Part I.
Texas Department of Human Services
Chapter 15.
Medicaid Eligibility
Subchapter F. Budgets and Payment Plans
40 TAC §15.503
The Texas Department of Human Services (DHS) adopts an amendment
to §15.503, without changes to the proposed text published in the December
18, 1998, issue of the
Texas Register
(23
TexReg 12890) and will not be repubished.
The justification of the amendment is to clarify that the expanded protected
resource amount (PRA) determined by the hearing officer at appeal cannot exceed
the value of the couple's combined countable resources as of the first month
of entry to a medical care facility for a continuous stay.
The amendment will function by assuring that the formula used by hearing
officers to develop the expanded PRA will be applied correctly and consistently
statewide.
No comments were received regarding the adoption of the amendment.
The amendment is adopted under the Human Resources Code, Title
2, Chapters 22 and 32, which authorizes the department to administer public
and medical assistance programs and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendment implements the Human Resources Code, §§22.001-22.030
and §§32.001-32.042.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January
25, 1999.
TRD-9900533
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: March 1, 1999
Proposal publication date: December 18, 1998
For further information, please call: (512) 438-3765
Subchapter C. Nursing Facility Licensure Application Process
40 TAC §19.201
The Texas Department of Human Services (DHS) adopts an amendment
to §19.201, in its Nursing Facility Requirements for Licensure and Medicaid
Certification chapter. The amendment is adopted without changes to the proposed
text published in the December 18, 1998, issue of the
Texas Register
(23 TexReg 12891) and will not be republished.
The justification for the amendment is to correct an error in the rule
as previously adopted in the October 9, 1998, issue of the
Texas Register
. The word "unable" was left out.
The amendment will function by correcting the error in the rule.
The department received no comments regarding adoption of the amendment.
The amendment is adopted under the Health and Safety Code, Chapter
242, which gives the department the authority to license and regulate nursing
facilities.
The amendment implements the Health and Safety Code, §242.037.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January
28, 1999.
TRD-9900590
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: March 15, 1999
Proposal publication date: December 18, 1998
For further information, please call: (512) 438-3765
Chapter 141.
General Provisions
40 TAC §141.21
The Texas Commission on Alcohol and Drug Abuse adopts amendments
to §141.21 concerning general provisions without changes to the proposed
text as published in the November 13, 1998 issue of the
Texas Register
(23 TexReg 11562).
This section is amended to clarify the role of commission staff in relation
to each advisory council, to state that travel expenses for all advisory councils
may be paid only when funds have been appropriated for this purpose, and to
establish and describe a statewide planning committee that will assist in
the development and implementation of the Statewide Services Delivery Plan.
This section contains the requirements for advisory councils.
No comments were received regarding adoption of the amendments.
The amendments are adopted under the Texas Health and Safety
Code, Title 6, Subtitle B, §461.012(a)(15) which provides the Texas Commission
on Alcohol and Drug Abuse with the authority to adopt rules governing the
functions of the commission, including rules that prescribe the policies and
procedures followed by the commission in administering any commission programs,
and the Texas Health and Safety Code, Title 6, Subtitle B, §461.012(b)
and §461.012(c) which provides the Texas Commission on Alcohol and Drug
Abuse with the authority to appoint advisory committees.
The code affected by these amendments is the Texas Health and Safety Code,
Chapter 461.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January
27, 1999.
TRD-9900584
Mark Smock
Deputy for Finance and Administration
Texas Commission on Alcohol and Drug Abuse
Effective date: February 16, 1999
Proposal publication date: November 13, 1998
For further information, please call: (512) 349-6733
Subchapter A. General Provisions
40 TAC §144.21
The Texas Commission on Alcohol and Drug Abuse adopts an
amendment to §144.21 concerning general provisions for contract requirements
without changes to the proposed text as published in the November 13, 1998
issue of the
Texas Register
(23 TexReg 11563).
This amendment is adopted to revise the definition of Qualified Credentialed
Counselor so that this term is consistently defined in all agency rules.
This section contains the definitions used in this chapter.
No comments were received regarding adoption of this amendment.
The amendment is adopted under the Texas Health and Safety Code,
Title 6, Subtitle B, §461.012(a)(15) which provides the Texas Commission
on Alcohol and Drug Abuse with the authority to adopt rules governing the
functions of the commission, including rules that prescribe the policies and
procedures followed by the commission in administering any commission programs.
The code affected by the amendment is the Texas Health and Safety Code,
Title 6, Subtitle B, Chapter 461.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January
27, 1999.
TRD-9900583
Mark Smock
Deputy for Finance and Administration
Texas Commission on Alcohol and Drug Abuse
Effective date: February 16, 1999
Proposal publication date: November 13, 1998
For further information, please call: (512) 349-6733
40 TAC §144.211
The Texas Commission on Alcohol and Drug Abuse adopts an
amendment to §144.211 concerning audits without changes to the proposed
text as published in the November 13, 1998 issue of the
Texas Register
(23 TexReg 11564).
The amendment is adopted to comply with revised applicable state requirements
regarding independent financial audits.
This section contains requirements for independent financial audits.
No comments were received regarding adoption of this amendment.
The amendment is adopted under the Texas Health and Safety Code,
Title 6, Subtitle B, §461.012(a)(15) which provides the Texas Commission
on Alcohol and Drug Abuse with the authority to adopt rules governing the
functions of the commission, including rules that prescribe the policies and
procedures followed by the commission in administering any commission programs.
The code affected by the proposed amendment is the Texas Health and Safety
Code, Title 6, Subtitle B, Chapter 461.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January
27, 1999.
TRD-9900582
Mark Smock
Deputy for Finance and Administration
Texas Commission on Alcohol and Drug Abuse
Effective date: February 16, 1999
Proposal publication date: November 13, 1998
For further information, please call: (512) 349-6733
40 TAC §144.431, §144.432
The Texas Commission on Alcohol and Drug Abuse adopts amendments
to §144.431 and §144.432 concerning prevention and intervention
without changes to the proposed text as published in the November 13, 1998
issue of the
Texas Register
(23 TexReg 11565).
The amendments are adopted to add requirements for staff who perform HIV
antibody counseling and testing, better describe the components of case management
and documentation requirements for case management, specify the documentation
requirements for comprehensive community resource networks, clarify the training
requirements and expectations for outreach workers, add requirements for outreach
workers who perform HIV antibody test counseling and for the counseling itself,
and to specify that written procedures are required to ensure the confidentiality
of individuals identified as HIV infected or at risk for HIV through outreach
activities.
These sections contain the requirements for HIV Early Intervention Services
and HIV Outreach Services.
A comment was received from an individual.
Comment: We have not been funded for the lab analyses required to screen
for tuberculosis and sexually transmitted diseases.
Response: Providers are only required to provide access to these services.
They can conduct the screening internally or refer clients to another agency
such as the local health department.
The amendments are adopted under the Texas Health and Safety
Code, Title 6, Subtitle B, §461.012(a)(15) which provides the Texas Commission
on Alcohol and Drug Abuse with the authority to adopt rules governing the
functions of the commission, including rules that prescribe the policies and
procedures followed by the commission in administering any commission programs.
The code affected by the amendments is the Texas Health and Safety Code,
Title 6, Subtitle B, Chapter 461.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on January
27, 1999.
TRD-9900581
Mark Smock
Deputy for Finance and Administration
Texas Commission on Alcohol and Drug Abuse
Effective date: February 16, 1999
Proposal publication date: November 13, 1998
For further information, please call: (512) 349-6733
40 TAC §§144.524, 144.531, 144.545
The Texas Commission on Alcohol and Drug Abuse adopts amendments
to §§144.524, 144.531 and 144.545 concerning treatment. Section
144.545 is adopted with changes to the proposed text as published in the November
13, 1998 issue of the
Texas Register
(23 TexReg
11566). Section 144.524 and §144.531 are adopted without changes to the
proposed text and will not be republished.
The amendments are adopted to clarify the facility capacity system requirements
for programs that treat individuals for intravenous substance abuse to comply
with the federal block grant, to specify what guidelines are to be used for
HIV education and for HIV risk assessments and risk reduction counseling,
to prohibit the use of commission funds for services available through other
sources, to add problem identification to the design of family services, to
more specifically state the components of family services, to include requirements
for those that provide family counseling services, and to more fully describe
the documentation requirements and processes for family services.
These sections contain the requirements for the facility capacity system,
screening and assessment, and family services. Section 144.545 has been revised
to identify which family services can be provided by Licensed Chemical Dependency
Counselors.
Comments were received from the Texas Association of Addiction Professionals
and a number of individuals.
Comment: Because language regarding pharmacotherapy programs has been deleted
in §144.524, will it be more difficult for a methadone treatment program
to obtain additional dollars at 90% capacity? Does this mean that any provider
who treats even a single intravenous drug user could apply for additional
funds when they reach capacity?
Response: Language was revised to parallel language in the Substance Abuse
Block Grant which imposes this requirement. The intent is to make treatment
available to intravenous drug users, and methadone treatment programs remain
a vital means of providing such treatment.
Comment: With regard to §144.545 subsection (a), would any chemical
dependency services other than those related strictly to methadone be considered
a duplication of services?
Response: Methadone treatment programs are expected to provide comprehensive
chemical dependency counseling for their clients. This rule only prevents
programs from using commission funds to provide ancillary services that are
available through other sources.
Comment: The wording of §144.545(d) seems to prohibit Licensed Chemical
Dependency Counselors (LCDCs) from providing substance abuse counseling to
families within the context of treatment. Such services are within the professional
scope of practice of a licensed professional counselor. Requiring all family
services to be provided by master-level professionals would diminish the professional
status of LCDCs and significantly increase the cost of providing client services.
Response: The commission agrees that LCDCs are qualified to provide substance-abuse
related counseling to families within the context of treatment. The intent
of this rule is to prevent LCDCs from practicing outside their scope of practice.
We have revised the language to clarify this.
The amendments are adopted under the Texas Health and Safety
Code, Title 6, Subtitle B, §461.012(a)(15) which provides the Texas Commission
on Alcohol and Drug Abuse with the authority to adopt rules governing the
functions of the commission, including rules that prescribe the policies and
procedures followed by the commission in administering any commission programs.
The code affected by the amendments is the Texas Health and Safety Code,
Title 6, Subtitle B, Chapter 461.
§144.545.Family Services.
(a)
Family services supplement an existing treatment program
by providing services to the family of the primary client. Commission funds
shall not be used to provide services available through other sources.
(b)
Family services shall be designed to identify family problems
associated with the client's chemical dependency, improve the health and functioning
of the family unit and/or to assist individual family members to achieve healthy,
drug-free life styles.
(c)
Family services may be provided to the entire family, individual
family members, or a subset of family members. Family services include:
(1)
family psychosocial evaluations;
(2)
individual therapy;
(3)
group therapy; and
(4)
structured, curriculum-based education and/or skills
training accompanied by group process.
(d)
Family services must be provided by qualified staff who
have the training and experience needed to perform the specific function.
Qualifications shall be based on industry standards and applicable licensure
requirements. LCDCs may provide family education, assessment, and counseling
services for issues that are directly related to substance abuse within the
family (including the development of healthy behavior patterns), commensurate
with the individual's training and experience. However, clients and/or family
members in need of counseling on issues outside the LCDC's scope of professional
practice must be referred to a qualified mental health professional such as
an LPC, LMFT, or LMSW.
(e)
Family services must be documented in a separate section
of the client record. The file must include the elements listed.
(1)
Family psychosocial evaluation. The evaluation must be
conducted by a properly credentialed professional.
(2)
Family service plan. The counselor and family shall
develop the plan, which must include:
(A)
problems and needs identified during the evaluation;
(B)
goals that address identified needs and state in behavioral
terms what the family is expected to achieve during the treatment period;
(C)
services to be provided to help the family achieve identified
goals.
(3)
Progress notes. Progress notes must document
the services provided and describe the family's progress towards stated goals.
The family therapist shall document each service contact in a signed progress
note that includes:
(A)
date, nature, and duration of the contact;
(B)
individuals involved;
(C)
content and goals addressed;
(D)
progress toward the goals; and
(E)
other relevant information.
(4)
Discharge plan. The discharge plan shall address
ongoing family needs, including:
(A)
family goals or activities to sustain progress;
(B)
referrals for other needed services; and
(C)
aftercare services, if applicable.
This agency hereby certifies that the adoption
has been reviewed by legal counsel and found to be a valid exercise of the
agency's legal authority.
Filed with the Office of the Secretary of State on January
27, 1999.
TRD-9900585
Mark Smock
Deputy for Finance and Administration
Texas Commission on Alcohol and Drug Abuse
Effective date: February 16, 1999
Proposal publication date: November 13, 1998
For further information, please call: (512) 349-6733
Chapter 182.
Specialized Telecommunications Device Assistance Program
Subchapter A. Definitions
Chapter 19.
Nursing Facility Requirements for Licensure and Medicaid Certification
Part III.
Texas Commission on Alcohol and Drug Abuse
Chapter 144.
Contract Requirements
Subchapter C. Audits
Subchapter E. Prevention and Intervention
Subchapter F. Treatment
Part VI.
Texas Commission for the Deaf and Hard of Hearing