TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 7. REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS

The Texas Department of Human Services (DHS) proposes to repeal Subchapter A, concerning program purpose and scope, §7.101; Subchapter B, concerning eligibility criteria, §§7.201-7.213; Subchapter C, concerning eligibility determination, §§7.301-7.307; Subchapter D, concerning eligibility for other programs, §§7.401-7.405; Subchapter E, concerning client reporting requirements, §7.502; and Subchapter F, concerning penalty provisions, §§7.601-7.603; and proposes new Subchapter A, concerning purpose and scope, §§7.101-7.103; Subchapter B, concerning contractor requirements for the Refugee Cash Assistance Program (RCA), §§7.201, 7.203, 7.205, 7.207, 7.209, 7.211, 7.213, 7.215, 7.217, 7.219, and 7.221; Subchapter C, concerning program administration for the Refugee Cash Assistance Program (RCA), §§7.301, 7.303, 7.305, 7.307, 7.309, 7.311, 7.313, 7.315, 7.317, 7.319, 7.321, 7.323, 7.325, 7.327, 7.329, 7.331, 7.333, 7.335, 7.337, 7.339, 7.341, 7.343, 7.345, 7.347, 7.349, 7.351, and 7.353; Subchapter D, Refugee Cash Assistance participant requirements, §§7.401, 7.403, 7.405, 7.407, 7.409, 7.411, 7.413, 7.415, 7.417, and 7.419; and Subchapter E, concerning Refugee Medical Assistance, §§7.501, 7.503, 7.505, 7.507, 7.509, 7.511, 7.513, 7.515, 7.517, 7.519, 7.521, 7.523, 7.525, 7.527, 7.529, 7.531, 7.533, 7.535, 7.537, and 7.539, in its Refugee Cash Assistance Program chapter. The purpose of the repeals and new sections is to change the RCA program from a public administration to a public/private administration and to state the RMA rules in language that is easier for the public to understand.

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

Mr. Hine also has determined that for each year of the first five years the sections are in effect, the public benefit anticipated as a result of enforcing the sections will be the opportunity for refugees to attain economic self-sufficiency and to have rules that are more clearly understood by the public. There will be no adverse economic effect on small or micro businesses, because the public/private RCA program provides direct cash assistance to newly arriving refugees. The program does not contract with small businesses or micro-businesses. There is no anticipated economic cost to persons who are required to comply with the proposed sections. There is no anticipated effect on local employment in geographic areas affected by these sections.

Questions about the content of this proposal may be directed to Scott L. Miller at (512) 438- 5517 in DHS's Office of Immigration and Refugee Affairs. Written comments on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-192, 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.

Subchapter A. PROGRAM PURPOSE AND SCOPE

40 TAC §7.101

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

The repeal is proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The repeal implements the Human Resources Code, §§22.001-22.036 and 31.001- 31.053.

§7.101.Refugee Cash Assistance Program (RCA) Purpose and Scope.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202635

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter A. PURPOSE AND SCOPE

40 TAC §§7.101 - 7.103

The new sections are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The new sections implement the Human Resources Code, §§22.001-22.036 and 31.001-31.053.

§7.101.What is the scope of the chapter?

The Refugee Cash Assistance (RCA) and Refugee Medical Assistance (RMA) Programs were established by the Refugee Act of 1980 (referred to in this chapter as "the Act"). The Act, among other provisions, provides for Refugee Cash Assistance and Refugee Medical Assistance to help participants become self-sufficient within the first eight months after arrival. Cash assistance payments and medical assistance are provided to eligible participants for a maximum of eight months. Refugee Cash Assistance is administered by the Texas Department of Human Services (DHS) through contracts with local refugee resettlement agencies. The goal of the RCA program is to assist refugees in achieving self-sufficiency. All participants in the RCA program are required to participate in employment programs. Refugee Medical Assistance is administered directly by DHS. Each year the president of the United States decides the regional and total number of refugees the U.S. will admit. The program is 100% federally funded and depends on the availability of federal funds.

§7.102.What is the purpose of this chapter?

This chapter provides procedures and criteria that govern both the Refugee Cash Assistance and Refugee Medical Assistance programs. The chapter assists the Texas Department of Human Services in the management of contracts by ensuring efficient and economical objectives are met.

§7.103.How are the terms in this chapter defined?

The following words and terms, when used in this chapter, have the following meanings unless the context clearly indicates otherwise.

(1) Adult--An individual 18 years of age or older.

(2) Applicant--An individual who has applied for Refugee Cash Assistance (RCA) or Refugee Medical Assistance (RMA) and is waiting on an eligibility determination.

(3) Asylee--An individual who has been granted asylum under section 208 of the Immigration and Nationality Act.

(4) Cash Assistance--Financial assistance to refugees, including Temporary Assistance for Needy Families (TANF), Social Security Income, Refugee Cash Assistance, and general assistance.

(5) Contractor--An organization that has applied for and been awarded a RCA open enrollment contract.

(6) CFR--Code of Federal Regulations.

(7) CHIP--Texas Children's Health Insurance Program.

(8) DHS--Texas Department of Human Services.

(9) DOJ--Department of Justice.

(10) Employability plan--An employment plan designed to lead to the earliest possible employment in the shortest time period.

(11) Family unit--An unmarried adult, married couple without children, or parents, or custodial relatives, with a minor child who are not eligible for TANF, who live in the same household.

(12) Fund accounting--A system of accounting that requires separate records for each source of funding.

(13) INA--Immigration and Nationality Act.

(14) Incentive payment--A one-time payment for early employment.

(15) INS--Immigration and Naturalization Service.

(16) LEP--Limited English Proficiency.

(17) MAA--Mutual Assistance Agency, an organization incorporated as a non-profit agency that has not less than 51% of the Board of Directors or governing board comprised of refugees or former refugees, including both refugee men and women.

(18) MNIL--Medically Needy Income Limit.

(19) OIRA--Office of Immigration and Refugee Affairs under DHS.

(20) ORR--Office of Refugee Resettlement.

(21) P-3--Public/Private Partnership, a state-administered option for the provision of refugee cash assistance through contracts or grants with local resettlement agencies.

(22) Participant--A person who has applied for and been determined eligible for RCA or RMA.

(23) Refugee--An individual admitted to the U.S. under section 207 of the INA.

(24) Refugee Cash Assistance (RCA)--A time-limited cash assistance program available to eligible refugees who are ineligible for TANF.

(25) Refugee Medical Assistance (RMA)--A time-limited medical assistance program provided to eligible refugees who are ineligible for Medicaid.

(26) TAC--Texas Administrative Code.

(27) TANF--Temporary Assistance for Needy Families.

(28) UNHCR--United Nations High Commissioner for Refugees.

(29) Vendor Payment--Payment made on behalf of a RCA participant for rent or utilities.

(30) Victim of a Severe Form of Trafficking--An adult individual certified by the U.S. Department of Health and Human Services as a victim of a severe form of trafficking.

(31) VOLAG--Voluntary Resettlement Agency.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202636

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter B. ELIGIBILITY CRITERIA

40 TAC §§7.201 - 7.213

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

The repeals are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The repeals implement the Human Resources Code, §§22.001-22.036 and 31.001- 31.053.

§7.201.TANF Ineligibility.

§7.202.Identity.

§7.203.Voluntary Quit.

§7.204.Social Security Numbers.

§7.205.Domicile.

§7.206.SSI Applications.

§7.207.Permanent Residents.

§7.208.Eight-month.

§7.209.Household Composition.

§7.210.Children Born to Refugees in the United States.

§7.211.Marriage to a United States Citizen.

§7.212.Employment Services.

§7.213.Refusal to Register.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202637

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter B. CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA)

40 TAC §§7.201, 7.203, 7.205, 7.207, 7.209, 7.211, 7.213, 7.215, 7.217, 7.219, 7.221

The new sections are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The new sections implement the Human Resources Code, §§22.001-22.036 and 31.001-31.053.

§7.201.What is the purpose of this subchapter?

This subchapter contains the minimum requirements for contracting with the Texas Department of Human Services (DHS) to provide Refugee Cash Assistance (RCA) benefits to eligible individuals in Texas. An organization becomes a contractor when awarded a contract from DHS.

§7.203.Who can apply for a RCA contract?

An organization may apply for a contract if:

(1) it operates a local refugee resettlement program and provides the Texas Department of Human Services (DHS) a letter of affiliation from a national voluntary resettlement agency that has a cooperative agreement for reception and placement with the U.S. Department of State; and

(2) it is incorporated and maintains the following documents and provides them to DHS upon request:

(A) articles of incorporation;

(B) by-laws;

(C) tax exemption certification;

(D) board minutes;

(E) financial statements;

(F) informational materials related to providing refugee services;

(G) case records; and

(H) other relevant material as described by DHS.

§7.205.What is the financial responsibility of the contractor's board of directors?

When an organization enters into a contract with the Texas Department of Human Services, the agency's board of directors must ensure financial accountability of all funds received and spent by their agency. The board of directors or the finance committee must regularly review actual income and expenses and compare them to approved budgets and year-to-date costs.

§7.207.Are there accounting requirements the contractor must meet to receive a contract?

Yes, each contractor must:

(1) maintain an accounting system that records revenues and expenditures using generally accepted accounting principles as recognized by the American Institute of Certified Public Accountants and follow the Texas Department of Human Services financial management policies and procedures in maintaining fiscal records;

(2) maintain a chart of accounts that includes all accounts using an assigned number;

(3) maintain a general ledger;

(4) maintain supporting documentation of expenses including but not limited to:

(A) receipts or vouchers for incoming cash;

(B) bank statements;

(C) canceled checks (if provided by bank);

(D) deposit slips;

(E) approved invoices;

(F) receipts or vouchers for purchases;

(G) leases;

(H) contracts;

(I) time sheets;

(J) inventory;

(K) written cost allocation methodology; and

(L) cost allocation worksheets; and

(5) identify all funding sources and expenditures by separate fund type.

§7.209.Does the Texas Department of Human Services (DHS) require contractors to have a fidelity bond?

Each contractor must have a fidelity bond. The minimum value will be determined by DHS on an annual basis.

§7.211.What are the confidentiality requirements of a contract?

Contractors must keep confidential all information about or obtained from a participant. Contractors may release participant information as long as it does not identify a participant in any way. The following exceptions apply:

(1) information can be released with written consent of the participant;

(2) in the case of minors, information can be released with written consent of the parent or legal guardian; and

(3) federal regulations require the release of confidential information to the Texas Department of Human Services (DHS) or anyone designated by DHS.

§7.213.Are contractors responsible for having a nepotism policy?

Each contractor must have a written board-approved nepotism policy.

§7.215.Are contractors responsible for having a conflict of interest policy?

Each contractor must have a written board-approved conflict of interest policy. The conflict of interest policy must address situations in which board members or employees have a direct or indirect interest, financial or otherwise, of any nature that is in substantial conflict with the proper discharge of their duty to the organization.

§7.217.Are contractors required to comply with the Limited English Proficiency (LEP) provisions of Title VI of the Civil Rights Act?

Yes, each contractor must comply with the provisions of Title VI of the Civil Rights Act and Immigration and Nationality Act as it affects persons with Limited English Language proficiency during the time they are receiving grant funding. Requirements include a regular assessment of language needs; compliance by any discretionary sub-grantee or subcontractor, including written LEP policies and implementation plans; and staff training.

§7.219.What are the record keeping requirements of the contract?

Contractors must keep all records that are needed for federal and state monitoring of the Refugee Cash Assistance program. Required records include:

(1) identification of participants;

(2) statistical and programmatic records on services provided;

(3) records of participant costs;

(4) eligibility determination materials; and

(5) other records required by the Texas Department of Human Services.

§7.221.How long are contractors required to keep records?

Contractors must keep all records for three years and 90 days after the end of the contract, or until an open audit is completed, or until litigation is resolved.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202638

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter C. ELIGIBILITY DETERMINATION

40 TAC §§7.301 - 7.307

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

The repeals are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The repeal implements the Human Resources Code, §§22.001-22.036 and 31.001- 31.053.

§7.301.Application and Interview.

§7.302.Refugee Status.

§7.303.Age and Relationship.

§7.304.Income from Voluntary Resettlement Agencies and Sponsors.

§7.305.Income and Resources.

§7.306.Grant Amounts and Budgeting.

§7.307.Management.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202639

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter C. PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA)

40 TAC §§7.301, 7.303, 7.305, 7.307, 7.309, 7.311, 7.313, 7.315, 7.317, 7.319, 7.321, 7.323, 7.325, 7.327, 7.329, 7.331, 7.333, 7.335, 7.337, 7.339, 7.341, 7.343, 7.345, 7.347, 7.349, 7.351, 7.353

The new sections are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The new sections implement the Human Resources Code, §§22.001-22.036 and 31.001-31.053.

§7.301.What is the purpose of this subchapter?

This subchapter contains eligibility requirements for participants in the Refugee Cash Assistance Assistance Program (RCA). It also contains contractor responsibilities in providing RCA services.

§7.303.Who is eligible for Refugee Cash Assistance (RCA) benefits?

RCA is restricted to individuals who meet the eligibility requirements as follows:

(1) meet immigration status and identification requirements in Subpart D of 45 CFR Part 400 and who can provide documentation of one of the following statuses from the Immigration and Naturalization Service:

(A) paroled as a refugee or asylee under Section 212(d) of the Immigration and Nationality Act (INA);

(B) admitted as a refugee under Section 207 of the INA;

(C) granted asylum under Section 208 of the INA;

(D) admitted as a Cuban or Haitian entrant in accordance with requirements in 45 CFR part 401;

(E) admitted as an Amerasian from Vietnam pursuant to Section 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1988 (as contained in Section 101 (e) of Public law 100-202 and amended by the ninth proviso under Migration and Refugee Assistance in Title II of the Foreign Operation, Export, Financing, and Related Programs Appropriations Acts, 1989, (Public Law 100-461 as amended));

(F) certified as a victim of a severe form of trafficking; or

(G) designated as eligible by the director of Office of Refugee Resettlement (ORR).

(2) are within the eligibility period as established by ORR;

(3) have categorically tested ineligible for Temporary Assistance for Needy Families (TANF) or have applied but not received an approval for Social Security Income (SSI). Persons awaiting decision on SSI eligibility are RCA-eligible until SSI benefits are granted;

(4) are not full-time students in institutions of higher education, as defined by the director of ORR;

(5) meet the income eligibility standard established by the Texas Department of Human Services in consultation with local refugee service providers; and

(6) have not been sanctioned off TANF or Match Grant.

§7.305.What is the income eligibility standard for months one through four of the eight months of eligibility?

The income eligibility standard for enrollment in Refugee Cash Assistance benefits during months one through four is 125% of the Federal Poverty Income Limit.

§7.307.What is the income eligibility standard for months five through eight of the eight months of eligibility?

The income eligibility standard for enrollment in Refugee Cash Assistance benefits during months five through eight is 165% of the Federal Poverty Income Limit.

§7.309.What income must be disregarded when determining eligibility?

Contractors must disregard any income or resources:

(1) remaining in the applicant's country of origin;

(2) from a non-spousal sponsor;

(3) from the Department of State and Department of Justice Reception and Placement programs; and

(4) from the spouse's Social Security Income benefits.

§7.311.Are contractors required to report changes in a participant's income to the Texas Department of Human Services (DHS)?

Contractors must report changes in a participant's income within 10 days to designated DHS staff.

§7.313.Who determines a refugee's eligibility for Refugee Cash Assistance (RCA) benefits?

Anyone may apply for RCA. Contractors must determine if the applicant meets the eligibility requirements specified in §§7.303, 7.305, and 7.307 (relating to Who is eligible for Refugee Cash Assistance (RCA) benefits?, What is the income eligibility standard for months one through four of the eight months of eligibility?, and What is the income eligibility standard for months five through eight of the eight months of eligibility?) to become a participant and must keep all eligibility determination information in the participant's file.

§7.315.Are there special provisions when enrolling families with children in Refugee Cash Assistance?

Families with children should be eligible for assistance through the Temporary Assistance for Needy Families (TANF) program. Providers assessing eligibility for family units with children must notify the Office of Immigration and Refugee Affairs (OIRA) prior to enrolling participants. OIRA will assess justification of ineligibility for TANF.

§7.317.How long can a participant receive Refugee Cash Assistance (RCA) benefits?

The maximum time period a participant may receive benefits is specified by the director of the Office of Refugee Resettlement (ORR). The current time period is up to eight months from the beginning date of eligibility, as indicated in §7.319 of this title (relating to What is the beginning date of the eligibility period for Refugee Cash Assistance (RCA) benefits?).

§7.319.What is the beginning date of the eligibility period for Refugee Cash Assistance (RCA) benefits?

The beginning date of the eligibility period for RCA benefits is as follows:

(1) for refugees, the date of arrival to the U.S., as stamped on the individual's Form I-94;

(2) for asylees, the date that a final grant of asylum was made;

(3) for victims of a severe form of trafficking, the date on the certification letter signed by the director of the Office of Refugee Resettlement (ORR);

(4) for Cuban and Haitian entrants, the date on the individual's Form I-94, or other entry document as specified by ORR and indicated in the Texas Refugee Cash Assistance Provider Manual.

(5) for Amerasians, the date of arrival to the U.S., as stamped on Form I-94, or other entry document as specified by ORR and indicated in the Texas RCA Provider Manual.

§7.321.How does the contractor determine eligibility for a refugee who has moved from another state to Texas?

(a) The contractor determines eligibility on the same basis as for a refugee whose first placement was in Texas, with the following exceptions.

(1) The contractor must verify with the original sponsoring resettlement agency that the refugee has not voluntarily quit employment within the past 30 days.

(2) The contractor must also verify with the sponsoring resettlement agency and/or welfare agency at the original placement site whether the refugee has received an assistance payment for the month of application in Texas.

(b) The contractor may not issue duplicate benefits.

§7.323.What happens if a participant has a child after arriving in the U.S.?

If a participant has a child after arriving in the U.S., the contractor must refer the family to the Texas Department of Human Services (DHS) for a Temporary Assistance for Needy Families (TANF) eligibility determination before continuing with RCA benefits. If categorically ineligible for TANF, the size of the family unit changes and the contractor will calculate benefits based on the revised family unit size effective the month of birth.

§7.325.Can a contractor consider participants as a family unit if they do not live together?

No, participants must live together to be considered a family unit.

§7.327.If two or more unrelated participants live together, are they considered a family unit?

No, the contractor must consider unrelated participants who live together individually for benefits.

§7.329.What is the start date for benefits for approved applicants entering the program?

The contractor must issue payment for the month of application for an approved applicant entering the program at anytime during his Refugee Cash Assistance (RCA) time period of eligibility. If the approved applicant remains eligible, he will receive benefits for each of the remaining months during the RCA time period of eligibility. The contractor cannot issue benefit payments for months during the time period of eligibility that preceded the month of initial application for RCA.

§7.331.What payment levels and types of payments will the contractor use when providing cash assistance?

Benefit payments made during the first four months of the eligibility time period may be a combination of cash and vendor payments. Benefit payments made during months five through eight will be cash. Payment levels are established by the Texas Department of Human Services (DHS) and approved by the Office of Refugee Resettlement (ORR). DHS will update payment levels as needed and will publish them in the Refugee Cash Assistance Provider Manual, and in the DHS State Plan for Refugee Services submitted annually to ORR.

§7.333.Who is eligible to receive an incentive payment?

Refugees who are employed at any point within the first three months after arrival or after the date asylum was granted and have been employed at least 35 hours per week for at least 30 continuous days are eligible for an incentive payment of $150.

§7.335.How is the incentive payment disbursed for a family unit larger than one?

For family units larger than one, the contractor will grant an incentive in the amount of $150 when the first participant in the family unit meets the incentive requirements. The contractor will make an additional reduced incentive payment as described in the provider manual payment schedule as each additional member of the family unit meets the requirements.

§7.337.What happens if a participant is underpaid?

The contractor must correct underpayments to participants within 10 working days of recognizing the error.

§7.339.What happens if a participant is overpaid?

(a) If a participant is overpaid, the contractor must make every reasonable effort to arrange repayment. Contractors must arrange a repayment plan with the participant. The repayment plan may not require a payment of more than 10% of the total overpayment amount during any month. A contractor may not require a repayment be made during a month that would result in undue financial hardship. Repayments by participants continuing on the program may be made through a deduction in benefits.

(b) What are reasonable efforts? Reasonable efforts must include notifying the participant of the amount of overpayment, the reason for the overpayment, and that repayment is required.

(c) What are the exceptions?

(1) Contractors do not have to attempt arranging repayment if the participant is no longer receiving benefits and the overpayment amount is less than $35.

(2) Contractors do not have to arrange repayment if the participant is no longer receiving benefits and the overpayment is greater than $35 if:

(A) every reasonable effort has been made to arrange repayment and

(B) it is no longer cost-effective to continue overpayment recovery efforts.

(3) If the overpayment is the result of nondisclosure of information or fraud, the contractor must make every effort to recover the overpayment, regardless of the amount. Repayment arrangements under this condition are not subject to the 10% maximum monthly repayment ceiling; however, repayment arrangements must not result in undue financial hardship.

§7.341.Are contractors responsible for translating materials for participants?

(a) The Texas Department of Human Services (DHS) will provide contractors with translated participant rights and responsibilities. Contractors are responsible for distributing the translated materials in appropriate languages. If translated written material is not available, the contractor must provide an oral translation of the material.

(b) Participant's rights and responsibilities include, but are not limited to:

(1) review of adverse benefit determinations resulting from a sanction;

(2) a fair hearing to appeal any adverse benefit determinations;

(3) timely and adequate notice of benefit determinations and/or changes in benefits; and

(4) written policies of the Refugee Cash Assistance Program regarding eligibility standards, time period of eligibility, amount of assistance, participation and employment requirements, and penalties for non-cooperation.

§7.343.What information and materials must a contractor provide to the participant upon enrollment?

Contractors are responsible for advising and giving the participant the notice of all participant rights and responsibilities for acceptance of cash assistance, as well as the right to have a fair hearing.

§7.345.What procedures must a contractor follow when authorizing or denying an applicant benefits?

Contractors must follow procedures established by federal regulations as described in the provider manual when authorizing or denying benefits. This includes, but is not limited to, giving the participant written notice that:

(1) clearly states the action, the reasons for the action, and the right to a hearing in the case of denial; and

(2) clearly states that the notice is for the Refugee Cash Assistance Program and not any other program.

§7.347.When may a contractor reduce, suspend, or terminate benefits?

Contractors may reduce, suspend, or terminate benefits when:

(1) the size of a participant's family unit changes; or

(2) a participant does not fulfill employment requirements.

§7.349.What must a contractor do when reducing, suspending, or terminating benefits?

Contractors must follow procedures established by federal regulations in 45 CFR §400.54 as described in the Texas Refugee Cash Assistance Provider Manual when denying, reducing, suspending, or terminating benefits.

(1) If the action is taken because of a change in the size of the family unit, the contractor must give the participant written notice that:

(A) clearly states the action, the reasons for the action, and the right to a hearing;

(B) clearly states that the notice is for the Refugee Cash Assistance Program (RCA) and not any other program; and

(C) is postmarked or provided in person to the participant at least 10 days before the effective date of the change.

(2) If the action is taken because the participant has not fulfilled employment requirements, the contractor must give the participant written notice that:

(A) clearly states the action, the reasons for the action, and the right to a fair hearing preceded by a review period;

(B) clearly states that the notice is for RCA and not any other program; and

(C) is postmarked or provided in person to the participant at least 10 days before the date of the change.

§7.351.Can a contractor reduce, suspend, or terminate cash assistance if the participant requests a hearing?

(a) No, if the participant requests a hearing, the contractor cannot reduce, suspend, or terminate cash assistance until the hearing process is complete and a final decision has been made.

(b) If the contractor's action is upheld, a participant may have to repay assistance that was given during the hearing process.

(c) Participants can request that payments be held until a final hearing decision has been reached to avoid possible repayment.

§7.353.How must contractors participate in coordination activities with other refugee providers?

Contractors must actively participate in coordination activities involving the Office of Immigration and Refugee Affairs, Mutual Assistance Associations, and other ethnic representatives to ensure that services are:

(1) appropriate to the linguistic and cultural needs of the incoming populations; and

(2) coordinated with the longer term resettlement services frequently provided by ethnic community organizations after Refugee Cash Assistance eligibility has ended.

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. Issued in Austin, Texas, on April 29, 2002.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202640

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter D. ELIGIBILITY FOR OTHER PROGRAMS

40 TAC §§7.401 - 7.405

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

The repeals are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The repeals implement the Human Resources Code, §§22.001-22.036 and 31.001- 31.053.

§7.401.Food Stamps.

§7.402.Medicaid/Texas Health Steps (THSteps).

§7.403.Refugee Medically Needy Program.

§7.404.Refugee Medical Assistance (RMA) Program.

§7.405.Self-support Services.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202641

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter D. REFUGEE CASH ASSISTANCE PARTICIPANT REQUIREMENTS

40 TAC §§7.401, 7.403, 7.405, 7.407, 7.409, 7.411, 7.413, 7.415, 7.417, 7.419

The new sections are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The new sections implement the Human Resources Code, §§22.001-22.036 and 31.001-31.053.

§7.401.What is the purpose of this subchapter?

This subchapter contains the requirements Refugee Cash Assistance participants must meet in order to receive or continue benefits. Contractors are required to enforce all participant requirements.

§7.403.Are there employment requirements for participants in this program?

Yes, participants must continuously meet all requirements established by federal regulations that include:

(1) registering for employment services;

(2) participating, within 30 days of receipt of aid, in employability service programs that may include job and language training, as indicated in the participant's employability plan developed by the employment provider;

(3) going to job interviews; and

(4) accepting appropriate offers of employment.

§7.405.What are the exemptions for employment participation requirements?

Participants are exempt from the employment requirements if they are a:

(1) single parent or caretaker of a child under age one;

(2) single parent or caretaker who is needed in the home to care for a disabled child in the family unit;

(3) participant who is needed in the home to care for a disabled adult who is in the family unit and is disabled for more than 180 days;

(4) single grandparent age 50 or over who is a caretaker for a child under age three;

(5) participant who is disabled for more than 180 days;

(6) participant who is unable to work as a result of pregnancy;

(7) participant who is age 60 or older;

(8) participant under age 16 who is not a caretaker or second parent; or

(9) participant who is age 16 through 18 years old attending elementary, secondary, vocational, or technical school full-time.

§7.407.What are the temporary good cause exemptions from employment participation requirements?

(a) Participants may be eligible for a two-month temporary good cause exemption from employment requirements if they are:

(1) needed at home to care for an ill or temporarily disabled child or adult in the family unit. The caretaker must provide a current medical statement from a doctor to claim this exemption unless the child/adult receives a temporary government disability benefit;

(2) temporarily disabled when the incapacity is expected to last 180 days or less. A current medical statement from a doctor must be provided to claim this exemption; or

(3) a victim of family violence for whom participation would endanger the participant and/or his children.

(b) A two-month temporary good cause exemption is subject to renewal if the participant continues to meet the exemption.

§7.409.What happens if a non-exempt participant fails to meet employment requirements?

(a) As required by the 45 CFR §400.82(a), the contractor must terminate assistance if an employable participant who does not qualify for an exemption fails or refuses to meet employment requirements. The contractor must follow the requirements in §7.349 of this title (relating to What must a contractor do when reducing, suspending, or terminating benefits?).

(b) Termination of assistance under this provision will remain in effect for three payment months for the first failure or refusal and six payment months for any subsequent failure or refusal.

§7.411.What happens to a family unit's benefits if one member of a family unit fails to meet employment requirements?

(a) If an employable participant of a family unit, who does not qualify for a permanent or temporary good cause exemption from employment requirements, does not meet employment requirements then the amount of assistance given to the family unit is reduced to the number of participants meeting the requirements. The contractor must follow the requirements in §7.349 of this title (relating to What must a contractor do when reducing, suspending, or terminating benefits?).

(b) Termination of assistance under this provision will remain in effect for three payment months for the first failure or refusal and six payment months for any subsequent failure or refusal.

§7.413.What action does a contractor take if an applicant voluntarily quits employment within 30 days of applying for Refugee Cash Assistance (RCA) benefits?

If an employable applicant, who does not qualify for a permanent or temporary good cause exemption from employment requirements, voluntarily quits employment within 30 days or fewer before applying for benefits, the contractor must deny benefits to the applicant. Denial of assistance must follow the rule established under §7.345 of this title (relating to What procedures must a contractor follow when authorizing or denying an applicant benefits?).

§7.415.What action does a contractor take if a participant voluntarily quits employment after enrolling in Refugee Cash Assistance (RCA) benefits?

If an employable participant, who does not qualify for a permanent or temporary exemption from employment requirements, quits employment without good cause after enrolling in RCA, the contractor must terminate benefits. Contractors must provide a written notice to the participant explaining that benefits are being terminated and the reason for the action following the guidelines in §7.349 of this title (relating to What must a contractor do when reducing, suspending, or terminating benefits?). Termination of benefits will remain in effect for three payment months for the first sanction and six payment months for any subsequent sanction.

§7.417.If a Refugee Cash Assistance (RCA) contractor denies, terminates, or reduces benefits, how may an applicant or participant appeal the decision?

(a) An applicant or participant may appeal a decision by the following methods:

(1) The participant has the right to appeal to the Texas Department of Human Services (DHS), at which time a hearing will take place. The request for a hearing must be made within 10 days of the contractor's decision. Final administrative action must be taken within 60 days of the date of request for the hearing.

(2) An applicant or participant may follow the internal appeal procedures of the contractor.

(3) An applicant or participant may have the appeal forwarded to a statewide review board comprised of representatives from refugee service providers. The request for review by the review board must be made within four days of the contractor's decision. The review board must begin reviewing the request within 10 days of the contractor's decision. The review process may not exceed 30 days from the date of the contractor's decision.

(b) A participant may appeal to DHS for a hearing and attempt resolution through steps in paragraphs (2) and (3) of this subsection simultaneously.

§7.419.If a participant's benefits are denied, terminated, or reduced because the employment provider has reported that the participant is not meeting the employment requirements of the program, how can a participant appeal the decision?

(a) A participant may appeal the decision by the following methods:

(1) A participant has the right to appeal to the Texas Department of Human Services (DHS), at which time a hearing will take place. The request for a hearing must be made within 10 days of the contractor's decision. Final administrative action must be taken within 60 days of the date of request for the hearing.

(2) The participant may follow the internal appeal procedures of the employment contractor.

(3) The participant may attempt resolution by requesting a mediation period. The request for mediation must be made to the Refugee Cash Assistance (RCA) contractor within four days of the dated notice of adverse action. The RCA contractor must begin working on a resolution within 10 days following the adverse action. The mediation process may not exceed 30 days from the date of the adverse action. If the RCA contractor or the participant determines that the dispute cannot be resolved, either may terminate the resolution process.

(b) A participant may appeal to DHS for a hearing and attempt resolution through steps in paragraphs (2) and (3) of this subsection simultaneously.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202642

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter E. REFUGEE MEDICAL ASSISTANCE

40 TAC §§7.501, 7.503, 7.505, 7.507, 7.509, 7.511, 7.513, 7.515, 7.517, 7.519, 7.521, 7.523, 7.525, 7.527, 7.529, 7.531, 7.533, 7.535, 7.537, 7.539

The new sections are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The new sections implement the Human Resources Code, §§22.001-22.036 and 31.001-31.053.

§7.501.What is the purpose of this subchapter?

This subchapter governs the Refugee Medical Assistance Program administered by the Texas Department of Human Services.

§7.503.Who is eligible for Refugee Medical Assistance (RMA) benefits?

RMA is restricted to individuals who meet the eligibility requirements listed below:

(1) meet immigration status and identification requirements in Subpart D of 45 CFR Part 400 and who can provide documentation of one of the following statuses from the Immigration and Naturalization Service:

(A) paroled as a refugee or asylee under Section 212(d) of the Immigration and Nationality Act (INA);

(B) admitted as a refugee under Section 207 of the INA;

(C) granted asylum under Section 208 of the INA;

(D) admitted as a Cuban or Haitian entrant in accordance with requirements in 45 CFR part 401;

(E) admitted as an Amerasian from Vietnam pursuant to Section 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1988 (as contained in Section 101 (e) of Public law 100-202 and amended by the ninth proviso under Migration and Refugee Assistance in Title II of the Foreign Operation, Export, Financing, and Related Programs Appropriations Acts, 1989, (Public Law 100-461 as amended));

(F) victims of a severe form of trafficking; or

(G) designated as eligible by the director of the Office of Refugee Resettlement (ORR).

(2) are within the prescribed eight-month RMA eligibility period as regulated by ORR;

(3) meet documentation of eligibility requirements under §7.513 of this title (relating to What documentation is needed to determine eligibility?);

(4) are not full-time students in institutions of higher education, as defined by the director of ORR, except if enrollment is part of an individual's employability plan for a refugee under 45 CFR 400.79; or

(5) are ineligible for Medicaid, Children's Health Insurance Program (CHIP), and state medical programs.

§7.505.How does a person apply for Refugee Medical Assistance (RMA)?

An individual can apply for RMA by contacting the designated Texas Department of Human Services office.

§7.507.Are Refugee Medical Assistance (RMA) applicants required to apply for Refugee Cash Assistance (RCA)?

The Texas Department of Human Services does not require an applicant for RMA to apply for RCA as a condition of eligibility.

§7.509.Are there special considerations when Refugee Cash Assistance (RCA) participants apply for Refugee Medical Assistance (RMA)?

All participants enrolled in RCA who are not eligible for Medicaid are eligible for RMA.

§7.511.Who determines eligibility for Refugee Medical Assistance (RMA)?

Texas Department of Human Services staff determine eligibility for RMA.

§7.513.What documentation is needed to determine eligibility?

(a) The Texas Department of Human Services (DHS) requires the following documentation to determine eligibility for RMA:

(1) for refugees, Form I-94 issued by the Immigration and Naturalization Service (INS) and the name of the resettlement agency that provided initial resettlement;

(2) for asylees, an official document as approved by the Office of Refugee Resettlement (ORR) stating that a final grant of asylum has been made under Section 208 of the Immigration and Nationality Act (INA);

(3) for victims of a severe form of trafficking, a certification letter signed by the director of ORR;

(4) for Cuban and Haitian entrants, Form I-94 issued by the INS or other entry document as specified by ORR;

(5) for Amerasians, Form I-94 issued by the INS or other entry document as specified by ORR.

(b) Applicants must submit documentation to the designated DHS office.

§7.515.How is the beginning date of the eight-month period of eligibility for Refugee Medical Assistance (RMA) benefits determined?

The beginning date of the eligibility for RMA benefits is determined as follows:

(1) for refugees, the date of arrival to the U.S., as stamped on the individual's Form I-94;

(2) for asylees, the date that a final grant of asylum was made;

(3) for victims of a severe form of trafficking, the date on the certification letter signed by the director of the Office of Refugee resettlement (ORR);

(4) for Cuban and Haitian entrants, the date on the individual's Form I-94, or other entry document as specified by ORR and indicated in the Texas Refugee Cash Assistance Provider Manual;

(5) for Amerasians, the date of arrival to the U.S., as stamped on Form I-94, or other entry document as specified by ORR and indicated in the Texas Refugee Cash Assistance Provider Manual.

§7.517.What are the financial eligibility limits for Refugee Medical Assistance (RMA)?

The RMA financial eligibility requirements are the same as the Temporary Assistance for Needy Families (TANF) Medically Needy Income Limit (MNIL) requirements found in §2.1010(2) of this title (relating to Determining Income Eligibility).

§7.519.What are the income and resource considerations for Refugee Medical Assistance (RMA) eligibility?

(a) RMA follows the same income and resource considerations as Medicaid rules under Chapter 2, Subchapter A, of this title (relating to Program Requirements). In addition to the Temporary Assistance to Needy Families (TANF) considerations, the following are disregarded when determining RMA eligibility:

(1) any in-kind services and shelter provided to an applicant by a non-spousal sponsor or local resettlement agency; and

(2) any cash assistance payments provided to an applicant.

(b) The Texas Department of Human Services (DHS) bases eligibility for RMA on the applicant's income and resources on the date of application. DHS does not average income prospectively over the application processing period when determining income eligibility.

(c) Applicants whose income exceeds the Medically Needy Income Limit (MNIL) on the date of application are eligible if deducting incurred medical expenses puts the income under MNIL.

§7.521.How does marriage affect Refugee Medical Assistance (RMA) benefits?

The spouse's income is considered using stepparent policies outlined in the Medicaid rules under Chapter 2, Subchapter A, of this title (relating to Program Requirements).

§7.523.How does having a child after arrival affect Refugee Medical Assistance (RMA) benefits?

(a) If a refugee has a child after arriving in the U.S. and the child is not the result of marriage to a U.S. citizen, the child is eligible for RMA as long as the parent(s) are eligible.

(b) The family unit must be determined ineligible for Medicaid to remain on RMA.

§7.525.Can applicants who do not live together be certified as a family unit?

No, applicants must live together to be certified as a family unit.

§7.527.If two or more unrelated applicants live together, can they be certified as a family unit?

No, unrelated applicants must be certified separately.

§7.529.Are benefits continued if a participant's income increases due to employment?

Yes. Income from employment does not affect Refugee Medical Assistance (RMA) benefits. A recipient will continue to receive RMA until he reaches the end of the time period of eligibility.

§7.531.Is a refugee who has been terminated from Medicaid because of earnings eligible for Refugee Medical Assistance (RMA)?

Yes, if the participant has been terminated from Medicaid because of income from employment and is within the eligibility period for RMA, the Texas Department of Human Services will transfer Medicaid participants or family units to RMA without an RMA eligibility determination.

§7.533.What changes are Refugee Medical Assistance (RMA) participants required to report?

RMA participants must report all changes within 10 days to the Texas Department of Human Services following the Medicaid reporting requirements under §4.1016 of this title (relating to Client Reporting Requirements).

§7.535.What services are provided under Refugee Medical Assistance (RMA)?

The Texas Department of Human Services (DHS) provides the same services in the same manner and to the same extent as provided under the state's Medicaid program. DHS also provides Refugee Health Screening through an interagency contract with the Texas Department of Health.

§7.537.What happens if the refugee becomes covered by employer-provided insurance?

The Texas Department of Human Services will reduce Refugee Medical Assistance payments by the amount of the third-party payment.

§7.539.What notices will the Texas Department of Human services (DHS) provide to Refugee Medical Assistance (RMA) participants?

DHS must provide notice to RMA participants that assistance has been authorized because they are ineligible for Medicaid. DHS will specify whether the notice applies to RMA or Medicaid. DHS will also provide notice that participants have the right to appeal through the fair hearings process.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202643

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter E. CLIENT REPORTING REQUIREMENTS

40 TAC §7.502

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

The repeal is proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The repeal implements the Human Resources Code, §§22.001-22.036 and 31.001- 31.053.

§7.502.Reporting Changes.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202644

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Subchapter F. PENALTY PROVISIONS

40 TAC §§7.601 - 7.603

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

The repeals are proposed under the Human Resources Code, Title 2, Chapters 22 and 31, which authorizes the department to administer public and financial assistance programs.

The repeals implement the Human Resources Code, §§22.001-22.036 and 31.001- 31.053.

§7.601.Sanctions for Noncompliance with Employment Services Requirements.

§7.602.Fraud, Recoupment, and Appeal.

§7.603.Good Cause.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202645

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: June 9, 2002

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


Part 2. TEXAS REHABILITATION COMMISSION

Chapter 106. PURCHASE OF GOODS AND SERVICES BY TEXAS REHABILITATION COMMISSION

Subchapter A. GENERAL

40 TAC §106.3

The Texas Rehabilitation Commission (TRC) proposes a change to Title 40, Chapter 106, §106.3, concerning purchase of goods and services by TRC. The change is being proposed to correct an error in the citation to the Government Code for TRC's delegated authority for procuring administrative goods and services.

David McKay, Acting Deputy Commissioner for Financial Services, has determined that for the first five-year period the section is in effect, there will be no material fiscal implications for state or local government.

Mr. McKay 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 enforcing the section will be the agency's compliance with Chapter 111, Human Resources Code. There will be no material effect on small businesses. There is no material anticipated economic cost to persons who are required to comply with the section as proposed. In accordance with Government Code, §2001.022, TRC has determined that the proposed rule will not affect a local economy.

Comments on the proposal may be submitted to Roger Darley, Assistant General Counsel, Texas Rehabilitation Commission, 4900 North Lamar Boulevard, Suite 7300, Austin, Texas 78751.

The amendment is proposed under the Texas Human Resources Code, Title 7, Chapter 111, §111.018 and §111.023, which provides the Texas Rehabilitation Commission with the authority to promulgate rules consistent with Title 7, Texas Human Resources Code.

No other statute, article, or code is affected by this proposal.

§106.3.Authority.

The Texas Rehabilitation Commission receives delegated purchasing authority for procuring administrative goods and services from Government Code, §2155.144 [ §2154.144 ]. The legal authority for the Texas Rehabilitation Commission to enter into contracts is Title 7, §111.052, Human Resources Code. TRC will also comply with specific contracting procedures found in the Interagency Cooperation Act, Government Code §§771.001-771.010; Interlocal Cooperation Act (Government Code §§791.001, et seq.)

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202649

Sylvia F. Hardman

Deputy Commissioner for Legal Services

Texas Rehabilitation Commission

Earliest possible date of adoption: June 9, 2002

For further information, please call: (512) 424-4050


Subchapter D. PURCHASE OF GOODS AND SERVICES

40 TAC §106.107

The Texas Rehabilitation Commission (TRC) proposes an amendment to §106.107, concerning schedule of rates. The amendment is necessary to update the annual schedule rates.

Charles E. Harrison, Jr., Deputy Commissioner for Financial Services, has determined that for the first five-year period the section is in effect, there will be no fiscal implications for state or local government.

Mr. Harrison 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 enforcing the section will be an updated rule. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed. In accordance with Government Code §2001.022, TRC has determined that the proposed rule will not affect a local economy.

Comments on the proposal may be submitted to Roger Darley, Assistant General Counsel, Texas Rehabilitation Commission, 4900 North Lamar Boulevard, Suite 7300, Austin, Texas 78751.

The amendment is proposed under the Texas Human Resources Code, Title 7, Chapter 111, A7111.018 and A7111.023 and §111.0552(b) which provides the Texas Rehabilitation Commission with the authority to promulgate rules consistent with Title 7, Texas Human Resources Code.

No other statute, article, or code is affected by this proposal.

§106.107.Schedule of Rates.

Pursuant to Human Resources Code, §111.0552(b) and Texas Administrative Code Title 40, §106.105(3), the Board of the Texas Rehabilitation Commission adopts by reference the annual schedule rates the Commission will pay for medical services, to be effective September 2, 2002 [ September 3, 2001 ]. The schedule of rates may be viewed or copies may be obtained by calling the Texas Rehabilitation Commission at (512-424-4019) or visiting the Texas Rehabilitation Commission at the Brown Heatly Building at 4900 North Lamar; Austin, Texas; 78751.

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

Filed with the Office of the Secretary of State on April 29, 2002.

TRD-200202650

Sylvia F. Hardman

Deputy Commissioner for Legal Services

Texas Rehabilitation Commission

Earliest possible date of adoption: June 9, 2002

For further information, please call: (512) 424-4050


Part 20. TEXAS WORKFORCE COMMISSION

Chapter 815. UNEMPLOYMENT INSURANCE

Subchapter B. BENEFITS, CLAIMS AND APPEALS

40 TAC §815.12

The Texas Workforce Commission (Commission) proposes new §815.12 Waiver of Repayment and Recovery of Temporary Extended Unemployment Compensation Overpayments to Chapter 815, Unemployment Insurance, Subchapter B. Benefits, Claims and Appeals.

The purpose of the rule is to set forth the provisions relating to the TEUC repayment waiver process, including:

(1) the method for requesting the waiver;

(2) the applicable time limit for making the request;

(3) the explanation for the "fault" and "equity and good conscience" provisions;

(4) the definition of "financial hardship;" and

(5) the clarification regarding the appeal of the denial of a request for waiver.

Background/History: On March 9, 2002, the President signed into law as Public Law 107-147 "Job Creation and Worker Assistance Act of 2002," which included Title II related to the "Temporary Extended Unemployment Compensation" (TEUC) program. The TEUC program provides qualified unemployed individuals with up to 13 weeks of temporary extended Unemployment Insurance (UI) benefits. Under the TEUC provisions, these TEUC benefits are 100% federally funded. Thus, payment of the TEUC benefits will not impact the Texas UI Trust Fund. Therefore, payment of TEUC benefits does not subject taxed employers' accounts to chargeback, nor are accounts of reimbursing employers subject to reimbursement as a result of the payment of TEUC benefits. In addition, the TEUC benefits paid to the claimants will not impact the UI tax rates of the base period employers. Under §206(b) of the TEUC provisions, a state is required to obtain repayment and recovery (repayment) of overpayments from claimants who have received TEUC benefits to which they were not entitled (whether fraudulent or non-fraudulent), unless the state, under the optional language of § 206(b), elects to waive repayment of the TEUC overpayment. A state may elect to implement a TEUC waiver procedure even if it has no waiver provisions under state law for regular compensation. If the state elects to have a TEUC waiver and has a state law with waiver provisions for regular compensation, the state provision may be applied to TEUC. The Commission has elected to implement a TEUC waiver process, since there are no provisions for the waiver of non TEUC overpayments in state law. The Commission has elected to allow the waiver of repayment of TEUC overpayments in part due to a recognition that because of the large number of qualified applicants and the critical urgency of processing payments, there may be occasional mis-payments that result through no fault of the claimants. The Commission also recognized that the TEUC was implemented to assist those individuals who have been out of work for an extended period of time through no fault of their own; therefore requiring these individuals to repay an overpayment that is not their fault would be contrary to equity and good conscience.

The Commission received guidance from the United States Department of Labor (USDOL) through an Unemployment Insurance Program Letter (UIPL 17-02) dated March 19, 2002, that provided instructions for implementing the legislation. Generally, TEUC is payable to individuals who:

(1) filed an initial (new or additional) claim that was effective during or after the week of March 15, 2001;

(2) have exhausted regular benefits or have no benefit rights due to expiration of a benefit year ending during or after the week of March 15, 2001;

(3) have no right to regular or extended benefits under any state or federal law; and

(4) are not receiving benefits under the Canadian law.

In addition, UIPL 17-02 provided guidance regarding the implementation of the TEUC repayment waiver process. The Commission will implement the TEUC repayment waiver process through the promulgation of this rule. Pursuant to UIPL 17-02 the Commission may waive repayment of a non-fraudulent overpayment if the Commission finds that the claimant was not at fault for the overpayment and repayment of the overpayment by the claimant would be contrary to equity and good conscience.

UIPL 17-02 also sets forth the requirement that the Commission publish notice of the waiver process to the public. This notification is being accomplished by the publication of the notice in the Texas Register . The notice will inform individuals about the process for applying and qualifying for the TEUC waiver of repayment of an overpayment.

The rule requires that a claimant's written request for waiver of repayment of an overpayment be filed within 14 days of the date the overpayment determination and request to waive repayment of the overpayment notification are mailed by the Commission. This requirement provides consistent filing requirements for the request for waiver of a repayment and the appeal of an overpayment. The common time frame will be less confusing for the claimants receiving the overpayment determination and the request for waiver of a repayment. This will result in more efficient administration of both repayment waiver requests and appeals of overpayments, and a more effective system for processing claims.

In the rule the Commission permits a claimant to request a waiver from the repayment of a TEUC overpayment if the Commission determines, on a case-by-case basis, that: (1) the overpayment was through no fault of the claimant; and (2) repayment of the overpayment by the claimant would be contrary to equity and good conscience. The Commission also sets forth in the rule the criteria for determining when equity and good conscience would result in the waiver of a TEUC overpayment by the Commission. UIPL 17-02 provides guidance and direction regarding implementation of the no fault and a portion of the equity and good conscience criteria, but provides no specific criteria for the final component of equity and good conscience, financial hardship.

To provide clarification and consistency in administering the TEUC repayment waiver process, the Commission found that it would cause "financial hardship" to require a claimant to repay a TEUC overpayment if the claimant meets the criteria for TEUC benefits. The Commission has determined that individuals eligible for TEUC benefits have been unemployed for a long period of time through no fault of their own; and therefore, have faced significant and serious financial burdens resulting from prolonged unemployment. For that reason, meeting the criteria for TEUC benefits would itself be sufficient to constitute a financial hardship upon the individuals.

Randy Townsend, Chief Financial Officer, has determined that for the first five years the rules are in effect, the following statements will apply:

there are no additional estimated costs to the state or to local governments expected as a result of enforcing or administering the rules;

there are no estimated reductions in costs to the state or to local governments expected as a result of enforcing or administering the rules;

there are no estimated losses or increases in revenue to the state or to local governments as a result of enforcing or administering the rules;

there are no foreseeable implications relating to costs or revenues to the state or to local governments as a result of enforcing or administering the rules; and

there are no anticipated costs to persons who are required to comply with the rules as proposed.

Mr. Townsend, Chief Financial Officer, has determined that there is no anticipated adverse impact on small businesses as a result of enforcing or administering these rules because the TEUC benefits are federally funded and do not impact the tax rate of any base-period employers, whether the business is small or large.

LaSha Lenzy, Director, Unemployment Insurance and Regulation Division, has determined that for each year of the first five years that the rule will be in effect the public benefit anticipated as a result of the adoption of the proposed rule will be efficient administration of both the federal TEUC program and the related TEUC waiver of repayment of overpayment process.

James Barnes, Director, Labor Market Information, has determined that there is no foreseeable negative impact upon employment conditions in this state as a result of this proposed rule.

Comments on the proposed section may be submitted to John Moore, Acting General Counsel, Texas Workforce Commission, 101 East 15th Street, Room 608, Austin, Texas 78778; Fax Number 512-463-2220; or e-mailed to john.moore@twc.state.tx.us. Comments must be received by the Agency no later than thirty (30) days from the date this proposal is published in the Texas Register .

For more information about the Commission and services available, see www.texasworkforce.org.

The rule is proposed under Texas Labor Code §301.061, Public Law 107-147 "Job Creation and Worker Assistance Act of 2002" regarding the administration of the Temporary Extended Unemployment Compensation Program, and the United States Department of Labor's Unemployment Insurance Program Letter (UIPL 17-02) dated March 19, 2002, that provides the Texas Workforce Commission with the authority to adopt, amend, or repeal this rule as it deems necessary for the effective administration of Texas Workforce Commission services and the TEUC function.

The proposed new rule affects Texas Labor Code, Title 4.

§815.12.Waiver of Repayment and Recovery of Temporary Extended Unemployment Compensation Overpayments.

(a) This section implements the Temporary Extended Unemployment Compensation (TEUC) waiver of repayment program by setting out the process that the Agency and Commission shall use to determine whether to waive the repayment and recovery of non-fraudulent overpayments. The terms repayment and recovery will be referred to as repayment in this section, and Temporary Extended Unemployment Compensation overpayment will be referred to as overpayment.

(b) When a decision of the Agency or Commission results in an overpayment, an appealable determination and a request for waiver of repayment of an overpayment are mailed to the claimant.

(c) A claimant may appeal an overpayment determination pursuant to the provisions of Chapter 212 of the Act and the provisions set out in §815.16 of this chapter (relating to Appeals to Appeal Tribunals from Determinations), §815.17 of this chapter (relating to Appeals to the Commission from Decisions), and §815.18 of this chapter (relating to General Rules for Both Appeal Stages).

(d) A claimant's written request for waiver of repayment of an overpayment must be filed within 14 days of the date a request to waive the repayment of an overpayment notification is mailed by the Agency. The filing must be in accordance with §815.16 (1)(A) of this chapter (relating to Appeals to Appeal Tribunals from Determinations).

(e) The Agency or Commission will deny a request to waive the repayment of a non-fraudulent overpayment if it determines that:

(1) the payment of TEUC benefits is the fault of the claimant, or

(2) the repayment is not contrary to equity and good conscience.

(f) The Agency or Commission will waive the repayment of a non-fraudulent overpayment if it determines that:

(1) the payment of TEUC benefits is not the fault of the claimant, and

(2) the repayment is contrary to equity and good conscience.

(g) In determining whether fault exists, the Agency or Commission shall consider the following:

(1) whether a material statement or representation was made by the claimant in connection with the application for TEUC that resulted in an overpayment, and whether the claimant knew or should have known that the statement or representation was inaccurate;

(2) whether the claimant failed or caused another to fail to disclose a material fact, in connection with an application for TEUC that resulted in an overpayment, and whether the claimant knew or should have known that the fact was material;

(3) whether the claimant knew or could have been expected to know that the claimant was not entitled to the TEUC payment; and

(4) whether, for any other reason, the overpayment resulted directly or indirectly, and partially or totally, from any act or omission of the claimant or of which the claimant had knowledge, and which was erroneous or inaccurate or otherwise wrong.

(h) In determining whether equity and good conscience exists, the Agency or Commission shall consider the following factors:

(1) whether the overpayment is the result of a decision on appeal;

(2) whether the Agency gave notice to the claimant that the claimant may be required to repay the overpayment in the event of a reversal of a TEUC eligibility determination on appeal; and

(3) whether repayment of the TEUC overpayment will cause financial hardship to the claimant.

(i) The Commission has determined that requiring the claimant to repay a TEUC overpayment will cause financial hardship to the claimant, because in order to receive TEUC benefits, the claimant had to have been unemployed for an extended period of time.

(j) A claimant may appeal a denial of a request to waive the repayment of an overpayment pursuant to subsection (c) of this section.

(k) Hearings under this section will be conducted in a fair and impartial manner in accordance with the provisions of §815.15 of this chapter (relating to Parties with Appeal Rights), §815.16 of this chapter (relating to Appeals to Appeal Tribunals from Determinations), §815.17 of this chapter (relating to Appeals to the Commission from Decisions), and §815.18 of this chapter (relating to General Rules for Both Appeal Stages), except to the extent that the sections are clearly inapplicable.

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

Filed with the Office of the Secretary of State on April 23, 2002.

TRD-200202505

John Moore

Acting General Counsel

Texas Workforce Commission

Earliest possible date of adoption: June 9, 2002

For further information, please call: (512) 463-2573