10 TAC §§257.901 - 257.907
The Office of Rural Community Affairs (office) adopts new §§257.901
- 257.907 which implements a Locum Tenens program to provide temporary relief
to physicians in rural areas by other physicians or services. Sections 257.902
and 257.904 are adopted with changes to the text as published in the November
7, 2003, issue of the
Texas Register
(28 TexReg
9653). Sections 257.901, 257.903, 257.905 - 257.907 are adopted without changes
and will not be republished. The office, through these rules, would maintain
a registry, facilitate the arrangement for the physician relief and provide
for the receipt and payment of funds.
The rules will assist the office by providing the mechanism for administering
the program. Section 257.901 states the purpose of the rules, §257.902
defines the terms used in the program, §257.903 provides for the charge,
collection and payment of fees for the service provided, §257.904 establishes
priorities for the services, §257.905 provides for the recruitment of
physicians and the establishment of a registry, §257.906 establishes
an Advisory Committee and §257.907 establishes the application process.
The rules are adopted to implement the provisions of Acts of 2003, 78th
Legislative Session, Chapter 487 of the Texas Government Code, (HB 1877).
This bill amended the legislation creating the Office of Rural Community Affairs.
A comment letter was received from the Texas Medical Association. The comments
were actually questions. One comment questioned the absence of hospitals with
staffed emergency rooms not being listed as a priority. Following a meeting
with representatives of the Texas Medical Association, the staff of the agency
recommended and the Executive Committee agreed to amend the proposal to include
the criteria as a listed priority in the rules.
The new sections are adopted under Government Code, §487.052
that provides the office with the authority to adopt rules to implement its
responsibilities
§257.902.Definitions.
The following words and terms, when used in this subchapter, shall
have the following meanings, unless the context clearly indicates otherwise.
(1)
Office--The Office of Rural Community Affairs.
(2)
Executive Committee--The nine member governing body of
the Office of Rural Community Affairs appointed by the governor, lieutenant
governor and speaker.
(3)
Executive Director--The chief executive officer of the
Office of Rural Community Affairs.
(4)
Physician--A person licensed to practice medicine in this
state under Subtitle B, Title 3, Occupation Code.
(5)
Relief Services--The temporary coverage of a physician's
practice by another physician for a predetermined time during the physician's
absence and before the physician's return.
(6)
Rural Community--A community meeting any of the following
criteria listed in subparagraphs (A)-(C) of this paragraph:
(A)
a community located in a county with a population not greater
than 50,000;
(B)
an area designated under state or federal law as:
(i)
a health professional shortage area; or
(ii)
a medically underserved area; or
(C)
a medically underserved community designated by the office.
(7)
Registry--a listing of physicians, maintained by the office,
who are available to provide relief services.
§257.904.Prioritizing Assignment of Relief Physicians.
(a)
The office shall assign physicians to provide relief to
a rural area in accordance with the following priorities:
(1)
solo practitioners;
(2)
counties that have fewer than seven residents per square
mile;
(3)
counties that have been designated under federal law as
a health professional shortage area;
(4)
counties that do not have a hospital;
(5)
counties that have a hospital but do not have a continuously
staffed emergency room; and
(6)
counties that have a hospital with a continuously staffed
emergency room.
(b)
The office shall consider the number of physicians in the
area available to provide relief services and the distance in that area to
the nearest physician who practices in the same specialty, in determining
where to assign relief physicians.
(c)
At the request of the office, residency program directors
may assist the office in coordinating the assignment of relief physicians.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 1, 2004.
TRD-200401640
Robt. J. "Sam" Tessen, MS
Executive Director
Office of Rural Community Affairs
Effective date: March 21, 2004
Proposal publication date: November 7, 2003
For further information, please call: (512) 936-6710
Subchapter M. CRITICAL ACCESS HOSPITAL BOARD OF TRUSTEE CONTINUING EDUCATION PROGRAM
10 TAC §§257.951 - 257.953
The Office of Rural Community Affairs (office) adopts new §§257.951
- 257.953 for the purpose of encouraging the continuing education of Critical
Access Hospital Board of Trustees. Section 257.952 is adopted with changes
to the proposed text as published in the November 7, 2003, issue of the Texas Register
(28 TexReg 9654). Sections 257.951
and 257.953 are adopted without changes and will not be republished. The office,
through these rules, is encouraging trustees to receive a minimum of six hours
of continuing education each year in hospital governance, Medicare and Medicaid
reimbursement, Critical Access Hospital reimbursement and the purposes of
the Critical Access program with evidence of the training. Critical Access
Hospitals may receive the incentive of points added to their scores in grant
applications being considered by the office.
The rules will assist the office by providing the mechanism and standards
for administering the program. Section 257.951 establishes the purpose of
the rules, §257.952 defines the terms used in the program, and §257.953
establishes the requirements, criteria and incentives. This rule is adopted
to implement the provisions of Section 487 of the Texas Government Code that
administers programs supporting rural health care.
A comment letter was received from the Texas Hospital Association. The
association suggested that the office amend its proposed definition of "trustee"
to track language in the Hospital licensing rules. They recommended that the
trustee be a member of the governing authority of a critical access hospital
which is responsible for a hospital's organization, management, control and
operation. The Executive Committee agreed to amend the proposal as recommended
in the comment.
This new sections are adopted under Government Code, §487.052
that provides the office with the authority to adopt rules to implement its
responsibilities.
§257.952.Definitions.
The following words and terms, when used in this subchapter, shall
have the following meanings, unless the context clearly indicates otherwise:
(1)
Critical Access Hospital--A hospital designated by the
Centers for Medicare and Medicaid Services to receive cost based reimbursement
for covered services provided to Medicare recipients. Such hospitals are small
facilities that give limited outpatient and inpatient services to people in
rural areas.
(2)
Executive Committee--The nine member governing body of
the Office of Rural Community Affairs appointed by the governor, lieutenant
governor, and speaker.
(3)
Executive Director--The chief executive officer of the
Office of Rural Community Affairs.
(4)
Office--The Office of Rural Community Affairs.
(5)
In Person Classroom Continuing Education--This includes
education at a meeting or seminar and interactive videoconferencing involving
more than one Critical Access Hospital.
(6)
Continuing Education--Education received by a Critical
Access Hospital trustee that is approved by the office.
(7)
Trustee--A member the governing authority of a Critical
Access Hospital which is responsible for a hospital's organization, management,
control and operation.
This agency hereby certifies that the adoption has been
reviewed by legal counsel and found to be a valid exercise of the agency's
legal authority.
Filed with the Office of
the Secretary of State on March 1, 2004.
TRD-200401641
Robt. J. "Sam" Tessen, MS
Executive Director
Office of Rural Community Affairs
Effective date: March 21, 2004
Proposal publication date: November 7, 2003
For further information, please call: (512) 936-6710