TITLE health-services

Part II. Texas Department of Mental Health and Mental Retardation

Chapter 419. Medicaid State Operating Agency Responsibilities

Subchapter G. Medicaid Fair Hearings

25 TAC §419.301

The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes new §419.301, of new Chapter 419, Subchapter G, concerning Medicaid fair hearings.

The new section would adopt by reference rules of the Health and Human Services Commission (HHSC) contained in 1 TAC §§357.1, 357.3, 357.5, 357.7, 357.9, 357.11, 357.13, 357.15, 357.17, 357.19, 357.21, 357.23, 357.25, 357.27, and 357.29 of Chapter 357 (relating to Medicaid Fair Hearings), which were published in the March 26, 1999, issue of the Texas Register . The new section would also define the term "authorized representative."

New sections relating to Medicaid fair hearings were previously proposed in the September 4, 1998, issue of the Texas Register , but not adopted. Response to public comments received on the previous proposal are addressed in HHSC's order adopting the above-referenced rules.

Stephen Zeeck, acting chief financial officer, has determined that for each year of the first five years the new rule is in effect, as proposed, enforcing or administering the rule does not have foreseeable implications relating to cost or revenues of the state or local governments.

Ernest McKenney, director, Medicaid Administration, has determined that for each year of the first five years the rule is in effect, as proposed, the public benefit expected as a result of the adoption of the rule is the implementation of fair hearing procedures that are uniform for all operating agencies. The uniformity of rules among the operating agencies allows the public to more easily become familiar with fair hearing procedures. There would be no economic cost to persons required to comply with the rule.

It is not anticipated that the rule will affect a local economy.

It is not anticipated that this rule will have an adverse economic effect on small businesses because small businesses will not participate in the administration of fair hearings for Medicaid recipients.

Written comments on the proposal may be sent to Linda Logan, director, Policy Development, TDMHMR, 909 West 45th Street, Austin, Texas 78751, within 30 days of publication.

This section is proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of HHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program; and the Texas Government Code, §531.024, which requires the promulgation of uniform fair hearings rules for all Medicaid-funded services. HHSC has delegated to TDMHMR the authority to operate certain Medicaid programs.

This section would affect the Texas Government Code, §531.024.

§419.301.Medicaid Fair Hearings.

(a)

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts by reference rules of the Health and Human Services Commission contained in 1 TAC §§357.1, 357.3, 357.5, 357.7, 357.9, 357.11, 357.13, 357.15, 357.17, 357.19, 357.21, 357.23, 357.25, 357.27, and 357.29 of Chapter 357 (relating to Medicaid Fair Hearings).

(b)

As used in 1 TAC §357.1(b)(2), the term "authorized representative" means the parent, guardian, or managing conservator of an individual who is a minor or the guardian of the person of an individual who is an adult.

(c)

Copies of the Health and Human Services Commission rules are available by contacting the Office of Policy Development, TDMHMR, 909 West 45th Street, Austin, Texas 78751.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on April 1, 1999.

TRD-9901960

Charles Cooper

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: May 16, 1999

For further information, please call: (512) 206-4516


Part V. Center for Rural Health Initiatives

Chapter 500. Executive Committee for the Center for Rural Health Initiatives

The Center for Rural Health Initiatives (center) proposes the repeal of §§500.2 and 500.10, and proposes amendments to §§500.1 and 500.3-500.9 concerning Policies and Procedures of the Center and its Executive Committee.

The repeal of §500.2 and §500.10 are to eliminate duplication. The membership of the Center's Executive Committee is already laid out in state statute and thus requires no repetition. Membership for the Center's Executive Committee will remain the same as currently required in state statute. These rules also propose to repeal §500.10 which require Executive Committee approval of other actions by the Center's Executive Director where approval is required by law. This rule has been incorporated into §500.9 and therefore no longer requires a separate section.

The center was established by the Texas Legislature in the Health and Safety Code, Chapter 106. The center works or contracts with state and federal agencies, universities, private interest groups, communities, foundations and offices of rural health to develop rural health initiatives and maximize use of existing resources. The center provides a central information and referral source and serves as the primary state resource in coordinating, planning, and advocating for the continued access to rural health care services in the state.

The amendments to the sections clarify the time at which the election of officers of the center's executive committee shall occur, authorize advisory committee members to designate employees of the agency of the member to serve as liaison officers, authorize the executive committee to establish standing or ad hoc committees as working extensions of the executive committee which may have non-executive committee members as members of the committees, allow for meetings of the executive committee to be held at places fixed by the executive committee or its presiding officer, allow for meetings of the executive committee to be held at the call of three members of the executive committee, eliminate provisions for special meetings because all meetings are public and subject to the posting requirements established by state law, eliminate the reasons under which the executive committee may meet in executive session because the provisions are already stated in state law, and eliminate the requirement that executive sessions have both a tape recording and a certified agenda of the proceedings.

Further amendments clarify that notices of meetings shall be furnished by the executive director and posted at least seven days prior to the day of the meeting in the main office of the secretary of state; clarify that the presiding officer shall approve the agenda prior to its distribution; state that any or all parts of an open meeting may be recorded by any person in attendance but that the presiding officer shall determine the location of any recording equipment and the manner in which the recording is conducted; eliminate the unnecessary notation that legislation prescribes requirements which may be incorporated as administrative procedures; eliminate duplicative language requiring that members of special ad hoc committees be approved by the executive committee; and move a section noting that the executive committee is responsible for approving any actions by the executive director where approval is required by law, requested by the executive director or desired by the executive committee. The amendments update legal citations to state laws. In addition the amendments include other minor language changes for the purpose of clarification and numerous numbering and lettering changes to reflect consistency.

Robt. J. "Sam" Tessen, Executive Director, has determined that for each year of the first five years the sections are in effect, there will be no fiscal implications to state or local government as a result of enforcing or administering the sections as proposed.

Robt. J. "Sam" Tessen, Executive Director, has determined that for each of the first five years the sections are in effect, the public benefits anticipated as result of enforcing or administering the sections will provide for more effective and efficient governance of operations of the center as the public agency for rural health advocacy by the appointed members of the executive committee, allow for clearer rules more easily understood by the public, and clarify access to and information about open meetings of the executive committee. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the amendments as proposed. There is no anticipated impact on local government.

Comments on the proposal may be substituted to Robt. J. "Sam" Tessen, Executive Director, Center for Rural Health Initiatives, P.O. Drawer 1708, Austin, Texas 78767, (512) 479-8891. Comments will be accepted for 30 days following publication of the proposal in the Texas Register .

Subchapter A. Policies and Procedures

25 TAC §500.2, §500.10

(Editor's note: The text of the following sections proposed for repeal will not be published. The sections may be examined in the offices of the Center for Rural Health Initiatives or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The repeals are proposed under the Health and Safety Code, §106.021 which requires the center to adopt rules relating to executive committee meetings and to implement Chapter 106.

The repeals affect the Health and Safety Code, Chapter 106.

§500.2. Membership.

§500.10. Other Actions.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on March 30, 1999.

TRD-9901876

Robert J. “Sam” Tessen

Executive Director

Center for Rural Health Initiatives

Earliest possible date of adoption: May 16, 1999

For further information, please call: (512) 479-8891


25 TAC §§500.1, 500.3-500.9

The amendments are proposed under the Health and Safety Code, §106.021 which requires the center to adopt rules relating to executive committee meetings and to implement Chapter 106.

The amendments affect the Health and Safety Code, Chapter 106.

Introduction [ Preamble ].

The Center for Rural Health Initiatives (center) has been established by the legislature in the Health and Safety Code, Chapter 106 [ Texas Civil Statutes, Article 4414b-1 ], to enhance and preserve the access and viability of rural health care delivery systems and services in Texas through rural health initiatives. The center consists of the executive committee, the executive director, [ and ] the advisory committee, and center personnel . The executive committee, as the governing body of the center, has formulated these operating policies and procedures for the orderly and efficient functioning of the center [ executive committee ] in carrying out its responsibilities under the law. In the development of policies and procedures related to rural health initiatives [ laws (federal, state, and local) ], the executive committee shall at all times remain cognizant of the rights of individuals [ the individual ] and organized groups by responsible action without favoritism or prejudice.

§500.3. Organization.

(a)

The Executive Committee for the Center for Rural Health Initiatives (executive committee) shall annually elect one member to serve as presiding officer (chairman), one member to serve as vice-chairman, and one member to serve as secretary at the first meeting of the executive committee which occurs after September 1 of each year .

(b)

(No change.)

(c)

Any actions taken by the executive committee shall be approved by a majority vote of all members present .

§500.4. Committees.

(a)

The Executive Committee for the Center for Rural Health Initiatives (executive committee) is the governing body of the [ Texas ] Center for Rural Health Initiatives (center). The executive committee shall meet as a committee of the whole. [ The presiding officer may appoint standing and special ad hoc committees from the executive committee to expedite its work. The executive committee may request advisory committee members to designate employees to serve as liaison officers. ]

(b)

The Advisory Committee for the Center for Rural Health Initiatives (advisory committee) shall participate in the executive committee meetings; however, advisory committee members do not have voting privileges. The advisory committee members shall provide staff support to the center and staff and may provide other support services to the executive committee to expedite the work of the executive committee. The executive committee may request advisory committee members to designate employees to serve as liaison officers.

(1)

[ (c) ] The costs of participation on an advisory committee for a member representing a particular agency or organization shall be borne by that member agency.

(2)

[ (d) ] Advisory committee members, including special or ad hoc members, shall advise the executive committee:

(A)

[ (1) ] of rural health missions in their agencies;

(B)

[ (2) ] of rules, regulations, policies, procedures, programs, and services relative to rural health in their agencies;

(C)

[ (3) ] of appropriate rules for rural health;

(D)

[ (4) ] on priorities of emphasis;

(E)

[ (5) ] on amount of money needed;

(F)

[ (6) ] on priorities among criteria for consideration of application approval;

(G)

[ (7) ] on the dissemination of information on programs and service;

(H)

[ (8) ] on minority status;

(I)

[ (9) ] on geographical emphasis; and

(J)

[ (10) ] on other information or issues as requested by the executive director or the executive committee.

(c)

Standing or special ad hoc committees. The executive committee may establish standing or special ad hoc committees which are working extensions of the executive committee. The presiding officer of the executive committee may appoint members of the executive committee to the standing or ad hoc committees. The presiding officer may also appoint non-executive committee members to the standing or ad hoc committees.

§500.5. Executive Director.

(a)

(No change.)

(b)

The executive director, as the chief executive officer of the [ Texas ] Center for Rural Health Initiatives (center), shall:

(1)-(8)

(No change.)

(c)

The executive director shall take appropriate administrative action to direct or to delegate to staff responsibilities and authority to carry out center duties. The authority must assure the existence of an appropriate organization; adequate personnel; suitable administrative[ , ] and clerical [ , and laboratory ] facilities; and sufficient financial support to function effectively. The executive director shall take the actions necessary to comply with and enforce the federal or state laws applicable to the center and its mission to enhance and preserve the health of the citizens of the state.

§500.6. Executive Committee Policies.

(a)

Policy goals.

(1)

The Executive Committee for the Center for Rural Health Initiatives (executive committee) shall conduct all business of the Center for Rural Health Initiatives (center) through the executive director. [ Standing and special ad hoc committees of the executive committee are working extensions of the executive committee. ] In keeping with the spirit of this policy, individual members of the executive committee when contacting center staff shall refrain from giving directives or establishing policy. All center staff personnel are to be advised of this policy. When making statements to the general public concerning matters under the jurisdiction of the executive committee, individual members shall not state or imply that the individual member's opinion necessarily represents the opinion or policy of the executive committee.

(2)

(No change.)

(b)

General policies. The executive committee, in discharging its legal responsibilities as the governing body of the center, shall establish policy in the form of statements recorded in the official minutes of the executive committee which shall be directive and provide the executive director the authority to administer the services, programs, and activities of the center. [ Although policies and rules adopted by the executive committee can only be eliminated, changed, or amended by the executive committee, legislation may specifically determine policies of the executive committee. ]

(c)

Adoption and amendment of executive committee policies. Specific policies may be adopted or amended under the following conditions. Each member of the executive committee shall be furnished a copy of the proposed new policy or a proposed amendment with the agenda [ in the preliminary and official agendas ] for the meeting at which it is to be considered. An affirmative vote by a majority of the executive committee members attending shall be required for the adoption of the new policy or policy amendment. New or amended policies shall be effective on the date of adoption unless otherwise specified.

§500.7. Executive Committee Meetings.

(a)

Meetings [ Regular meetings ] of the Executive Committee for the Center for Rural Health Initiatives (executive committee). The executive committee shall meet in Austin, or at other places fixed by the executive committee or presiding officer , at least quarterly on dates to be fixed by the executive committee, at the call of three members of the executive committee or at the call of the presiding officer. Meetings [ Regular or called meetings ] shall include Advisory Committee for the Center for Rural Health Initiatives (advisory committee) members at the will of the executive committee.

[ (b)

Special meetings of the executive committee. Special meetings of the executive committee may be held at times and places as ordered by the executive committee during a formal session, or special meetings may be called by the presiding officer to be held at a time and place as he/she shall designate in a notice of meeting. The notice of special meeting shall state the date, time, and place of the meeting and shall be forwarded to the members not less than 72 hours in advance of the time of meeting. Special meetings shall include advisory committee members at the will of the executive committee.]

(b)

[ (c) ] Open meeting and executive sessions. Meetings [ Regular, special, and committee meetings ] of the executive committee shall be open to the public; however, as provided by the Texas Open Meetings Act, Texas Government Code, Chapter 551 [ Civil Statutes, Article 6252-17 ], the executive committee may meet in executive sessions . [ on items: ]

[(1)

involving the appointment, employment, evaluation, reassignment, duties, discipline, or dismissal of a public officer or employee or to hear complaints or charges against such officer or employee, unless such officer or employee requests a public hearing; ]

[(2)

with respect to the purchase, exchange, lease, or value of real property and negotiated contracts for prospective gifts or donations to the state or the governing body, when such discussion would have a detrimental effect on the negotiating position of the executive committee as between the executive committee and a third person, firm, or corporation;]

[(3)

regarding the deployment, or specific occasions for implementation of security personnel or devices; or]

[(4)

in private consultations between a governing body and its attorney, instances in which the executive committee seeks the attorney's advice with respect to pending or contemplated litigation, settlement offers, and matters where the duty of the executive committee's counsel to his client, pursuant to the Code of Professional Responsibility of the State Bar of Texas, clearly conflicts with applicable statutory provisions.]

(c)

[ (d) ] Executive sessions. Executive sessions of the executive committee shall be meetings with only executive committee members and invited persons present. Executive sessions shall be held only to consider such items as provided by law. [ Each meeting that is closed to the public shall keep a tape recording and a certified agenda of the proceedings. Actions of the executive session resulting from deliberation in executive committee session will be announced in open meeting. ]

(d)

[ (e) ] Notice of meetings. A written notice [ of the date and place ] of each [ regular ] meeting of the executive committee shall be furnished by the executive director to the secretary of state at least seven days prior to the day of the meeting to be posted in the main office of the secretary of state [ capitol building ]. In cases of emergency or urgent public necessity, notice shall be given as authorized by the emergency notice provisions of the open meetings law.

(e)

[ (f) ] Agendas. The executive director shall prepare and submit to each member of the executive committee and the advisory committee prior to each meeting a preliminary copy of the agenda, outlining items to [ that he/she believes should ] be considered by the executive committee, those required by law, and others as members have requested. Materials supplementing the agenda may be included. The presiding officer shall approve the agenda prior to its distribution to the secretary of state or committee members. [ Official agendas shall be distributed on the day of the executive committee meeting. ]

(f)

[ (g) ] Quorum. Five members of the executive committee shall constitute a quorum.

(g)

[ (h) ] Official transaction of business. The executive committee may transact official business only when in session with a quorum present and shall not be bound in any way by any statement or action on the part of any individual member except when a statement or action is in pursuance of specific instructions of the executive committee.

(h)

[ (i) ] Rules of order. The executive committee shall observe Robert's Rules of Order, Newly Revised, except as otherwise provided by [ executive committee policies of ] this chapter or [ by ] a statute.

(i)

[ (j) ] Minutes. The official minutes of the executive committee shall be kept in the office of the executive director of the Center for Rural Health Initiatives (center) to be available to a person [ citizen ] desiring to examine them. Official minutes are those which the recording secretary prepares, the executive committee approves at a [ regular or special ] meeting, and are affixed with the original signatures of the presiding officer and the secretary of the executive committee. Drafts of the minutes shall be forwarded to each member for review and comments or corrections prior to approval of the executive committee.

(j)

Recording meetings. All or any part of an open meeting may be recorded by any person in attendance. The presiding officer will determine the location of any recording equipment and the manner in which the recording is conducted, provided that the determination does not prevent or unreasonably impair camera coverage or tape recording.

§500.8. Press and Public Relations.

(a)

Prior to each Executive Committee for the Center for Rural Health Initiatives (executive committee) meeting, copies of the [ preliminary ] agenda shall be sent to the capitol press corp, governor's office, lieutenant governor's office, office of the speaker of the House of Representatives, secretary of state, and legislative budget board.

(b)-(d)

(No change.)

§500.9. Actions Requiring Executive Committee Approval.

(a)

(No change.)

(b)

Approval and revision of administrative procedures.

[ (1) ]

Administrative procedures are determined and implemented by the executive director in accordance with the policies of the executive committee. [ However, on occasion, legislation specifically prescribes requirements which are incorporated as administrative procedures. ] The executive committee shall approve administrative procedures when required by law, required by executive committee policy, or requested by the executive director.

[(2)

When executive committee action is required, the executive director shall present the proposed administrative procedure(s) change in the official agenda of the executive committee.]

(c)

Standards and rules. [ Special ad hoc committee members. Members of special ad hoc committees shall be approved by the executive committee upon recommendation of the executive director. ] Any standards[ , ] or rules [ , or regulations ] developed or streamlined to assist in developing rural health service through advisory committee or Center for Rural Health Initiatives (center) activity shall be approved by the executive committee prior to adoption and implementation.

(d)

(No change.)

(e)

Budget request. The center's consolidated budget, including contracts, grants, gifts and donations necessary to carry out the center's duties under state law [ Article 4414b-1 ], will be approved by the executive committee prior to submission to the Texas Department of Health and the legislature.

(f)

Other actions. The executive committee is responsible for approving any other actions by the executive director or the center where approval of the executive committee is required by law, requested by the executive director, or desired by the executive committee.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on March 30, 1999.

TRD-9901877

Robert J. “Sam” Tessen

Executive Director

Center for Rural Health Initiatives

Earliest possible date of adoption: May 16, 1999

For further information, please call: (512) 479-8891