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 I. State Finance Commission Chapter 3. Banking Section Subchapter B. General 7 TAC sec.3.36 The Finance Commission of Texas, Banking Section, adopts new sec.3.36 concerning banks and trust companies conducting business under the same conditions as national banks, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 89). The Texas Constitution provides that state banks shall have the same rights and privileges as are accorded national banks. National banks are permitted to remain open on state designated holidays unless otherwise directed by the comptroller of the currency. The new rule allows state banks to operate under these same conditions. The new section permits banks to operate in competitive equality with national banks and does not require any advance permission from the Commissioner or Department. State banks that choose to so operate must adhere to the proper procedures for effecting same and comply with all laws and regulations affecting those operations. One favorable comment was received. The commentor generally favored adoption of the rule. Commenting in favor was the Independent Bankers Association. The new section is adopted under the Texas Constitution, Article 16, sec.16(c) and Texas Civil Statutes, Article 342-113, which provides the State Finance Commission with the authority to promulgate rules to permit state banks to transact their affairs in any manner which they could do under existing law, rule or regulation were they organized and operating as a national bank under the laws of the United States. 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 March 5, 1992. TRD-92032263 Ann Graham General Counsel Department of Banking Effective date: March 26, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 475-1300 Chapter 4. Currency Exchange Subchapter B. General 7 TAC sec.4.01 The Finance Commission of Texas, Banking Section, adopts new sec.4.01 concerning provisional licenses, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 89). The new section was prepared in order to provide for the orderly administration of the Currency Exchange Act. The Finance Commission is empowered with general rule making authority under Texas Civil Statutes Article 350, sec.7, (Vernon Supplement 1992). The new section is adopted to allow currency exchange and transmission businesses to continue operations on a temporary basis while their license applications are being processed. The new section will allow the commissioner to grant a temporary license if the applicant has made a good faith effort to comply with the Act. The commissioner, at his discretion, may extend such a license as circumstances warrant. A provisional license would expire after 60 days unless extended or earlier terminated. No comments were received regarding adoption of the new section. The new section is adopted under the Texas Civil Statutes, Article 350, sec.7, which directs the State Finance Commission to adopt rules necessary to implement the Act, including, but not limited to, rules with respect to issuance of licenses. 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 March 5, 1992. TRD-9203264 Ann Graham General Counsel Department of Banking Effective date: March 26, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 475-1300 TITLE 16. ECONOMIC REGULATION Part IV. Texas Department of Licensing and Regulation Chapter 75. Air Conditioning and Refrigeration Contractor License Law 16 TAC sec.75.20, sec.75.70 The Texas Department of Licensing and Regulation adopts amendments to sec.75. 20 and sec.75.70, concerning licensing requirements and responsibilities of the licensee, without changes to the proposed text as published in the February 2, 1992, issue of the Texas Register (17 TexReg 1000). The amendments to these sections were recommendations of the Air Conditioning and Refrigeration Contractors Advisory Board. The amendments will function to make the rule governing reissuance of expired licenses more consistent with the requirement in the Act and establishes the provision that a license holder is responsible for all work done under his license. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 8861, which provide the Texas Department of Licensing and Regulation with the authority to promulgate rules necessary to effectuate the purpose of the 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 March 6, 1992. TRD-9203365 Larry E. Kosta Executive Director Texas Department of Licensing and Regulation Effective date: March 27, 1992 Proposal publication date: February 7, 1992 For further information, please call: (512) 463-3127 Part VIII. Texas Racing Commission Chapter 307. Practice and Procedure Subchapter C. Proceedings by Stewards and Racing Judges Appeals to Commission 16 TAC sec.307.261 The Texas Racing Commission adopts an amendment to sec.307.261, concerning appeal to the commission, without changes to the proposed text as published in the December 27, 1991, issue of the Texas Register (16 TexReg 7693). The amendment is adopted to ensure that the administrative processes of the commission are efficient and effective. The amendment clarifies the procedure for filing an appeal from a ruling by the stewards or racing judges. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.3.08, which provides that decisions by stewards and racing judges are appealable to the commission in accordance with the Administrative Procedure and Texas Register Act; and Texas Civil Statutes, Article 6252-13a, sec.4, which authorizes the commission to adopt rules of practice setting forth the nature and requirements of all formal and informal procedures available. 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 February 28, 1992. TRD-9203337 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 Chapter 309. Operation of Racetracks Subchapter C. Greyhound Racetracks Operations 16 TAC sec.309.352 The Texas Racing Commission adopts an amendment to sec.309.352, concerning Texas preference, without changes to the proposed text as published in the December 27, 1991, issue of the Texas Register (16 TexReg 7693). The amendment is adopted to ensure that the rules of the commission are technically correct. The amendment corrects a technical error regarding the requirements for a greyhound racetrack in contracting with kennel owners. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.10.06, which states the requirements for contracting with kennel owners. 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 February 28, 1992. TRD-9203316 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 Chapter 311. Conduct and Duties of Individual Licensees Subchapter A. General Provisions 16 TAC sec.311.6 The Texas Racing Commission adopts an amendment to sec.311.6, concerning influence of race prohibited, without changes to the proposed text as published in the December 27, 1991, issue of the Texas Register (16 TexReg 7693). The amendment is adopted to ensure that pari-mutuel racing is conducted fairly, humanely, and with the utmost integrity. The amendment clarifies the prohibition against the possession or use of a device designed to increase or decrease the speed of a horse, other than an ordinary riding whip. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.14.03, which authorizes the commission to adopt rules prohibiting the illegal influencing of a race. 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 February 28, 1992. TRD-9203336 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 16 TAC sec.311.7 The Texas Racing Commission adopts an amendment to sec.311.7, concerning inhumane treatment, without changes to the proposed text as published in the December 27, 1991 issue of the Texas Register (16 TexReg 7694). The amendment is adopted to ensure the rules of the commission are internally consistent and non-repetitive. The amendment deletes the reference to the possession or use of a device designed to increase or decrease the speed of a horse, other than an ordinary riding whip, because this prohibition has been moved to another section of the commission's rules. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.14.03, which authorizes the commission to adopt rules prohibiting the illegal influencing of a race. 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 February 28, 1992. TRD-9203335 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 16 TAC sec.311.10 The Texas Racing Commission adopts an amendment to sec.311.10, concerning conduct, without changes to the proposed text as published in the December 27, 1991, issue of the Texas Register (16 TexReg 7694). The amendment is adopted to ensure that participants in pari-mutuel racing are qualified and that pari-mutuel racing is safe for the participants. The amendment clarifies the responsibilities of the commission's licensees regarding fire safety in the stable or kennel area, security in the stable or kennel area, and the decision-making process by stewards or racing judges. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.6.06, which authorizes the commission to adopt rules relating to the operation of racetracks. 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 February 28, 1992. TRD-9203334 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 Subchapter B. Specific Licensees Licensees for Horse Racing 16 TAC sec.311.159 The Texas Racing Commission adopts new sec.311.159, concerning conduct in stable area, with changes to the proposed text as published in the December 27, 1991, issue of the Texas Register (16 TexReg 7695). The section is adopted to ensure that pari-mutuel racing is safe for the participants. The section describes the responsibilities of licensees participating in horse racing regarding their conduct in the stable area. The change from the proposed text clarifies the duty of a licensee to wear a helmet when galloping or ponying a horse or riding a horse in a race. The change was made from the proposed text to ensure consistency with other rules of the commission. No comments were received regarding adoption of the new section. The new section is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.6.06, which authorizes the commission to adopt rules relating to the operation of racetracks. sec.311.159. Conduct in Stable Area. (a) An individual licensee may not sleep in the stable area of an association's grounds except in a facility provided for that purpose by the association in accordance with commission rules. (b) An individual licensee may not possess, keep, or maintain a pet in the stable area of an association's grounds unless: (1) the pet is confined and prevented from going at large on associations grounds; and (2) the pet is annually vaccinated against rabies. (c) An individual licensee who is galloping or ponying a horse or riding a horse in a race shall wear a properly fastened helmet, of a type approved by the commission, at all times. (d) An individual licensee may not hold a horse in a starting gate unless the licensee wears properly fastened headgear, of a type approved by the commission. (e) Except as otherwise provided by this subsection, an individual licensee may not operate a motor vehicle in the stable area during training hours. This subsection does not apply to: (1) a person who has power of entry under the Act, sec.3.03; (2) the stewards; (3) security personnel employed by the association; (4) the commission veterinarian; (5) the racing secretary; (6) a veterinarian licensed by the commission; (7) a trainer; (8) a jockey's agent at a Class 1 racetrack; or (9) a farrier. 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 February 28, 1992. TRD-9203333 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 Chapter 313. Officials and Rules of Horse Racing Subchapter A. Officials General Provisions 16 TAC sec.313.4 The Texas Racing Commission adopts an amendment to sec.313.4, concerning approval of officials, without changes to the proposed text as published in the December 27, 1991, issue of the Texas Register (16 TexReg 7696). The amendment is adopted to ensure that pari-mutuel racing is supervised by qualified officials who are of the utmost integrity. The amendment describes the procedure for obtaining and rescinding commission approval of officials at horse racetracks. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 179e, sec.3.02, which authorize the commission to adopt rules for conducting racing involving wagering and for administering the Texas Racing Act and sec.3.07, which authorizes the commission to approve all racetrack officials. 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 February 28, 1992. TRD-9203332 Paula Cochran Carter General Counsel Texas Racing Commission Effective date: March 27, 1992 Proposal publication date: December 27, 1991 For further information, please call: (512) 794-8461 TITLE 22. EXAMINING BOARDS Part I. Texas Board of Architectural Examiners Chapter 1. Architects Subchapter A. Scope; Definitions 22 TAC sec.1.9 The Texas Board of Architectural Examiners adopts an amendment to sec.1.9, concerning the officers and employees of the board, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7067). The amendment is necessary to provide language in the rules that is consistent with recent legislation. The amendment will function to provide consistency between the rules and Texas Civil Statutes, Article 249a. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203188 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Subchapter B. Registration 22 TAC sec.sec.1.21, 1.22, 1.25 The Texas Board of Architectural Examiners adopts amendments to sec.sec.1.21, 1. 22, and 1.25, registration, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7067). The amendment is necessary to provide eligibility requirements and deadline dates for applicants applying for architectural registration. The amendment will provide applicants with notice of actions which may affect their eligibility as candidates for registration. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203189 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Subchapter D. Certification and Annual Registration 22 TAC sec.1.67, sec.1.69 The Texas Board of Architectural Examiners adopts amendments to sec.1.67 and sec.1.69, concerning the annual registration procedure and the reinstatement of licensure, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7068). The amendments are necessary to clarify the board's intent to require of registrants a written change of mailing address and to exercise its statutory authority for the requirements for reinstatement of license. The amendments will provide current and former licensees with notice of reinstatement requirements and procedures. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203190 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 22 TAC sec.1.70 The Texas Board of Architectural Examiners adopts new sec.1.70, concerning denial of annual renewal, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7068). The new rule will bring the board's rule into compliance with the Texas Education Code. The rule will function to provide notice to registrants of action which may affect their renewal of license. No comments were received regarding adoption of the new section. The new section is adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203191 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Subchapter E. Fees 22 TAC sec.sec.1.81, 1.82, 1.84-1.86, 1.88 The Texas Board of Architectural Examiners adopts amendments to sec.sec.1.81, 1. 82, 1.84-1.86, and 1.88, concerning fees, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7069). The amendments increase the fees the agency must charge in compliance with Senate Bill 429 and House Bill 11. The sections will function to inform the persons affected of the increased fees and create increased revenue to the general revenue and school foundation funds. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203192 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Subchapter F. Architect's Seal 22 TAC sec.1.103 The Texas Board of Architectural Examiners adopts an amendment to sec.1.103, concerning the affixation of the architect's seal to documents issued for use in this state, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7072). The amendment is necessary to inform the public if documents are sealed by architects holding current registrations. The section will function to provide registrants with specific instructions concerning the addition of the expiration date of their licenses under their signatures. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203193 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Subchapter H. Rules of Conduct 22 TAC sec.1.143 The Texas Board of Architectural Examiners adopts an amendment to sec.1.143, the rules of conduct for architects, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7072). The amendment is necessary to clarify the board's authority concerning the discipline of a registrant. The section will function to provide a degree of discipline more appropriate to the seriousness of a violation of law or rules. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203194 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Subchapter I. Charges Against Architects: Action 22 TAC sec.1.161, sec.1.173 The Texas Board of Architectural Examiners adopts amendments to sec.1.161, and sec.1.173, concerning disciplinary actions against architects, without changes to the proposed text as published in the December 10, 1991, issue of the Texas Register (16 TexReg 7072). The amendments are necessary to clarify to the persons affected by these rules the board's authority concerning disciplinary actions. The rules will function to provide increased protection of the public by additional disciplines should a registrant be found guilty of alleged violations of law or rules. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with the authority to promulgate rules. 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 March 3, 1992. TRD-9203195 Robert H. Norris Executive Director Texas Board of Architectural Examiners Effective date: March 26, 1992 Proposal publication date: December 10, 1991 For further information, please call: (512) 458-1363 Part XXV. Structural Pest Control Board Chapter 593. Licenses 22 TAC sec.593.21 The Structural Pest Control Board adopts the repeal of sec.593.21, concerning technician license standards, without changes to the proposed text as published in the January 10, 1992, issue of the Texas Register (17 TexReg 153). The repeal is necessary so that new technician license requirements may be adopted. No comments were received regarding adoption of the repeal. The repeal is adopted under Texas Civil Statutes, Article 135b-6, which provide the Structural Pest Control Board with the authority to adopt rules concerning testing and licensing of persons engaged in the businesses of structural pest control. 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 March 5, 1992. TRD-9203312 Benny M. Mathis, Jr. Executive Director Structural Pest Control Board Effective date: August 31, 1992 Proposal publication date: January 10, 1992 For further information, please call: (512) 835-4066 22 TAC sec.593.21, sec.593.22 The Structural Pest Control Board adopts new sec.593.21, and sec.593.22, concerning licenses. Section 593.22 is adopted with changes to the proposed text as published in the January 17, 1992, issue of the Texas Register (17 TexReg 377). Section 593.21 is adopted without changes and will not be republished. The new sections are adopted in order to implement new standards for the training and testing of technicians licensed in the structural pest control business. The sections were amended to reflect the expanded role of the Texas Agricultural Extension Service in the training process. The new sections create step-by-step procedures and standards for the registration of employees as technician-apprentices and the training and testing standards which must be met for technician licensure. Comments received were more in the nature of inquiries as to how the sections would function. The Texas Pest Control Association opposed the institution of an initial $18 if it did not automatically include a criminal background check. The name of a group or association making comments against the section is as follows: Texas Pest Control Association. The agency, for reasons of time management and processing agreements, is unable to assure that 100% of applicants will receive a background check. The fee is justified on the basis that it pays for six months of licensure by the agency. The new sections are adopted under Texas Civil Statutes, Article 135b-6, which provide the Structural Pest Control Board with the authority to test, license, regulate, and develop standards for the structural pest control industry. sec.593.22. Technician License Standards. (a) A technician-apprentice may become a licensed technician by taking the approved technician training courses for the general category and the category of licensure desired and passing the technician examination. The technician examination application must be accompanied by a fee of $30 per category. A technician-apprentice may take the technician examination as many times as necessary, but shall maintain a technician-apprentice license for a maximum of six months out of any 12-month period. Technicians who were licensed on or before September 1, 1991 must verify that they have completed the board-approved technician training course before September 1, 1996. Failure of a licensed technician to complete the technician training courses shall be a violation of this section. (b) The Technician Training Manual for each category may be obtained from the Texas Agriculture Extension Service. (c) An individual must pass the subject area examination for each category of structural pest control in which the individual wishes to become licensed. Reexamination is not necessary if the license is renewed annually by the technician. (d) Examinations shall be given at dates and at locations to be at the discretion of the board. A fee of $30 per examination category shall be paid by the applicant. (e) All other testing procedures shall be governed by sec.593.5(c)(3)-(11), (13), and (14) of this title (relating to Examinations) except that a technician-apprentice may retest at any time. (f) Persons who make a passing grade and qualify for a technician license must make application to obtain a license within six months of the exam date or be retested. (g) Each technician-apprentice license application shall be shall be accompanied by a fee of $18. (h) Each technician license application shall be accompanied by a fee of $36. 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 March 5, 1992. TRD-9203313 Benny M. Mathis, Jr. Executive Director Structural Pest Control Board Effective date: August 31, 1992 Proposal publication date: January 10, 1992 For further information, please call: (512) 835-4066 TITLE 31. NATURAL RESOURCES AND CONSERVATION Part I. General Land Office Chapter 21. Oil Spill Prevention and Response Hearings Procedures 31 TAC sec.sec.21.9, 21.10, 21.12, 21.41 The General Land Office adopts amendments to sec.sec.21.9, 21.10, 21.12, and 21. 41, concerning statement of grounds, docketing and notice, pleadings, and rehearing, without changes to the proposed text as published in the September 20, 1991, issue of the Texas Register (16 TexReg 5198). The amendments are necessary to clarify the classification of pleadings. The adoption of these sections will eliminate incorrect references and redundancies in this chapter. No comments were received regarding adoption of the amendments. The amendments are adopted under Senate Bill 14, 72nd Legislature, 1991, which authorizes the commissioner to promulgate rules necessary and convenient to the administration of the Oil Spill Prevention and Response Act of 1991. 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 March 5, 1992. TRD-9203344 Garry Mauro Commissioner General Land Office Effective date: March 27, 1992 Proposal publication date: September 20, 1991 For further information, please call: (512) 463-5394 TITLE 34. PUBLIC FINANCE Part I. Comptroller of Public Accounts Chapter 3. Tax Administration Subchapter O. State Sales and Use Tax 34 TAC sec.3.320 The Comptroller of Public Accounts adopts the repeal of sec.3.320, concerning ice and dry ice, without changes to the proposed text as published in the January 21, 1992, issue of the Texas Register (17 TexReg 464). The section is being repealed in order that a substantially revised section dealing with the same subject matter may be adopted. No comments were received regarding adoption of the repeal. The repeal 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 March 6, 1992. TRD-9203342 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 27, 1992 Proposal publication date: January 21, 1992 For further information, please call: (512) 463-4028 The Comptroller of Public Accounts adopts new sec.3.320, concerning ice and dry ice, without changes to the proposed text as published in the January 21, 1992, issue of the Texas Register (17 TexReg 464). The new section removes the exemption for ice and dry ice used as packaging material by someone other than manufacturers or processors. The exemption was removed from the Tax Code, Chapter 151, by the 72nd Legislature, 1991, First Called Session, and is effective October 1, 1991. No comments were received regarding adoption of the new section. The 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 March 6, 1992. TRD-9203343 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 27, 1992 Proposal publication date: January 21, 1992 For further information, please call: (512) 463-4028 Chapter 7. Administration of State Lottery Act Subchapter A. Procurement 34 TAC sec.7.101 The Comptroller of Public Accounts adopts new sec.7.101, concerning lottery procurement procedures, without changes to the proposed text as published in the December 20, 1991, issue of the Texas Register (16 TexReg 7457). These procedures outline the solicitation process for the lease and purchase of various goods and services by the Lottery Division. These procedures also define the contract award process, as well as the protest process. A comment was received regarding subsection (a). It was suggested that this subsection be amended to include a definition of "minority business" and "disadvantaged business entity" (DBE) for clarification purposes. The comptroller declined to define these terms in the section because the term "minority business" is already defined in the State Lottery Act (Act) and the section refers to that definition. Further, the term "DBE" is not used anywhere in the Act. Had the legislature desired to include this term in the Act, it could have easily broadened its preference to include all DBEs and not just minority businesses, as defined in the Act. A second comment from the same person on the proposed section was received regarding subsection (g)(2). It was recommended that this subsection be amended to encourage cooperation, innovative strategies, and conscientious efforts by prime contractors in the utilization of minority firms. The comptroller declined to incorporate the suggested language because the specific information the language would elicit from prime contractors in already being elicited through the request for proposals (RFP) process. Information such as the name and location of the minority business, the service offered, its certification status, and any planning strategies are items that must be addressed in the proposer's response to the RFP. Because minority business utilization has been one of the evaluation criteria in every RFP issued by the Texas Lottery, failure to address this aspect would result in a loss of evaluation points and jeopardize a proposer's chances of becoming the successful proposer. The new section is adopted under the Texas Civil Statutes, Article 179g, State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203395 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: December 20, 1991 For further information, please call: (512) 463-4028 Subchapter B. Licensing of Sales Agents 34 TAC sec.7.151 The Comptroller of Public Accounts adopts new sec.7.151, concerning general rules governing the licensing of sales agents to sell lottery tickets pursuant to the State Lottery Act, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 99). The new section relates to the licensing of a sales agent to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203396 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.152 The Comptroller of Public Accounts adopts new sec.7.152, concerning general matters to be complied with in an application for sales agent license submitted pursuant to the State Lottery Act, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 100). The new section relates to the licensing of a sales agent to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203397 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.153 The Comptroller of Public Accounts adopts new sec.7.153, concerning general criteria to be considered by the director of the lottery division in determining the eligibility of applicants to be licensed as sales agents for the sale of lottery tickets pursuant to the State Lottery Act, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 100). The new section relates to the licensing of a sales agent to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203398 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.154 The Comptroller of Public Accounts adopts new sec.7.154, concerning certain terms to be included in licenses issued to sales agents for the purpose of selling lottery tickets pursuant to the State Lottery Act, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 102). The new section relates to the licensing of a sales agent to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203399 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.155 The Comptroller of Public Accounts adopts new sec.7.155, concerning the expiration of a sales agent license issued pursuant to the State Lottery Act, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 102). The new section relates to the expiration of a sales agent's license to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203400 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.156 The Comptroller of Public Accounts adopts new sec.7.156, concerning certain requirements associated with the renewal of a sales agent's license issued pursuant to the State Lottery Act, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 102). The new section relates to the renewal of a sales agent's license to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203401 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.157 The Comptroller of Public Accounts adopts new sec.7.157, concerning temporary license, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 103). The new section relates to the issuances of temporary licenses to applicants to become sales agents authorized to sell lottery tickets pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203402 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.158 The Comptroller of Public Accounts adopts new sec.7.158, concerning suspension or revocation of license, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 103). The new section sets forth the circumstances under which the comptroller may suspend or revoke the license of a sales agent issued pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203403 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 34 TAC sec.7.159 The Comptroller of Public Accounts adopts new sec.7.159, concerning summary suspension of license, without changes to the proposed text as published in the January 7, 1992, issue of the Texas Register (17 TexReg 104). The new section sets forth the circumstances under which the comptroller may summarily suspend a sales agent's license issued pursuant to the State Lottery Act. No comments were received regarding adoption of the new section. The new section is adopted under the State Lottery Act, sec.2.02, which provides the comptroller with the authority to adopt all rules necessary to administer the State Lottery 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 March 9, 1992. TRD-9203404 Charles Johnstone Senior Legal Counsel, General Law Section Comptroller of Public Accounts Effective date: March 30, 1992 Proposal publication date: January 7, 1992 For further information, please call: (512) 463-4028 TITLE 37. PUBLIC SAFETY AND CORRECTIONS Part XI. Texas Juvenile Probation Commission Chapter 341. Texas Juvenile Probation Commission 37 TAC sec.341.7 The Texas Juvenile Probation Commission adopts an amendment to sec.341.7, concerning local juvenile boards-advisory councils, without changes to the proposed text as published in the November 29, 1991, issue of the Texas Register (16 TexReg 6915). The amendment is made to delete from the rule a requirement that has been enacted in state law since adoption of the rule. Juvenile boards are required by law to appoint citizen advisory councils. No comments were received regarding adoption of the amendment. The amendment is adopted under the Texas Human Resources Code, sec.141.042, which provide the Texas Juvenile Probation Commission with the authority to adopt rules for the operation of juvenile boards that are necessary to provide adequate and effective probation services. 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 March 5, 1992. TRD-9203267 Bernard Licarione, Ph.D. Executive Director Texas Juvenile Probation Commission Effective date: March 26, 1992 Proposal publication date: November 29, 1991 For further information, please call: (512) 443-2001 37 TAC sec.341.23 The Texas Juvenile Probation Commission adopts an amendment to sec.341.23 concerning memorandum of understanding regarding service delivery to dysfunctional families without changes to the proposed text as published in the November 29, 1991, issue of the Texas Register (16 TexReg 6915). The amendment is made to update the memorandum of understanding was published in the Texas Register. The three agencies will jointly contract to provide dysfunctional families with training in parenting skills, training in coping skills for children, and support groups for both parents and children. No comments were received regarding adoption of the amendment. The amendment is adopted under the Texas Human Resources Code, sec.71.001(a), which provides the Texas Juvenile Probation Commission with the authority to enter into a memorandum of understanding with the Texas Department of Human Services and the Texas Youth Commission, regarding service delivery to dysfunctional families. 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 March 5, 1992. TRD-9203269 Bernard Licarione, Ph.D. Executive Director Texas Juvenile Probation Commission Effective date: March 26, 1992 Proposal publication date: November 29, 1991 For further information, please call: (512) 443-2001 TITLE 40. SOCIAL SERVICES AND ASSISTANCE Part I. Texas Department of Human Services Chapter 10. Family Self-support Services Child Care Management Services Statewide Implementation 40 TAC sec.10.3404, sec.10.3445 The Texas Department of Human Services (DHS) adopts amendments to sec.10. 3404 and sec.10.3445, concerning family self-support services, without changes to the proposed text as published in the January 28, 1992, issue of the Texas Register (17 TexReg 671). The amendments are justified to simplify the rules and to provide a wider choice of vendors for parents and the opportunity for more providers to become vendors. The amendments will function by deleting duplicate material and adding a new group of providers eligible to become vendors; specifically, day camps licensed by the Texas Department of Health as youth camps. The department received no comments regarding adoption of the amendments. The amendments are adopted under the Human Resources Code, Title 2, Chapters 22 and 44, which authorizes the department to administer public assistance and day care 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 March 4, 1992. TRD-9203174 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 Proposal publication date: January 28, 1992 For further information, please call: (512) 450-3765 Chapter 19. Long-Term Care Nursing Facility Requirements for Licensure and Medicaid Certification The Texas Department of Human Services (DHS) adopts amendments to sec.sec.19. 1, 19.101, 19.202-19.204, 19.206-19.208, 19.213, 19.216, 19.217, 19.302-19.304, 19.401, 19.502, 19.503, 19.505, 19.601-19.603, 19.701, 19.801, 19.902, 19.903, 19.907, 19.908, 19.911, 19.1001-19.1003, 19.1005, 19.1010, 19.1101, 19.1201, 19. 1301, 19.1303, 19.1401, 19.1501, 19.1606, 19.1906, 19.1908-19.1910, 19.1914, 19. 1915, 19.1917, and 19.1918; adopts the repeal of sec.sec.19.220, 19.301, and 19. 1903; and adopts new sec. sec.19.220, 19.301, and 19.1903, concerning DHS's Long Term Care Nursing Facility Requirements for Licensure and Medicaid Certification. The justification for the amendments, repeals, and new sections is to comply with final regulations published by the Health Care Financing Administration in the September 26, 1991, issue of the Federal Register. The amendments, repeals, and new sections will function by incorporating into Chapter 19 corrections, clarifications, and procedural changes mandated by federal law. Subchapter A. Basis and Scope 40 TAC sec.19.1 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1. Basis and scope. (a) Basis in legislation. (1) The following laws govern the requirements for the Long Term Care nursing facility requirements for licensure and Medicaid certification, unless noted otherwise in this chapter: Texas Civil Statutes, Health and Safety Code, Chapter 242; sec.sec.1819(a)-(d), 1863, 1871, 1905(a) and (c), and the Social Security Act, 1919(a)-(d) (42 United States Code, sec.sec.1395i-3(a)-(d), 1395(z), 1395hh, 1396d(a) and (c), and 1396r(a)-(d)); and 42 Code of Federal Regulations, Part 483. (2)-(3) (No change.) (b)-(c) (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 March 5, 1992. TRD-9203242 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter B. Definitions 40 TAC sec.19.101 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.101. Definitions. The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise. Facility-Unless otherwise indicated, a nursing facility (NF) which meets the requirements of the Social Security Act, sec.1919(a)-(d). (A)-(B) (No change.) (C) For Medicare and Medicaid purposes (including eligibility, coverage, certification, and payment), the facility is always the entity which participates in the program, whether that entity is comprised of all of, or a distinct part of, a larger institution. For Medicare, a skilled nursing facility (SNF) (see the Social Security Act, sec.1819(a)(1)) and for Medicaid, a nursing facility (NF) (see the Social Security Act, sec.1919(a)(1)) may not be an institution for mental diseases as defined in 42 Code of Federal Regulations, sec.435.1009. (D)-(E) (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 March 5, 1992. TRD-9203243 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 40 TAC sec.sec.19.202-19.204, 19.206-19.208, 19.213, 19.216, 19.217, 19.220 The amendments and new section are 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. The amendments and new section are adopted in compliance with federal requirements effective April 1, 1992. sec.19.202. Exercise of Rights. (a)-(f) (No change.) (g) In the case of a resident not adjudicated incompetent by the state court, any legal surrogate designated in accordance with state law may exercise the resident's rights to the extent provided by state law. sec.19.203. Notice of Rights and Services. (a) The facility must inform the resident, both orally and in writing, in a language that the resident understands, of his rights and all rules and regulations governing resident conduct and responsibilities during the stay in the facility. The facility must also provide the resident with the notice of the state-developed rights under the Social Security Act, sec.1919(e)(6) (see also sec.19.202 of this title (relating to Exercise of Rights)). Such notification must be made prior to or upon admission and during the resident's stay if changed. (b)-(d) (No change.) (e) The resident or his legal representative has the following rights: (1) upon an oral or written request, to access all records pertaining to himself, including clinical records, within 24 hours; and (2) after receipt of his records for inspection, to purchase photocopies of all or any portion of the records, at a cost not to exceed the community standard, upon request and two workdays advance notice to the facility. (f) -(i) (No change.) (j) The facility must furnish a written description of legal rights which includes: (1) a description of the manner of protecting personal funds, described in sec.19.204 of this title (relating to Protection of Resident Funds); (2) a description of the requirements and procedures for establishing eligibility for Medicaid, including the right to request an assessment under the Social Security Act, sec.1924(c) which: (A) is used to determine the extent of a couple's nonexempt resources at the time of institutionalization; and (B) attributes to the community spouse an equitable share of resources which cannot be considered available for payment toward the cost of the institutionalized spouse's medical care in his process of spending down to Medicaid eligibility levels; (3) a posting of names, addresses, and telephone numbers of all pertinent state client advocacy groups such as the state survey and certification agency, the state licensure office, the state ombudsman program, the protection and advocacy network, and the Medicaid fraud control unit; and (4) a statement that the resident may file a complaint with the Texas Department of Health concerning resident abuse, neglect, and misappropriation of resident property in the facility. (k)-(m) (No change.) (n) Notification of changes. (1) A facility must immediately inform the resident; consult with the resident's physician; and if known, notify the resident's legal representative or an interested family member when there is: (A) an accident involving the resident which results in injury and has the potential for requiring physician intervention; (B) a significant change in the resident's physical, mental, or psychosocial status (that is, a deterioration in health, mental, or psychosocial status in either life-threatening conditions or clinical complications); (C) a need to alter treatment significantly (that is, a need to discontinue an existing form of treatment due to adverse consequences, or to commence a new form of treatment); or (D) (No change.) (2) The facility must also promptly notify the resident and, if known, the resident's legal representative or interested family member when there is: (A) (No change.) (B) a change in resident rights under federal or state law or regula-tions as described in subsection (a) of this section. (3) (No change.) sec.19.204. Protection of Resident Funds. (a)-(d) (No change.) (e) Funds in excess of $50. The facility must deposit any residents' personal funds in excess of $50 in an interest-bearing account (or accounts) that is separate from any of the facility's operating accounts, and that credits all interest earned on the residents' funds to that account. In pooled accounts, there must be a separate accounting for each resident's share. (f) Funds less than $50. The facility must maintain a resident's personal funds that do not exceed $50 in a noninterest bearing account, interest-bearing account, or petty cash fund. (g)-(h) (No change.) (i) Conveyance upon death. Upon the death of a resident with a personal fund deposited with the facility, the facility must convey within 30 days the resident's funds and a final accounting of those funds to the individual or probate jurisdiction administering the resident's estate (see also sec.19.214 of this title (relating to Personal Property)), or make a bona fide effort to locate the responsible party or heir to the estate (see also sec.19.214 of this title (relating to Personal Property)). Within 30 days of a Medicaid recipient's death, the facility must use the following procedures to clear the recipient's account. (1)-(3) (No change.) (j) Assurance of financial security. The facility must purchase a surety bond, or otherwise provide assurance satisfactory to the secretary of health and human services to assure the security of all personal funds of residents deposited with the facility. (k)-(l) (No change.) (m) Quarterly statement. The individual financial record must be available, through quarterly statements on request, to the resident or his legal representative. The statement must reflect any recipient funds which the facility has deposited in an account as well as any recipient funds held by the facility in a petty cash account. The statement must include at least the following: (1)-(5) (No change.) (n) Banking charges. (1)-(4) (No change.) (5) If the facility places any part of the resident's money in savings accounts, certificates of deposit, or any other plan whereby interest or other benefits are accrued, the facility must distribute the interest or benefit to participating residents on an equitable basis. If pooled accounts are used, interest must be prorated on the basis of actual earnings or end-of-quarter balances. (o)-(s) (No change.) sec.19.206. Privacy and Confidentiality. The resident has the right to personal privacy and confidentiality of his personal and clinical records. (See also sec.19.1910(e) of this title (relating to Clinical Records) and sec.19.203(e) of this title (relating to Notice of Rights and Services.)) (1) Personal privacy includes accommodations, medical treatment, written and telephone communications, personal care, visits, and meetings of family and resident groups, but this does not require the facility to provide a private room for each resident. (2) (No change.) (3) The resident's right to refuse release of personal and clinical records does not apply when: (A) (No change.) (B) record release is required by law; or (C) (No change.) (4)-(5) (No change.) sec.19.207. Grievances. A resident has the right to: (1) voice grievances without discrimination or reprisal. Such grievances include those with respect to treatment which has been furnished as well as that which has not been furnished. (2)-(3) (No change.) sec.19.208. Examination of Survey Results. The resident has the right to: (1) examine the results of the most recent survey of the facility conducted by federal or state surveyors and any plan of correction in effect with respect to the facility. The results must be made available by the facility for examination, in a place readily accessible to residents; and (2) (No change.) sec.19.213. Telephone. (a) The resident has the right to have reasonable access to the use of a telephone (other than a pay phone), where calls can be made without being overheard, and which can also be used for making calls to summon help in case of emergency. (b) (No change.) sec.19.216. Self-administration of Drugs. An individual may self-administer drugs if the interdisciplinary team, as defined in sec.19.602(b) (2) of this title (relating to Comprehensive Care Plans), has determined that this practice is safe. sec.19.217. Directives and Durable Powers of Attorney for Health Care. Competent adults may issue directives or durable powers of attorney for health care, subject to the requirements of this section, and the Texas Natural Death Act and law governing durable powers of attorney for health care. (See sec.19.219 of this title (relating to Documentation for the Delegation of Long Term Care Resident's Rights) and sec.19.205(b) of this title (relating to Free Choice.)) When an individual has issued no directive, has no legal guardian, and has been determined by the physician to be incapable of understanding and exercising his rights, treatment decisions must be made according to the Texas Natural Death Act, sec.672.009. (1) (No change.) (2) Durable power of attorney for health care. (A)-(D) (No change.) (E) The durable power of attorney for health care must be signed in the presence of two witnesses, as defined in paragraph (1)(B) of this section. (F)-(G) (No change.) (3) (No change.) sec.19.220. Refusal of Certain Transfers. (a) An individual has the right to refuse a transfer to another room within the facility, if the purpose of the transfer is to relocate: (1) a resident of a skilled nursing facility (SNF) from the distinct part of the facility that is an SNF to a part of the facility that is not an SNF; or (2) a resident of a nursing facility (NF) from the distinct part of the facility that is an NF to a distinct part of the facility that is an SNF. (b) A resident's exercise of the right to refuse transfer under this section does not affect the individual's eligibility or entitlement to Medicaid benefits. 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 March 5, 1992. TRD-9203245 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter C. Resident Rights 40 TAC sec.19.220 The repeal 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. The repeal is adopted in compliance with federal requirements effective April 1, 1992. sec.19.220. Right to Refuse Transfer to Medicare Qualified Distinct Part. 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 March 5, 1992. TRD-9203244 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter D. Admission, Transfer, and Discharge Rights 40 TAC sec.19.301 The repeal 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. The repeal is adopted in compliance with federal requirements effective April 1, 1992. sec.19.301. Admissions Policy. 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 March 5, 1992. TRD-9203246 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 40 TAC sec.sec.19.301-19.304 The new section and amendments are 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. The new section and amendments are adopted in compliance with federal requirements effective April 1, 1992. sec.19.301. Admissions Policy. (a) The facility must: (1) not require residents or potential residents to waive their rights to Medicare or Medicaid; and (2) not require oral or written assurance that residents or potential residents are not eligible for, or will not apply for, Medicare benefits. (b) The facility must not require a third party guarantee of payment to the facility as a condition of admission or expedited admission, or continued stay in the facility. However, the facility may require an individual who has legal access to a resident's income or resources available to pay for facility care to sign a contract, without incurring personal financial liability, to provide facility payment from the resident's income or resources. (c) In the case of a person eligible for Medicaid, a nursing facility must not charge, solicit, accept, or receive, in addition to any amount otherwise required to be paid under the state plan, any gift, money, donation, or other consideration as a precondition of admission, expedited admission, or continued stay in the facility. However: (1) a nursing facility may charge a resident who is eligible for Medicaid for items and services the resident has requested and received, and that are not specified in the state plan as included in the term "nursing facility services" so long as the facility gives proper notice of the availability and cost of these services to residents and does not condition the resident's admission or continued stay on the request for and receipt of such additional services; and (2) a nursing facility may solicit, accept, or receive a charitable, religious, or philanthropic contribution from an organization or from a person unrelated to a Medicaid-eligible resident or potential resident, but only to the extent that the contribution is not a condition of admission, expedited admission, or continued stay in the facility for a Medicaid eligible resident. (See sec.19.1708 of this title (relating to Limitations on Provider Charges.)) (d) States or political subdivisions may apply stricter admission standards under state or local laws than specified in subsections (a) and (b) of this section, to prohibit discrimination against individuals entitled to Medicaid benefits. sec.19.302. Transfer and Discharge. (a) Definition. Transfer and discharge includes movement of a resident to a bed outside the certified facility, whether that bed is in the same physical plant or not. Transfer and discharge does not refer to movement within the same certified facility. (b) Transfer and discharge requirements. (See also sec.19.1915 of this title (relating to Transfer Agreement.)) The facility must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility unless: (1)-(8) (No change.) (c) Documentation. When the facility transfers or discharges a resident under any of the circumstances specified in subsection (b)(1)-(5) of this section, the resident's clinical record must be documented. The documentation must be made by: (1) the resident's physician when transfer or discharge is necessary under subsection (b)(1) or (2) of this section; and (2) a physician when transfer or discharge is necessary under subsection (b)(4) of this section. (d) Notice before transfer. Before a facility transfers or discharges a resident, the facility must: (1) notify the resident and, if known, a responsible party or family or legal representative of the resident about the transfer or discharge and the reasons for the move in writing and in a language and manner they will understand; (2)-(3) (No change.) (e) Timing of the notice. (1) Except when specified in paragraph (3) of this subsection, the notice of transfer or discharge required under subsection (d) of this section must be made by the facility at least 30 days before the resident is transferred or discharged. (2) (No change.) (3) Notice may be made as soon as practicable before transfer or dis-charge when: (A) the safety of individuals in the facility would be endangered, as specified in subsection (b)(3) of this section; (B) the health of individuals in the facility would be endangered, as specified in subsection (b) (4) of this sect tion; (C) the resident's health improves sufficiently to allow a more immediate transfer or discharge, as specified in subsection (b)(2) of this section; (D) an immediate transfer or discharge is required by the resident's urgent medical needs, as specified in subsection (b)(1) of this section; or (E) (No change.) (f) Contents of the notice. For nursing facilities, the written notice specified in subsection (d) of this section must include the following: (1)-(6) (No change.) (g) Orientation for transfer or discharge. A facility must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility. (h) Notice of relocation to another room. Except in an emergency, or as provided by subsection (e)(2) of this section, the facility must notify the resident and either the responsible party or the family or legal representative at least five days before relocation of the resident to another room within the facility. The facility must prepare a written notice which contains: (1)-(3) (No change.) (i) Fair hearings-preadmission screening and annual resident review (PASARR) as described in subsection (b)(7) of this section. Any individual discharged as a result of a determination by TDMHMR must be informed of his right to request a fair hearing and to be represented by an authorized representative. Fair hearings must be conducted according to the provisions of Chapter 79, Subchapters L, M, and N of this title (relating to Fair Hearings, Appeals Process, and Hearing Procedure). Individuals requesting admission to Medicaid contracted nursing facilities have 90 days to appeal. Individuals currently residing in a Medicaid contracted nursing facility have 10 days to appeal. Payments for Medicaid residents to the facility continue until the hearing officer makes a final determination. When decisions are upheld, overpayments to the nursing facility are immediately recouped. (j) Fair hearings-All other discharges. (1)-(3) (No change.) (k) Discharge of married residents. If two residents in a facility are married and the facility proposes to discharge one spouse to another facility, the facility must give the other spouse notice of his or her right to LJHJLK-charged to the same facility. If the spouse notifies a facility, in writing, that he or she wishes to be discharged to another facility, the facility must discharge both spouses on the same day, pending availability of accommodations. sec.19.303. Notice of Bed-Hold Policy and Readmission. (a) Notice before transfer. Before a nursing facility transfers a resident to a hospital or allows a resident to go on therapeutic leave, the nursing facility must provide written information to the resident and a family member or legal representative that specifies: (1)-(2) (No change.) (b) Bed-hold notice upon transfer. At the time of transfer of a resident to a hospital or for therapeutic leave, a nursing facility must provide to the resident and a family member or legal representative, written notice which specifies the duration of the bed hold policy described in subsection (a) of this section. (c)-(d) (No change.) sec.19.304. Equal Access to Quality Care. (a) (No change.) (b) The facility may charge any amount for services furnished to non-Medicaid residents consistent with the notice requirement in sec.19.203(h) and (i) of this title (relating to Notice of Rights and Services). (c) (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 March 5, 1992. TRD-9203248 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter E. Resident Behavior and Facility Practice 40 TAC sec.19.401 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.401. Resident Behavior and Facility Practice. (a) Restraints. The resident has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms. See also sec.19.810(g) and (h) of this title (relating to Nursing Practices). (1)-(2) (No change.) (b) Abuse. The resident has the right to be free from verbal, sexual, physical and mental abuse, corporal punishment, and involuntary seclusion. (c) Staff treatment of residents. The facility must develop and implement written policies and procedures that prohibit mistreatment, neglect and abuse of residents, and misappropriation of residents' property. (1) The facility must: (A) not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; and (B) not employ individuals who have: (i) been found guilty of abusing, neglecting, or mistreating individuals by a court of law; or (ii) had a finding entered into the state nurse aide registry concerning abuse, neglect, mistreatment of residents, or misappropriation of their property; and (C) report any knowledge it has of actions by a court of law against an employee, which would indicate unfitness for service as a nurse aide or other nursing facility staff to the state nurse aide registry or licensing authority. (2) The facility must ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source, and misappropriation of resident property, are reported immediately to the administrator of the facility and to other officials in accordance with Texas law through established procedures (including to the state survey and certification agency). (3) (No change.) (4) The results of all investigations must be reported to the adminis-trator or his designated representative and to other officials in accordance with Texas law (including to the state survey and certification agency) within five working days of the incident; and if the alleged violation is verified, appropriate corrective action must be taken. 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 March 5, 1992. TRD-9203249 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter F. Quality of Life 40 TAC sec.sec.19.502, 19. 503, 19.505 The amendments are 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. The amendments are adopted in compliance with federal requirements effective April 1, 1992. sec.19.502. Activities. (a) (No change.) (b) The activities program must be directed by a qualified professional who: (1) is a qualified therapeutic recreation specialist or an activities professional who is: (A) licensed or registered, if applicable, by the state in which practicing; and (B) eligible for certification as a therapeutic recreation specialist or an activities professional by a recognized accrediting body, such as the National Council for Therapeutic Recreation Certification, on October 1, 1990; or (2)-(4) (No change.) (c) (No change.) sec.19.503. Social Services General Requirements. (a) The facility must provide medically-related social services to attain the highest practicable physical, mental, or psychosocial well-being of each resident. See also sec.19.701 of this title (relating to Quality of Care) for information concerning psychosocial functioning. (1) A facility with more than 120 beds must employ a qualified social worker on a full-time basis. (2) (No change.) (b) Qualifications of a social worker. A qualified social worker is an individual who is certified, or provisionally certified, by DHS as prescribed by the Human Resources Code, Chapter 50, and who has at least: (1) a bachelor's degree in social work, or a bachelor's degree in a human services field, including, but not limited to, sociology, special education, rehabilitation counseling, and psychology; and (2) one year of supervised social work experience in a health care setting working directly with individuals. sec.19.505. Environment. (a) The facility must provide: (1) -(3) (No change.) (4) private closet space in each resident room; (5)-(7) (No change.) (b) (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 March 5, 1992. TRD-9203250 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter G. Resident Assessment 40 TAC sec.sec.19. 601-19.603 The amendments are 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. The amendments are adopted in compliance with federal requirements effective April 1, 1992. sec.19.601. Resident Assessment. The facility must conduct initially and periodically a comprehensive accurate, standardized, reproducible assessment of each resident's functional capacity. (1) (No change.) (2) Comprehensive assessments. (A) The facility must make a comprehensive assessment of all residents' needs, utilizing the Health Care Financing Administration's (HCFA) approved resident assessment instrument (RAI). (B) The comprehensive assessment must include at least the following information: (i)-(ii) (No change.) (iii) physical and mental functional status; (iv)-(vi) (No change.) (vii) mental and psychosocial status; (viii)-(xiii) (No change.) (C) Assessments must be conducted: (i) no later than 14 days after the date of admission; (ii) for current nursing facility residents, not later than October 1, 1991; (iii)-(iv) (No change.) (D)-(F) (No change.) (G) The comprehensive assessment shall include the HCFA-approved resident assessment instrument to be completed as required in paragraph (2)(C) of this section, and the client assessment, review, and evaluation (CARE) form to be completed as required in sec.19.604 of this title (relating to Preadmission Screening and Annual Resident Review (PASARR)). (3) (No change.) sec.19.602. Comprehensive Care Plans. (a) The facility must develop a comprehensive care plan for each resident that includes measurable short-term and long-term objectives and timetables to meet a resident's medical, nursing, and psychosocial needs that are identified in the comprehensive assessment. Approaches must be listed that identify the activity that will be provided and by whom. The plan of care must deal with the relationship of items or services to be provided (or withheld) to the facility's responsibility for fulfilling other requirements in this chapter. (b) The comprehensive care plan must be: (1) (No change.) (2) prepared by an interdisciplinary team that includes the attending physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident's needs, and, to the extent practicable, with the participation of the resident, the resident's family, or legal representative; and (3) (No change.) (c)-(d) (No change.) sec.19.603. Discharge Summary (Discharge Plan of Care). (a) When the facility anticipates discharges, the resident must have a discharge summary that includes: (1)-(3) (No change.) (b) (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 March 5, 1992. TRD-9203251 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter H. Quality of Care 40 TAC sec.19.701 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.701. Quality of Care. Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, as defined by and in accordance with the comprehensive assessment and plan of care. (1) (No change.) (2) Vision and hearing. To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility must, if necessary, assist the resident: (A) (No change.) (B) by arranging for transportation to and from the office of a practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices. (3) (No change.) (4) Urinary incontinence. Based on the comprehensive assessment of the resident, the facility must ensure that: (A) a resident who enters the facility without an indwelling catheter is not catheterized unless his clinical condition demonstrates that catheter-ization is necessary; and (B) a resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible. (5) (No change.) (6) Mental and psychosocial functioning. Based on the comprehensive assessment of the resident, the facility must ensure that: (A) a resident who displays mental or psychosocial adjustment difficulty receives appropriate treatment and services to correct the assessed problem; and (B) a resident whose assessment does not reveal a mental or psychosocial adjustment difficulty does not display a pattern of decreased social interaction and/or increased withdrawn, angry, or depressive behaviors, unless his clinical condition demonstrates that such a pattern is unavoidable. (7)-(10) (No change.) (11) Special needs. The facility must ensure that residents receive proper treatment and care for the following special services: (A) -(F) (No change.) (G) foot care; and (H) (No change.) (12) Unnecessary drugs. (A) General. Each resident's drug regimen must be free from unnecessary drugs. An unnecessary drug is any drug when used: (i) in excessive dose (including duplicate drug therapy); or (ii) for excessive duration; or (iii) without adequate monitoring; or (iv) without adequate indications for its use; or (v) in the presence of adverse consequences which indicate the dose should be reduced or discontinued; or (vi) any combination of the circumstances in clauses (i)-(v) of this subparagraph. (B) Antipsychotic drugs. Based on the comprehensive assessment of the resident, the facility must ensure that: (i) residents who have not used antipsychotic drugs are not given these drugs unless antipsychotic drug therapy is necessary to treat a specific condition as diagnosed and documented in the clinical record; and (ii) residents who use antipsychotic drugs receive gradual dose reductions, and behavioral interventions, unless clinically contraindicated, in an effort to discontinue use of these drugs. (13) Medication errors. The facility must ensure that: (A) it is free of medication error rates of 5.0% or greater; and (B) (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 March 5, 1992. TRD-9203252 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter I. Nursing Services 40 TAC sec.19.801 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.801. Nursing Services. The facility must have sufficient staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care. Care and services are to be as specified in sec.19.701 of this title (relating to Quality of Care). (1)-(2) (No change.) (3) Waiver of requirement to provide licensed nurses on a 24-hour basis. To the extent that a facility is unable to meet the requirements of paragraphs (1)(B) and (2)(A) of this section, the state may waive such requirements with respect to the facility, if: (A) (No change.) (B) the state determines that a waiver of the requirement will not endanger the health or safety of individuals staying in the facility; (C) the state finds that, for any periods in which licensed nursing services are not available, a registered nurse or a physician is obligated to respond immediately to telephone calls from the facility; (D) a waiver granted under the conditions listed in this paragraph is subject to annual state review; (E) in granting or renewing a waiver, a facility may be required by the state to use other qualified, licensed personnel; (F) the state agency granting a waiver of such requirements provides notice of the waiver to the state long term care ombudsman (established under the Older Americans Act of 1965, sec.307(a)(12)) and the protection and advocacy system in the state for the mentally ill and mentally retarded; and (G) the nursing facility that is granted such a waiver by the state notifies residents of the facility (or, where appropriate, the guardians or legal representatives of such residents) and members of their immediate families of the waiver. (4) Waiver of the requirement to provide services of a registered nurse for more than 40 hours a week in a Medicare SNF. (A) The secretary may waive the requirement that a Medicare SNF provide the services of a registered nurse for more than 40 hours a week, including a director of nursing specified in paragraph (2) of this section, if the secretary finds that: (i) the facility is located in a rural area and the supply of Medicare skilled nursing facility services in the area is not sufficient to meet the needs of individuals residing in the area; (ii) the facility has one full-time registered nurse who is regularly on duty at the facility 40 hours a week; and (iii) the facility either: (I)-(II) (No change.) (B) The secretary provides notice of the waiver to the state long term care ombudsman (established under the Older Americans Act of 1965, sec.307(a)(12)) and the protection and advocacy system in the state for the mentally ill and mentally retarded. (C) The skilled nursing facility that is granted such a waiver by the state notifies residents of the facility (or, where appropriate, the guardians or legal representatives of such residents) and members of their immediate families of the waiver. (D) A waiver of the registered nurse requirement under subparagraph (A) of this paragraph is subject to annual renewal by the secretary. (5)-(9) (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 March 5, 1992. TRD-9203253 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter J. Dietary Services 40 TAC sec.sec.19.902, 19.903, 19.907, 19.908, 19.911 The amendments are 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. The amendments are adopted in compliance with federal requirements effective April 1, 1992. sec.19.902. Staffing. The facility must employ a qualified dietitian either full-time, part-time, or on a consultant basis. (1) (No change.) (2) All qualified dietitians not registered as provided by paragraph (1)(A) of this section must have 15 hours dietetic continuing education annually. (3) If a qualified dietitian is not employed full-time, the facility must designate a person to serve as the director of food service who receives frequently scheduled consultation from a qualified dietitian. (4)-(5) (No change.) sec.19.903. Sufficient Staffing. The facility must employ sufficient dietary support personnel who are competent to carry out the functions of the dietary service. sec.19.907. Menus and Nutritional Adequacy. (a)-(j) (No change.) (k) The facility must ensure that trays for bedfast residents rest on firm supports such as over-bed tables. The facility must provide sturdy tray stands of proper height to residents able to be out of bed for their meals. The facility must provide special eating equipment and utensils for residents who need them. (l)-(m) (No change.) sec.19.908. Food. Each resident must receive and the facility must provide: (1) food prepared by methods that conserve nutritive value, flavor, and appearance; (2)-(4) (No change.) sec.19.911. Sanitary Conditions. The facility must: (1) (No change.) (2) store, prepare, and serve food under sanitary conditions, as required by the Texas Department of Health food service sanitation requirements; and (3) (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 March 5, 1992. TRD-9203254 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter K. Physician Services 40 TAC sec.sec.19.1001, 19.1002, 19.1003, 19.1005, 19.1010 The amendments are 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. The amendments are adopted in compliance with federal requirements effective April 1, 1992. sec.19.1001. Physician Services. A physician must personally approve in writing a recommendation that an individual be admitted to a facility. Each resident must remain under the care of a physician. The facility must ensure that: (1)-(3) (No change.) sec.19.1002. Physician Visits. The physician must: (1)-(2) (No change.) (3) sign and date all orders; (4)-(6) (No change.) sec.19.1003. Frequency of Physician Visits. Physician visits must conform to the following schedule. (1) The resident must be seen by a physician at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter. (2) A physician visit is considered timely if it occurs not later than 10 days after the date the visit was required. (3) Except as provided in paragraph (4) of this section and sec.19.1005(c) of this title (relating to Physician Delegation of Tasks), all required visits must be made by the physician personally. (4) At the option of the physician, required visits in Medicare SNFs after the initial visit may alternate between personal visits by the physician and visits by a physician assistant, nurse practitioner, or clinical nurse specialist in accordance with sec.19.1005 of this title (relating to Physician Delegation of Tasks). (5) Each resident shall have a physical examination at least annually by his or her physician. See also sec.19.1401(2)(E) of this title (relating to Infection Control). sec.19.1005. Physician Delegation of Tasks. (a) In a Medicare SNF, except as specified in subsection (b) of this section, a physician may delegate tasks to a physician assistant, nurse practitioner, or clinical nurse specialist who: (1) meets the applicable definition in 42 Code of Federal Regulations sec.491.2 (see sec.19.101 of this title (relating to Definitions)) or in the case of a clinical nurse specialist, is licensed as such by the state; (2)-(3) (No change.) (b) In a Medicare SNF, a physician may not delegate a task when the regulations specify that the physician must perform it personally, or when the delegation is prohibited under state law or by the facility's own policies. (c) In a Medicaid nursing facility, any required physician task except certification, recertification, and the ordering of medications and treatments, may also be satisfied when performed by a nurse practitioner, clinical nurse specialist, or physician assistant who is not an employee of the facility but who is working in collaboration with a physician. (d) If physician assistant (PA), nurse practitioner (NP), or clinical nurse specialist's (CNS) services are used in the facility, facility staff must ensure that the following conditions exist. (1) The facility has written agreements with physicians who intend to use the services of PAs, NPs, or CNSs. (2) The facility has established, written procedures specifying that: (A) the PA, NP, or CNS is identified clearly to residents, responsible parties, and to employees as a PA, NP, or CNS; (B) residents are informed that the PA, NP, or CNS is not a physician and that the resident may see the supervising physician at the resident's request; (C) residents or responsible party has given consent, in writing, to receive services from the PA, NP, or CNS; and (D) (No change.) sec.19.1010. Physicians' Reporting Communicable Diseases. The physician must report all reportable communicable diseases immediately according to the requirements specified in sec.19.1401(2)(D) of this title (relating to Infection Control). 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 March 5, 1992. TRD-9203255 Nancy Murphy Agency Liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter L. Specialized Rehabilitative 40 TAC sec.19.1101 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1101. Provision of Specialized Rehabilitative Services. (a) Provision of services. If specialized rehabilitative services, such as, but not limited to, physical therapy, speech/language pathology, occupational therapy, and health rehabilitative services for mental illness and mental retardation are required in the resident's comprehensive plan of care, the facility must: (1) provide the required services; or (2) obtain the required services from an outside resource, in accordance with sec.19.1906 of this title (relating to Use of Outside Resources), from a provider of specialized rehabilitative services. (b) The facility must ensure that safe and adequate space and equipment are available for rehabilitative services offered. (c) The facility must ensure that rehabilitative services are provided under a written plan of treatment based on the physician's diagnosis and orders, and that services are documented in the resident's clinical record. 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 March 5, 1992. TRD-9203256 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter M. Dental Services 40 TAC sec.19.1201 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1201. Dental Services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (1) Skilled nursing facilities (resident's daily reimbursement paid by Medicare). (A) The facility must provide or obtain from an outside resource, in accordance with sec.19.1906 of this title (relating to Use of Outside Resources), routine and emergency dental services to meet the needs of each resident. (B) A skilled nursing facility (SNF) may charge a Medicare resident an additional amount for routine and emergency dental services. (C) An SNF must, if necessary, assist the resident: and (ii) by arranging for transportation to and from the dentist's office. (D) An SNF must promptly refer residents with lost or damaged dentures to a dentist. (2) Nursing facilities. The facility must provide or obtain from an outside resource, in accordance with sec.19.1906 of this title (relating to Use of Outside Resources), the following dental services to meet the needs of each resident: (A) routine dental services (to the extent covered under the state plan). (i) (No change.) (ii) Routine restorative procedures are not considered emergency procedures. Emergency root canal procedures must be accompanied by x-rays. Dental services not covered include, but are not limited to, the following: (I) cleaning; (II) filling teeth with amalgam composite, glass ionomer, or any other restorative material; (III) cast or preformed crowns (capping); (IV) restoration of carious or non-carious permanent or primary teeth, including those requiring root canal therapy; (V) replacement or repositioning of teeth; (VI) services to the alveolar ridges or periodontium of the maxilla and the mandible, except for procedures covered under subparagraph (B) of this paragraph; and (VII) complete or partial dentures; (B) (No change.) (C) assistance to the resident, if necessary: and (ii) by arranging for transportation to and from the dentist's office; (D) prompt referral of residents with lost or damaged dentures to a dentist. (3)-(4) (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 March 5, 1992. TRD-9203257 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter N. Pharmacy Services 40 TAC sec.19.1301, sec.19.1303 The amendments are 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. The amendments are adopted in compliance with federal requirements effective April 1, 1992. sec.19.1301. Pharmacy Services. The facility must provide routine and emergency drugs and biologicals to its residents, or obtain them under an agreement described in sec.19.1906 of this title (relating to Use of Outside Resources). See also sec.19.701(12) and (13) of this title (relating to Quality of Care) for information concerning drug therapy and medication errors. (1) -(5) (No change.) (6) Labeling of drugs and biologicals. Drugs and biologicals used in the facility must be labeled in accordance with currently accepted professional principals and in compliance with the Texas State Board of Pharmacy laws and regulations, Chapter 291, including the appropriate accessory and cautionary instructions and the expiration date when applicable. (7) Storage of drugs and biologicals. (A) (No change.) (B) The facility must provide separately locked, permanently affixed compartments for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention and Control Act of 1976 and other drugs subject to abuse, except when the facility uses single unit package drug distribution systems in which the quantity stored is minimal and a missing dose can be readily detected (see sec.19.1309 of this title (relating to Controlled Substances)). sec.19.1303. Additional Supervision and Consultation Requirements. (a) (No change.) (b) A pharmacist, currently licensed by the State of Texas and in good standing, must be an employee of the facility or act as a consultant to the facility. The facility must ensure that notes on the monthly visits by the consulting pharmacist are entered in the resident's clinical record. The pharmacist must prepare a written report for quarterly review. This report may consist of the monthly summaries (see sec.19.1301(5) of this title (relating to Pharmacy Services)). (c)-(f) (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 March 5, 1992. TRD-9203258 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter O. Infection Control 40 TAC sec.19.1401 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1401. Infection Control. The facility must establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of disease and infection. See also sec.19.1920 of this title (relating to Operating Policies and Procedures). (1) (No change.) (2) Preventing spread of infection. (A) (No change.) (B) The facility must prohibit employees with a communicable disease or infected skin lesions from direct contact with residents or their food, if direct contact will transmit the disease. (C)-(E) (No change.) (3)-(4) (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 March 5, 1992. TRD-9203259 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter P. Physical Plant and Environment 40 TAC sec.19.1501 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1501. General Requirements. The facility must be designed, constructed, equipped, and maintained to protect the health and ensure the safety of residents, personnel, and the public. (See also sec.19.505 of this title (relating to Environment.)) (1) Life safety from fire. The facility must meet the applicable provisions of the 1985 edition of the Life Safety Code of the National Fire Protection Association (which is incorporated by reference). Incorporation of the 1985 edition of the National Fire Protection Association's Life Safety Code (published February 7, 1985; ANSI/NFPA) was approved by the director of the Federal Register in accordance with 5 United State Code 552(a) and 1 Code of Federal Regulation, Part 51 that govern the use of incorporation by reference. The code is available for inspection at the Office of the Federal Register Information Center, Room 8301, 1110 L Street NW, Washington, D.C. Copies may be obtained from the National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02200. If any changes in this code are also to be incorporated by reference, a notice to that effect will be published in the Federal Register . (A) After consideration of the state survey agency findings, the Health Care Financing Administration (HCFA) or in the case of a nursing facility (including a dually participating facility), the state survey agency, may waive specific provisions of the Life Safety Code which, if rigidly applied, would result in unreasonable hardship upon the facility but only if the waiver does not adversely affect the health and safety of residents or personnel. (B) The provisions of the Life Safety Code do not apply in a state in which HCFA finds, in accordance with applicable provisions of the Social Security Act sec.1819(d)(2)(B)(ii) and sec.1919(d)(2)(B)(ii), that a fire and safety code imposed by state law adequately protects patients, residents, and personnel in long term care facilities. (2) Emergency power. (A) An emergency electrical power system must supply power adequate at least for lighting all entrances and exits; equipment to maintain the fire detection, alarm, and extinguishing systems; and life support systems in the event the normal electrical supply is interrupted. (See sec.19.1510 of this title (relating to Emergency Electrical Services.)) (B) (No change.) (3) (No change.) (4) Resident rooms. Resident rooms must be designed and equipped for adequate nursing care, comfort, and privacy of residents. (A) Bedrooms must: (i)-(ii) (No change.) (iii) have direct access to an exit corridor; (iv) (No change.) (v) in facilities initially certified after September 30, 1990, except in private rooms, have ceiling-suspended curtains for each bed, which extend around the bed to provide total visual privacy, in combination with adjacent walls and curtain (see clause (iv) of this subparagraph); (vi)-(vii) (No change.) (B) (No change.) (C) HCFA or the state survey agency agency may permit variations in requirements specified in paragraph (4)(A)(i) and (ii) of this section relating to rooms in individual cases when the facility demonstrates in writing that the variations: (i)-(ii) (No change.) (D)-(N) (No change.) (5)-(19) (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 March 5, 1992. TRD-9203260 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter Q. Medical Review and Re-evaluation 40 TAC sec.19.1606 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. The amendment is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1606. Utilization Review Effective Dates. When the recipient is admitted to or discharged from the Medicaid nursing facility vendor payment system, the administrator of the facility must submit, within 72 hours, a resident transaction notice form. (1) The administrator of the facility must submit to the Utilization Review Committee a new Texas nursing facility CARE form within 20 calendar days following admission to the Medicaid nursing facility vendor payment system. See sec.19.1603(2)(B)(iv) of this title (relating to the Utilization Review Process) for instructions on when to submit admission assessments. (A) The CARE form must be completed and signed by the physician within 20 working days following admission to the nursing facility vendor payment system. (B)-(C) (No change.) (2)-(5) (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 March 5, 1992. TRD-9203261 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter T. Administration 40 TAC sec.19.1903 The repeal 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. The repeal is adopted in compliance with federal requirements effective April 1, 1992. sec.19.1903. Required Training of Nurse Aides. 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 March 5, 1992. TRD-9203437 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Subchapter T. Administration 40 TAC sec.sec.19.1903, 19.1906, 19.1908-19.1910, 19.1914, 19.1915, 19.1917, 19.1918 The new and amended sections are 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. The new and amended sections are adopted in compliance with federal requirements effective April 1, 1992. sec.19.1903. Required Training of Nurse Aides. See also sec. 19. 1929 of this title (relating to Staff Development). (1) Definitions. The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise. (A) Licensed health professional-A physician; physician assistant; nurse practitioner; physical, speech, or occupational therapist; physical or occupational therapy assistant; registered professional nurse; licensed practical nurse; or licensed or certified social worker. (B) Nurse aide-An individual providing nursing or nursing-related services to residents in a facility under the supervision of a licensed nurse. This definintion does not include an individual who is a licensed health professional or a registered dietitian or someone who volunteers such services without monetary compensation. (2) General rule. A facility must not use any individual working in the facility as a nurse aide for more than four months, on a full-time basis, unless: (A) that individual is competent to provide nursing and nursing related services; and (B) that individual: (i) has completed a training and competency evaluation program, or a competency evaluation program approved by the state as meeting the requirements of 42 Code of Federal Regulations, sec.sec.483.151-493.154; or (ii) has been deemed or determined competent as provided in 42 Code of Federal Regulations, sec.483.150(a) and (b). (3) Nonpermanent employees. A facility must not use on a temporary, per diem, leased, or any basis other than a permanent employee any individual who does not meet the requirements in paragraph (2)(A) and (B) of this section. (4) Competency. A facility must not use any individual who has worked less than four months as a nurse aide in that facility unless the individual: (A) is a full-time employee in a state-approved training and competency evaluation program; (B) has demonstrated competence through satisfactory participation in a state- approved nurse aide training and competency evaluation program, or competency evaluation program; or (C) has been deemed or determined competent as provided in 42 Code of Federal Regulations, sec.483.150(a) and (b). (5) Registry verification. Before allowing an individual to serve as a nurse aide, a facility must receive registry verification that the individual has met competency evaluation requirements, unless: (A) the individual is a full-time employee in a training and competency evaluation program approved by the state; or (B) the individual can prove that he has recently successfully completed a training and competency evaluation program, or competency evaluation program approved by the state and has not yet been included in the registry. Facilities must follow up to ensure that such an individual actually becomes registered. (6) Multi-state registry verification. Before allowing an individual to serve as a nurse aide, a facility must seek information from every state registry, established under the Social Security Act, sec.1819(e)(2)(A) or sec.1919(e)(2)(A), that the facility believes will include information about the individual. (7) Required retraining. If, since an individual's most recent completion of a training and competency evaluation program, there has been a continuous period of 24 consecutive months during none of which the individual provided nursing or nursing-related services for monetary compensation, the individual must complete a new training and competency evaluation program or a new competency evaluation program. (8) Regular in-service education. The facility must complete a performance review of every nurse aide at least once every 12 months, and must provide regular in-service education based on the outcome of these reviews. The in- service training must: (A) be sufficient to ensure the continuing competence of nurse aides, but must be no less than 12 hours per year; (B) address areas of weakness as determined in nurse aides' performance reviews and may address the special needs of residents as determined by the facility staff; and (C) for nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired. (9) Training and registry rules. The facility must comply with the nurse aide training and registry rules found in 25 TAC Chapter 151 (relating to Nurse Aides). sec.19.1906. Use of Outside Resources. (a) (No change.) (b) Arrangements as described in the Social Security Act, sec.1861(W) or agreements pertaining to services furnished by outside resources must specify in writing that the facility assumes responsibility for: (1)-(2) (No change. ) (c) (No change.) sec.19.1908. Laboratory Services. (a) The facility must provide or obtain clinical laboratory services to meet the needs of its residents. The facility is responsible for the quality and timeliness of the services. (1) If the facility provides its own laboratory services, the services must meet the applicable conditions for coverage of the services furnished by laboratories specified in 42 Code of Federal Regulations, Part 493. (2) If the facility provides blood bank and transfusion services, it must meet the requirements for laboratories specified in 42 Code of Federal Regulations, Part 493. (3) If the laboratory chooses to refer specimens for testing to another laboratory, the referral laboratory must be approved or licensed to test specimens in the appropriate specialties and/or subspecialties of services in accordance with 42 Code of Federal Regulations, Part 493. (4) If the facility does not provide laboratory services on site, it must have an agreement to obtain these services only from a laboratory that meets the requirements of 42 Code of Federal Regulations, Part 493, or from a physician's office. (b) The facility must: (1)-(3) (No change.) (4) file in the resident's clinical record laboratory reports that are dated and contain the name and address of the issuing laboratory; (5) (No change.) sec.19.1909. Radiology and Other Diagnostic Services. (a) The nursing facility must provide or obtain radiology and other diagnostic services to meet the needs of its residents. The facility is responsible for the quality and timeliness of the services. (1) (No change.) (2) If the facility does not provide its own diagnostic services, it must have an agreement to obtain these services from a provider or supplier that is approved to provide these services under Medicare. (b) (No change.) sec.19.1910. Clinical Records. (a)-(e) (No change.) sec.19.1914. Disaster and Emergency Preparedness. (a) (No change.) (b) The facility must train all employees in emergency procedures when they begin to work in the facility, periodically review the procedures with existing staff, and carry out unannounced staff drills using those procedures. sec.19.1915. Transfer Agreement. (a) In accordance with the Social Security Act, sec.1861(1), the facility (other than a nursing facility which is located in a state on an Indian Reservation) must have in effect a written transfer agreement with one or more hospitals approved for participation under the Medicare and Medicaid programs that reasonably assures that: (1) -(2) (No change.) (b)-(e) (No change.) sec.19.1917. Quality Assessment and Assurance. (a) (No change.) (b) The Quality Assessment and Assurance Committee: (1) (No change.) (2) develops and implements appropriate plans of action to correct identified quality deficiencies. (c) Texas or the secretary of health and human services may not require disclosure of the records of the Quality Assessment and Assurancy Committee except insofar as such disclosure is related to the compliance of the committee with the requirements of subsection (b) of this section. (d) The Quality Assessment and Assurance Committee, or a subcommittee thereof, will establish and monitor an infection control program according to sec.19.1401 of this title (relating to Infection Control), and will monitor the pharmaceutical services of the facility according to sec.19. 1301 of this title (relating to Pharmacy Services). (e) See sec.19.701(12) and (13) of this title (relating to Quality of Care) and sec.19.1923 of this title (relating to Incident or Accident Reporting) for additional items that should be monitored by the Quality Assessment and Assurance Committee. sec.19.1918. Disclosure of Ownership. (a) (No change.) (b) The facility must provide written notice to the Texas Department of Health at the time of change if a change occurs in: (1)-(4) (No change.) (c)-(e) (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 March 5, 1992. TRD-9203438 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 For further information, please call: (512) 450-3765 Chapter 27. Intermediate Care Facility for the Mentally Retarded (ICF-MR) Subchapter G. Additional Facility Responsibilities 40 TAC sec.27.701 The Texas Department of Human Services (DHS) adopts an amendment to sec.27. 701, concerning agreements with local school districts, without changes to the proposed text as published in the January 31, 1992, issue of the Texas Register (17 TexReg 840). The justification for the amendment is to comply with Senate Bill 417, passed by the 71st Texas Legislature. This legislation requires DHS and the Texas Education Agency (TEA) to develop a memorandum of understanding concerning educational space and education-related services for school-age residents of intermediate care facilities for the mentally retarded (ICFs-MR). The amendment will function by citing the memorandum of understanding which DHS and TEA developed to clarify the responsibilities of the ICFs-MR and the school districts. The responsibilities include providing space for educational activities, treatment and education-related services, and coordination of services between the ICFs-MR and school districts. The memorandum of understanding also delineates the respective responsibilities of TEA and DHS for assisting in the resolution of problems between school districts and ICFs-MR. 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 March 9, 1992. TRD-9203388 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 15, 1992 Proposal publication date: January 31, 1992 For further information, please call: (512) 450-3765 Chapter 50. Day Activity and Health Services Reimbursement Methodology for Day Activity and Health Services 40 TAC sec.50.6903, sec.50.6905 The Texas Department of Human Services adopts amendments to sec.50.6903 and sec.50.6905, concerning reimbursement methodology, in its Day Activity and Health Services chapter, without changes to the proposed text as published in the February 4, 1992, issue of the Texas Register (17 TexReg 935). The amendments are justified because they better reflect the activities of the Day Activity and Health Services program. The amendments also help providers better understand the department's rules, thus resulting in better cost reporting. The amendments will function by clarifying and correcting existing rule language. During the public comment period, the department received one written comment commending the department for proposing the amendments. The amendments are adopted under the Human Resources Code, Title 2, Chapter 22, which authorizes the department to administer public assistance programs, and Chapter 32, which authorizes the department to administer 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 March 9, 1992. TRD-9203389 Nancy Murphy Agency liaison, Policy and Document Support Texas Department of Human Services Effective date: April 1, 1992 Proposal publication date: February 4, 1992 For further information, please call: (512) 450-3765