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 19. EDUCATION Part II. Texas Education Agency Chapter 61. School Districts Subchapter G. School Facilities School Facilities Standards 19 TAC sec.sec.61.101-61.104 The Texas Education Agency adopts new sec.sec.61.101-61.104, concerning school facilities standards. Sections 61.101, 61.102, and 61.104 are adopted with changes to the proposed text as published in the May 1, 1992, issue of the Texas Register (17 TexReg 3117). Section 61.103 is adopted without changes and will not be republished. The new sections are necessary to ensure the quality and safety of public school facilities. The changes in sec.61.101 add definitions of the terms "final design documents," "library," and "renovations." They also clarify responsibilities for certification of facilities design and construction. Other changes in the section are editorial in nature. The changes in sec.61.102 refine minimum square foot requirements for various instructional spaces. The changes in sec.61.104 clarify qualifications and requirements for independent third-party review of construction documents for conformance with adopted building codes. They also require districts to comply with the Americans with Disabilities Act and other applicable local, state, and federal requirements. The sections establish standards in the areas of space, educational adequacy, and construction quality. They outline minimum square footage requirements for specific instructional spaces and require districts to comply with recognized building codes. The sections also authorize the commissioner to make recommendations concerning the best practices for facility construction in relation to educational adequacy. The agency received the following comments regarding the new sections. Comment: The School Facilities Advisory Committee (SFAC) asked staff to clarify the term "major renovations." Response: The agency incorporated the substitute language. Comment. The SFAC recommended changes to text concerning independent third- party review responsibilities and indicated concern over associated costs that would be incurred by the district. Response: The agency incorporated the substitute language. Comment: The SFAC recommended changes to text concerning the plan review process for building code compliance and the qualifications of the independent third-party code consultant. Response: The agency incorporated the substitute language. Comment: The SFAC recommended changes to text concerning the definition of the term "final design documents" to allow latitude to districts with projects in progress. This was suggested because of the potential hardships associated with making the transition. Response: The agency incorporated the substitute language. Comment: The SFAC recommended including definitions for the following: flexible standards; guidelines; educational specifications; square foot per room measurements; and certificate of design and construction. Response: The agency concluded that the concepts of flexible standards, guidelines, and educational specifications are not addressed in the rules and therefore do not require definition. The term "square foot per room measurements" is already defined in the rules. The agency incorporated recommendations regarding certification of design compliance. Comment: The Texas State Board of Registration for Professional Examiners recommended adding the term "engineers" at various points throughout the rules to include engineers in the school facilities standards regulatory process. Response: The agency incorporated the substitute language. Comment: The Austin Chapter of Associated General Contractors of America recommended changes to text concerning certification of construction. Response: The agency incorporated the substitute language. Comment: The Texas Association of School Boards (TASB) recommended changes to text concerning architect/engineer certification of design and construction. Response: The agency incorporated the substitute language. Comment: The TASB recommended changes to text concerning minimum library space. Response: Based on suggestions from the Committee on Finance, the agency incorporated the substitute language and negotiated the area requirement. This recommendation was also accepted by the SFAC. For clarification, the agency added the definition of "library." Comment: The TASB recommended changes to text concerning the scope of required services for third-party code consultants. Response: The agency incorporated substitute language proposed by the TASB, the SFAC, and the Committee on Finance. Comment: The TASB recommended changes to text concerning proposed construction inspection requirements in areas with no locally adopted building codes. Response: The agency incorporated the substitute language. Comment: The TASB recommended changes to text concerning compliance with local, state, and federal regulations. Response: The staff responded that this text served only to remind school districts of their obligation to comply with other regulations, and thus no changes to the language should be made. The new sections are adopted under the Texas Education Code, sec.16.402, which provides the State Board of Education with the authority to establish standards for adequacy of school facilities. sec.61.101. Applicability. (a) Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Final design documents-These documents shall include all of the following: (A) evaluation of owner's program, schedule, and construction budget; (B) the development of alternate approaches to design and construction; (C) preparation of drawings illustrating scale, size, and relationship of project components; and (D) a preliminary estimate of construction cost based on current area, volume, or other unit costs. (2) Instructional space-General classrooms and specialized classrooms, and major support areas. (3) Library-Library will include the following minimum requirements: (A) reading room; (B) stack area; and (C) necessary service areas. (4) Renovations-At least 50% of the building's gross area is within the limits of the work. This section and sections 61.102, and 61.104 of this title (relating to Applicability; Space, Minimum Square Foot Requirements; and Construction Quality) shall apply to renovation projects. All renovations shall comply with applicable building codes. (5) Square feet per pupil-The net interior space of a room divided by the maximum number of pupils to be housed in that room during a single class period. (6) Square foot per room measurements-Actual sizes for a room that will house 22 students at the elementary level and 25 students at the middle or high school level. Net room square footage is inclusive of exposed storage space, such as cabinets or shelving, but exclusive of hallway space. Storage space such as closets or preparation offices is not included in the room square footage. (b) Documents required by effective date. These requirements shall apply to projects for new construction or major renovations for which final design documents have not been approved by a school board prior to September 1, 1992. (c) All other requirements applicable. School districts shall meet all requirements contained in this section and sec.sec.61.102-61.104 of this title. (d) Certification of design and construction. (1) In this section, the word "certify" indicates that the architect/engineer has reviewed the standards and used the best professional judgment and reasonable care consistent with the practice of architecture or engineering in the State of Texas in executing the construction documents. The architect/engineer also certifies that these documents conform with all requirements contained in this section and sec.sec.61.102 and 61.104 of this title, except as indicated on the certification. (2) The school district shall give notice and obligate the architect/engineer to provide the required certification. The architect's/engineer's signature and seal on the construction documents shall certify compliance. (3) To ensure that buildings have been designed and constructed according to requirements of this part each of the involved parties must execute responsibilities as follows. (A) The school district shall provide the architect/engineer with enrollment projections, educational specifications, building code specifications, and educational objectives for the facility. The district shall provide this information to the architect/engineer as specified by the commissioner of education. (B) The architect/engineer shall perform a code search under applicable regulations that may influence the project, and shall certify that the design has been researched before it is final. (C) The architect/engineer shall also certify that the building has been designed according to the criteria established in this section and sec.sec.61.102 and 61.104 of this title, based on enrollment information, educational specifications, and building code specifications as provided by the district. (D) The building contractor or construction manager shall certify that the facility has been constructed according to the construction documents as specified in subparagraph (C) of this paragraph. sec.61.102. Space, Minimum Square Foot Requirements. (a) A school district, if required by the district educational specification or educational program, is required to provide instructional space as indicated in subsection (b) of this section. (b) For each type of instructional space, a district may satisfy the requirements of the rule by using either the standard for the minimum square feet per pupil or the standard for square feet per room, as appropriate. Room size requirements are based on rooms that will house 22 students at the elementary level and 25 students at the middle or high school level. (1) General classrooms. (A) Classrooms for prekindergarten through first grade shall have a minimum of 36 square feet per pupil or 800 square feet per room. (B) Classrooms at the elementary school level shall have a minimum of 30 square feet per pupil or 700 square feet per room. (C) Classrooms at the secondary school level shall have a minimum of 28 square feet per pupil or 700 square feet per room. (2) Specialized classrooms. (A) Computer laboratories shall have a minimum of 41 square feet per pupil or 900 square feet per room at the elementary school level; and 36 square feet per pupil or 900 square feet per room at the secondary school level. (B) Science lecture/lab shall have a minimum of 41 square feet per pupil or 900 square feet per room at the elementary school level; 50 square feet per pupil or 1,000 square feet per room at the middle school level; and 50 square feet per pupil or 1,200 square feet per room at the high school level. (3) Major support areas. (A) Primary gymnasiums or physical education space, if required by the district's educational program, shall have a minimum of 3,000 square feet at the elementary school level; 4,800 square feet at the middle school level; and 7,500 square feet at the high school level. (B) Libraries shall have a minimum of 3.0 square feet times the planned student capacity of the school. The minimum size of any elementary school library shall be 1,400 square feet. The minimum size of any middle school library shall be 2,100 square feet, and the minimum high school library shall be 2,800 square feet. sec.61.104. Construction Quality. (a) Districts with existing codes. School districts located in an area with an adopted building code shall meet their local building codes (including fire and mechanical, electrical, and plumbing codes). School districts located in areas where there is already a locally adopted building code do not have to seek additional plan review of their school facilities projects other than what is required in the local building code. (b) Districts with no existing codes. School districts located in areas where there is no locally adopted building code shall adopt and use the latest edition of either the Uniform Building Code or Standard (Southern) Building Code (and related fire and mechanical, electrical, and plumbing codes). A third-party qualified independent code review shall be conducted to ensure that plans conform with either the Uniform Building Code or the Standard Building Code (and related fire and mechanical, electrical, and plumbing codes) before the start of construction. This plan review must be conducted by an independent certified building code consultant, architect, or engineer not employed by the design architect/engineer who will certify building code compliance. (c) Americans with Disabilities Act of 1990. School districts shall comply with the provisions of the Americans with Disabilities Act of 1990 and other local, state, and federal requirements as may be applicable. 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 July 15, 1992. TRD-9209822 Criss Cloudt Coordinator, Policy Planning and Evaluation Texas Education Agency Effective date: August 6, 1992 Proposal publication date: May 1, 1992 For further information, please call: (512) 463-9701 Chapter 75. Curriculum Subchapter B. Essential Elements-Prekindergarten-Grade 6 19 TAC sec.75.32 The Texas Education Agency (TEA) adopts amendments to sec. sec.75.32, 75.47, 75.62-75.64, 75.66, and 75.67, concerning curriculum. Section 75.32 and sec.75. 67 are adopted with changes to the proposed text as published in the May 19, 1992, issue of the Texas Register (17 TexReg 3687). Sections 75.47, 75. 62- 75.64, and 75.66 are adopted without changes and will not be republished. The amendments are necessary to refine essential curriculum elements. The changes in sec.75.32 place more emphasis on the traditional study of Texas history. The changes in sec.75.67 are editorial in nature. Based on a five-year review, the amendments revise essential elements in the state curriculum related to subjects and courses that will be included in the 1993 textbook proclamation. The Task Force for Review and Revision of the Social Studies, the Daughters of the Republic of Texas, and numerous individuals commented in favor of the amended sections. Two individuals recommended including reference to religious history and heritage in sec.75.32. This suggestion was incorporated. Several individuals who initially opposed sec.75.32 later commented in favor of the section after reviewing the changes proposed by agency staff that place more emphasis on the traditional study of Texas history. The amendments are adopted under the Texas Education Code, sec.21.101(c), which authorizes the State Board of Education to promulgate rules designating the essential elements of each subject and course in the state curriculum. sec.75.32. Social Studies, Texas and United States History. (a) (No change.) (b) Social studies, Grade 1. Essential elements described in this subsection for social studies, Grade 1, shall be superseded by the essential elements described in subsection (h) of this section effective September 1996. (1)-(7) (No change.) (c) Social studies, Grade 2. Essential elements described in this subsection for social studies, Grade 2, shall be superseded by the essential elements described in subsection (i) of this section effective September 1996. Social studies, Grade 2, shall include the following essential elements. (1)-(7) (No change.) (d) Social studies, Grade 3. Essential elements described in this subsection for social studies, Grade 3, shall be superseded by the essential elements described in subsection (j) of this section effective September 1996. Social studies, Grade 3, shall include the following essential elements. (1)-(7) (No change.) (e) Social studies, Grade 4. Essential elements described in this subsection for social studies, Grade 4, shall be superseded by the essential elements described in subsection (k) of this section effective September 1996. Social studies, Grade 4, shall include the following essential elements. (1)-(7) (No change.) (f) Social studies, Grade 5. Essential elements described in this subsection for social studies, Grade 5, shall be superseded by the essential elements described in subsection (l) of this section effective September 1996. Social studies, Grade 5, shall include the following essential elements. (1)-(7) (No change.) (g) Social studies, Grade 6. Essential elements described in this subsection for social studies, Grade 6, shall be superseded by the essential elements described in subsection (m) of this section effective September 1996. Social studies, Grade 6, shall include the following essential elements. (1)-(7) (No change.) (h) Social studies, Grade 1. Essential elements for social studies, Grade 1, as described in this subsection shall be effective September 1996. Social studies, Grade 1, shall include the following essential elements. (1) Social study skills. The student shall be provided opportunities to: (A) identify the main idea of a social studies selection; (B) recall facts and details to support a social studies generalization; (C) place events in proper sequence; (D) classify information; (E) identify cause-and-effect relationships; (F) predict probable future outcomes; (G) interpret visuals (e.g., pictures, charts, graphs, tables, time lines); (H) organize and express ideas in written and oral form; (I) apply decision-making skills and recognize consequences of decisions; (J) use problem-solving skills; and (K) draw logical conclusions. (2) Citizenship. The student shall be provided opportunities to: (A) identify positive traits of self and others using literature and personal experiences; (B) identify and accept responsibilities using appropriate behavior in the environment (e.g., home, family, school, neighborhood, community); (C) describe the role of self in the environment; (D) recognize the value of friendships and positive interactions with others; and (E) accept and respect the rights of self and others. (3) Economics. The student shall be provided opportunities to: (A) demonstrate that individuals and families have unlimited wants but limited resources to satisfy their wants (concept of scarcity); (B) recognize that individuals and families must make economic choices among alternatives (by choosing one thing, something else is given up-opportunity costs); (C) demonstrate how individuals and families trade one thing for another and trade things for money (concepts of exchange and price); and (D) describe the kinds of work performed by family, school, and community members and how they help one another (concept of interdependence). (4) History. The student shall be provided opportunities to: (A) identify anthems, patriotic customs, symbols, and mottos of Texas and the United States through songs, visuals, and stories; (B) explain the importance of patriotic customs, celebrations, and traditions of the community, Texas, and the United States; (C) identify people who have contributed to the founding of the community, Texas, and the United States (e.g., Stephen F. Austin, George Washington); and (D) use vocabulary related to time and chronology (e. g., yesterday, today, tomorrow). (5) Government. The student shall be provided opportunities to: (A) explain the need for rules/laws in the home, school, and community and participate in rulemaking; (B) identify local authority figures (e.g., teacher, principal, crossing guard, police officer) and their responsibilities for enforcing rules in the school and community; (C) identify Texas and national authority figures and describe their roles (e.g., president, governor); (D) demonstrate the democratic process through voting and elections using age- appropriate topics/issues; and (E) identify major historical documents (e.g., Texas Declaration of Independence, Texas Constitution, Treaty of Velasco). (6) Geography. The student shall be provided opportunities to: (A) locate school, city, state, nation, and continent on maps and globes; (B) use maps to identify the relative location of places in the classroom, school, and neighborhood; (C) use directional terms such as above/below, near/far, left/right, north/south, and east/west; (D) use simple maps to locate places and gather information; (E) distinguish between land and water on maps and globes; (F) identify local landforms and describe their characteristics; and (G) identify seasons and describe their effects on people and the local environment. (7) Psychology, sociology, and anthropology. The student shall be provided opportunities to: (A) identify various racial, ethnic, and cultural groups in one's community; (B) compare similarities and differences among individuals and families in North America and other parts of the world; (C) describe cultural customs and traditions of specific groups of people using literature and personal experiences; and (D) demonstrate the multicultural diversity of North America and the world through a variety of activities or performances related to art, music, literature, dance, and architecture. (i) Social studies, Grade 2. Essential elements for social studies, Grade 2, as described in this subsection shall be effective September 1996. Social studies, Grade 2, shall include the following essential elements. (1) Social study skills/processes. The student shall be provided opportunities to: (A) identify the main idea of a social studies selection; (B) recall facts and details to support a social studies generalization; (C) place events in proper sequence; (D) classify information; (E) identify cause-and-effect relationships; (F) predict probable future outcomes; (G) construct and interpret visuals (e.g., pictures, charts, graphs, tables, time lines); (H) organize and express ideas in written and oral form; (I) apply decision-making skills and recognize consequences of decisions; (J) use problem-solving skills; (K) differentiate between fact and nonfact (fantasy); and (L) draw logical conclusions. (2) Citizenship. The student shall be provided opportunities to: (A) identify qualities of a leader and follower using literature and personal experiences; (B) identify and accept consequences of one's behavior; (C) establish rules, duties, responsibilities, and privileges of citizenship in classroom settings; (D) use problem-solving skills to develop reasonable ways of dealing with individual and group conflicts (e.g., trust, friendship, communication); and (E) explain the importance of the right to hold differing opinions. (3) Economics. The student shall be provided opportunities to: (A) provide examples of markets as places where people buy or sell goods and services, emphasizing the free enterprise system and its benefits; (B) distinguish between making (producing) and using (consuming) things; (C) identify examples of how individuals and families depend on others in the community for services (e.g., food, water, protection, education); (D) explain that scarcity causes the need for goods to be exchanged among countries in the Western Hemisphere (concept of trade); and (E) explain the concept of working to earn money to provide for wants and needs. (4) History. The student shall be provided opportunities to: (A) identify individuals of various racial, ethnic, and cultural groups who have contributed to the community and state (e.g., Antonio Olivarez, Sam Houston, Barbara Jordan); (B) describe the origins and historical significance of major celebrations in the community, state, and nation (e.g., Independence Day, Cinco de Mayo, Emancipation Day, Martin Luther King's Birthday, Thanksgiving, Presidents' Day, San Jacinto Day); (C) identify historical landmarks in the state and nation; (D) explain the symbolism of Texas and the United States flags and their respective pledges; and (E) identify and use vocabulary of time and chronology using clocks and calendars. (5) Government. The student shall be provided opportunities to: (A) identify some governmental services in the community (e.g., police department, highway department); (B) identify elected governing bodies that make rules and laws in the community (e.g., city council, school board); (C) recognize that voting for governmental bodies is the public's way of making decisions for all; (D) predict consequences for the violation of rules and laws in school and the community; and (E) demonstrate the democratic process through voting and elections using age-appropriate topics/issues. (6) Geography. The student shall be provided opportunities to: (A) locate one's community, Texas, the United States, and selected nations of the Western Hemisphere on maps and globes; (B) identify and use a compass rose, grid, and cardinal directions to locate places; (C) construct and use maps to identify the relative location of places (e.g., classroom, school, neighborhood); (D) interpret simple legends on maps; (E) identify and locate major landforms and bodies of water on maps and globes; (F) distinguish between urban, suburban, and rural areas; and (G) identify ways people adapt to and change their environments. (7) Psychology, sociology, and anthropology. The student shall be provided opportunities to: (A) describe how individuals and families change over time; (B) identify several groups to which students belong; (C) describe and compare family responsibilities in various cultures; (D) compare traditions and customs of the students' own culture with other cultures of the Western Hemisphere; and (E) demonstrate the multicultural diversity of the Western Hemisphere through a variety of activities or performances related to art, music, literature, dance, and architecture. (j) Social studies, Grade 3. Essential elements for social studies, Grade 3, as described in this subsection shall be effective September 1996. Social studies, Grade 3, shall include the following essential elements. (1) Social study skills/processes. The student shall be provided opportunities to: (A) identify the main idea of a social studies selection; (B) recall facts and details to support a social studies generalization; (C) place historical events in proper sequence; (D) classify information; (E) identify cause-and-effect relationships; (F) predict probable future outcomes; (G) construct and interpret visuals (e.g., pictures, charts, graphs, tables, time lines); (H) organize and express ideas in written and oral form; (I) apply decision-making skills and recognize consequences of decisions; (J) use problem-solving skills; (K) differentiate between fact and nonfact (fantasy); (L) locate and gather information from a variety of sources (e.g., current news sources, reference works, media, databases); and (M) draw logical conclusions. (2) Citizenship. The student shall be provided opportunities to: (A) identify examples of community leaders, past and present, who make a difference; (B) identify and demonstrate an individual's responsible behavior for protecting and preserving the environment; (C) identify individuals' civic responsibilities to the community, Texas, and the United States; (D) participate in groups to solve problems, make decisions, and communicate effectively with others; and (E) demonstrate tolerance for and acceptance of others. (3) Economics. The student shall be provided opportunities to: (A) identify and classify natural and human resources in the community and explain the interdependence of people and products in the world; (B) identify examples of specialization and division of labor in a community; (C) describe how technology has influenced and changed the ways of making a living in the local community and selected communities around the world; (D) explain the purposes of spending and saving money; and (E) distinguish between public and private property. (4) History. The student shall be provided opportunities to: (A) identify common characteristics of all communities (e.g., location, government, services provided); (B) explain how communities are diverse (e.g., cultural identity and pluralism, languages, religions); (C) compare the local community to selected rural and urban communities around the world, past and present; and (D) describe how communities change over time (e.g., population, transportation, technology, communication, buildings). (5) Government. The student shall be provided opportunities to: (A) identify basic functions of local and state government; (B) demonstrate the democratic process through voting and elections using age appropriate topics/issues; (C) discuss the need for the enforcement of laws in all communities; and (D) analyze compromise as a way to resolve conflicting political issues in the community. (6) Geography. The student shall be provided opportunities to: (A) locate the local community in relation to Texas, the United States, and the world; (B) locate places on maps and globes using a compass rose, cardinal and intermediate directions, and grid systems; (C) create and use maps with legends; (D) use maps and globes to locate states, countries, continents, and major bodies of water relative to other places; (E) describe physical and human features of the local community; (F) compare and contrast communities in Texas, the United States, and world in terms of physical and cultural characteristics; (G) describe the relationship between people and their environment in various communities; (H) identify an environmental issue in the community and analyze it to propose possible solutions; and (I) identify regions by their common characteristics (e.g., cultural, physical, political). (7) Psychology, sociology, and anthropology. The student shall be provided opportunities to: (A) identify the contributions of various racial, ethnic, and cultural groups in the community and state; (B) compare traditions and customs of one's community to those of other communities in the world (e.g., cultures, religions, family structures, education, recreation); and (C) demonstrate the multicultural diversity of the local community and selected communities of the world through a variety of activities and performance related to art, music, literature, dance, and architecture. (k) Social studies, Grade 4. Essential elements for social studies, Grade 4, as described in this subsection shall be effective September 1996. Social studies, Grade 4, shall include the following essential elements. (1) Social studies skills/processes. The student shall be provided opportunities to: (A) identify the main idea of a social studies selection; (B) formulate and support social studies generalizations; (C) place historical events in proper sequence; (D) classify information; (E) identify cause-and-effect relationships; (F) predict probable future outcomes; (G) construct and interpret visuals (e.g., pictures, charts, graphs, tables, time lines); (H) organize and express ideas in written and oral form (e.g., legends, family and personal history); (I) apply decision-making skills and recognize consequences of decisions; (J) use problem-solving skills; (K) differentiate between factual statements and personal opinions; (L) locate, gather, analyze, and evaluate information from a variety of sources (e.g., current news sources, reference works, media, databases); and (M) differentiate between primary and secondary sources. (2) Citizenship. The student shall be provided opportunities to: (A) identify characteristics of leaders, past and present; (B) use problem-solving skills to develop possible solutions to a local environmental problem; (C) identify some of the rights, duties, and responsibilities of citizens in society, past and present; and (D) analyze issues that represent different points of view and opinions. (3) Economics. The student shall be provided opportunities to: (A) explain why conservation of Texas resources is important; (B) identify types of resources (natural, human, capital) in Texas and selected regions of the Western Hemisphere; (C) identify economic activities in Texas and selected regions of the Western Hemisphere, past and present, with emphasis given to the free enterprise system and its benefits; (D) identify examples of mediums of exchange used in present and past societies (e.g., money); and (E) describe how migration, transportation, and communication have contributed to the interdependence of the regions of Texas and selected regions of the Western Hemisphere. (4) History. The student shall be provided opportunities to: (A) explain basic facts about the founding of Texas as a republic and state; (B) identify significant leaders (e.g., Stephen F. Austin, David G. Burnet, James Fannin, William Goyens, Sam Houston, Anson Jones, Jane Long, Jos'e Antonio Navarro, Francisco Ruiz, William B. Travis, Lorenzo de Zavala) and their contributions to Texas history; (C) trace the historical and cultural development of Texas through the settlement of Indians, Europeans, Anglo Americans, Africans, Hispanics, and Asians; (D) analyze selected Pre-Columbian Indian cultures of the Americas (e.g., Caddo, Inca, Aztec, Pueblo, Eskimo); (E) compare and contrast selected communities in the Western Hemisphere (e.g., San Antonio, New Orleans, Mexico City, Buenos Aires), past and present; (F) compare and contrast African American cultures in the Western Hemisphere (e.g., the Caribbean, Brazil, Texas), past and present; (G) describe the contributions of various individuals and racial, ethnic, and cultural groups (e.g., Asians, Czechs, Germans, Hispanics, Poles) to Texas and the Western Hemisphere; and (H) identify historical landmarks that reflect the heritage of Texas and the Western Hemisphere. (5) Government. The student shall be provided opportunities to: (A) explain why and how societies organize their governments; (B) identify executive, legislative, and judicial roles at local and state levels; (C) distinguish among the concepts of city, county, state, and nation; (D) describe the benefits that could result from cooperation among governments (Texas and other states or nations); and (E) identify major historical documents (e.g., Texas Declaration of Independence, including the signers, Texas Constitution, Treaty of Velasco). (6) Geography. The student shall be provided opportunities to: (A) locate places in Texas and the Western Hemisphere; (B) apply geographic tools (e.g., legends, scale, compass rose, direction) to interpret data presented in various forms (maps, globes, charts, graphs); (C) identify major landforms, water bodies, and river systems in Texas and the Western Hemisphere; (D) use maps and globes to trace settlement patterns in Texas and the Western Hemisphere, past and present; (E) compare and contrast regions of Texas and the Western Hemisphere in terms of physical and cultural characteristics; (F) compare the sites and reasons for settlement of major population centers in Texas and the Western Hemisphere, past and present; (G) analyze ways in which people in Texas and the Western Hemisphere have adapted to and modified their environment; and (H) identify an environmental issue and describe its effects on selected regions. (7) Psychology, sociology, and anthropology. The student shall be provided opportunities to: (A) identify basic institutions common to all cultures (e.g., family, religion, education, government, economy); (B) analyze ways traditions, customs, folkways, and religious beliefs are similar and different in Texas and the Western Hemisphere; (C) describe examples of cultural borrowing among societies; and (D) demonstrate the multicultural diversity of Texas through a variety of activities and performances related to art, music, literature, dance, and architecture. (l) Social studies, Grade 5. Essential elements for social studies, Grade 5, as described in this subsection shall be effective September 1996. Social studies, Grade 5, shall include the following essential elements. (1) Social studies skills/processes. The student shall be provided opportunities to: (A) identify the main idea of a social studies selection; (B) classify information; (C) formulate and support social studies generalizations; (D) place historical events in proper sequence; (E) identify cause-and-effect relationships; (F) predict probable future outcomes; (G) construct and interpret visuals (e.g., pictures, charts, graphs, tables, time lines); (H) organize and express ideas in written and oral form; (I) apply decision-making skills and recognize consequences of decisions; (J) use problem-solving skills; (K) differentiate between factual statements and personal opinions; (L) locate, gather, analyze, and evaluate information from a variety of sources (e.g., current news sources, reference works, media, databases); and (M) differentiate between primary and secondary sources. (2) Citizenship. The student shall be provided opportunities to: (A) identify traits of democratic leadership and demonstrate them by assuming leadership positions; (B) respect rights of people to behave in ways consistent with personal and societal value systems; (C) identify basic civic values of American society such as responsibility, freedom, privacy, diversity, and public and private property rights; (D) recognize that individuals must accept the consequences of their decisions; (E) explain why participation in civic affairs is an important part of the democratic process; (F) use compromise and negotiation to resolve conflicts and differences; and (G) work individually or with others to decide an appropriate course of action. (3) Economics. The student shall be provided opportunities to: (A) trace the transition of work patterns and economic activities in the regions of the United States from past to present; (B) explain the effects of technology and innovation on the development of the nation (e.g. , Industrial Revolution, Agricultural Revolution); (C) trace the development of private property rights and business in the United States; (D) describe how migration, transportation, and communication have contributed to economic interdependence within the United States; (E) provide examples of buyers' and sellers' reactions to prices (laws of supply and demand); and (F) explain why the conservation of economic resources and protection of the environment are important in the United States. (4) History. The student shall be provided opportunities to: (A) describe the various Indian cultures that existed on the North American continent before the arrival of the Europeans; (B) analyze why Europeans and Africans came to the Americas; (C) identify major examples of revolution and change in the development of the United States (e.g. , the American Revolution, the Westward Movement, the Civil War); (D) trace the development of major ideas (e.g., democracy, private enterprise, education) in the history of the United States; and (E) identify significant Americans of various racial, ethnic, and cultural groups who contributed to change in the United States (e.g., explorers, statesmen, reformers, inventors, military leaders, entertainers, sports figures, literary figures). (5) Government. The student shall be provided opportunities to: (A) explain basic rights and responsibilities of United States citizens; (B) describe the basic structures and function of the United States government; (C) identify major United States political documents (e.g., the Declaration of Independence and United States Constitution, including the Bill of Rights) and explain their purposes, significance, beliefs, and values; (D) explain the function of political parties in the democratic process; (E) explain the importance of representative government and majority rule/minority rights to the democratic process; and (F) predict the benefits that could result from cooperation among individuals and governments in the United States to solve selected problems. (6) Geography. The student shall be provided opportunities to: (A) describe and compare the location of places to other places within the United States and between the United States and the world; (B) analyze exploration, migration, and settlement patterns in the development of the United States; (C) apply geographic tools to interpret data presented in various forms (maps, globes, charts, graphics); (D) compare and contrast regions of the United States in terms of physical and cultural characteristics and describe their connections; (E) explain how people have adapted to and modified their environment; and (F) identify environmental issues and discuss their effects on the United States. (7) Psychology, sociology, and anthropology. The student shall be provided opportunities to: (A) analyze the development of the basic cultural institutions (e.g., family, religion, education, government, economy) that have shaped our national identity; (B) describe how traditions, customs, folkways, and religious beliefs differed among groups and influenced the development of our nation; (C) identify examples of cultural borrowing that shaped the development of the emerging nation; (D) demonstrate the multicultural diversity of the United States through a variety of activities or performances related to art, music, literature, dance, and architecture; and (E) use major social issues, past and present, to analyze cooperation and conflict (e.g., voting rights, religious issues, slavery, status of women, displacement of American Indians). (m) Social studies, Grade 6. Essential elements for social studies, Grade 6, as described in this subsection shall be effective September 1996. Social studies, Grade 6, shall include the following essential elements. (1) Social studies skills/processes. The student shall be provided opportunities to: (A) identify the main idea of a social studies selection; (B) formulate and support social studies generalizations; (C) place historical events in proper sequence; (D) classify information; (E) identify cause-and-effect relationships; (F) predict probable future outcomes; (G) construct and interpret visuals (e.g., pictures, charts, graphs, tables, time lines); (H) organize and express ideas in oral and written form; (I) apply decision-making skills and recognize consequences of decisions; (J) use problem-solving skills; (K) differentiate between factual statements and personal opinions; (L) locate, gather, analyze, and evaluate information from a variety of sources (e.g., current news sources, reference works, media, databases, and interviews); and (M) differentiate between primary and secondary sources. (2) Citizenship. The student shall be provided opportunities to: (A) identify and analyze cultural values and their impact on individual beliefs, attitudes, and actions in selected world cultures; (B) recognize that value systems differ from one culture to another; (C) respect the right of other individuals, groups, and cultures to have differing opinions and beliefs; (D) explain the value of compromise as a method of resolving conflict within the context of world affairs; and (E) analyze ways modern societies have cooperated to solve ecological, economic, and humanitarian problems. (3) Economics. The student shall be provided opportunities to: (A) analyze the economic impact of physical environment, industrialization, and technology on selected world economies; (B) compare and contrast traditional, command, and market economies in selected world cultures; (C) define gross domestic product (GDP) and explain its use; and (D) describe the effects of international trade and interdependence on selected economies. (4) History. The student shall be provided opportunities to: (A) analyze why cities developed in ancient Egypt, China, and India; (B) analyze ways in which the Greeks and the Maya forged great civilizations during their respective classical eras; (C) identify the contributions of Rome to Western culture (e.g., law, architecture, language); (D) trace trade and cultural exchanges between Europe and Asia and between Africa and Asia in the medieval world; (E) trace the spread of great ideas from one society to another (e.g., democracy, religion, human rights, government by law); and (F) describe the characteristics of selected men and women from various ethnic, racial, and cultural groups who have contributed to selected world cultures. (5) Government. The student shall be provided opportunities to: (A) describe and compare forms of government in selected world cultures; (B) examine contributions of religion to the political thought, institutions, and legal systems of selected cultures; (C) compare and contrast the concepts of majority rule and minority rights in the context of selected world cultures; and (D) examine ways that selected world cultures have or have not accepted responsibility for the consequences of their political decisions and actions. (6) Geography. The student shall be provided opportunities to: (A) locate places in the world including major physical features; (B) develop criteria for determining physical and cultural regions of the world; (C) identify major cultural regions of the world; (D) compare and contrast regions of the world in terms of physical and cultural characteristics; (E) apply geographic tools to interpret data presented in various forms (maps, globes, charts, graphs); (F) describe the interactions between cultural groups and their physical environments, past and present (e.g., desert civilizations of North Africa and Southwest Asia); (G) identify geographic influences on the growth of urban centers and the patterns of human movement; (H) describe how humans adapt to and change the environment over time; and (I) develop possible solutions to world environmental problems (e.g., desertification, deforestation, acid rain, pollution, depletion of resources). (7) Anthropology, psychology, and sociology. The student shall be provided opportunities to: (A) compare and contrast basic institutions common to all cultures (family, religion, government, education, and economy); (B) identify examples of cultural borrowing that brought about changes in basic institutions; (C) describe how traditions, customs, and folkways differ among cultures; and (D) demonstrate the multicultural diversity of the world through a variety of activities or performances related to art, music, literature, dance, and architecture. 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 July 15, 1992. TRD-9209825 Criss Cloudt Coordinator, Policy Planning and Evaluation Texas Education Agency Effective date: August 6, 1992 Proposal publication date: May 19, 1992 For further information, please call: (512) 463-9701 Subchapter C. Essential Elements-Grade 7-8 19 TAC sec.75.47 The amendment is proposed under the Texas Education Code, sec.21.101(c), which authorizes the State Board of Education to promulgate rules designating the essential elements of each subject and course in the state curriculum. 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 July 15, 1992. TRD-9209823 Criss Cloudt Coordinator, Policy Planning and Evaluation Texas Education Agency Effective date: August 6, 1992 Proposal publication date: May 19, 1992 For further information, please call: (512) 463-9701 Subchapter D. Essential Elements-Grades 9-12 19 TAC sec.sec.75.62-75.64, 75.66-75.67 The amendments are adopted under the Texas Education Code, sec.21.101(c), which authorizes the State Board of Education to promulgate rules designating the essential elements of each subject and course in the state curriculum. sec.75.67. Fine Arts. (a)-(d) (No change.) (e) Theatre arts I (1/2-1 unit). Essential elements described in this subsection for theatre arts I shall be superseded by the essential elements described in subsection (w) of this section effective September 1996. Theatre arts I shall include the following essential elements. (1)-(4) (No change.) (f) Theatre arts II, III, IV (scope and sequence to be determined locally) (1/2-1 unit). Essential elements described in this subsection for theatre arts II, III, IV shall be superseded by the essential elements described in subsection (x) of this section effective September 1996. Theatre arts II, III, IV shall include the following essential elements. (1)-(3) (No change.) (g) Technical theatre I, II (scope and sequence to be determined locally) (1/2-1 unit). Essential elements described in this subsection for technical theatre I, II shall be superseded by the essential elements described in subsection (y) of this section effective September 1996. Technical theatre I, II shall include the following essential elements. (1)-(2) (No change.) (h) Theatre production I, II, III, IV (1/2-1 unit). Essential elements described in this subsection for theatre production I, II, III, IV shall be superseded by the essential elements described in subsection (aa) of this section effective September 1993. Theatre production I, II, III, IV shall include the following essential elements. (1)-(3) (No change.) (i)-(j) (No change.) (k) Choral music I, II, III, IV (1/2-1 unit). Essential elements described in this subsection for choral music I, II, III, IV shall be superseded by the essential elements described in subsection (bb) of this section effective September 1996. Choral music I, II, III, IV shall include the following essential elements. (1)-(7) (No change.) (l)-(r) (No change.) (s) Dance I (1/2-1 unit). Essential elements described in this subsection for dance I shall be superseded by the essential elements described in subsection (cc) of this section effective September 1993. Dance I shall include the following essential elements. (1)-(5) (No change.) (t) Dance II (1/2-1 unit). Essential elements described in this subsection for dance II shall be superseded by the essential elements described in subsection (dd) of this section effective September 1993. Dance II shall include the following essential elements. (1)-(5) (No change. ) (u) Dance III (1/2-1 unit). Essential elements described in this subsection for dance III shall be superseded by the essential elements described in subsection (ee) of this section effective September 1993. Dance III shall include the following essential elements. (1)-(5) (No change.) (v) Dance IV (1/2-1 unit). Essential elements described in this subsection for dance IV shall be superseded by the essential elements described in subsection (ff) of this section effective September 1993. Dance IV shall include the following essential elements. (1)-(5) (No change. ) (w) Theatre arts I (1/2-1 unit). Essential elements for theatre arts I as described in this section shall be effective September 1996. Theatre arts I shall include the following essential elements. (1) Expressive use of the body and voice. The student shall be provided opportunities to: (A) develop relaxation and warm-up techniques; (B) use pantomime; (C) practice stage movement; and (D) develop voice and diction. (2) Acting concepts and skills. The student shall be provided opportunities to: (A) understand dramatic structure and genres; (B) use improvisation, relating it to acting; (C) analyze and interpret scripts; and (D) analyze and interpret characters. (3) Theatre production concepts and skills. The student shall be provided opportunities to: (A) recognize the interdependence of all theatrical elements; (B) explore technical theatre; and (C) practice theatre safety. (4) Aesthetic growth through appreciation of theatrical events. The student shall be provided opportunities to: (A) recognize theatre as a reflection of the human experience; (B) learn basic theatre history; (C) develop an appreciation of theatre; (D) practice audience etiquette; (E) attend live theatrical events; and (F) analyze and evaluate theatrical experiences. (x) Theatre arts II, III, IV (scope and sequence to be determined by school district) (1/2-1 unit). Essential elements for theatre arts II, III, IV as described in this subsection shall be effective September 1996. Theatre arts II, III, IV shall include the following essential elements. (1) Acting, directing, and playwriting concepts and skills. The student shall be provided opportunities to: (A) use advanced characterization; (B) develop directing techniques; (C) develop playwriting techniques; (D) relate technical theatre elements to acting, directing, and playwriting; and (E) recognize career opportunities. (2) Theatre production concepts and skills. The student shall be provided opportunities to: (A) explore classical production styles; (B) explore contemporary production styles; (C) explore a selection from the following specialized theatrical modes: dance drama, film and television, improvisational theatre, masked theatre, mime, musical theatre, puppetry, theatre for children; and (D) practice theatre safety. (3) Theatre heritage concepts. The student shall be provided opportunities to: (A) know significant dramatic literature and theatrical works from a variety of historical periods and cultures; and (B) understand theatre as a reflection of the human experience. (4) Aesthetic growth through appreciation of theatrical events. The student shall be provided opportunities to: (A) attend live theatrical events; (B) understand how the elements of theatre are integrated to enhance audience perception and aesthetic response; (C) understand the conventions of live theatre, film, and television; (D) use appropriate audience etiquette; and (E) analyze and evaluate theatrical experiences. (y) Technical theatre I, II (scope and sequence to be determined by school district) (1/2-1 unit). Essential elements for technical theatre I, II as described in this subsection shall be effective September 1996. Technical theatre I, II shall include the following essential elements. (1) Technical theatre concepts and skills. The student shall be provided opportunities to: (A) explore scenery; (B) explore properties; (C) explore lighting; (D) explore sound; (E) explore costumes; (F) explore makeup; (G) explore public relations; (H) develop stagecraft skills; (I) develop skills in stage and house management and in technical direction; (J) practice theatre safety; (K) maintain theatre and work areas for safety and efficiency; (L) analyze and interpret scripts for technical theatre applications; (M) learn basic theatre history, emphasizing the development of theatre architecture and aspects of technical theatre; (N) learn basic design techniques for elements of production; and (O) recognize career opportunities. (2) Aesthetic growth through appreciation of theatrical events. The student shall be provided opportunities to: (A) recognize the interdependence of all theatrical elements; (B) recognize theatre as a reflection of the human experience; (C) develop an appreciation of theatre; (D) practice audience etiquette; (E) attend live theatrical events; and (F) analyze and evaluate theatrical experiences. (z) Technical theatre III, IV (scope and sequence to be determined by school district) (1/2-1 unit). Essential elements for technical theatre III, IV as described in this subsection shall be effective September 1993. Technical theatre III, IV shall include the following essential elements. (1) Technical theatre concepts and skills. The student shall be provided opportunities to: (A) select and specialize in one or more of the following areas: (i) scenery; (ii) properties; (iii) lighting; (iv) sound; (v) costumes; (vi) makeup; and (vii) public relations; (B) use script analysis, research, and design techniques for the selected area(s) of specialization; (C) construct and/or render designs in selected area(s) of specialization; (D) practice stagecraft skills; (E) practice skills in technical direction, stage, or house management; (F) practice theatre safety; (G) maintain theatre and work areas for safety and efficiency; and (H) recognize career opportunities. (2) Theatre production concepts and skills. The student shall be provided opportunities to: (A) explore classical production styles; (B) explore contemporary production styles; and (C) explore other production styles from a variety of historical periods and cultures. (3) Aesthetic growth through appreciation of theatrical events. The student shall be provided opportunities to: (A) understand how the elements of theatre are integrated to enhance audience perception and aesthetic response; (B) understand theatre as a reflection of the human experience; (C) develop an appreciation of theatre; (D) practice audience etiquette; (E) attend live theatrical events; and (F) analyze and evaluate theatrical experiences. (aa) Theatre production I, II, III, IV (1/2-1 unit). Essential elements for theatre production I, II, III, IV as described in this subsection shall be effective September 1993. For a specific production, students will be given either acting or technical assignments. Consequently, students will be required to meet only one of the first two essential elements (either acting concepts and skills or technical theatre concepts and skills). All students will be expected to meet paragraphs (3) and (4) of this subsection (theatre production concepts and skills and aesthetic growth through appreciation of theatrical events). Theatre production I, II, III, IV shall include the following essential elements. (1) Acting concepts and skills. The student shall be provided opportunities to: (A) audition; (B) use relaxation and warm-up techniques; (C) use characterization skills; (D) rehearse; and (E) perform in public. (2) Technical theatre concepts and skills. The student shall be provided opportunities to: (A) research and design elements of production; (B) work on technical crews: stage management, scenery, properties, lighting, sound, costumes, makeup, and public relations (publicity, business, house management); (C) rehearse when appropriate; and (D) perform in public when appropriate. (3) Theatre production concepts and skills. The student shall be provided opportunities to: (A) maintain theatre areas for safety and efficiency; (B) practice theatre safety; (C) develop the self-discipline and concentration required of the theatre artist; (D) collaborate responsibly in the creation/performance of theatre; (E) participate in strike activities; and (F) recognize career opportunities. (4) Aesthetic growth through appreciation of theatrical events. The students shall be provided opportunities to: (A) understand how the elements of theatre are integrated to enhance audience perception and aesthetic response; (B) recognize theatre as a reflection of the human experience and as an instrument for illuminating problems of society; (C) attend live theatrical events; (D) practice audience etiquette; and (E) analyze and evaluate theatrical experiences. (bb) Choral music I, II, III, IV (1/2-1 unit). Essential elements for choral music I, II, III, IV as described in this subsection shall be effective September 1996. Choral music I, II, III, IV shall include the following essential elements. (1) Development of the singing voice. The student shall be provided opportunities to: (A) understand the vocal mechanism, including: (i) parts and functions; and (ii) the changing voice; (B) develop and use correct singing posture, including positions for rib cage, mid-section, shoulders, jaw, and stance; (C) develop and use correct breathing skills, demonstrating relaxed jaw, open throat, tongue placement, diaphragm movement, and rib cage movement; (D) develop vocal tone, demonstrating proper breath support, vowel pronunciation and placement/focus, tongue placement, and head/chest voice; (E) develop proper diction through correct use of vowel shapes, syllabic stress, consonants, and diphthongs; (F) develop intonation awareness through: (i) hearing and matching pitches; and (ii) recognizing and manipulating pitch movement; and (G) exercise responsible use and care of the voice. (2) Choral ensemble techniques. The student shall be provided opportunities to: (A) listen critically to self as an individual and as a participating member of an ensemble; (B) sing in tune through tone/vowel placement and careful listening; (C) blend with other ensemble voices utilizing tone quality, diction, and intonation; (D) respond to conducting; and (E) develop performance techniques including: (i) pitch and rhythm accuracy; (ii) style characteristics (historical period, dynamics, composer intent); (iii) phrasing (shape, movement); (iv) textual clarity (word accent, syllabic stress); and (v) expression (sensitivity, mood, physical indication of feeling). (3) Theory. The student shall be provided opportunities to: (A) learn and use conventional and unconventional music notation, including, but not limited to: (i) the grand staff; (ii) key and time signatures; (iii) pitch and rhythm notation; and (iv) dynamic marking symbols; (B) learn and use musical terminology; (C) develop ear training skills through the study and use of: (i) scale systems; (ii) key relationships; (iii) chord progressions and other harmonic structures; and (iv) meters; and (D) recognize musical forms. (4) Sight singing. The student shall be provided opportunities to develop sight singing and music reading skills through daily work in a sequential curriculum to sing and recognize intervals; read and sing melodic patterns and harmonic structures in a variety of keys and tonalities; and read, write, and perform rhythm patterns. (5) Literature and styles. The student shall be provided opportunities to: (A) hear, identify, describe, and perform music from a variety of musical styles, eras, and composers; and (B) recognize similarities and differences between choral styles of the major historical periods. (6) Performance activities. The student shall be provided opportunities to: (A) perform individually, in small ensembles, and in large groups; and (B) articulate and practice proper concert etiquette as both a listener and performer. (7) Critical evaluation. The student shall be provided opportunities to: (A) monitor progress toward musical goals; (B) evaluate self as both a solo and ensemble performer; and (C) evaluate his own and others' solo and group rehearsals and/or performances. (8) Citizenship through group endeavor. The student shall be provided opportunities to: (A) work effectively with others as a responsible team member; and (B) develop leadership abilities. (9) Music career awareness. The student shall be provided opportunities to explore careers in the field of music, including, but not limited to, teacher, performer, composer, technician, producer, and manager. (cc) Dance I (1/2-1 unit). Essential elements for dance I as described in this subsection shall be effective September 1993. Dance I shall include the following essential elements. (1) Dance vocabulary: introduction to the principles, concepts, skills, and techniques of dance as a fine arts form. The student shall be provided opportunities to: (A) demonstrate general dance principles involving rhythmic terminology and aesthetic concepts; (B) learn and perform beginning movements and short phrases associated with dance form in one or more of the following: (i) modern dance; (ii) classical ballet; (iii) folk and ethnic dance; (iv) jazz dance; and/or (v) tap dance; (C) learn basic dance concepts relating to anatomy, movement, and conditioning; (D) develop a basic awareness of the movement factors that influence the shaping of dance phrases such as: (i) motion, space, and energy; (ii) kinesthesis; (iii) tempo and rhythm; (iv) breath control; and (v) focus and concentration; (E) identify and perform movement phrases that vary quality and dynamics, using such elements as time, space, flow, energy, rhythm, and weight; (F) develop respect for self and others as dancers; and (G) develop self-discipline and decision-making and assessment skills in dance. (2) Dimensions of creativity: introduction to processes of perception and exploration. The student shall be provided opportunities to: (A) develop concepts of expressive movement; (B) apply principles of basic design and movement qualities to improvisation; (C) investigate the connection between the body and emotions, ideas, values, and moods; (D) explore processes of movement; and (E) explore dance as a creative problem-solving activity. (3) Choreography: introduction to composition as a process of creating dances. The student shall be provided opportunities to: (A) identify and explore basic choreographic forms; (B) experience the expressive aspects of basic locomotor and axial movements; (C) alter movement and the overall design of learned phrases; (D) create motifs through dance improvisation; (E) explore the environment through the use of props; (F) develop perceptual abilities; and (G) demonstrate personal and group movement through dance. (4) Dance in diverse cultures and contemporary society: introduction to cultural and historical dimensions. The student shall be provided opportunities to: (A) explore dance in its principal forms: classical ballet, modern dance, jazz dance, tap dance, and/or folk and ethnic dance; (B) learn dances and related customs of various cultures; (C) recognize dance as an aesthetic and kinetic medium of communication and expression throughout history; (D) improvise movement phrases in the style of a particular people or historical period; and (E) appreciate movement forms derived from personal experiences and diverse cultures. (5) Artistic judgment: introduction to description and analysis of dance works and aesthetic experiences. The student shall be provided opportunities to: (A) analyze artistic characteristics of a learned phrase; (B) view and analyze recorded and/or live dance performances; and (C) develop an appreciation of dance as cultural expression. (dd) Dance II (1/2-1 unit). Essential elements for dance II as described in this subsection shall be effective September 1993. Dance II shall include the following essential elements. (1) Dance vocabulary: exploration of the principles, concepts, skills, and techniques of dance as a fine arts form. The student shall be provided opportunities to: (A) evaluate personal performance of basic dance patterns and phrases; (B) demonstrate and perform increasingly complex dance movements and phrases in one or more of the following: (i) modern dance (emphasize); (ii) classical ballet (emphasize); (iii) folk and ethnic dance; (iv) jazz dance; and/or (v) tap dance; (C) understand factors affecting personal alignment and design a plan for personal conditioning in dance; (D) know primary kinesiological and biomechanical principles relative to dance in order to develop a sound body and prevent injury; (E) develop perceptual skills associated with dance such as rhythmic awareness, movement memory, and ideokinetic imagery; (F) demonstrate sequence and phrasing skills; and (G) perform movement emphasizing qualities of expression, dynamics, and internal and external focus. (2) Dimensions of creativity: exploration of processes of perception and exploration. The student shall be provided opportunities to: (A) represent one's personal world through movement; (B) use dance to shape expressions of life experiences and imagination through improvisation; (C) develop concepts of dance associated with human and natural images and characterization; (D) relate communication and self-expression in dance to other subjects; and (E) create expressive dance phrases. (3) Choreography: exploration of composition as a process of creating dances. The student shall be provided opportunities to: (A) practice choreographic forms such as ABA, rondo, theme and variations, call and response, and unison; (B) explore the symbolic role of natural versus abstract gesture in communicating a dance idea; (C) analyze transitions in basic movement and spatial designs; (D) use various choreographic tools such as lines of energy, focus, weight, mass, floor pattern, vocalization, and scripted narratives; (E) explore thoughts, kinesthetic and kinetic sensitivity, and emotional experiences; and (F) alter complementary, sequential, and/or contrasting designs and analyze the result. (4) Dance in diverse cultures and contemporary society: exploration of cultural and historical dimensions. The student shall be provided opportunities to: (A) compare different cultural traditions and related belief systems that affect dance expression of a people; (B) create a simple dance in the style of a specific cultural group and/or historical period; (C) appreciate the choreography and media images of historical dance; and (D) explore movement forms derived from personal cultural experiences. (5) Artistic judgment: exploration of description and analysis of dance works and aesthetic experiences. The student shall be provided opportunities to: (A) analyze images and choreographic structures of various dances; (B) classify dance movements by their aesthetic characteristics; (C) view and analyze live and/or recorded dance performances of diverse cultures; and (D) analyze form and meaning in dance. (ee) Dance III (1/2-1 unit). Essential elements for dance III as described in this subsection shall be effective September 1993. Dance III shall include the following essential elements. (1) Dance vocabulary: development of movement principles, skills, and techniques of dance as a fine arts form. The student shall be provided opportunities to: (A) engage in and express stylistic variations among dance forms; (B) analyze and perform complex dance movements and phrases in one or more of the following: (i) modern dance (emphasize); (ii) classical ballet (emphasize); (iii) folk and ethnic dance; (iv) jazz dance; and/or (v) tap dance; (C) demonstrate the ability to vary qualities and dynamics that affect technique and style; (D) apply physical and kinesiological principles to learning new dance movements; (E) demonstrate perceptual awareness and musicality; (F) describe aesthetic elements and indicators of style; (G) demonstrate aesthetic line and design in dance; and (H) participate in the process of developing and assessing artistic growth. (2) Dimensions of creativity: development of processes of perception and exploration. The student shall be provided opportunities to: (A) integrate life experiences and the imagination through improvisation; (B) apply imagery concepts to group and individual projects associated with artistic forms and characterization; and (C) use other subjects to increase understanding of self-expression and communication through complex movement problems. (3) Choreography: development of the elements of composition as a process for creating dances. The student shall be provided opportunities to: (A) explore ideas, kinesthetic and kinetic expression, and emotional qualities in dance; (B) relate current issues, nature, and other subjects to movement images and ideas; (C) analyze chance and serial compositional experiences by using devices such as natural images, breath action, dance vocabulary, poetry and musical structures, and pedestrian gestures; (D) relate technical theatre elements to choreography and to the support of dance production; (E) create long phrases or dances; (F) recognize movement image and meaning that result from the creation and alteration of complex movement designs; (G) use democratic decision-making procedures to develop performances; and (H) explore career opportunities. (4) Dance in diverse cultures and contemporary society: development of an understanding of cultural and historical dimensions. The student shall be provided opportunities to: (A) research a dance work, choreographer, choreographic style, dancer, or culture; (B) learn and appreciate dances from one's own and other cultures; (C) understand the cultural and aesthetic characteristics of dance in history; and (D) reconstruct a historical style of dance. (5) Artistic judgment: development of an appreciation of dance. The student shall be provided opportunities to: (A) outline the choreographic structure in selected dance works of excellence; and (B) view and analyze dance performances using standards for critiquing. (ff) Dance IV (1/2-1 unit). Essential elements for dance IV as described in this subsection shall be effective September 1993. Dance IV shall include the following essential elements. (1) Dance vocabulary: refinement of the principles, concepts, skills, and techniques of dance as a fine arts form. The student shall be provided opportunities to: (A) apply aesthetic elements, techniques, and styles by using appropriate dance and related vocabulary; (B) perform intermediate dance movements and phrases with an awareness of the design and biomechanical factors that influence movement and style in one or more of the following: (i) modern dance (emphasize); (ii) classical ballet (emphasize); (iii) ethnic/folk dance; (iv) jazz dance; and/or (v) tap dance; (C) perform dance technique phrases, emphasizing expression, musicality, line and design, and aesthetic images; and (D) participate in the process of developing and assessing artistic growth. (2) Dimensions of creativity: refinement of artistic processes relating to dance. The student shall be provided opportunities to: (A) identify basic theories and principles that relate to improvisation and choreography; (B) create and perform structured improvisations and movement studies in various performance settings; (C) integrate aesthetic elements derived from other subject areas; (D) collaborate in creating improvisation and sustaining long time periods of movement exploration; and (E) explore world beliefs and values through improvisation. (3) Choreography: refinement of composition as a process of creating and performing dances. The student shall be provided opportunities to: (A) coordinate the use of advanced compositional structures such as inversion, task activities, retrograde, jump cutting; (B) relate technical theatre elements to choreography and to the support of dance production; (C) design costumes for dance; (D) explore surrealistic dance ideas and innovative choreography; (E) appreciate and evaluate artistic choices made by oneself and others; (F) create, produce, and perform formal dances and/or improvisational works for two or more dancers; (G) explore alternative performance sites; and (H) explore career opportunities. (4) Dance in diverse cultures and contemporary society: refinement of an understanding of cultural and historical dimensions. The student shall be provided opportunities to: (A) research the role of culture in contemporary dance; (B) understand historical or ethnic dance forms; (C) relate sociopolitical events and developments to changes found in dance; (D) explore movement styles of a specific dancer or historical period as the basis for a choreographic project; (E) perform movement phrases derived from personal cultural experiences; and (F) analyze the aesthetic characteristics of dance in a particular period. (5) Artistic judgment: refinement of analysis of dance works and aesthetic experiences. The student shall be provided opportunities to: (A) serve as rehearsal director or dance assistant; (B) view and critique a dance performance using personal aesthetic standards; (C) review a cultural dance event (e.g., a folk festival); and (D) apply one's knowledge of dance and dance aesthetics to other performances and exhibitions. 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 July 15, 1992. TRD-9209824 Criss Cloudt Coordinator, Policy Planning and Evaluation Texas Education Agency Effective date: August 6, 1992 Proposal publication date: May 19, 1992 For further information, please call: (512) 463-9701 TITLE 22. EXAMINING BOARDS Part XXII. Texas State Board of Public Accountancy Chapter 501. Professional Conduct Other Responsibilities and Practices 22 TAC sec.501.40 The Texas State Board of Public Accountancy adopts an amendment to sec.501. 40, concerning licensing/registration requirements, without changes to the proposed text as published in the May 15, 1992, issue of the Texas Register (17 TexReg 3540). The amendment is necessary to order to clarify the board's position that some CPAs may identify themselves as CPAs when performing accounting functions through unregistered entities. The amendment will permit CPAs to hold out when the non-registered entities are federal, state, or local governments, or when the entities do not offer accounting services to the public. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 41a-1, sec.6(a), which provide the Texas State Board of Public Accountancy with the authority to promulgate rules relating to licensing and registration requirements. 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 July 17, 1992. TRD-9209731 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 5, 1992 Proposal publication date: May 15, 1992 For further information, please call: (512) 450-7066 Chapter 505. The Board 22 TAC sec.505.8 The Texas State Board of Public Accountancy adopts an amendment to sec.505. 08, concerning board meetings, without changes to the proposed text as published in the May 15, 1992, issue of the Texas Register (17 TexReg 3540). The amendment is necessary in order to ensure that the newly appointed members will have the opportunity to participate in the meeting. The amendment will change the date scheduled for annual board meetings. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Civil Statutes, Article 41a-1, sec.6(a), which provide the Texas State Board of Public Accountancy with the authority to promulgate rules relating to board meetings. 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 July 17, 1992. TRD-9209732 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 5, 1992 Proposal publication date: May 15, 1992 For further information, please call: (512) 450-7066 Chapter 519. Practice and Procedure 22 TAC sec.sec.519.3, 519.6, 519.9, 519.11, 519.17, 519.19, 519. 20, 519.21, 519.23, 519.26, 519.27, 519.29 The Texas State Board of Public Accountancy adopts amendments to sec.sec.519. 3, 519.6, 519.9, 519.11, 519.17, 519.19, 519.20, 519.21, 519.23, 519.26, 519. 27, and 519.29, concerning rules of practice and procedure, without changes to the proposed text as published in the May 15, 1992, issue of the Texas Register (17 TexReg 3519). The rules are necessary in order to clarify the agency's procedures for contested hearings. The amendments will set forth the agency's procedures for contested hearings. No comments were received regarding adoption of the amendments. The amendments are adopted under Texas Civil Statutes, Article 41a-1, sec.6(a), which provide the Texas State Board of Public Accountancy with the authority to promulgate rules to effectuate 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 July 17, 1992. TRD-9209734 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 5, 1992 Proposal publication date: May 15, 1992 For further information, please call: (512) 450-7066 22 TAC sec.sec.519.10, 519.13, 519.15, 519.16, 519.30, 519. 31 The Texas State Board of Public Accountancy adopts the repeal sec.sec.519.10, 519.13, 519.15, 519.16, 519.30, and 519.31, concerning rules of practice and procedure, without changes to the proposed text as published in the May 15, 1992, issue of the Texas Register (17 TexReg 3522). The repeals are necessary in order to ensure the internal consistency of the board's procedures. The repeal of the rules will allow the agency to effectively conduct hearings while ensuring that procedural due process is afforded to all participants. No comments were received regarding adoption of the repeals. The repeals are adopted under Texas Civil Statutes, Article 41a-1, sec.6(a), which provide the Texas State Board of Public Accountancy with the authority to promulgate rules to effectuate 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 July 17, 1992. TRD-9209733 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 5, 1992 Proposal publication date: May 15, 1992 For further information, please call: (512) 450-7066 TITLE 28. INSURANCE Part I. Texas Department of Insurance Chapter 19. Agents' Licensing Subchapter R. Utilization Review Agents 28 TAC sec.sec.19.1701-19.1719 The State Board of Insurance of the Texas Department of Insurance adopts new sec.sec.19.1701-19.1719. Sections 19.1702, 19.1703, 19.1704, 19.1706, 19.1708, and 19.1716-19.1719 are adopted with changes to the proposed text as published in the May 8, 1992, issue of the Texas Register (17 TexReg 3337). Sections 19.1701, 19.1705, 19.1707, and 19.1709-19.1715 are adopted without changes and will not be republished. The new sections are necessary to provide procedures for regulating the activities of utilization review agents, and to implement the provisions of the Insurance Code, Article 21.58A. New sec.19.1701 contains general provisions and describes the purpose of the rules. Section 19.1702 describes the limitations on applicability of the Act and sec.19.1703 contains definitions of certain terms used in the regulations. Section 19.1704 describes the process for obtaining certification as a utilization review agent. Section 19.1705 describes the general standards for utilization review and sec.19.1706 describes the standards for personnel who conduct utilization reviews and their compensation. Section 19.1707 prohibits certain activities of utilization review agents. Section 19.1708 describes the manner in which utilization review agents may have contact with health care providers and the way in which utilization review agents receive information from those providers. Section 19.1709 describes certain procedures to be followed by utilization review agents when conducting on site utilization reviews. Section 19.1710 describes the manner in which utilization review agents must give notice of determinations. Section 19.1711 sets out the requirements for affording health care providers a reasonable opportunity to discuss the services with appropriate professionals prior to the issuance of an adverse determination, and sec.19.1712 sets out the requirements for appeal procedures of adverse determinations which are to be provided by the utilization review agent. Section 19.1713 describes the manner in which the utilization review agent must assure telephone access to the agent. Section 19. 1714 describes the requirements for the utilization review agent to preserve the confidentiality of individual medical records. Section 19.1715 describes the requirements for retrospective review of medical necessity. Section 19. 1716 sets out the requirements for a utilization review agent complaint system, describes the Texas Department of Insurance complaint process for complaints alleging a violation of the Act governing utilization review agents, the Insurance Code, Article 21.58A, or these rules, describes the authority of the Texas Department of Insurance to make inquiries of utilization review agents, and provides for on site review by the Texas Department of Insurance. Section 19.1717 describes the sanctions for administrative violations and the procedures for initiating proceedings and appeals related to allegations of those violations. Section 19.1718 describes the criminal penalties for performing utilization review without a certificate of registration. Section 19.1719 sets forth the responsibilities of HMOs and insurers performing utilization review under the Insurance Code, Article 21.58A, sec.14(g) and (h). This summary of comments and the responses to them are organized according to the sections of the rules to which they correspond. Where the subject matter of the comments referred to more than one rule, the comments are grouped together for clarity. Comments related to sec.19.1702(c)(1)(E) -Limitations on applicability. Two comments were made concerning the limitation on ERISA plans. They commented that ERISA supersedes any state laws and the definition contained in the proposed rules should be broadened to include language that the limitation applies to matters "related to" the plan. The board believes that the most appropriate way to describe the ERISA limitation is to substitute the statutory language in the Insurance Code, Article 21.58A, for the language in the proposed rule. This change has been made in the rule as finally adopted. Comments related to sec.19.1702(c)(3)(C) -Limitations on applicability. A commenter expressed concern that utilization review agents who review only worker's compensation are except from the Insurance Code, Article 21.58A, and the Texas Workers' Compensation Act, Texas Civil Statutes, Article 8308-1.01- 8308-11.10. The board is unable to change this situation as the exemption is statutory. Comments related to sec.19.1703-Definitions. One commenter stated that there is no provision for organizations that perform utilization review in the sub-specialties of psychiatric and substance abuse and wanted to have the definition of physician changed to include those specialities. The board is unable to make this change because the definition of physician is statutory. Comments related to sec.19. 1704(f)-Certification of utilization review agents. One commenter recommended adding a requirement for the submission of screening criteria with each renewal; however, another commenter noted that requiring the submission of screening material might require the submission of proprietary information which the statute had sought to eliminate. The board recognizes the need for the protection of the information which is proprietary and confidential under the statute, but also recognizes the need to have current screening criteria information at the time of the renewal. The rule as finally adopted will require the submission of a summary of the screening criteria which should fulfil the regulatory needs of the agency and still preserve the statutory confidentiality. The board points out that the complete screening criteria can be requested by the commissioner when needed to carry out the commissioner's duties, under the provisions of Insurance Code, Article 21.58A, sec.4(i). Comments related to sec.19.1704(c)(1)(B), sec.19.1705, and sec.19.1715(a)(2) - Certification of utilization review agents, general standards of utilization review, and retrospective review of medical necessity. Commenters recommended changing all references to "physician" to "health care provider of the same license type" throughout the utilization review agent rules. The commenters stated that reference to physician is too narrow to include all specialty areas of review. The plans and reviews should be approved by each and every independently licensed health care provider whose services may come under review. The board disagrees with this comment. The rule as proposed contains references to input from health care providers. Comments related to sec.19.1705(1) -General standards of utilization review. One commenter stated that there is no specific reference to pre-certification and felt that pre- certification was crucial to utilization review. The board believes that pre- certification is included within the term "prospective review" which is used in the proposed rule. Comments related to sec.19.1706-Personnel. One commenter recommends changing the language "all utilization review shall be under the direction of a physician" to "under the direction of a professional who is trained and licensed in the area being reviewed." The board is unable to accede to this comment as the language in the rule is a reference to a statutory provision in the Insurance Code, Article 21.58A, sec.4(h). Comments related to sec.19.708(c)-Utilization review agent contact with and receipt of information from health care providers. Comments were made to urge the addition of the Utilization Review Accreditation Commission language containing a list of items which the utilization review agent may ask the hospitals and health care providers. Other comments were made urging that such a list not be adopted. One commenter suggested that the task force might have gone too far in recommending language which went beyond the statute, but urged that alternative language be added to the task force language if it was to remain. The board believes that some additional language to clarify the statutory requirement is necessary and adopts the language suggested by the commenters. This language appeared to be acceptable to most of the commenters and appears to give some guidance to utilization review agents and health care providers. The board believes that the language in this section relating to matters which the utilization review agent may collect clarifies the language of the statute and is within the statutory authority of the board. Comments related to sec.19.1708(b)-Utilization review agent contact with and receipt of information from health care providers. One commenter recommended that the amount paid to the health care provider for providing information be changed from the provisions requiring that the amount be the cost of copying set by the rules of the Texas Workers' Compensation Commission as the commenter felt those costs were not adequate to cover the cost of producing the documents. The board is unable to raise the amount because the language in the rule is statutory. Comments related to sec.19.1711 and 19.1719(g)(10)-Requirements prior to adverse determination, and responsibility of HMOs and insurers performing utilization review under the Insurance Code, Article 21.58A, sec.14(g) and (h). One commenter recommended changing the provisions in the referenced sections that providers whose proposed services are being questioned can discuss the plan with a physician or dentist to allow discussion with a professional of like licensure. The board does not feel that it can make the requested change. The references in both sections to physician is based on statutory language. The board notes that sec.19.1712 of this subchapter does allow a provider to request a review by a specialty provider within 10 days of denial. Comments related to sec.19.1715 -Retrospective review of medical necessity. One commenter recommended legislative action on expanding the provisions relating to retrospective review and another recommended that retrospective review be governed by the entire subchapter, including the development of screening criteria. The board responds that the legislature has requested a study to collect information on retrospective review so that this area can be addressed in the next legislative session. Comments related to sec.19.1719(a)(1), (5), (6)-Responsibility of HMOs and insurers performing utilization review under the Insurance Code, Article 21. 58A, sec.14(g) and (h). A commenter has suggested adding a reference to dentists as well as physician in the previously referenced section. The board disagrees with the comment with respect to sec.19.1719(a)(l) and (6) as those provision mirrors sec.19.1705, and follow statutory language. Section 19.1719(a) (6) allows for input from other health care providers. With respect to sec.19. 1719(a)(5), however, the board agrees that wording to recognize the need for review by a dentist of dental plans should be added and the rule as adopted will include that language. There were no comments for the sections. The following made comments against one or more sections of the rule: Houston Area Health Care Coalition; Texas Business Group on Health; Texas Association on Professional Benefit Administrators; Texas Health Information Management Association; American Trust Administrators, Inc.; Texas Physical Therapy Association; Texas Psychological Association; Texas Health Maintenance Association; Metroplex Psych Network; Texas Hospital Association; American Managed Care & Review Association; a non- profit corporation for group hospital services; and two utilization review agents. The new sections are adopted under the Insurance Code, Articles 21.58A and l.04, and Texas Civil Statutes, Article 6252-13a, sec.4 and sec.5. The Insurance Code, Article 21.58A, sec.13, grants the board authority to adopt rules and regulations to implement the provisions of Article 21.58A relating to health care utilization review agents. Article 1.04(b) authorizes the board to determine rules. Texas Civil Statutes, Article 6252-13a, sec.4 and sec.5, authorize and require each state agency to adopt rules of practice setting forth the nature and requirements of available procedures and prescribe the procedures for adoption of rules by a state administrative agency. sec.19.1702. Limitations on Applicability. (a) Except as noted in sec.19.1719 of this title (relating to Responsibility of HMOs and Insurers Performing Utilization Review Under the Insurance Code, Article 21. 58A, sec.14 (g) and (h)), all utilization review agents performing utilization reviews of services provided or proposed to be provided to an individual within the state on or after June 1, 1992, regardless of where the utilization review activities are physically based, must comply with this subchapter. All regulations in this subchapter shall relate to persons or entities subject to this subchapter. (b) Insurers and HMOs are not required to obtain a certificate of registration, but must comply with sec.19.1719 of this title (source: based upon the Act, sec.14(g), (h), and (i)). However, an insurer or HMO which performs utilization review for a person other than the one for which it is the payor is required to obtain a certification of registration. (c) This subchapter does not apply to a utilization review agent or other person which conducts only the functions of categories of utilization review listed in paragraphs (1)-(3) of this subsection (source: based upon the Act, sec.14(a)-(e)): (1) a person who provides information to enrollees about scope of coverage or benefits provided under a health insurance policy or health benefit plan and who does not determine whether particular health care services provided or to be provided to an enrollee are medically necessary or appropriate; (2) a person performing utilization review who is employed by, or under contract to, a certified utilization review agency; (3) a utilization review agency which conducts only the categories of utilization review listed in subparagraphs (A)-(E): (A) reviews performed pursuant to any contract with the federal government for utilization review of patients eligible for services under Title XVIII or XIX of the Social Security Act (42 United States Code, sec.sec.1395 et seq or sec. sec.1396 et seq); (B) reviews performed for the Texas Medicaid Program, the chronically ill and disabled children's services program created pursuant to the Health and Safety Code, Chapter 35, any program administered under Title 2, Human Resources Code, any program of the Texas Department of Mental Health and Mental Retardation, or any program of the Texas Department of Criminal Justice; (C) reviews of health care services provided to patients under the authority of the Texas Workers' Compensation Act (Texas Civil Statutes, sec.sec.8308-1.01 et seq); (D) reviews of health care services provided under a policy or contract of automobile insurance promulgated by the department under the Insurance Code, Subchapter A, Chapter 5 or issued pursuant to the Insurance Code, sec.1.14; (E) reviews that apply to the terms and benefits of the employee welfare benefit plans as defined in the Employee Retirement Income Security Act of 1974, sec.31(I) (29 United States Code, sec.1002). sec.19.1703. Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. Act-Insurance Code, Article 21.58A, entitled "Health Care Utilization Review Agents." Administrative Procedure Act-Administrative Procedure and Texas Register Act (Texas Civil Statutes, Article 6252-13a). Administrator-A person holding a certificate of authority under the Insurance Code, Article 21.07-6. Adverse determination -A determination by a utilization review agent that the health care services furnished or proposed to be furnished to a patient are not medically necessary or not appropriate in the allocation of health care resources. Board-The State Board of Insurance. Certificate-A certificate of registration granted by the board to a utilization review agent. Commissioner-The commissioner of insurance. Department-Texas Department of Insurance. Dental plan-An insurance policy or health benefit plan, including a policy written by a company subject to the Insurance Code, Chapter 20, that provides coverage for expenses for dental services. Dentist-A licensed doctor of dentistry, holding either a D.D.S. or a D.M.D. degree. Emergency care -Bona fide emergency services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in: (A) placing the patient's health in serious jeopardy: (B) serious impairment to bodily functions; or (C) serious dysfunction of any bodily organ or part. Enrollee-A person covered by a health insurance policy or plan. This term includes a person who is covered as an eligible dependent of another person. Health benefit plan-A plan of benefits that defines the coverage provisions for health care for enrollees offered or provided by any organization, public or private, other than health insurance. Health care provider-Any person, corporation, facility, or institution licensed by a state to provide or otherwise lawfully providing health care services that is eligible for independent reimbursement for those services. Health insurance policy-An insurance policy, including a policy written by a company subject to the Insurance Code, Chapter 20, that provides coverage for medical or surgical expenses incurred as a result of accident or sickness. Nurse-A professional or registered nurse, a licensed vocational nurse, or a licensed practical nurse. Open records law-Chapter 424, Acts of the 63rd Legislature, 1973 (Texas Civil Statutes, Article 6252-17a). Patient-An enrollee or an eligible dependent of the enrollee under a health benefit plan or health insurance plan. Payor-An insurer writing health insurance policies; any preferred provider organization, health maintenance organization, self-insurance plan; or any other person or entity which provides, offers to provide, or administers hospital, outpatient, medical, or other health benefits to persons treated by a health care provider in this state pursuant to any policy, plan, or contract. Person-An individual, a corporation, a partnership, an association, a joint stock company, a trust, an unincorporated organization, any similar entity, or any combination of the foregoing acting in concert. Physician-A licensed doctor of medicine or a doctor of osteopathy. Provider of record-The physician or other health care provider that has primary responsibility for the care, treatment, and services rendered to the enrollee and includes any health care facility when treatment is rendered on an inpatient or outpatient basis. Screening criteria -The written policies, decision rules, medical protocols, or guides used by the utilization review agent as part of the utilization review process (e.g., appropriateness evaluation protocol (AEP) and intensity of service, severity of illness, discharge, and appropriateness screens (ISD-A)). Utilization review -A system for prospective or concurrent review of the medical necessity and appropriateness of health care services being provided or proposed to be provided to an individual within the state. Utilization review shall not include elective requests for clarification of coverage. Utilization review agent-An entity that conducts utilization review for an employer with employees in this state who are covered under a health benefit plan or health insurance policy; a payor; and/or an administrator. Utilization review plan-The screening criteria and utilization review procedures of a utilization review agent. Working day-A weekday, excluding New Years Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, and Christmas Day. sec.19.1704. Certification of Utilization Review Agents. (a) An application for certification of a utilization review agent must be filed with the Texas Department of Insurance at the following address: Texas Department of Insurance, Mail Code 106-1G, P.O. Box 149104, Austin, Texas 78714- 9104. (b) The application must be submitted on a form which can be obtained from the Utilization Review Section, Mail Code 106-1G, Texas Department of Insurance, 333 Guadalupe, P.O. Box 149104, Austin, TX 78714-9104. (c) The attachments to the application form require the following information: (1) a summary of the utilization review plan which must include the matters listed in subparagraphs (A) and (B) of this paragraph. The utilization review plan must meet the requirements of sec.19.1705 of this subchapter (relating to General Standards of Utilization Review); (A) an adequate summary description of screening criteria and review procedures to be used to determine medical necessity and appropriateness of health care; and (B) assurance that screening criteria and review procedures to be applied in review determination are established with input from appropriate health care providers and approved by physicians; (2) copies of procedures established for appeal of an adverse determination. These procedures must comply with the provisions of sec.19.1712 of this title (relating to Adverse Determinations of Utilization Review Agents) ; (3) copies of procedures established for handling complaints by enrollees, patients, or health care providers. These procedures must comply with sec.19.1716 of this title (relating to Complaints and Information); (4) copies of policies and procedures which ensure that all applicable state and federal laws to protect the confidentiality of medical records are followed. These procedures must comply with sec.19.1714 of this title (relating to Confidentiality); (5) a certification that the utilization review agent will comply with the provisions of the Act; (6) a description of the categories of persons employed to perform utilization review; (7) copies of policies and procedures for orientation and training of personnel who perform utilization review who are not physicians, dentists, nurses, physicians assistants, registered records administrators, or accredited record technicians as addressed in sec.19.1706 of this title (relating to Personnel); (8) a description of the hours of operation within the State of Texas and how the utilization review agent may be contacted during weekends and holidays. This description must be in compliance with sec.19.1713 of this title (relating to Telephone Access); (9) representative samples of all materials provided by the utilization review agent/applicant to inform its clients, enrollees, or providers of the requirements of the utilization review plan; (10) a description of the basis by which the utilization review agent compensates its employees or agents to ensure compliance with paragraph (11) of this subsection; (11) a certification that the utilization review agent shall not permit or provide compensation or anything of value to its employees or agents, condition employment or its employee or agent evaluations, or set its employee or agent performance standards, based on the amount or volume of adverse determinations, reductions, or limitations on lengths of stay, benefits, services, or charges or on the number or frequency of telephone calls or other contacts with health care providers or patients, which are inconsistent with the provisions of this subchapter (source: subsection (c) is based upon the Act, sec.3(e)). (d) The utilization review agent shall report any material changes in the information in the application or renewal form referred to in this section, not later than the 30th day after the date on which the change takes effect (source: subsection (d) is based upon the Act, sec.3(g)). (e) The application process is described in paragraphs (1)-(6) of this subsection. (1) The department shall have 30 days after receipt of an application to determine whether the application is complete. In the event that an application is found to be incomplete, the department will give the applicant written notice of the required information necessary to complete the application. If the application is complete, the applicant will be advised that the application has been received and accepted for review. (2) The department shall have 60 days from the date the application is determined to be complete pursuant to paragraph (1) of this subsection to process the application and approve or disapprove it. The department shall give the applicant written notice of any deficiencies noted as a result of the review conducted pursuant to this paragraph. (3) The department shall afford the applicant an opportunity for a meeting to discuss any omissions or deficiencies noted. (4) The applicant must correct the omissions or deficiencies in the application within 30 days of the date of the department's latest notice of such omissions or deficiencies. If the applicant fails to do so, the application file will be closed as an incomplete application. The application fee will not be refundable. (5) The applicant may waive any of the time limits described in this subsection, except in paragraph (4). The applicant may waive the time limit in paragraph (4) of this subsection, only with the consent of the department. (6) The department shall maintain an application file which shall contain the application, notices of omissions or deficiencies, responses, and any written materials generated by any person that was considered by the department in evaluating the application. (f) A utilization review agent must apply for renewal of the certificate of registration every two years, not later than March 1. A renewal form must be used for this purpose. The renewal fee must be submitted with the renewal form. The renewal form can be obtained from the address listed in subsection (b) of this section. The completed renewal form, a summary of the current screening criteria, and the renewal fee must be submitted to the department at the address listed in subsection (a) of this section. A utilization review agent may continue to operate under its certificate of registration after a completed renewal application form, a summary of the current screening criteria, and the renewal fee has been timely received by the department until the renewal is finally denied or issued by the department. If a completed renewal application, a summary of the screening criteria, and fee is not received prior to March 1 of the year in which the certificate of registration must be renewed, the certificate of registration will automatically be cancelled and the utilization review agent must complete and submit a new application form with a summary of the current screening criteria and the new application fee for another certificate of registration. (g) If an application or renewal is initially denied under this section, the applicant or registrant may appeal such denial under the terms of the provisions of Chapter 1, Subchapter A of this title (relating to Rules of Practice and Procedure) and Texas Civil Statutes, Article 6252-13a (Administrative Procedure and Texas Register Act). A hearing of such appeal shall be conducted within 45 days of the date the petition for such hearing is filed with the commissioner. A decision by the commissioner shall be rendered within 60 days of the date of the hearing. (h) Applications which are filed on or before December 31, 1992, will be processed on a first in, first out basis by the department. The timelines set out for processing applications in subsections (d) and (e) of this section will not apply to these applications. (i) Entities which were operating in Texas as utilization review agents prior to June 1, 1992, must file the application described in subsections (a), (b), and (c) of this section, by June 1, 1992. Those entities may continue to operate as utilization review agents pending review of the application unless they are advised in writing that the application has been disapproved, or closed as an incomplete application as described in subsection (e) of this section. No entity may continue to operate after 15 days from the date of the notice of the denial or closure of the file. (j) An applicant for a certificate of registration as a utilization review agent must provide evidence that the applicant: (1) has available the services of physicians, nurses, physician's assistants, registered records administrators, accredited records technicians, or individuals who have received formal orientation and training in accordance with policies established by the utilization review agent and filed with the commissioner of insurance to carry out its utilization review activities in a timely manner; (2) meets any applicable provisions of these rules and regulations relating to the qualifications of the utilization review agents or the performance of utilization review; (3) has policies and procedures which protect the confidentiality of medical records in accordance with applicable state and federal laws; (4) make itself accessible to patients and providers 40 working hours a week during normal business hours in this state in each time zone in which it operates. sec.19.1706. Personnel. (a) Personnel employed by or under contract with the utilization review agent to perform utilization review shall be appropriately trained and qualified and if applicable, currently licensed. Personnel who obtain information directly from the physician, dentist, or health care provider, either orally or in writing, and who are not physicians or dentists, shall be nurses, physicians assistants, registered records administrators, or accredited records technicians, who are either licensed or certified, or shall be individuals who have received formal orientation in accordance with policies and procedures established by the utilization review agent to assure compliance with this section, and a description of such policies and procedures shall be filed with the application referred to in sec.19.1704 of this title (relating to Certification of Utilization Review Agents). This provision shall not be interpreted to require such qualifications for personnel who perform clerical or administrative tasks (source: based upon the Act, sec.4(c)). (b) A utilization review agent may not permit or provide compensation or any thing of value to its employees or agents, condition employment or its employee or agent evaluations, or set its employee or agent performance standards, based on the amount or volume of adverse determinations, reductions, or limitations on lengths of stay, benefits, services, or charges or on the number or frequency of telephone calls or other contacts with health care providers or patients, which are inconsistent with the provisions of this subchapter (source: based upon the Act, sec.4(f)). (c) The utilization review agent is required to provide the number, type, and minimum qualification or qualifications of the personnel either employed or under contract to perform the utilization review to the commissioner. Utilization review agents shall be required to adopt written procedures used to determine if physicians or other health care providers utilized by the utilization review agent are licensed, qualified, and appropriately trained, and must maintain records on such. (d) Utilization review conducted by a utilization review agent shall be under the direction of a physician currently licensed to practice medicine by a state licensing agency in the United States (source: the Act, sec.4(h)). (e) Utilization review dental plans shall be reviewed by a dentist currently licensed by a state licensing agency in the United States. sec.19.1708. Utilization Review Agent Contact with and Receipt of Information from Health Care Providers. (a) A health care provider may designate one or more individuals as the initial contact or contacts for utilization review agents seeking routine information or data. In no event shall the designation of such an individual or individuals preclude a utilization review agent or medical advisor from contacting a health care provider or others in his or her employ where a review might otherwise be unreasonably delayed or where the designated individual is unable to provide the necessary information or data requested by the utilization review agent (source: the Act, sec.4(g)). (b) Unless precluded or modified by contract, a utilization review agent shall reimburse health care providers for the reasonable costs for providing medical information in writing, including copying and transmitting any requested patient records or other documents. A health care provider's charge for providing medical information to a utilization review agent shall not exceed the cost of copying set by rules of the Texas Workers' Compensation Commission for records and may not include any costs that are otherwise recouped as a part of the charge for health care (source: the Act, sec.4(l)). (c) When conducting routine utilization review, the utilization review agent shall collect only the information necessary to certify the admission, procedure, or treatment and length of stay. This information may include identifying information about the patient and enrollee, the benefit plan, the treating health care provider, and facilities rendering care. It may also include clinical information regarding the diagnoses of the patient and the medical history of the patient relevant to the diagnoses; the patient's prognosis; and the treatment plan prescribed by the treating health care provider along with the provider's justification for the treatment plan. Second opinion information may also be required when applicable, sufficient to support benefit plan requirements. These items shall only be requested when relevant to the utilization review in question and be requested as appropriate from the beneficiary, plan sponsor, health care provider, or health care facility. The required information should be obtained from the appropriate source since no one source will have all of this information. (1) Utilization review agents shall not routinely require hospitals and physicians to supply numerically codified diagnoses or procedures to be considered for certification. Utilization review agents may ask for such coding, since if it is known, its inclusion in the data collected increases the effectiveness of the communication. (2) Utilization review agents shall not routinely request copies of medical records on all patients reviewed. During prospective and concurrent review, copies of medical records should only be required when a difficulty develops in certifying the medical necessity or appropriateness of the admission or extension of stay. In those cases, only the necessary or pertinent sections of the record should be required. (d) Information in addition to that described in this section may be requested by the utilization review agent or voluntarily submitted by the health care provider, when there is significant lack of agreement between the utilization review agent and health care provider regarding the appropriateness of certification during the review or appeal process. "Significant lack of agreement" means that the utilization review agent: (1) has tentatively determined, through its professional staff, that a service cannot be certified; (2) has referred the case to a physician for review; and (3) has talked to or attempted to talk to the health care provider for further information. (e) The utilization review agent should share all clinical and demographic information on individual patients among its various divisions (e. g., certification, discharge planning, care management) to avoid duplicate requests for information from enrollees or providers. sec.19.1716. Complaint and Information. (a) Utilization review agent's complaint system (source: based on the Act, sec.4(m)). A utilization review agent shall establish and maintain a complaint system that provides reasonable procedures for the resolution of written complaints initiated by enrollees, patients, or health care providers concerning the utilization review and shall maintain records of such written complaints for two years from the time the complaints are filed. The complaint procedure shall include a written response to the complainant by the agent within 60 days. By March 1, of each year, the utilization review agent shall submit to the commissioner or his or her delegated representative, a summary report of all complaints at such times and in such form as the board may require and shall permit the commissioner to examine the complaints and all relevant documents at any time. The summary report covers reviews performed by the utilization review agent during the preceding calendar year and includes: (1) a summary of the resolved complaints listing the number of complaints, classification of complainant (i.e., health care provider, enrollee, patient, etc.), the type of complaints filed, and the complaint resolution; (2) a summary of the unresolved complaints listing the number of complaints, classification of complainant, and a brief explanation of all complaints not resolved; and (3) a summary of appeals listing the number of appeals and the results of any appeals under adverse determinations procedures. (b) Complaints to the department. Within a reasonable time period, upon receipt of a written complaint alleging a violation of this subchapter or the Act, by a utilization review agent, from an enrollee's health care provider, a person acting on behalf of the enrollee, or the enrollee, the commissioner, or his or her delegated representative shall investigate the complaint and furnish a written response to the complainant and the utilization review agent named. The response will not identify in any manner, the patient or patients, without written consent. This response must include the following: (1) a statement of the original complaint; (2) a copy of any written response by the utilization review agent. The written response should not contain privileged medical records. If it is necessary to refer to medical records they shall be separately forwarded with the response and clearly marked as privileged medical records; (3) a statement of the findings of the commissioner or his or her delegated representative and an explanation of the basis of such findings; (4) corrective actions, if any, on the part of the utilization review agent which the commissioner or his or her delegated representative finds appropriate and whether the utilization review agent has voluntarily agreed to take such action; (5) a time frame in which any corrective actions should be completed. (c) The utilization review agent will provide evidence of corrective action within the specified time frame to the commissioner or his or her representative. (d) Authority of the department to make inquiries. In addition to the authority of the commissioner to respond to complaints described in subsection (b) of this section, the department is authorized to address inquiries to any utilization review agent in relation to the agents' business condition or any matter connected with its transactions which the department may deem necessary for the public good or for a proper discharge of its duties. It shall be the duty of the agent to promptly answer such inquiries in writing. (e) Lists of utilization review agents. The commissioner shall maintain and update monthly a list of utilization review agents issued certificates and the renewal date for those certificates. The commissioner shall provide the list at cost to all individuals or organizations requesting the list (source: the Act, sec.12). (f) On-site review by the Texas Department of Insurance. (1) The commissioner or the commissioner's designated representative is authorized to make a complete on-site review of the operations of each utilization review agent at the principal place of business for such agent, as often as is deemed necessary. (2) Utilization review agents will be notified of the scheduled on-site visit by letter, which will specify, as a minimum, the identity of the commissioner's designated representative and the expected arrival date and time. (3) The utilization review agent must make available during such on-site visits all records relating to its operation. (4) The commissioner or the designated representative may perform periodic telephone audits of utilization review agents authorized to conduct business in this state, to determine if the agents are reasonably accessible. sec.19.1717. Administrative Violations (Source: Subsections (a)-(d) are based on the Act, sec.9). (a) If the commissioner through the commissioner's designated representative, believes that a utilization review agent has violated or is violating the Act, the commissioner's designated representative shall notify the utilization review agent of the alleged violation and may compel the production of any and all documents or other information. (b) The commissioner's designated representative may initiate the proceedings under this section after the 30th day after the date the commissioner's designated representative notifies the agent as required by subsection (a) of this section. (c) Proceedings under this article are a contested case for the purpose of Texas Civil Statutes, Article 6252-13a (Administrative Procedure and Texas Register Act). (d) If, after notice and hearing, the commissioner determines that the utilization review agent has violated or is violating any provision of this Act, the commissioner may: (1) impose sanctions under the Insurance Code, Article 1.10, sec.7; or (2) issue a cease and desist order under the Insurance Code, Article 1.10A. (e) If the utilization review agent has violated or is violating any provisions of the Insurance Code other than the Act, or applicable rules of the department, sanctions may be imposed under the Insurance Code, Article 1. 10 or 1.10A. (f) The commission of fraudulent or deceptive acts or omissions in obtaining, attempting to obtain, or use of certification as a utilization review agent shall be a violation of the Act. sec.19.1718. Criminal Penalties. Any person or entity performing utilization review without a certificate as required by the Act commits an offense. Except as otherwise provided by this section, an offense under this section is a Class A misdemeanor. If it is shown in the trial of a violation of this section that the person or entity has once before been convicted of a violation of this section, on conviction the person or entity shall be punished for a third degree felony. Each day of violation constitutes a separate offense (source: the Act, sec.10). sec.19.1719. Responsibility of HMOs and Insurers Performing Utilization Review Under the Insurance Code, Article 21.58A, sec.14(g) and (h). (a) HMOs performing utilization review under the Act, sec.14(g), must respond to the annual survey on utilization review distributed by the Texas Department of Insurance within 30 days of receipt of the survey, and comply with all the following requirements of the Act: (1) the utilization review plan, including reconsideration and appeal requirements, shall be reviewed by a physician and conducted in accordance with standards developed with input from appropriate health care providers and approved by a physician (source: the Act, sec.4(b)). (2) personnel employed by or under contract with HMOs performing utilization review shall be appropriately trained and qualified. Personnel who obtain information directly from the physician or dentist or health care provider, either orally or in writing, and who are not physicians or dentists shall be nurses, physicians assistants, registered records administrators, or accredited records technicians, who are either licensed or certified, or shall be individuals who have received formal orientation in accordance with policies and procedures established by the utilization review agent to assure compliance with this section, and a description of such policies and procedures shall be filed with the commissioner. This provision shall not be interpreted to require such qualifications for personnel who perform clerical or administrative tasks (source: based upon the Act, sec.4(c)); (3) unless approved for an individual patient by the provider of record or modified by contract, an HMO performing utilization review shall be prohibited from observing, participating in, or otherwise being present during a patient's examination, treatment, procedure, or therapy. In no event shall this section otherwise be construed to limit or deny contact with a patient for purposes of conducting utilization review unless otherwise specifically prohibited by law (source: the Act, sec.4(e)); (4) an HMO performing utilization review may not permit or provide compensation or any thing of value to its employees or agents, condition employment or its employee or agent evaluations, or set its employee or agent performance standards, based on the amount or volume of adverse determinations, reductions or limitations on lengths of stay, benefits, services, or charges or on the number or frequency of telephone calls or other contacts with health care providers or patients, which are inconsistent with the provisions of this subchapter (source: the Act, sec.4(f)); (5) utilization review conducted by an HMO performing utilization review shall be under the direction of a physician licensed to practice medicine by a state licensing agency in the United States (source: the Act, sec.4(h)); (6) utilization review dental plans shall be reviewed by a dentist currently licensed by a state licensing agency in the United States; (7) each HMO performing utilization review shall utilize written medically acceptable screening criteria and review procedures which are established and periodically evaluated and updated with appropriate involvement from the physicians, including practicing physicians, and other health care providers. Such written screening criteria and review procedures shall be available for review and inspection by the commissioner and copying as necessary for the commissioner to carry out his or her lawful duties under this code, provided, however, that any information obtained or acquired under the authority of this subsection and article is confidential and privileged and not subject to the open records law or subpoena except to the extent necessary for the board or commissioner to enforce the Act (source: the Act, sec.4(i)); and (8) unless precluded or modified by contract, an HMO performing utilization review shall reimburse health care providers for the reasonable costs for providing medical information in writing, including copying and transmitting any requested patient records or other documents. A health care provider's charge for providing medical information to a utilization review agent shall not exceed the cost of copying set by rules of the Texas Workers' Compensation Commission for records and may not include any costs that are otherwise recouped as a part of the charge for health care (source: the Act, sec.4(l)). (b) Nothing in the Act or this subchapter shall be construed to prohibit or limit the distribution of a proportion of the savings from the reduction or elimination of unnecessary medical services, treatment, supplies, confinements, or days of confinement in a health care facility through profit sharing, bonus, or withhold arrangements to participating physicians or participating health care providers for rendering health care services to enrollees (source: Based upon the Act, sec.14(g)(1)). (c) The complaint system established by 28 TAC sec.11. 506(6) shall be considered to be in compliance with this section so long as it provides for complaints for health care providers. (d) HMOs must submit to assessment of maintenance taxes under the Insurance Code, Article 20A.33, Texas Health Maintenance Organization Act, to cover the costs of administering compliance of health maintenance organizations under the Act (source: the Act, sec.14(g)(3)). (e) When a health maintenance organization performs utilization review for a person or entity subject to this article other than one for which it is the payor, such health maintenance organization shall be required to obtain a certificate under the Act, sec.3, and comply with all the provisions of the Act (source: the Act, sec.14(i)). (f) HMOs performing utilization review under the Insurance Code, Article 21.58A, sec.14(g), will be subject to sec.19.1714 of this title (relating to Confidentiality), sec.19.1716(b) of this title (relating to Complaints and Information), and sec.19.1717 of this title (relating to Administrative Violations), with respect to their operations under the provisions of the Act, sec.14(g) restated in subsection (a) of this section. (g) Insurers performing utilization review under the Act, sec.14(h) must comply with the requirements of paragraphs (1)-(14) of this subsection. (1) The utilization review plan, including reconsideration and appeal requirements, shall be reviewed by a physician and conducted in accordance with standards developed with input from appropriate health care providers and approved by a physician (source: the Act, sec.4(b)). (2) Personnel employed by or under contract with insurers performing utilization review shall be appropriately trained and qualified. Personnel who obtain information directly from the physicians, dentists, or health care providers, either orally or in writing, and who are not physicians or dentists shall be nurses, physician assistants, registered records administrators, or accredited records technicians, who are either licensed or certified, or shall be individuals who have received formal orientation and training in accordance with policies and procedures established by the insurer to assure compliance with this section, and a description of such policies and procedures shall be filed with the department. This provision shall not be interpreted to require such qualifications for personnel who perform clerical or administrative tasks (source: Based upon the Act, sec.4(c)). (3) An insurer performing utilization review shall not set or impose any notice or other review procedures contrary to the requirements of the health insurance policy or health benefit procedures contrary to the requirements of the health insurance policy or health benefit plan. (Source: the Act, sec.4(d)). (4) Unless approved for an individual patient by the provider of record, or modified by contract, an insurer performing utilization review shall be prohibited from observing, participating in, or otherwise being present during a patient's examination, treatment, procedures, or therapy (source: the Act, sec.4(e)). (5) An insurer performing utilization review may not permit or provide compensation or any thing of value to its employees or agents, condition employment or its employee or agent evaluations, or set its employee or agent performance standards, based on the amount or volume of adverse determinations, reductions or limitations on lengths of stay, benefits, services, or charges or on the number of frequency of telephone calls or other contacts with health care providers or patients, which are inconsistent with the provisions of the Act (source: the Act, sec.4(f)). (6) A health care provider may designate one or more individuals as the initial contact or contacts for insurers performing utilization review seeking routine information or data. In no event shall the designation of such an individual or individuals preclude a utilization review agent or medical advisor from contacting a health care provider or others in his or her employ where a review might otherwise be unreasonably delayed or where the designated individual is unable to provide the necessary information or data requested by the insurer performing utilization review (source: the Act, sec.4(g)). (7) Utilization review conducted by an insurer performing utilization review shall be under the direction of a physician licensed to practice medicine by a state licensing agency in the United States (source: the Act, sec.4(h)). (8) Each insurer performing utilization review shall utilize written medically acceptable screening criteria and review procedures which are established and periodically evaluated and updated with appropriate involvement from physicians, including practicing physicians, and other health care providers. Such written screening criteria and review procedures shall be available for review and inspection by the commissioner and copying as necessary for the commissioner to carry out his or her lawful duties under the Act, provided, however, that any information obtained or acquired under the authority of this subsection and the Act is confidential and privileged and not subject to the open records law or subpoena except to the extent necessary for the board or commissioner to enforce the Act (source: the Act, sec.4(i)). (9) An insurer performing utilization review may not engage in unnecessary or unreasonable repetitive contacts with the health care provider or patient and shall base the frequency of contacts or reviews on the severity or complexity of the patient's condition or on necessary treatment and discharge planning activity (source: the Act, sec.4(j)). (10) Subject to the notice requirements of the Act, sec.5, in any instance where the insurer performing utilization review is questioning the medical necessity or appropriateness of health care services, the health care provider who ordered the services shall be afforded a reasonable opportunity to discuss the plan of treatment for the patient and the clinical basis for the insurer's decision with a physician or, in the case of a dental plan with a dentist, prior to issuance of an adverse determination (source: Based upon the Act, sec.4(k)). (11) Unless precluded or modified by contract, an insurer performing utilization review shall reimburse health care providers for the reasonable costs for providing medical information in writing, including copying and transmitting any requested patient records or other documents. A health care provider's charges for providing medical information to an insurer performing utilization review shall not exceed the cost of copying set by rule of the Texas Workers' Compensation Commission for records and may not include any costs that are otherwise recouped as a part of the charge for health care (source: the Act, sec.4(l)). (12) An insurer performing utilization review shall establish and maintain a complaint system that provides reasonable procedures for the resolution of written complaints initiated by enrollees, patients, or health care providers concerning the utilization review and shall maintain records of such written complaints for two years from the time the complaints are filed. The complaint procedure shall include a written response to the complainant by the agent within 60 days. The insurer performing utilization review shall submit to the commissioner a summary report of all complaints at such times and in such form as the board may require and shall permit the commissioner to examine the complaints and all relevant documents at any time (source: the Act, sec.4(m)). (13) The insurer performing utilization review may delegate utilization review to qualified personnel in the hospital or health care facility where the health care services were or are to be provided. (Source: the Act, sec.4(n)). (14) Insurers performing utilization review must comply with clauses (A)-(E) of this paragraph. (A) Insurers must respond to the annual survey on utilization review distributed by the Texas Department of Insurance within 30 days of receipt of the survey. (B) Insurers must comply with all the requirements of the Act, sec.8 restated in sec.19.1714 of this title. (C) When an insurer performs utilization review for a person or entity subject to this article other than one for which it is the payor, such insurer shall be required to obtain a certificate under the Act, sec.3, and comply with all the provisions of the Act (source: the Act, sec.14(i)) . (D) Insurers performing utilization review under, the Act, sec.14(h), will be subject to sec.19.1714 of this title sec.19. 1716(b) of this and sec.19.1717 of this title with respect to their operations under the provisions of the Act, sec.14(h), restated in subsection (g) of this section. (E) Insurers performing utilization review under the Act, sec.14(g) and (h), must furnish the information listed in clauses (i)-(iii) of this subparagraph to the Utilization Review Department of the Texas Department of Insurance: (i) complete name; (ii) principal locality in which utilization review is being performed; and (iii) complete address, including contact person. 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 July 17, 1992. TRD-9209863 Linda K. von Quintus-Dorn Chief Clerk Texas Department of Insurance Effective date: August 7, 1992 Proposal publication date: May 8, 1992 For further information, please call: (512) 463-6327 TITLE 34. PUBLIC FINANCE Part VII. State Property Tax Board Chapter 155. Tax Record Requirements 34 TAC sec.sec.155.6, 155.37, 155.51, 155.60 The Comptroller of Public Accounts adopts the repeal of sec.sec.155.6, 155.37, 155.51, and 155.60, concerning exemption applications for residence homesteads, current and delinquent tax receipts, miscellaneous exemptions, and application for exemption of goods exported from Texas, without changes to the proposed text as published in the June 12, 1992, issue of the Texas Register (17 TexReg 4237). The duties and responsibilities of the State Property Tax Board were transferred to the Comptroller of Public Accounts of November 26, 1991. Senate Bill 45, 72nd Legislature, 1991, Second Called Session, provides that State Property Tax Board rules remain in effect until amended, repealed, withdrawn, or otherwise superseded by the comptroller. The sections on which repeal is proposed have been superseded by the comptroller. No comments were received regarding adoption of the repeals. The repeals are adopted under Senate Bill 45, sec.68(c), 72nd Legislature, 1991, Second Called Session, which provides that all forms, rules, and procedures adopted by the State Property Tax Board and in effect on or after the effective date of Senate Bill 45, 72nd Legislature, 1991, Second Called Session, remain in effect as if adopted by the comptroller until amended, repealed, withdrawn, or otherwise superseded by the comptroller. 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 July 17, 1992. TRD-9209871 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: August 7, 1992 Proposal publication date: June 12, 1992 For further information, please call: (512) 463-4028 Chapter 157. Tax Assessor Education Requirements 34 TAC sec.sec.157.21-157.25 The Comptroller of Public Accounts adopts the repeal of sec.sec.157.21- 157.25, concerning education rules, without changes to the proposed text as published in the June 12, 1992, issue of the Texas Register (17 TexReg 4238). The duties and responsibilities of the State Property Tax Board were transferred to the Comptroller of Public Accounts of November 26, 1991. Senate Bill 45, 72nd Legislature, 1991, Second Called Session, provides that State Property Tax Board rules remain in effect until amended, repealed, withdrawn, or otherwise superseded by the comptroller. The sections on which repeal is proposed are no longer necessary to administer the comptroller's property tax administration rules. No comments were received regarding adoption of the repeals. The repeals are adopted under Senate Bill 45, sec.68(c), 72nd Legislature, 1991, Second Called Session, which provides that all forms, rules, and procedures adopted by the State Property Tax Board and in effect on or after the effective date of Senate Bill 45, 72nd Legislature, 1991, Second Called Session, remain in effect as if adopted by the comptroller until amended, repealed, withdrawn, or otherwise superseded by the comptroller. 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 July 17, 1992. TRD-9209870 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: August 7, 1992 Proposal publication date: June 12, 1992 For further information, please call: (512) 463-4028 Chapter 163. Reporting Procedures 34 TAC sec.sec.163.1-163.3 The Comptroller of Public Accounts adopts the repeal of sec.sec.163.1-163.3, concerning the delinquent state ad valorem tax lists, without changes to the proposed text as published in the June 12, 1992, issue of the Texas Register (17 TexReg 4238). The duties and responsibilities of the State Property Tax Board were transferred to the Comptroller of Public Accounts of November 26, 1991. Senate Bill 45, 72nd Legislature, 1991, Second Called Session, provides that State Property Tax Board rules remain in effect until amended, repealed, withdrawn, or otherwise superseded by the comptroller. The sections on which repeal is proposed are no longer necessary to administer the comptroller's property tax administration duties. No comments were received regarding adoption of the repeals. The repeals are adopted under Senate Bill 45, sec.68(c), 72nd Legislature, 1991, Second Called Session, which provides that all forms, rules, and procedures adopted by the State Property Tax Board and in effect on or after the effective date of Senate Bill 45, 72nd Legislature, 1991, Second Called Session, remain in effect as if adopted by the comptroller until amended, repealed, withdrawn, or otherwise superseded by the comptroller. 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 July 17, 1992. TRD-9209867 Martin Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: August 7, 1992 Proposal publication date: June 12, 1992 For further information, please call: (512) 463-4028 TITLE 40. SOCIAL SERVICES AND ASSISTANCE Part I. Texas Department of Human Services Chapter 5. Medicaid Programs for Aliens Subchapter A. Medicaid Benefits for Temporarily Legalized Aliens 40 TAC sec.5.1002 The Texas Department of Human Services (DHS) adopts an amendment to sec.5. 1002, concerning the legal basis for DHS's Medicaid Programs for Aliens. The Immigration Act of 1990, sec.301, effective October 1, 1991, provides that the spouse and unmarried children of an alien legalized under the Immigration Reform and Control Act (IRCA) of 1986 are eligible immigrants and are eligible for Medicaid. The justification for the amendment is to expand Medicaid eligibility to spouses and unmarried children of aliens legalized under the IRCA. The section as amended will function by providing medical coverage to more needy individuals. 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 to be effective October 1, 1991. sec.5.1002. Legal Basis. The following clients are eligible for Medicaid coverage if they are otherwise qualified for Medicaid and have an emergency medical condition, are pregnant, or are under age 18: (1) aliens lawfully admitted for temporary residence in the United States under the Immigration and Nationality Act, sec.sec.210, 210A, or 245A; (2) spouses and unmarried children of aliens lawfully admitted for temporary residence in the United States as specified in paragraph (1) of this section. 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 July 20, 1992. TRD-9209913 Nancy Murphy Agency Liaison, Policy and Document Support Texas Department of Human Services Effective date: October 1, 1991 For further information, please call: (512) 450-3765 Chapter 33. Early and Periodic Screening, Diagnosis, and Treatment Subchapter J. Medical Phase 40 TAC sec.33.140 The Texas Department of Human Services (DHS) adopts new sec.33.140, with changes to the proposed text as published in the June 2, 1992, issue of the Texas Register (17 TexReg 3973). The justification for the new section is to define the eligible provider types. Additionally, the section states the approved Medicaid reimbursement methodology for each provider type. The amendment will function by providing enhanced access to Medicaid services because of an increase in the number of providers providing services to clients. On June 22, 1992, DHS held a public hearing on the proposed rule. A representative of the National Association of Social Workers/Texas, commended DHS for including reimbursement for mental health services to children by certified social workers-advanced clinical practitioners because professional social workers are major providers of mental health services in Texas. DHS is adopting paragraphs (2) and (3) with minor editorial corrections to correctly identify the organizations that license or certify the providers. The new section 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. sec.33.140. Early and Periodic Screening, Diagnosis, and Treatment- Comprehensive Care Program Providers (EPSDT-CCP). The following are approved EPSDT-CCP provider types and the approved Medicaid reimbursement methodology for each provider type. (1) Approved providers enrolled in the Texas Medicaid Program. Except as otherwise noted, reimbursement for EPSDT-CCP services to these providers is based on existing Medicare and/or Medicaid reimbursement methodologies. (2) Licensed professional counselors. These providers must be licensed by the Texas Board of Examiners of Professional Counselors in accordance with the Texas Licensed Professional Counselor Act, Article 4512g. Medicaid benefits under the EPSDT-CCP are for mental health counseling for emotional disorders or conditions. Licensed early and periodic screening, diagnosis, and treatment professional counselors are reimbursed at 70% of the existing fee for similar services provided by psychiatrists and psychologists. Covered outpatient services are further reduced to 62.5% of the Medicaid fee allowances. (3) Certified social workers (advanced clinical practitioners). These providers must be certified by the Counsel of Social Worker Certification as advanced clinical practitioners in accordance with sec.85.6001 of this title (relating to General Rule). Medicaid benefits under the EPSDT-CCP are for mental health counseling for emotional disorders or conditions. Certified social workers (advanced clinical practitioners) are reimbursed at 70% of the existing fee for similar services provided by psychiatrists and psychologists. Covered outpatient services are further reduced to 62.5% of the Medicaid fee allowances. 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 July 17, 1992. TRD-9209878 Nancy Murphy Agency Liaison, Policy and Document Support Texas Department of Human Services Effective date: September 1, 1992 Proposal publication date: June 2, 1992 For further information, please call: (512) 450-3765 Texas Department of Insurance Exempt Filing Notification Pursuant to the Insurance Code, Chapter 5, Subchapter L (Editor's note: As required by the Insurance Code, Article 5.96 and Article 5.97, the Register publishes notices of actions taken by the State Board of Insurance pursuant to Chapter 5, Subchapter L, of the Code. Board action taken under these articles is not subject to the Administrative Procedure and Texas Register Act. These actions become effective 15 days after the date of publication or on a later specified date. The text of the material being adopted will not be published, but may be examined in the offices of the State Board of Insurance, 333 Guadalupe, Austin.) The State Board of Insurance of the Texas Department of Insurance adopted on July 15, 1992, a filing by the Cumis Insurance Society, Madison, Wisconsin, of revisions to the standard and uniform Credit Union Errors and Omissions Policy. In accordance with the provisions of the Insurance Code, Article 5.97, a text of the filing has been filed in the office of the Chief Clerk of the Texas Department of Insurance. The filing has been available for public inspection for 15 days, and a public hearing has not been requested by any party. The revisions add policy wording required by the Insurance Code, Article 21. 56 and Article 21.49-2D. There are no rate consequences to the adopted form revisions. This filing becomes effective on the 15th day after notice of this action is published in the Texas Register. This notice is filed pursuant to the Insurance Code, Article 5.97, which exempts board action on this filing from the requirements of the Administrative Procedure and Texas Register Act (Reference Number O-0692-35I). 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 July 17, 1992. TRD-9209864 Linda K. von Quintus-Dorn Chief Clerk Texas Department of Insurance Effective date: August 8, 1992 Proposal publication date: July 3, 1992 For further information, please call: (512) 463-6327 The State Board of Insurance of the Texas Department of Insurance adopted on July 15, 1992, a filing by the International Insurance Company, Basking Ridge, New Jersey, The North River Insurance Company, Basking Ridge, New Jersey, United State Fire Insurance Company, Basking Ridge, New Jersey and the Westchester Fire Insurance Company, Basking Ridge, New Jersey of revisions to the standard and uniform Insurance Agents and Brokers Errors and Omissions Policy. In accordance with the provisions of the Insurance Code, Article 5.97, a text of the filing has been filed in the office of the Chief Clerk of the Texas Department of Insurance. The filing has been available for public inspection for 15 days, and a public hearing has not been requested by any party. The policy revisions add policy wording required by the Insurance Code, Articles 21.56 and 21.49-2D. There are no rate consequences to the adopted form revisions. This filing becomes effective on the 15th day after notice of this action is published in the Texas Register . This notice is filed pursuant to the Insurance Code, Article 5.97, which exempts board action on this filing from the requirements of the Administrative Procedure and Texas Register Act (Reference Number O-0692-34I). 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 July 17, 1992. TRD-9209865 Linda K. von Quintus-Dorn Chief Clerk Texas Department of Insurance Effective date: August 8, 1992 Proposal publication date: July 3, 1992 For further information, please call: (512) 463-6327 The State Board of Insurance of the Texas Department of Insurance adopted on July 15, 1992, a filing by the Western Surety Company of Sioux Falls, South Dakota, of revisions to the standard and uniform Employers Comprehensive Notary Public Errors and Omissions Policy. In accordance with the provisions of the Insurance Code, Article 5.97, a text of the filing has been filed in the office of the Chief Clerk of the Texas Department of Insurance. The filing has been available for public inspection for 15 days, and a public hearing has not been requested by any party. The policy revisions incorporate previously board approved amendatory language into the policy. The revision also adds policy wording required by the Insurance Code, Articles 21.56 and 21.49-2D. There are no rate consequences to the adopted form revisions. This filing becomes effective on the 15th day after notice of this action is published in the Texas Register . This notice is filed pursuant to the Insurance Code, Article 5.97, which exempts board action on this filing from the requirements of the Administrative Procedure and Texas Register Act (Reference Number O-0692-36I). 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 July 17, 1992. TRD-9209866 Linda K. von Quintus-Dorn Chief Clerk Texas Department of Insurance Effective date: August 8, 1992 Proposal publication date: July 3, 1992 For further information, please call: (512) 463-6327