TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 97. HOME AND COMMUNITY SUPPORT SERVICES AGENCIES

Subchapter D. ENFORCEMENT

40 TAC §97.52

The Texas Department of Human Services (DHS) adopts an amendment to §97.52 without changes to the proposed text pub-lished in the July 7, 2000, issue of the Texas Register (25 TexReg 6479).

Justification for the adoption is to correct a technical error in transmitting the final adopted version of 40 TAC §97.52. The Severity Level 1 Violations chart was inadvertently omitted from §97.52(b)(3)(C)(iii) when it was transmitted to the Texas Register as the adopted rule and published in the June 16, 2000, issue (25 TexReg 5941). DHS filed a public notice in the "In Addition" section of the July 7, 2000, issue of the Texas Register (25 TexReg 6479).

The department received no comments regarding the adoption.

The amendment is adopted under the Health and Safety Code, Chapter 142, which provides the department with the authority to adopt rules for the licensing and regulation of home and community support services agencies.

The amendment implements the Health and Safety Code, Chapter 142.001-142.030.

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 August 10, 2000.

TRD-200005579

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: September 1, 2000

Proposal publication date: July 7, 2000

For further information, please call: (512) 438-3108


Part 3. TEXAS COMMISSION ON ALCOHOL AND DRUG ABUSE

Chapter 144. CONTRACT REQUIREMENTS

Subchapter A. GENERAL PROVISIONS

40 TAC §§144.1, 144.11, 144.21

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §§144.1, 144.11, and 144.21 concerning General Provisions without changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5558).

These sections contain information regarding applicability, waivers and definitions.

These amendments are adopted to more clearly state that statutes governing state agencies apply if there is a conflict between such statutes and these rules; to change the term variance to waiver; to establish a time limit for waivers; to clarify several definitions; to add new definitions for graduate, unethical conduct and unprofessional conduct; to add the term cost reimbursement and eliminate the term financial assistance to more precisely describe this type of payment mechanism; to replace the term unit cost with the term unit rate; and to make grammatical changes to improve readability and understanding.

Comments on the rules were received from the Association of Substance Abuse Programs and an individual.

The following comments were received regarding §144.21.

Comment: The definition of financial assistance is being eliminated. Is it being replaced with cost reimbursement? This is an important shift in basic terminology , and we recommend the Commission provide more information about how this term will be referenced and used. Response: The term "financial assistance" is being replaced with "cost reimbursement". Financial assistance contracts were defined as those based on a line-item budget rather than a unit cost rate. Those contracts have always been cost reimbursement contracts. More information about this and other changes will be published in the Provider Bulletin. Comment: You define which professionals are QCCs. Some period of work experience should be stated for many of these professionals. An LMSW or LPC may have no working knowledge of substance abuse. Response: The professionals defined as Qualified Credentialed Counselors (QCCs) are authorized by law to provide chemical dependency counseling. The commission agrees that specific knowledge and experience with substance abuse is important, but a competent counselor can acquire these assets on the job. In light of continued reports of counselor shortages, it is important to keep the pool of potential applicants as large as possible. Individual facilities may establish more stringent hiring criteria than those listed in the rules. Comment: The rules contain a definition for unit rate. We are pleased to see TCADA defining and utilizing this type of contract/payment system.

These amendments are adopted under the Texas Health and Safety Code, §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 adopted rules 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 August 9, 2000.

TRD-200005534

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


Subchapter B. CONTRACT ADMINISTRATION

40 TAC §144.101

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §144.101 concerning Contract Administration with changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5561).

This section contains information regarding general contract provisions.

The amendments are adopted to more fully outline the steps required before a contract is considered fully executed; to raise the cap on the required fidelity bond or insurance; to specify that providers will be held to performance standards stated in the contract; and to make other changes to improve readability and understanding.

Comments on the rules were received from the Association of Substance Abuse Programs.

The following comments were received.

Comment: The proposed rule requires signed contracts to be returned to the commission within 14 calendar days of the postmark date. Documents postmarked by TCADA are sometimes not actually received at the provider's office until as much as 10 days after the postmark. We believe 21 days is more reasonable considering the mail service factor. Or, delivery by certified mail with a 14 day deadline from the date of receipt.

Response: It is extremely important for all contracts to be signed and returned to the commission before the contract period begins. Negotiations are conducted in advance, so the content of the contract has been reviewed and agreed upon before it is mailed to the provider. Providers are expected to make advance arrangements if necessary so the document can be signed in a timely manner. The rule has been revised to require contracts to be returned before the start of the contract period.

Comment: This rule references §144.413 and §144.552. Neither one of these sections are included in the published rules.

Response: No changes are proposed for these sections, so the text was not published in the Texas Register . The current language in these sections remain in effect.

These amendments are adopted under the Texas Health and Safety Code, §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 adopted rule is the Texas Health and Safety Code, Chapter 461.

§144.101.General Contract Provisions.

(a)

A contract is not fully executed until it has been signed by the commission and the provider. The commission's policy is to have all contracts executed before the start date of the contract.

(1)

The commission shall send the provider two original contracts signed by the commission. Both copies of the contract must be signed by an official authorized to enter into such agreements on behalf of the governing body. One shall be submitted to the commission before the start of the contract period and the other shall be maintained by the organization.

(2)

If the provider makes any modifications to the original contract, both signed copies must be mailed to the commission for review. The commission may approve the counter-offer by co-signing the revised contracts and returning one copy to the provider or continue negotiations.

(3)

No payment or advance of funds will be made until the contract is fully executed.

(b)

Changes in state or federal laws and regulations may affect contract provisions. Any modifications resulting from such changes are automatically made part of the contract and go into effect on the date set by the law or regulation.

(c)

The provider shall have insurance or other provisions approved in writing by the commission to ensure that assets purchased with commission funds will be replaced if lost, destroyed, damaged, or stolen.

(d)

The provider shall carry a fidelity bond or insurance coverage. The fidelity bond or insurance must provide for indemnification of losses due to fraudulent or dishonest acts committed by any of the provider's employees or volunteers who have access to funds, either individually or in concert with others.

(1)

If the provider's contract with the commission is $100,000 or less, coverage shall be equal to the contract amount.

(2)

If the provider's contract is over $100,000, coverage shall be equal to $100,000 or 10% of the contract amount, whichever is greater, but in no event shall coverage exceed $500,000.

(e)

Providers shall follow this order of legal precedence:

(1)

federal and state laws (including, but not limited to the federal block grant found at United States Code, Title 42, §300x);

(2)

applicable federal regulations;

(3)

rules adopted by the commission ; and

(4)

the contract.

(f)

All providers shall be held to performance standards stated in the contract.

(1)

Performance standards for prevention and intervention programs include the performance and activity measures described in §144.413 of this title (relating to Performance and Activity Measures).

(2)

Performance standards for treatment programs include the performance measures defined in §144.552 of this title (relating to Select Performance Measure Definitions).

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 August 9, 2000.

TRD-200005535

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §144.102

The Texas Commission on Alcohol and Drug Abuse adopts the repeal of §144.102 concerning Contract Administration without changes to the proposal as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5562).

This section contains the requirements for amendments.

The repeal is adopted because requirements for contract amendments will be included in individual contracts.

The following comments were received from the Association of Substance Abuse Programs and an individual regarding the adoption of the repeal: Why are you deleting this section? Does it imply no contract amendments will ever be permitted? This seems very unrealistic for both TCADA and providers because circumstances do come up where it is reasonable and warranted to make a contract amendment(s). We recommend keeping this section or revising it to specify how amendments to the terms and conditions can be made in the current environment.

Response: Amendments will be permitted in FY 2001. Information about amending contracts will be found in the contract itself instead of in the rules.

The repeal is adopted under the Texas Health and Safety Code, §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 repeal 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 August 9, 2000.

TRD-200005537

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §§144.103 - 144.109, 144.121, 144.124, 144.131- 144.134, 144.141, 144.142, 144.145

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §§144.103-144.108, 144.121, 144.124, 144.131-144.133, 144.141, 144.142 and adopts new §§144.109, 144.134, and 144.145 concerning Contract Administration. Sections 144.104 - 144.106, 144.109, 144.121, 144.131, 144.132, 144.134, 144.141, 144.142 and 144.145 are adopted with changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5562). Sections 144.103, 144.107, 144.108, 144.24 and 144.133 are adopted without changes to the proposed text and will not be republished. These sections contain information regarding organizational and personnel changes, matching awards, financial eligibility and third party payment, payment requirements, reporting, cost reimbursement for treatment services, billing for treatment services, application of federal and state requirements, indirect costs, equipment and supplies, travel, minor remodeling, procurement of goods and services, subcontracting, and contract closeout.

These amendments and new sections are adopted to require all funded providers to contribute at least 5% match; to stipulate that rules regarding third party payments apply to all programs that are subject to financial eligibility requirements; to specify that providers cannot bill the commission for any services delivered to an individual who has access to another public or private funding source; to provide more direction on becoming a Medicaid provider; to require providers serving individuals under 18 years of age to become a Children's Health Insurance Program provider; to strictly prohibit double billing for any service; to require providers to collect client fees according to a sliding fee scale; to limit advance payments; to stipulate reporting requirements for various types of programs; to limit the use of cost reimbursement as a payment mechanism to 12 months unless the commission's executive director grants a waiver; to specify restrictions on billing including limitations on the types and hours of services that providers can charge to the commission; to clarify the application of federal and state regulations; to allow the commission to require that administrative expenses be charged as direct costs; to provide clearer guidance about the process by which a provider requests that administrative costs be charged as indirect costs; to limit the requirement for prior approval for certain expenditures only to providers on cost reimbursement; to require prior approval for transfers among program budget line items when cumulative transfers exceed 10% of the total program budget; to define and require a physical inventory of controlled items; to specify limits on costs for mileage and out-of-state travel; to fully describe the process required to expend Commission funds for minor remodeling; to provide more details regarding the procurement of goods and services by providers; to prohibit the use of subcontractors that are not in good standing with legal, regulatory, and funding agencies, including the commission; to specify what information a provider must submit to the commission regarding proposed subcontractors; to establish a time limit of 90 days after the end of a contract for claims for reimbursement for subcontractors to be submitted; to stipulate that subcontractors are subject to commission oversight; to establish a process for the closeout of contracts; and to make other changes to improve readability and understanding.

Comments on these sections were received from the Association of Substance Abuse Programs and individuals.

Comment received regarding §144.103. Organizational and Personnel Changes: Thank you for deleting (G) "any other individuals identified as key personnel in the application." With all of the personnel changes, that was difficult to keep up with.

The following are comments received regarding §144.104 Matching Awards.

Comment: This rule now requires all contracts, including treatment contracts where a waiver has historically been applied, to provide matching funds. For many treatment providers this equates to a 5% rate reduction. Many providers, including prevention programs have used or are using available "other" dollars to help offset the recent funding restrictions in order to maintain continuity and reduce disruption to services. If you are a large service provider, (i.e. $1 million) a 5% match equates to $50,000 which is a substantial sum of unrestricted funds to come up with for drug and alcohol non-profit agencies. Although in-kind contributions can be applied toward match, $50,000 of in-kind contributions can also be difficult to accrue. To assist providers in maintaining levels of service in light of budget reductions and to allow for stability and continuity, we recommend removing the proposed rules and utilizing TCADA's option to waive match for both prevention and treatment service providers. At a minimum, revise the wording in the proposed rule to clearly indicate individual requests for match waivers will be reviewed and granted by TCADA.

Response: Under state statute, the commission cannot waive the match requirement unless it determines that the requirement will jeopardize the provision of needed services. The commission does not agree that a blanket waiver meets the intent of the statute; such a determination can only be made on a case-by-case basis. Providers can request a waiver through existing provisions in the rules.

Comment: As the primary provider of substance abuse services to medically indigent clients, we have extremely limited opportunity to access additional funding eligible to be used for matching purposes. Few of our clients have private insurance, and most billings are denied. Client fees are minimal, and local city and county funds are already limited and spread thin to meet diverse needs. Other sources of income include federal and state criminal justice contracts. Clarification is needed as to the eligibility of these funds to be used as match. The 5% match requirement is unrealistic given our limited opportunities to generate additional income given the population we are charged to serve.

Response: In general, other federal and state funds may not be used to match federal block grant dollars. Organizations should refer to the grant or contract and laws and rules that govern the other state or federal funds to determine whether or not they can be used as match. The rule has been revised to clarify that in-kind contributions and program income may be used to meet the match requirement.

Comment: The initiation of a 5% match for treatment services, which includes significant match restrictions, imposes a large hurdle for an existing program and an even larger obstacle for a start-up program. Unlike prevention or intervention services that can typically be managed from a leased office, treatment services are cost-efficiently and program-effectively provided from program-owned facilities. Even in the best circumstances, a large cash investment is a huge risk for the short-term contracts offered by TCADA. To mitigate this risk and encourage programs that provide much-needed treatment capacity, the matching fund requirements should be greatly expanded. Specifically, we encourage TCADA to consider as match: a. Building and remodeling costs not funded by grants b. Food stamp payment to residents paid over to programs c. Federal program income sources such as breakfast/lunch programs d. Federal education entitlements such as Eisenhower, Title I, and SDFSC leveraged to strengthen our education services for clients

Response: The commission can accept match only to the extent permitted by applicable regulations. Cash and in-kind match must meet the same requirements as contract expenditures. In general, federal and state funds cannot be used as match. Providers should review their federal and state grants and related regulations to see if permission is given to use the dollars as match. The federal block grant prohibits building and remodeling costs except for minor remodeling. Food stamps cannot be used as match because the source is federal funds.

The following are comments received regarding §144.105 Financial Eligibility and Third Party Payment.

Comment: The rule requires any provider offering services eligible for Medicaid reimbursement to take all necessary steps to obtain a Medicaid provider number and become an approved Medicaid provider. The services funded by the Medicaid state plan should be listed and referenced.

Response: The commission does not agree that this information should be included as part of the commission's rules because it is governed by the state Medicaid plan. Detailed information regarding eligible services is provided through the Provider Bulletin and other publications.

Comment: Programs providing outpatient treatment services to children and adolescents are required to enroll in the Texas Medicaid Program. A question has arisen about programs providing counseling in adolescent intervention programs and substance abuse assessments. Do these programs need a Medicaid number or only licensed treatment programs?

Response: This rule does not apply to adolescent intervention programs. The services provided by such programs are not eligible for Medicaid reimbursement.

Comment: The rules states that any provider in a STAR or STAR+ service area must take all necessary steps to enroll with those program health plans to be reimbursed for services delivered to those clients. If the client is on Medicaid and the provider does not receive authorization from a STAR or STAR+ program can they discharge the client based on inability to pay?

Response: A commission-funded provider cannot deny services to a client based solely on inability to pay. If the provider has exhausted all appeals, the costs of treating the client can be charged to the commission.

Comment: Providers serving individuals under 18 years of age are required to take all necessary steps to become an approved Children's Health Insurance Program (CHIP) provider. The CHIP portion is confusing because assessment and intervention activities are included in the benefit package which are services often performed by councils under OSAR and prevention providers and not typically viewed as "insured services". It would be helpful here to list covered CHIP services under (d)(2) and providers that must apply.

Response: At this time, the rules do not require prevention and intervention providers (including OSARs) to enroll as CHIP providers. Detailed information about CHIP is provided through the Provider Bulletin and other publications. The commission will also provide a training session on CHIP.

Comment: Will TCADA be providing information or references as to where providers can find both Medicaid and CHIP eligibility standards?

Response: This information will be provided through the Provider Bulletin and other publications.

Comment: This entire section poses a documentation nightmare. In addition, it seems that substance abuse providers are being asked to perform the duties of Medicaid and CHIP program staff. These are activities which in many hospitals or similar settings require several staff members to perform. Perhaps they have the money to hire those people; we do not.

Response: The commission recognizes that billing multiple funding sources increases administrative procedures and documentation. However, the commission does not agree that the burden outweighs the benefit of leveraging all available funding sources to extend the limited dollars allocated to the commission for substance abuse programs. As of August,1999, less than 20% of the need for treatment was being met in Texas. Every unit of service billed to Medicaid or CHIP leverages federal dollars and increases the total quantity of substance abuse services available for poor Texans. Furthermore, ability to access multiple funding streams enhances the financial stability of providers in a rapidly changing environment.

Comments received regarding §144.106 Payment Requirements follow.

Comment: This section does not address prevention/intervention programs which receive cash advances. I suggest that some mention be added to make it more clear.

Response: Under the new rules, no commission-funded program will receive monthly cash advances.

Comment: We recommend that TCADA continue to give providers the option to choose method of payment rather than allow an advance on an exception basis only. We believe a failsafe system is already in place for advance payments through the FSR or quarterly financial reports. To improve accountability, TCADA can increase internal controls of the existing safeguards and only require reimbursements for providers who don't comply with procedures. At a minimum, allow providers to choose advance payments for personnel costs. Providers do not necessarily have adequate reserve or access to a line of credit to function on a reimbursement basis. Although we do appreciate that the rule allows working capital advances on an exception basis, we are unclear about what constitutes an exception.

Response: The amount of surplus cash that remains in the contracting system at closeout and the commission's previous inability to predict carryforward from year to year indicates that the current system does not have adequate operational safeguards. Furthermore, cost reimbursement is the standard method of payment in most comparable state and federal programs. Providers may request a working capital advance based on their organization's cash flow. The commission would expect to see supporting information such as: all sources of funding for the agency, timing of other funding, restricted versus unrestricted sources of revenue, timing of liquidation of liabilities, whether or not the agency has a relationship with a bank for a loan or line of credit, and sources of match and program income and flexibility associated with those resources.

The following are comments received regarding §144.107 Reporting.

Comment: Why has the commission changed the deadline for submitting reports from 30 to 20 days? Unless TCADA is then able to significantly reduce the time it takes to turn around reports back to providers as a result of this 10 day reduction, we believe providers should be given the 30 day period currently in effect.

Response: The timeframe has been shortened to enhance the commission's ability to manage cash flow. This is also consistent with the practices of other health and human service agencies which require reports to be submitted as early as three days after the close of a reporting period. It is unclear what turnaround the commenter is referring to in the last sentence.

Comment: The 20-day deadline is unrealistic, particularly for providers in a network setting. Because the last half of the month payroll and expenses are run on the 15th of the following month it would be very difficult to accurately report all expenses if the FSR is due 20 days after the end of the reporting period. We are in a network, and the network management organization (NMO) requires the FSR to be submitted in 20 days so they can meet the current 30-day deadline. We have had to continually request an extension to ensure accurate reporting. If the NMO deadline will be 20 days, participating providers will have an even shorter deadline.

Response: Deadlines within the network are an issue for negotiation between the subcontractor and the NMO.

Comment: Programs that treat individuals for intravenous substance abuse shall notify the commission through the facility capacity management system when the program's capacity for treating intravenous substance abusers reaches 90%. What does this mean? We report all available beds on a daily basis. Is this sufficient?

Response: There is a separate question on the reporting form for this item. It is in addition to reporting the number of beds.

The following comment was received regarding §144.121. Application of State and Federal Regulations: It would be helpful if TCADA would cite the appropriate UGMS sections we must comply with much as it does the other federal circulars.

Response: Providers are required to comply with all of UGMS, as is true of the federal circulars.

One comment was received regarding §144.124. Indirect Cost: A new rule states that the commission reserves the right to require administrative expenses to be charged as direct costs. Since the RFP process upon which an award is based clearly distinguishes between program, administrative, and indirect costs, an award should not be subject to a "reserves the right" clause. This implies an after-the-fact change to the RFP process. Since the chosen provider is obligated to perform under the terms and conditions of the RFP, TCADA should also be bound to abide by the characterization of costs as presented in the RFP.

Response: The budget instructions for the Comprehensive Services Request for Proposal for FY 2001 states (on page 173) that the commission reserves the right to mandate direct charging.

The following are comments received regarding §144.142 Subcontracting.

Comment: Requiring a provider to perform an annual documented subcontractor monitoring visit appears to be a significant new requirement and is a big area of TCADA audit vulnerability for providers. We recommend more specific instruction be provided in the rule about the scope of sub-contractor monitoring and what it needs to entail, how it should be documented and generally what TCADA expects from a provider in order to successfully comply with this provision.

Response: The proposed rule simply states that the provider shall monitor subcontractor compliance; it does not specifically mandate an annual on-site visit. The commission will provide additional guidance in the Provider Bulletin.

Comment: Providers are told to require all subcontractors to permit access to TCADA staff. Does this apply in situations such as NorthSTAR?

Response: The rules in this chapter do not apply to NorthSTAR. However, the NorthSTAR contract contains similar provisions.

These amendments and new sections are adopted under the Texas Health and Safety Code, §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 adopted rules is the Texas Health and Safety Code, Chapter 461.

§144.103.Organizational and Personnel Changes.

The provider shall notify the commission in writing within ten business days of:

(1)

changes in the provider's legal name, address, telephone number, or legal status; and

(2)

changes in the following personnel:

(A)

certifying representative;

(B)

board chair;

(C)

chief executive officer;

(D)

chief financial officer;

(E)

project director; or

(F)

contact person.

§144.104.Matching Awards.

(a)

Unless waived in writing by the commission, all providers shall contribute at least 5.0% of the total commission-funded program expenditures in cash or in-kind match from sources eligible to be used for matching purposes.

(b)

Match shall comply with requirements found in the applicable Office of Management and Budget (OMB) circulars as stated in §144.121 of this title (relating to Application of State and Federal Regulations).

§144.105.Financial Eligibility and Third Party Payment.

(a)

The rules in this section apply to all programs subject to financial eligibility requirements, including all treatment programs. If applicable to a prevention or intervention program, the requirement for financial eligibility determination shall be stipulated in the contract.

(b)

The Commission is the payor of last resort for substance abuse services. A provider shall not bill the commission for services provided to a client if:

(1)

the individual does not meet the commission's eligibility criteria as described in §144.521 of this title (relating to Client Eligibility); or

(2)

the individual has access to another public or private funding source that pays for substance abuse services addressing the individual's diagnosis or condition.

(c)

Any provider offering services eligible for Medicaid reimbursement shall take all necessary steps to obtain a Medicaid provider number and become an approved Medicaid provider. The process must be initiated no later than 30 days after the beginning date of a contract with the commission.

(1)

All programs providing outpatient treatment services to children and adolescents must contact the National Heritage Insurance Company (NHIC) to initiate enrollment as a Chemical Dependency Treatment Facility (CDTF) in the Texas Medicaid Program.

(2)

Any provider delivering services in the STAR, STAR+, and/or NorthStar service areas must take all necessary steps to enroll with those Program Health Plans to be reimbursed for services delivered to those clients.

(3)

The provider must screen all clients for Medicaid eligibility. If a client appears eligible but has not yet applied, the provider shall direct the client to apply for Medicaid benefits and provide assistance as needed to facilitate the enrollment process.

(4)

The provider must bill Medicaid for all covered services delivered to eligible clients.

(d)

Providers serving individuals under 18 years of age shall take all necessary steps to become an approved Children's Health Insurance Program (CHIP) provider by contacting the contracted Health Maintenance Organization (HMO), Behavioral Health Organization (BHO), or Exclusive Provider Organization (EPO) in the region. The process must be initiated no later than 30 days after the beginning date of a contract with the commission.

(1)

The provider must screen all clients under the age of 18 for CHIP eligibility. If a client appears eligible but has not yet applied, the provider shall direct the client's consentor to apply for CHIP benefits and provide assistance as needed to facilitate the enrollment process.

(2)

The provider must bill CHIP for all covered services delivered to eligible clients.

(e)

The provider shall not bill the commission for any part of any unit of service that has been billed to another entity or that is eligible for reimbursement by another entity. If the third party payor denies payment and all appeals have been exhausted, the provider may bill the commission for that unit of service.

(f)

The provider shall make a reasonable effort to collect fees generated from clients paying according to a sliding fee scale, but the provider may waive collection if the administrative cost of collection will exceed the fee to be collected. The provider shall not bill the commission for any uncollected client fees.

§144.106.Payment Requirements.

(a)

Payments shall be made only when the contract has been fully executed.

(b)

To be eligible for payments, the provider must comply with provisions of the contract, rules, policies, and procedures of the commission, and other applicable state and federal laws and regulations.

(c)

The commission may delay or deny payment if the provider is not in compliance with commission requirements, which include:

(1)

rules adopted by the commission;

(2)

the contract; and

(3)

other applicable statutes and regulations.

(d)

Providers paid through cost reimbursement may request a working capital advance.

(1)

A working capital advance may be granted if the provider submits documentation justifying the need for working capital. Advances shall be granted on an exception basis only.

(2)

A provider receiving a cash advance shall minimize the time between disbursement of funds by the commission and expenditure of funds by the program. The commission may reduce or reject payment if the program has excess cash on hand.

(e)

All providers must submit requests for payment promptly and regularly.

(1)

Payment requests must be submitted at least monthly.

(2)

Failure to submit payment requests in a timely manner may result in nonpayment.

(f)

Payment requests shall be complete, accurate, submitted in the format required by the commission, and certified by the provider's authorized representative (specified in the contract).

(g)

Treatment programs funded through the unit rate payment mechanism shall use the client billing forms to request reimbursement. A billing form must be submitted for each client served in the program who is supported with commission funds. Treatment programs funded through cost reimbursement shall also submit client billing forms, but payments will be based on satisfactory submission of a request for reimbursement.

(h)

The provider shall maintain documentation necessary to support all payment requests.

§144.107.Reporting.

(a)

The provider shall submit all reports as required by commission rules, the contract, and applicable instruction manuals. Reports shall be submitted in the specified form, manner, and timeframe. Unless otherwise specified, reports are due 20 days after the end of the reporting period.

(b)

The provider shall submit all performance reports, financial reports, and requests for payment through the designated web-based computer system. The provider's authorized official or designee specified in the Electronic Forms Signature Agreement is responsible for the completeness and accuracy of the data.

(c)

Treatment programs shall report available capacity and waiting list information daily through the commission's facility capacity management system and comply with procedures specified by the commission.

(d)

A provider that treats individuals for intravenous substance abuse shall notify the commission through the facility capacity management system when the program's capacity for treating intravenous substance abusers reaches 90%.

(e)

All treatment programs shall submit Client Data System (CDS) forms to the commission through the commission's web-based computer system for all clients receiving commission-funded substance abuse treatment services.

(f)

The provider shall acquire and maintain the equipment and software needed for the web-based computer system.

(g)

The provider shall establish adequate internal controls, security, and oversight for the approval and transfer of complete and accurate information.

(h)

When equipment problems prevent electronic submission of required reports, the provider shall fax or mail paper copies to the commission.

(i)

Providers shall reconcile internal accounting records with documentation submitted to the commission and maintain supporting documentation on site.

(j)

Adjustments to the final FSR will not be made more than 90 days after the end of the contract period unless the provider's independent audit report demonstrates that the FSR is incorrect.

§144.108.Cost Reimbursement for Treatment Services.

(a)

The commission's standard payment mechanism for treatment services is the unit rate payment mechanism.

(b)

The commission may place a treatment program on cost reimbursement if the provider does not have the resources to provide needed treatment services without start-up funding and meets at least one of the following criteria:

(1)

has never before provided treatment or prevention services funded by the commission;

(2)

will provide commission-funded services in a specific geographic area or to a specific population for the first time;

(3)

will provide services at the commission's request to meet identified needs; or

(4)

demonstrates other extenuating circumstances.

(c)

Cost reimbursement is granted for a single 12-month period unless the commission's executive director grants a waiver based on extenuating circumstances.

§144.109.Billing for Treatment Services.

(a)

Treatment programs shall not bill the commission for services provided:

(1)

at an unlicensed site if the site is required to have a license; or

(2)

by a staff person who does not meet the commission's minimum requirements.

(b)

Programs may bill for only one level and service type (outpatient or residential) per client per day.

(c)

An outpatient program shall not bill the commission for more than:

(1)

nine hours of service per week for Level IV;

(2)

19 hours of service per week for Level III; and

(3)

29 hours of service per week for Level II.

(d)

Outpatient programs shall only request payment for substance abuse education, life skills training, and counseling (individual, group, or family). The following activities are not reimbursable: peer support groups, case management, academic courses, and recreation.

(e)

A residential program may hold an empty bed and bill for a client who is on a planned, approved absence for up to two consecutive days. The frequency of approved absences shall be reasonable and appropriate and shall not exceed four days in a 30-day period, except as provided below.

(1)

Providers shall include planned absences for delivery in treatment plans for each pregnant female, and shall ensure that a bed is available for the female upon her return.

(2)

Absences for medical treatment (including delivery), court appearances, or other emergencies may exceed 48 hours, but commission approval is required if the absence exceeds 96 hours.

(f)

The provider shall maintain complete documentation for all services paid for by commission funds as described in §144.553 of this title (related to Treatment Documentation).

§144.121.Application of Federal and State Regulations.

(a)

All providers shall comply with the provisions of the Uniform Grant Management Standards (UGMS). Expenditures of commission funds, including required cash match, shall be reasonable, necessary, and allowable, and must receive required prior approval as stated in UGMS. All providers shall also comply with federal cost principles and administrative requirements as appropriate for the organization. When there is a conflict between UGMS and the federal regulations, the most restrictive shall apply. The federal cost principles and administrative requirements are applicable as follows:

(1)

state and local governments or Indian Tribal governments shall comply with cost principles found in the Office of Management and Budget (OMB) Circular A-87 and administrative requirements found in the OMB Circular A-102;

(2)

not-for-profit providers shall comply with cost principles found in the OMB Circular A-122 and administrative requirements found in the OMB Circular A-110 (with changes incorporated as the Code of Federal Regulations, Title 45, Part 74);

(3)

educational organizations shall comply with cost principles found in OMB Circular A-21 and administrative requirements found in OMB Circular A-110; (with changes incorporated as the Code of Federal Regulations, Title 45, Part 74);

(4)

commercial organizations shall comply with cost principles found in Code of Federal Regulations, Title 48, Part 31, and administrative requirements found in OMB Circular A-110 (with changes incorporated as the Code of Federal Regulations, Title 45, Part 74); and

(5)

hospitals shall comply with cost principles found in the Code of Federal Regulations, Title 45, Part 74, and administrative requirements found in OMB Circular A-110.

(b)

All references in the circulars to "Federal" or "Federally' shall be expanded to read "Federal or State" or "Federally or State", as applicable. References to "recipient" shall be expanded to read "recipient, contractor, subcontractor, subrecipient, or provider".

(c)

The provider shall also comply with requirements and restrictions found in the Substance Abuse Prevention and Treatment federal block grant, found at United States Code, Title 42, §300x.

§144.124.Indirect Cost.

(a)

The commission reserves the right to require administrative expenses to be charged as direct costs.

(b)

A provider may request approval to charge administrative expenses as indirect costs. Three mechanisms are available for charging shared administrative costs. The provider may:

(1)

submit documentation of an indirect cost rate approved by the provider's cognizant agency;

(2)

request a negotiated rate with the commission based on a cost allocation plan; or

(3)

use an indirect cost rate not to exceed 10% as provided in the Uniform Grant Management Standards (UGMS). If requesting this option, the provider must provide supporting documentation to show the direct salary and wage costs of providing the service (excluding overtime, shift premiums, and fringe benefits).

(c)

All providers receiving funds from other sources must maintain a cost allocation plan showing how administrative costs are distributed among funding sources.

§144.131.Expenditures Requiring Prior Approval.

For providers on a cost reimbursement payment mechanism, prior written approval is required for certain costs charged to the commission contract or reported as program income or match. Costs that are allowable only with prior written approval from the commission include:

(1)

Equipment. Items used solely for the delivery of funded substance abuse services that have a unit cost of $1,000 or more and a useful life of more than one year.

(2)

Minor remodeling. Work described in §144.134 of this title (relating to Minor Remodeling) costing $1,000 or more in the aggregate.

(3)

Contractual services. Contracting out, subgranting, or otherwise obtaining the services of a third party to perform activities which:

(A)

are central to the purposes of the contract; or

(B)

cost $5,000 or more.

(4)

Transfers. Any transfer among program budget line items for direct costs when cumulative transfers exceed or are expected to exceed 10% of the total approved program budget.

(5)

Other. Items requiring prior approval in accordance with the Uniform Grant Management Standards or the appropriate Office of Management and Budget (OMB) circular.

§144.132.Equipment and Supplies.

(a)

Equipment includes all tangible personal property that costs $1,000 or more per unit and has a useful life of more than one year. A set of components designed to function together shall be treated as a single unit.

(b)

Supplies include all materials and other expendable property needed to carry out a contract with a unit cost of less than $1,000.

(c)

The provider shall conduct an annual physical inventory of all equipment and controlled items purchased with commission funds no later than 60 days after the close of the provider's fiscal year.

(1)

Controlled items are those that have a unit cost of $500 - $999 and/or a high risk of theft. Examples include televisions, fax machines, video recorder/players, printers, software, and mobile telephones.

(2)

The inventory shall conform with standards found in the Uniform Grant Management Standards or the applicable Office of Management and Budget (OMB) circular.

(3)

Inventory records shall be current, maintained at the program site, and reported as part of the annual contract closeout.

§144.133.Travel.

(a)

Expenses for transportation, lodging, meals, and related items are allowable when they are incurred by an employee or volunteer on official business which is directly attributable to the contract or required for administration of the provider.

(b)

Costs for lodging, meals, and related items may not exceed the State of Texas per diem rates and costs for mileage may not exceed the State of Texas rate for mileage reimbursement. When applicable, the provider may use the state's schedule of per diem rates for out-of-state travel. If the provider's policies and procedures establish a lower per diem rate, the lower rate shall apply.

(c)

Alcoholic beverages and tobacco products are not allowable costs.

§144.134.Minor Remodeling.

(a)

Minor remodeling is work which is required to change the interior arrangements or other physical characteristics of an existing building, or to install equipment so that the building may be used more effectively. It does not include work which substantially increases the value of the building.

(b)

The provider shall have written approval from the commission before starting any minor remodeling project.

(c)

Any remodeling project must meet the following conditions:

(1)

The building's useful life shall be consistent with the funded program purposes;

(2)

The remodeling shall be essential to the commission-funded program;

(3)

The remodeled space shall be occupied by the program; and

(4)

The building shall be owned by the provider; or if the facility is leased, there shall be at least three years remaining in the lease period.

(d)

If the program is funded only in part by the commission, only a pro-rata share of the total minor remodeling costs may be charged to the commission.

(e)

Costs for minor remodeling shall not exceed an aggregate of $5,000 per provider per year.

(f)

The following expenses are examples of unallowable costs:

(1)

relocation of exterior walls, roof, and floors in order to increase the amount of space to be used;

(2)

development or repair of parking lots; and

(3)

completion of unfinished shell space to make it suitable for human occupancy.

(g)

A written request for remodeling must include a narrative description of the proposed functional utilization of the space and the final cost estimate. The following documents must accompany the request, as applicable:

(1)

a single line drawing of the existing space and proposed alterations;

(2)

equipment requirements prepared by the persons who will use and be responsible for the working space;

(3)

final working drawings and specifications; and

(4)

the design analysis report describing the heating, ventilation, air conditioning, plumbing, and electrical systems.

§144.141.Procurement of Goods and Services.

(a)

The provider may use small purchase procurement procedures to obtain services, supplies, or other property if the total cost of all purchases does not exceed $25,000 for the contract period. These rules do not apply to obtaining the services of a professional as defined in Texas Government Code, Chapter 2254.

(1)

For any purchase under $2,000, price or rate quotations are not required.

(2)

The provider shall obtain three verbal or written price or rate quotations for any purchase between $2,000 and $10,000. Telephone and other verbal quotations must be documented and available for inspection.

(3)

The provider shall obtain three written price or rate quotations for any purchase of over $10,000. Facsimiles or printed copies of electronic transmissions are acceptable.

(b)

The provider shall select the vendor providing the best value for the goods or services desired and document the rationale for selection.

(c)

A single purchase may include more than one item. Large purchases shall not be divided into small lots in order to avoid bid requirements, especially when bought from the same vendor in the same fiscal year.

(d)

If purchases for the contract period are expected to exceed $25,000, the provider shall comply with requirements found in the Uniform Grant Management Standards or the applicable Office of Management and Budget (OMB) circular.

§144.142.Subcontracting.

(a)

The provisions in this section apply when a provider subcontracts, assigns, or transfers any activity central to the purposes of the contract to a third party.

(1)

The subcontractor shall be a corporation, partnership, sole proprietor, or other entity with legal authority to operate in the State of Texas.

(2)

The subcontractor shall be in good standing with all applicable legal, regulatory and funding agencies. If the subcontractor has been funded by the commission, the organization shall not be suspended or delinquent on a repayment agreement, and shall not have had a contract terminated by the commission for cause within the past three years. The provider shall require any potential subcontractor to disclose all legal, regulatory, or contractual actions initiated against it in the past three years, including pending actions and/or investigations.

(3)

The provider shall submit the following information about each subcontractor within five business days after entering a contract:

(A)

the name, address, and telephone number of the subcontractor;

(B)

the names, addresses, and telephone numbers of the chief executive officer, chief financial officer, clinical director, and members of the governing authority; and

(C)

the name of any person employed by or associated with the subcontractor who has been sanctioned by the commission within the past three years, and a description of the person's relationship and responsibilities with the subcontractor.

(b)

The provider shall, in writing, require any subcontractor to comply with applicable laws and regulations and with the provisions and stipulations of the provider's contract with the commission.

(c)

The relationship between the provider and the subcontractor shall be formalized in a written agreement that is signed by the governing body or legally responsible party of both the provider and the subcontractor.

(d)

The provider shall retain sufficient rights and controls to fulfill its contract responsibilities to the commission. Subcontracting does not relieve the funded provider of any responsibility to the commission under the contract.

(e)

The provider shall monitor subcontractor compliance with provisions of the contract and applicable laws and regulations, and shall take appropriate steps to ensure corrective action when issues of non-compliance are identified. The monitoring activity must be documented and will be subject to review by the commission.

(f)

The provider is responsible for paying subcontractors. When a contract ends, the provider and each subcontractor shall settle all claims promptly, including those from employees, vendors, and other subcontractors. Claims for reimbursement to pay subcontractors will not be considered more than 90 days after the end date of the contract.

(g)

When a subcontractor becomes insolvent or otherwise incapacitated, abandons the contract, or is discharged by the funded provider, the funded provider shall notify the commission in writing within three working days.

(h)

Subcontractors must also comply with all applicable state and federal laws and regulations and commission requirements contained in the commission's rules. These specifically include the audit requirements of Office of Management and Budget (OMB) Circular A-133 if applicable, and all other federal and state regulations required in §144.121 of this title (relating to Application of Federal and State Regulations).

(i)

Subcontractors are subject to commission oversight. The provider shall, in writing, require the subcontractor to permit access as described in §144.201 (relating to Commission Oversight).

§144.145.Contract Closeout.

(a)

Submission of Documents. Providers shall submit all financial, performance, and other closeout reports required under the contract within 60 days after the contract end date. The commission is not liable for any claims that are not resolved with the commission within 90 days after the contract end date.

(b)

Equipment. Providers shall submit an inventory of commission owned property at closeout and request disposition instructions for commission owned property that is no longer needed.

(c)

Payment of Refunds. Any funds paid to the provider in excess of the amount to which the provider is finally determined to be entitled under the terms of the contract constitute a debt to the commission and will result in a refund due. The provider shall pay any refundable amount within the time period established by the commission.

(d)

Disallowances and Adjustments. The closeout of the contract does not affect:

(1)

The commission's right to disallow costs and recover funds on the basis of a later audit or other review.

(2)

The provider's obligation to return any funds due as a result of later refunds, corrections, or other transactions.

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 August 9, 2000.

TRD-200005536

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


Subchapter C. PROGRAM OVERSIGHT

40 TAC §§144.201, 144.204, 144.211, 144.214 - 144.216

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §§144.201, 144.204, 144.211, 144.214, 144.215 and 144.216 concerning Program Oversight. Sections 144.201 and 144.214 are adopted with changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5569). Sections 144.204, 144.211, 144.215 and 144.216 are adopted without changes to the proposed text and will not be republished.

These sections contain information regarding commission oversight, on-site reviews, independent audit report, independent audit report submission, corrective action plan, and audit report desk reviews.

These amendments are adopted to reserve for the Commission the right to require an audit for a program with expenditures of less than $300,000; to require that providers submit documentation of their board's approval or disapproval of audit reports; to specify that the commission will approve corrective action plans and may require modifications to the plan before approval; to stipulate that if a desk review identifies excess revenue, the provider must refund the money within the specified time frame; and to make grammatical changes to improve readability and understanding.

Comments on these sections were received from the Association of Substance Abuse Programs and individuals

The following comments were received regarding §144.204. On-site Reviews.

Comment: I suggest TCADA include time frames for its response to agencies much as it has for service providers.

Response: The purpose of rules is to define standards with which providers must comply. Procedures and timeframes for commission staff are located in the commission's internal administrative procedures manual.

Comment: Providers are required to respond to inspection reports within 14 days of the postmark date. Again, the issue of mail time experience from postmark. We recommend 21 days or 14 days from the date it is received through a vehicle such as certified mail.

Response: Issues described in the inspection report are shared with the provider during the exit conference. Commission staff also fax a copy of the report to the provider at the time of mailing. This gives the provider a full 14 days to prepare a response. The following comments were received regarding §144.214. Independent Audit Report Submission.

Comment: The amended paragraph replacing the Audit Report Submission Checklist with Board approval imposes an undue burden to some providers in the timing and method of assurance that information contained in the Single Audit report is accurate. The complexity of an audit for a large, multi-state corporation requires the entire nine-month period allowed in the regulations. The addition of board approval to submit the report would require the external audit to be completed several weeks earlier. The report would need to be approved by the national board and then sent to the Texas board for its approval of the grant information relevant to Texas programs. The Audit Report Submission Checklist requires assurance by the individual CPA or firm that the required disclosures are included in the audit report. Since the audit report is addressed to and presented to board at the next scheduled board meeting, it is an undue burden to require board approval of the report as a prerequisite to timely filing. The required assurances are provided by the required CPA opinions and not by a Board action on those assurances.

Response: The purpose for requiring board approval is to ensure that the board has reviewed the audit report and is aware of any findings in the report and that the report submitted to TCADA is a final report and not a draft version. To avoid placing an undue burden on providers, the commission has revised the rule to require board approval prior to the commission's final acceptance of the report rather than prior to submission.

Comment: I'm glad to see you changed the rule to require that all audits be submitted nine months after the close of the provider's fiscal year. Thirteen months seemed to be a very long time which could have posed problems for TCADA and the agency.

Response: This rule was revised to correspond to a change in federal and state guidance.

One comment was received regarding §144.215 Audit Report Desk Reviews: Providers are required to respond to inspection reports within 14 days of the postmark date. Again, the issue of mail time experience from postmark. We recommend 21 days or 14 days from the date it is received through a vehicle such as certified mail.

Response: This section refers to corrective action plans for the independent audit report, not commission audit reports. The time frame for responses to inspection reports is addressed under §144.204. The rule regarding resolution of desk audits provides an additional 14 day period to submit a satisfactory response.

These amendments are adopted under the Texas Health and Safety Code, §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 adopted rules is the Texas Health and Safety Code, Chapter 461.

§144.201.Commission Oversight.

(a)

All commission-funded providers, regardless of the level of funding, are subject to periodic reviews by the commission for adherence with applicable federal, state and commission statutes and regulations and contract requirements. These include desk reviews and on-site reviews.

(b)

The commission shall determine the extent of the review.

(c)

The commission may conduct a scheduled or unannounced on-site review.

(d)

Under certain circumstances, the provider must also submit a single audit or a program-specific audit as described in §144.211 of this title (relating to Independent Audit Report).

(e)

The applicant shall allow commission staff to access the facility's grounds, buildings, and records and to interview members of the governing body, staff, participants, and clients.

(f)

The provider shall allow commission staff to examine all property and examine or copy all books, recordings, client records, and documents related to or potentially related to the contract or a commission requirement.

§144.214.Independent Audit Report Submission.

(a)

The provider shall submit four copies of all required audit documentation to the commission, including:

(1)

the audit report;

(2)

any separately issued management letters;

(3)

management responses as required in §144.215 of this title (relating to Corrective Action Plan); and

(4)

documentation of board approval or disapproval of the audit report.

(b)

Audits shall be completed and submitted no later than nine months after the provider's fiscal year end. Documentation of board approval may be submitted separately if the board is unable to review the audit report before the due date, but this documentation must be provided before the commission's final acceptance of the audit.

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 August 9, 2000.

TRD-2000005538

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §144.203

The Texas Commission on Alcohol and Drug Abuse adopts the repeal of §144.203 concerning Program Oversight without changes to the proposal as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5570).

This section contains the requirements for on-site contract reviews.

The repeal is adopted because the requirements contained in this section have been incorporated into other sections.

No comments were received regarding the repeal of this section.

The repeal is adopted under the Texas Health and Safety Code, §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 repeal 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 August 9, 2000.

TRD-200005539

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


Subchapter D. ORGANIZATIONAL

40 TAC §§144.311, 144.313, 144.321 - 144.323, 144.325

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §§144.311, 144.313, 144.321-144.323, and 144.325 concerning organizational requirements. Section 144.311 is adopted with changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5571). Sections 144.313, 144.321-144.323, and 144.325 are adopted without changes to the proposed text and will not be republished.

These sections contain information regarding general requirements, management and organization, policies and procedures, documentation and records, commission logo and slogan, and complaints and reports.

These amendments are adopted to reorganize a portion of these rules; to expand the policies and procedures section to include a listing of all the policies and procedures that must be contained in the organization's policy and procedures manual; to specify that documentation must be complete, current, factual, accurate, permanent and legible; to add requirements for authentication and error correction; to expand the rule regarding use of the commission's logo to include electronic media; to require that all providers report serious incidents to the commission within 24 hours of discovery; and to make other changes to improve readability and understanding. The change made to §144.311 is to correct a spelling error.

The following comments were received from the Association of Substance Abuse Programs and individuals regarding §144.321 Policies and Procedures.

Comment: We appreciate the listing of required polices and procedures for the policy and procedure manual.

Comment: This seems redundant and somewhat confusing. We all know we have to maintain a policy and procedure manual which addresses all requirements in the chapter. However, (b) seems to imply as stated that those items (1) through (19) are all that are required to be in the manual. I know that is not the case but if all of these items are enumerated elsewhere in the rules why restate them here?

Response: The proposed rules do not require that the policy and procedure manual address all requirements in the chapter. This is a comprehensive listing of procedures required by Chapter 144. The inclusion of other policies and procedures is left to the discretion of the provider based on internal management needs.

These amendments are adopted under the Texas Health and Safety Code, §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 adopted rules is the Texas Health and Safety Code, Chapter 461.

§144.311.General Requirements.

Funded providers shall establish and maintain effective internal programmatic and financial controls to ensure:

(1)

commission-funded programs are operated efficiently and effectively;

(2)

the provider maintains compliance with other funding and regulatory agencies;

(3)

appropriate controls are in place to safeguard assets;

(4)

commission funds are properly spent;

(5)

commission funds are properly accounted for;

(6)

client/participants receive appropriate services; and

(7)

client services are adequately documented.

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 August 9, 2000.

TRD-200005540

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §144.312

The Texas Commission on Alcohol and Drug Abuse adopts the repeal of §144.312 concerning organizational requirements without changes to the proposal as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5573).

This section contains the requirements for organizational structure.

The repeal is adopted because requirements for organizational structure have been incorporated into other sections.

No comments were received regarding the repeal of this section.

The repeal is adopted under the Texas Health and Safety Code, §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 repeal 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 August 9, 2000.

TRD-200005542

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §144.326

The Texas Commission on Alcohol and Drug Abuse adopts amendments to § 144.326 concerning organizational requirements without changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5574).

This section contains information regarding staffing.

The amendments are adopted to establish minimum qualifications for clinical program directors; to stipulate that annual training must include both cultural competency and standards of conduct; and to make grammatical changes to improve readability and understanding.

The following comments were received from the Association of Substance Abuse Programs and individuals.

Comment: The rule states that every program shall have an employee designated to serve as director and that the individual must have appropriate education and training and at least two years of experience providing related services. Does these mean each program has to have an individual program director, or can one person serve as director over several programs. Does this imply the title has to be Director or does a job description describing managerial responsibility suffice?

Response: One person may serve as program director for multiple programs. The job title is not important, but the job description must document that the person is clinically responsible for the program.

Comment: While we support and agree that experience is desirable and necessary for program directors, there are instances when a person can possess a track record of needed program management/clinical skills but not meet two years in direct substance abuse services. Provisions for flexibility need to be incorporated into this rule to allow providers to manage their own programs. Two years should be a benchmark not a requirement. We recommend wording that allows an exception when the candidate's background and experience clearly demonstrate strong ability to perform the job functions.

Response: The commission believes that two years of related experience is a minimal standard for a person who has clinical responsibility for program design and implementation. Exceptions may be addressed by requesting a waiver.

Comment: The proposed rule requires providers to obtain the results of a statewide criminal background check on all staff and to use criteria listed in the Texas Occupations Code 53.022 and 53.023 to evaluate criminal history reports and make related employment decisions. The time and cost (I believe the cost is $17.00 per check plus duplication) and time involved in getting checks has been and remains a concern regarding this rule. Although in and of itself not an exorbitant fee, when added together with the many administrative costs of implementing the new rules it does become an issue. We agree safety is a foremost concern and that background checks for staff working with children and youth is necessary as is counseling staff, but all staff seems over burdensome. The rule clearly states the program shall develop and implement written procedures for reviewing the background and suitability of any employee with access to the program's clients, participants or funds. This rule requires that processes be in place to protect clients and TCADA funds, and along with a program's required liability insurance, should provide needed assurances without requiring background checks on all employees. We recommend keeping the previous wording related to children and youth or expanding to include counseling staff, but removing the proposed language for all staff.

Response: The commission recognizes that criminal background checks add to the provider's administrative cost. However, the commission disagrees that the general language provides sufficient protection and that the requirement should apply only to counseling staff. The commission has a responsibility to protect the health and safety of service recipients and to see that state funds are managed responsibly. Because many crimes are committed by repeat offenders, we believe it is a basic precaution to obtain a criminal background check for all staff with access to service recipients and/or funds.

Comment: I was unable to locate the Texas Occupations Code over the Internet to check the criteria are that providers will use to evaluate. Without knowing what the criteria are, a general caution is that in the substance abuse field many people in recovery are hired who may likely have a criminal background. We hope TCADA has reviewed the criteria and considered this carefully when they elected to adopt these guidelines. Finally, I hope TCADA will make a copy of this available to providers.

Response: The Texas Occupations Code is not yet available on the Internet. The referenced criteria are currently used by the commission in reviewing the criminal histories of licensed counselors and applicants for licensure. They provide a framework for evaluating the history but do not impose rigid mandates. Providers will be given a copy of the guidelines.

Comment: The new rules require prospective employees to pass a pre-employment drug test that meets criteria established by the commission. Drug and alcohol prevention and treatment programs take drug and alcohol use among their employees very seriously. They recognize signs quickly and take action with regard to possible use. Many do test not only at pre-employment but intermittently. We believe pre-employment drug tests should be the choice of a provider organization.

Response: The commission recognizes that many providers have adequate procedures but does not agree that leaving this to the discretion of individual providers is sufficient. It is the commission's intention to contract only with providers who can support that they maintain a drug-free workplace, and requiring employees to pass a drug screen is an essential element of a drug-free workplace.

Comment: The specific criteria for the required employee drug test should be clearly defined in the rule. Providers should have the opportunity to comment on the criteria when it is develop by TCADA staff.

Response: The commission disagrees that the specific parameters of the drug screen must be included in the text of the rule. Providers are welcome to comment on the criteria when they are published.

Comment: I do not like the addition of the required criminal background checks or drug screens. We seem to be getting more and more intrusive in the lives of our employees and prospective employees. Neither one of these checks, criminal background or drug, will prevent someone from doing drugs or stealing funds after they have become employees and its adds more costs to program services. These are unfunded mandates.

Response: The commission agrees that these measures cannot guarantee that an employee will not steal funds or use drugs. They do, however, minimize the risk by identifying individuals with a history of similar behavior. The commission believes the added protection for clients and state funds justifies the additional cost to providers.

These amendments are adopted under the Texas Health and Safety Code, §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 adopted rules 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 August 9, 2000.

TRD-200005541

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


Subchapter E. PREVENTION AND INTERVENTION

40 TAC §§144.411, 144.412, 144.414, 144.415, 144.416, 144.418, 144.446, 144.447, 144.451 - 144.453, 144.455, 144.458, 144.460, 144.462

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §§144.411, 144.412, 144.414, 144.415, 144.416, 144.446, 144.447, 144.451-144.453, 144.455, 144.458, 144.460, 144.462 and adopts new §144.418 concerning Prevention and Intervention without changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5575).

These sections contain information regarding program design and implementation, program self-evaluation, performance measure review, participant rights, tobacco products, transportation, environmental and social policy, intervention services, youth prevention programs, youth intervention programs, community coalitions, prevention resource centers, pregnant postpartum intervention programs, HIV early intervention services, and HIV outreach services.

These amendments and new section are adopted to change a program name to Youth Intervention Program; to state that programs must perform self-evaluations unless the contract waives this requirement; to delete obsolete references; to clarify actions the commission may take after receiving a corrective action plan, which now include imposing contract restrictions or sanctions or terminating the contract; to require that providers maintain documentation that participants receiving individualized services in an intervention program have received required information and agreed to participate in the program; to clarify requirements regarding tobacco products and related prohibitions; to add requirements regarding transportation of participants; to specify the elements required for documentation of minors and tobacco presentations; to update the requirements for the intervention assessment; to add documentation requirements for intervention services; to expand requirements for Youth Intervention Programs; to stipulate that community coalitions are to implement community-based processes and environmental and social policy strategies; to change the reporting requirement for prevention resource centers from a monthly report to a quarterly report; to enhance the services and outreach efforts of pregnant postpartum intervention programs; to clarify the responsibility of both HIV early intervention services and HIV outreach services to provide interim services; to clarify that these two programs are to link with Texas Department of Health sponsored community or regional planning groups; to stipulate that both of these types of programs are to market their services; to identify the target population for HIV outreach services; and to make grammatical changes to improve readability and understanding.

Comments on these sections were received from the Association of Substance Abuse Programs and individuals.

The following comment was received regarding §144.414 Performance Measure Review: Does the elimination of the statement-a revision of the performance goals and/or interim goals, with appropriate timelines established to measure progress-imply that there will no longer be an action available to TCADA and providers to negotiate new performance goals? Or, is that assumed to be an option within the corrective action plan? There are situations where revising performance measures/goals is reasonable, indicated and warranted. We recommend that the option to negotiate revised performance goals be continued and should be stated in rule.

Response: The commission expects providers to establish realistic goals and will hold providers accountable for performance in relation to those goals. Occasionally, circumstances beyond the provider's control do justify revised measures, and such revisions can be part of a corrective action plan. The commission does not agree that this option should be explicitly stated in the rule.

The following comment was received regarding §144.447 Intervention Services: The provider is required to collect information about family history of ATOD use. For school-based programs, there is a problem in some school districts with asking family members these types of questions. A parent survey was sent out in one school district that caused a major controversy and the school district now will not permit these questions. We recommend excluding this item, at least for school-based intervention programs.

Response: This section does not apply to school-based universal or selected programs that typically involve large groups of adolescents. It applies only to indicated programs when they provide individualized counseling for youth who are showing early warning signs of substance use or abuse and/or exhibiting other high risk problem behaviors. When an adolescent enters intervention counseling services, a thorough assessment is necessary to identify his or her needs and develop an appropriate service plan. The family history of substance use and abuse is a critical element of such an assessment. The rules specify that the assessment shall be conducted in a culturally appropriate face-to-face session. Whenever possible, parents and other family members participate in the assessment interview and subsequent services and can provide the information directly. When it is not possible to engage parents, providers can request such information from the adolescent. It is neither necessary nor appropriate to gather this data through a survey. If the school has policies that prohibit this information from being discussed within the context of a private counseling session, the program can request a waiver.

These amendments and new section are adopted under the Texas Health and Safety Code, §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 adopted rules 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 August 9, 2000.

TRD-200005543

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §144.417

The Texas Commission on Alcohol and Drug Abuse adopts amendments to § 144.417 concerning Prevention and Intervention without changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5579).

This section contains information staff training.

These amendments are adopted to increase the basic training required for direct service prevention and intervention staff from eight to 16 hours; to add one required topic; and to make other changes to improve readability and understanding.

No comments were received regarding adoption of the amendments.

The amendments are adopted under the Texas Health and Safety Code, §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 adopted rule 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 August 9, 2000.

TRD-200005544

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §§144.448, 144.456, 144.457, 144.459

The Texas Commission on Alcohol and Drug Abuse adopts the repeal of §§144.448, 144.456, 144.457, and 144.459 concerning Prevention and Intervention without changes to the proposal as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5579).

These sections contain the requirements for assessment for treatment, core council services, pregnant postpartum prevention programs, and other special prevention programs.

The repeals are adopted because some of these requirements are deleted and others are incorporated into amended or new sections that are concurrently proposed.

No comments were received regarding the repeal of these sections.

The repeals are adopted under the Texas Health and Safety Code, §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 repeals 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 August 9, 2000.

TRD-200005546

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §144.456

The Texas Commission on Alcohol and Drug Abuse adopts new §144.456. concerning Prevention and Intervention with changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5580).

This section contains information regarding outreach, screening, assessment, and referral services.

This new section is adopted to establish requirements for outreach, screening, assessment and referral services (OSARs), which were previously referred to as core council services; to require that crisis intervention services be handled by a Qualified Credentialed Counselor or counselor intern; and to permit OSARs to provide brief intervention counseling to motivate and prepare an individual for treatment or self-directed change. The change that was made to the proposed text was to delete a phrase that was inadvertently inserted in paragraph (m).

The following comments on this section were received from the Association of Substance Abuse Programs and individuals.

Comment: The proposed rule allows funded OSAR providers to provide treatment services as well as assessment services. We support the rule revision because it increases the flexibility in rural or underserved areas to provide needed services.

Comment: OSAR providers are required to do Minors and Tobacco activities. This is a service more directly involved in Youth Prevention than in OSAR. This is especially true now that information dissemination for OSARs is limited to increasing the knowledge of how to access services. Furthermore, OSAR staff are already performing multiple functions and do not have sufficient time for the Minors and Tobacco activities.

Response: The commission disagrees that the Minors and Tobacco activities should be performed by Youth Prevention Programs. OSARs are the only providers who are assigned catchment areas that ensure coverage for the entire state. Although the subject matter is different, the activity is not incompatible with other OSAR functions. The Minors and Tobacco activities are an information dissemination function which is one of the OSAR's required services. Providers are expected to budget sufficient staff to provide all required services.

Comment: OSAR Counselors are doing screenings, assessments, and referrals for clients. These are very important but very time consuming functions. It is very difficult for a counselor to stop in midstream to go out of the office in order to carry out the required Outreach component of the OSAR function (and the Minors and Tobacco function). Also, when outreach is being conducted more clients are accessing the needed service thus creating more business. Increased funding is needed in order for the OSARs to carry out all of their functions.

Response: The commission believes that outreach is a critical function, particularly because priority populations are less likely to access services on their own. Outreach encompasses a variety activities, and many of them do not require face-to-face contact. OSARs are not expected to implement outreach models that rely primarily on street outreach and other intensive casefinding activities. Instead, OSAR providers should design a multi-faceted outreach plan that uses resources as efficiently as possible. Such a plan usually focuses on gatekeepers who already interact with members of the commission's priority population. The commission acknowledges that limited time is always a factor. Assessment, usually the most time-consuming activity, is not required for every person who accesses OSAR services and should only be conducted when necessary. Moreover, OSARs are expected to work with local treatment providers to eliminate duplicative assessments. Because treatment providers need to conduct an in-depth assessment in order to develop a treatment plan, it is possible that some of the assessments currently conducted by your organization could be eliminated by expanding the screening process to elicit information needed to make a referral to an appropriate treatment provider.

Comment: Under the new requirements, how much flexibility will we have within our network regarding the assessment requirements?

Response: The rules provide the fundamental framework for all commission-funded services, including those provided through networks. The commission's contract with the network management organization may include further provisions specific to the network. The specific division of responsibilities within a network is determined through negotiation between the management organization and its subcontractors.

Comment: Wouldn't it be a conflict of interest to allow OSARs to make referrals to themselves-which is what will happen if OSARs are also treatment providers?

Response: Many OSARs have been treatment providers for many years with no apparent problems with conflict of interest. In rural areas, OSARs may be the only accessible treatment provider or the only provider offering the level of services needed by an applicant. Prohibiting self-referral would severely limit access to services. Furthermore, current treatment capacity meets less than 20% of the need. With effective outreach, the capacity of all providers should be fully utilized.

Comment: Programs are required to establish an avenue for a person in crisis to speak with a trained counselor within one hour of the initial call. "Trained counselor" should be clearly defined. Can a person who has received training in crisis intervention provide this service or must it be a QCC? It is also important to note that there is a financial aspect to implementing this rule, as overtime pay may be required of staff responding to crisis calls after normal business hours.

Response: As defined in the rules, a counselor is a QCC, a counselor intern working under direct supervision, or a graduate. Under this rule, the counselor must be trained in crisis intervention. The requirement for after-hours coverage is not new. The change is that coverage must be provided by a trained counselor. This is necessary because crisis calls sometimes involve severely disturbed individuals. The commission considered the financial impact of this rule when it was proposed.

Comment: The OSAR in our area cannot possibly do all of the things outlined in (a) unless TCADA provides additional funding to hire more staff. At present, they are inundated with client screenings. We operate in a managed care network. I recommend that OSARs conduct the client assessments, crisis intervention and other related duties for the network and the Councils on Alcohol and Drug Abuse be given back the responsibility for (and funding associated with) information dissemination, community based process and other community information and education duties.

Response: The commission expects applicants who are competing for funds to budget sufficient staff to provide all required services. The Councils on Alcohol and Drug Abuse are no longer associated with specific programs. Like other community-based organizations, they request funding for a variety of services. Traditionally, these providers have competed for SIC contracts to provide screening, referral, and related services. In FY 2001, SIC contracts are being converted to OSARs. The services required in these contracts have not changed, except that all OSARs are expected to offer treatment assessments (in FY 2000 it was optional for an SIC to have the capacity to conduct assessments). The OSAR provides an integrated package of services that provides essential infrastructure. The commission does not agree that it would be equally effective to divide these activities among different providers. Within a network, the configuration of services and the level of subcontractor funding are determined by negotiations between the managed care organization and the subcontractors.

This new section is adopted under the Texas Health and Safety Code, §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 adopted rule is the Texas Health and Safety Code, Chapter 461.

§144.456.Outreach, Screening, Assessment, and Referral Services

(a)

Outreach, Screening, Assessment, and Referral (OSAR) service providers are community-based organizations that provide alcohol, tobacco and other drug prevention and intervention services to the community at large in their identified catchment area. OSAR service providers conduct a variety of services aimed to reduce use and abuse of ATOD in the targeted community.

(b)

OSAR services programs shall offer universal, selective and indicated strategies to individuals, families, and communities within the service area defined in the contract.

(c)

Information dissemination shall be provided for the purposes of education and awareness in the community. Information dissemination shall be focused on increasing access to services for the community, including the commission's priority populations described in §144.522 of this title (relating to Priority Populations).

(d)

Problem identification and referral shall be provided for the purpose of the identification of appropriate service needs through screening, referral, placement and follow-up.

(e)

Crisis intervention services shall be provided for the purpose of responding to individuals and/or families in need of immediate services.

(1)

Crisis intervention may be a single contact or a short series of contacts.

(2)

The program shall develop written policies and procedures for crisis intervention services during and after normal business hours.

(3)

Crisis intervention must be provided by a QCC or a counselor intern working under direct supervision.

(4)

The program shall establish an avenue for a person in crisis to speak with a trained counselor within one hour of the initial call received during and after normal business hours.

(5)

The program shall provide training annually on crisis telephone call policies and procedures for all employees who answer (or may answer) the telephone during or after normal business hours. Training must include crisis intervention techniques and available community resources.

(f)

The program shall provide treatment assessments and placements.

(1)

All assessments shall be conducted in a confidential, face-to-face interview.

(2)

All assessments shall be conducted by qualified credentialed counselors (QCCs) or counselor interns working under direct supervision.

(3)

The program shall use an assessment tool that is approved by the commission and appropriate for the target population.

(4)

If an individual meets the DSM-IV criteria for substance abuse or dependence, the program shall refer the individual for appropriate treatment services. With written consent, the program shall forward a copy of the assessment to the treatment provider.

(5)

The OSAR shall maintain written agreements with referral sources/treatment providers to identify assessment roles in order to minimize duplicate efforts in conducting treatment assessments.

(6)

Documentation shall include:

(A)

date of assessment;

(B)

zipcode of the individual assessed;

(C)

demographics of the individual assessed

(D)

the written assessment, including a diagnostic impression based on DSM-IV criteria;

(E)

referrals and placements made; and

(F)

any follow-up contacts.

(g)

The program may provide brief motivational counseling to motivate and prepare an individual for treatment or self-directed change in behavior if treatment is not indicated.

(h)

Minors and tobacco activities shall be provided for the purpose of reducing minors' access to tobacco products throughout the catchment area served. The OSAR shall submit a quarterly narrative report on minors and tobacco activities, including:

(1)

tobacco retailer education;

(2)

tobacco information and education;

(3)

media awareness; and

(4)

tobacco coalition and community involvement.

(i)

Community-based process shall be provided for the purpose of enhancing the ability of the community to more effectively provide substance abuse services.

(j)

The program shall maintain a resource manual or file that contains current information about local referral resources, including location and contact information, services offered, and eligibility criteria. At a minimum, the resource manual or file shall include information about all prevention, intervention, and treatment programs in the OSAR's catchment area.

(k)

The program shall develop and implement written procedures to identify and provide appropriate referrals for individuals exhibiting conditions or behavior that may suggest unmet mental health needs. The program shall also provide annual training on mental health issues to all staff members who interact with service recipients.

(l)

OSAR programs shall work with other organizations in the area to coordinate substance abuse and other services for the individual and/or family.

(m)

OSAR providers may operate separate prevention, intervention, and/or treatment programs to meet the needs of the community. These services may not, however, be provided with resources allocated to the OSAR function.

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 August 9, 2000.

TRD-200005545

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


Subchapter F. TREATMENT

40 TAC §§144.511, 144.521 - 144.523, 144.525, 144.526, 144.532, 144.541, 144.543, 144.545, 144.551, 144.553

The Texas Commission on Alcohol and Drug Abuse adopts amendments to §§144.511, 144.522, 144.523, 144.526, 144.532, 144.541, 144.543, 144.545, 144.551 and adopts new §§144.521, 144.525, and 144.553 concerning Treatment. Sections 144.511, 144.525, 144.526, 144.532, 144.545, 144.551 and 144.553 are adopted with changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5581). Sections 144.521-144.523, 144.541, 144.543 are adopted without changes to the proposed text and will not be republished.

These sections contain information regarding program plan and implementation, client eligibility, priority populations, waiting list and interim services, admission determination and placement, length of stay guidelines, core program requirements, specialized treatment services for females, pharmacotherapy services, family services, performance measure review, and client record documentation.

These amendments and new sections are adopted to more fully describe the requirements for a written program plan; to require programs to develop admission criteria that addresses their specific target population; to require a quality improvement system for all treatment programs and to specify the requirements for this system; to revise the rules regarding client eligibility to require the use of financial eligibility criteria and procedures developed by the commission; to delete former Supplemental Security Income recipients previously disabled from substance abuse as a priority population; to stipulate that providers are to accept applicants from the whole state when space is available; to combine requirements for capacity management and interim services into one section; to prohibit providers from holding empty beds or slots for anticipated clients for more than 48 hours; to implement the Texas Department of Insurance admission criteria to place clients in the most appropriate level of care available; to describe the utilization review process that must be used with the length of stay guidelines; to clarify that pregnant women and women with dependent children may remain in residential treatment for three months; to require that programs offering specialized treatment services for females have documented, regular contact with certain programs and organizations that serve the target population; to prohibit these programs from admitting females who are not in their priority population unless they can document that all community outreach contacts have been contacted and no potential priority clients can be identified for admission; to require that pharmacotherapy programs develop and implement a plan to achieve accreditation as required by federal regulations; to stipulate that the consent of the adult client is required before family services are provided; to delete family case management from the list of reimbursable family services; to revise the steps the commission may take after receiving a program's corrective action plan to include imposing contract restrictions or sanctions or terminating the contract; to outline requirements for client record documentation; and to make grammatical changes to improve readability and understanding.

Comments on these sections were received from the Association of Substance Abuse Programs and individuals.

One comment was received regarding §144.511 Program Plan and Implementation: We support continuous quality improvement programs and many of our members operate a system similar to the one outlined in this rule. We believe a system should be in place, but are concerned about specificity of program design and content outlined in the rule(s) related to this function. We believe the direction to establish a quality improvement program can be accomplished in j (1) by adding review of TCADA performance measures. The rest of the subject specific rules-- j(2), (k) (1-6) can be removed. This will allow for more flexibility and still provide a provision for quality improvement programs. If need be, documentation guidelines can be included in a rule handbook.

Response: The rule has been revised as suggested.

The following are comments received regarding §144.521 Client Eligibility.

Comment: The rule requires programs to use financial eligibility criteria, forms and assessment procedures established by the commission. To date, there does not seem to be any clear and specific TCADA criteria, forms and assessment procedures established. We recommend these be developed, with provider input, and distributed prior to the rule being placed into effect.

Response: Providers will receive this information with their FY 2001 contracts. The commission will also provide training on how to implement these instruments. The short timeframe did not allow for a period of provider comment prior to implementation, but the commission will consider all suggestions for revisions.

Comment: Sliding fee scales should be the purview of the provider. Can this not be an area of local option? One board may have the funds to not wish to charge in excess of TCADA's payment rate while others may know that the patient will never pay the required match and either choose to waive it entirely or reject the client because the amount owed would work a detriment on the provider's finances. If there is to be a provision for a sliding fee scale, it is important that the provider set it in keeping with their local needs and area financial restraints.

Response: The commission does not agree that the sliding fee scale should be a local option. Financial eligibility is one of the most basic and most important standards relating to publicly funded services. The commission is obligated to establish standards that direct public funds to people who do not have the means to pay for services. The commission recognizes that some people above the income threshold for free services can afford to pay a portion but not the full cost of treatment. Without a sliding fee scale, these clients would not have access to services. The rules require providers to make a reasonable effort to collect client fees, but does not expect that 100% of those fees will be collected. Providers do, however, have the option not to charge client fees and not to bill TCADA.

Comments received regarding §144.522. Priority Populations follow.

Comment: I object to the priority populations. All of us are here to serve those who abuse alcohol and other drugs. Can't we just serve those who need services?

Response: These priority populations are established in the federal Substance Abuse Prevention and Treatment block grant and/or state law.

Comment: I think local funding sources will object when they learn we are required to serve applicants from every region in the state when we do not have sufficient treatment capabilities to serve "our own". I realize that we can give preference to local applicants but will you change this in the future?

Response: These rules apply only to commission-funded services. Although local funding sources may contribute match, most of the cost is borne by the state. The proposed rule requires providers to accept clients from other regions only when capacity is available. An applicant from any part of the state who is part of the commission's priority populations must be given preference over a non-priority applicant. The commission has no plans to change its policy on allowing providers to give preference to local applicants of equal or greater priority status than applicants from other parts of the state.

The following are comments received regarding §144.523. Waiting List and Interim Services.

Comment: The rule states that when a program does not have the capacity to admit an injecting drug user or pregnant female, the program shall place the individual in another treatment facility or provide reasonable access to interim services. We have always complied with a best effort approach to finding help for applicants for service. But no provider has the ability or resources to arrange for services at some other facility. How shall any provider "place" the individual in another treatment facility. "Refer" would be a more appropriate word.

Response: The commission recognizes that a treatment provider cannot ensure that the client will be admitted when a referral is made. In this case, however, if the client is not admitted, interim services must be provided. The term "place" is used to communicate that the provider's responsibility for providing interim services is not absolved by making a referral that does not result in admission.

Comment: There are far too many interim services to arrange in a rural service area. It would be very difficult in an urban area. For us, it is impossible.

Response: Interim services are required by the federal Substance Abuse Prevention and Treatment block grant. The commission does not have the discretion to waive the requirement. Most of the required interim services (counseling and education about HIV and TB and referrals for HIV and TB treatment) can be obtained through the local health department. The additional services required for pregnant women (counseling on the effects of alcohol and drugs on the fetus and referrals for prenatal care) are generally available through local health clinics.

Comments received regarding §144.525 Admission Determination and Placement follow.

Comment: Under the new rules, providers implement TDI admission criteria to determine the appropriate level of service. To comply providers need access to training on administering the criteria and guidelines for documenting administration of TDI admission criteria in a fashion acceptable to TCADA. Rather than immediate implementation of this rule on September 1, we suggest it go into effect following receipt of appropriate TCADA training.

Response: The commission disagrees that training should be a prerequisite to implementation of the rule. Training will be provided, but the rule and the admission criteria are sufficiently detailed to permit immediate implementation.

Comment: The rules state that if an appropriate provider is not accessible to the client, the provider shall arrange for treatment in a program with the most appropriate level of care accessible to the client. If a provider does not offer a program or if a provider is not accessible to the client, a reasonable effort at referral should suffice. The wording in "shall arrange for" suggests a case management function that the treatment provider is not funded to provide.

Response: The rule has been revised to clarify the intent.

Comment: The word applicant should be used and not used interchangeably with client. A distinction needs to be made between someone who has not been accepted because they do not meet TDI criteria for the program, and client who is currently being served but no longer meets criteria.

Response: The commission agrees with the comment and has revised the rule accordingly.

Comment: While we are already involved in a strong QCC program here we object to the rules providing such a strong encroachment into local management prerogatives with all the detail that is provided here. Make it shorter and more permissive.

Response: It is not clear which section the commenter is referencing, but the commission assumes it is the language in paragraph (b). The TDI criteria are designed for a delivery system where clients have access to all levels of service. However, public funds are insufficient to provide all levels of service throughout the state. This detail is provided so that providers know how to apply the placement criteria when a full continuum of services is not available.

Comment: This is very confusing. We are going to utilize the DSM-IV diagnostic criteria then we are going to further evaluate the admission according to TDI admission criteria to determine appropriate level of care? Then, to assess HIV, we are going to use NIDA's reference. You are making this more difficult than it has to be.

Response: The commission disagrees that these requirements are unnecessarily complex. To ensure appropriate use of available treatment dollars, the commission must establish standards to ensure that clients admitted to commission-funded programs need treatment and that they receive the most appropriate treatment available. Furthermore, the federal Substance Abuse Prevention and Treatment block grant requires the commission to improve the process for referring individuals to treatment facilities that can provide the treatment modality that is most appropriate for their individual needs. Structured criteria provide a consistent and reliable way to achieve those goals. The DSM-IV is the single national standard used to establish chemical abuse and dependency, and the TDI admission criteria are the state's uniform standard for chemical dependency treatment placement. HIV is a major health problem in this country, and substance abusers are at high risk. The block grant places great emphasis on HIV issues, and the commission believes that HIV screening and referral is a critical need for this population. The NIDA criteria provide a scientifically sound method for substance abuse professionals to assess an individual's HIV risk.

Comments received regarding §144.526 Length of Stay Guidelines follow.

Comment: The length of stay for women with children Level II Residential Treatment was substantially reduced in FY 00. While we continue to meet all contract performance measures, comparison of FY 99 and FY 00 data shows there has been a 17% decrease in the number of women abstinent at the time of follow-up. It is our experience that all the issues involved in treating women and their children and preparing them for independent living cannot be addressed adequately within this shortened length of stay.

Response: In the proposed rule, TCADA interpreted the TDI length of stay guidelines to address the special needs of this population by adjusting the guideline for residential treatment from 35 days (applicable to other adults) to three months. The intent was to permit three months in a Level II Residential program, and the rule will be clarified to reflect that. An individual client may stay in residential treatment longer than three months if clinical justification is documented in the client record. The guidelines allow an additional 70 days in a Level III Residential program. Providers should also consider whether other levels of care might be sufficient to meet the woman's needs for a portion of her treatment.

Comment: The rule states that women with children and pregnant women with a substance abuse or dependence diagnosis are eligible for three months of residential treatment at a specialized female service provider. Depending at what point in her pregnancy a female arrives in treatment as well as her progress and life situation, a 3 month stay may not take her through delivery or allow time for her to be in a safe environment after treatment to delivery. We recommend a rule be added that outlines extended stay criteria for pregnant females up to delivery and through initial post partum periods.

Response: When the lengths of stay for Level II and Level III are combined, a pregnant woman could stay in residential treatment for more than six months without exceeding the guidelines. Furthermore, the rules already allow extended lengths of stay if clear clinical justification is documented in the client record.

The following are comments received regarding §144.532 Core Program Requirements.

Comment: The rules require programs to implement a written plan of operation explaining outreach efforts, including specific strategies to reach members of the priority populations. There is no funding for treatment centers to provide outreach services to find priority population clients. They are funded to provide treatment services for TCADA's priority and eligible populations. Outreach strategies and activities are often full programs in and of themselves. Unless these outreach "efforts" are meant to be simple and focused on maximizing bed capacity, we believe this rule should removed. And, if this rule is being implemented in an effort to ensure beds are fully utilized, then the phrase that was deleted-the commission may waive this requirement if the program demonstrates high capacity utilization and adequate engagement of the priority population-- should remain.

Response: The outreach efforts are meant to be simple and focused on maximizing utilization by the priority populations. The commission accepts the comment and has revised the rule as requested.

Comment: Levels II, III, and IV treatment programs funded by the commission shall provide family education and counseling related to the client's substance abuse. If you aren't funding this why do you now require it?

Response: Research clearly indicates that family involvement is a critical factor in achieving positive treatment outcomes. The commission believes that these services must be an integral part of every treatment program. The costs associated with these services should be included when calculating the cost of a unit of treatment.

One comment was received regarding §144.551 Performance Measure Review: Does the elimination of the statement-a revision of the performance goals and/or interim goals, with appropriate timelines established to measure progress-imply that there will no longer be an action available to TCADA and providers to negotiate new performance goals? Or, is that assumed to be an option within the corrective action plan. There are situations where revising performance measures/goals is reasonable, indicated and warranted. We recommend that the option to negotiate revised performance goals be continued and should be stated in rule.

Response: The commission expects providers to establish realistic goals and will hold providers accountable for performance in relation to those goals. Occasionally, circumstances beyond the provider's control do justify revised measures, and such revisions can be part of a corrective action plan. The commission does not agree that this option should be explicitly stated in the rule. A comment was received regarding §144.553. Client Record Documentation: Sections (b) and (c) seem to be contradictory. Are you requesting each session attended by the client to be documented or do you want one weekly progress note which addresses all sessions? If counselors try to remember what went on in each session during a once weekly progress note, that might pose some auditing problems. I believe you should state either one weekly progress note or progress note written after each session.

Response: The commission concurs and has revised the rule to require a brief note for each session and a summary note each week addressing the client's progress toward treatment goals.

These amendments and new sections are adopted under the Texas Health and Safety Code, §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 adopted rules is the Texas Health and Safety Code, Chapter 461.

§144.511.Program Plan and Implementation.

(a)

The program shall develop a written plan to guide the delivery of services for the contract period. The plan must be approved through the application process and any changes to the plan must be approved through a contract amendment.

(b)

The program shall revise the plan each year on the basis of needs data and results of self-evaluation, and these changes must be approved through the contract renewal or amendment process.

(c)

The written plan shall include a description of the program design, target population, goals and objectives, admission criteria, and services and activities.

(d)

The program design must be based on a logical, conceptually sound framework with the intended result of reducing alcohol, tobacco, and other drug problems. The program shall gather and use reliable evidence of effectiveness from comparable programs to select and guide the program design. The program shall use results that come from sound studies to assess potential effectiveness of the program design related to the needs of the target population.

(e)

The program shall identify and describe the target population, including specific information about:

(1)

age, gender, and ethnicity;

(2)

patterns of substance use;

(3)

social and cultural characteristics;

(4)

knowledge, beliefs, values, and attitudes; and

(5)

needs.

(f)

The program shall identify long-range goals which:

(1)

address identified needs and/or problems; and

(2)

clearly describe behavioral and/or societal changes to be achieved.

(g)

The program shall establish objectives for each contract period that are linked to the long range goals. Objectives must:

(1)

be realistic, outcome-oriented, measurable, and time-specific; and

(2)

address effectiveness, efficiency, and client satisfaction; and

(3)

include performance measures required in the contract.

(h)

The program shall develop admission criteria that identify members of the target population and ensure that the needs of persons admitted are appropriate to the program's design and services.

(i)

The written plan shall include key services and activities used to achieve program goals and objectives. Each service and activity must:

(1)

relate directly to the goals and objectives;

(2)

address identified needs; and

(3)

be appropriate for the target population. The program design, content, communications, and materials shall be:

(A)

available in the primary language of the target population; and

(B)

appropriate to the literacy level, gender, race, ethnicity, sexual orientation, age, and developmental level of the target population.

(j)

The program shall develop and implement a quality improvement system that uses data to monitor and evaluate program implementation and performance. This system shall include a quality improvement team that meets on a regular basis (at least quarterly) to review commission performance measures and other relevant program data, identify issues, and implement appropriate action to improve service delivery.

(k)

The program shall maintain documentation of its quality improvement activities, including minutes of each quality improvement meeting.

(l)

The program shall conduct and document an annual self assessment of program implementation and performance that covers all components of the written program plan.

(m)

The program shall use information gained from the annual self assessment and other quality improvement activities to make appropriate changes to the program plan and the staff training plan. Any change requiring commission approval must be made through the contract renewal or amendment process.

§144.525.Admission Determination and Placement.

(a)

All admissions must be authorized or denied by a QCC.

(1)

For every applicant admitted to treatment, the client record must include documentation signed by a QCC that the individual met all applicable admission criteria, including the DSM-IV diagnostic criteria.

(2)

When an applicant is denied admission, the program shall maintain documentation signed by a QCC which explains why the admission was denied.

(b)

The admission determination shall include an evaluation based on Texas Department of Insurance (TDI) admission criteria (as interpreted in subsection (c) of this section) to determine the appropriate level of service. The provider shall match individual applicant needs with appropriate treatment intensity and setting.

(1)

If the provider does not offer a program appropriate for the applicant as determined by the TDI criteria, the provider shall refer the applicant to a provider that does offer the needed service.

(2)

If an appropriate provider is not accessible to the applicant, the provider shall arrange for treatment (through admission or referral) in a program with the most appropriate level of care accessible to the applicant.

(3)

If the applicant is placed on a waiting list, the provider may admit the client to a less intensive program on an interim basis.

(4)

The client record shall contain documentation demonstrating that the client met the TDI admission criteria or justifying the reason for admission if the criteria were not met.

(c)

The commission has interpreted the TDI admission criteria to apply them to the commission's priority populations. Any revisions adopted by the Texas Department of Insurance supercede the admission criteria listed in this section. For pregnant women and/or women with children under their care, a DSM-IV diagnosis of Substance Dependence or Substance Abuse shall suffice for admission to a residential treatment program.

(d)

As part of the assessment, the program shall assess each applicant's risk for HIV infection, tuberculosis, and other sexually transmitted diseases. Risk assessments shall follow guidelines as set by the National Institute on Drug Abuse's "Preventing HIV Among Substance Abusers: Risk Assessment/Risk Reduction."

(e)

The program's admission criteria shall not exclude members of the commission's priority populations defined in §144.522 of this title (relating to Priority Populations).

(f)

The program's admission criteria shall not automatically exclude individuals based on:

(1)

physical or mental health history;

(2)

current physical or mental health diagnoses or services;

(3)

past or present prescription medications;

(4)

assumptions of ability to benefit from treatment without documented current behavioral evidence;

(5)

drugs being abused;

(6)

ability to read and write; or

(7)

pregnancy.

(g)

The program shall not automatically deny admission to a previous client based on prior treatment. If the applicant has been admitted to the facility three or more times in the past 12 months, the provider may consider this information (including circumstances of prior discharges) in determining whether to admit the applicant. The program shall not deny admission based on prior treatment if the applicant has only one or two prior admissions or if the applicant is in need of detoxification.

(h)

The program shall not automatically deny admission based on a perceived threat of harm to self or others. The program shall have a policy and procedures for assessment of potential harm to self or others. If the program determines that an individual is a current risk to self or others, the program may require an evaluation from a qualified mental health provider prior to admission.

(i)

The program shall not require a period of abstinence prior to admission or require treatment clients to complete detoxification unless the client meets TDI admission criteria for detoxification services.

(j)

All treatment programs shall develop and implement written procedures to identify clients exhibiting conditions or behavior that may suggest unmet mental health needs. The program shall collaborate with and provide referrals to available resources (including qualified and credentialed mental health professionals) to address the client's mental health needs.

(k)

The program shall provide appropriate referrals for all persons who are denied treatment. Documentation shall include:

(1)

date(s) of application and denial;

(2)

identifying information;

(3)

the reason the person was denied admission; and

(4)

organizations to which the client was referred.

§144.526.Length of Stay Guidelines.

(a)

Length of stay in treatment shall be determined by the needs of the individual client. Whenever possible, multiple levels of care shall be used to provide a continuum of care for each individual client.

(b)

The commission has adopted Texas Department of Insurance length of stay guidelines to provide a tool for monitoring service utilization. Clients may remain in a specific level of treatment for a longer or shorter period of time based on individual need.

(c)

When the client is admitted, the projected length of stay (LOS) shall be documented in the client record. The initial projected length of stay shall not exceed Texas Department of Insurance (TDI) Guidelines.

(d)

All facilities shall implement procedures to monitor length of stay according to TDI guidelines.

(1)

The program shall conduct the first treatment plan review no later than midway through the client's projected length of stay. The review shall include a comparison of the client's status with the TDI continuing stay criteria.

(2)

If the client meets the continuing stay criteria, the program shall revise the treatment plan and the estimated length of stay (not to exceed the TDI guidelines).

(3)

If the client does not meet the continuing stay criteria, the program shall confirm that the client meets the discharge criteria. Based on client need, the program shall transfer the client to a lower level of care (if available) or discharge the client.

(4)

The program shall conduct a treatment plan review shortly before the estimated date of discharge (or earlier, if appropriate).

(5)

If the client has reached the maximum recommended length of stay but is not ready for transfer or discharge, justification for extending treatment shall be documented in the client record. The client's status shall be reviewed regularly, and the client shall be moved to a less restrictive level of care as quickly as clinically appropriate.

(e)

The commission has interpreted the Texas Department of Insurance Guidelines to apply them to the commission's defined levels of service. Any revisions adopted by the Texas Department of Insurance supercede the recommended lengths of stay listed in this section.

(1)

Residential Level I (Detoxification): 1-14 days for adults and adolescents.

(2)

Outpatient Level I (Detoxification) 3-9 days for adults, not applicable for adolescents.

(3)

Residential Level II (Intensive Residential): 14-35 days for adults and 14-60 days for adolescents.

(4)

Outpatient Level II (Day Treatment): 14-35 days for adults and 14-60 days for adolescents.

(5)

Residential Level III (Residential): 28-70 days for adults and 28-120 days for adolescents.

(6)

Outpatient Level III (Intensive Outpatient): 30-84 days for adults and 30-84 days for adolescents.

(7)

Outpatient Level IV (Outpatient): Up to 180 days for adults and adolescents.

(f)

The commission has interpreted the TDI guidelines to apply them to the commission's priority populations and specialized services. Regardless of the length of stay guidelines listed in subsection (e) of this section, women with dependent children and pregnant women with substance abuse or dependence diagnosis are eligible for three months of Level II residential treatment at a specialized female service provider.

§144.532.Core Program Requirements.

(a)

All treatment programs shall comply with applicable chemical dependency treatment facility licensure requirements for the specified level of service established in Chapter 148 of this title (relating to Facility Licensure).

(b)

All programs funded by the commission shall:

(1)

implement a systematic process to identify and offer appropriate referrals for family members of clients;

(2)

inform clients and involved family members of family services offered directly and through other community resources; and

(3)

document family participation and attempts to engage family members in services.

(c)

Levels II, III, and IV treatment programs funded by the commission shall provide:

(1)

family education and counseling related to the client's substance abuse;

(2)

life skills training;

(3)

case management;

(4)

disease management;

(5)

support group opportunities for adolescents and adults, including older adults; and

(6)

individual and/or family aftercare. Level IV treatment can be used to satisfy this requirement if it is provided as a transitional level of care for a client transferring from a Level I, II or III treatment program.

(d)

The program shall have written descriptions of all educational and didactic sessions, including curricula, outlines, and activities.

(e)

Group size shall be limited to a number that allows effective interaction between the group and facilitator and between group members.

(1)

Group counseling sessions are limited to a maximum of 16 clients.

(2)

Group education sessions, didactic sessions, and other non-therapeutic groups are limited to a maximum of 32 clients. This limitation does not apply to seminars, outside speakers, or other events designed for a large audience.

(f)

The program shall establish and demonstrate active use of cooperative agreements with available substance abuse and other mental health, health care, and social services to meet the needs of clients and family members. Agreements to coordinate services must be established in writing and renewed annually (through signature or other documented contact), and shall include:

(1)

names of the organizations entering into the agreement;

(2)

services or activities each organization will provide;

(3)

signatures of authorized representatives; and

(4)

dates of action and expiration.

(g)

The program shall develop and implement a written plan of operation explaining outreach efforts, including specific strategies to reach members of the priority populations listed in §144.522 of this title (relating to Priority Populations). The commission may waive this requirement if the program demonstrates high capacity utilization and adequate engagement of the priority population.

(h)

The program shall document active participation in collaborations to support community resource development.

(i)

Levels II, III, and IV residential programs shall schedule planned, structured activities during evenings and weekends. These hours are in addition to those required by licensure rules. The minimum number of additional hours for Levels II, III, and IV are 10 hours for adults and 15 hours for adolescents. The program shall maintain documentation that the activities were provided, including sign-in sheets. Client participation does not need to be individually recorded in client records.

(j)

All counseling sessions and other activities counted toward the required hours of service must last at least 30 minutes.

§144.545.Family Services.

(a)

Providing services to the family of the primary client is required of all commission funded programs. Family centered services are a crucial ingredient in providing comprehensive, community-based services to children, adolescents and adults. The family service program should not duplicate existing community prevention or intervention programs that offer appropriate services. Treatment, intervention, and prevention programs are expected to collaborate to establish a coordinated array of substance abuse services for families.

(b)

Family services shall be designed to identify family risk factors associated with the client's chemical dependency, improve the health and functioning of the family unit and/or to assist individual family members to support the client in achieving and maintaining a healthy, drug-free life style. All services provided to family members shall be age and developmentally appropriate. Family services shall be initiated only with knowledge and consent of an adult client, and the timing of all family services shall be clinically appropriate for the individual client.

(c)

Family services may be provided to the entire family, including older adults, individual family members, and/or a subset of family members.

(d)

Family services must be provided by qualified staff including LCDCs who have the documented education, training and experience needed to perform the specific family services being provided. 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 treatment and prevention within the family (including the development of healthy family behavior patterns), commensurate with the individual's training and experience. However, clients and/or family members in need of therapy on issues outside the LCDC's scope of professional practice must be referred to a qualified mental health professional such as an LMSW (Licensed Master Social Worker), LMFT (Licensed Marriage and Family Therapist), LPC (Licensed Professional Counselor) or LPA (Licensed Psychological Associate).

(e)

Family services must be documented in the client record. If the client and/or family refuses family services or if the services are clinically contraindicated, supporting documentation must be included in the client record. When family services are provided, the record must include the elements listed.

(1)

Family psychosocial assessment. The assessment must be conducted by a licensed and qualified professional based upon education and training.

(2)

Family service plan. The counselor, client and family shall develop the plan and update it as goals are accomplished or needs change. This plan must include:

(A)

abilities, strengths, preferences, problems and needs identified from the client and family assessment;

(B)

goals that are realistic, outcome-oriented, measurable, time limited and stated in behavioral terms that are understandable to the client and family;

(C)

specific services to be provided that enable the family to achieve the agreed upon goals; and

(D)

aftercare services to be provided upon discharge, including necessary community supports.

(3)

Progress notes. Progress notes must document the services provided and the family's response. The provider 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 or lack of progress toward the goals; and

(E)

other relevant information.

(4)

Discharge plan. Discharge planning shall begin at the time of the initial treatment plan and shall address ongoing family needs and support activities. The family shall receive a copy of the discharge plan, including:

(A)

family goals or activities to sustain progress;

(B)

referrals for other needed support services;

(C)

aftercare services; and

(D)

follow-up.

§144.551.Performance Measure Review.

(a)

The treatment program will be held to specific performance measures as stated in the contract.

(b)

The commission shall review actual performance and notify the program in writing if the program failed to achieve the expected level of performance.

(c)

If the program fails to achieve the expected level of performance, the program shall respond within 30 days from the postmark date of the commission's written notification. The program must submit a written corrective action plan to the commission. The corrective action plan must include the program's method and timeframes for correcting or resolving the noted deficiencies.

(d)

After receiving the response, the commission shall take at least one of the following actions.

(1)

Notify the program in writing that the corrective action plan has been approved and should be implemented as outlined.

(2)

Specify additional corrective actions or conditions.

(3)

Impose contract restrictions or sanctions or terminate the contract.

§144.553.Client Record Documentation.

(a)

The provider shall maintain complete documentation for all services paid for by commission funds. Documentation shall comply with licensure rules and with the standards in this section.

(b)

The progress notes shall contain a record of all sessions attended by the client. The following information shall be included for each session:

(1)

the date of the session and beginning and end times;

(2)

the topic and/or goal of the session; and

(3)

the level of the client's participation.

(c)

In addition, a summary progress note shall be written at least weekly. The weekly progress note shall include a summary of observations made over the course of the week, including specific information about the client's progress toward or away from each treatment plan goal. Other significant information relating to the client's status shall also be recorded.

(d)

Progress notes shall also include:

(1)

documentation of the purpose, duration, justification, and approval of any approved absence from a residential program;

(2)

a record of all case management, referral, linkage, and follow-up activities; and

(3)

a progress note documenting the information gathered in the 60-day follow-up contact, including:

(A)

the date and time of successful follow-up contact;

(B)

the name of the person contacted and relationship to the client;

(C)

the telephone number of the person contacted;

(D)

documentation of any unsuccessful attempts at follow-up; and

(E)

the signature of the person who conducted and documented the follow-up interview.

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 August 9, 2000.

TRD-200005547

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


40 TAC §§144.512, 144.521, 144.524, 144.525, 144.531, 144.533, 144.554

The Texas Commission on Alcohol and Drug Abuse adopts the repeal of §§144.512, 144.521, 144.524, 144.525, 144.531, 144.533, and 144.554 concerning Treatment without changes to the proposal as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5587).

These sections contain the requirements for self-evaluation, client eligibility, facility capacity management, interim services, admission, client billings, and client data systems (CDS) forms.

The repeals are proposed because some of these requirements are deleted and others are incorporated into amended or new sections.

No comments were received regarding the repeal of these sections.

The repeals are adopted under the Texas Health and Safety Code, §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 repeals 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 August 9, 2000.

TRD-200005548

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call:


Subchapter G. NETWORK MANAGEMENT ORGANIZATIONS (NMOS)

40 TAC §§144.611 - 144.616

The Texas Commission on Alcohol and Drug Abuse adopts the repeal of §§144.611-144.616 concerning Network Management Organizations (NMOs) without changes to the proposal as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5588).

These sections contain the requirements for service structure; outreach; screening, assessment, and referral; care coordination; monitoring service utilization; and service delivery planning and implementation.

The repeals are adopted because provisions specific to individual network management organizations will be included in their contracts.

The following comments were received from the Association of Substance Abuse Programs and an individual regarding the adoption of the repeal: All items pertaining to NMOs have been eliminated from the rules, so where do networks stand in the scope of things? What happens when contract stipulations conflict with the rules? Which takes precedent?

Response: Should a conflict exist, the rules take precedence over contract stipulations.

The repeals are adopted under the Texas Health and Safety Code, §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 repeals 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 August 9, 2000.

TRD-200005549

Karen Pettigrew

General Counsel

Texas Commission on Alcohol and Drug Abuse

Effective date: September 1, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 349-6733


Part 4. TEXAS COMMISSION FOR THE BLIND

Chapter 159. ADMINISTRATIVE RULES AND PROCEDURES

Subchapter A. GENERAL INFORMATION

40 TAC §159.1

The Texas Commission for the Blind adopts the amendment of §159.1 in its administrative rules and procedures pertaining to complaints without changes to the text proposed in the June 2, 2000, issue of the Texas Register (25 TexReg 5292). The amendment is adopted to satisfy the requirement in SB 1563 of the 76th Legislature (1999) that agencies must include the method for directing complaints to the agencies on their Internet site. The agency has amended its rule accordingly.

No comments were made in response to the proposal.

The amendment is adopted under the authority of Human Resources Code, Title 5, Chapter 91, §91.018, which authorizes the Commission to promulgate rules establishing methods for directing complaints to the agency. The adoption affects Subtitle C, Title 10, Government Code, Chapter 2113.

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 August 11, 2000.

TRD-200005624

Terrell I. Murphy

Executive Director

Texas Commission for the Blind

Effective date: August 31, 2000

Proposal publication date: June 2, 2000

For further information, please call: (512) 377-0611


40 TAC §159.5

The Texas Commission for the Blind adopts new §159.5 concerning conducting criminal history checks on applicants for employment without changes to the text proposed in the June 2, 2000, issue of the Texas Register (25 TexReg 5293). The rule is adopted to satisfy requirements that the agency adopt criteria that will be considered during reviews for the purpose of determining whether to deny a person employment based on the information contained in a criminal history record.

No comments were received on the proposal.

The rule is adopted under the authority of Human Resources Code, Title 5, Chapter 91, §91.0165, which states that the Commission by rule shall establish criteria for denying a person's employment application based on the results of a criminal history check.

The adoption affects no other statutes.

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 August 11, 2000.

TRD-200005611

Terrell I. Murphy

Executive Director

Texas Commission for the Blind

Effective date: August 31, 2000

Proposal publication date: June 2, 2000

For further information, please call: (512) 377-0611


40 TAC §159.6

The Texas Commission for the Blind adopts §159.6 concerning payment rates for medical services provided to consumers without changes to the text published in the June 2, 2000, issue of the Texas Register (25 TexReg 5294). The rule is adopted to define how rates for medical treatment and procedures are set to ensure that the State is getting the best value for services while at the same time ensuring that consumers have adequate access to assessment and treatment services. The rules also establish a method for waiving rates in cases where a particular rate would deny a person access to services and establishes the Board's schedule for periodic review of all rates.

No comments were received on the proposal.

The rule is adopted under the authority of Human Resources Code, Title 5, Chapter 91, § 91.029, which authorizes the Commission to adopt rules and standards governing the determination of rates the Commission will pay for medical services.

The adoption affects no other statutes.

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 August 11, 2000.

TRD-200005625

Terrell I. Murphy

Executive Director

Texas Commission for the Blind

Effective date: August 31, 2000

Proposal publication date: June 2, 2000

For further information, please call: (512) 377-0611


Chapter 163. VOCATIONAL REHABILITATION PROGRAM

Subchapter A. GENERAL INFORMATION

40 TAC §163.6

The Texas Commission for the Blind adopts new §163.6 concerning service delivery without changes to the text proposed in the June 2, 2000, issue of the Texas Register (25 TexReg 5294). The rule is adopted to comply with statutory requirements that the agency establish standards for the delivery of services. The section addresses oversight and monitoring of service delivery, guidelines to service delivery staff, reasonable time frames for service delivery, and sharing of financial information for planning purposes.

No comments were received on the proposal.

The rule is adopted under the authority of Human Resources Code, Title 5, Chapter 91, §91.022, which authorizes the agency to establish and maintain, by rule guidelines for the delivery of services by the Commission consistent with state and federal law

The adoption affects no other statutes.

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 August 11, 2000.

TRD-200005622

Terrell I. Murphy

Executive Director

Texas Commission for the Blind

Effective date: August 31, 2000

Proposal publication date: June 2, 2000

For further information, please call: (512) 377-0611


Chapter 164. INDEPENDENT LIVING PROGRAM

Subchapter A. GENERAL INFORMATION

40 TAC §164.5

The Texas Commission for the Blind adopts new §164.5 concerning service delivery without changes to the text proposed in the June 2, 2000, issue of the Texas Register (25 TexReg 5295). The rule is adopted to comply with statutory requirements that the agency establish standards for the delivery of services. The section addresses oversight and monitoring of service delivery, guidelines to service delivery staff, reasonable time frames for service delivery, and sharing of financial information for planning purposes.

No comments were received on the proposal.

The rule is adopted under the authority of Human Resources Code, Title 5, Chapter 91, §91.022, which authorizes the agency to establish and maintain, by rule guidelines for the delivery of services by the Commission consistent with state and federal law

The adoption affects no other statutes.

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 August 11, 2000.

TRD-200005620

Terrell I. Murphy

Executive Director

Texas Commission for the Blind

Effective date: August 31, 2000

Proposal publication date: June 2, 2000

For further information, please call: (512) 377-0611


Chapter 169. BLIND AND VISUALLY IMPAIRED CHILDREN'S PROGRAM

Subchapter A. GENERAL INFORMATION

40 TAC §169.7

The Texas Commission for the Blind adopts §169.7 concerning service delivery without changes to the text proposed in the June 2, 2000, issue of the Texas Register (25 TexReg 5296). The rule is adopted to comply with statutory requirements that the agency establish standards for the delivery of services. The section addresses oversight and monitoring of service delivery, guidelines to service delivery staff, reasonable time frames for service delivery, and sharing of financial information for planning purposes.

No comments were received on the proposal.

The rule is adopted under the authority of Human Resources Code, Title 5, Chapter 91, §91.022, which authorizes the agency to establish and maintain, by rule guidelines for the delivery of services by the Commission consistent with state and federal law

The adoption affects no other statutes.

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 August 11, 2000.

TRD-200005619

Terrell I. Murphy

Executive Director

Texas Commission for the Blind

Effective date: August 31, 2000

Proposal publication date: June 2, 2000

For further information, please call: (512) 377-0611


Part 9. TEXAS DEPARTMENT ON AGING

Chapter 260. AREA AGENCY ON AGING ADMINISTRATIVE REQUIREMENTS

The Texas Department on Aging adopts the repeal of §260.3 relating to Access and Assistance Program, §260.5 relating to Information and Assistance Services, §260.7 relating to Case Management Services, §260.9 relating to Legal Awareness/Legal Assistance Services and §260.13 relating to Implementation of the Options for Independent Living Program and adopts new §260.3 relating to System of Access and Assistance. The repeals of §§260.3, 260.5, 260.7, 260.9 and 260.13 are adopted without changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5588) and will not be republished. New §260.3 is adopted with changes to the proposed text and will be republished.

New §260.3 consolidates the current rules relating to Access and Assistance and creates a single comprehensive rule. In addition, the new rule provides Area Agencies on Aging with the necessary information and direction needed to provide information and coordinate services for older persons in accordance with the Older Americans Act.

New §260.3 outlines the general requirements of the Area Agency on Aging System of Access and Assistance and outlines the specific requirements for each component making up the system of access and assistance. The new rule includes sections relating to system and client outcomes, professional staffing, system integration, client eligibility, client intake, prohibited service activities, confidentiality of client records, release of client information, client contributions, conflicts of interest, reporting, Information, Referral and Assistance, Care Coordination and Benefits Counseling.

The following comments were received regarding §260.3:

Comment #1, §260.3(b)(1)(D)

North Texas Area Agency on Aging

Comment: The rule does not identify what services are to be included.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (D) Access and assistance services are accessible, flexible, coordinated and designed to support an individual's highest level of functioning in the least restrictive environment.

Comment #2, §260.3(b)(1)(E)

North Texas Area Agency on Aging

Comment: The rule does not identify what services are to be included.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (E) Access and assistance services are available to persons age 60 years and older regardless of income or location within the service area.

Comment #3, §260.3(e)(1)

Health and Human Services Commission

Comment: We would like to suggest the following change to the rule as currently drafted. In subsection (e), paragraph (1), add the phrase "information about community services" following the word "services" and before the word "maximizes."

Department Response: The Department concurs. Language has been added to include "information about services." The text of the rule has been modified to read: (1) The system of access and assistance shall strive to develop cooperative working relationships with local service providers to build an integrated service delivery system which ensures broad access to and information about community services, maximizes the utilization of existing resources, avoids duplication of effort and gaps in services and facilitates the ability of people who need services to easily find the most appropriate provider.

Comment #4, §260.3(n)

North Texas Area Agency on Aging

Comment: The rule identifies possible activities under Information, Referral and Assistance. The rule should state "...consists of activities such as" instead of "consists of..."

Department Response: The Department concurs. The text of the rule has been modified to read: (n) Information, Referral and Assistance. The information, referral and assistance process consists of activities such as assessing the needs of the inquirer, evaluating appropriate resources, assessing appropriate response modes, indicating organizations capable of meeting those needs, providing enough information about each organization to help inquirers make an informed choice, helping inquirers for whom services are unavailable by locating alternative resources, when necessary, actively participating in linking the inquirer to needed services and following up on referrals to ensure the service was received or provided.

Comment #5, §260.3(n)(5)(A)

Health and Human Services Commission

Comment: We would like to suggest the following change to the rule as currently drafted. In subsection (n), paragraph (5), subparagraph (A), you make reference to developing criteria for inclusion or exclusion of agencies and programs in the resource database. Such criteria have already been developed for use by the I&R Network and should be referenced as available in the rule.

Department Response: The Department generally concurs. The Department believes multiple criteria sources may exist in the network. Language has been added to clarify. The text of the rule has been modified to read: (A) Access and assistance staff shall develop criteria for the inclusion or exclusion of agencies and programs in the resource database or use criteria developed by other information, referral and assistance entities. These criteria shall be uniformly applied and published so that staff and the public will be aware of the scope and limitations of the database.

Comment #6, §260.3(n)(5)(B)

North Texas Area Agency on Aging

Comment: The statement is unclear. Please clarify.

Department Response: The Department concurs. The text of the rule has been modified to read: (B) A standardized profile shall be developed for each organization that is part of the community service delivery system.

Comment #7, §260.3(n)(5)(D)

Health and Human Services Commission

Comment: Similarly, in subparagraph (D) of the same paragraph, you reference using a standard service classification system; we would suggest explicitly referencing the AIRS/Infoline Taxonomy.

Department Response: The Department concurs AIRS/Infoline Taxonomy is the standard service classification system. Language has been added to clarify. The text of the rule has been modified to read: (D) Access and assistance staff shall use the AIRS/Infoline Taxonomy to facilitate retrieval of community resource information and to promote the reliability and consistency of information across the service region and across the state.

Comment #8, §260.3(n)(6)(C)

North Texas Area Agency on Aging

Comment: Please identify what is meant by "this" information. Language is unclear.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (C) The area agency on aging shall use recorded information to identify service gaps and overlaps, assist with needs assessments, support the development of products, identify issues for staff training, facilitate the development of the resource information system.

Comment #9, §260.3(n)(7)

Office of the Attorney General

Comment: Spell out acronym (I&R).

Department Response: The suggested change has been made. The text of the rule has been modified to read: (7) Cooperation with Local Information and Referral (I&R) Providers.

Comment #10, §260.3(n)(7)(A)

Health and Human Services Commission

Comment: Finally, in paragraph (7), subparagraph (A), you discuss working with local I&R systems; we would suggest using a little stronger language that explicitly references working with the Area Information Center.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (A) In communities with comprehensive and/or specialized I&R providers, including Area Information Centers, when applicable, the area agency on aging shall develop cooperative working relationships to build an integrated system of information, referral and assistance which ensures broad access to services, maximizes the utilization of existing resources, avoids duplication of effort and encourages seamless access to community resource information.

Comment #11, 260.3(n)(8)(A)

Office of the Attorney General

Comment: Insert "which are adopted by reference" after "Systems."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (A) Access and assistance staff providing information, referral and assistance services shall adhere to the standards of conduct set forth by the Alliance of Information and Referral Systems which are adopted by reference.

Comment #12, §260.3(n)(8)(B)

Capital Area Agency on Aging

Comment: While I agree philosophically with having an Information, Referral and Assistance program that performs in a professional manner and follows the standards set out by the Alliance of Information and Referral Systems (AIRS), I strongly disagree with the requirement that we seek AIRS accreditation. In the current form, the accreditation process is onerous for small agencies with little administrative staff to oversee the process, which consists of two steps: consultation and on-site review. This process can take well over a year to complete.

The initial accreditation application fee is $1,000, which is non-refundable. Additional expenses incurred during the On-Site Review process, all expenses related to travel (hotel, food, incidentals), are also the responsibility of the applying agency. These are funds that would be taken away from providing services to our clients.

I would strongly urge reconsideration of inclusion of this rule or modification of the language that would encourage area agencies to seek AIRS accreditation but not require it.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (B) Area agencies on aging are encouraged to seek agency accreditation with the Alliance of Information and Referral Systems.

Comment #13, §260.3(o)(1)(B)

Office of the Attorney General

Comment: Insert "defined as by the program entitled" after "management," and "as required by" after "Living."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (B) Care Management, which includes the model of care management as defined by the program entitled, Options for Independent Living, as required by in Human Resource Code Chapter 101, Subchapter C.

Comment #14, §260.3(o)(2), (o)(2)(A), (o)(2)(A)(i), (o)(2)(A)(ii), (o)(2)(A)(iii)

Office of the Attorney General

Comment: Language is unclear and should include "without an assessment" after authorization wherever listed.

Department Response: The suggested change has been made. The text of the rule has been modified to read: (2) Service Authorization. A process which identifies a need for a service(s) and uses the direct purchase of service procedures to obtain and initiate one or more services. There are two types of service authorization. They include service authorization without an assessment and service authorization requiring an assessment.

(A) Service Authorization Without an Assessment.

(i) Service authorization without an assessment may be used to procure all services except home delivered meals, homemaker, personal assistance and residential repair.

(ii) Service authorization without an assessment may be performed by any area agency on aging- approved access and assistance staff member either by phone or in person.

(iii) Service authorization without an assessment must be based on a client intake completed by area agency on aging access and assistance staff or by a qualified source.

Comment #15, §260.3(o)(2)(C)(i)

Office of the Attorney General

Comment: In this section you should identify the additional criteria identified in Human Resource Code, Chapter 101, Subchapter C, relating to Options for Independent Living for a total of five criteria. In addition, insert "only" after provided.

Department Response: The suggested change has been made. The text of the rule has been modified to read: (i) Care management services may be provided only to persons age 60 years and older, with priority given to those:

(I) who have recently suffered a major illness or health care crisis or have recently been hospitalized and need additional attention during the recuperation period in accordance with Human Resource Code, Chapter 101, Subchapter C, relating to Options for Independent Living;

(II) who live in a rural area;

(III) who are moderately to severely impaired in activities of daily living and instrumental activities of daily living;

(IV) have insufficient caregiver support; and

(V) who are in great economic or social need, particularly low-income, minority older persons.

Comment #16, §260.3(o)(2)(C)(ii)(II)

Office of the Attorney General

Comment: Insert "Care managers shall develop" before "a written plan."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (II) Care Plan. Care Managers shall develop a written plan that is based upon the client's preferences, as supported by identified priority needs and within available public/private resources. The care plan must specify the amount, frequency and duration of each service to be provided and identify the outcomes to be achieved.

Comment #17, §260.3(o)

North Texas Area Agency on Aging

Comment: Omit "for" after arrange.

Department Response: The suggested change has been made. The text of the rule has been modified to read: (o) Care Coordination. The purpose of care coordination is to assess the needs of a client and effectively plan, arrange, coordinate and follow-up on services which most appropriately meet the identified needs as mutually defined by access and assistance staff, the client, and where appropriate, a family member(s) or other caregiver.

Comment #18, §260.3(o)(2)(C)(ii)(III)

North Texas Area Agency on Aging

Comment: The rule identifies possible activities under Care Coordination. The rule should state "...with the capacity of the provider and may include but is not limited to:"

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (III) Service Arrangement. Care managers shall arrange for services identified in the care plan to begin at the earliest possible date, consistent with the capacity of the provider and may include, but is not limited to:

Comment #19, §260.3(o)(2)(C)(ii)(IV)

Office of the Attorney General

Comment: Insert "Care managers shall conduct monitoring and follow-up activities which include" before "verifying."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (IV) Monitoring/Follow-up Activities. Care managers shall conduct monitoring and follow-up activities which include verifying service delivery, determining the extent to which services meet the needs and expectations of the client, and where necessary, advocating for improvements in service delivery. Monitoring shall include at least monthly contacts with the client and a home visit not less than every six months.

Comment #20, §260.3(o)(2)(C)(ii)(V)

North Texas Area Agency on Aging

Comment: Change "upon" to "on."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (V) Reassessments shall be conducted and the care plan shall be amended as needed based on changes in client status and provider effectiveness and may be conducted by phone or in person.

Comment #21, §260.3(o)(2)(C)(ii)(VI)(-a-)

North Texas Area Agency on Aging

Comment: Language is unclear. Please clarify.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (-a-) the client needs assessment, including initial referral date and date of completion of assessment; re-assessment(s), if applicable;

Comment #22, §260.3(o)(2)(C)(ii)(VIII)

Office of the Attorney General

Comment: Insert "and adopted by reference" after "Managers."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (VIII) Professional Conduct. Care managers must adhere to the pledge of ethics and the standards of practice for professional geriatric care managers as set forth by the National Association of Professional Geriatric Care Managers and adopted by reference.

Comment #23, §260.3(p)(3)(E)

Office of the Attorney General

Comment: Should this say "dispute resolution?"

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (E) Individual Rights. Age discrimination, disability discrimination, abuse, neglect, exploitation and dispute resolution.

Comment #24, §260.3(p)(4)(D)

North Texas Area Agency on Aging

Comment: This statement is very awkward. System integration is addressed under subsection (e).

Department Response: Department concurs. Subsection (p)(4)(D) has been deleted from rule.

40 TAC §§260.3, 260.5, 260.7, 260.9, 260.13

The repeals are adopted under Texas Human Resources Code §101.021, which provides the Texas Department on Aging with the authority to promulgate rules governing the operation of the Department.

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 August 14, 2000.

TRD-200005674

Gary Jessee

Program Specialist

Texas Department on Aging

Effective date: September 3, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 424-6857


40 TAC §260.3

The new section is adopted under Texas Human Resources Code §101.021, which provides the Texas Department on Aging with the authority to promulgate rules governing the operation of the Department.

§260.3.System of Access and Assistance.

(a)

Purpose and Goals. This rule establishes the requirements for implementation by area agencies on aging of the system of access and assistance. Each area agency on aging shall establish and/or maintain a system of access and assistance. The program shall incorporate necessary strategies and activities to meet the following goals:

(1)

to provide persons age 60 years and older efficient access to needed services;

(2)

to conduct effective screening and assessment of individual needs and preferences;

(3)

to efficiently and effectively target resources so that persons most in need receive assistance; and

(4)

to establish a strong local role and clear identity of the area agency on aging as a source of access and assistance for eligible persons and/or their family members or other caregivers.

(b)

Outcomes.

(1)

The area agency on aging shall achieve the following system outcomes.

(A)

The area agency on aging will conduct outreach and/or marketing to inform eligible persons and/or their family members or other caregivers of available services.

(B)

The area agency on aging shall serve as a source of connection to comprehensive information on services, benefits and opportunities.

(C)

The area agency on aging system of access and assistance shall meet specific local needs and take advantage of specific local strengths and resources including volunteers.

(D)

Access and assistance services are accessible, flexible, coordinated and designed to support an individual's highest level of functioning in the least restrictive environment.

(E)

Access and assistance services are available to persons age 60 years and older regardless of income or location within the service area.

(F)

The area agency on aging system of access and assistance shall have the capability to respond to racially, culturally and ethnically diverse groups.

(2)

The area agency on aging shall achieve the following client outcomes.

(A)

Eligible persons and/or their family members or other caregivers served are provided sufficient information to make informed decisions about services.

(B)

People in need are connected with existing benefits and services.

(C)

Clients are provided an opportunity to express their level of satisfaction with access and assistance services received.

(D)

Services are provided so that clients maintain hope, dignity, respect and independence.

(c)

The area agency on aging system of access and assistance shall include:

(1)

Information, Referral and Assistance;

(2)

Benefits Counseling;

(3)

Care Coordination; and

(4)

Ombudsman Services.

(d)

Professional Staffing. The area agency on aging shall strive to maintain an adequate level of professional access and assistance staff who possess necessary general and specialized knowledge. Where applicable, access and assistance staff must complete the training and certification requirements set forth by the Department.

(e)

System Integration.

(1)

The system of access and assistance shall strive to develop cooperative working relationships with local service providers to build an integrated service delivery system which ensures broad access to and information about community services, maximizes the utilization of existing resources, avoids duplication of effort and gaps in services and facilitates the ability of people who need services to easily find the most appropriate provider.

(2)

Coordination with the Texas Department of Human Services. Area agency on aging access and assistance staff shall work with the local Texas Department of Human Services (TDHS) staff to ensure any person who may be eligible for TDHS services will be referred to that agency. The area agency on aging may provide services to persons who are eligible for TDHS services in the following instances:

(A)

the person is on a interest list for TDHS services;

(B)

the person is in need of immediate service provision and awaiting determination of eligibility for TDHS services; or

(C)

the person is in need of immediate service provision and awaiting location and placement of a TDHS family care or primary home care service provider.

(f)

Client Eligibility. Eligible clients include any person age 60 years and older.

(g)

Client Intake. The intake process varies with the type of service indicated. For all clients, access and assistance staff will determine client needs and preferences. If clients have multiple or complex needs, access and assistance staff will gather identifying information to determine eligibility for services funded by the area agency on aging or other agencies.

(h)

Prohibited Service Activities. Access and assistance staff will not perform or participate in any of the following activities:

(1)

accepting gifts from a client;

(2)

lending or borrowing money or articles to or from a client;

(3)

transporting a client in an access and assistance staff person's automobile unless appropriate liability insurance is in force; and

(4)

driving or riding in a client's automobile.

(i)

Confidentiality of Client Records. Area agency on aging access and assistance staff shall comply with the requirements described in 40 TAC §270.1(d), regarding confidentiality of client records.

(j)

Release of Client Information. When referrals are made, access and assistance staff must obtain and clearly document the consent of the client for release of confidential information to other service provider agency(ies). This consent may be obtained from the client verbally or in writing.

(k)

Client Contributions.

(1)

Area agency on aging access and assistance staff must comply with the requirements described in 40 TAC §270.1(j), regarding client contributions.

(2)

Care management clients who meet the criteria identified in Human Resource Code 101, Subchapter C relating to Options for Independent Living shall be encouraged to contribute towards the cost of their care through a suggested co-payment schedule.

(l)

Conflicts of Interest. The area agency on aging shall ensure that any conflicts of interest between the function of access and assistance and the provision of direct client services are disclosed to the Department. The intent is to separate the function of access and assistance from the provision of other client services.

(m)

Reporting. The area agency on aging must comply with the reporting requirements identified in §260.1(c)(2) of this title (relating to programmatic reports).

(n)

Information, Referral and Assistance. The information, referral and assistance process consists of activities such as assessing the needs of the inquirer, evaluating appropriate resources, assessing appropriate response modes, indicating organizations capable of meeting those needs, providing enough information about each organization to help inquirers make an informed choice, helping inquirers for whom services are unavailable by locating alternative resources, when necessary, actively participating in linking the inquirer to needed services and following up on referrals to ensure the service was received or provided.

(1)

Target Population.

(A)

Information, referral and assistance services shall be provided to any person age 60 years and older and/or his/her family member or other caregiver.

(B)

Information, referral and assistance services shall be provided to Medicare and Medicaid beneficiaries of any age under the provisions of funds received from the Health Care Financing Administration.

(2)

Access and assistance staff shall provide telephone, electronic or walk-in information, referral and assistance services in which the inquirer has one-to-one contact with an information, referral and assistance specialist.

(3)

Service providers shall coordinate with emergency response organizations, such as local law enforcement agencies or other existing agencies/activities as appropriate to provide the necessary coverage.

(4)

The area agency on aging telephone messaging system will provide callers with appropriate emergency phone numbers when calls are received after hours.

(5)

Resource Information.

(A)

Access and assistance staff shall develop criteria for the inclusion or exclusion of agencies and programs in the resource database or use criteria developed by other information, referral and assistance entities. These criteria shall be uniformly applied and published so that staff and the public will be aware of the scope and limitations of the database.

(B)

A standardized profile shall be developed for each organization that is part of the community service delivery system.

(C)

Information in the resource database shall be indexed and accessible in ways that support the information, referral and assistance process.

(D)

Access and assistance staff shall use the AIRS/Infoline Taxonomy to facilitate retrieval of community resource information and to promote the reliability and consistency of information across the service region and across the state.

(E)

The resource database shall be updated through continuous revision or at intervals sufficiently frequent to ensure accuracy of information and comprehensiveness of its content.

(6)

Information, Referral and Assistance Log.

(A)

Access and assistance staff shall maintain a system for collecting and organizing inquirer information that facilitates appropriate referrals and provides a basis for describing requests.

(B)

A unit of service is a client's initial request for information or assistance. The area agency on aging shall have a system for recording both initial inquiries and follow-up contacts made by either the client or the agency.

(C)

The area agency on aging shall use recorded information to identify service gaps and overlaps, assist with needs assessments, support the development of products, identify issues for staff training, facilitate the development of the resource information system.

(7)

Cooperation with Local Information and Referral (I&R) Providers.

(A)

In communities with comprehensive and/or specialized information and referral (I&R) providers, including Area Information Centers, when applicable, the area agency on aging shall develop cooperative working relationships to build an integrated system of information, referral and assistance which ensures broad access to services, maximizes the utilization of existing resources, avoids duplication of effort and encourages seamless access to community resource information.

(B)

If the area agency on aging is designated by the Texas Information and Referral Network as an Area Information Center, the area agency on aging must meet the expectations of the designation.

(8)

Professional Conduct.

(A)

Access and assistance staff providing information, referral and assistance services shall adhere to the standards of conduct set forth by the Alliance of Information and Referral Systems which are adopted by reference.

(B)

Area agencies on aging are encouraged to seek agency accreditation with the Alliance of Information and Referral Systems.

(o)

Care Coordination. The purpose of care coordination is to assess the needs of a client and effectively plan, arrange, coordinate and follow-up on services which most appropriately meet the identified needs as mutually defined by access and assistance staff, the client, and where appropriate, a family member(s) or other caregiver.

(1)

Program Design. The operational design of care coordination is dictated by the needs of the area agency on aging service area and includes a combination of levels of care. These levels of care coordination include:

(A)

Service Authorization; and

(B)

Care Management, which includes the model of care management as defined by the program entitled, Options for Independent Living, as required by in Human Resource Code Chapter 101, Subchapter C.

(2)

Service Authorization. A process which identifies a need for a service(s) and uses the direct purchase of service procedures to obtain and initiate one or more services. There are two types of service authorization. They include service authorization without an assessment and service authorization requiring an assessment.

(A)

Service Authorization Without an Assessment.

(i)

Service authorization without an assessment may be used to procure all services except home delivered meals, homemaker, personal assistance and residential repair.

(ii)

Service authorization without an assessment may be performed by any area agency on aging- approved access and assistance staff member either by phone or in person.

(iii)

Service authorization without an assessment must be based on a client intake completed by area agency on aging access and assistance staff or by a qualified source.

(B)

Service Authorization Requiring an Assessment.

(i)

Service authorization requiring an assessment may be used to procure home delivered meals, homemaker, personal assistance and residential repair.

(ii)

Service authorization requiring an assessment may be performed by any area agency on aging-approved access and assistance staff member either by phone or in person.

(iii)

In addition to completing the client intake, a modified assessment must be conducted which may include:

(I)

TDHS Form 2060;

(II)

Nutritional Risk Assessment; or

(III)

Service appropriate assessment.

(iv)

Area agency on aging access and assistance staff may conduct the assessment, procure it or accept it from a qualified source.

(C)

Care Management. Care management is a process that assists clients with multiple needs by developing and implementing comprehensive plans of care.

(i)

Care management services may be provided only to persons age 60 years and older, with priority given to those:

(I)

who have recently suffered a major illness or health care crisis or have recently been hospitalized and need additional attention during the recuperation period in accordance with Human Resource Code, Chapter 101, Subchapter C, relating to Options for Independent Living;

(II)

who live in a rural area;

(III)

who are moderately to severely impaired in activities of daily living and instrumental activities of daily living;

(IV)

have insufficient caregiver support; and

(V)

who are in great economic or social need, particularly low-income, minority older persons.

(ii)

Care management must include the following:

(I)

Comprehensive Client Assessment: A needs assessment may be provided, procured or accepted from a qualified source and must include the following components:

(-a-)

cognitive status (if applicable);

(-b-)

emotional status (if applicable);

(-c-)

physical environment (requires on-site evaluation);

(-d-)

social environment, including informal or family support;

(-e-)

physical status;

(-f-)

economic status;

(-g-)

self-care capacity; and

(-h-)

services presently received.

(II)

Care Plan. Care Managers shall develop a written plan that is based upon the client's preferences, as supported by identified priority needs and within available public/private resources. The care plan must specify the amount, frequency and duration of each service to be provided and identify the outcomes to be achieved.

(III)

Service Arrangement. Care managers shall arrange for services identified in the care plan to begin at the earliest possible date, consistent with the capacity of the provider and may include, but is not limited to:

(-a-)

exploring the availability and quality of services, eligibility criteria and accessibility of a service to the client;

(-b-)

making and documenting referrals to community service agencies;

(-c-)

working with volunteers to provide services;

(-d-)

working with family and friends of the client to help achieve specific service goals; and

(-e-)

authorizing services deemed appropriate by the area agency on aging using direct purchase of service procedures.

(IV)

Monitoring/Follow-up Activities. Care managers shall conduct monitoring and follow-up activities which include verifying service delivery, determining the extent to which services meet the needs and expectations of the client, and where necessary, advocating for improvements in service delivery. Monitoring shall include at least monthly contacts with the client and a home visit not less than every six months.

(V)

Reassessment. Reassessments shall be conducted and the care plan shall be amended as needed based on changes in client status and provider effectiveness and may be conducted by phone or in person.

(VI)

Client Case Records. A confidential client case record shall be maintained on each client served and shall be protected from damage, theft and unauthorized inspection and shall contain at least:

(-a-)

the client needs assessment, including initial referral date and date of completion of assessment; re-assessment(s), if applicable;

(-b-)

the care plan including amount, frequency and duration of each service to be provided;

(-c-)

names of service providers and informal caregivers who render services to the client;

(-d-)

a notation explaining any lapse in service;

(-e-)

notation of hospital admission and/or discharge, with dates;

(-f-)

date and signature for each notation;

(-g-)

record of all care manager contacts and visits;

(-h-)

record of any client complaints and action taken;

(-i-)

record of termination or closure; and

(-j-)

list of names and phone numbers for notification in event of an emergency.

(VII)

Care management may not be provided by any entity with a vested interest in the delivery of services purchased by the area agency on aging without an approved waiver from the Department.

(VIII)

Professional Conduct. Care managers must adhere to the pledge of ethics and the standards of practice for professional geriatric care managers as set forth by the National Association of Professional Geriatric Care Managers and adopted by reference.

(p)

Other key components of the area agency on aging system of access and assistance include Benefits Counseling and Ombudsman Services. The requirements for the Ombudsman Program are identified in §260.11 of this title (relating to Ombudsman Services).

(1)

Benefits Counseling. Benefits counseling includes both legal assistance and legal awareness services.

(A)

Legal Assistance. Legal assistance includes the provision of client-specific advice, counseling and/or representation on matters involving insurance issues, public/private benefits, consumer problems and other legal issues.

(B)

Legal Awareness. Legal awareness includes general education and outreach on matters involving insurance issues, public/private benefits, consumer problems and other legal issues.

(2)

Targeting.

(A)

Benefits counseling services shall be provided to persons age 60 years and older and/or their family members or other caregivers.

(B)

Benefits counseling services shall be provided to Medicare and Medicaid beneficiaries of any age under the provisions of funds received from the Health Care Financing Administration.

(3)

The area agency on aging shall focus its benefits counseling services on the following priority issue areas:

(A)

Income Maintenance/Public Benefit. Food Stamps, Social Security, Social Security Disability, Supplemental Security Income, veterans benefits, pensions, railroad retirement, child support, unemployment compensation, general assistance and other income benefits.

(B)

Medical Entitlements. Medicare, Medicaid, QMB/SLMB, Veterans Administration Medical, indigent health and other medical entitlements.

(C)

Insurance. Medicare Supplement, HMO, long-term care policies, individual health policies, group health policies/COBRA and non-health insurance.

(D)

Surrogate Decision Making. Advanced directives, durable/general powers of attorney, money management, guardianship, custody and other probate matters.

(E)

Individual Rights. Age discrimination, disability discrimination, abuse, neglect, exploitation and dispute resolution.

(F)

Housing. Landlord/tenant issues, repair/modification, utilities, rent subsidy, alternative housing, home equity lending/reverse mortgage, homestead tax credit, weatherization, property tax, housing relocation and general property.

(G)

Institutional Care. Acute care, nursing facility care, assisted living facility care and mental health care.

(H)

Consumer Issues. Bankruptcy, collections, financial counseling, bill reductions, solicitation and unfair sales practices/fraud.

(4)

Benefits counseling services shall be provided according to the following:

(A)

If a request for assistance involving any of the priority issue areas identified in Paragraph (3) of this subsection requires intervention by an attorney or paralegal, the client shall be referred to an appropriate provider in the area.

(B)

For the purpose of handling requests or referrals which originate from sources other than the area agency on aging, the benefits counselor, in consultation with the local legal provider(s), shall develop an appropriate and timely referral process.

(C)

Regardless of the referral source, it shall first be determined whether or not the client may be assisted with other resources, such as the Legal Hotline for Older Texans, pro-bono or reduced-fee providers or through services funded by the Legal Services Corporation.

(5)

Relationship with Providers. The area agency on aging shall establish the following procedures when working with providers of benefits counseling and related legal services:

(A)

To accomplish Paragraph (4), Subparagraph (A) of this Subsection, the area agency on aging shall coordinate with the Legal Hotline for Older Texans, Texas Young Lawyers Association, the private bar and local legal programs (such as law clinics or student law programs), Legal Services Corporation grantees, the Ombudsman Program or other programs.

(B)

The area agency on aging shall utilize the Legal Hotline for Older Texans to provide legal consultation and back-up to access and assistance staff, as needed.

(C)

If consultation/back-up is needed for access and assistance staff in addition to Paragraph (5), Subparagraph (B) of this Subsection, such assistance may be obtained through agreements with programs such as pro-bono or reduced-fee attorneys, law school students, local legal programs or Legal Services Corporation grantees.

(6)

Education and Outreach.

(A)

Education and outreach activities include the dissemination of accurate, timely and relevant information regarding any issue identified under the priority areas in paragraph (3) of this Subsection to persons identified under Paragraph (2) of this Subsection.

(B)

Education and outreach may be provided to individuals or through a group setting such as forums, workshops, seminars and training sessions and other public venues, and shall be reported as legal awareness.

(7)

Classification of Activities.

(A)

The provision of activities described in Paragraph (6) of this Subsection to eligible persons in a one-on-one setting or by telephone where detailed information is provided but no client intake is necessary shall be reported as legal awareness.

(B)

The provision of advice, counseling and/or representation on matters involving insurance issues, public/private benefits, consumer problems and other legal issues shall be reported as legal assistance if a client intake is completed.

(C)

If a client has a simple request for information on any topic including those identified under Paragraph (3) of this Subsection, it shall be reported as information, referral and assistance.

(D)

While education and outreach initiatives that include the dissemination of information through mass media may be budgeted as associated costs under legal awareness, the activities may not be reported as units of service.

(E)

Presentations or other activities that describe the services of the area agency on aging in general including the benefits counseling program may not be reported as units of service.

(8)

The area agency on aging shall collaborate and/or partner with local, state and federal entities to provide education and outreach. Such entities may include but are not limited to the Texas Department of Insurance, Texas Legal Services Center, Texas Medical Foundation, Health Care Financing Administration and the Social Security Administration.

(9)

Benefits counselors shall complete the training and certification requirements as set forth in the benefits counseling certification manual issued by the Department.

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 August 14, 2000.

TRD-200005675

Gary Jessee

Program Specialist

Texas Department on Aging

Effective date: September 3, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 424-6857


Chapter 270. GENERAL SERVICE REQUIREMENTS

The Texas Department on Aging adopts the repeal of §270.5 and adopts new §270.5 relating to Nutrition Service Requirements. The repeal is adopted without changes to the proposed text as published in the June 9, 2000, issue of the Texas Register (25 TexReg 5594) and will not be republished. New §270.5 is adopted with changes and will be republished.

New §270.5 provides Area Agencies on Aging and contracted meal providers with the information necessary to ensure the provision of congregate and home delivered meals meets the requirements of the Older Americans Act as well as state and local regulations. In addition, this rule is the result of a coordinated rule making process between the Texas Department on Aging and the Texas Department of Human Services.

The new rule as adopted includes sections relating to compliance with laws and regulations, compliance with USDA, match requirements, program income, facilities, record keeping, service days, meal requirements, menus, standard recipes, modified diets, meal packaging, holding times, delivery windows, training, nutrition outreach, nutrition education, monitoring, complaint handling, subcontracting and customer satisfaction surveys.

The following comments were received regarding §270.5:

Comment #1, §270.5(c), (d), (q)(3)

North Texas Area Agency on Aging

Comment: There are several places in the rule where "vendor" as well as "contract agency" should be identified.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (c) Compliance with Laws and Regulations. The contract agency/vendor shall follow procedures and maintain facilities that are in compliance with all applicable federal, state and local fire, health, sanitation and safety laws and regulations. All food preparation, handling, and service activities shall comply with Texas Department of Health Division of Food and Drug, "Rules on Food Service Sanitation." The contractor must provide a copy of all required inspection results to the area agency on aging within five calendar days of receipt of the results.

(d) USDA Compliance. Contract agencies/vendors must comply with the Older Americans Act, §311, concerning surplus commodities and United States Department of Agriculture Food Distribution Regulations, 7 Code of Federal Regulations, Part 350; must ensure that only eligible meals served by Older Americans Act funded projects are reported for USDA cash/commodity reimbursement; and must ensure that cash will only be used to purchase food grown in the United States.

(3) Contract agencies/vendors may be reimbursed for up to two consecutive deliveries per month per client when a meal is delivered and the participant is not home to accept it. However, contract agencies must have written procedures in place to ensure a follow-up with participants when they are not home to receive meals.

Comment #2, §270.5(b)(2)

Texoma Area Agency on Aging

Tri-County Senior Nutrition Project, Inc.

Comment: Does TDoA currently dictate a minimum score requirement? We feel that this would be contradictory to the OAA, as we currently use their definitions for an eligible home delivered meal client, not a score from the 2060.

Department Response: The Department does not concur. The Older Americans Act defines general eligibility for home delivered meal clients. However, the Department in coordination with the Texas Department Human Services (TDHS) has established requirements which will target services to those persons most in need.

Comment #3, §270.5(b)(1), (b)(2)

Texoma Area Agency on Aging

Tri-County Senior Nutrition Project, Inc.

Comment: Subsection (b)(1) seems to contradict subsection (b)(2).

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (1) Eligibility criteria shall meet the provisions stated in the Older Americans Act, §307 (a)(13)(A) and (I) relating to eligibility.

Comment #4, §270.5(b)(4)

Texoma Area Agency on Aging

Tri-County Senior Nutrition Project, Inc.

Comment: Do you mean the nutritional risk assessment? If so, perhaps the proper wording should be used here.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (4) All meal participants must complete a Nutritional Risk Assessment not less than once per year.

Comment #5, §270.5(c)

Texoma Area Agency on Aging

Tri-County Senior Nutrition Project, Inc.

Comment: It usually takes our nutrition provider up to 10 days to collect the information from all 20 sites. Can this be modified?

Department Response: The Department does not concur. The rule requires contract agency provider sites to provide a copy of all required inspection results to the area agency on aging within five calendar days of receipt of the results. It does not require the contract agency wait until all provider sites have their inspections completed. They should be submitted as they are completed. Five days seems reasonable for provider sites to submit the information.

Comment #6, §270.5(e)(1), (e)(2)

Combined Community Action, Inc.

Hill County Community Action Association, Inc.

Meals on Wheels Nutrition and Fellowship Project

Texas Association of Aging Programs

Comment: We strongly oppose the 10% cash match requirement in the proposed new rule. The 10% match currently required by the Older Americans Act is not a required cash match.

Department Response: The Department concurs. A workgroup was held to discuss the match requirement. Language has been added to clarify. The text of the rule has been modified to read: (e) Match. Contract agencies will provide a minimum of 10% cash or in-kind match.

Because a cash match is no longer required, the need for a waiver has become obsolete. Subsection (e)(2) has been deleted from rule.

Comment #7, §270.5(k)(1)

Office of the Attorney General

Comment: Include "meal included on the" after "each."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (1) Each meal included on the menu and a list of allowable substitutions must be approved by a dietician consultant as meeting 1/3 of the recommended dietary allowance (RDA) for older adults and the Dietary Guidelines for Americans. The approval must occur and be documented prior to the date the meal is served. The dietary consultant must be a registered dietician who is:

Comment #8, §270.5(q)(3)

Texoma Area Agency on Aging

Tri-County Senior Nutrition Project, Inc.

Comment: Can the same protocols established by TDHS for Title XX meals be referenced here so providers will not have to use two different procedures?

Department Response: The Department does not concur. These rules were written in coordination with the TDHS. In the near future, TDHS nutrition standards will be modified to include the same language in subsection (q)(3).

Comment #9, §270.5(q)(4)

Office of the Attorney General

Comment: Modify "changes" to "change."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (4) Contract agencies must have written procedures in place to ensure significant change in the meal participant's physical or mental condition or environment is reported, investigated and appropriate action is implemented within one business day following notification of the change.

Comment #10, §270.5(r)(2)

Office of the Attorney General

Comment: End the sentence after duties and insert "Training" before "must include."

Department Response: The suggested change has been made. The text of the rule has been modified to read: (2) The contract agency must provide all staff, including volunteers who come in contact with clients in a capacity other than just serving or delivering meals, with at least two hours of training before assuming duties. Training must include:

Comment #11, §270.5(r)(4)

Office of the Attorney General

Comment: Include "to be completed no later than" after training, remove "within" and include "after" before "assumption."

Department Response: The suggested changes have been made. The text of the rule has been modified to read: (4) The contract agency must provide the food service supervisor with at least six hours of training to be completed no later than 30 days after assumption of duties in the following food preparation areas:

Comment #12 & #13, §270.5(r)(5)

Coastal Bend Area Agency on Aging

Comment: We pulled the current state standards and compared the proposed requirement. We recommend this be changed as follows: Texas Food Protection Management certification requires 14 hours of food safety education by the state accredited FPM program and passing an examination. Recertification is required every 3 years after initial certification and entails 6 hours of education by a state accredited FPM program and passing an examination. Students passing the examinations are issued a state FPM certification card entitling them to reciprocity for FPM certification throughout all jurisdiction of the state.

Texoma Area Agency on Aging

Tri-County Senior Nutrition Project, Inc.

Comment: We do not believe the requirements in the Texas Food Establishment Rules published by the Texas Department of Health give the food service supervisor the option of being certified within one year.

Department Response: The Department generally concurs. Language has been added to clarify the requirements for the food service supervisor. The text of the rule has been modified to read: (5) The food service supervisor must comply with the Texas Department of Health rules regarding the knowledge and demonstration of a food protection manager.

By clarifying (r)(5), (r)(6) is unnecessary. Subsection (r)(6) has been deleted from rule. Subsection (r)(7) has been renumbered (r)(6).

Comment #14, §270.5(t)

Office of the Attorney General

Comment: Remove "includes" after which and insert "identifies." After "source" insert "of information presented."

Department Response: The suggested changes have been made. The text of the rule has been modified to read: (t) Nutrition Education. Nutrition Education must be provided on a monthly basis to congregate and home delivered meal clients. An annual written plan for nutrition education must be developed which identifies subject matter, presenter, materials used and source of information presented. This plan must be maintained for monitoring purposes.

Comment #15, §270.5(u)(1)

North Texas Area Agency on Aging

Comment: I believe this section should make reference to the monitoring requirements for vendors.

Department Response: The Department concurs. Language has been added to clarify. The text of the rule has been modified to read: (1) The contract agency will be monitored by the area agency on aging in accordance with 40 TAC 260.1 (d) relating to provider reviews or, for a vendor, 40 TAC 260.19 (f) relating to quality assurance.

Comment #16, §270.5(w)(1)

Office of the Attorney General

Comment: Include "by the contract agency" after maintained.

Department Response: The suggested change has been made. The text of the rule has been modified to read: (1) The contract agency must inform clients in writing of complaint procedures on or before initiation of service. Documentation of receipt of the complaint procedure by the meal participant must be maintained by the contract agency for monitoring purposes.

40 TAC §270.5

The repeal is adopted under Texas Human Resources Code §101.021, which provides the Texas Department on Aging with the authority to promulgate rules governing the operation of the Department.

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 August 14, 2000.

TRD-200005676

Gary Jessee

Program Specialist

Texas Department on Aging

Effective date: September 3, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 424-6857


40 TAC §270.5

The new section is adopted under Texas Human Resources Code §101.021, which provides the Texas Department on Aging with the authority to promulgate rules governing the operation of the Department.

§270.5.Nutrition Service Requirements.

(a)

Purpose. This rule establishes the requirements for providing congregate and/or home delivered nutrition services.

(b)

Eligibility.

(1)

Eligibility criteria shall meet the provisions stated in the Older Americans Act, §307(a)(13)(A) and (I) relating to eligibility.

(2)

Home delivered meal participants, at the time of service initiation, must meet the minimum score requirement on the DHS Form 2060 as established by the Department and must have demonstrated need.

(3)

Home delivered meal participants must be reassessed by the area agency on aging or the contract agency not less than once per year.

(4)

All meal participants must complete a Nutritional Risk Assessment not less than once per year.

(c)

Compliance with Laws and Regulations. The contract agency/vendor shall follow procedures and maintain facilities that are in compliance with all applicable federal, state and local fire, health, sanitation and safety laws and regulations. All food preparation, handling, and service activities shall comply with Texas Department of Health Division of Food and Drug, "Rules on Food Service Sanitation." The contractor must provide a copy of all required inspection results to the area agency on aging within five calendar days of receipt of the results.

(d)

USDA Compliance. Contract agencies/vendors must comply with the Older Americans Act, §311, concerning surplus commodities and United States Department of Agriculture Food Distribution Regulations, 7 Code of Federal Regulations, Part 350; must ensure that only eligible meals served by Older Americans Act funded projects are reported for USDA cash/commodity reimbursement; and must ensure that cash will only be used to purchase food grown in the United States.

(e)

Match. Contract agencies will provide a minimum of 10% cash or in-kind match.

(f)

Program Income.

(1)

Contract agencies will comply with the requirements described in 40 TAC §260.2 relating to program income.

(2)

Contract agencies shall recover at a minimum the full meal cost as defined for ineligible meals for staff and guests under 60. Payment for ineligible meals shall be receipted separately from contributions and handled the same as program income. The meal cost for purposes of cost recovery from staff and guests under age 60 shall be posted in a prominent location and easily visible to guests.

(g)

Facilities. Facilities must meet all requirements as described in Subsection (c) relating to compliance with applicable federal, state and local fire, health, sanitation and safety laws and regulations laws and regulations and the Older Americans Act, §307 (a)(13)(D).

(h)

Records. Contract agencies must comply with the requirements described in 40 TAC §260.1 (e) relating to records.

(i)

Service Days. The contract agency shall serve meals in accordance with the provisions identified in the Older Americans Act, §331 and §336 concerning program authorization.

(j)

Meal Requirements. Each meal shall comply with the provisions of the Older Americans Act, §339, concerning compliance with Dietary Guidelines for Americans and recommended dietary allowances.

(k)

Menus.

(1)

Each meal included on the menu and a list of allowable substitutions must be approved by a dietician consultant as meeting 1/3 of the recommended dietary allowance (RDA) for older adults and the Dietary Guidelines for Americans. The approval must occur and be documented prior to the date the meal is served. The dietary consultant must be a registered dietician who is:

(A)

licensed by the Texas State Board of Examiners of Dieticians; or

(B)

has a baccalaureate degree with major studies in food and nutrition, dietetics or food service management.

(2)

Planned menus should provide for variety in flavor, consistency, texture, temperature and variety.

(l)

Standard Recipes. Food production shall be planned and managed by the contract agency through the use of standardized recipes adjusted to yield the number of servings needed, and to provide for consistency in quality and documented nutrient content of food prepared.

(m)

Modified Diets.

(1)

Therapeutic medical diets may deviate from the standard menu pattern as required by the participant's medical condition as documented by his/her physician.

(2)

The provision of therapeutic medical diets will be determined by a nutrition/meal provider agency's ability to provide therapeutic medical diets.

(n)

Frozen, chilled or shelf-stable meals shall be provided in accordance with the Department's procedures and may be used only if the following conditions exist:

(1)

Sanitary and safe conditions can be provided by the contract agency and the participant for storage, thawing and reheating.

(2)

Meals can be safely handled by the participant or by another available person when the participant is confused, frail or otherwise disabled and unable to safely handle the meal.

(o)

Meal Packaging.

(1)

Supplies and carriers will be used so that hot foods are packaged and transported separately from cold foods.

(2)

Meal carriers used to transport trays or containers of hot or cold foods that may be easily damaged will be enclosed to protect such food from contamination, crushing or spillage and will be equipped with insulation and/or supplemental hot or cold sources as is necessary to maintain safe temperatures.

(3)

Meal packaging must meet the following criteria:

(A)

be sealed to prevent the moisture loss or spillage to the outside of the container, and to maintain a safe temperature throughout transport;

(B)

be designed with compartments to separate food items for visual appeal and minimize spillage between compartments; and

(C)

be easy for the participant to open.

(p)

Holding Time. Holding time for hot food shall not exceed four hours from the time when the food is taken from the equipment in which cooking or reheating is completed until it is served to the participant.

(q)

Delivery of Home Delivered Meals.

(1)

Meals will be prepared and packaged so that delivery can be made within the preferred delivery window of 11:00 am to 1:00 pm.

(2)

Meals may not be left unattended. Written procedures for meal delivery shall be developed by the contract agency which require maximum sanitation and safety for the meal participant.

(3)

Contract agencies/vendors may be reimbursed for up to two consecutive deliveries per month per client when a meal is delivered and the participant is not home to accept it. However, contract agencies must have written procedures in place to ensure a follow-up with participants when they are not home to receive meals.

(4)

Contract agencies must have written procedures in place to ensure significant changes in the meal participant's physical or mental condition or environment is reported, investigated and appropriate action is implemented within one business day following notification of the change.

(r)

Training.

(1)

The contract agency must provide at least one hour of training to all staff and volunteers who serve and/or deliver meals. Alternatively, the same information may be provided to staff and volunteers in an area agency on aging contract manager-approved written document. This information must be provided before staff assume duties and must include:

(A)

client confidentiality;

(B)

procedures used in handling emergency situations involving clients;

(C)

sanitary methods used in serving and delivering meals;

(D)

general knowledge and basic techniques of working with persons who are aged and persons who are disabled; and

(E)

personal hygiene.

(2)

The contract agency must provide all staff, including volunteers who come in contact with clients in a capacity other than just serving or delivering meals, with at least two hours of training before assuming duties. Training must include:

(A)

client confidentiality;

(B)

procedures used in handling emergency situations involving clients;

(C)

sanitary methods used in serving and delivering meals;

(D)

general knowledge and basic techniques of working with persons who are aged and persons who are disabled; and

(E)

orientation in applicable Department, area agency on aging and contract agency forms, rules, procedures and policies.

(3)

The contract agency must provide the food service supervisor with at least two hours of training before assuming duties. The training must cover the following sanitation and safety areas:

(A)

personal hygiene;

(B)

food storage, preparation and service;

(C)

equipment cleaning before, during and after meal service;

(D)

selections of proper utensils and equipment for transporting and serving foods; and

(E)

automatic and manual dishwashing procedures.

(4)

The contract agency must provide the food service supervisor with at least six hours of training to be completed no later than 30 days after assumption of duties in the following food preparation areas:

(A)

practical procedures for food preparation, storage and serving;

(B)

portion control of food in appropriate dishes;

(C)

use of standardized recipes;

(D)

nutritional needs and meal pattern requirements of older adults to be served; and

(E)

quality control of:

(i)

flavor;

(ii)

consistency;

(iii)

texture;

(iv)

temperature; and

(v)

appearance (including the use of garnishes).

(5)

The food service supervisor must comply with the Texas Department of Health rules regarding the knowledge and demonstration of a food protection manager.

(6)

Verification of all training activities and the completion thereof as described in this Subsection must be maintained by the contract agency for monitoring purposes.

(s)

Nutrition Outreach. A written activity plan must be designed to identify eligible clients, with an emphasis on high risk clients within the target population as identified in the Older Americans Act §306 (a)(1). This plan must be maintained by the contract agency for monitoring purposes.

(t)

Nutrition Education. Nutrition Education must be provided on a monthly basis to congregate and home delivered meal clients. An annual written plan for nutrition education must be developed which identifies subject matter, presenter, materials used and source of information presented. This plan must be maintained for monitoring purposes.

(u)

Monitoring.

(1)

The contract agency will be monitored by the area agency on aging in accordance with 40 TAC §260.1 (d) relating to provider reviews or, for a vendor, 40 TAC §260.19 (f) relating to quality assurance.

(2)

The contract agency shall conduct in-house monitoring to document holding times, safe temperatures and quality of meals.

(v)

Weather-Related Emergencies, Fire and Other Disasters.

(1)

Facilities and equipment of the contract agency shall be available in emergencies and disasters according to a plan that puts high risk older participants as a priority.

(2)

The contract agency shall adopt written procedures to provide for the availability of food to participants in emergencies and disasters.

(w)

Complaints.

(1)

The contract agency must inform clients in writing of complaint procedures on or before initiation of service. Documentation of receipt of the complaint procedure by the meal participant must be maintained by the contract agency for monitoring purposes.

(2)

Contract agencies shall investigate and respond in writing to all written complaints in a timely manner.

(3)

The contract agency shall maintain documentation of complaints that includes but is not limited to:

(A)

the date the complaint is received by the contract agency;

(B)

who the complaint is from;

(C)

the nature of the complaint;

(D)

the outcome of the complaint; and

(E)

the date final action was taken.

(4)

The contract agency shall promptly initiate investigation by local health authorities of complaints involving two or more persons with symptoms of foodborne illnesses within a similar timeframe after consuming food from the contract agency. Contract agencies shall report such complaints as required in Department procedures.

(x)

Subcontracting. If the contract agency intends to subcontract meal preparation and or service delivery, the contract agency must obtain written prior approval from the area agency on aging.

(y)

Customer Satisfaction Survey.

(1)

The contract agency must provide meal participants the opportunity to complete a customer satisfaction survey not less than once per year.

(2)

The contract agency will use the results from the completed customer satisfaction surveys to establish benchmarks and to make necessary improvements identified through the surveys.

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 August 14, 2000.

TRD-200005677

Gary Jessee

Program Specialist

Texas Department on Aging

Effective date: September 3, 2000

Proposal publication date: June 9, 2000

For further information, please call: (512) 424-6857