TITLE 1.ADMINISTRATION

Part 1. OFFICE OF THE GOVERNOR

Chapter 3. CRIMINAL JUSTICE DIVISION

The Office of the Governor, Criminal Justice Division (CJD), adopts the amendment of Subchapter A, §3.3 and §3.19; Subchapter B, §§3.51, 3.53, and 3.79; Subchapter C, §§3.103, 3.401, 3.403, 3.405, 3.503, 3.505, 3.511, 3.603, 3.703, 3.719, 3.721, 3.803, 3.1205, 3.1301, 3.1303, and 3.1305; Subchapter E, §§3.2501, 3.2519, and 3.2527; and Subchapter G, §3.8210, without changes to the proposed text as published in the December 24, 2004, issue of the Texas Register (29 TexReg 11825).

CJD adopts the amendment of Subchapter B, §3.87 with changes to the proposed text as published in the December 24, 2004, issue of the Texas Register (29 TexReg 11825). A comma was added after the word "agency" in subsection (c) to correct the grammar in this subsection.

CJD adopts the addition of Subchapter C, §3.1311, without changes to the proposed text as published in the December 24, 2004, issue of the Texas Register (29 TexReg 11825).

CJD adopts the repeal of Subchapter C, §§3.1001, 3.1003, and 3.1005, without changes to the proposal as published in the December 24, 2004, issue of the Texas Register (29 TexReg 11825).

The amendment to §3.3: (1) clarifies in paragraph (12) that drug court fees collected pursuant to §469.004, Texas Health and Safety Code, are not considered program income because drug courts are authorized by the legislature to collect such fees; and (2) changes the way the dollar amount is written in paragraph (13)(B) to ensure the use of uniform language in this chapter.

The amendment to §3.19: (1) corrects the punctuation in subsection (b); and (2) in subsection (b)(5), clarifies the organizations to whom Office of Management and Budget (OMB) Circular No. A-110 is applicable.

The amendment to subsections (a) and (c) of §3.51 clarifies that a community plan must not simply address the community's criminal justice "needs," but must address the specific criminal justice "priorities" of the community.

The amendment to §3.53: (1) updates the section to include the current priorities developed in coordination with the Governor's Juvenile Justice Advisory Board; and (2) clarifies that projects must address the "priorities" listed in this section.

Instead of requiring task force personnel to travel to points at least 50 miles from the agency headquarters to be permitted to receive reimbursement for meals and lodging, the amendment to subsection (a) of §3.79 now requires task force personnel to travel to points at least 50 miles from their assigned location. This revision takes in account the fact that many task force personnel are assigned to locations other than the agency headquarters.

The amendment to §3.87 clarifies that: (1) CJD may require or allow a grantee receiving grant funds for a multi-jurisdictional drug task force project under the Byrne Formula Grant Program or grant funds under the State Criminal Justice Planning (421) Fund to transfer program income to another grant, grantee, agency, or CJD in accordance with the Uniform Grant Management Standards (UGMS) and the applicable federal requirements for the Byrne Formula Grant Program; (2) the listed grantees may request to carry forward program income from one grant period to the next in accordance with the requirements of UGMS and the applicable federal requirements for the Byrne Formula Grant Program; (3) a request to carry forward program income must be submitted to CJD with the grantee's final financial expenditure report because a request to carry forward program income necessitates the reporting of the amount of program income earned by the grantee; (4) the grantee must report program income in a timely and accurate manner to be eligible to carry over program income from one grant period to the next to promote accurate and efficient reporting of program income; (5) program income carried over from one grant period to the next must be used to further the objective of the grant project to ensure that the income is used in an effective and appropriate manner. In addition, the amendment corrects the grammar in this subsection by adding comma after the word "agency" in subsection (c).

The amendment to paragraph (2) of §3.103 clarifies that only applicants that are requesting grant funds for a juvenile project or a project serving delinquent or at-risk youth must meet the requirements of §3.53.

The amendment to subsections (a) and (b) of §3.401 updates the language of the subsections to reflect the current federal legislation applicable to the Safe and Drug-Free Schools and Communities Act Fund.

The amendment to §3.403 makes changes to the spelling and grammar in this section to ensure the use of uniform language in this chapter.

The amendment to §3.405 changes "These grantees" to "Grantees" to ensure the use of uniform language in this chapter.

The amendment to §3.503 makes changes to the spelling and grammar in this section to ensure the use of uniform language in this chapter.

The amendment to §3.505 conforms the requirements for eligible applicants under the Victims of Crime Act Fund to the federal requirements for this funding source.

The amendment to §3.511: (1) replaces former paragraph (6) with former paragraph (21) because former paragraph (6) is duplicative of former paragraph (21); and (2) makes a change to the grammar in paragraph (7) to ensure the use of uniform language in this chapter.

The amendment to §3.603 makes a change to the spelling in this section to ensure the use of uniform language in this chapter.

The amendment to paragraphs (3), (5), (9), (18) and (28) of §3.703 makes changes to the grammar in this section to ensure the use of uniform language in this chapter.

The amendment to §3.719 requires an applicant for a multi-jurisdictional drug task force project or other drug enforcement project to maintain on file a signed copy of district attorney agreements instead of requiring the district attorney agreements to be submitted to CJD with the grant application.

The amendment to §3.721: (1) requires that all projects that are involved in drug enforcement are required to certify that they conduct drug testing; and (2) clarifies the language of this section.

The amendment to §3.803: (1) clarifies that projects with a local impact are eligible under the Local Law Enforcement Block Grant Program pursuant to the federal requirements for this funding source; and (2) conforms the language of paragraph (2) to the federal requirements for this funding source.

The amendment to subsection (a) of §3.1205: (1) adds nonprofit corporations and faith-based organizations to the list of eligible applicants in accordance with the federal requirements for the Juvenile Accountability Block Grant Program; and (2) makes a change to the reference within this section to ensure the use of uniform language in this chapter.

The amendment to subsection (b) of §3.1301 updates the language of this subsection to reflect the current citation for the Coverdell Forensic Sciences Program.

The amendment to §3.1303 expands the list of eligible applicants to include accredited laboratories, as well as unaccredited laboratories that are in the process of obtaining accreditation, and permits funds to be used for the salaries and wages of state or local personnel, pursuant to the federal requirements for the Coverdell Forensic Sciences Program.

The amendment to §3.1305 expands the list of eligible applicants to include accredited laboratories, as well as unaccredited laboratories that are in the process of obtaining accreditation, as allowed under the federal requirements for the Coverdell Forensic Sciences Program.

The amendment to subsection (a)(2) of §3.2501 makes a change to the grammar and capitalization in this section to ensure the use of uniform language in this chapter.

The amendment to §3.2519 clarifies that CJD may reduce or terminate a grant under the circumstances listed in this section. One of the circumstances under which CJD is permitted to reduce or terminate a grant is when state or federal funds are no longer available to CJD or are insufficient to fund a grant project.

The amendment to subsection (c) of §3.2527 makes a change to the grammar in this section to ensure the use of uniform language in this chapter.

The amendment to §3.8210 updates the language of the section to reflect the current federal legislation applicable to the Governor's Juvenile Justice Advisory Board.

The addition of §3.1311 clarifies ineligible activities and costs under the Coverdell Forensic Sciences Program.

The repeal of §§3.1001, 3.1003 and 3.1005 deletes provisions applicable to the federal Challenge Grant Program, which is no longer administered by CJD.

CJD reviewed the rules affecting the CJD grant processes and procedures with the goal of increasing efficiency and updating the rules to address changes in the administration process. The review disclosed that a number of the rules required further clarification and simplification. As a result, CJD adopts the amendment, addition, and repeal of the sections in the Texas Administrative Code identified above.

Subchapter A. GENERAL GRANT PROGRAM PROVISIONS

1 TAC §3.3, §3.19

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

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 January 28, 2005.

TRD-200500410

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


Subchapter B. GENERAL GRANT PROGRAM POLICIES

1. ELIGIBILITY REQUIREMENTS

1 TAC §3.51, §3.53

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

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 January 28, 2005.

TRD-200500408

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


2. GRANT BUDGET REQUIREMENTS

1 TAC §3.79, §3.87

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

§3.87.Program Income.

(a) Rules governing the use of program income are included in the provisions adopted by reference in §3.19 of this chapter.

(b) Program income may only be used for allowable project costs as reflected in an approved budget, except as provided in subsection (c) of this section. Otherwise, grantees must refund program income to CJD.

(c) CJD may require or allow a grantee receiving grant funds for a multi-jurisdictional drug task force project under the Byrne Formula Grant Program or grant funds under the State Criminal Justice Planning (421) Fund to transfer the CJD portion of program income to another grant, grantee, agency, or to CJD.

(d) Grantees may not carry forward program income from one grant year to the next, except as provided by subsections (e) and (f) of this section.

(e) A grantee receiving grant funds for a multi-jurisdictional drug task force project under the Byrne Formula Grant Program may request to carry forward program income obtained from forfeiture actions from one grant period to the next.

(f) A grantee receiving grant funds under the State Criminal Justice Planning (421) Fund may request to carry forward program income from one grant period to the next.

(g) A request to carry forward program income in accordance with subsections (e) and (f) of this section must be submitted to CJD with the grantee's final financial expenditure report. Program income may not be carried forward without written CJD approval. A grantee must report program income on its quarterly financial expenditure reports in a timely and accurate manner to be eligible to carry forward program income in accordance with subsections (e) and (f) of this section.

(h) Program income carried forward in accordance with subsections (e) and (f) of this section must be used to further the objectives of the grant project.

(i) As provided in §3.3(12) of this chapter, all funds, accrued interest, and property awarded to a grantee under a forfeiture action represent program income.

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 January 28, 2005.

TRD-200500407

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


Subchapter C. FUND-SPECIFIC GRANT POLICIES

1. STATE CRIMINAL JUSTICE PLANNING (421) FUND

1 TAC §3.103

The amendment of this rule is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rule implements the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of this rule.

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 January 28, 2005.

TRD-200500406

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


4. SAFE AND DRUG-FREE SCHOOLS AND COMMUNITIES ACT FUND

1 TAC §§3.401, 3.403, 3.405

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

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 January 28, 2005.

TRD-200500405

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


5. VICTIMS OF CRIME ACT FUND

1 TAC §§3.503, 3.505, 3.511

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

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 January 28, 2005.

TRD-200500404

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


6. CRIME STOPPERS ASSISTANCE FUND

1 TAC §3.603

The amendment of this rule is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rule implements the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of this rule.

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 January 28, 2005.

TRD-200500403

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


7. BYRNE FORMULA GRANT PROGRAM

1 TAC §§3.703, 3.719, 3.721

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

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 January 28, 2005.

TRD-200500411

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


8. LOCAL LAW ENFORCEMENT BLOCK GRANT PROGRAM

1 TAC §3.803

The amendment of this rule is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rule implements the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of this rule.

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 January 28, 2005.

TRD-200500402

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


10. CHALLENGE GRANT PROGRAM

1 TAC §§3.1001, 3.1003, 3.1005

The repeal of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The repealed rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the repeal of these rules.

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 January 28, 2005.

TRD-200500401

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


12. JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM

1 TAC §3.1205

The amendment of this rule is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rule implements the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of this rule.

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 January 28, 2005.

TRD-200500400

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


13. COVERDELL FORENSIC SCIENCES PROGRAM

1 TAC §§3.1301, 3.1303, 3.1305, 3.1311

The amendment and addition of these rules are adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended and added rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment and addition of these rules.

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 January 28, 2005.

TRD-200500399

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


Subchapter E. ADMINISTERING GRANTS

1 TAC §§3.2501, 3.2519, 3.2527

The amendment of these rules is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rules implement the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of these rules.

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 January 28, 2005.

TRD-200500398

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


Subchapter G. CRIMINAL JUSTICE DIVISION ADVISORY BOARDS

2. GOVERNOR'S JUVENILE JUSTICE ADVISORY BOARD

1 TAC §3.8210

The amendment of this rule is adopted under the Texas Government Code, Title 7, §772.006(a)(10), which authorizes CJD to adopt rules and procedures as necessary.

The amended rule implements the Texas Government Code, Title 7, §772.006(a), which requires CJD to award and administer state and federal grant programs, and to assist the Governor in developing policies, plans, programs, and proposed legislation for improving the coordination, administration, and effectiveness of the criminal justice system.

No other statutes, articles, or codes are affected by the amendment of this rule.

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 January 28, 2005.

TRD-200500397

David Zimmerman

Assistant General Counsel

Office of the Governor

Effective date: February 17, 2005

Proposal publication date: December 24, 2004

For further information, please call: (512) 463-1919


Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 354. MEDICAID HEALTH SERVICES

Subchapter A. PURCHASED HEALTH SERVICES

32. DISEASE MANAGEMENT

1 TAC §§354.1415 - 354.1417

The Texas Health and Human Services Commission (HHSC) adopts amendments to §354.1415, concerning disease management vendor requirements and conditions for participation in the Medicaid program, with changes to the proposed text as published in the December 3, 2004, issue of the Texas Register (29 TexReg 11208). The text of the rule will be republished. In addition HHSC adopts new §354.1416, which outlines the eligibility criteria for the Disease Management Program, and §354.1417, which provides definitions for Disease Management services, without changes to the proposed text as published in the December 3, 2004, issue of the Texas Register (29 TexReg 11208) and will not be republished.

HHSC did not receive any comments regarding the proposed amendments to §354.1415 or to the proposed new §354.1416 and §354.1417 during the comment period, which included a public hearing on December 16, 2004.

The amendment and new rules are adopted under the Texas Government Code, §531.033, which provides the commissioner of HHSC with broad rulemaking authority; the Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and the Texas Government Code, §531.021(b), which provides HHSC with the authority to propose and adopt rules governing the determination of Medicaid reimbursements.

§354.1415.Vendor Requirements and Conditions for Participation.

(a) In addition to the general requirements for contractors listed in Chapter 391, Purchase of Goods and Services by the Health and Human Services Agencies and Chapter 392, Procurements by the Health and Human Services Commission, disease management companies must meet all of the following program requirements to be considered for a contract with the state. Entities who wish to contract with the Health and Human Services Commission (HHSC) to provide disease management services must meet the following conditions:

(1) Have an appropriate method for using HHSC healthcare data to identify targeted disease populations;

(2) Have nationally recognized evidence-based healthcare practice guidelines with minimum standards of care and clinical outcomes for each targeted disease;

(3) Have collaborative healthcare practice models in place to include HHSC's contracted physicians, support service providers, and existing community resources;

(4) Ensure that a recipient's primary care physician (PCP) and other appropriate specialty physicians, or registered nurses, advance practice nurses, or physician assistants become directly involved in the disease management program through which the recipient receives services;

(5) Have patient self-care management education materials and methods appropriate to each targeted disease population that demonstrate cultural competency;

(6) Have service provider education materials and methods appropriate to each targeted disease population;

(7) Have process and outcome measurements, evaluations, and management systems based on standardized best practice guidelines;

(8) Have routine reporting processes that are proven to properly support disease management goals;

(9) Have demonstrable, measurable, and successful experience in disease management for the targeted disease populations;

(10) Provide access to 24 hour-a-day, seven days-per-week nurse call center;

(11) Have the ability to guarantee program savings;

(12) Ensure compliance with all laws, regulations, and administrative rules that govern the performance of the disease management services and deliverables including all state and federal tax laws, employment laws, regulatory requirements, and licensing provisions;

(13) Ensure each of its personnel who provides services or deliverables through the disease management program is properly licensed, certified, and/or has proper permits to perform the required disease management activities;

(14) Ensure data entered, maintained, or generated to meet disease management program requirements are retained and accessible according to Federal requirement 42 CFR §431.17 and in accordance with the Health and Human Services Commission Medicaid Records Retention and Disposition Schedule;

(15) Maintain an accounting system that provides an audit trail containing sufficient financial documentation to allow for the reconciliation of billings, expenses, and financial information with all general ledger accounts applicable to the contract;

(16) Maintain and retain financial records and supporting documents relating to the disease management program for a period of five years, after the date of the final payment under the contract, or until the resolution of all litigation, claims, and financial management review or audit pertaining to the contract, whichever is longer.

(17) Provide authorized state and federal governments full access to all information needed to conduct reviews and audits required by law or by the contract in accordance with applicable auditing standards;

(18) Ensure contractor's systems and processes, to include files or data transferred from the contractor's internal system, comply with the requirements of the Health Insurance Portability Accountability Act of 1996 (Public Law 104-191) ("HIPAA"); and

(19) Ensure contractor and its subcontractors will comply with any policy, rule, or reasonable requirement of HHSC that relates to the safeguarding or disclosure of information relating to Medicaid applicants and recipients, contractor's operations, or the disease management services.

(b) The contracted disease management vendor must provide at a minimum, the following services to eligible clients and participating providers:

(1) Identify eligible clients and stratify them based on health severity level and risk for non-adherence to recommended care;

(2) Provide appropriate interventions that may include, at a minimum, development, implementation, and evaluation of an individual plan of care that:

(A) addresses the client's (multiple) health, behavioral, and social needs to ensure continuity, quality of care, and effectiveness;

(B) assures and facilitates appropriate collaboration between the client's family and/or caregivers, health care providers, and community case managers; and

(C) links health care providers with allied health and social services agencies to facilitate access to necessary services. This includes, but is not limited to, medically necessary services such as pharmacy, mental health, equipment and supplies, rehabilitative therapies, and transportation or interpreter services.

(3) Intensive outreach to find hard-to-serve clients, including home visits if the client does not have telephone service available, or cognitive or physical difficulties that interfere with phone usage. The vendor must use effective, appropriate, and culturally sensitive methods to accomplish this service;

(4) Enroll eligible clients in the disease management program and track active acceptance, refusal to participate, and disenrollment information;

(5) Establish a medical home or primary care provider for clients as needed;

(6) Identify gaps between recommended prevention and treatment and actual care provided to clients. Assure that client's medical care follows nationally recognized evidence-based guidelines for practice. Give providers feedback on differences between recommended prevention and treatment and actual care received by clients, and client adherence to their plan of care;

(7) Assess client's adherence to prescribed medical care and instructions;

(8) Prepare initial health assessments and conduct periodic health status follow-ups based on the risk and health severity level of the client. In-person visits are required for hard to reach clients;

(9) Assist client in accessing appropriate primary and preventive medical care;

(10) Development and demonstration of educational and care management techniques by phone and face-to-face personal interaction;

(11) Development and circulation of client educational materials which must be:

(A) written at the 5th grade reading level;

(B) available for clients who are blind, sight impaired, or have reading impairments; and

(C) provided in a language that may be understood by each individual client.

(12) Educate eligible clients and/or their caregivers regarding the client's particular health care condition and needs to:

(A) Increase the client's understanding of his or her disease and become more effective in self-care management of their health problems;

(B) understand the appropriate use of resources needed to care for his or her problem(s);

(C) identify negative changes in his or her health condition and seek appropriate attention before reaching crisis levels; and

(D) become more compliant with medical recommendations.

(13) Provide a 24 hour-a-day, seven day-a-week, culturally sensitive, toll-free nurse consultation service to respond to eligible clients and/or caregivers' questions;

(14) Have English and Spanish-speaking nurses, with other languages available through a translation or interpretation service. Translation and interpreter services should be available on-line and not require an additional phone call by the client;

(15) Provide service referrals for specialty, social and ancillary services through the use of a nurse consultation telephone line;

(16) Maintain documentation of disease management services in a member file and distribute to appropriate providers on a periodic basis;

(17) Develop collaboration with client and local hospitals to receive timely notification of hospital admissions of disease management clients;

(18) Provide care coordination support, discharge planning for early discharge and to prevent readmissions, revisions to client's plan of care as appropriate, and on-site visits when needed;

(19) Develop a process to respond to client and provider complaints;

(20) Provide intensive recruitment of providers (including specialists when warranted by the client's medical condition) to participate in the disease management program and serve as primary care providers, or as a medical home for eligible clients as needed;

(21) Develop and offer provider education regarding specific evidence-based guidelines selected for use;

(22) Ensure that there are no barriers to medical provider input into the development of the eligible client's plan of care;

(23) Implement a system for providers to request specific disease management interventions;

(24) Provide assistance in assuring necessary specialists care; and

(25) Provide reports on client's health status changes to their participating primary care provider.

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 January 31, 2005.

TRD-200500429

Steve Aragón

Chief Counsel

Texas Health and Human Services Commission

Effective date: February 20, 2005

Proposal publication date: December 3, 2004

For further information, please call: (512) 424-6900


Chapter 355. REIMBURSEMENT RATES

Subchapter J. PURCHASED HEALTH SERVICES

34. DISEASE MANAGEMENT PROGRAM

1 TAC §355.8640

The Health and Human Service Commission (HHSC) adopts new §355.8640, Reimbursement for the Disease Management Program, without changes to the proposed text as published in the December 3, 2004, issue of the Texas Register (29 TexReg 11212) and will not be republished.

New §355.8640 describes the reimbursement process for disease management contractors, which uses a prepayment methodology in compliance with 42 C.F.R. §438.6(c). Capitation payments are made on a monthly basis. Capitation rates vary according to the specific disease state group.

HHSC did not receive any comments regarding the proposed rule during the comment period, which included a public hearing on December 16, 2004.

The new rule is adopted under Texas Government Code §531.033, which provides the commissioner of HHSC with broad rulemaking authority; Human Resources Code §32.021 and the Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Government Code §531.021(b), which provides HHSC with the authority to propose and adopt rules governing the determination of Medicaid reimbursements.

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 January 31, 2005.

TRD-200500428

Steve Aragón

Chief Counsel

Texas Health and Human Services Commission

Effective date: February 20, 2005

Proposal publication date: December 3, 2004

For further information, please call: (512) 424-6900