for seeking pre-authorization might not be the physician who determined that the service should be performed. The commission agrees that clarification is needed, and allowed the treating doctor to designate a representative to seek pre-authorization; the procedure for seeking pre-authorization has also been clarified to allow for facsimile requests (as an alternative to telephone requests). The same commentor noted that pre-authorization has never been demonstrated to contain medical costs and is being abandoned by medicare in 1992. The commission disagrees with withdrawing the section, noting that the Texas Workers' Compensation Act, sec.8. 28, expressly requires the commission to adopt a rule listing services and procedures that must be pre-authorized. The same commentor notes that this increases the amount of physician paperwork; the commission disagrees, although it has clarified the rule to simplify the paperwork requirements. The same commentor noted that five days was too long to delay treating a patient in pain. While the commission agrees that five days is too long, it is pointed out that the section allows a carrier three working days to respond, which will often translate to three calendar days. Another commentor noted that the three working day provision in subsection (e) of the section should be expanded to five days, or that response time should be "tiered" for specific procedures. The commission disagrees, noting that three working days should provide sufficient time to research the medical necessity; the suggested expansion of time could propose problems for the injured worker who is in need of the procedure that is ultimately approved. The commission would also note that it received public comment that a five day period would be too long. The same commentor noted that the turn-around time for a carrier to send written reasons for a telephone denial of pre-authorization was too short, because documentation may take time to draft if not already prepared. The commission disagrees, noting that documentation of the denial is essential to prevent future disputes; carriers are free to draft whatever forms they need to expedite the written notification process. The same commentor noted that the carrier could lack necessary information to be able to mail documentation to the injured employee's representative, and suggested alternative language to subsection (e) of this section which would allow mailing to the representative "if known". The commission agrees with the suggested change and has incorporated it into this section, to prevent delays in the notification process. Another commentor questioned the necessity of the section, regarding application to durable medical equipment, noting that a fee guideline would prevent overpricing; that a physician should be required to bill on the 1500 form and send it with the doctor's prescription; that by the time most suppliers received an order for equipment or supplies that the carrier should already have the first medical report or employer's notice of injury; and that the process would take away freedom of choice for the patient as carriers would deny authorization in order to use their out-of-state supplier. The commission disagrees with these comments, for the following reasons: A fee guideline does not take the place of pre-authorization, and the Act, sec.8.28 specifically directs the commission to promulgate pre-authorization rules; that sec.134.800 of this title (relating to Health Care Provider Billing) is the proper place to enact rules regarding billing, not this rule; that knowledge of an injury alone on the carrier's part does not justify the need for a certain service or piece of equipment, and that the documents already on file may not address the need for certain services, or contain information allowing the carrier to evaluate the necessity for them; and that pre-authorization will be monitored and tracked by medical review division to detect and sanction inappropriate denials or approvals based upon identity of the provider. The same commentor noted that delays in authorization would add cost to the carrier, because the extra days of hospitalization pending approval of medical equipment would exceed the monthly rental charge for the equipment, if eventually preauthorized. The commission disagrees with the comment, noting that discharge planning by hospitals identifies the need for supplies and equipment that will be needed prior to discharge, especially in cases where discharge cannot occur without the proper equipment in place. The commission further points out that utilization review by the commission will address poor discharge planning by a facility that may result in additional costs. Another commentor proposed an alternative to the proposed rule to reduce the burdens on the treating doctor, avoid carrier decisions made on the lack of professional input, and curtail unnecessary delays in treatment while awaiting authorization. The commentor suggested that a rule be promulgated to define certain procedures that wouldn't require preauthorization if ordered in writing by the treating doctor; these services would be one-time psychological or psychiatric evaluation or testing; initial evaluation for programs such as work hardening, pain clinics, biofeedback, weight loss clinics, chemical dependency clinics, or inpatient psychiatric programs. The commentor's suggested rule would state that additional treatment in these areas would require pre-authorization, to be obtained by the consulting, rather than treating, doctor. The commission disagrees with the proposal submitted by the commentor, noting that it might violate provisions of the Act, specifically sec.4.61, which requires the treating doctor to approve or recommend all care to the worker, and sec.4.66, which accords the treating doctor primary responsibility for maintaining efficient utilization of medical care. The same commentor noted that the requirement that the treating doctor bear primary responsibility for justifying the service to the carrier was unduly burdensome and bypassed the vital input of the consulting doctor. The commission notes that the section has been clarified to allow the treating doctor to designate a representative to convey needed information, but disagrees with removing primary responsibility from the treating doctor or his/her designee. In response to the first comment, the commission also notes that it has partly agreed with the commentor in that the pre-approval for chemical dependency and weight loss programs has been removed from this section. The commentor also stated that allocating primary responsibility to the treating doctor for pre-authorization was unduly burdensome, and ignored the vital input of the consulting doctor. The commission disagrees, for reasons noted above. Finally, the commentor noted that the section raised the additional issue as to whether insurance adjusters were qualified to make what amounted to clinical decisions without professional input. The commission disagrees with changing the section to alter the role of the adjuster, noting that adjusters are licensed to review medical bills and reimbursement, as the party liable for payment of such bills. Another commentor noted that preauthorization for surface electromyography, work hardening, repeat diagnostic studies, video fluoroscopy, and transcutaneous neuromuscular or muscular stimulators would delay or prevent the use of these essential services. The commission disagrees, noting that pre-authorization of medical services ensured providing of treatment necessary and related to the specific injury, so that complete denial across the board should not be the result of the section. Further, the commission notes that subsection (h)(16) has been clarified to limit pre-authorization of diagnostic studies to repeat baseline studies. The same commentor noted that the medical fee guideline and the soon-to-be proposed utilization review guidelines accomplished the same purpose of cost effective utilization of services, without risking interference under this section with proper and effective patient care. The commission disagrees, noting the statutory directive to effect preauthorization; although utilization guidelines will address treatment, this section is intended to limit unnecessary treatment and services with a different emphasis. Another commentor recommended that pre-authorization of surface EMG and video fluoroscopy be required only after four procedures rendered in a six-month period. The commission disagrees, noting that limits for surface EMGs and video fluorscopy are included in the medical fee guideline, but that all such services should be subject to preauthorization to ensure that such treatment is necessary and related to the specific injury. The commentor also asked that radiographic assessments be exempt from pre-approval; the commission agrees to some clarification insofar as these are used as diagnostic tools, and has amended subsection (h)(6) to require pre-approval for repeat baseline studies only. Another commentor asked that the insurance carrier be required to provide a preauthorization number, to maintain accurate tracking of cases, when such approval was granted. The commission disagrees with the recommendation, noting that an oral response followed by a written response should be sufficient; however, a carrier could voluntarily establish a numbering i.d. system for pre- authorization. The same commentor, and several others, with respect to subsection (e) of this section, asked for clarification that a carrier notify the treating doctor or a designated representative of the decision; the concern was expressed that failure of the carrier to establish direct contact with the physician could be used as a delaying tactic, and would prolong the time for treatment. The commission agrees and has allowed the decision to be transmitted to a designee of the treating physician; the health care provider is entitled to speedy response to the request for pre-approval. The same commentor felt that the list of treatments subject to pre-authorization was too extensive and was ambiguous on some descriptions of the items covered. The commission agrees, and has reduced the number of procedures subjected to pre-approval, and has clarified other provisions. The original list of 34 procedures has been reduced and condensed to 16 procedures. The commentor further incorporated comments of another commentor to a proposed (but not adopted) section on utilization review; these comments noted that screening criteria and medical protocols should be established with input from practicing providers, with the criteria disclosed to providers; that pre- approval reviewers should be properly trained and qualified, to assure consistent application of criteria; that appropriate specialty physicians should be used to review determinations that certain medical services are not medically necessary or appropriate; that specific time frames should be set forth in the section for review decisions and appeals, particularly in situations where prospective or concurrent review is performed; that adverse determinations should be provided to the injured worker and provider, with clear statements of the reasons and the criteria used in making the determination; that specific standards on duplicate billing, and billing of services as a global service should be examined and explained in the rules; and that an ad hoc committee be established to assist commission staff in development and review of utilization review rules. The commission responds as follows. The commission disagrees with changing this particular section, and further agrees that treatment protocols used for utilization review (UR) should be developed in co-ordination with practicing health care providers; agrees that UR personnel should be properly trained; agrees that peer review conducted as part of UR, or under the Act, sec.8. 26, should involve practitioners in a like specialty; agrees that as part of development of treatment protocols to have staff engage in on-going research in the area of specific time frames for prospective, concurrent, and retrospective review for expedient processing of appeals and decisions, including contact with other governmental agencies to ensure consistency; agrees that written notification of UR (or pre-authorization decisions, as required in subsection (e) of this section) will allow for corrective actions to be planned on the part of the carrier or provider; notes that this comment refers to sec.134.800 of this title and not to the section at hand; and notes that the Medical Advisory Committee appointed under the Act, sec.8.23, encompasses many disciplines and representatives of carriers and the public, as well as providers; this committee has been giving input to staff about proposals relating to treatment protocols, in addition to informal input received through staff research. The commission notes that all of the foregoing are comments to the issue of utilization review or treatment protocols, rather than the specific section in issue here. Another commentor asked for a public hearing on the section, but did not meet the requirements set forth in Article 6252-13a, sec.5(c). The commentor also asked to review development of qualifications of reviewers and the policies and process for preauthorization. The commission disagrees with changing the section, noting that the section itself sets out the policies and process, but is not intended to get into qualifications of a carrier's reviewers. The commentor pointed out that House Bill 2 would accomplish much of what this section did; the commission disagrees, noting that House Bill 2 does not adequately address pre-authorization, and that the Act, sec.8.28, requires the commission to establish by rule procedures that are subject to pre- authorization. The commentor recommended that medical emergency be defined; the commission agrees and has adopted more definition as part of subsection (a)(1). The commentor also asked that section be amended to allow preauthorization to be requested of a carrier's agent delegated to handle such requests; the commission agrees and has incorporated this concept throughout the section. The commentor asked that the section allow a doctor to request pre-authorization on, rather than prior to, the date of the treatment; the commission disagrees, in order to take pressure off carrier to react immediately, without evaluating information on the claim. The commentor asked that a written decision be required from the carrier or agent. The commission agrees, and has incorporated suggested language as part of subsection (e) of this section. The same commentor noted that the section did not make provision for appeal to the carrier prior to the use of dispute resolution. The commission agrees and has included reference to sec.133.305 of this title (relating to Request for Medical Dispute Resolution) in subsection (g) of this section. The commentor asked for clarification of preauthorization as applied to outpatient services which are also performed as inpatient services. The commission agrees that the proposed subsection on this was not clear, and has deleted such services from those requiring pre-authorization. Finally, the commentor asked that psychological treatment not be subject to pre-approval when it is a compensable condition. The commission disagrees, noting that pre-authorization ensures appropriate medical necessity for this and prevents unnecessary treatment. One commentor suggested that other persons be allowed to request pre- authorization on behalf of the treating doctor; a facsimile transmission be permitted for making the requests, in order to start the three-day time limit running; that the section be amended to define the minimum medical information necessary to substantiate the need for the treatment; that clarification be added that no pre-authorization be required for psychological or psychiatric therapy that is part of work hardening; that biofeedback needs to be pre- authorized only if not part of an interdisciplinary program such as pain management; that pre-authorization of work hardening and work conditioning be made consistent with the ground rules of the Medical Fee Guideline; and that the commission define what constitutes a pain clinic, and what constitutes pain management, so that these procedures do not have to be individually pre-approved if a part of an interdisciplinary program. The commission responds as follows: agrees, and has allowed a treating doctor's designee to make the pre- authorization request and receive the response; agrees, and has incorporated this into subsections (c) and (d) of the section; disagrees, noting that a carrier needs sufficient information, which varies on a case-by-case basis, in order to evaluate the need for the requested treatment; agrees, and has added clarification under subsection (h)(2) of this section; agrees, and has made this addition under subsection (h)(9) of this section; agrees, and has added this under subsection (h)(ll) and (12) of this section; and disagrees, and notes that a pain center is too varied for an accurate, all-encompassing definition. Some commentors noted that pre-authorization should be required only in instances of providers abuse of the system, noting that it gave license to carriers to practice medicine. Specific objection was made to having Durable Medical Equipment which is prescribed by a patient's doctor from being subject to pre-authorization. The commission disagrees, noting that pre-authorization of such equipment is a valid way to ensure that expensive DME is necessary and required to treat the specific injury. The commission notes, however, that the amount has been raised for "per item" pre-authorization of DME. On its own motion, the commission has added non-emergency care rendered by an ambulatory surgical center to the list of pre-authorization procedures, to clarify the original proposal for non-emergency hospitalization pre-approved. Comments against the section as proposed were received from individual health care practitioners, and the American Insurance Association, Allen Medical Equipment Rents & Sells, Texas Chiropractic Association, Texas Chiropractic College, Texas Medical Association, NME Specialty Hospitals Group, American Rehabilitation Center, A.C. Medical, and A-Tech Medical, Inc. No comments specifically in favor of the proposed section were received. The new section is adopted under Texas Civil Statutes, Article 8308-2.09(a), which authorizes the commission to adopt rules to implement and enforce the Texas Workers' Compensation Act, Article 8308-1.01 et seq; and Article 8308-8. 28(a), which requires the commission to specify by rule those health care treatments and services requiring express pre-authorization, except for medical emergency, by the insurance carrier. sec.134.600. Procedure for Requesting Pre-Authorization of Specific Treatments and Services. (a) The insurance carrier is liable for the reasonable and necessary medical costs relating to the health care treatments and services listed in subsection (h) of this section, required to treat a compensable injury, when any of the following situations occur: (1) there is a documented life-threatening degree of a medical emergency necessitating one of the treatments or services listed in subsection (h) of this section; (2) the treating doctor, his/her designated representative, or injured employee has received pre-authorization from the carrier prior to the health care treatments or services; or (3) when ordered by the commission. (b) Second opinions for spinal surgery are addressed in Chapter 133, Subchapter C, of this title (relating to Second Opinions for Spinal Surgery). (c) The insurance carrier shall designate an accessible direct telephone number, and may also designate a facsimile number for use by the treating doctor or the injured employee to request pre-authorization during normal business hours. The direct number shall be answered or the facsimile responded to, by the carrier's agent who is delegated to approve or deny requests for preauthorization, within the time limits established in subsection (e) of this section. (d) Prior to the date of the proposed treatment or service, the treating doctor, or his/her designated representative, shall notify the insurance carrier's delegated agent by telephone or transmission of a facsimile, of the recommended treatment or service listed in subsection (h) of this section. Notification shall include the medical information to substantiate the need for the treatment or service recommended. If requested to do so by the carrier, the treating doctor shall also notify the insurance carrier of the location and estimated date of the recommended treatment or service, and the name of the health care provider performing the treatment or service, if other than the treating doctor. (e) Within three working days of the treating doctor's request for pre- authorization, the insurance carrier's delegated agent shall notify the treating doctor by telephone or transmission of a facsimile, of the insurance carrier's decision to grant or deny pre-authorization. When the insurance carrier denies or approves pre-authorization, the insurance carrier shall send written approval, or, if denying pre-authorization, documentation identifying the reasons for denial. Notification shall be sent to the injured employee, injured employee's representative if known, and the treating doctor, or the treating doctor's designated representative, within twenty-four hours after notification of denial or approval. (f) The insurance carrier must maintain accurate records to reflect information regarding the pre-authorization request and approval/denial process. (g) If a dispute arises over the denial of pre-authorization by the insurance carrier, the doctor or the injured employee may proceed to a medical dispute resolution as described in the Act, sec.8.26, and sec.133.305 of this title (relating to Request for Medical Dispute Resolution). (h) The health care treatments and services requiring pre-authorization are: (1) all non-emergency hospitalizations, ambulatory surgical center care, and transfers between facilities; (2) psychiatric or psychological therapy or testing except as a part of work hardening; (3) all external and implantable bone growth stimulators; (4) all chemonucleolysis, facet, or trigger point injections; (5) all non-emergency myelograms, discograms, or surface electromyograms; (6) repeat baseline diagnostic studies and laboratory testing; (7) video fluoroscopy; (8) radiation therapy or chemotherapy; (9) biofeedback except as a part of work hardening; (10) physical therapy or occupational therapy beyond eight weeks of treatment; (11) work hardening, in excess of six weeks (limited to a one-time two week extension); (12) work conditioning, in excess of four weeks (limited to a one-time two-week extension); (13) all durable medical equipment in excess of $500 per item and all TENS units; (14) nursing home, convalescent, residential, and all home health care services and treatments; (15) pain clinics, chemical dependency clinics, or weight loss clinics; and (16) all non-emergency dental services, including reconstructive dental care or dental appliances. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 2, 1991. TRD-9115056 Susan M. Kelley General Counsel Texas Workers' Compensation Commission Effective date: December 23, 1991 Proposal publication date: June 4, 1991 For further information, please call: (512) 440-3972 TITLE 34. PUBLIC FINANCE Part I. Comptroller of Public Accounts Chapter 3. Tax Administration Subchapter O. State Sales and Use Tax 34 TAC sec.3.290 The Comptroller of Public Accounts adopts an amendment to sec.3.290, concerning automotive repair and maintenance shops, without changes to the proposed text as published in the October 18, 1991, issue of the Texas Register (16 TexReg 5816). The amendment changes the section reference for persons repairing motor vehicles from 34 TAC sec.3.292, concerning repair, remodeling, maintenance, and restoration of tangible personal property to 34 TAC sec.3.359, concerning motor vehicles and private aircraft. Other minor changes were made for clarity. No comments were received regarding adoption of the amendment. The amendment is adopted under the Tax Code, sec.111.002, which provides the comptroller with the authority to prescribe, adopt, and enforce rules relating to the administration and enforcement of the provisions of the Tax Code, Title 2. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115073 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: December 24, 1991 Proposal publication date: October 18, 1991 For further information, please call: (512) 463-4028 34 TAC sec.3.345 The Comptroller of Public Accounts adopts new sec.3.345, concerning state sales and use tax refunds to qualified business in enterprize zones, without changes to the proposed text as published in the October 18, 1991, issue of the Texas Register (16 TexReg 5890). The refund provisions of this new section are based on legislation passed by the 71st Legislature, 1989. This new section provides information about state sales and use tax refunds to businesses located in enterprize zones. The provisions of this section are effective September 1, 1991. No comments were received regarding adoption of the new section. This new section is adopted under the Tax Code, sec.111.002, which provides the comptroller with the authority to prescribe, adopt, and enforce rules relating to the administration and enforcement of the provisions of the Tax Code, Title 2. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115075 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: December 24, 1991 Proposal publication date: October 18, 1991 For further information, please call: (512) 463-4028 TITLE 40. SOCIAL SERVICES AND ASSISTANCE Part I. Texas Department of Human Services Chapter 2. Medically Needy Program Program Requirements 40 TAC sec.2.1006 The Texas Department of Human Services (DHS) adopts an amendment to sec.2. 1006 concerning medically needy programs, without changes to the proposed text as published in the November 1, 1991, issue of the Texas Register (16 TexReg 6203). The justification for the amendment is to comply with federal requirements pertaining to eligibility of strikers for Aid to Families with Dependent Children (AFDC) program benefits. The amendment will function, as a result of a federal policy clarification, by exempting certain persons from the AFDC program requirements concerning strikers. AFDC striker policy disallows benefits for families when the caretaker relative of deprived children is on strike the last day of the month. The new policy requires DHS to exempt from this policy pregnant women, children whose eligibility is not based on deprivation, and caretakers and second parents of deprived children when the second parent is on strike and the children continue to be deprived. No comments were received regarding adoption of the amendment. The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which provides the department with the authority to administer public and medical assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115098 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: November 1, 1991 For further information, please call: (512) 450-3765 Chapter 3. Income Assistance Services Subchapter G. Resources The Texas Department of Human Services (DHS) adopts amendments to sec.3.704 and sec.3.902, concerning resources, without changes to the proposed text as published in the November 12, 1991, issue of the Texas Register (16 TexReg 6581). The justification for the amendments is to comply with federal changes mandated to become effective January 1, 1992. The amendments to sec.3.704 and sec.3.902 will function by excluding the following income and resources for Native Americans who receive AFDC: income and resources distributed under the Alaska Native Claims Settlement Act, and Indian judgement funds that are held in trust or distributed to tribal members. In addition, sec.3.704 is amended to exempt from resources those lump sum payments which are intended and used to repair or replace resources that would not otherwise deny eligibility. No comments were received regarding adoption of the amendments. 40 TAC sec.3.704 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115099 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: November 12, 1991 For further information, please call: (512) 450-3765 Subchapter I. Income 40 TAC sec.3.902 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115100 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: November 12, 1991 For further information, please call: (512) 450-3765 Subchapter Y. Issuing Benefits 40 TAC sec.3.2504 The Texas Department of Human Services (DHS) adopts new sec.3.2504 concerning issuing benefits, without changes to the proposed text as published in the November 1, 1991, issue of the Texas Register (16 TexReg 6203). The justification for the new section is to comply with federal requirements concerning issuance of combined food stamp allotments. Combined allotments are two months' benefits issued together to persons who apply after the 15th of the month and represent benefits for the month of application and following month. The new section will function, as a result of a federal policy clarification, in permitting issuance of combined food stamp allotments only when the initial month's benefits are prorated. Food stamp benefits to migrant and seasonal farmworker households are prorated only if they have not received benefits a full month. No comments were received regarding adoption of the new section. The new section is adopted under the Human Resources Code, Title 2, Chapters 22 and 33, which provides the department with the authority to administer public and nutritional assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115101 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: November 1, 1991 For further information, please call: (512) 450-3765 Subchapter AA. Special Households 40 TAC sec.3.2701 The Texas Department of Human Services (DHS) adopts an amendment to sec.3. 2701 concerning special households, without changes to the proposed text as published in November 1, 1991, issue of the Texas Register (16 TexReg 6203). The justification for the amendment is to comply with state and federal licensing requirements pertaining to drug and alcoholic residential treatment centers. The amendment will function by requiring drug and alcoholic residential treatment centers to be licensed by the Texas Commission on Alcohol and Drug Abuse if they wish to apply for food stamp benefits on behalf of recipients. No comments were received regarding adoption of the amendment. The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 33, which provides the department with the authority to administer public and nutritional assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115102 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: November 1, 1991 For further information, please call: (512) 450-3765 Chapter 4. Medicaid Programs-Children and Pregnant Women Eligibility Requirements 40 TAC sec.4.1006 The Texas Department of Human Services (DHS) adopts an amendment to sec.4. 1006 concerning eligibility requirements without changes to the proposed text as published in the November 1, 1991, issue of the Texas Register (16 TexReg 6204). The justification for the amendment is to comply with federal requirements pertaining to eligibility of strikers for Aid to Families with Dependent Children (AFDC) program benefits. The amendment will function, as a result of a federal policy clarification, by exempting certain persons from the AFDC program requirements concerning strikers. AFDC striker policy disallows benefits for families when the caretaker relative of deprived children is on strike the last day of the month. The new policy requires DHS to exempt from this policy pregnant women, children whose eligibility is not based on deprivation, and caretakers and second parents of deprived children when the second parent is on strike and the children continue to be deprived. No comments were received regarding adoption of the amendment. The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which provides the department with the authority to administer public and medical assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115103 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: November 1, 1991 For further information, please call: (512) 450-3765 Chapter 10. Family Self-Support Services Employment Services 40 TAC sec.10.2303, sec.10.2307 The Texas Department of Human Services (DHS) adopts amendments to sec.10. 2303 and sec.10.2307 concerning employment services, without changes to the proposed text as published in the October 25, 1991, issue of the Texas Register (16 Tex Reg 6042). Justification for the amendments is increased efficiency in service delivery for case management and employment services. The amendments will function by clarifying extended eligibility and the length of time a volunteer participant who fails to participate must wait to participate in Job Opportunities and Basic Skills Training (JOBS) again. No comments were received regarding adoption of the amendments. The amendments are adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115104 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: October 25, 1991 For further information, please call: (512) 450-3765 Employment Services 40 TAC sec.10.2304 The Texas Department of Human Services (DHS) adopts an amendment to sec.10. 2304 concerning employment services, without changes to the proposed text as published in the October 25, 1991, issue of the Texas Register (16 Tex Reg 6042). Justification for the amendment is to enable more clients to accept employment due to reimbursement of specific employment-related expenses. The amendment will function by allowing an increase up to $65 in the limit for reimbursement of actual costs of one-time, work-related expenses, effective January 1, 1992. No comments were received regarding adoption of the amendment. The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115105 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: October 25, 1991 For further information, please call: (512) 450-3765 Employment Services 40 TAC sec.10.2310 The Texas Department of Human Services (DHS) adopts new sec.10.2310 concerning employment services, without changes to the proposed text as published in the October 25, 1991, issue of the Texas Register (16 Tex Reg 6042). Justification for the new section is the removal of a financial barrier for clients to obtain a Texas Certificate of High School Equivalency. The new section will function by establishing a system to defray the costs of GED tests and certificates for JOBS participants who successfully complete GED preparation courses. As of January 1, 1992, the maximum reimbursement will be $40 ($30 for the test and $10 for the certificate). No comments were received regarding adoption of the new section. The new section is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public financial assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115106 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: October 25, 1991 For further information, please call: (512) 450-3765 Chapter 29. Purchased Health Services Subchapter G. Hospital Services 40 TAC sec.29.609 The Texas Department of Human Services (DHS) adopts an amendment to sec.29. 609 concerning hospital services, without changes to the proposed text as published in the October 29, 1991, issue of the Texas Register (16 TexReg 6125). The justification for the amendment is to comply with Senate Bill 82 which was passed during the special legislative session. The amendment will function by establishing a fourth disproportionate share program, which will provide additional reimbursement to significant rural disproportionate share providers. No comments were received regarding adoption of the amendment. However, implementation is contingent upon approval of the Title XIX State Plan amendment by the Health Care Financing Administration. The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which provides the department with the authority to administer public and medical assistance programs. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on December 3, 1991. TRD-9115107 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: January 1, 1992 Proposal publication date: October 29, 1991 For further information, please call: (512) 450-3765