Part 1.
TEXAS DEPARTMENT OF HEALTH
Chapter 157.
EMERGENCY MEDICAL CARE
Subchapter C. EMERGENCY MEDICAL SERVICES TRAINING AND COURSE APPROVAL
25 TAC §§157.33, 157.34, 157.38
The Texas Department of Health (department) proposes amendments
to §157.33 and §157.38 and new §157.34 concerning minimum standards
and requirements for recertification of emergency medical services (EMS) personnel.
Specifically, these amendments and new section cover new options for the recertification
process. An amendment to §157.33 removes the recertification requirements
out of the section and places the requirements in the new §157.34, which
describes five different options for an EMS certificant to recertify. An amendment
to §157.38 reflects the new requirements contained in the continuing
education (CE) option of the proposed new rule. In accordance with Health
and Safety Code, Chapter 773, 76th Legislature, 1999, the department is required
to adopt rules concerning minimum requirements for recertification of EMS
personnel.
Kathryn C. Perkins, Bureau Chief, has determined that for the first five
years the proposed sections are in effect there will be no fiscal impact on
local governments. The cost to the state government to implement §157.34
of this title (relating to Recertification) will be approximately $5,000 in
the first year of implementation and $1,000 each year afterward. There will
be no fiscal impact on the state government to implement the amendments to §157.33
(relating to Certification) and §157.38 (relating to Continuing Education)
of this title.
Kathryn C. Perkins has also determined that for the first five years the
sections are in effect, the public benefit anticipated as a result of enforcing
the sections will be increased standards for the recertification of EMS personnel.
The benefit anticipated for the EMS community is that the options offered
for recertification will confront the obstacles of location and availability
of resources, without compromising standards set to ensure the safety of the
public. There will be no new fees assessed; therefore, it was determined that
there will be no adverse economic effect on small businesses or micro-businesses
or persons who are required to comply with these sections. There will be no
adverse impact on local employment.
Comments on the proposal may be submitted to Kathryn Perkins, Bureau Chief
of Emergency Management, Texas Department of Health, 1100 West 49th Street,
Austin, Texas, 78756-3182, (512) 834-6700. Comments will be accepted for 30
days following the date of publication of this proposal in the
Texas Register
.
The amendments and new section are proposed under the Health
and Safety Code, Chapter 773, which provides the department with the authority
to adopt rules concerning the standards and requirements for recertification
of emergency medical services (EMS) personnel; and §12.001 which provides
the board with the authority to adopt rules for the performance of every duty
imposed by law on the board, the department, and the commissioner of health.
The amendments and new section affect Health and Safety Code, Chapter 773.
§157.33.Certification.
(a)-(d)
(No change.)
(e)
Retesting.
(1)
(No change.)
(2)
A candidate who does not pass a retest may request a second
retest after:
(A)
submitting documentation that verifies completion of a
department-approved
formal refresher course;
(B)-(C)
(No change.)
(3)
(No change.)
(f)-(i)
(No change.)
[(j)
Recertification.]
[(1)
A certificant shall meet the following requirements for
recertification. The certificant shall:]
[(A)
complete the continuing education (CE) requirements for
recertification as required in this title (relating to Continuing Education)
prior to the expiration of the certificate and prior to meeting the requirement
in subparagraph (D) of this paragraph;]
[(B)
submit to the department an application for recertification
and the nonrefundable fee as set out in subsection (a)(4) of this section;
and]
[(C)
complete the department's CE evaluation which shall be
an attempt to measure the individual's knowledge necessary for the adequate
provision of emergency care for current level of certification. The department
has final authority for scheduling all written CE evaluation sessions.]
[
After verification by the department of the
information submitted by the certificant, a certificant who meets requirements
of this subsection will be recertified for four years commencing on the day
following the expiration date of the most recent certificate. A new certificate
and wallet-sized certificate signed by department officials shall be issued.]
[(3)
The results of the CE evaluation along with information
relevant to interpretation of the scores will be issued to the recertifying
candidate, associated medical directors, providers, first responder organizations,
and/or employers.]
[(4)
One re-evaluation may be taken. A fee of $25 shall accompany
the request for a re- evaluation. The re-evaluation results will be issued
as in paragraph (3) of this subsection.]
[(5)
In conjunction with the certificant's two-year interim
CE reporting cycle, the certificant may elect to complete the CE evaluation
or the certificant's medical directors, providers, first responder organizations
and/or employers may mandate that the certificant complete the CE evaluation
and, if applicable, one re-evaluation. The first CE evaluation shall be completed
within 180 days after the deadline date of the interim two-year reporting
cycle. The re-evaluation may be completed after the 180-day period. The CE
evaluation results will be issued as described in paragraph (3) of this subsection.]
[(6)
To take a two-year interim CE evaluation, the certificant
shall submit an application, and a nonrefundable fee as set out in subsection
(a)(4) of this section. A fee of $25 shall accompany the request for a re-evaluation.]
[(k)
Reentry or late recertification.]
[(1)
Reentry is the process for regaining EMS certification:]
[(A)
after the certificate has been surrendered;]
[(B)
during a period of inactive status;]
[(C)
when an application for renewal is postmarked after the
expiration of the most recent certificate; or]
[(D)
when all requirements for recertification are not met
prior to the end of the latest certification period.]
[(2)
Late recertification.]
[(A)
The candidate shall be considered as non-certified and
may not function in the capacity of an EMS certificant or represent that he
is EMS certified until recertification is issued.]
[(B)
A candidate whose certificate has been expired for 90
days or less may renew the certificate by submitting an application and paying
to the department a nonrefundable renewal fee that is equal to 1 1/2 times
the normally required application renewal fee for that level as listed in
subsection (a)(4) of this section.]
[(C)
A candidate whose certificate has been expired for more
than 90 days but less than one year may renew the certificate by submitting
an application and paying to the department a nonrefundable renewal fee that
is equal to two times the normally required application renewal fee as listed
in subsection (a)(4) of this section. A candidate shall submit documentation
that verifies completion of a formal refresher course.]
[(D)
A candidate shall pass the department's written exam.]
[(E)
A candidate whose certificate has been expired for one
year or more may not renew the certificate. The candidate may become certified
by complying with the requirements of subsection (a) of this section including
the successful completion of another initial course.]
(j)
[
(k)
[
(1)
The request for inactive status shall be accompanied by
a nonrefundable fee of $25 in addition to the regular nonrefundable application
fee.
(2)
The initial inactive status period shall remain in effect
until the end of the current certification period for those candidates who
are currently certified and may be renewable every four years thereafter by
submitting an application and the appropriate nonrefundable fee as in subsection
(a)(4) of this section.
(3)
The initial inactive status period shall remain in effect
for four years from the date of issuance for those candidates not currently
certified.
(4)
While on inactive status, a person shall not practice other
than to act as a bystander rendering first aid or cardiopulmonary resuscitation
(CPR)
or the use of an Automated External Defibrillator in the capacity
of a lay person
. Practicing in any other capacity for compensation or
as a volunteer shall be cause for denial of reentry and decertification.
(l)
[
(1)
After evaluation of the application and verification of
the certification by the department, the candidate will be certified for one
year.
(2)
Prior to the expiration of the one-year certification,
the certificant shall:
(A)
submit a completed personnel certification application
and a nonrefundable fee as in subsection (a)(4) of this section;
[(B)
complete 25 percent of the CE requirement
for the appropriate level as indicated in this title or complete a refresher
course at the appropriate level; and]
(B)
[
[(3)
A candidate who fails the written examination
may retest one time after:]
[(A)
submitting an application to retest; and]
[(B)
paying a nonrefundable fee of $25.]
[(4)
The retest shall be completed no later
than the end of the one-year certification period.]
(3)
[
[(6)
A candidate who does not complete the
requirements for certification before the expiration date of the one-year
certificate or who fails a retest shall meet the requirements of subsection
(a) of this section including the successful completion of another initial
course as applicable to achieve certification.]
(m)
[
(1)
A candidate for certification who completed EMS training
outside the United States or its possessions, or a candidate who is certified
or licensed in another healthcare discipline shall:
(A)
be at least 18 years of age;
(B)
submit a copy of the curriculum completed by the candidate
for review by a regionally accredited post secondary institution approved
by the department to sponsor an EMS education program;
(C)
document correction of any deficiencies identified during
review of the curriculum by submitting evidence of remedial training from
a department approved EMS education program;
(D)
submit an application and appropriate nonrefundable fee
listed in subsection (a) of this section to the department; and
(E)
pass the department's
initial
written examination.
(2)
Evaluations of curricula conducted by post secondary educational
institutions under this subsection shall be consistent with the institution's
established policies and procedures for awarding credit by transfer or advanced
placement.
(n)
[
§157.34.Recertification.
(a)
Recertification.
(1)
Not later than the 30th day before the date a person's
certificate is scheduled to expire, the department may send to the person
a notice of expiration at the address shown in the current records of the
department.
(2)
If a certificant has not received a notice of expiration
from the bureau 30 days prior to the expiration, it is the duty of the certificant
to notify the bureau and to request an application for recertification or
download an application from the Internet. Failure to apply for recertification
shall result in expiration of the certificate.
(3)
To maintain certification status without a lapse, a completed
application for recertification shall be submitted to the department prior
to the expiration date of the current certificate, but no earlier than 1 year
prior to the expiration date. When submitting an application, applicants should
consider the department's processing time as described in §157.3 of this
title (relating to Processing of EMS Provider Licenses and Applications for
EMS Personnel Certification and License).
(4)
The certificant shall submit an application and the following
non-refundable fees as applicable:
(A)
$50 for Emergency Care Attendant (ECA) or Emergency Medical
Technician (EMT);
(B)
$75 for EMT-Intermediate (EMT-I) or EMT-Paramedic (EMT-P);
and
(C)
EMS volunteer - no fee. However, if such an individual
receives compensation during the certification period, the exemption ceases
and the individual shall pay a prorated fee to the department based on the
number of years remaining in the certification period when employment begins.
The non-refundable fee for ECA or EMT certification shall be $12.50 per each
year remaining in the certification. The non-refundable fee for EMT-I or EMT-P
shall be $18.75 per each year remaining in the certification. Any portion
of a year will count as a full year.
(5)
An application for a level of certification lower than
the applicant's current level may be submitted with the applicable fee as
described in paragraph (4) of this subsection if the applicant meets the requirements
for the level of certification requested as described.
(6)
A certificate is not transferable.
(b)
Recertification Options. Upon submission of a completed
application for recertification, the applicant shall commit to, and recertify
through, only one of the options described in paragraphs (1)-(5) of this subsection.
(1)
Option 1 - Written Examination Recertification Process.
(A)
The applicant shall pass the state's written examination
for recertification, which is designed to measure ongoing competencies and
current EMS practices for the applicant's level of certification.
(B)
If the applicant fails the examination for recertification,
the applicant may attempt two retests of the examination after:
(i)
submitting a retest application for each attempt at any
eligible level; and
(ii)
submitting a non-refundable retest fee of $25 for each
attempt.
(C)
An applicant may recertify by taking an initial recertification
examination for a lower level of certification for each subsequent attempt.
(D)
An applicant who attempts and fails the recertification
examination may not gain recertification by any other option.
(E)
An applicant who does not pass the recertification examination:
(i)
shall successfully complete a Formal Recertification Course
as described in paragraph (4)(A) and (B) of this subsection; and
(ii)
shall submit a course completion certificate of the Formal
recertification course, reflecting that the course was completed after the
2nd retest failure; and
(iii)
shall pass the state written recertifying examination
in accordance with the provisions in subparagraphs (A)-(D) of this paragraph.
(F)
The certification status of an applicant who does not successfully
complete the examination recertification process as described in subparagraphs
(A)-(E) of this paragraph shall expire on the date of the current certificate.
The applicant will have until 90 days after expiration date of the current
certificate to successfully complete the examination recertification process.
If applicant does not successfully complete recertification process within
90 days following expiration, applicant shall meet requirements of late recertification
described in subsection (f)(4) of this section. Successful completion of the
late recertification process shall be accomplished within one year of expiration
as described in subsection (f)(6) of this section.
(2)
Option 2 - Continuing Education Recertification Process.
The certificant shall attest to accrual of department approved EMS continuing
education as specified in §157.38 of this title (relating to Continuing
Education).
(3)
Option 3 - National Registry Recertification Process. The
applicant shall attest to current National Registry certification at the time
of applying for recertification.
(4)
Option 4 - Formal Course Recertification Process. The applicant
shall attest to successful completion of a department approved recertification
course.
(A)
The recertification course, as prescribed by the Education
and Training Manual, shall be a formal, classroom-presented, live participation,
training course as approved by the department and conducted within the four
year certification period. Course completion date shall be within one year
prior to the expiration date of current certification.
(B)
The minimum contact hours required for recertification
courses are:
Figure: 25 TAC §157.34(b)(4)(B)
(5)
Option 5 - CCMP Recertification Process. An applicant affiliated
with an EMS provider that has a department-approved Comprehensive Clinical
Management Program (CCMP) may be recertified if:
(A)
the applicant is currently credentialed in the provider's
CCMP;
(B)
the applicant has been enrolled in the provider's CCMP
for at least six continuous months; and
(C)
the applicant submits to the department a statement, signed
by the medical director, of participation in the provider's CCMP.
(c)
After verification by the department of the information
submitted by the applicant, that the information is true, correct and complete
with regard to the applicant meeting recertification requirements by the certification
expiration date, the department shall recertify the applicant for four years,
commencing on the day following the expiration date of the most recent certificate.
(d)
Return to active status.
(1)
To regain active status, an applicant holding inactive
certification shall complete the following requirements. All requirements
shall be completed within one year of the application.
(A)
The applicant shall successfully complete a department
approved recertification course as described in subsection (b)(4) of this
section;
(B)
The applicant shall submit an application and the non-refundable
fees applicable, as described in subsection (a)(4) of this section, before
expiration of the inactive certification period;
(C)
The applicant shall successfully complete the examination
recertification process, as described in subsection (b)(1)(A)-(F) of this
section.
(2)
A candidate whose inactive certification expires shall
comply with late recertification as described in subsection (f)(1)-(6) of
this section.
(e)
Renewal of inactive status. To renew inactive status, an
applicant holding inactive certification shall submit an application and the
non-refundable fee applicable, as described in §157.33(l)(1) of this
title, before expiration of the inactive certification period.
(f)
Late recertification.
(1)
A candidate whose certificate has been expired for 90 days
or less may renew the certificate by submitting an application and paying
to the department a non-refundable renewal fee that is equal to 1-1/2 times
the normally required application renewal fee for that level as listed in
subsection (a)(4) of this section. Applicant shall meet one of the recertification
options described in subsection (b)(1)-(5) of this section.
(2)
The candidate whose certification has expired shall be
considered as non-certified and may not function in the capacity of an EMS
certificant or represent that the candidate is EMS certified until recertification
is issued.
(3)
An individual who has not met the requirements for recertification
prior to his expiration date shall be considered late.
(4)
A candidate whose certificate has been expired for more
than 90 days but less than one year may renew the certificate by submitting
an application and paying to the department a non-refundable renewal fee that
is equal to two times the normally required application renewal fee as listed
in subsection (a)(4) of this section. An applicant shall submit documentation
that verifies completion of a formal Recertification course, which reflects
completion date to be within one year prior to application. An applicant shall
pass the department's written exam for recertification as described in subsection
(b)(1)(A)-(F) of this section.
(5)
The applicant shall be recertified for a period of four
years beginning on the date of issuance.
(6)
A candidate whose certificate has been expired for one
year or more may not renew the certificate. The candidate may become certified
by complying with the requirements of §157.33(a) of this title.
(7)
A candidate who was certified in this state, moved to another
state, and is currently certified or licensed and has been in practice in
the other state for the two years preceding the date of application may become
certified without reexamination. The candidate may gain recertification by:
(A)
submitting to the department a non-refundable fee that
is equal to two times the normally required renewal fee for certification
as listed in subsection (a)(4) of this section, and
(B)
attesting to regular practice of emergency medical care
in the other state for the two years preceding the date of application.
§157.38.Continuing Education.
(a)
Purpose. The purpose of this section is to establish the
minimum continuing education (CE) requirements necessary for emergency medical
services (EMS) personnel
electing
to maintain certification
through the CE recertification process
. These requirements are intended
to keep the certificant knowledgeable of current techniques and practice,
maintain the quality of emergency medical services provided to the public,
and encourage improvement in the skill and competence of EMS personnel.
(b)
General. CE is a recertification option provided by
provisions of §157.34
[
[(1)
Emergency care attendants (ECA) shall
be required to document 20 contact hours of CE every two years, with a total
of 40 contact hours within the four-year certification period.]
[(2)
Emergency medical technicians (EMT) shall
be required to document 40 contact hours of CE every two years, with a total
of 80 contact hours within the four-year certification period.]
[(3)
EMT-intermediates (EMT-I) shall be required
to document 60 contact hours of CE every two years, with a total of 120 contact
hours within the four-year certification period.]
[(4)
EMT-paramedics (EMT-P) shall be required
to document 80 contact hours of CE every two years, with a total of 160 contact
hours within the four-year certification period.]
(c)
Content requirements. Candidates at each
certification level shall, at a minimum, accrue department-approved CE in
the following content areas.
Figure: 25 TAC §157.38(c)
[(c)
Content requirements. Candidates at each
certification level shall at a minimum accrue hours in department-approved
CE in the following content areas.]
[Figure: 25 TAC §157.38(c)]
(d)
(No change.)
(e)
Types of CE programs and additional specific criteria necessary
for consideration of CE approval.
(1)-(4)
(No change.)
[(5)
Formal refresher courses. A refresher
course shall:]
[(A)
be provided by a department-approved EMS initial training
program;]
[(B)
meet the CE course approval criteria as in subsection
(d) of this section;]
[(C)
meet at least the minimum content area hour requirements
for the applicable certification level as in subsection (c) of this section;
and]
[(D)
offer skills proficiency verification.]
(5)
[
(A)
be pre-approved by the department;
(B)
be developed by a professional group such as an educational
institution, corporation, professional association or other approved provider
of continuing education;
(C)
involve the learner by requiring an active and appropriate
response to the educational materials presented;
(D)
provide a test as in subsection (d)(10) of this section;
and
(E)
provide a record of completion which complies with subsection
(f) of this section concerning records indicating completion of the program.
(6)
[
(A)
A candidate may receive CE credit for development and publication
of a manuscript in a periodical.
(B)
The number of CE credit hours awarded for each article
shall be determined by the department.
(C)
CE credit will be awarded in the appropriate content areas
as related to the manuscript.
(D)
Credit for publication will be awarded only once per two-year
CE time period and the candidate must, upon audit, submit a letter from the
publisher indicating acceptance or a copy of the published work.
(7)
[
(A)
Upon review by the department, a candidate may receive
CE credit for academic courses within the specified content areas for each
level of certification.
(B)
Completion of academic course work shall be credited on
the basis of up to 15 CE contact hours for each semester hour successfully
completed, within appropriate content areas. Less than 15 hours may be awarded
if the academic course content is only partially applicable to content areas.
(C)
When approved, the candidate shall receive notification
from the department of acceptance of academic hours and amount of CE credit
awarded.
(8)
[
(9)
[
(A)
Candidates may receive CE credit for passing the National
Registry of Emergency Medical Technicians written and practical examination
for their current level of EMS personnel certification.
(B)
Passing the examination shall be credited on the basis
of 20 contact hours for EMT level, 30 contact hours for EMT-I level, and 40
contact hours for EMT-P level. CE credit for passing the National Registry
examination shall be an option only once during the four-year certification
period.
(f)-(i)
(No change.)
(j)
Audit.
(1)-(2)
(No change.)
(3)
Falsification of CE documentation shall be cause for probation,
suspension, or decertification as in
§157.36
[
(4)-(5)
(No change.)
(k)
Failure to complete required CE.
(1)
A certificant who has failed to complete the requirements
by the expiration date of the certification period
[
(2)
A certificant who has failed to complete and submit all
the CE requirements prior to the expiration of their certification may apply
for late recertification in accordance with
§157.34
[
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on May 21, 2001.
TRD-200102833
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: July 1, 2001
For further information, please call: (512) 458-7236
Subchapter E. DOG AND CAT STERILIZATION
25 TAC §169.102
The Texas Department of Health (department) proposes new §169.102,
concerning the establishment of guidelines for the distribution of money credited
to the Animal Friendly account. Specifically, the new section will create
the Texas Department of Health Animal Friendly Grants and define eligibility
for grants; requirements for grants; procedures for grant announcements; procedures
for grant applications; the review process; selection criteria; project approval;
and continuation funding.
Jane C. Mahlow, DVM, MS, Director of the Zoonosis Control Division, has
determined that for each year of the first five years, because the section
only prescribes the standards for grant eligibility, there will be no additional
fiscal implications for state and local government as a result of enforcing
or administering the section.
Dr. Mahlow has also determined that for each year of the first five years
the section is in effect the public benefit anticipated as a result of this
will be the distribution of funding to provide low-cost surgical sterilization
of dogs and cats, thereby reducing the public health threat due to stray animals.
The proposed changes do not involve major adaptation from current practice;
therefore, there is no anticipated additional cost to small businesses or
microbusinesses nor to persons who may be required to comply with the sections
as proposed. There is no anticipated effect on local employment.
Comments on the proposal may be submitted to Jane C. Mahlow, DVM, MS, Texas
Department of Health, Zoonosis Control Division, 1100 West 49th Street, Austin,
Texas, 78756, fax (512) 458-7454, jane.mahlow@tdh.state.tx.us. Comments will
be accepted for 30 days after publication in the
Texas Register
.
The new section is proposed under the Texas Health and Safety
Code, Chapter 828, "Dog and Cat Sterilization," §828.014, which provides
the Texas Board of Health (board) with the authority to make grants to eligible
organizations for the purpose of providing low-cost dog and cat sterilization
to the general public; and §12.001, which provides the board with the
authority to adopt rules for the performance of every duty imposed by law
on the board, the department, and the commissioner of health.
The new section affects Texas Health and Safety Code, §828.014.
§169.102.Texas Department of Health Animal Friendly Grants.
(a)
Purpose.
(1)
As authorized by the Texas Health and Safety Code, §828.014,
relating to the Animal Friendly Fund, the department shall institute and administer
grants under this subchapter.
(2)
The grants shall be known as a part of the "Texas Department
of Health Animal Friendly Grants."
(3)
This subchapter governs the administration of the grants,
the submission and review of grant applications, and the award of the grants.
(b)
Definitions. The following words and terms, when used in
this subchapter, shall have the following meanings unless the context clearly
indicates otherwise.
(1)
Closing date--Date specified in the request for proposals
as the date on which applications must be received or postmarked.
(2)
Commissioner--Commissioner of Health or his or her designee.
(3)
Department--Texas Department of Health.
(4)
Local non-profit veterinary medical association--An organization
set up by and comprised of several volunteer veterinarians in their immediate
region for the purpose of presenting continuing education, planning group
activities, or discussing issues common to their professional field.
(5)
Nonprofit organization--A private, nonprofit, tax-exempt
corporation, association or organization under Internal Revenue Code of 1986, §501(c)(3)
(26 United States Code §501(c)(3)).
(6)
Owner--A person which feeds, shelters, harbors, has possession
or control, or has the responsibility to control an animal.
(c)
Philosophy.
(1)
The intent of the grants is to increase the sterilization
of dogs and cats owned by the general public at minimal or no cost.
(2)
Grant funds will not be used to:
(A)
augment a releasing agency's adoption sterilization program;
(B)
fund agencies from which members of the Animal Friendly
Advisory Committee serve in an official capacity as a volunteer or employee;
or
(C)
fund programs that do not operate within the State of Texas.
(3)
One grant per grant period will be awarded per agency for
the sterilization of dogs and/or cats.
(4)
Efforts will be made to distribute funds to all areas of
the state.
(d)
Sources and Allocation of Funds.
(1)
Funds for the grants shall be provided in accordance with
the Health and Safety Code, §828.014, relating to the Animal Friendly
account.
(2)
All grants shall be awarded competitively according to
the provisions of this subchapter.
(3)
Grants shall be made only to the extent that funds are
available in the Animal Friendly fund.
(4)
The department shall have the authority and discretion
to:
(A)
determine the purpose(s) of the grants pursuant to law
and this subchapter;
(B)
approve or deny grant applications;
(C)
determine the number, size and duration of grants; and
(D)
modify or terminate grants.
(5)
The department shall not be liable, nor shall grant funds
be used, for any costs incurred by applicants in the development, preparation,
submission, or review of applications.
(e)
Eligibility for Grants. Eligible applicants include:
(1)
a releasing agency;
(2)
an organization that is qualified as a charitable organization
under the Internal Revenue Code, §501(c)(3), that has animal welfare
or sterilizing animals owned by the general public at minimal or no cost as
its primary purpose; or
(3)
a local nonprofit veterinary medical association that has
an established program for sterilizing animals owned by the general public
at minimal or no cost.
(f)
Requirements for Grants.
(1)
The department shall specify reasonable requirements for
grant applications.
(2)
Applicants for grants shall submit as a part of their application
a plan of how they intend to provide sterilization services and their target
population.
(3)
Grant recipients shall make semi-annual reports to the
department in a form and at a time determined by the department.
(g)
Procedures for Grant Announcements.
(1)
Before applications are requested, the department shall
publish one or more notices of grant availability in the Texas Register. These
notices shall also be distributed throughout the state through mail and electronic
means. The notices will include details about the grants, instructions for
obtaining a request for proposals, and the names of persons to contact in
the department for further information.
(2)
The department shall maintain a list of persons to be notified
of requests for proposals. Any person wanting to be placed on the list should
contact: Animal Friendly Grants, Zoonosis Control Division, 1100 West 49th
Street, Austin, Texas 78756.
(3)
The department shall develop and publish one or more requests
for proposals, which shall contain details concerning, but not limited to,
the following:
(A)
the nature and purpose(s) of the grants;
(B)
the total amount of funds available for the grants under
each part;
(C)
the maximum and minimum dollar amounts that will be awarded
for individual grants and for individual grantees;
(D)
the information and format required for grant applications;
(E)
information about the criteria used to judge grant applications;
and
(F)
the closing date.
(h)
Procedures for Grant Applications.
(1)
The department may specify any reasonable requirements
for grant applications, including, but not limited to, length, format, authentication,
and supporting documentation.
(2)
Applications that are incomplete or substantially inconsistent
with the requirements of this subchapter may be rejected without further consideration
at the discretion of the department.
(3)
Applications received after the closing date will not be
considered, unless the closing date is extended by the department.
(4)
Applicants will be given a minimum of 60 calendar days
to file applications after a request for proposals is published. Applications
must be received by the department on or before the closing date specified
in the request for proposal.
(i)
Competitive Review Process.
(1)
Each application shall be reviewed by the Animal Friendly
Advisory Committee for completeness, relevance to the published request for
proposals, adherence to department policies, general quality, technical merit,
and budget appropriateness.
(2)
The committee's review process shall be completed within
45 days after the closing date.
(j)
Selection Criteria.
(1)
No grant shall be approved unless, in the opinion of the
department:
(A)
the application contains an explanation as to why provision
of low-cost sterilization for pets will help minimize pet-overpopulation in
their community;
(B)
the application includes a workable plan to provide sterilization
of dogs and cats for the general public at low or no cost;
(C)
the application includes a method to report the number,
species, and sex of animals sterilized;
(D)
the applicant specifies how the general public will be
made aware of the availability of low-cost surgery;
(E)
the applicant has a written non-discrimination policy in
place to ensure that no person is discriminated against on the grounds of
race, color, religion, sex, national origin, age, or disability.
(2)
A grant application will be given funding preference, in
a manner determined by the department and announced in the request for proposal,
to the extent that it:
(A)
targets low-income pets owners, describing how the applicant
defines, ascertains, and verifies that the person is financially challenged;
(B)
documents the intent and ability of the applicant to communicate
and collaborate with the local health departments, animal control agencies,
animal welfare agencies, veterinary organizations and human services organizations;
(C)
demonstrates a low cost for surgery on a per animal basis,
thereby maximizing the number of animals which can be sterilized;
(D)
is a new, qualified program that does not duplicate existing
low-cost sterilization efforts in a given community; and
(E)
contains such other information or criteria that the department
may specify and include in the request for proposals.
(k)
Project Approval. Grant recipients shall execute a contract
with the department. The contract shall detail items such as budget, reporting
requirements, general provisions for department grant contracts, and any other
specifics that might apply to the award.
(l)
Continuation Funding.
(1)
Grant recipients may be eligible for continuation funding.
The department will consider the grant recipient's accomplishments, progress
toward stated goals and objectives, award of past grants, and development
of alternative funding. Applications shall be submitted in accordance with
this subchapter.
(2)
The department will award continuation grants after a review
of applications in accordance with the provisions of this subchapter.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on May 18, 2001.
TRD-200102814
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: July 1, 2001
For further information, please call: (512) 458-7236
Chapter 409.
MEDICAID PROGRAMS
Subchapter L. MENTAL RETARDATION LOCAL AUTHORITY (MRLA) PILOT PROGRAM
25 TAC §§409.505, 409.523, 409.525
The Texas Department of Mental Health and Mental Retardation
(department) proposes amendments to §409.505, concerning eligibility
criteria, §409.523 concerning maintenance of MRLA program waiting list,
and §409.525, concerning process for referral and enrollment of individuals,
of Chapter 409, Subchapter L, concerning mental retardation local authority
(MRLA) program.
The amendments to §409.505, concerning eligibility criteria, correspond
to proposed revisions in Intermediate Care Facilities for Persons with Mental
Retardation (ICF/MR) Program rules that combine the criteria for level-of-care
(LOC) I, V, and VI under a single LOC designation, LOC I, while retaining
the current LOC VIII designation. The proposed amendments also update references
to the proposed new sections of Chapter 419, Subchapter E, concerning ICF/MR
Program rules, which are expected to be adopted in June by the Texas Mental
Health and Mental Retardation Board. A reference to the proposed new ICF/MR
Program rules also is updated by an amendment to §409.525, concerning
process for referral and enrollment of individuals.
The amendments to §409.523, concerning maintenance of MRLA program
waiting list, changes the length of time an applicant or the applicant's legally
authorized representative (LAR) has to respond to an MRA's notification that
a program opening is available to the applicant. The current rule permits
60 calendar days; the proposed amendments shorten the time to 20 working days.
In addition, the proposed amendments would allow the MRA to remove an applicant's
name from the waiting list if the applicant or the LAR does not respond to
the MRA's attempts to contact the applicant or LAR during its annual update
of its waiting list. The proposed amendments add provisions allowing an applicant's
name to be re-instated to the waiting list following a department review of
the circumstances under which the name was removed.
Bill Campbell, deputy commissioner, Finance and Administration, has determined
that for each year of the first five years the proposed amendments are in
effect, the enforcement or administering of the amendments does not have foreseeable
implications relating to costs or revenues of state or local government.
Ernest McKenney, director, Medicaid Administration, has determined that
for each year of the first five-year period the amendments are in effect,
the public benefit expected is the consistency between the waiver program
eligibility criteria related to ICF/MR LOC designations and that contained
in the ICF/MR Program rules. In addition, applicants for waiver program services
will have more timely access to those services. It is not anticipated that
the proposed amendments will have an adverse economic effect on small businesses
or micro-businesses because these changes do not impose any measurable cost
to program providers. It is not anticipated that there will be an economic
cost to persons required to comply with the amendments. It is not anticipated
that the amendments will affect a local economy.
A hearing to accept oral and written testimony from members of the public
concerning the proposal has been scheduled for 1:30 p.m., Wednesday, June
13, 2001, in the department's Central Office Auditorium in Building 2 at 909
West 45th Street, in Austin, Texas. Persons requiring an interpreter for the
deaf or hearing impaired should contact the department's Central Office operator
at least 72 hours prior to the hearing at TDD (512) 206-5330. Persons requiring
other accommodations for a disability should notify Tera Jones, at least 72
hours prior to the hearing at (512) 206-5854 or at the TDY phone number of
Texas Relay, 1-800-735-2988.
Comments concerning this proposal must be submitted in writing to Linda
Logan, director, Policy Development, Texas Department of Mental Health and
Mental Retardation, by mail to P.O. Box 12668, Austin, Texas 78711, or by
fax to (512) 206-4750, within 30 days of publication of this notice.
The amendments are proposed under the Texas Health and Safety
Code, §532.015(a), which provides the Texas Board of Mental Health and
Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a),
and the Texas Human Resources Code, §32.021(a), which provide the Texas
Health and Human Services Commission (THHSC) with the authority to administer
the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th
Texas Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies
the authority of THHSC to delegate the operation of all or part of a Medicaid
program to a health and human services agency; and the Human Resources Code, §32.021(c),
which provides an agency operating part of the Medicaid program with the authority
to adopt necessary rules for the proper and efficient operation of the program.
THHSC has delegated to the department the authority to operate the MRLA Program.
The proposed amendments affect Texas Government Code, §531.021(a),
and the Texas Human Resources Code, §32.021(a) and (c).
§409.505.Eligibility Criteria.
(a)
To be determined eligible by TDMHMR for MRLA program services,
an applicant and individuals enrolled in MRLA program must:
(1)
(No change.)
(2)
be enrolled in the HCS or HCS-O program immediately prior
to enrollment in the MRLA program or meet the:
(A)
ICF/MR I[
(B)
ICF/MR I[
(3)
(No change.)
(4)
have an IPC with an annual cost of services which does
not exceed 125% of the annual ICF/MR reimbursement rate paid to a small ICF/MR,
as defined in 1 TAC §355.456 (
relating to
Rate Setting Methodology),
for the individual's level of need as it would be assigned under
§419.240
of this title (relating to Level of Need)
[
(5)
(No change.)
(b)-(f)
(No change.)
§409.523.Maintenance of MRLA Program Waiting List.
The local MRA will maintain an up-to-date waiting list of individuals
living in and waiting to receive MRLA Program services in the MRA's local
service area.
(1)-(2)
(No change.)
(3)
The MRA must remove an individual's name from the waiting
list only when it is documented that:
(A)-(E)
(No change.)
(F)
the individual or the individual's LAR has not responded
to the MRA's notification of a program vacancy within
20 working
[
(G)
the applicant or the applicant's LAR chooses participation
in the ICF/MR Program instead of in the MRLA Program when offered this choice
in accordance with §419.164(a) of this title (relating to Process for
Enrollment of applicants) [
(H)
the applicant or the applicant's LAR refuses MRLA services
; or
(I)
the applicant or the applicant's LAR has
not responded to the MRA's attempts to contact the applicant or LAR during
its annual update of the waiting list.
(4)
If an applicant's name is removed from
a waiting list in accordance with paragraph (3) of this subsection, the applicant,
the applicant's LAR, or the MRA may request the department to review the circumstances
under which the applicant's name was removed from the MRA's waiting list.
At its discretion, the department may direct the MRA to reinstate the applicant's
name to the waiting list using the previously assigned date.
(5)
[
§409.525.Process for Referral and Enrollment of Individuals.
(a)
An individual or an individual's LAR on behalf of the individual
who seeks MRLA Program services must submit a written request to the MRA serving
the area where the individual lives.
(1)-(3)
(No change.)
(4)
The MRA compiles and maintains information necessary to
process the individual's or LAR's request for enrollment in the MRLA Program.
(A)
(No change.)
(B)
The MRA will complete a MR/RC Assessment if necessary.
(i)
(No change.)
(ii)
The MRA will verify that the individual has been diagnosed
by a licensed physician as having a related condition as defined in
§419.203
[
(iii)
(No change.)
(C)
(No change.)
(5)
(No change.)
(b)-(c)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on May 14, 2001.
TRD-200102705
Andrew Hardin
Chair, Texas MHMR Board
Texas Department of Mental Health and Mental Retardation
Earliest possible date of adoption: July 1, 2001
For further information, please call: (512) 206-5232
Subchapter D. HOME AND COMMUNITY - BASED SERVICES (HCS) PROGRAM
(2)
(F)
] A candidate who was certified
in this state, moved to another state, and is currently certified or licensed
and has been in practice in the other state for the two years preceding the
date of application may become certified without reexamination. The candidate
must pay to the department a nonrefundable fee that is equal to two times
the normally required renewal fee for certification as listed in subsection
(a)(4) of this section.
(l)
] Inactive status. A certified
EMT, EMT-I, or EMT-P may make application to the department for inactive status
at any time during or after the certification period so long as the certification
can be verified by department.
(m)
] Reciprocity. A person currently
certified by the National Registry or in another state may be certified by
submitting an application and a nonrefundable fee of $100.
(C)
] pass the department's written
examination.
(5)
] After verification by the department
of the information submitted, a candidate who meets the requirements of this
section shall be certified for four years beginning on the date of issuance
of the certificate.
(n)
] Equivalency.
(o)
] Military personnel. A person
certified by the department who is deployed in support of military, security,
or other action by the United Nations Security Council, a national emergency
declared by the president of the United States, or a declaration of war by
the United States Congress is eligible for recertification under timely recertification
requirements, from the person's date of demobilization until one calendar
year after the date of demobilization but will not be certified during that
period.
Hour requirements. CE is a requirement
of §157.45
] of this title (relating to Recertification). A contact
hour shall consist of 50 consecutive minutes of attendance and participation
in an approved CE experience. Credit
units
[
hours
] for
CE activities will only be awarded for
certification period
[
the two-year time period
] in which they are completed; and if participating
in a graded activity, only if the individual receives a grade of "C" or better,
or "Pass" in a "Pass/Fail" grading system.
(6)
] Independent study. Independent
study such as CE articles in professional journals, ongoing serial productions
or interactive computer programs shall:
(7)
] Authorship.
(8)
] Academic courses.
(9)
] Instruction in approved initial
training and continuing education courses. EMS personnel instructing in an
approved initial training course or in an approved CE program may apply the
contact hours of actual teaching to the appropriate content areas during the
two-year CE period.
(10)
] CE by optional examination.
§157.51
] of this title (relating to Criteria for
Denial and Disciplinary
Actions for EMS Personnel and Voluntary Surrender of a Certificate or License
[
Emergency Suspension, Suspension, Probation, and Decertification
of an EMS Certificate
]);
§157.16
[
§157.19
] of this title (relating to Emergency Suspension, Suspension, Probation,
Revocation of a License [
, and Administrative Penalty
]);
§157.43 of this title (relating to Course Coordinator Certification); §157.44
of this title (relating to EMS Instructor Certification); and/or §157.32
of this title (relating to Emergency Medical Services Education Program and
Course Approval)
[
and §157.64 of this title (relating to Criteria
for Suspension, Probation, and Decertification of Course Coordinator, Program
Instructor, and/or Examiner Certification)
].
for the initial
two-year CE time period
] will be granted a 90-day extension period to
complete and submit the required CE. [
Failure to complete and submit
the CE requirements within that time frame shall be cause for emergency suspension
until CE requirements are met.
]
§157. 45(d)
] of this title (relating to Recertification).
Chapter 169.
ZOONOSIS CONTROL
Part 2.
TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION
, V, or VI
] level-of-care criteria
as determined by TDMHMR in accordance with
§419.237 of this title
(relating to Level of Care)
[
Chapter 406, Subchapter E of this
title (relating to Eligibility and Review)
] and documented on a current
MR/RC Assessment; or
, V, VI,
] or VIII level-of-care criteria
as determined by TDMHMR in accordance with
§419.237 of this title
(relating to Level of Care)
[
Chapter 406, Subchapter E of this
title (relating to Eligibility and Review)
] and be part of the targeted
population eligible for the HCS-O program in accordance with Chapter 419,
Subchapter P of this title (relating to Home and Community-based Services
- OBRA (HCS-O)); and
§406.204(b) of
this title (relating to LOC Determination and LON Assignment)
] or 125%
of the estimated annualized per capita cost for ICF/MR services, whichever
is greater; and
60 calendar
] days of the date of the MRA's notification;
or
];
(4)
]At the written request of an
individual or the LAR of an individual who moves to the local service area
of a different MRA, the original MRA will transfer the individual's name and
date of request for MRLA Program services to the MRA in the local service
area where the individual has moved. The MRA receiving the information will
add the individual's name to its list using the date of the request for MRLA
Program services provided by the transferring MRA.
§406.202
] of this title (relating to
Definitions); and
Chapter 419.
MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES