TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

Subchapter X. REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES

40 TAC §19.2320

The Texas Department of Human Services (DHS) proposes to amend §19.2320, concerning medical transportation, in its Nursing Facility Requirements for Licensure and Medicaid Certification chapter. The purpose of the amendment is to comply with the requirements of House Bill 2292, 78th Texas Legislature, which amended Human Resources Code, §32.024. The amendment will allow nursing facilities to use the state's Medicaid community-based Title XIX medical transportation program to transport recipients for renal dialysis treatments.

Gordon Taylor, DHS's Chief Financial Officer, has determined that, for the first five-year period the proposed amendment is in effect, there are no fiscal implications for DHS as a result of enforcing or administering the section. However, there are fiscal implications for the state in the related policy proposed by the Texas Health and Human Services Commission (HHSC) in the May 28, 2004, issue of the Texas Register . Tom Suehs, Deputy Executive Commissioner for Financial Services, HHSC, has determined that during the first five years the proposed amendments to 1 Texas Administrative Code (TAC) §380.203 and §380.207 (HHSC, Medical Transportation Program) are in effect, there will be an estimated fiscal impact to the state for State Fiscal Year 2004 of $104,784 in general revenue and for the State Fiscal Year 2005 of $418, 926 in general revenue. There are no foreseeable fiscal implications for local governments.

Bettye M. Mitchell, Deputy Commissioner for Long Term Care, 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 is that nursing facility residents will have improved access to dialysis services because they can access medical transportation services for renal dialysis treatments.

There is no adverse economic effect on small or micro businesses, or on businesses of any size, as a result of enforcing or administering the section, because the rule does not add an expense for the facility but instead allows transportation to be funded through the Title XIX program for facilities that transport residents to dialysis treatments. There is no anticipated economic cost to persons who are required to comply with the proposed section for the same reason. There is no anticipated effect on local employment in geographic areas affected by this section.

Questions about the content of this proposal may be directed to Marcia Bowen at (512) 438- 3161 in DHS's Long-Term Care Regulatory Policy section. Written comments on the proposal may be submitted to Supervisor, Rules Unit-191, 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 Government Code, §2007.003(b), DHS has determined that Chapter 2007 of the Government Code does not apply to this rule. The change this rule makes does not implicate a recognized interest in private real property. Accordingly, DHS is not required to complete a takings impact assessment regarding this rule.

This rule is proposed by DHS, subject to the subsequent transfer of rulemaking authority to HHSC. DHS is currently scheduled to transition sometime in 2004 into two successor agencies, the existing HHSC and a new agency, the Texas Department of Aging and Disability Services (DADS).

This reorganization is mandated by House Bill 2292, 78th Leg., R.S. (2003). At the inception of operations of DADS, the authority to adopt all rules for the operation and provision of health and human services by DADS will lie with HHSC. These changes may result in the migration of this rule from one title of the Texas Administrative Code to another or other changes.

The amendment is proposed under the Human Resources Code, Chapters 22 and 32, which authorizes DHS to administer public and medical assistance programs; and under Government Code, §531.021, which provides the Texas Health and Human Services Commission with the authority to administer federal medical assistance funds.

The amendment affects the Human Resources Code, §§22.0001-22.040 and §§32.001-32.067.

§19.2320.Medical Transportation.

(a)-(c) (No change.)

(d) The facility may not charge the state's Medicaid health insuring agent, the recipient, the family, or responsible party for normal transportation as defined in this section. Normal transportation charges are covered in the monthly vendor rate. The facility may not use the state's Medicaid community-based Title XIX medical transportation program except to transport recipients for renal dialysis treatments .

(e)-(g) (No change.)

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

Filed with the Office of the Secretary of State on June 4, 2004.

TRD-200403694

Carey Smith

Deputy Commissioner, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: July 18, 2004

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