ADOPTED RULES 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 25. HEALTH SERVICES Part I. Texas Department of Health Chapter 97. Communicable Diseases The Texas Department of Health (department) adopts the repeal of existing sec.sec.97.1-97.22 and new sec.sec.97.1-97.13, and the repeal of existing sec.sec.97. 131-97.136, and new sec.sec.97.131-97.144. Sections 97.1-97.3, 97.5- 97.7, 97.11-97. 13, 97.131-97.135, 97.137-97.140, and 97.142-97.144 are adopted with changes to the proposed text as published in the October 8, 1993, issue of the Texas Register (18 TexReg 6900). The repeal of existing sec.sec.97.1-97.22 and sec. sec.97.131-97.136, and new sec. sec.97.4, 97.8-97.10, 97.136, and 97.141 are adopted without changes and will not be republished. Proposed new sec.97.145 was deleted due to passage of Senate Bill 981 by the 73rd Texas Legislature, which suspended the Syphilis Serology Approval Program for laboratories in-state operating under the Prenatal Screening Laws, as long as the federal Clinical Laboratory Improvement Amendments of 1988 are in effect. Section 81. 090(d) of the Texas Health and Safety Code has been repealed. The differences between the existing sections and the new sections are the removal and additions of diseases to the list of reportable diseases and implement major revisions in the format used in all sections to more clearly identify the rules and procedures. The new sections will allow for improved reporting of reportable conditions leading to better control of those important public health conditions. A summary of comments received regarding the proposed new sections are as follows. COMMENT: Several commenters suggested the complete rejection of the rules. The commenters believe the rules are too cumbersome and recommended more simplified rules. RESPONSE: The department disagrees. The public health follow-up of disease is not a uniform process and is very complex. The current rules and regulations were felt to be too cumbersome and confusing. The proposed rules and regulations are more clearly written. COMMENT: Concerning sec.97.2 and sec.97.132, a commenter suggested adding nursing care facilities, e.g. nursing homes and non-hospitals, blood centers and MHMR facilities as reporting entities. RESPONSE: The department disagrees. In sec.97.2 individuals, not institutions, are required to report whether patients and/or clients in nursing care facilities are either receiving services under the direction of a physician or are attended by a physician. The physician or his/her designee is required to report in these settings. COMMENT: Concerning sec.97.2, a commenter suggested that a person to perform reporting functions within institutions should not be designated. It was explained that this should best be handled internally since it was based on job title/responsibilities. RESPONSE: In sec.97.2(a), an individual is not designated to report. An employee from the clinic or office staff may be designated to serve as a reporting officer. This employee can be selected by each institution. COMMENT: Concerning sec.97.2, a commenter suggested changing the wording of sentences dealing with duplicate reporting so that there would be no misinterpretation concerning this issue. It would also make it consistent with the wording in sec.97.132. RESPONSE: The department agrees and has made the changes suggested in all sections relating to "Who Shall Report." COMMENT: Concerning sec.97.3, several commenters recommend to include only diseases in which some therapeutic action and/or contact will be taken by the local health department. RESPONSE: The department disagrees. All reportable diseases are of public health importance and most are preventable to some degree. Therapeutic and contact activities are not the only activities initiated because of reporting. Health department decisions to initiate preventive measures, public education and advisories are based on reported incidence data. COMMENT: Concerning sec.97.3, several commenters recommend to include an address on the information to collect for a patient with a reportable condition. Several commenters recommend to include a telephone number on the required information to collect. RESPONSE: The department agrees. The addition of address and phone number will assist local health department officials in patient follow-up. COMMENT: Concerning sec.97.3(b)(1), a commenter suggested that we do not add "Tuberculosis infection in persons less than 15 years of age" and that the same minimal information be reported for all diseases to keep it simple and promote compliance. RESPONSE: The department disagrees. Pediatric tuberculosis infections are indicative of active cases and ongoing transmission of tuberculosis in the community. COMMENT: Concerning sec.97.3(b)(1), commenters suggested that E. coli 0157:H7 infection, hemolytic uremic syndrome (HUS), and hantavirus infection be added to the list of reportable diseases. RESPONSE: The department agrees. E. coli 0157:H7 and hantavirus are recognized as emerging human pathogens. HUS is commonly associated with E. Coli 0157:H7 infection. All diseases have been added throughout these sections where appropriate. COMMENT: Concerning sec.97.3(b)(1), several commenters suggested that coccidioidomycosis, influenza and flu-like illnesses, leptospirosis, psittacosis, Q fever, and tularemia not be removed from the list of reportable diseases. RESPONSE: The department disagrees. Influenza virus infections are tracked by another surveillance system. The consensus of previous discussions and meetings with local public health officials was that the rest of these conditions were of minimal public health concern. COMMENT: Concerning sec.97.3(b)(1), a commenter recommended the addition of congenital cytomegalovirus (CMV) to the list of reportable conditions. RESPONSE: The department disagrees. Congenital CMV is not of sufficient public health concern to be reportable. COMMENT: Concerning sec.97.3, a commenter suggested the deletion of chickenpox, meningitis (except that caused by Haemophilus influenzae or Neisseria meningitidis), legionellosis, Lyme disease, relapsing fever, Rocky Mountain spotted fever, and invasive, beta-hemolytic streptococcal infection from the list of reportable conditions. RESPONSE: The department disagrees. These proposed reportable conditions are of public health importance and should be included on the reportable disease list. COMMENT: Concerning sec.97.4(a), (b), (e) and (f) a commenter recommends the deletion of timeframes for the reporting of reportable conditions. Another commenter suggested changing those diseases listed as immediately reportable. RESPONSE: The department disagrees. Some conditions must be immediately reported. Immediate preventive treatment of contacts may be necessary. COMMENT: Concerning sec.97.11, a commenter recommends that unless the disease is reportable by name, the disease should not be included in subsection (a)(1) or (2) of this section. RESPONSE: The department disagrees. Section 97.11 requires hospitals to notify a health authority when an emergency medical responder has been exposed to a particular disease. A name is not needed to provide information to the health director regarding the exposure to a disease. The emergency responder in attendance in the case should be medically assessed and, if required, treated appropriately to prevent infection. COMMENT: Concerning sec.97.12(d)(2), a commenter recommends the addition of moist heat disinfection as a method for the disposal and disinfection of needles and other contaminated wastes. A commenter suggested that sec.97.12(d) of this section be deleted. RESPONSE: The department will delete sec.97.12(d)(1)-(3) of this section. Section 97.12(d) will now read, "All persons should routinely practice standard infection control procedures when performing post-mortem care on a deceased person who is known or suspected of having a communicable disease listed in subsection (c) of this section." COMMENT: Concerning sec.97.12(c), a commenter suggested that we clarify whether the potential for exposure exists after death with all of the diseases listed. RESPONSE: The potential of exposure does exist in dealing with a corpse. The conditions listed in sec.97.12 can be transmitted by contact to blood, body fluids, or tissue. COMMENT: Concerning sec.97.13, a commenter suggested that health care workers be listed in the group called "Emergency Responders". RESPONSE: The department disagrees. Health care workers are covered under infection control protocols in their respective hospitals or health care institutions. "Emergency Responders" are usually not associated with a specific health care institution and, therefore, these rules were drafted to cover these individuals. COMMENT: Concerning sec.97.132(b)(4), a commenter suggested that we define social services. RESPONSE: The department disagrees. This section is requiring the physician who is in the medical director's role in the organization to report. It is not the responsibility of the organization to report; therefore, a definition of social services is not needed in this section. Staff have made the necessary changes to clarify that it is the medical director of the organization who is required to report. COMMENT: Concerning sec.97.133, department staff suggested adding the zip code of residence and physician's telephone number to the reporting information and requiring the AIDS defining condition(s) (if present), and mode of exposure (if known). RESPONSE: The department agrees and has made the necessary changes. COMMENT: Concerning sec.97.133(c)(1), several commenters expressed the need to have HIV infection reported by name. RESPONSE: The department staff held numerous meetings in which we invited all interested parties to discuss the issue of reporting HIV infection by name. The overwhelming recommendation of the groups that were present was that HIV be reported by unique identifier and improve private laboratory reporting. Staff recommends that the unique identifier system be evaluated, and if it does not provide the information needed we will then address the issue of reporting HIV infection by name. COMMENT: Concerning sec.97.133, a commenter suggested that reporting of HIV by demographics only defeats the purpose of reporting communicable diseases, i. e. prevention of additional cases and outbreak investigation. RESPONSE: Reporting by demographics and unique identifiers was the consensus achieved by interested groups that met to discuss HIV infection reporting. Demographic information can be analyzed to target prevention messages to certain populations to prevent additional cases of HIV infection. Case investigation takes place when individuals are diagnosed with AIDS, which is reported by name. COMMENT: Concerning sec.97.133, a commenter suggested that language address a way to deal with individuals who do not have a social security number. RESPONSE: Reporting by demographics and unique identifiers was the consensus achieved by interested groups that met to discuss HIV infection reporting. Staff will address and evaluate the issue of HIV reporting of individuals that do not have a social security number. COMMENT: Concerning sec.97.135(d), a commenter suggested that blood tests for syphilis should not be noted on birth certificates, but should only be included in medical records. RESPONSE: These rules do not regulate or require information to be recorded on the birth certificate. COMMENT: Concerning sec.97.140(B)(3)(b), relating to Counseling and Testing for State Employees Exposed to HIV on the Job, one commenter recommended need for clarification regarding the issue of biting or being bitten. RESPONSE: Biting and being bitten is not considered as an exposure to HIV because without visible blood present, saliva does not contain quantities of the virus large enough to cause infection after exposure. If a bite or being bitten has caused the transfer of blood or other body fluids containing a high concentration of the virus between two individuals, then the exposure could lead to infection. Each biting incident should be reviewed by appropriate medical personnel to determine if an exposure has taken place. Department staff added language to define what constituted risk of exposure of health care workers performing medical procedures as required in the Texas Health and Safety Code, sec.81.102(a)(3). Proposed new sec.97.145 was deleted due to passage of Senate Bill 981 by the 73rd Texas Legislature which suspended the Syphilis Serology Approval Program for laboratories in state operating under the Prenatal Screening Laws, as long as the federal Clinical Laboratory Improvement Amendments of 1988 are in effect. Section 81.090(d) of the Texas Health and Safety Code has been repealed. Minor editorial changes were made for clarification purposes. The following associations presented comments on the proposed rules: the City of Houston Health and Human Services Department, the Corpus Christi-Nueces County Department of Public Health, and the Texas Youth Commission. Several individuals presented comments and comments were received from department staff. Control of Communicable Diseases 25 TAC sec.sec.97.1-97.22 The repeals are adopted under the Health and Safety Code, Chapter 81, which provides the Board of Health with the authority to adopt rules concerning the reporting of communicable diseases; and sec.12.001, which provides the Texas Board of Health with the authority to adopt rules for the performance of every duty imposed by law on the Texas Board of Health, the Texas Department of Health, and the Commissioner of Health. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 23, 1994. TRD-9436575 Susan K. Steeg General Counsel, Office of General Counsel Texas Department of Health Effective date: March 16, 1994 Proposal publication date: October 8, 1993 For further information, please call: (512) 458-7463 25 TAC sec.sec.97.1-97.13 The new sections are adopted under the Communicable Disease Prevention and Control Act, Health and Safety Code, Chapter 81, which provides the Board of Health with the authority to adopt rules concerning the reporting of communicable diseases; and sec.12. 001, which provides the Texas Board of Health with the authority to adopt rules for the performance of every duty imposed by law on the Texas Board of Health, the Texas Department of Health, and the Commissioner of Health. sec.97.1. Definitions. The following words and terms, when used in these sections, shall have the following meanings, unless the context clearly indicates otherwise. Act-Communicable Disease Prevention and Control Act, Health and Safety Code, Chapter 81. AIDS-Acquired immune deficiency syndrome as defined by the Centers for Disease Control and Prevention of the United States Public Health Service. The publication designating the most current definition may be requested from: Texas Department of Health, HIV/STD Epidemiology Division, 1100 West 49th Street, Austin, Texas 78756, (512) 458-7504 or 1-800-252-8239. Carrier-An infected person or animal that harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source or reservoir for the infection of man. Case-As distinct from a carrier, the term "case" is used to mean a person in whose tissues the etiological agent of a communicable disease is lodged and which usually produces signs or symptoms of disease. Evidence of the presence of a communicable disease may also be revealed by laboratory findings. Commissioner-Commissioner of Health. Communicable disease -An illness due to an infectious agent or its toxic products which is transmitted directly to a well person from an infected person or animal, or indirectly through an intermediate plant or animal host, vector, or the inanimate environment. Contact-A person or animal that has been in such association with an infected person or a contaminated environment so as to have had opportunity to acquire the infection. Department-Texas Department of Health. Disinfection-Destruction of infectious agents outside the body by chemical or physical means directly applied. Epidemic or outbreak-The occurrence in a community or region of a group of illnesses of similar nature, clearly in excess of normal expectancy, and derived from a common or a propagated source. Health authority -A physician designated to administer state and local laws relating to public health under the Local Public Health Reorganization Act, Health and Safety Code, Chapter 121. The health authority, for purposes of these sections, may be: (A) a local health authority: (i) director of a local health department; or by the Commissioner of Health if there is no director of a local health department; or (B) a regional director of the Texas Department of Health if no physician has been appointed by the Commissioner of Health as a local health authority. HIV-Human immunodeficiency virus. HIV infection-Infection with HIV confirmed by one of the following laboratory procedures: (A) a serum specimen that is repeatedly reactive for HIV antibody by a licensed screening test (e.g. enzyme-linked immunosorbent assay (ELISA)) and the same or an additional serum specimen that is positive by a subsequent test (e.g. Western blot, immunofluorescence assay); or (B) a positive test for serum HIV antigen; or (C) a positive lymphocyte culture confirmed by an HIV-specific antigen test (not just reverse transcriptase detection); or (D) by in situ hybridization technique using a deoxyribonucleic acid (DNA) probe (e.g. polymerase chain replication (PCR)). Hospital laboratory -Any laboratory that performs laboratory test procedures for a patient of a hospital either as a part of the hospital or through contract with the hospital. Outbreak-See definition of epidemic in this section. Physician-A person licensed by the Texas State Board of Medical Examiners to practice medicine in Texas. Regional director -The physician who is the chief administrative officer of a region as designated by the department under the Local Public Health Reorganization Act, Health and Safety Code, Chapter 121. Report-Information that is required to be provided to the department. Report of a disease-The notification to the appropriate authority of the occurrence of a specific communicable disease in man or animals, including all information required by the procedures established by the department. Reportable disease -Any disease or condition that is required to be reported under the Act or by these sections. See sec.97.3 of this title (relating to What to Report). Any outbreak, exotic disease, or unusual group expression of illness which may be of public health concern, whether or not the disease involved is listed in sec.97.3 of this title, shall be considered a "reportable disease." School administrator -The city or county superintendent of schools, or the principal of any school not under the jurisdiction of a city or county board of education. sec.97.2. Who Shall Report. (a) A physician, dentist, veterinarian, or chiropractor shall report as required by these sections, each patient or animal he or she shall examine and who has or is suspected of having any reportable disease or health condition, and shall report any outbreak, exotic disease, or unusual group expression of illness of any kind whether or not the disease is known to be communicable or reportable. An employee from the clinic or office staff may be designated to serve as the reporting officer. A physician, dentist, veterinarian, or chiropractor who can assure that a designated or appointed person from the clinic or office is regularly reporting every occurence of these diseases or health conditions in their clinic or office does not have to submit a duplicate report. (b) The chief administrative officer of a hospital shall appoint one reporting officer who shall be responsible for reporting each patient who is medically attended at the facility and who has or is suspected of having any reportable disease or health condition. Hospital laboratories may report through the reporting officer or independently in accordance with the hospital's policies and procedures. (c) Except as provided in subsection (b) of this section, any person who is in charge of a clinical laboratory, blood bank, mobile unit, or other facility in which a laboratory examination of any specimen derived from a human body yields microscopical, cultural, serological, or other evidence of a reportable disease or health condition shall report as required by this section. (d) School authorities, including a superintendent, principal, teacher, school health official, or counselor of a public or private school and the administrator or health official of a public or private institution of higher learning should report as required by these sections those students attending school who are suspected of having a reportable disease. School authorities are exempt from reporting sexually transmitted diseases in accordance with sec.97.132(b)(5) of this title (relating to Who Shall Report Sexually Transmitted Diseases.) (e) Any person having knowledge that a person is suspected of having a reportable disease or health condition should notify the local health authority or the department and provide all information known to them concerning the illness and physical condition of such person or persons. (f) Sexually transmitted diseases including HIV and AIDS shall be reported in accordance with sec.97.132 of this title. (g) Failure to report a reportable disease is a Class B misdemeanor under the Texas Health and Safety Code, sec.81. 049. sec.97.3. What to Report. (a) Identification of reportable conditions. (1) The Texas Department of Health's (department) publication titled "Identification and Confirmation of Reportable Diseases" is a guideline to be used to determine when a reportable disease shall be reported under these sections based on a specific diagnosis, test procedure, and/or confirmatory test. Copies are available upon request to the Materials Acquisition and Management Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756. (2) Repetitive test results from the same patient do not need to be reported except for mycobacterial infections. (b) Reportable conditions. (1) Confirmed and suspected cases of the following diseases are reportable: acquired immune deficiency syndrome (AIDS); amebiasis; anthrax; botulism-adult and infant; brucellosis; campylobacteriosis; chancroid; chickenpox; Chlamydia trachomatis infection; cholera; dengue; diphtheria; encephalitis (specify etiology); Escherichia coli 0157:H7; gonorrhea; Hansen's disease (leprosy); Haemophilus influenzae infection, invasive; hantavirus infection; hemolytic uremic syndrome (HUS); hepatitis, acute viral (specify type); human immunodeficiency virus (HIV) infection; legionellosis; listeriosis; Lyme disease; malaria; measles (Rubeola); meningitis (specify type); meningococcal infection, invasive; mumps; pertussis; plague; poliomyelitis, acute paralytic; rabies in man; relapsing fever; Rocky Mountain spotted fever; rubella (including congenital); salmonellosis, including typhoid fever; shigellosis; streptococcal disease, invasive Group A; syphilis; tetanus; trichinosis; tuberculosis; tuberculosis infection in persons less than 15 years of age; typhus; vibrio infection; viral hemorrhagic fevers; and yellow fever. (2) In addition to individual case reports, any outbreak, exotic disease, or unusual group expression of disease which may be of public health concern should be reported by the most expeditious means. (c) Minimal reportable information requirements. The minimal information that shall be reported for each disease is as follows: (1) for chickenpox-numeric totals by age group; (2) for AIDS and HIV infection-shall be reported in accordance with sec.sec.97.132, 97.133, and 97.134 of this title (relating to Sexually Transmitted Diseases including AIDS and HIV infection); (3) for chancroid, Chlamydia trachomatis infection, gonorrhea, and syphilis- shall be reported in accordance with sec. sec.97.132, 97.133, 97.134, and 97.135 of this title (relating to Sexually Transmitted Diseases including AIDS and HIV infection); (4) for tuberculosis-name, city, age, date of birth, sex, race and ethnicity, physician, disease, type of diagnosis, date of onset, and antibiotic susceptibility results; and (5) for all other reportable diseases-name, city, age, date of birth, sex, race and ethnicity, physician, disease, type of diagnosis, date of onset, address, and telephone number. sec.97.5. Where to Report. (a) A physician, dentist, veterinarian, chiropractor, reporting officer of a hospital and a person in charge of a hospital laboratory (if the laboratory reports independently), or school authority shall report to the local health authority where the office, clinic, hospital, or school is located. If there is no local health authority appointed for the jurisdiction where the office, clinic, hospital, or school is located, the report shall be made to the Texas Department of Health (department) regional director. Public health emergencies shall be reported to the department's central office if the local health authority or the department's regional director is not immediately accessible. (b) The administrative officer of a clinical laboratory, blood bank, mobile unit, or other facility shall report as follows. (1) If the laboratory examination was requested by a physician, notice shall be sent to the local health authority for the jurisdiction where the physician's office is located, to the department's regional director for the jurisdiction where the physician's office is located if no local health authority exists, or to the department's central office when the regional director or local health authority are unknown to the laboratory. (2) If the laboratory examination was not requested by a physician, notice shall be sent to the local health authority for the jurisdiction where the laboratory is located, to the department's regional director for the jurisdiction where the laboratory is located if no local health authority has been appointed, or to the department's central office when the regional director or local health authority are unknown to the laboratory. (c) Sexually transmitted diseases including HIV and AIDS shall be reported in accordance with sec.sec.97. 132-97.135 of this title (relating to Sexually Transmitted Diseases Including Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV)). sec.97.6. Reporting and Other Duties of Local Health Authorities and Regional Directors. (a) The purpose of this section is to provide procedures for local health authorities and regional directors to report a disease to the Texas Department of Health's (department) central office. (b) Those reportable conditions identified as public health emergencies in sec.97.4(a) of this title (relating to When to Report) shall be reported immediately to the department by telephone. (c) Chancroid, Chlamydia trachomatis infection, gonorrhea, and syphilis shall be reported in accordance with sec. sec.97.132, 97.133, 97.134, and 97.135 of this title (relating to Sexually Transmitted Diseases including AIDS and HIV Infection). (d) AIDS and HIV infection shall be reported in accordance with sec.sec.97.132, 97.133, and 97.134 of this title. (e) The local health authority or the department's regional director shall collect reports of disease and transmit the following information at weekly intervals as directed by the department: (1) for chickenpox-numerical totals by age group; and (2) for all other reportable diseases-by name, city, age, date of birth, sex, race and ethnicity, physician, disease, type of diagnosis, date of onset, address, and telephone number. (f) Transmittal may be by telephone, mail, courier, or electronic transmission. (1) If by mail or courier, the reports shall be on a form provided by the department and placed in a sealed envelope addressed to the attention of the appropriate receiving source and marked "Confidential." (2) If by electronic transmission, including facsimile transmission by telephone, the local health authority or the department's regional director must obtain prior approval of the manner and form of the transmission from the Commissioner of Health (commissioner) or his/her designee. Any electronic transmission of the reports must provide at least the same degree of protection against unauthorized disclosure as those of mail or courier transmittal. (g) The health authority shall notify health authorities in other jurisdictions of a case or outbreak of a communicable disease that has been reported if the case resides in another jurisdiction or there is cause to believe transmission of a disease may have occurred in another jurisdiction. The department shall assist the health authority in providing such notifications upon request. The health authority of the area where the case or outbreak is diagnosed shall report the case or outbreak to the department on the same basis as other reports. (h) The health authority upon identification of a case or upon receipt of notification or report of disease shall take such action and measures as may be necessary to conform with the appropriate control measure standards. The health authority may upon identification of a case or upon report of a communicable disease in a child attending a public or private child-care facility or a school notify the owner or operator of the child-care facility or the school administrator. The commissioner is authorized to amend, revise, or revoke any control measure or action taken by the health authority if necessary or desirable in the administration of a regional or statewide public health program or policy. (i) The health authority is empowered to close any public or private child- care facility, school or other place of public or private assembly when in his or her opinion such closing is necessary to protect the public health; and such school or other place of public or private assembly shall not reopen until permitted by the health authority who caused its closure. sec.97.7. Diseases Requiring Exclusion from Child-care Facilities and Schools. (a) The Texas Department of Health (department) publication titled "Communicable Disease Chart for Schools and Child Care Centers" may be used to determine the incubation period, early signs of illness, and prevention/treatment measures of communicable conditions. Copies are available on request. (b) The owner or operator of a child-care facility, or the school administrator, shall exclude from attendance any child having or suspected of having a communicable condition. Exclusion shall continue until the readmission criteria for the conditions are met. The conditions and readmission criteria are as follows. (1) amebiasis-exclude until treatment is initiated; (2) campylobacteriosis-exclude until after diarrhea and fever subside; (3) chickenpox-exclude until after seven days from onset of rash, except immunocompromised individuals who should not return until all blisters have crusted over (may be longer than seven days) ; (4) common cold-exclude until fever subsides; (5) conjunctivitis, bacterial and/or viral-exclude until written permission and/or permit is issued by a physician or local health authority; (6) fever-exclude until fever subsides; (7) fifth disease (erythema infectiosum)-exclude until fever subsides; (8) gastroenteritis, viral-exclude until diarrhea subsides; (9) giardiasis-exclude until diarrhea subsides; (10) head lice (pediculosis)-exclude until one medicated shampoo or lotion treatment has been given; (11) hepatitis, viral, type A-exclude until one week after onset of illness; (12) impetigo-exclude until treatment has begun; (13) infectious mononucleosis-exclude until physician decides or fever subsides; (14) influenza-exclude until fever subsides; (15) measles (rubeola)-exclude until four days after rash onset or in the case of an outbreak, unimmunized children should also be excluded for at least two weeks after last rash onset occurs; (16) meningitis, bacterial-exclude until written permission and/or permit is issued by a physician or local health authority; (17) meningitis, viral-exclude until fever subsides; (18) mumps-exclude until nine days after the onset of swelling; (19) pertussis (whooping cough)-exclude until completion of five days of antibiotic therapy; (20) ringworm of the scalp-exclude until treatment has begun; (21) rubella (German measles)-exclude until seven days after rash onset or in the case of an outbreak, unimmunized children should be excluded for at least three weeks after last rash onset occurs; (22) salmonellosis-exclude until diarrhea and fever subside; (23) scabies-exclude until treatment has begun; (24) shigellosis-exclude until diarrhea and fever subside; (25) streptococcal sore throat and scarlet fever-exclude until 24 hours from time antibiotic treatment was begun and fever subsided; and (26) tuberculosis, pulmonary-exclude until antibiotic treatment has begun and a physician's certificate or health permit obtained. (b) The owner or operator of a child-care facility, or the school administrator, shall exclude from attendance any child having or suspected of having a communicable disease designated by the Commissioner of Health (commissioner) as cause for exclusion until one of the criteria listed in subsection (c) of this section is fulfilled. (c) Any child excluded for reason of communicable disease may be readmitted, as determined by the health authority, by submitting: (1) a certificate of the attending physician attesting that the child does not currently have signs or symptoms of a communicable disease or to the disease's non-communicability in a child-care or school setting; (2) a permit for readmission issued by a local health authority; or (3) readmission criteria as established by the commissioner. sec.97.11. Notification of Emergency Medical Service Employee, Firefighter, or Peace Officer of Possible Exposure to a Disease. (a) The Communicable Disease Prevention and Control Act (Act), sec.81.048, requires a licensed hospital to notify a health authority in certain instances when an emergency medical service employee, a peace officer, or a firefighter may have been exposed to a communicable disease during the course of duty from a person delivered to the hospital under conditions that were favorable for transmission. The following diseases and conditions constitute a possible exposure to the disease for the purposes of the Act, sec.81.048: (1) chickenpox; diphtheria; Haemophilus influenzae infections, invasive; meningitis (specify type); meningococcal infections, invasive; mumps; pertussis; poliomyelitis; psittacosis; Q fever (pneumonia); rabies; rubella; and tuberculosis, if there has been an examination of the throat, oral or tracheal intubation or suctioning, or mouth-to-mouth resuscitation; (2) acquired immune deficiency syndrome (AIDS); anthrax; brucellosis; dengue; hepatitis, viral; human immunodeficiency virus (HIV) infection; malaria; plague; syphilis; tularemia; typhus; viral hemorrhagic fevers and yellow fever, if there has been a needlestick or other penetrating puncture of the skin with a used needle or other contaminated item; or either a splatter or aerosol into the eye, nose, or mouth or any significant contamination of an open wound or non-intact skin with blood or body fluids; (3) amebiasis; campylobacteriosis; cholera; Escherichia coli 0157:H7; hepatitis A; salmonellosis, including typhoid fever; shigellosis; and vibrio infections, if fecal material is ingested; and (4) measles (Rubeola); pneumonic plague; tuberculosis; and viral hemorrhagic fevers if the worker and patient are in the same room, vehicle, ambulance, or other enclosed space. (b) A hospital shall report to the health authority the name of the transport person exposed, the date of exposure, the type of exposure, and the disease or condition to which exposure may have occurred. sec.97.12. Death of a Person with Certain Communicable Diseases. (a) If a physician has knowledge that a person had, at the time of death, a communicable disease listed in subsection (c) of this section, then the physician shall affix or cause to be affixed a tag on the body, preferably on a great toe. (b) The tag shall be on card stock paper and shall be no smaller than five centimeters by ten centimeters. The tag shall include the words "COMMUNICABLE DISEASE-BLOOD/BODY SUBSTANCE PRECAUTIONS REQUIRED" in letters no smaller than six millimeters in height. The name of the deceased person shall be written on the tag. The tag shall remain affixed to the body until the preparation of the body for burial has been completed. (c) Diseases that shall require tagging are acquired immune deficiency syndrome (AIDS); anthrax; brucellosis; cholera; Creutzfeldt-Jakob disease; hepatitis, viral; human immunodeficiency virus (HIV) infection; plague; Q fever; rabies; relapsing fever; Rocky Mountain spotted fever; syphilis; tuberculosis; tularemia; and viral hemorrhagic fevers. (d) All persons should routinely practice standard infection control procedures when performing post-mortem care on a deceased person who is known or suspected of having a communicable disease listed in subsection (c) of this section. sec.97.13. Mandatory Testing of Persons Suspected of Exposing Certain Other Persons to Reportable Diseases, Including Human Immunodeficiency Virus (HIV) Infection. (a) Purpose. The Communicable Disease Prevention and Control Act, Health and Safety Code, sec.81.050, provides a mechanism by which an emergency medical service employee, paramedic, fire fighter, a correctional officer, or a law enforcement officer, who receives a bona fide exposure to a reportable disease, including HIV infection, in the course of employment or volunteer service may request the Texas Department of Health (department) or the department's designee to order testing of the person who may have exposed the worker. This section establishes guidelines to designate the criteria that constitute exposure to a reportable disease, including HIV infection. The guidelines also prescribe minimum training requirements of the department's designee who will judge if the request meets criteria establishing risk of infection with a reportable disease, including HIV infection. (b) Definitions. The following words and terms, when used in this section, shall have the following meanings, unless the contest clearly indicates otherwise. (1) Emergency responder-An emergency medical services employee, paramedic, fire fighter, correctional officer or law enforcement officer who is employed by or volunteers for an employer with the responsibility of answering emergency calls for assistance. (2) Requestor-Emergency responder who presents a sworn affidavit to a local health authority to request testing of a person who may have exposed him/her to an infectious disease in the course of his/her duties. (3) Designated health official-For the purposes of implementing the Health and Safety Code, sec.81.050(d)-(e), the following physicians have been delegated by the department to be the designated health officials who determine if a risk of exposure to a reportable disease has occurred: (A) the health authority for the jurisdiction in which the emergency responder is employed; (B) if the health authority does not choose to make a determination of the risk of exposure, a licensed physician employed by the local health department who has responsibility for the control of communicable diseases in the municipality or county served by the health department; (C) if the health authority does not choose to make determinations of the risks of exposure and there is not a separate physician employed by the county or municipal health department with responsibility for the control of communicable diseases, or for counties which do not have an appointed health authority, the regional director of the Texas Department of Health (department) region of which the county or municipality is a part; and (D) for the Texas Department of Criminal Justice (TDCJ), the TDCJ Deputy Director of Health Services (Institutional Division) who must serve as the designated health official in determining risk of exposure to correctional officers employed by the TDCJ. (4) Source-The person who may have exposed an emergency responder to a reportable, communicable disease during the emergency responder's course of duties. (c) Diseases and designated conditions that constitute exposure to reportable diseases. For the purposes of the Health and Safety Code, sec.81.050, the diseases and designated conditions constitute exposure to a reportable disease, including HIV infection, are as follows: (1) chickenpox; diphtheria; Haemophilus influenzae infections, invasive; meningitis (specify type); meningococcal infections, invasive; mumps; pertussis; poliomyelitis; psittacosis; Q fever (pneumonia); rabies; rubella; and tuberculosis if there has been an examination of the throat, oral or tracheal intubation or suctioning, or mouth-to-mouth resuscitation; (2) acquired immune deficiency syndrome (AIDS); anthrax; brucellosis; dengue; hepatitis, viral; human immunodeficiency virus (HIV) infection; malaria; plague; syphilis; tulameria; typhus; viral hemorrhagic fevers; and yellow fever, if there has been a needlestick or other penetrating puncture of the skin with a used needle or other contaminated item; or either a splatter or aerosol into the eye, nose, or mouth or any significant contamination of an open wound or non- intact skin with blood or body fluids; (3) amebiasis; campylobacteriosis; cholera; Escherichia coli 0157:H7; hepatitis A; salmonellosis, including typhoid fever; shigellosis; and vibrio infections, if fecal material is ingested; and (4) measles (Rubeola); pneumonic plague; tuberculosis; and viral hemorrhagic fevers if the worker and the patient are in the same room, vehicle, ambulance or other enclosed space. (d) Department designee. For the purposes of the Health and Safety Code, sec.81.050, the following guidelines prescribe requirements of the department's designee who will judge if the request for testing meets criteria establishing risk of infection with a reportable disease, including HIV infection. (1) The health authority for the jurisdiction in which the emergency medical services employee, paramedic, fire fighter, correctional officer, or law enforcement officer, who is employed or volunteers shall review the request, presented as a sworn affidavit, and determine whether the request meets the criteria set out in subsection (c) of this section. (2) If an exposure is judged to have occurred, the health authority will then determine whether that exposure constitutes a reasonable risk of infection to the requester. However, if the correctional officer is employed by the Texas Department of Criminal Justice (TDCJ) (Institutional Division), the Deputy Director for Health Services of that department shall judge if the request for testing meets the criteria for risk of infection. In determining risk of infection, the health authority or the TDCJ Deputy Director for Health Services shall follow guidance given in the current edition of "Control of Communicable Diseases in Man," published as an official report by the American Public Health Association. (e) Procedures for mandatory testing. Steps necessary to mandate testing for a reportable communicable disease. (1) Submitting a request for testing of a source. If an employed or volunteer emergency responder believes he or she may have been exposed to a reportable disease while discharging his or her duties, then he or she, within 72 hours, must have postmarked or submitted in person a sworn affidavit to his or her designated health official requesting that the source be tested for the reportable communicable disease(s) which is (are) of concern. The sworn, written affidavit of the requestor must contain: (A) name; (B) home address; (C) telephone number at work; (D) telephone number at home; (E) the name and address of the emergency agency where he or she works or volunteers; (F) an emergency telephone number; (G) date and time of exposure; (H) the circumstances of the exposure; (I) the source's symptoms, if known (e.g. rash, fever, chills, jaundice, productive cough, diarrhea, nausea/vomiting, neurologic signs, coryza, hemorrhage, other); (J) transport designation of the source; and (K) if known, the source's name, address, preliminary diagnosis, and probable present location. (2) Responsibilities of the requestor. If the requestor believes he or she may have been exposed to a reportable disease and that, if infection occurs, he/she may file for worker's compensation, then the requestor must obtain an appropriate medical test which demonstrates susceptibility to the infection of concern. This test must be obtained within ten days of the alleged exposure. The requester should also be aware that he or she may be liable for any court costs if the source person refuses to be tested for infection with a reportable disease and the requester takes the matter to court and loses. (3) Determination of exposure. The designated health official must decide within three working days of receipt of the sworn affidavit if an exposure likely to lead to an infection has occurred. The designated health official must also consult the most recent edition of Control of Communicable Diseases in Man, published by the American Public Health Association, and should also consult any other reference which may provide additional relevant information. (4) Relating the determination of exposure. (A) Ruling of a non-exposure. If the designated health official determines that an exposure likely to lead to an infection with a reportable disease did not occur, then he or she must so inform the requestor by letter. The letter must contain a brief explanation of the basis of the decision. The designated health official may also notify the requestor by telephone, but this does not preclude the need for a written response. (B) Ruling of an exposure. (i) If the designated health official determines that the conditions of exposure were such that there was a reasonable chance that infection may have occurred, then he or she must notify the requestor by registered/certified mail and request that the requestor consult the designated health official. If the situation is such that control or treatment measures are immediately advisable, then the designated health official must also make a reasonable effort to notify the requestor of what actions need to be taken. (ii) During the consultation with the designated health official, the requestor must receive the following information both verbally and in writing: (I) the disease(s) which may have been transmitted during the exposure; (II) the tests that are available to detect infection; (III) where and when to obtain testing; (IV) the prophylactic measures which are appropriate; and (V) signs and symptoms of infection. (iii) If the requestor may have been exposed to HIV virus, then approved pretest counseling must be provided. The designated health official must state that he or she will proceed to locate the source and request the source to undergo testing. The designated health official must also state that if the source refuses to be tested, then the designated health official will consult with the requestor to determine if he or she wishes to pursue the matter into court. The designated health official must warn the requestor that if the matter is taken to court and the court rules that testing of the source is not required, then the requestor may be liable for court costs. (5) Disagreement with designated health official's ruling. If the requestor does not agree with the determination of the designated health official, and wants to pursue the matter further then the requestor must submit a copy of his or her original sworn affidavit to the Commissioner of Health (commissioner) for an independent assessment. The petition must be within seven days of the written notification by the designated health official. The decision of the commissioner is final. If the commissioner decides that the conditions of the exposure were such that there existed a reasonable chance of exposure to a reportable disease, then the designated health official in whose jurisdiction the exposure occurred must continue action to obtain testing of the source. (6) Notification of the source. (A) Once the designated health official determines that an exposure with risk of transmission of a reportable disease has occurred, the designated health official must within three working days attempt to locate and notify the source or the source's legal guardian. Notification must be by hand-delivered letter which will ask the source or the source's legal guardian to contact the designated health official but will not relate the reasons for the request. The designated health official must personally converse with the source or the source's legal guardian regarding the potential transmission of a reportable disease to an emergency responder. (B) If the source is hospitalized, incarcerated, or otherwise unable to personally consult with the designated health official, then a health professional trained in relating health information (e.g. registered or licensed vocational nurse, disease intervention specialist, epidemiologist) must relate verbally and in writing the request for information regarding the source's current status related to certain reportable diseases. (C) At least three attempts must be made to deliver the notice to the source or source's legal guardian. If after three attempts, the notice has not been delivered then the designated health official will mail the notice by registered mail to the last known address of the source or source's legal guardian. (7) Information provided to source. (A) Once contacted, the designated health official must relate to the source or source's legal guardian (both verbally and in writing in a language the source can understand) that: (i) an emergency responder has had contact with the source in a manner that transmission of disease may have occurred; (ii) this person is now requesting information on the possible contagiousness of the source with a disease(s) reportable by law; (iii) the source or source's legal guardian is asked to present laboratory or other medically valid evidence that he or she did or did not have the disease(s) at the time of exposure; and (iv) that the source or source's legal guardian is required to present this information or evidence that an appropriate specimen has been submitted for testing within 14 days of receipt of a written request for testing. (I) The request must describe the type of test required (e.g. blood for antigen or antibody, culture) and where such a test and appropriate counseling can be obtained. (II) The request must also state that if the source or source's legal guardian chooses not to use public health facilities for testing, then he or she is liable for any costs incurred from testing. (B) The test results or proof that the test specimen had been taken must be in the form of a signed and dated statement from a physician or laboratory stating the specimen has been collected and the approximate date that the laboratory or other results would be ready. The proof of specimen collection must be returned to the designated health official within 17 days after receipt of the written request for testing from the designated health official. If the source or source's legal guardian already has proof of laboratory results which demonstrate that the source was or could not have been infectious at the time of the exposure to the source, then the previous results substitute for new testing. (C) A source or the source's legal guardian who states that the source has been tested in the past and was positive for HIV or chronic hepatitis B but is unable to produce valid written results (anonymous test sites, special screens, lost records) must be asked to be retested. If they refuse, then this information must be relayed to the requestor. (8) Source objection to determination of exposure. If the source or the source's legal guardian objects to the designated health official's decision that he or she was involved in potentially exposing an emergency responder to a reportable disease, then he or she must present a copy of his or her original sworn affidavit to the commissioner for an independent assessment. The decision of the commissioner is final. (9) Test results. The source or the source's legal guardian has the responsibility of presenting the test result(s) to the health authority within five days of receipt. The results must show that the tested specimen was collected from the source, the date of collection, the type of test which was conducted, and the results of the test. The results must have the original signature of the physician who ordered, performed, or was responsible for the testing. (10) Notification of the requestor. When the test results from the source are obtained, the designated health official must arrange for an interview with the requestor. During the interview the designated health official must provide verbally and in writing the results of any testing on the source. If warranted by the test results, the designated health official must also provide recommendations for medical follow-up. (11) Refusal to be tested. If the source refuses to be tested, a statement to that effect must be signed by the source or the source's legal guardian. If the source or the source's legal guardian refuses to sign a statement or does not comply with the written request to be tested within the allotted 14-day time interval after notification, then the designated health official will ask for a written statement from the requestor stating that the matter should or should not be referred to the district court. The written request must state that the requestor understands he or she may be liable for court costs if the court does not rule in favor of mandated testing of the source. The designated health official will then refer the request to the prosecuting attorney who represents the state in district court. The prosecuting attorney will request a hearing on the order. (12) Court proceedings. The source has the right to an attorney at the hearing and the court will appoint an attorney for a person who cannot afford legal representation. The source or source's legal guardian cannot waive the right to an attorney unless he or she has consulted with an attorney. The court will then review the order and determine whether exposure occurred and represents a probable risk of infection. Evidence may be introduced by the attorney for the state or the attorney for the source. The court will then order testing and appropriate counseling or refuse to issue the order. If the court does not find reasonable cause to have the person tested, then the court may charge court costs to the requestor. (13) Results of court ordered tests. If a test is ordered, the designated health official must make arrangements for appropriate counseling, specimen collection, testing and maintenance of confidentiality of the source. The designated health official has the responsibility of notifying both the requestor and the source or source's legal guardian of the results of the testing and of any follow-up treatment and/or counseling. The designated health official must develop a protocol to code test specimens to ensure that identifying information concerning the source is destroyed as soon as testing is complete. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 23, 1994. TRD-9436574 Susan K. Steeg General Counsel, Office of General Counsel Texas Department of Health Effective date: March 16, 1994 Proposal publication date: October 8, 1993 For further information, please call: (512) 458-7463 Sexually Transmitted Diseases 25 TAC sec.sec.97. 131-97.136 The repeals are adopted under the Health and Safety Code, Chapter 81; and sec.12.001, which provides the Texas Board of Health with the authority to adopt rules for the performance of every duty imposed by law on the Texas Board of Health, the Texas Department of Health, and the Commissioner of Health. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 23, 1994. TRD-9436573 Susan K. Steeg General Counsel, Office of General Counsel Texas Department of Health Effective date: March 16, 1994 Proposal publication date: October 8, 1993 For further information, please call: (512) 458-7463 Sexually Transmitted Diseases Including Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) 25 TAC sec.sec.97.131-97.144 The new sections are adopted under the Communicable Disease Prevention and Control Act, Health and Safety Code, Chapter 81, which provides the Board of Health with the authority to adopt rules concerning the reporting of communicable diseases; and sec.12.001, which provides the Texas Board of Health with the authority to adopt rules for the performance of every duty imposed by law on the Texas Board of Health, the Texas Department of Health, and the Commissioner of Health. sec.97.131. Definitions. The following words and terms when used in these sections shall have the following meanings unless the context clearly indicates otherwise: AIDS-Acquired immune deficiency syndrome as defined by the Centers for Disease Control and Prevention of the United States Public Health Service. The publication designating the most current definition may be requested from: Texas Department of Health, HIV/STD Epidemiology Division, 1100 West 49th Street, Austin, Texas 78756, (512) 458-7504 or 1-800-252-8239. HIV-Human immunodeficiency virus. HIV infection-Infection with HIV confirmed by one of the following laboratory procedures: (A) a serum specimen that is repeatedly reactive for HIV antibody by a licensed screening test (e.g. enzyme-linked immunosorbent assay (ELISA)) and the same or an additional serum specimen that is positive by subsequent test (e.g. Western blot, immunofluorescence assay); (B) a positive test for serum HIV antigen; (C) a positive lymphocyte culture confirmed by HIV-specific antigen test (not just reverse transcriptase detection); or (D) an in situ hybridization technique using a deoxyribonucleic acid (DNA) probe (e.g. polymerase chain replication (PCR)). Sexually transmitted disease-An infection, with or without symptoms or clinical manifestations, that is or may be transmitted from one person to another during or as a result of sexual relations of whatever kind between two persons, and that produces or might produce a disease in or otherwise impair the health of either person or might cause an infection or disease in a fetus in utero or a newborn. AIDS, chancroid, Chlamydia trachomatis infection, gonorrhea, HIV infection, and syphilis are sexually transmitted diseases. sec.97.132. Who Shall Report Sexually Transmitted Diseases. (a) The following shall provide information on cases of chancroid, Chlamydia trachomatis infection, gonorrhea, or syphilis: (1) A physician or dentist shall report each patient that is diagnosed or treated for chancroid, Chlamydia trachomatis infection, gonorrhea, or syphilis. A physician or dentist may designate an employee of the clinic or physician's/dentist's office to serve as the reporting officer. A physician or dentist who can assure that a designated or reporting every occurrence of these diseases in their clinic or office does not have to submit a duplicate report. (2) The chief administrative officer of a hospital, a medical facility or a penal institution shall report each patient who is medically attended at the facility and is diagnosed with chancroid, Chlamydia trachomatis infection, gonorrhea, or syphilis. The chief administrative officer may designate an employee of their institution to serve as the reporting officer. A chief administrative officer who can assure that a designated or reporting every occurrence of these diseases in their institution does not have to submit a duplicate report. Hospital laboratories may report through the reporting officer or independently in accordance with the hospital's policies and procedures. (3) Any person in charge of a clinical laboratory, blood bank, mobile unit, or other facility in which a laboratory examination of a blood specimen or any specimen derived from a human body that yields microscopic, cultural, serological or any other evidence of chancroid, Chlamydia trachomatis infection, gonorrhea, or syphilis shall report according to sec.97.133 of this title (relating to Reporting Information for Sexually Transmitted Diseases). (4) School authorities as described in sec.97.2(e) of this title (relating to Who Shall Report) who are not medical directors meeting the criteria described in this section are exempt from reporting chancroid, Chlamydia trachomatis infection, gonorrhea, or syphilis. (b) The following shall report cases of HIV infection and AIDS cases. (1) A physician or dentist shall report each patient that is diagnosed or treated for HIV infection or AIDS. A physician or dentist may designate an employee of the clinic or physician's/dentist's office to serve as the reporting officer. A physician or dentist who can assure that a designated or appointed person from the clinic or office is regularly reporting every occurrence of these diseases in their clinic or office does not have to submit a duplicate report. (2) The chief administrative officer of a hospital, a medical facility or a penal institution shall report each patient who is medically attended at the facility and is diagnosed with HIV infection or AIDS. The chief administrative officer may designate an employee of their institution to serve as the reporting officer. A chief administrative officer who can assure that a designated or appointed person from their institution is regularly reporting every occurrence of these diseases in their institution does not have to submit a duplicate report. Hospital laboratories may report through the reporting officer or independently in accordance with the hospital's policies and procedures. (3) Any person in charge of a clinical laboratory, blood bank, mobile unit, or other facility in which a laboratory examination of a blood specimen or any specimen derived from a human body that yields microscopic, cultural, serological or any other evidence of HIV infection or AIDS shall report according to sec.97.133 of this title. (4) The medical director or other physician responsible for the medical oversight of an HIV counseling and testing site or a community-based organization shall report each patient that is diagnosed with HIV infection or acquired immune deficiency syndrome. The medical director or other physician may designate an employee of the counseling and testing site or community-based organization to serve as the reporting officer. A medical director or other physician who can assure that a designated or appointed person from their HIV counseling and testing site or community-based organization is regularly reporting according to sec.97.133 of this title every occurrence of these diseases in the organization or counseling and testing site does not have to submit a duplicate report. (5) School authorities as described in sec.97.2(e) of this title who are not medical directors meeting the criteria described in this section are exempt from reporting HIV infection, AIDS. (6) Failure to report a reportable disease is a Class B misdemeanor under the Texas Health and Safety Code, sec.81.049. sec.97.133. Reporting Information for Sexually Transmitted Diseases. (a) The following information, at a minimum, shall be reported for chancroid and/or syphilis: (1) laboratories: name, address, city, county and zip code of residence, date of birth (month, day, year), sex, race/ethnicity, type of test(s) performed, result of the test(s), date test(s) were performed, physician's name, physician's/clinic's address and telephone number. Only positive tests shall be reported; and (2) others as described in sec.97.132 of this title (relating to Who Shall Report Sexually Transmitted Diseases): name, address, city, county and zip code of residence, date of birth (month, day, year), sex, race/ethnicity, stage of diagnosis (syphilis only), pertinent laboratory results, treatment provided, physician's name, physician's/clinic's address and telephone number. (b) The following information, at a minimum, shall be reported for gonorrhea and/or Chlamydia trachomatis infection: (1) Laboratories: name, city, county and zip code of residence, age, date of birth (month, day, year), sex, race/ethnicity, type of test(s) performed, result of the test(s), date test(s) were performed, physician's name, physician's/clinic's address, physician's/clinic's telephone number. Only positive tests shall be reported. (2) Others as described in sec.97.132 of this title: city, county and zip code of residence, age, date of birth (month, day, year), sex, race/ethnicity, diagnosis, physician's name, physician's/clinic's address, physician's/clinic's telephone number if the following conditions are met: (A) the patient is twelve years of age or older; (B) there is no in vivo or in vitro evidence of resistance of the causative organism to therapeutic levels of penicillin or other drugs designated by the Commissioner or his/her designee; (C) the disease is an uncomplicated infection of the urethra, pharynx, cervix, uterus, and/or rectum; and (D) if the conditions specified in subparagraphs (A)-(C) of this paragraph are not met then the information reported on each case shall be as follows: name, address, city, county and zip code of residence, date of birth (month, day, year), sex, race/ethnicity, stage of diagnosis (syphilis only), pertinent laboratory results, treatment provided, physician's name, physician's/clinic's address and telephone number. (c) For HIV infection in adults and children 13 years of age and older the following information shall be reported within 30 days: (1) laboratories: type of test(s) performed, result of the test(s), date test(s) were performed, last four digits of the patient's social security number, date of birth (month, day, year), sex, race/ethnicity, city, county, and zip code of residence, physician's name, clinic address and telephone number. Only positive tests shall be reported; and (2) others as described in sec.97.132 of this title: date of test, last four digits of the patient's social security number, date of birth (month, day, year), sex, race/ethnicity, city, county, and zip code of residence, physician's name, clinic address, and telephone number. (d) For HIV infection in children under 13 years of age the following information, at a minimum, shall be reported within 30 days: (1) laboratories: type of test(s) performed, result of the test(s), date test(s) were performed, date of birth (month, day, year), sex, race/ethnicity, name, city, county, and zip code of residence, physician's name, clinic address and telephone number. Only positive tests shall be reported. (2) others as described in sec.97. 132 of this title: date of test, date of birth (month, day, year), sex, race/ethnicity, name, city, county, and zip code of residence, physician's name, clinic address and telephone number. (e) For acquired immune deficiency syndrome the following information, at a minimum, shall be reported within 30 days: (1) laboratories: CD4+ T-lymphocyte count of less than 200 cells/microLiter or a CD4+ T-lymphocyte percentage of less than 14%, date of test, date of birth (month, day, year), sex, race/ethnicity, name, city, county and zip code of residence, physician's name, clinic address and telephone number; and (2) others as described in sec.97.132 of this title: date of birth (month, day, year), sex, race/ethnicity, name, city, county and zip code of residence, AIDS defining condition(s) (if present), mode of exposure (if known), CD4+ T- lymphocyte count, physician's name, clinic's address and telephone number. sec.97.134. How To Report Sexually Transmitted Diseases. (a) Reporting forms and/or information from all entities required to report should be sent to the local health department director where the physician's office, hospital, laboratory or medical facility is located or if there is none, the reports should be forwarded to the regional director in the region where the physician's office, hospital, laboratory, or medical facility is located. (b) If any individual or entity is unsure where to report any of the diseases mentioned in this title the reports shall be placed in a sealed envelope addressed to the appropriate program as follows: (1) For chancroid, syphilis, gonorrhea, Chlamydia trachomatis infection: Texas Department of Health, HIV/STD Epidemiology Division, 1100 West 49th Street, Austin, Texas 78756 and the envelope shall be marked "Confidential." The envelope shall be delivered with the seal unbroken to the HIV/STD Epidemiology Division office for opening and processing of the contents. (2) For HIV infection, acquired immune deficiency syndrome: Texas Department of Health, HIV/STD Epidemiology Division, 1100 West 49th Street, Austin, Texas 78756 and the envelope shall be marked "Confidential." The envelope shall be delivered with the seal unbroken to the HIV/STD Epidemiology Division office for opening and processing of the contents. Postage paid envelopes may be obtained by contacting the HIV/STD Epidemiology Division at (512) 458-7504. Envelopes are provided without charge. (c) Reporting forms can be obtained from local health departments, regional offices, and the Texas Department of Health offices in Austin. (1) Forms to report chancroid, Chlamydia trachomatis infection, gonorrhea, or syphilis may be requested by mail or by telephone from: Texas Department of Health, HIV/STD Epidemiology Division, 1100 West 49th Street, Austin, Texas 78756, (512) 458-7225 or 1-800-252-8239. Forms shall be provided without charge to individuals required to report. (2) Forms to report HIV infection and acquired immune deficiency syndrome may be requested by mail or by telephone from: Texas Department of Health, HIV/STD Epidemiology Division, 1100 West 49th Street, Austin, Texas 78756, (512) 458- 7504 or 1-800-252-8239. Forms shall be provided without charge to individuals required to report. (d) Laboratories shall submit information weekly. If during any calendar quarter, tests for chancroid, Chlamydia trachomatis infection, gonorrhea, HIV infection, and syphilis are performed and all test results are negative, the person in charge of reporting for the laboratory shall submit a statement to this effect on or before January 5, April 5, July 5, and October 5 following that calendar quarter. (e) A local health director or regional director may authorize one or more employees under his/her supervision to receive the report from the physician by telephone and to complete the form on behalf of the physician; use of this alternative, if authorized, is at the option of the reporting physician. The local health department director or regional director shall implement a method for verifying the identity of the telephone caller when that person is unfamiliar to the employee. (f) A local health department director or regional director shall forward to the department at least weekly all reports of cases received by him/her. Transmittal may be by mail, courier, or electronic transmission. (g) If reporting by electronic transmission, including facsimile transmission by telephone, the same degree of protection of the information against unauthorized disclosure shall be provided as those of reporting by mail or courier transmittal. The department shall, before authorizing such transmittal, establish guidelines for establishing and conducting such transmission. sec.97.135. Serologic Testing for Syphilis During Pregnancy and at Delivery. (a) Every physician or other person permitted by law to attend a pregnant woman during gestation or at the delivery of the infant resulting from such pregnancy shall, for each woman so attended, take or cause to be taken a sample of the blood of the woman at the time of first examination and visit and submit such sample to a laboratory certified by the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88). If the first examination and visit of the pregnant woman is within 24 hours of delivery of the infant, then this sample of blood will also satisfy the requirements of subsection (b) of this section. (b) Within 24 hours of delivery, the physician or other person in attendance shall take or cause to be taken a sample of blood from the mother of the infant and submit the sample to a laboratory certified by the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88). (c) A person attending the delivery of an infant or fetus who is not authorized by law or regulation to draw blood may obtain the specimen of blood for testing from the umbilical cord attached to the placenta after separation from the infant; otherwise, this person shall arrange for collection of the specimen within 24 hours of delivery by a person authorized to do so. (d) Every physician or other person required to report births or fetal deaths shall state on each birth or fetal death certificate whether a blood test for syphilis was performed during the pregnancy and on the maternal blood or the umbilical cord blood of the newborn infant. sec.97.137. Exposure of Health-Care Personnel to Acquired Immune Deficiency Syndrome (AIDS), Human Immunodeficiency Virus (HIV) Infection. (a) Health-care personnel are at risk of exposure to HIV or AIDS if the personnel are in contact with blood or other body fluids (amniotic fluid, pericardial fluid, peritoneal fluid, pleural fluid, synovial fluid, cerebrospinal fluid, semen, and vaginal secretions) or any body fluid visibly contaminated with blood through percutaneous inoculation or contact with an open wound, nonintact skin or mucous membrane during the performance of normal job duties. (b) Health-care personnel are at risk of exposure to HIV or AIDS during a medical procedure if the personnel have their mucous membranes or skin in contact with any body fluid or tissue (other than patient's intact skin) and if the procedure to be performed is an invasive procedure that involves surgical entry into tissues, cavities, or organs or the repair of major traumatic injuries, including angiographic, bronchoscopic, endoscopic, and obstetrical procedures. (c) Emphasis must be placed on preventing the transmission of HIV or AIDS and not on testing for its presence. Health-care personnel should follow the guidance given in the publication titled "Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health- Care and Public-Safety Workers," United States Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Atlanta, Georgia, February 1989. (d) Copies of the publications listed in subsection (c) of this section are available upon request from: Bureau of HIV and STD Prevention, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756. sec.97.138. Guidelines for Testing Certain Indicted Persons for Certain Diseases. (a) A court may order a person who is indicted for sexual assault or aggravated sexual assault to submit to a medical procedure or test for presence of sexually transmitted diseases or acquired immune deficiency syndrome (AIDS), human immunodeficiency virus (HIV) infection, or other agent of AIDS, under authority of the Code of Criminal Procedure, Article 21.31; and Texas Health and Safety Code, sec.81.094. The physician who is directed by the court to perform the medical procedure or test shall follow the rules in this section that prescribe the criteria for testing and that respect the rights of the victim of the alleged offense and the rights of the person accused. (b) In order to protect the privacy of the person being tested, the court, in consultation with the health authority, shall use or arrange the use of a pseudonym for the person on all requests and reports pertaining to the procedure or test. The pseudonym shall be distinct and known only to the physician, the health authority, the person being tested, and the court. The person performing the procedures or test shall make the results available directly to the local health authority. (c) For AIDS, gonorrhea, HIV infection, genital infections from Chlamydia trachomatis infection, syphilis, and hepatitis (acute or chronic viral type B), the procedures and tests should be those specified in the Texas Department of Health's (department) publication titled "Identification and Confirmation of Reportable Diseases," (pertaining to the reporting of diseases and health conditions) which is by referenced in sec.97.3(a)(1) of this title (relating to What to Report). For other sexually transmitted diseases, the physician shall request instructions from the Commissioner of Health (Commissioner) or his/her designee. (d) The health authority shall meet with the victim of the alleged offense and disclose the results of the medical procedures or test; no other person shall be present during the notification unless permitted by the victim. The local health authority shall advise the victim of the medical implications of the test results whether or not the test results are positive or negative. The health authority shall instruct the victim to receive further medical intervention by the victim's personal physician. If the victim resides outside the State of Texas, the notification may be made by telephone. (e) The health authority shall notify the person accused of the results of the procedure or test and, if the result indicates the presence of a communicable disease, shall instruct the person accused as required by the Communicable Disease Prevention and Control Act, Texas Health and Safety Code, sec.81.083 or sec.81.109 and shall perform the appropriate duties and make the reports, as required by sec.97.3 of this title. (f) After reporting of the results of the procedure or test to the victim and to the person accused, the health authority shall file an affidavit with the court attesting that he or she has executed the order. Disclosure of the test results to any persons other than the victim and the accused person is prohibited under the Code of Criminal Procedure, Article 21. 31. (g) A health authority may delegate any duty imposed by these sections to a person who is under the health authority's supervision. If a victim or a person tested under this section resides outside the jurisdiction of the local health authority, the notifications required by this section may be made by the local health authority in the jurisdiction where the person resides. sec.97.139. Fee for Providing Written Notice of a Positive Human Immunodeficiency Virus (HIV)-Related Test Result to an Applicant for Insurance. An applicant for insurance must be given written notice of a positive HIV- related test result by a physician designated by the applicant, or in the absence of that designation, by the Texas Department of Health (department). If the department is requested to make this notification: (1) the form designated by the department for this purpose must be used. Copies of the form and other information concerning notification by the department may be requested from: Bureau of HIV and STD Prevention, 1100 West 49th Street, Austin, Texas 78756-3199, (512) 458-7463; and (2) the insurer shall pay the department a fee of $25 to cover the cost of the department providing the written notice to the applicant for insurance. sec.97.140. Counseling and Testing for State Employees Exposed to Human Immunodeficiency Virus (HIV) Infection on the Job. (a) Purpose. The purpose of this section is to implement the provisions of the Communicable Disease Prevention and Control Act, the Texas Health and Safety Code, sec.85. 116, which requires the Texas Department of Health (department) to adopt rules to implement the Act. (b) Counseling and testing. (1) The counseling and testing should be performed in accordance with the "HIV Serologic Testing and Documentation Guidelines", dated September, 1992. Copies of the Guidelines are available for review in the HIV/STD Prevention Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3199. Copies also are available on request. (2) A state employee who may have been exposed to HIV while performing duties of state employment may not be required to be tested. (3) HIV counseling and testing will be performed on a state employee at the expense of the state agency if: (A) the employee documents to the agency's satisfaction that he or she may have been exposed to HIV while performing duties of employment of the agency; and (B) the exposure was a needlestick or other penetrating puncture of the skin with a used needle or other contaminated item; or either a splatter or aerosol into the eye, nose, or mouth or any significant contamination of an open wound or non-intact skin with blood or body fluids known to transmit HIV. (c) Worker's compensation. To qualify for workers' compensation or similar benefits or compensation, the employee must provide the state agency with a written statement of the date and circumstances of the exposure and document that, within ten days after the date of the exposure, the employee had a test result that indicated the absence of HIV infection. Further information can be obtained from "Risk Management for Texas State Agencies, Volume III, Workers' Compensation Exposures," which is available from the Risk Management Division, Texas Workers' Compensation Division, 4000 South IH-35, Southfield Building, Austin, Texas 78704. sec.97.142. Model Health Education Program/Resource Guide for HIV/AIDS Education of School-Age Children. (a) The Texas Department of Health has prepared the Model Education Programs required by the Texas Health and Safety Code, sec.sec.85.004, 85.005, and 85.007. It is the department publication titled, "Model Health Education Program/Resource Guide for HIV/AIDS Education of School-Age Children" dated January, 1993. The guide provides resources to develop a model health education program suitable for school-age children and is aimed at preventing the spread of the human immunodeficiency virus (HIV), which is the cause of acquired immunodeficiency syndrome (AIDS). (b) Copies of the guide are available for review and purchase from the HIV/STD Prevention Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3199. Regional HIV Coordinators (TDH) and regional Education Service Centers have inspection copies available. sec.97.143. Model HIV/AIDS Workplace Guidelines. (a) The Texas Department of Health has prepared Model Workplace Guidelines required by the Texas Health and Safety Code, sec.85.012. It is the department publication titled, "HIV/AIDS Model Workplace Guidelines" dated December, 1989. The guidelines consist of two parts, as follows: (1) The first part consists of general workplace guidelines concerning persons with HIV infection and related conditions, including AIDS. All state agencies shall adopt and all private employers are encouraged to adopt HIV-related workplace guidelines that incorporate at a minimum the general workplace guidelines. (2) The second part consists of more specific workplace guidelines which are an extension of the general workplace guidelines in paragraph (1) of this subsection. All state agencies and contractors with the state who provide direct client services and programs shall adopt and implement workplace guidelines similar to the specific workplace guidelines. (b) Copies of the guidelines are available for review in the HIV/STD Prevention Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3199. Copies also are available on request. sec.97.144. Model Policies for the Handling, Care and Treatment of HIV/AIDS- infected Persons in the Custody of or Under the Supervision of Correctional Facilities, Law Enforcement Agencies, Fire Departments, Emergency Medical Services Providers and District Probation Departments. (a) The Texas Department of Health has prepared the Model Policies Concerning Persons in Custody required by the Texas Health and Safety Code, sec.85.141. It is the department publication titled, "Model Policies for the Handling, Care and Treatment of HIV/AIDS-Infected Persons in the Custody of or Under the Supervision of Correctional Facilities, Law Enforcement Agencies, Fire Departments, Emergency Medical Services Providers and District Probation Departments" dated October, 1990. The model policies consist of three sections, as follows. (1) The first part consists of policies concerning the provision of education for employees, inmates, and probationers; provision of information and training relating to infection control procedures; provision of infection control supplies, equipment, and training; provision of access to appropriate services; and provision of confidentiality of medical records relating to HIV infection. (2) The second part consists of policies concerning potential exposure to HIV infection while performing job duties. (3) The third part consists of policies concerning HIV testing, segregation, and isolation of detainees in correctional facilities or specified supervisory entities. All specified entities must develop and implement HIV/AIDS workplace policies similar to the model policies. (b) Copies of the policies are available for review in the HIV/STD Prevention Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3199. Copies also are available upon request. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 23, 1994. TRD-9436572 Susan K. Steeg General Counsel, Office of General Counsel Texas Department of Health Effective date: March 16, 1994 Proposal publication date: October 8, 1993 For further information, please call: (512) 458-7463 TITLE 28. INSURANCE Part I. Texas Department of Insurance Chapter 5. Property and Casualty Subchapter E. Texas Catastrophe Property Insurance Association Building Code Advisory Committee 28 TAC sec.5.4002 The Texas Department of Insurance adopts new sec.5.4002, concerning the Building Code Advisory Committee, which is appointed pursuant to the Insurance Code, Article 21.49, sec.6A(f), to advise and make recommendations to the Commissioner of Insurance on building specifications in the plan of operation of the Texas Catastrophe Property Insurance Association (TCPIA), as set forth in sec.5.4001 of this title. The new section is adopted without changes to the proposed text as published in the November 26, 1993, issue of the Texas Register (18 TexReg 8764). The new section is necessary to comply with the rule requirements of Texas Civil Statutes, Article 6252-33, which governs State Agency Advisory Committees. Article 6252-33 was enacted by the 73rd Texas Legislature in Senate Bill 383 and requires a state agency that is advised by an advisory committee to adopt rules stating the purpose of the committee, the tasks of the committee, and the manner in which the committee will report to the agency. Article 6252-33, sec.1, defines "advisory committee" to mean a committee, council, commission, task force, or other entity in the executive branch of state government that is not a state agency, is created by or under state law, and has as its primary function the advising of a state agency. The Building Code Advisory Committee is an advisory committee appointed by the Commissioner pursuant to the Insurance Code, Article 21.49, sec.6A(f), to advise and make recommendations on building specifications in the TCPIA plan of operation. The Commissioner of Insurance is required to adopt rules for compliance with Article 6252-33 in order for the Building Code Advisory Committee to continue to function. Subsection (a) of new sec.5.4002 states the purpose of the rule which is to specify the purpose, task, reporting requirements, membership composition, and duration of the Building Code Advisory Committee. Subsection (b) specifies the purpose of the committee which is to advise and make recommendations to the Commissioner of Insurance on building specifications in the plan of operation of the Texas Catastrophe Property Insurance Association. Subsection (c) outlines the tasks of the committee which are determined by the Commissioner of Insurance and include the writing, revising, updating, and otherwise advising the Commissioner on building specifications in the TCPIA plan of operation for residents of the 14 first tier counties who are provided windstorm and hail insurance through the TCPIA. Subsection (d) outlines the committee's reporting requirements. Subsection (e) specifies the membership composition of the committee, and subsection (f) provides for the duration of the appointees' membership and service on the committee. No comments were received regarding adoption of the new section. The new section is proposed pursuant to Texas Civil Statutes, Article 6252-33; the Insurance Code, Articles 21.49, 1.02, 1.03A, and 1.04C; and the Government Code sec.2001.004 et seq. Texas Civil Statutes, Article 6252-33, sec.5, requires a state agency that is advised by an advisory committee to adopt rules stating the purpose of the committee, the tasks of the committee, and the manner in which the committee will report to the agency. Article 21.49, sec.6A(f), of the Insurance Code provides that the Commissioner of Insurance shall appoint an advisory committee to advise and make recommendations on building specifications in the plan of operation of the Texas Catastrophe Property Insurance Association. Article 21.49, sec.6A(f) by its terms delegates appointment authority to the State Board of Insurance; however, this authority is interpreted to be delegated to the Commissioner of Insurance under Article 1.02 of the Insurance Code, as amended by the 73rd Texas Legislature in House Bill 1461, which provides that a reference in the Insurance Code or another insurance law to the State Board of Insurance means the Commissioner of Insurance or the Texas Department of Insurance, as consistent with the respective powers and duties of the Commissioner and the Department under Article 1.02. Section 1.23(c) of House Bill 1461 provides that on September 1, 1993, the Board shall relinquish authority over all areas of activity of the Texas Department of Insurance except the promulgation and approval of rates and policy forms and endorsements and hearings, proceedings, and rules related to these activities; such authority shall be exercised by the Board until no later than September 1, 1994. Section 1.23(d) of House Bill 1461 provides that on and after the date a Commissioner of Insurance is appointed under subsection (a) of sec.1.23 the Commissioner shall cooperate with the Board to assume the authority granted to the Board under subsection (c) of sec.1.23 and shall adopt rules as necessary to govern those activities. Section 1.23(d) further provides that as soon as possible after the appointment of the Commissioner under sec.1.23(a) but not later than September 1, 1994, the Commissioner shall assume the authority granted to the Board under sec.1.23(c). Pursuant to Board Order Number 60574, November 29, 1993, the State Board of Insurance transferred the authority granted to the Board under sec.1.23(c) of House Bill 1461 to the Commissioner of Insurance, effective December 16, 1993. Article 1.03A, as enacted in House Bill 1461, provides that the Commissioner of Insurance may adopt rules and regulations, which must be for general and uniform application, for the conduct and execution of the duties and functions of the Texas Department of Insurance only as authorized by a statute. Article 1.04C of the Insurance Code, as enacted in House Bill 1461, requires the Commissioner of Insurance to develop and implement policies that provide the public with a reasonable opportunity to appear before the Commissioner and to speak on any issue under the Commissioner's jurisdiction. The Government Code sec.2001.004 et seq. (Administrative Procedure Act) authorize and require each state agency to adopt rules of practice setting forth the nature and requirement of available procedures and to prescribe the procedures for adoption of rules by a state agency. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 18, 1994. TRD-9436499 Linda K. von Quintus-Dorn Chief Clerk Texas Department of Insurance Effective date: March 11, 1994 Proposal publication date: November 26, 1993 For further information, please call: (512) 463-6327 TITLE 31. NATURAL RESOURCES AND CONSERVATION Part X. Texas Water Development Board Chapter 355. Research and Planning Fund Subchapter B. Economically Distressed Areas Facility Engineering 31 TAC sec.sec.355.71-355.73 The Texas Water Development Board (the board) adopts amendments to sec.355. 71 and sec.355.73, without changes to the proposed text as published in the January 14, 1994, issue of the Texas Register (19 TexReg 259). Section 355.71 is amended to include criteria to determine the percentage of board funding for the cost of facility planning. Under the current section, the board will routinely fund up to 75% of the cost of the facility planning unless the board determines that the applicant is entitled to hardship status, in which case the board would fund 100% of the facility planning. The circumstances which entitle a community to hardship status have heretofore been undefined. The new subsection would remove the hardship distinction and set forth the criteria which the board will consider in determining the percentage of funds the board will make available to all applicants for facility planning. No comments were received regarding adoption of the amendments. The board also adopts an amendment to sec.355.73, which will permit the executive administrator the authority to require the preparation of an environmental review consistent with sec.375.35, when applicable as part of the scope of work for the facility engineering plans. The facility engineering plan is the first step toward acquiring financial assistance from the economically distressed areas program for the construction of water supply or wastewater treatment facilities. The economically distressed areas program has acquired federal funds and in order for eligible applicants to use the federal funds the environmental review process identified in sec.375.35 is required. The amendment would allow the executive administrator to require the environmental review required in sec.375.35 in the event the applicant may be eligible for federal funds. No comments were received regarding adoption of the amendments. The amendments are adopted pursuant to Texas Water Code, sec.6.101 and sec.15. 403, which require the Board to adopt rules to carry out the purposes of the Texas Water Code and the Texas Water Assistance Program. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 22, 1994. TRD-9436548 Suzanne Schwartz General Counsel Texas Water Development Board Effective date: March 15, 1994 Proposal publication date: January 14, 1994 For further information, please call: (512) 463-7981 TITLE 34. PUBLIC FINANCE Part I. Comptroller of Public Accounts Chapter 9. Property Tax Administration Subchapter C. Appraisal District Administration 34 TAC sec.9.404 The Comptroller of Public Accounts adopts an amendment to sec.9.404, concerning application for exemption of goods exported from Texas ("freeport exemption"), without changes to the proposed text as published in the December 21, 1993, issue of the Texas Register (18 TexReg 9832). Section 9.404 sets out the contents of the exemption application and adopts the exemption application form by reference. The amendment is necessary because Senate Bill 1487, 73rd Legislature, 1993, amended the Tax Code, sec.11. 251, providing the exemption for goods exported from Texas. The amendment to sec.11.251 states that property that meets the requirements of the Texas Constitution, Article VIII, sec.sec.1-j(a)(1) and (2), and that is transported outside of the state 175 days or fewer after the date the person who owns it on January 1 acquired or imported it into the state qualifies as freeport goods regardless of whether the person owning the goods on January 1 transported them outside of the state. The proposed amendment revises the information required in the application form to provide that the property owner may claim the exemption regardless of whether the owner is the person who transported the goods outside of the state. The rule adopts an amended application form by reference. No comments were received regarding adoption of the amendment. The amendment is adopted under the Tax Code, sec.11.43(f), which requires the comptroller to prescribe the contents and form for each kind of property tax exemption. The amendment implements the Tax Code, sec.11.251 and sec.11.43(a) . This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 22, 1994. TRD-9436568 Martin E. Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 16, 1994 Proposal publication date: December 21, 1993 For further information, please call: (512) 463-4028 34 TAC sec.9.407 The Comptroller of Public Accounts adopts new sec.9.407, concerning an application for exemption for cotton stored in a warehouse, without changes to the proposed text as published in the December 21, 1993, issue of the Texas Register (18 TexReg 9835). The new section sets out the contents of the exemption application, which incorporate the requirements of the Tax Code, sec.11.251 and sec.11.436, effective January 1, 1994. The section is necessary because Senate Bill 1487, 73rd Legislature, 1993, created the new exemption for cotton stored in a warehouse. The new rule specifies the language and order of the information in the application form. The form is similar to the one for goods exported from Texas ("freeport exemption"), reflecting the requirements of the Tax Code, sec.11.251. The rule adopts the application form by reference. No comments were received regarding adoption of the amendment. The new section is adopted under the Tax Code, sec.11.43(f), which requires the comptroller to prescribe the contents and form for each kind of property tax exemption. The new section implements the Tax Code, sec.11.436 and sec.11. 43(a). This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 22, 1994. TRD-9436567 Martin E. Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 16, 1994 Proposal publication date: December 21, 1993 For further information, please call: (512) 463-4028 Subchapter H. Tax Record Requirements 34 TAC sec.9.3015 The Comptroller of Public Accounts adopts an amendment to sec.9.3015, concerning the report of decreased value forms, with changes to the proposed text as published in the December 14, 1993, issue of the Texas Register (18 TexReg 9265). The change occurred in subsection (b)(1) and clarifies the report's filing deadline. Section 9.3015 sets out the contents of the forms for the report of decreased value by any property owner. The amendment is necessary because House Bill 1016, 73rd Legislature, 1993, changed the deadline to file a report of decreased value from "before April 1" to "before April 15." The proposed amendment reflects the new filing deadline for renditions and property reports. One comment was received concerning the filing date for the report of decreased value. The comptroller changed the rule's language to clarify the report's filing deadline. The amendment is adopted under the Tax Code, sec.5.07, which requires the comptroller to prescribe the contents of all forms necessary for the administration of the property tax system, and the Tax Code, sec.22.24, which permits the comptroller to prescribe the contents of renditions and reports of property value. The amendment implements the Tax Code, sec.23.03 and sec.22.23. sec.9.3015. Report of Decreased Value Forms. (Tax Code, sec.23.03 and sec.22.23). (a) All appraisal offices shall prepare and make available forms for the report of decreased value by any property owner. (b) All forms for the report of decreased value by any property owner shall provide for the following information: (1) a statement indicating that the report form is to be filed by the property owner after January 1 and before April 15; (2) the year for which the report of decreased value is filed; (3) the name of any taxing units to which the report of decreased value is filed; (4) the identification of the property owner filing the report of decreased value (name and address); (5) the legal description of the property involved in the filing of the report of decreased value and its location; (6) the name and address of a person to contact for additional information; (7) the date of the report of decreased value; (8) the signature of the property owner, or the authorized officer or agent, filing the report of decreased value; and (9) a statement that the report of decreased value is confidential and not open to public inspection, except for those instances set forth in the Texas Property Tax Code, sec.22.27(b). (c) In order to determine the appraised value of property that is the subject of a completed and timely filed report of decreased value, the report form will provide for the following necessary information: (1) a statement indicating the nature and cause of decreased value of the property subject to the report; and (2) a statement indicating that the property owner may state his or her opinion about the market value of the property subject to the report. (d) All forms for the report of decreased value by any property owner shall require the property owner to state that the information contained in the form is true and correct. (e) All forms for the report of decreased value by any property owner shall make provision for the following information on the back of the form: (1) the name of the person from the tax office who reviews the property to verify any change in value; (2) the date the person from the tax office views the property subject to the report or, in the case of an oil and gas property, reviews the appraisal of the property; and (3) the determination of any decrease in appraised value and its cause and nature by the person from the tax office who views the property to verify any change in value. (f) Appraisal offices failing to establish a form for the report of decreased value as required in this section may be judged to be in compliance upon a showing to the board that a form for the report of decreased value substantially equivalent to that required in this section has been established. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 22, 1994. TRD-9436569 Martin E. Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 16, 1994 Proposal publication date: December 14, 1993 For further information, please call: (512) 463-4028 34 TAC sec.9.3038 The Comptroller of Public Accounts adopts an amendment sec.9.3038, concerning the current, delinquent, and special valuation rollback tax bills or statements, without changes to the proposed text as published in the December 14, 1993, issue of the Texas Register (18 TexReg 9269). Section 9.3038 sets forth the requirements for the contents of tax bills and statements. The amendment is necessary because Senate Bill 878, 73rd Legislature, 1993, creates a new method under which the owner of a special inventory as defined by the Tax Code, sec.23.12A, pays a tax levied against the inventory. The bill also requires relevant taxing units to itemize separately the taxes levied against special inventories on the tax bills prepared for the owners of special inventory. This bill becomes effective January 1, 1994. The proposed amendment requires that taxing units itemize separately the tax levied against a special inventory on the current and delinquent tax bills. No comments were received regarding adoption of the amendment. The amendment is adopted under the Tax Code, sec.5.07, which requires the comptroller to prescribe the contents of all forms necessary for the administration of the property tax system, and the Tax Code, sec.31.01, which permits the comptroller to require certain information on the tax bill. The bill implements the Tax Code, sec.23.12A. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 22, 1994. TRD-9436570 Martin E. Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 16, 1994 Proposal publication date: December 14, 1993 For further information, please call: (512) 463-4028 Subchapter I. Validation Procedures 34 TAC sec.9.4027 The Comptroller of Public Accounts adopts new sec.9.4027, concerning appraisal of special inventory consisting of motor vehicles and other applicable inventory required to register with the Texas Department of Transportation through the county tax assessor-collector, without changes to the proposed text as published in the December 14, 1993, issue of the Texas Register (18 TexReg 9274). The new section clarifies the requirements of the Tax Code, sec.23.12A and sec.23.12B, effective January 1, 1994. The section is necessary because of the passage of Senate Bill 878, 73rd Legislature, 1993, which created a new appraisal method for the owners of special inventory. The comptroller is directed to create a special inventory tax statement, which the owner of the special inventory must file monthly with the chief appraiser for each unit sold. The owner must also file on or before February 1 of each year, a special inventory declaration with the chief appraiser, with a copy to the county tax assessor-collector. The rule clarifies the definition of "most recent" in describing county aggregate tax rate, as provided for in the definition of "unit property tax value factor" in the Tax Code, sec.23.12B(10). This addition is necessary for the implementation of the requirements for the new appraisal of special inventory. No comments were received regarding adoption of the amendment. The new section is adopted under the Tax Code, sec.11.43(f), which requires the comptroller to prescribe the contents and form for each kind of property tax exemption. The bill implements the Tax Code, sec.23.12A and sec.23.12B. This agency hereby certifies that the rule as adopted has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on February 22, 1994. TRD-9436566 Martin E. Cherry Chief, General Law Section Comptroller of Public Accounts Effective date: March 16, 1994 Proposal publication date: December 14, 1993 For further information, please call: (512) 463-4028 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 5. 97, the Texas Register publishes notices of actions taken by the Department of Insurance pursuant to Chapter 5, Subchapter L, of the Code. Board action taken under these articles is not subject to the Administrative Procedure 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 Department of Insurance, 333 Guadalupe, Austin.) The Texas Department of Insurance at a public meeting held at 9:00 a.m., February 22, 1994, in Room 100 of the Texas Department of Insurance Building, 333 Guadalupe Street, Austin, Texas, adopted the surety bond form filed by the City of Austin, Texas entitled "Professional Fund-Raiser's Surety Bond." The form was filed in the Chief Clerk's Office on February 2, 1994. The Professional Fund-Raiser's Surety Bond (Bond) is required by provisions of Chapter 8-5 of the Code of the City of Austin, Texas of 1992 (Code). The Bond ensures charitable organizations that the named professional fund-raiser, as principal, shall be bound to faithfully perform all obligations and requirements imposed under the provisions of the Code, and supporting regulations. The term of the bond shall be for the entire period of the professional fund-raiser's license issued by the city clerk. The full text of the surety bond form filing (Reference Number 0-0294-02), was published in the February 8, 1994, issue of the Texas Register (19 TexReg 981). The Texas Department of Insurance has jurisdiction over this matter pursuant to the Insurance Code, Articles 5.13, 5.15, and 5.97. The full text of the surety bond form entitled "Professional Fund-Raiser's Surety Bond," as adopted by the Texas Department of Insurance is filed with the Chief Clerk under (Reference Number 0-0294-02) and is incorporated by reference by Commissioner Order Number 94-0187. This notification is made pursuant to the Insurance Code, Article 5.97, which exempts it from the requirements of the Administrative Procedure Act and Texas Register Act. The Texas Department of Insurance hereby certifies that the adopted form filing referenced herein has been reviewed by legal counsel and found to be within this agency's authority to adopt. Issued in Austin, Texas, on February 23, 1994. TRD-9436581 Linda K. von Quintus-Dorn Chief Clerk Texas Department of Insurance Effective: March 16, 1994 Filed: February 23, 1994