TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

The Texas Department of Human Services (DHS) proposes to amend §3.704, concerning types of resources, in its Texas Works chapter. The purpose of the amendment is to allow an exclusion of $15,000 of the fair market value of one motor vehicle owned by a Temporary Assistance for Needy Families-State Program (TANF-SP) family. DHS also proposes to apply the policy to two-parent families who apply for the Medically Needy Program. The amendment also allows the same exclusion for determining Food Stamp Program eligibility. In addition, the deletion of State Welfare Reform Control Group language in §3.704(b)(9) is a result of the Achieving Change for Texans (ACT) waiver expiration on March 31, 2002. The removal of control groups will create consistency by making the same TANF policy applicable to all TANF applicants and recipients after April 1, 2002.

James R. Hine, Commissioner, has determined that for the first five-year period the proposed section will be in effect there will be fiscal implications for state government as a result of enforcing or administering the section. The effect on state government for the first five-year period the section will be in effect is an estimated additional cost of $530 in fiscal year (FY) 2002, $0 in FY 2003, $0 in FY 2004, $0 in FY 2005, and $0 in FY 2006. There will be no fiscal implications for local governments as a result of enforcing or administering the section.

Mr. Hine also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of adoption of the proposed rule will be that eligible families will be allowed to retain reliable transportation, which is essential for working families. There will be no effect on small or micro businesses as a result of enforcing or administering the section, because the section applies to eligibility requirements for two-parent TANF, Medically Needy Program, and Food Stamp Program clients, not the operation of businesses. There is no anticipated economic cost to persons who are required to comply with the proposed section. There is also no probable effect on local employment in geographic areas affected by this section.

Questions about the content of this proposal may be directed to Eric McDaniel at (512) 438-2909 in DHS's Texas Works Section. Written comments on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-050, Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Under §2007.003(b) of the Texas Government Code, DHS has determined that Chapter 2007 of the Government Code does not apply to these rules. Accordingly, the department is not required to complete a takings impact assessment regarding these rules.

The amendment is proposed under the Human Resources Code, Title 2, Chapter 31, which authorizes DHS to administer financial assistance programs.

The amendment implements the Human Resources Code, §§31.001 - 31.030.

§3.704.Types of Resources.

(a) (No change.)

(b) Temporary Assistance for Needy Families (TANF). Exclusions from resources in TANF are:

(1) - (8) (No change.)

(9) Liquid resources. DHS excludes liquid resources resulting from earned income of a child as specified in Human Resources Code §31.0031[ , for clients who are not members of the State Welfare Reform Control Group described in §3.6004 of this title (relating to Applicability of Aid to Families with Dependent Children (AFDC) Policies Resulting from Human Resources Code §31.0031, Dependent Child's Income; Human Resources Code §31.012, Mandatory Work or Participation in Employment Activities Through the Job Opportunities and Basic Skills Training Program; Human Resources Code §31.014, Two-Parent Families; and Human Resources Code §31.032, Investigation and Determination of Eligibility) ].

(10) - (15) (No change.)

(16) Vehicles used for transportation.

[(A) For clients who are members of the State Welfare Reform Control Group described in §3.6004 of this title, (relating to Applicability of Aid to Families with Dependent Children (AFDC) Policies Resulting from Human Resources Code §31.0031, Dependent Child's Income; Human Resources Code §31.012, Mandatory Work or Participation in Employment Activities Through the Job Opportunities and Basic Skills Training Program; Human Resources Code §31.014, Two-Parent Families; and Human Resources Code §31.032, Investigation and Determination of Eligibility), DHS exempts the value of one vehicle owned and used by the certified group for transportation if the equity is less than $1,500. If the equity exceeds $1,500, DHS counts the excess as a resource. DHS counts the equity of all other vehicles.]

[ ~~(B)~~ ] For TANF State Program (TANF-SP) families, DHS exempts up to $15,000 of the fair market value of one countable vehicle owned by an applicant family. For all other TANF clients, DHS exempts licensed vehicles as specified in Human Resources Code §31.032(d)(2).

(17) (No change.)

(d) Food stamps. Exclusions from resources for food stamps are those stipulated in the Food Stamp Act of 1977 as amended by Title VIII, Section 810 of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. DHS excludes up to $15,000 of the fair market value of one countable vehicle in determining eligibility for the Food Stamp program.

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 February 12, 2002.

TRD-200200884

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: March 31, 2002

For further information, please call: (512) 438-3734

Chapter 48. COMMUNITY CARE FOR AGED AND DISABLED

Subchapter E. CONSUMER-MANAGED PERSONAL ASSISTANCE SERVICES

40 TAC §48.2619

The Texas Department of Human Services (DHS) proposes to amend §48.2619, concerning reimbursement methodology for Consumer-Managed Personal Assistance Services (CMPAS), in its Community Care for Aged and Disabled chapter. The purpose of the amendment is to establish the reimbursement methodology for the CMPAS program. The reimbursement methodology details the cost reporting requirements for providers and details the payment rate determination guidelines. In addition, DHS is changing the name of subchapter E to "Consumer-Managed Personal Assistance Services."

James R. Hine, Commissioner, has determined that for the first five-year period the proposed section will be in effect there will be no fiscal implications for state or local governments as a result of enforcing or administering the section.

Mr. Hine also has determined that for each year of the first five years the section is in effect, the public benefit anticipated as a result of adoption of the proposed amendment will be to make the reimbursement methodology for the CMPAS program available to the public. The reimbursement methodology details the cost reporting requirements for providers and details the payment rate determination program. There will be no effect on small or micro businesses as a result of enforcing or administering the section. There is no anticipated economic cost to persons who are required to comply with the proposed section. There will be no anticipated effect on local employment in geographic areas affected by this section.

Questions about the content of this proposal may be directed to Carolyn Pratt at (512) 438-4057 in DHS's Rate Analysis section. Written comments on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-078, Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Under §2007.003(b) of the Texas Government Code, the department has determined that Chapter 2007 of the Government Code does not apply to these rules. Accordingly, the department is not required to complete a takings impact assessment regarding these rules.

The amendment is proposed under the Human Resources Code, Title 2, Chapter 22, which authorizes the department to administer public assistance programs.

The amendment implements the Human Resources Code, §§22.001 - 22.030.

§48.2619. Reimbursement Methodology [ ~~Cost Reporting Guidelines~~ ] for [ ~~the~~ ] Consumer-Managed Personal Assistance Services (CMPAS) [ ~~Program~~ ].

(a) General requirements. The Texas Department of Human Services (DHS), or it's designee, applies the general principles of cost determination, as specified in §20.101 of this title (relating to Introduction).

(b) Cost reporting. Providers must follow the cost-reporting guidelines as specified in §20.105 of this title (relating to General Reporting and Documentation Requirements, Methods, and Procedures). All contracted providers must submit a cost report, unless the number of days between the date the first DHS client received services and the provider's fiscal year end is 30 days or fewer. The provider may be excused from submitting a cost report if circumstances beyond the control of the provider make cost report completion impossible, such as the loss of records due to natural disasters or removal of records from the provider's custody by any governmental entity. Requests to be excused from submitting a cost report must be received, at the address on the cover of the cost report, before the due date of the cost report.

(c) Guidelines for desk reviews and field audits. Guidelines for desk review of cost reports are specified in §20.106 of this title (relating to Basic Objectives and Criteria for Audit and Desk Review of Cost Reports). Desk reviews or field audits are performed on all contracted providers. The frequency and nature of the field audits are determined to ensure the fiscal integrity of the program. Providers will be notified of the results of a desk review or field audit in accordance with §20.107 of this title (relating to Notification of Exclusions and Adjustments). Providers may request an informal review and, if necessary, an administrative hearing to dispute an action taken under §20.110 of this title (relating to Informal Reviews and Formal Appeals). The reimbursement authority is specified in §20.101 of this title (relating to Introduction).

(d) Factors affecting allowable costs.

(1) Guidelines in determining allowable and unallowable costs. Providers must follow the guidelines in determining whether a cost is allowable or unallowable as specified in §20.102 of this title (relating to General Principles of Allowable and Unallowable Costs).

(2) Guidelines for allowable and unallowable costs. Providers must follow the guidelines for allowable and unallowable costs as specified in §20.103 of this title (relating to Specifications for Allowable and Unallowable Costs).

(3) Exclusion of certain reported expenses and cost reports.

(A) Providers are responsible for reporting only allowable costs on the cost report, except where cost report instructions indicate that other costs are to be reported in specific lines or sections. Only allowable cost information is used to determine recommended reimbursement. Unallowable expenses included in the cost report are excluded from reimbursement determination and appropriate adjustments are made to expenses and other information reported by providers. The purpose is to ensure that the database reflects costs and other information which are necessary for the provision of services and consistent with federal and state regulations.

(B) Individual cost reports may not be included in the database used for compilation of provider cost profiles if:

(i) there is doubt as to the accuracy or allowability of a significant part of the information reported; or

(ii) an auditor determines that reported costs are not verifiable.

(C) When material pertinent to proposed reimbursements is made available to the public, the material will include the number of cost reports eliminated from the database used for compilation of provider cost profiles for the reason stated in subparagraph (B)(i) of this paragraph.

(e) Reimbursement determination. Reimbursement per hour of service is determined for each individual contracted provider by its DHS contract manager. The reimbursement determination is based upon estimated costs reported by the contracted provider for the effective reimbursement period and upon historical information reported by the contracted provider in the form of annual cost reports covering the provider's fiscal year. Comparisons of each provider's individual cost profiles per unit of service from prior years, as well as comparisons with mean and weighted median cost profiles per unit of service across all providers, may be used by the DHS contract manager in the reimbursement determination process.

(1) Cost areas. Allowable costs, reported or estimated, are combined into five cost areas, after allocating payroll taxes to each salary line item on the cost report on a pro rata basis based on the portion of that salary line item to the amount of total salary expense and after applying employee benefits directly to the corresponding salary line item.

(A) Assessors of need cost area. This cost area collects costs and statistics associated with assessors of need, including salaries, travel expenses, training costs, and contracted expenses.

(B) Attendant recruitment and orientation cost area. This cost area collects costs and statistics associated with persons recruiting and orienting attendants, including salaries, travel expenses, training costs, contracted expenses, and advertising costs for attendant recruitment.

(C) Attendants cost area. This cost area collects costs and statistics associated with regular and substitute attendants, as well as on-call staff, including salaries, travel expenses, training costs, universal health and safety costs, and other miscellaneous costs.

(D) Building and transportation cost area. This cost area collects building and building equipment expenses, departmental equipment expenses, and transportation equipment expenses.

(E) Administration cost area. This cost area collects administrative salaries, office expenses, and central office overhead expenses.

(2) Projected costs. Allowable expenses are projected, excluding depreciation and mortgage interest, per hour of service from each provider's reporting period to the next ensuing reimbursement period. Reasonable and appropriate economic adjusters are determined as described in §20.108 of this title (relating to Determination of Inflation Indices) to calculate the projected expenses. Reimbursement may also be adjusted where new legislation, regulations, or economic factors affect costs as specified in §20.109 of this title (relating to Adjusting Reimbursement When New Legislation, Regulations, or Economic Factors Affect Costs).

(3) Provider cost profiles.

(A) Individual provider cost profile per unit of service. To determine a provider's individual cost profile, a cost component is determined for each cost area in paragraph (1)(A) - (E) of this subsection by dividing either the total reported or the total projected allowable costs for the cost area by the total units of service provided. The sum of the five cost components is the provider's individual reported or projected cost per unit of service.

(B) Mean cost profile per unit of service across all providers. To determine the mean cost profile across all providers submitting cost reports, the results from subparagraph (A) of this paragraph for each provider are taken and a mean (average) is calculated for each cost area. The sum of the mean cost area components is the mean cost profile (reported or projected) per unit of service across all providers.

(C) Weighted median cost profile per unit of service across all providers. To determine the weighted median cost profile across all providers submitting cost reports, all providers' (reported or projected) cost per hour of service is rank-ordered, from low to high, in each cost area. The hours of service for each provider that correspond with each cost array are summed until the median hour of service is reached, resulting in a weighted median cost area component. The sum of the five weighted median cost area components is the weighted median cost profile per unit of service across all providers.

(f) Reporting revenues. Revenues must be reported on the cost report in accordance with §20.104 of this title (relating to Revenues).

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 February 12, 2002.

TRD-200200870

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: March 31, 2002

For further information, please call: (512) 438-3734