TITLE 25.HEALTH SERVICES

Part 1. DEPARTMENT OF STATE HEALTH SERVICES

Chapter 1. TEXAS BOARD OF HEALTH

Subchapter A. PROCEDURES AND POLICIES

25 TAC §§1.1, 1.3 - 1.8

(Editor's note: The text of the following sections proposed for repeal will not be published.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

The Executive Commissioner of the Health and Human Services Commission on behalf of the Department of State Health Services (department) proposes the repeal of §1.1 and §§1.3 - 1.8, concerning procedures and policies of the Texas Board of Health (Board).

BACKGROUND AND PURPOSE

The repeal is necessary to comply with Acts 2003, 78th Legislature, Regular Session, Chapter 198 (House Bill 2292), §1.18 and §1.26, which abolished the Texas Department of Health and the Board. Repeal of these sections is necessary to align the department's rules more accurately with House Bill 2292.

SECTION-BY-SECTION SUMMARY

The repeal of §1.1 and §§1.3 - 1.8 is necessary to align the department's rules with the requirements of House Bill 2292 now that the Board no longer exists. As part of the repeal of those sections, §1.7(b)(4), concerning the commissioner of health's (now the commissioner of the department, pursuant to House Bill 2292) authority to execute contracts and delegate execution of contracts of greater than $1 million, is unnecessary as a rule because contract execution authority is now under the department's policies and is not required to be stated in a rule.

FISCAL NOTE

Cathy B. Campbell, General Counsel, Office of General Counsel, has determined that for each year of the first five-year period that the repeal will be in effect, there will be no fiscal implications to state or local government as a result of repealing the sections as proposed.

SMALL AND MICRO-BUSINESS IMPACT ANALYSIS

Ms. Campbell has also determined that there are no anticipated economic costs to small businesses, micro-businesses or persons because the rules are no longer necessary, and business practices will not be altered in order to comply with the proposed repeal of the sections. There will be no impact on local employment.

PUBLIC BENEFIT

In addition, Ms. Campbell has also determined that for each year of the first five years the repeal of the sections is in effect, the public benefit anticipated as a result of the repeal is more accurate alignment of department rules with House Bill 2292.

REGULATORY ANALYSIS

The department has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environment exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. This proposal is not specifically intended to protect the environment or reduce risks to human health from environment exposure.

TAKINGS IMPACT ASSESSMENT

The department has determined that the proposed repeal does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposal may be submitted to Sara Richardson, Legal Assistant, Office of General Counsel, Department of State Health Services, 1100 West 49th Street, Austin, Texas 78756, (512) 458-7111, ext. 6961. Comments will be accepted for 30 days following publication of the proposal in the Texas Register .

STATUTORY AUTHORITY

The proposed repeal is authorized by House Bill 2292, which abolished the Texas Department of Health and its governing board, the Texas Board of Health; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules reasonably necessary for the department to administer its regulatory and administrative functions.

The proposed repeal affects the Health and Safety Code, Chapter 1001; and Government Code, Chapter 531.

§1.1.Purpose.

§1.3.Organization of the Board of Health.

§1.4.General Powers and Duties of the Board of Health.

§1.5.Meetings of the Board of Health.

§1.6.Actions Requiring Board Approval.

§1.7.Commissioner of Health.

§1.8.Press and Public Relations.

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 22, 2005.

TRD-200501664

Cathy Campbell

Director, Legal Services

Department of State Health Services

Earliest possible date of adoption: June 5, 2005

For further information, please call: (512) 458-7236


Chapter 13. HEALTH PLANNING AND RESOURCE DEVELOPMENT

Subchapter A. WAIVER OF VISA REQUIREMENT FOR PHYSICIANS

25 TAC §§13.1, 13.2, 13.5, 13.8

The Executive Commissioner of the Health and Human Services Commission on behalf of the Department of State Health Services (department) proposes amendments to §§13.1, 13.2, 13.5, and 13.8, concerning waiver of visa requirements for physicians serving in health professional shortage areas, who apply to the J-1 visa waiver program.

BACKGROUND AND PURPOSE

The amendments are proposed to give the department more flexibility in determining appropriate practice locations for J-1 visa waiver physicians.

SECTION-BY-SECTION SUMMARY

Amendments to §13.1 remove the defined terms "fully served", "NHSC" and "primary care specialist" because these terms are removed from §13.2. Amendments to §13.2 remove the 3000:1 or fewer physicians per capita provision and remove language concerning primary care specialists, psychiatrists and non-primary care specialists and the other terms deleted from the definitions in §13.1. Language is added that recommendations will be made in areas that meet shortage area requirements as identified by the program annually. Amendments to §13.5 clarify employment contract requirements concerning scheduled work hours and remove language concerning Education Code, §51.949, as this section is no longer applicable to the J-1 visa waiver program. Amendments to §13.8 also remove language concerning Education Code, §51.949.

FISCAL NOTE

Connie Berry, Program Manager for the Primary Care Office, has determined that for each year of the first five years that the sections will be in effect there will be no fiscal implications to state or local governments as a result of administering the sections as proposed because the fee is not changed.

SMALL AND MICRO-BUSINESS IMPACT ANALYSIS

Ms. Berry has also determined that there is no anticipated cost to small businesses or micro-businesses because the proposed amendments will affect only those professional associations that employ physicians, and will increase the pool of physicians from which they can recruit. There are no anticipated economic costs to persons who are required to comply with the amendments as proposed. There is no anticipated negative impact on local employment.

PUBLIC BENEFIT

Connie Berry has also determined that for each year of the first five years the sections are in effect the public health benefit anticipated as a result of these rules will be greater access by physicians to the waiver process allowed by federal law, clear criteria for physicians who wish to serve this state in health professional shortage areas under these provisions, and a greater chance that physicians can be recruited to serve these areas as envisioned by state and federal law.

REGULATORY ANALYSIS

The department has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environment exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. This proposal is not specifically intended to protect the environment or reduce risks to human health from environment exposure.

TAKINGS IMPACT ASSESSMENT

The department has determined that the proposed amendments do not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposal may be submitted to Connie Berry, Program Manager, Department of State Health Services, Texas Primary Care Office, 1100 West 49th Street, Austin Texas 78756, (512) 458-7518, connie.berry@dshs.state.tx.us. Comments will be accepted for 30 days following publication of the proposal in the Texas Register .

STATUTORY AUTHORITY

These amendments are proposed under Health and Safety Code, §12.0127, which authorizes the department to request waiver of certain residence requirements for alien physicians who agree to practice in medically underserved areas; Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules reasonably necessary for the department to administer its regulatory and administrative functions.

The proposed amendments affect Health and Safety Code, Chapters 12 and 1001, and Government Code Chapter 531.

§13.1.Definition of Terms.

The following words and terms when used in these sections, shall have the following meaning.

(1) Employer--A director of a health care facility where the physician will practice.

[ (2) Fully Served--An area with a population to provider ratio of 3000:1 or more physicians per capita.]

(2) [ (3) ] HPSA--Health Professional Shortage Area.

(3) [ (4) ] J-1 Visa Waiver--Removal of the requirement that a J-1 visa holder must return to their country of origin for two years at the end of his/her graduate medical training. The waiver allows the J-1 visa holder to remain in the United States if they agree to practice in an underserved area.

(4) [ (5) ] MUA--Medically Underserved Area.

[ (6) NHSC--National Health Service Corps.]

(5) [ (7) ] Operational--Providing health care services to patients.

[ (8) Primary Care Specialist--A physician who has a degree and specialization in internal medicine, general practice, family practice, pediatrics, or obstetrics/gynecology.]

(6) [ (9) ] Provider--A physician requesting a J-1 visa waiver.

§13.2.J-1 Visa Waiver Rules.

[ The following apply to faculty and non-faculty waivers. ]

(a) [ (1) ] The [ Texas ] Department of State Health Services (department) will consider a recommendation for a J-1 visa waiver in the area or areas designated by the Secretary of Health and Human Services as a HPSA or a MUA and meet shortage area requirements as identified by the program annually. [ are not fully served by J-1, NHSC or other primary care physicians. The HPSA or MUA must have a population to physician ratio of 3000:1 or fewer physicians per capita. ]

[ (2) Primary care specialists will be considered eligible to apply to areas designated as Primary Care HPSAs or MUAs.]

[ (3) Psychiatrists will be considered eligible to apply to areas designated as Mental Health HPSAs or MUAs.]

[ (4) The department will consider J-1 visa waivers for physicians who are non-primary care specialists when additional documentation is submitted supporting the need for the services of the specialist and the shortage of that specialty in the HPSA or MUA.]

(b) [ (5) ] Applications [ The first 30 complete applications ] that meet federal and state requirements will be considered for recommendation on a first-come-first-served basis . The submission of a complete waiver application to the department does not ensure that the department will recommend a waiver to the United States Department of State and the Bureau of Citizenship and Immigration Services.

(c) [ (6) ] The employer or the employer's representative must submit the J-1 waiver request application to the department.

§13.5.Contract.

(a) - (b) (No change.)

(c) The contract must contain the following information:

(1) list of benefits, insurance to be provided to the provider;

(2) field of practice of the provider;

(3) practice site name, address and telephone number of the health care facility where the provider will work;

(4) scheduled work hours [ hours of work ];

(5) amount of leave; and

(6) statements that amendments shall adhere to state and federal J-1 visa waiver requirements.

[ (d) If applying under Education Code, §51.949, the applicant must demonstrate compliance with its provisions.]

§13.8.Other Federal or State Requirements.

All waiver request applications must meet federal laws 8 USC §1182 and §1184. [ All waiver request applications for faculty physicians must meet applicable state laws (Texas Education Code, §51.949). ]

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 25, 2005.

TRD-200501693

Cathy Campbell

Director, Legal Services

Department of State Health Services

Earliest possible date of adoption: June 5, 2005

For further information, please call: (512) 458-7236


Chapter 460. MISCELLANEOUS

Subchapter A. TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

1. TDMHMR RULEMAKING

25 TAC §§460.1 - 460.8

(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 Department of State Health Services or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Executive Commissioner of the Health and Human Services Commission on behalf of the Department of State Health Services (department) proposes the repeal of §§460.1 - 460.8, concerning rulemaking by the Texas Department of Mental Health and Mental Retardation.

BACKGROUND AND PURPOSE

The repeal is necessary to comply with Acts 2003, 78th Legislature, Regular Session, Chapter 198 (House Bill 2292), §1.18 and §1.26, which abolished the Texas Department of Mental Health and Mental Retardation, one of the department's legacy agencies, and transferred its rulemaking authority to the Executive Commissioner of the Health and Human Services Commission. Repeal of these sections is necessary to align the department's rules more accurately with House Bill 2292.

SECTION-BY-SECTION SUMMARY

The repeal of §§460.1 - 460.8 is necessary to align the department's rules with the requirements of House Bill 2292 concerning transfer of rulemaking authority to the Executive Commissioner of the Health and Human Services Commission.

FISCAL NOTE

Cathy B. Campbell, General Counsel, Office of General Counsel, has determined that for each year of the first five-year period that the repeal will be in effect, there will be no fiscal implications to state or local government as a result of repealing the sections as proposed.

SMALL AND MICRO-BUSINESS IMPACT ANALYSIS

Ms. Campbell has also determined that there are no anticipated economic costs to small businesses, micro-businesses or persons because the rules are no longer necessary, and business practices will not be altered in order to comply with the proposed repeal of the sections. There will be no impact on local employment.

PUBLIC BENEFIT

In addition, Ms. Campbell has also determined that for each year of the first five years the repeal of the sections is in effect, the public benefit anticipated as a result of the repeal is more accurate alignment of department rules with House Bill 2292.

REGULATORY ANALYSIS

The department has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environment exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. This proposal is not specifically intended to protect the environment or reduce risks to human health from environment exposure.

TAKINGS IMPACT ASSESSMENT

The department has determined that the proposed repeal does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposal may be submitted to Sara Richardson, Legal Assistant, Office of General Counsel, Department of State Health Services, 1100 West 49th Street, Austin, Texas 78756, (512) 458-7111, ext. 6961. Comments will be accepted for 30 days following publication of the proposal in the Texas Register .

STATUTORY AUTHORITY

The proposed repeal is authorized by House Bill 2292, which abolished the Texas Department of Mental Health and Mental Retardation and transferred its rulemaking authority to the Executive Commissioner of the Health and Human Services Commission; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules reasonably necessary for the department to administer its regulatory and administrative functions.

The proposed repeal affects the Health and Safety Code, Chapter 1001; and Government Code, Chapter 531.

§460.1.Purpose.

§460.2.Definitions.

§460.3.Coordination of the Rulemaking Process.

§460.4.Petitions for Rules or Changes to Rules.

§460.5.Public Comment on Rules.

§460.6.Emergency Rulemaking.

§460.7.Distribution.

§460.8.References.

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 22, 2005.

TRD-200501662

Cathy Campbell

Director, Legal Services

Department of State Health Services

Earliest possible date of adoption: June 5, 2005

For further information, please call: (512) 458-7236