TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 2. DEPARTMENT OF ASSISTIVE AND REHABILITATIVE SERVICES

Chapter 101. ADMINISTRATIVE RULES AND PROCEDURES

Subchapter I. ADMINISTRATIVE RULES AND PROCEDURES PERTAINING TO EARLY CHILDHOOD INTERVENTION SERVICES

The Texas Health and Human Services Commission proposes the repeal of four sections, and the amendment of an additional five sections, of Title 40, Part 2, Chapter 101, Subchapter I, of the rules of the Department of Assistive and Rehabilitative Services, pertaining to the Early Childhood Intervention Services. The four sections to be repealed are: §§101.5601, 101.5603, 101.5605 and 101.5607, concerning Division 1, Conduct of Board Meetings. The five sections to be amended are: §§101.5751, 101.5753, 101.5755, 101.5757 and 101.5759, concerning Division 3, Relationship With Private Donors.

The repeals and amendments are being proposed to conform the rules pertaining to Early Childhood Intervention Services to the organizational and operational requirements of House Bill 2292, 78th Legislature, Regular Session, and to conform nomenclature used in the rules to that resulting from consolidation of Health and Human Services Agencies under the Texas Health and Human Services Commission.

Bill Wheeler, Chief Financial Officer, Department of Assistive and Rehabilitative Services, estimates that for each year of the first five years that the repeals and amendments will be in effect, there will be no material fiscal implications for state or local government.

Mr. Wheeler also estimates that for each year of the first five years the repeals and amendments will be in effect, the public benefit anticipated as a result of adopting the proposed changes will be the agency's compliance with House Bill 2292, 78th Legislature, Regular Session, and other existing provisions of law pertaining to provision of health and human services in Texas. There should be no material economic cost to persons who are required to comply with the rules as proposed for repeal and amendment. There should be no material effect to small or micro businesses. In accordance with Government Code §2001.022, the Health and Human Services Commission has determined that the proposed repeals and amendments will not affect a local economy.

Comments on the proposal may be submitted to Roger Darley, Deputy General Counsel, Department of Assistive and Rehabilitative Services, 4800 North Lamar Boulevard, Suite 300, Austin, Texas 78756.

1. CONDUCT OF BOARD MEETINGS

40 TAC §§101.5601, 101.5603, 101.5605, 101.5607

(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 Assistive and Rehabilitative Services or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The repeals are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§101.5601.Introduction.

§101.5603.Applicability of Texas Open Meetings Law.

§101.5605.Council Procedures.

§101.5607.Public Participation.

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 13, 2006.

TRD-200603250

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


3. RELATIONSHIP WITH PRIVATE DONORS

40 TAC §§101.5751, 101.5753, 101.5755, 101.5757, 101.5759

The amendments are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§101.5751.Purpose.

The purpose of these sections is to establish the criteria, procedures, and standards of conduct governing the relationship between the Department of Assistive and Rehabilitative Services (DARS) [ Interagency Council on Early Childhood Intervention (Council) ], its [ officers and ] employees, and private donors and private organizations that exist to further the duties and purposes of the Division for Early Childhood Intervention Services [ Council ].

§101.5753.Definitions.

The following words and terms, when used in these sections, shall have the following meanings, unless the context clearly indicates otherwise.

(1) Commissioner--Commissioner of the Department of Assistive and Rehabilitative Services. [ Executive Director--The Executive Director of the Interagency Council on Early Childhood Intervention. ]

(2) Department--Department of Assistive and Rehabilitative Services. [ Board--Board of the Interagency Council on Early Childhood Intervention. ]

(3) Division--Division for Early Childhood Intervention Services (ECI). [ Council--Interagency Council on Early Childhood Intervention. ]

(4) Donation--A contribution of anything of value (financial or in-kind gifts such as goods or services) given to the Department [ Council ] or to a private organization or foundation that exists to further the duties or functions of the Department [ Council ].

(5) Employee--A regular full-time or part-time employee of the Department [ Council ].

[(6) Officer--A member of the Board of the Council.]

(6) [ (7) ] Private donor--A person who gives a donation to the Department [ Council on Early Childhood Intervention ] or to a private organization that exists to further the duties and purposes of the Department [ Council ].

(7) [ (8) ] Private organization--A private organization that exists to further the purposes and duties of the Department [ Council ].

§101.5755.Donations by Private Donors to the Department of Assistive and Rehabilitative Services [ Interagency Council on Early Childhood Intervention ].

(a) All donations to the Department [ Council ] shall be expended in accordance with the provisions of the state Appropriations Act and shall be deposited in the state treasury unless exempted by specific statutory authority.

(b) All donations will be coordinated through the Assistant Commissioner, Division for Early Childhood Intervention Services [ Executive Director of the Council ].

(c) The Department [ Council ] may not transfer a private donation to a foundation or private/public development fund without specific written permission from the donor and the written approval of the Commissioner [ Executive Director ].

§101.5757.Relationship Between Private Organizations and the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention ].

(a) A private organization that exists to further the duties and purposes of the Department's ECI mission and programs [ Council ] and the Department [ Council ] shall enter into a memorandum of understanding (MOU) that contains specific provisions regarding:

(1) the relationship between the private organization and the Department [ Council ];

(2) fundraising and solicitation;

(3) the use of all funds and other donations from fundraising or solicitation, minus the legitimate expenses described in the MOU, for the benefit of the Department's ECI Division [ Council ];

(4) the maintenance by the private organization of receipts and documentation of all funds and other donations received, including furnishing such records to the Department [ Council ];

(5) the furnishing to the Department [ Council ] of any audit of the private organization by the Internal Revenue Service or a private firm; and

(6) the conditions under which the Department [ Council ] will provide property and/or staff support to the organization to further the duties and purposes of the Department [ Council ] and the organization.

(b) The Department [ Council ] may assist a private organization in fund raising and solicitation when:

(1) the ultimate use of the funds, less administrative expenses, will benefit early childhood intervention programs and is consistent with and will further the goals and mission of the Department [ Council ]; and

(2) such fund raising activity does not violate rules governing standards of conduct between Department [ Council ] employees and private donors described in §101.5759 [ section 621.163 ] of this subchapter (relating to Standards of Conduct for Officers or Employees of the Department [ Council ]).

(c) The Department [ Council ] may accept from a private organization financial assistance designed to promote early childhood intervention services and programs in the state of Texas. These funds must enhance state funds and not supplant or replace state appropriations. Before the Department [ Council ] may accept such assistance, the Commissioner [ Executive Director ] must ascertain and document that the acceptance will promote the goals of the Department [ Council ], and that the acceptance does not violate the personnel or administrative policies of the Department [ Council ].

(d) With regard to all funds received:

(1) The private organization shall maintain receipts and documentation of all funds and other donations received, and shall furnish such documentation to the Department [ Council ] on request.

(2) The private organization shall maintain all funds in insured accounts at established financial institutions, unless the organization and the Commissioner of the Department of Assistive and Rehabilitative Services [ Council Executive Director ] approve other investments.

(3) State funds held by the organization shall be invested according to the state's Public Funds Investment Act.

(4) The organization shall obtain an independent audit on an annual basis and submit the results to the Commissioner of the Department of Assistive and Rehabilitative Services [ Executive Director of the Council ]. Records relating to activities supported by public funds will be subject to public scrutiny.

(5) Funds generated by the organization will be spent in accordance with the organization's established priorities. Department [ Council ] employees cannot directly spend organization funds - all organization expenditures will be controlled by the organization and its employees.

(6) Expenditures of funds by the organization shall meet requirements of the source of the funds, if applicable.

(7) The organization may solicit and accept corporate sponsorships and will ensure the sponsorships serve and support the organization and Department's Early Childhood Intervention [ ECI Board ] mission. The organization shall establish selection criteria and guidelines when seeking corporate sponsorships and ensure sponsorships serve the public interest and are consistent with the Department's [ Council's ] mission.

(8) Fundraising for the organization shall be conducted by organization employees and Board members and not by state employees with regulatory authority over the potential donor or those for whom it could pose a conflict of interest with a potential donor.

(9) No funding generated by the organization shall be used to provide a salary supplement or bonus to any state employee.

(10) The organization shall perform an annual evaluation of its achievement of established goals/objectives to determine the effectiveness of the organization.

§101.5759.Standards of Conduct for [ Officers or ] Employees of the Department [ Council ].

(a) An [ officer or ] employee shall not accept or solicit any gift, favor, or service from a private donor or private organization that might reasonably tend to influence his/her official conduct.

(b) An [ officer or ] employee shall not accept employment or engage in any business or professional activity with a private donor or private organization that the [ officer or ] employee might reasonably expect would require or induce him/her to disclose confidential information acquired by reason of his/her official position.

(c) An [ officer or ] employee shall not accept other employment or compensation from a private donor or private organization that would reasonably be expected to impair the [ officer's or ] employee's independence of judgment in the performance of his/her official position.

(d) An [ officer or ] employee shall not make personal investments in association with a private donor or private organization that could reasonably be expected to create a substantial conflict between the [ officer's or ] employee's private interest and the interest of the Department [ Council ].

(e) An [ officer or ] employee shall not solicit, accept, or agree to accept any benefits for having exercised his/her official powers on behalf of a private donor or private organization or performed his/her official duties in favor of a private donor or private organization.

(f) The Commissioner of the Department of Assistive and Rehabilitative Services or the Assistant Commissioner for the Division for Early Childhood Intervention Services [ The Executive Director of the Council or an officer of the Council ] may be a non-voting member(s) of the board of directors of a private organization that exists to further the duties and purposes of the Department [ Council ].

(g) An [ officer or ] employee shall not authorize a private donor or private organization to use property of the Department [ Council ], unless the property is used in accordance with a contract or memorandum of understanding between the Department [ Council ] and the private donor or private organization, or the Department [ Council ] is otherwise compensated for the use of the property.

(h) The relationship between a private donor and a private organization and the Department [ Council ], including fundraising and solicitation activities, is subject to all applicable federal and state laws, rules and regulations, and local ordinances governing each entity and its employees.

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 13, 2006.

TRD-200603251

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


Chapter 108. EARLY CHILDHOOD INTERVENTION SERVICES

The Texas Health and Human Services Commission proposes the repeal and the amendment of the following sections of Title 40, Part 2, Chapter 108, of the rules of the Department of Assistive and Rehabilitative Services, pertaining to the Early Childhood Intervention Services. The following sections will be amended: §§108.21, 108.23, 108.25, 108.27, 108.29, 108.31, 108.33, 108.35, 108.37, 108.39, 108.43, 108.57, 108.59, 108.61, 108.63, 108.65, 108.85, 108.87, 108.89, 108.91, 108.221, 108.223, 108.225, 108.227, 108.229, 108.231, 108.233, 108.261, 108.263, 108.265, concerning Early Childhood Intervention Services. The following section will be repealed: §108.237, concerning Reviews and Administrative Hearings.

The repeal and amendments are being proposed to conform the rules pertaining to Early Childhood Intervention Services to the organizational and operational requirements of House Bill 2292, 78th Legislature, Regular Session, and to conform nomenclature used in the rules to that resulting from consolidation of Health and Human Services Agencies under the Texas Health and Human Services Commission.

In addition, the repeals and amendments accomplish the following:

--removes requirements that are now included in provider contracts,

--streamlines restrictions on physicals for referrals consistent with current law;

--removes a partial listing of eligible medical conditions to instead reference the complete list which is available on the Department of Assistive and Rehabilitative Services website and Appendix;

--adds a requirement from the IDEA reauthorization that transition planning meetings may not occur more than 270 days before the child's third birthday;

--provides for the loss of professional status for early intervention specialists who fail to report timely;

--allows in-house safety and sanitation inspections for non-consumer service areas;

--increases the dollar value threshold for equipment reporting;

--eliminates the requirement that a court reporter prepare a transcript for each hearing to instead require that the hearing be recorded and that a transcript be provided on request;

--revises the ECI Advisory Committee composition and duties, including: replacing legacy agencies with HHS Enterprise agencies, allowing the Governor to have a designee make appointments, aligning the committee's duties with federal requirements, and establishing standard grounds for removal of members who no longer meet qualifications;

--expands the qualifications for parent representatives on the ECI advisory committee to include parents of children with developmental delay, as well as those with developmental disabilities.

Bill Wheeler, Chief Financial Officer, Department of Assistive and Rehabilitative Services, estimates that for each year of the first five years that the repeal and amendments will be in effect, there will be no material fiscal implications for state or local government.

Mr. Wheeler also estimates that for each year of the first five years the repeal and amendments will be in effect, the public benefit anticipated as a result of adopting the proposed changes will be the agency's compliance with House Bill 2292, 78th Legislature, Regular Session, and other existing provisions of law pertaining to provision of health and human services in Texas. There should be no material economic cost to persons who are required to comply with the rules as proposed for repeal and amendment. There should be no material effect to small or micro businesses. In accordance with Government Code §2001.022, the Health and Human Services Commission has determined that the proposed repeal and amendments will not affect a local economy.

Comments on the proposal may be submitted to Roger Darley, Deputy General Counsel, Department of Assistive and Rehabilitative Services, 4800 North Lamar Boulevard, Suite 300, Austin, Texas 78756.

Subchapter A. EARLY CHILDHOOD INTERVENTION SERVICE DELIVERY

40 TAC §§108.21, 108.23, 108.25, 108.27, 108.29, 108.31, 108.33, 108.35, 108.37, 108.39, 108.43

The amendments are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§108.21.Purpose.

These sections are intended to implement the provisions of the Interagency Council on Early Childhood Intervention Act, Human Resources Code, Chapter 73, and the Individuals with Disabilities Education Act, Part C (20 U.S.C. Sections 1431-1444) [ (Public Law 105-17) ], which established a statewide system of early childhood intervention comprehensive services for children with developmental delay.

§108.23.Definitions.

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

(1) - (3) (No change.)

(4) Committee--Advisory Committee to the Department concerning early childhood intervention services [ Interagency Council on Early Childhood Intervention ]. Its functions are those of the Interagency Coordinating Council described in the Individuals with Disabilities Education Act, 20 U.S.C. Sections 1431-1444 [ Public Law 105-17 ].

(5) Complaint--A formal written allegation submitted to the department [ council ] stating that a requirement of the Individuals with Disabilities Education Act, or an applicable federal or state regulation has been violated.

(6) Comprehensive services--Individualized intervention services, as determined by the interdisciplinary team and listed in the Individualized Family Service Plan (IFSP). Services are further defined in §108.25(5)(C) - (E) [ §621.23(5)(C) - (E) ] of this title (relating to Service Delivery Requirements for Comprehensive Services). Programs receiving funds from the Department [ Interagency Council on Early Childhood Intervention ] are required to have the capacity to provide or arrange for all services listed in §108.25(5)(C) [ §621.23(5)(C) ] of this title (relating to Service Delivery Requirements for Comprehensive Services).

(7) Department [ Council ]--The entity designated as the lead agency by the governor under the Individuals with Disabilities Education Act , Part C . The department [ council ] has the final authority and responsibility for the administration, supervision, and monitoring of programs and activities under this system. The department [ council ] has the final authority for the obligation and expenditure of funds and compliance with all applicable laws and rules. [ The council board includes eight lay members who are family members of children with developmental delay, appointed by the governor with the advice and consent of the senate, and one member from the Texas Education Agency appointed by the commissioner of education. Five of the lay members must be the parents of children who are receiving or have received early childhood intervention services. The board shall also have fully participating, non voting representatives appointed by the commissioner or executive head of the following agencies: Texas Department of Health (TDH), Texas Department of Human Services (TDHS), Texas Department of Mental Health and Mental Retardation (TDMHMR), Texas Commission on Alcohol and Drug Abuse (TCADA), Texas Department of Protective and Regulatory Services (TDPRS), and the Texas Workforce Commission (TWC). ]

(8) - (11) (No change.)

(12) Family Educational Rights and Privacy Act of 1974 (FERPA)-- 20 U.S.C. Section 1232g; 34 CFR Part 99 - Federal law that outlines privacy [ Requirements for the ] protection for [ of ] parents and children enrolled in the ECI program. FERPA includes rights to [ under the General Education Provision Act, Section 438, which include ] confidentiality and restrictions on [ , ] disclosure of personally identifiable information, and the right to inspect records.

(13) - (22) (No change.)

(23) Provider--A local private or public agency with proper legal status and governed by a board of directors that accepts funds from the Department [ Interagency Council on Early Childhood Intervention ] to administer the Early Childhood Intervention (ECI) Program.

(24) Public agency--The Department [ Interagency Council on Early Childhood Intervention ] and any other political subdivision of the state that is responsible for providing early intervention services to eligible children under the Individuals with Disabilities Education Act, Part C.

(25) - (26) (No change.)

(27) Referral date--The date the child's name and sufficient information to contact the family was obtained by the agency receiving funds for ECI services from the Department [ Interagency Council on Early Childhood Intervention ].

(28) Service coordinator (case manager)--A staff person with a local ECI provider who is assigned to a child or family who is the single contact point for families, and who is responsible for assisting and empowering families to receive the rights, procedural safeguards, and services authorized by these rules and Department [ ECI ] policy and procedures. The service coordinator is from the profession most immediately related to the child's or family's needs. (The term profession includes service coordination.)

(29) Services--Individualized intervention services, as determined by the interdisciplinary team and listed in the IFSP. Services are further defined in §108.25(5)(C) - (E) [ §621.23(5)(C) - (E) ] of this title (relating to Service Delivery Requirements).

(30) - (32) (No change.)

(33) UGMS [ UGCMS ]--Uniform grant management standards adopted by the governor's Office of Budget and Planning in 1 TAC §§5.141 - 5.167 under the authority of Chapter 783, Government Code [ Texas Civil Statutes, Article 4413(32g) ].

§108.25.Service Delivery Requirements for Comprehensive Services.

Programs that receive Early Childhood Intervention (ECI) funds for comprehensive services must have written policies and procedures which are implemented and evaluated in each of the following areas.

(1) Client eligibility. The comprehensive program must have written criteria for determining infants and toddlers with disabilities and accepting them into the program.

(A) - (B) (No change.)

(C) Determination of eligibility shall be as follows.

(i) (No change.)

(ii) Children who have a medically diagnosed physical or mental condition that has a high probability of resulting in developmental delay must be determined eligible by identification of specific conditions with known etiologies and developmental consequences that are included in the list of covered medical conditions approved by the Department. [ , including, but not limited to: ]

[(I) Down syndrome and other chromosomal abnormalities;]

[(II) sensory impairments;]

[(III) inborn errors of metabolism;]

[(IV) microcephaly;]

[(V) failure to thrive;]

[(VI) seizure disorders; and ]

[(VII) fetal alcohol syndrome.]

(2) - (3) (No change.)

(4) Health admission requirement for comprehensive services.

(A) Each child must have an examination by a physician, physicians assistant, an advanced pediatric nurse practitioner or clinician, or a registered nurse in a public health clinic. [ The public health clinic may provide physical examinations by a physician who assumes the responsibility for the examination and agrees to be available routinely for consultation to nursing staff, ensures that the registered nurse has the training and adequate skills for performing the physical examination, and reviews periodically the level of performance of the registered nurses administering the physical examination. ]

(B) (No change.)

(C) Children who will be participating in any ECI group activities must have immunizations appropriate to the child's age as recommended by the Texas Department of State Health Services (DSHS) [ Health ]. If medical or religious reasons contraindicate immunization requirements, documentation to that effect must be maintained by the program and the family must be notified that their infant could be excluded from group activities if a contagious outbreak occurs.

(5) Individualized family service plan (IFSP). An IFSP must be developed for each child eligible for comprehensive services and the child's family. Services must be delivered in conformity with an IFSP.

(A) - (B) (No change.)

(C) Required early intervention comprehensive services. Individualized intervention services, as determined by the interdisciplinary team, must be provided under public supervision in all geographic areas of the state to meet the developmental needs of the child, and to address the resources, priorities, and concerns of the family related to enhancing the child's development. All services identified as needed for the child by the interdisciplinary team must be addressed in the IFSP. With concurrence of the family, all services identified as needed by the family may be addressed in the IFSP. The array of services must include, but is not limited to, the following:

(i) - (iii) (No change.)

(iv) developmental services [ special instruction ];

(v) - (xx) (No change.)

(D) Types of services. For the purpose of this chapter the following types of services apply.

(i) - (xi) (No change.)

(xii) Developmental [ Special instruction ] services include:

(I) - (IV) (No change.)

(xiii) - (xvi) (No change.)

(E) - (G) (No change.)

(H) Contents of the plan. Programs which receive funds from the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention ] must have a written IFSP for each child developed jointly by the interdisciplinary team including the child's parents.

(i) - (ii) (No change.)

(iii) The IFSP must include a statement of the major [ strategies and ] outcomes expected to be achieved for the child and family, strategies to be implemented and the criteria, procedures, and timelines used to determine:

(I) - (II) (No change.)

(iv) - (vii) (No change.)

(I) Transition. The IFSP must include the steps to be taken to support the transition of the child to public school preschool services (Part B of the Individuals with Disabilities Education Act), upon reaching the age of three, or to other services that may be available, if appropriate. The steps required include:

(i) - (iii) (No change.)

(iv) with the approval of the family, the convening of a conference among the local ECI provider [ lead agency ], the family, and the local educational agency at least 120 days , but no more than 270 days, before the child's third birthday , or, if earlier, the date on which the child is eligible for the preschool program under Part B of the Individuals with Disabilities Education Act to:

(I) - (II) (No change.)

(J) - (K) (No change.)

(L) Reimbursement for comprehensive service.

(i) All programs will be required to establish third-party billing systems, determine client eligibility for all third-party reimbursement sources, and complete and submit reimbursement requests to corresponding third-party sources, in accordance with clause (iii) of this subparagraph. Third parties include, but are not limited to, health maintenance organizations (HMOs), private insurance, Medicaid programs ( Texas Health Steps [ Early Periodic Screening, Diagnosis, and Treatment Program (EPSDT) ] and Targeted Case Management), Children's Health Insurance Program and the Children with Special Health Care Needs Program [ and the Chronically Ill and Disabled Children's Program ].

(ii) Certain [ All ECI-required comprehensive ] services must be available at no cost to families, including, but not limited to, child find, evaluation and assessment, service coordination, and administration and coordination related to the development, review, and evaluation of IFSPs. The determination of the duration, scope, and nature of the services provided will not be based on parental consent to the use of funding resources for which they may be eligible.

(iii) (No change.)

(iv) Programs will be required to encourage the family to apply for all applicable funding resources for which they are potentially eligible including, but not limited to, Medicaid and CHIP . No child may be denied services because of the family's refusal to apply for Medicaid or other funding resources for which they may be eligible.

§108.27.Program Administration for Comprehensive Services.

(a) (No change.)

(b) Program requirements.

(1) Child find. Each program must develop and implement a child find plan which includes:

(A) ongoing contact and coordination with primary referral sources and other service providers, including, but not limited to:

(i) - (v) (No change.)

(vi) child [ day ] care programs;

(vii) - (xi) (No change.)

(xii) any program funded under the Developmental [ Development ] Disabilities Assistance and Bill of Rights Act; and

(xiii) (No change.)

(B) - (C) (No change.)

(2) Required services. Each comprehensive program must provide an evaluation and assessment, service coordination, and Individualized Family Service Plan (IFSP) and comprehensive services. Each program funded by the Department for comprehensive ECI services and follow along [ Interagency Council on Early Childhood Intervention ] must have the capacity to provide or arrange for all services described in §108.25(5)(C) [ §621.23(5)(C) ] of this title (relating to Service Delivery Requirements for Comprehensive Services). All services which the child or family receives, regardless of the funding sources, must be considered toward meeting the service needs of the child as defined in the child's IFSP. No ECI funding can be used to arrange, provide, or duplicate a service for which other funding sources, public or private, are available and could be used.

(3) Public awareness. Each program must develop and implement a public awareness plan which includes:

(A) - (C) (No change.)

(D) Programs [ By September 1, 2001 programs ] must implement the use of the ECI logo and slogan and meet requirements listed in the ECI Graphic Standards Manual for all materials used by the ECI program for marketing, public awareness, child find, promotion, public education, and program correspondence related to the ECI program. Programs must use "ECI" as part of their program name.

(E) The ECI logo and slogan are for use by providers under contract with ECI or by entities not under contract when directed or authorized by the Department [ Interagency Council on Early Childhood Intervention ]. All use must be in accordance with the ECI Graphic Standards Manual.

(4) Interagency coordination. Each program must develop and implement an interagency coordination plan which includes , as a minimum , procedures to :

(A) - (D) (No change.)

(5) Staff composition and qualifications.

(A) - (C) (No change.)

(D) The [ As of September 1, 1995, the ] following qualifications and responsibilities apply to [ for ] EIS Professionals [ are effective ].

(i) (No change.)

(ii) Scope of responsibilities. Early Intervention Specialist Professionals (Entry Level and Fully Qualified EIS Professionals) may represent the discipline of early intervention and may be one of the two required professionals on an Interdisciplinary Team (IDT). EIS Professionals may conduct family intake processes, participate in determining eligibility, conduct developmental screenings , evaluations and assessments, participate in the development and implementation of Individualized Family Service Plans, and provide service coordination, developmental services [ special instruction ], and family education services.

(iii) Supervision. The Entry Level EIS Professionals must receive a minimum of one hour per week of direct supervision from a fully qualified professional until successful completion of [ they have successfully completed ] the requirements to be Fully Qualified EIS Professionals. The supervising professionals may be from any of the disciplines related to early intervention and must meet the highest state standards for their profession.

[(iv) EIS Professionals and Provisional EIS Professionals who were hired before September 1, 1995, and are currently employed in ECI-funded programs, who failed to complete the required application process are not considered EIS Professionals. They will no longer be able to independently perform the scope of responsibilities of EIS Professionals as defined in clause (ii) of this subparagraph. To obtain status as Fully Qualified EIS Professionals, they must enter the system as Entry Level EIS Professionals and complete the conditions defined in clause (v) of this subparagraph.]

(iv) [ (v) ] To [ Professional recognition for EIS Professionals hired after September 1, 1995. Persons hired as EIS Professionals after September 1, 1995, who are not Fully Qualified EIS Professionals are identified as Entry Level EIS Professionals and to ] be recognized as a Fully Qualified EIS Professional an individual [ Professionals ] must:

(I) meet the educational requirements of a bachelor's degree which includes a minimum of 18 hours of course credit relevant to early intervention service provision and submit a statement of intent to complete the required demonstrations of early intervention knowledge and skills and apply for full professional recognition;

(II) within nine months of [ their hiring ] date of hire , submit a progress report of the demonstration of early intervention knowledge and skills signed [ completed ] by an [ their ] ECI program director and supervisor;

(III) within two years of [ their hiring ] date of hire , complete the Competency Demonstration System [ required demonstrations of early intervention knowledge and skills ] and submit documentation to the state office; and

(IV) complete the required processes in subclauses (I) and (II) of this clause, or lose professional status and privileges. Loss of professional status means the individual will [ If the required processes are not completed as specified in subclauses (I) - (III) of this clause; they will ] no longer be able to independently perform the scope of responsibilities of an EIS Professional [ Professionals ] as defined in clause (ii) of this subparagraph.

(v) [ (vi) ] Continuing professional education requirements. EIS Professionals must meet annual continuing professional education requirements to maintain their status. Continuing professional education consists of the planned individual learning experiences as described in the EIS Professional's annual Individual Professional Development Plan (IPDP) which shall include completion of a minimum of ten contact hours of approved continuing professional development education experiences.

(vi) [ (vii) ] EIS Professionals must submit annually the record of their continuing education on or before the anniversary of the certificate date. Failure to submit the record of continuing education by the anniversary date will result in a loss of professional status and privileges.

(vii) [ (viii) ] Registry. The Department [ Texas Interagency Council on Early Childhood Intervention ] shall issue certificates of recognition to and maintain a registry of individuals who are enrolled in and successfully complete the requirements to be Fully Qualified EIS Professionals.

(viii) [ (ix) ] Grievance process. Each local agency shall have a procedure for local resolution of personnel grievances. A party who has a disagreement with the local decision regarding his qualifications or status as an EIS Professional shall have an opportunity for dispute resolution at the local level. Agencies may use existing personnel grievance procedures to resolve disagreements and will inform their staff of their existence.

(ix) [ (x) ] Complaints. Any individual or organization may file a complaint with the Department [ Council ] alleging that a requirement of the applicable federal and/or state regulations has been violated as provided in §108.59 [ §621.43 ] of this title (relating to Confidentiality).

(E) The director of the local ECI program must provide and document the amounts of appropriate supervision for all ECI contract staff and program staff to ensure the philosophy and intent of these regulations are met as adopted by the Department [ Interagency Council on Early Childhood Intervention ].

(F) (No change.)

(6) (No change.)

(7) ECI child service standards.

(A) (No change.)

(B) Programs which provide child care as defined by the Texas Department of Family and Protective Services (DFPS) [ Human Services (TDHS) ] must meet licensing standards of DFPS [ TDHS ].

(8) Child health standards. Programs that receive ECI funds must have written policies and procedures which are implemented and evaluated in each of the following areas.

(A) (No change.)

(B) Infectious disease prevention and management.

(i) All programs must adhere to the procedures of the universal precautions for the Texas Early Childhood Intervention Program, as issued by the Department [ council ].

(ii) All programs must comply with the Texas Communicable Disease Prevention and Control Act, Chapter 81, Health and Safety Code [ Texas Civil Statutes, Article 4419b-1 ].

(iii) (No change.)

(C) (No change.)

(9) Safety regulations regarding emergencies for all buildings where ECI programs are housed. Programs that receive ECI funds must have written policies and procedures which are implemented and evaluated [ in the following areas ].

(10) Accessibility and safety. Programs that receive ECI funds must have written policies and procedures which are implemented and evaluated in the following areas.

(A) (No change.)

(B) Buildings where the ECI program is housed (including offices) must be inspected annually by a local or state fire authority. A safety and sanitation inspection must be completed annually [ by an entity outside of the ECI program using an approved ECI checklist ]. If the fire or safety and sanitation inspection indicates that hazards exist, these hazards must be corrected.

(C) - (E) (No change.)

(11) - (12) (No change.)

(13) Staff health regulations. Programs that receive ECI funds must have written policies and procedures which are implemented and evaluated [ in the following areas ].

(14) (No change.)

(15) Data collection and reporting. The provider shall collect and report data as required by [ council ] rules, the contract, and applicable instruction manuals. Reports shall be submitted in the form, manner, and timeframe specified by the department [ council ]. Required data may include, but is not limited to: client data, including personally identifiable information regarding children served or referred; services received by individual eligible children; family information, including family size and income; service provider information, including information about individual employees or subcontracted employees of the provider; agency and ECI program revenue and expenditure information; and any other information that might be necessary by the department [ council ] to perform their legally authorized functions, including the documentation of services planned and provided, billing and reimbursement functions, and other purposes.

(16) The Texas Kids Intervention Data System (TKIDS) [ (T-KIDS) ] and ECI data standards, established by the department [ council ] under Texas Human Resources Code §73.0051(k), shall be used by ECI providers to submit client and services information to the department [ council ]. [ The data standards and reporting requirements, including reporting deadlines, will be established with local provider input and will be published annually and disseminated to providers. The council may approve changes to the data standards or requirements outside of this process when necessary for efficient implementation of data collection. ]

§108.29.Application and Program Requirements for Comprehensive Services.

(a) Proposal format. The department [ council staff ] shall [ annually ] disseminate a funding application. [ document entitled "Funding Application." ] Copies are available upon request from the Department of Assistive and Rehabilitative Services (DARS), Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention (council), 4900 North Lamar Boulevard, Austin, Texas 78751-2399 ].

(b) Application content. The application shall consist of the forms and related material that the applicant shall complete to apply to receive funding for performing program services. Applications must be submitted for a [ one-year ] period specified in the funding application instructions [ unless the Funding Application Instructions specify otherwise ].

(c) (No change.)

(d) Program income.

(1) Program income is defined as all revenue directly generated by ECI contract-supported activities or earned only as a result of the ECI contract. It includes, but is not limited to, Medicaid Targeted Case Management (TCM), Medicaid Texas Health Steps/Comprehensive Care Program (THSteps/CCP), Medicaid Administrative Claiming (MAC), Children's Health Insurance Program (CHIP), Children with Special Health Care Needs (CSHCN) funds, and private insurance , and family cost share revenue .

(2) Program income also includes proceeds from the sale of equipment and [ or ] income collected by a subcontractor on behalf of the provider from Medicaid, CHIP or private insurance and accepted as payment in full for ECI services.

[(3) Program income excludes third party revenue generated from Developmental Rehabilitation Services (DRS).]

(3) [ (4) ] All program income collected by the ECI program must be reported and used for eligible ECI program expenditures.

(4) [ (5) ] Program income claims, collections, uncollected amounts, and prior year collections must be reported cumulatively by source on quarterly and annual financial reports. The ECI provider is accountable for and must report total program income on an accrual basis by the date of service. Program income earned during the state fiscal year ending August 31 and collected no later than October 31 of the following fiscal year must be used for allowable program expenses in the fiscal year in which the service was provided and the revenue was earned.

(5) [ (6) ] Interest earned on program income will be used to supplement the funds already committed to the program.

(6) [ (7) ] Cumulative collections are total program income received from current fiscal year claims. Cumulative uncollected program income is income not received for the current fiscal year cumulative claims. Accrued revenues must [ should ] be adjusted through periodic write-off of uncollectible amounts.

(e) Maintenance of Effort

(1) (No change.)

(2) The ECI provider's MOE may include, if applicable and allowable, the following:

(A) - (C) (No change.)

(D) Program income including [ and/or ] third party reimbursements.

(3) (No change.)

(4) Providers that have not previously contracted with the department [ council ] will be expected to achieve the MOE level as designated in their contract.

(5) Each program that has previously contracted with the department for ECI services [ council ] is required to budget and expend at least the same amount of MOE, [ from each revenue source other than program income and in-kind and cash contributions, ] as was actually expended [ from that source ] in the preceding fiscal year, and as specified in their approved funding application and contract.

(A) To determine the amount of MOE which must be maintained, subtract the ECI contract funds, program income, [ and ] in-kind contributions and unsolicited cash contributions from the total revenue [ program costs ] used for [ the ] ECI program expenditures . The remaining funding, known as the "effective MOE," must meet or exceed the previous year's expenditure level [ by specific source of funds ].

(B) (No change.)

(6) MOE will be reviewed by the department [ council ] and the provider's independent [ external ] auditor to ensure that the effective MOE is maintained at the appropriate level.

(A) ECI providers will report program revenue and expenditures by funding source on annual financial reports submitted to the department [ council ]. The department [ council ] will review MOE reporting throughout the year and as part of the final closeout process and follow up with providers to resolve any concerns about compliance with this policy. Settlement related to MOE shortages will be required prior to the closeout for each contract year.

(B) (No change.)

(7) The department [ council ] may make exceptions to the requirement that effective MOE must be maintained at a level equal to or above the level of that source in the previous year as a result of:

(A) (No change.)

(B) Unusually large amounts of funds [ Funds ] expended for long-term purposes such as the acquisition of equipment [ or the construction of facilities ];

(C) - (D) (No change.)

(8) Increases in program income revenues from one fiscal year to the next cannot be used to supplant other effective MOE funding sources. Supplanting is defined as the withdrawal of local, private, or other public funds for services that were available during the previous year of funding. All program income collected by the ECI program must be reported and used for eligible ECI program expenditures. [ Increases in one revenue source used as MOE cannot be used to replace, supplant or reduce the revenue obligation of another MOE source. ]

(9) Voluntary displacement of MOE funds is not allowed. Redistribution, reallocation or removal of a specific revenue source is only acceptable if the net amount of effective MOE is maintained [ prohibited unless the revenue source is discontinued, decreased, or no longer available to the provider ].

(f) Allowable costs. The following is intended to be a summary of the most frequently requested allowable costs, and should not be construed to be complete. Exclusion of a particular item from the allowable list does not necessarily mean it is unallowable. All costs to be reimbursed by ECI or applicant share must go exclusively for conducting the program. A complete list of expenditures is listed in the Uniform Grant Management Standards (UGMS):

(1) - (4) (No change.)

(5) equipment--tangible nonexpendable personal property with an acquisition cost of $5,000 [ $1,000 ] or greater per unit and a useful life of more than one year[ , with the following exceptions: facsimile machines, stereo systems, still and video cameras, VCRs and VCR/TV combinations, microcomputers, printers, and digital cameras. These items will be considered equipment if their unit cost is $500 or greater ].

(6) "Other expenses," such as:

(A) (No change.)

(B) depreciation--allowable whenever real or personal property are used for the benefit of the program with department [ council ] staff approval;

(C) - (E) (No change.)

(F) taxes--allowable only for those taxes which the ECI provider is required to pay for employment services, travel, renting, or purchasing for the program;

(G) - (L) (No change.)

(g) Unallowable costs.

(1) The following is intended to be a summary of the most frequently requested unallowable costs, and should not be construed to be complete. Exclusion of a particular item from the unallowable list does not necessarily mean it is allowable.

(A) - (F) (No change.)

[(G) Interest and other financing costs;]

(G) [ (H) ] Legislative expense;

(H) [ (I) ] Under recovery of costs under grant agreements;

(I) [ (J) ] Fund-raising expenses and investment management costs;

(J) [ (K) ] purchase of vehicles;

(K) [ (L) ] lobbying; and

(L) [ (M) ] Other costs not included in the approved ECI budget.

(2) (No change.)

§108.31.Financial Management and Recordkeeping Requirements.

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

(c) Reports and data submission.

(1) All providers will be expected to submit [ enrollment and service delivery information on a monthly basis, ] quarterly and final financial [ and program performance ] reports by the specified date and in the specified format[ , and must participate in the Texas Kids Intervention Data System as specified in §621.23 (15) of this title (relating to Service Delivery Requirements for Comprehensive Services) ].

(2) The department [ council ] will establish monthly, quarterly and final report deadlines at the beginning of each fiscal year and will notify providers in their contract.

(3) The department [ council ] is authorized to withhold payment and return vouchers to any provider whose reports are delinquent.

(d) Record Availability and Review [ Reviews ].

(1) Program review.

(A) DARS [ The council ] staff will conduct reviews of providers to determine compliance with the contract and evaluate the work performed by the ECI program. These include desk reviews and on-site reviews.

(B) Program review will include a review of policies and procedures, individual records of services provided to children and families, documentation of data submitted to DARS [ the council ], contact with parents, staff, community members, fiscal records, and documentation of other requirements of the ECI contract, rules, and policies.

(2) Financial review. DARS [ The council ] staff will conduct a financial review to ascertain that program costs are:

(A) - (D) (No change.)

(3) Record availability. Providers and subcontractors shall make all [ All ] records , books and documents [ shall be made ] available to the department's [ council's ] monitoring teams.

(e) Audit requirements. Providers shall have a financial audit of the ECI program performed by an independent certified public accountant (CPA) or other independent public accountant licensed by the Texas State Board of Public Accountancy for those fiscal years that include any portion of an ECI contract period. A copy of this audit must be sent to the department [ council ] within the earlier of 30 days after receipt from the independent CPA, or nine months after the end of the audit period, unless a longer period is agreed to in advance by the department [ council ] or a different period is specified in a program-specific audit guide.

§108.33.Funding Application Submission and Review.

(a) Submission of application.

(1) Applications are deemed received when logged by the department [ council ]. The department [ council ] staff will review each application to ensure that all parts of the proposal are included.

(2) (No change.)

(3) A completed original and one copy [ two copies ] of the application shall be submitted to Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention ], 4900 North Lamar Boulevard, Austin, Texas 78751-2399.

(4) - (5) (No change.)

(b) Review of Application(s). A "Request for Proposal" (RFP) process may be used to ensure that the department [ council ] is obtaining the best value in purchasing services. [ The council staff will be responsible for making recommendations to the board for approval or denial of all requests. ]

§108.35.Contract Award.

(a) Following the review process, the department [ board ] will [ meet to ] approve funding recommendations. Each applicant will be notified in writing of the department's [ board's ] decision. The reason for a denial will be communicated in writing to the applicant.

(b) (No change.)

§108.37.Contract.

(a) An approved provider will enter into a contract with the Department of Assistive and Rehabilitative Services (DARS), Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention (council) ] prior to being allocated funds. A contract is not fully executed until it has been signed by the department [ council ] and the provider.

(1) The department [ council ] shall send the provider two original contracts [ signed by the council ]. Both copies of the contract must be signed by an official authorized to enter into such agreements on behalf of the governing body. One copy shall be submitted to the department [ council ] before the start of the contract period and the other shall be maintained by the organization.

(2) The original contract cannot be altered by the ECI provider without department [ council ] consent. This consent can only be evidenced by authorized officials of both parties initialing and dating the change.

(3) (No change.)

(4) By signing the contract the provider agrees to all terms included therein and to adherence with all applicable statutes, rules, policies and procedures of the department [ council ], including subsequent amendments.

(b) The contract shall:

(1) contain provisions requiring the provider to comply with the requirements in these sections, including statutes, rules, policies and procedures of the department [ council ], including subsequent amendments, and the fiscal requirements on the administering, accounting, auditing, and recovering of funds as authorized by the Uniform Grant Management Standards (UGMS);

(2) (No change.)

(3) authorize the department [ council ] to impose sanctions for noncompliance with contract terms and conditions, statutes, rules, and department [ council ] policies and procedures in accordance with the provisions of the Human Resources Code, §73.0051;

(4) - (5) (No change.)

(6) authorize the department [ council ] to adjust the contract amount [ without board approval ] when the number of enrolled children on which the budget was based increases or decreases by a specified percentage or number of children . [ , and ]

[(7) require the provider to notify the council by January 31st of its intent to withdraw as a provider in the next fiscal year.]

(c) (No change.)

(d) The contract shall be concurrent with the current fiscal year, unless the department [ board ] approves partial year funding due to extenuating circumstances.

(e) Program and fiscal findings documented in department [ council ] monitoring or other reports must be cleared in accordance with the department [ council ] policies, provisions in the UGMS and within the time frame specified in the monitoring or other report.

(f) The contract shall identify the county(ies) in which the provider is authorized to perform ECI services and reference the service area approved by the Assistant Commissioner [ council staff ] within the county(ies).

(1) All requests to change the approved service area must be reviewed and approved by the department [ council ] staff.

(2) The department [ council ] will not incur additional expenses for the provision of the same level of services for the same number of children as a result of a request to change a service area.

(3) A request to change the designated service area must be either made during the annual contracting process or be submitted to the ECI Assistant Commissioner [ award process or at a regularly scheduled board meeting ].

§108.39.Contract Actions.

The Department [ Interagency Council on Early Childhood Intervention (council) ] may take the following actions with respect to a contract with a provider:

(1) (No change.)

(2) Withhold or reduce payments. The department [ council ] may withhold or reduce payments to offset any reimbursement made to the provider for any ineligible expenditures not refunded to the department [ council ] by the provider, or for services that are covered by Medicaid. The department [ council ] may withhold or reduce payments for noncompliance issues including, but not limited to, the following: failure to submit required program and financial reports, including failure to submit TKIDS [ T-KIDS ] data, by specified timelines; failure to respond to required corrective actions resulting from monitoring activities; failure to submit independent audit reports as required by applicable OMB Circulars; and failure to meet program requirements as specified in the contract, regulations or policies.

(3) Revise contract terms and provisions. The department [ council ] may revise contract terms and provisions to accomplish objectives including, but not limited to, the following: establishing additional prior approvals for expenditure of funds by the provider; reducing the contract amount for failure to achieve or maintain the proposed level of service; expending funds appropriately; or providing services as set out in the contract.

(4) Non-renewal of contract after contract term. The department [ council ] may choose not to issue another contract with a provider after the contract term expires.

(5) Terminate all or part of the contract.

(A) If the department [ council ] determines that the provider is not, or has not been, in substantial compliance with the contract provisions, applicable federal or state law or regulations, ECI Policies and Procedures, Uniform Grant Management Standards (UGMS) or applicable OMB circulars, the department [ council ] may propose to terminate part or all of the contract before the term of the contract expires.

(B) If the department [ council ] proposes to terminate the contract, the department [ council ] shall notify the provider in writing of the reasons for the proposed termination and give the provider an opportunity to contest the proposed action through a formal hearing. The hearing shall be in accordance with the hearing procedures in §108.41 [ §621.31 ] of this title (relating to Formal Hearing Procedures). The provider may request a hearing by giving written notification to the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention ], 4900 North Lamar Boulevard, Austin, Texas 78751-2399. Any questions which the provider might have concerning the proposed action shall be addressed to the Assistant Commissioner of ECI [ council's executive director ].

(C) The provider has 10 days from the date of the receipt of the notice of proposed termination to request a hearing on a proposed termination under subparagraphs (A) and (B) of this paragraph. If the provider does not request a hearing in writing within the 10-day period, the provider shall be deemed to have waived the hearing and the department [ council ] will proceed to terminate the contract.

(D) Between the time a provider files a request for a hearing and the final decision of the department [ board ], any funds eligible for distribution may be retained at the sole discretion of the department [ board ]. In the event the department's [ board's ] final decision is favorable to the provider, the eligible funds shall be promptly distributed to the provider. In the event the department's [ board's ] final decision is adverse to the provider, the funds may be withheld.

(E) No contract will be terminated prior to the final decision of the department [ board ] following a hearing provided under these sections if such a hearing is requested.

(6) (No change.)

§108.43.Waiver of Program Standards for All ECI Providers Funded by the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention ].

(a) When under an unusual circumstance, a provider funded by the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention ] wishes to request approval of a waiver from adherence to an Early Childhood Intervention (ECI) policy, the provider must submit to the ECI Assistant Commissioner [ assigned program or fiscal consultant ] a written request which includes the following:

(1) - (5) (No change.)

(b) The appropriate consultants will review the request and forward a recommendation within 10 working days to the Assistant Commissioner [ ECI executive director ] for assignment to the waiver review committee.

(c) (No change.)

(d) The waiver review committee will consist of the Assistant Commissioner for Early Childhood Intervention Services, the designated representative of the Assistant Commissioner [ ECI program executive director, the ECI board chairperson, the director of the Provider Relations Division of the ECI Program ], and any other person appointed by the Assistant Commissioner [ executive director ]. The recommendation of the waiver committee will be presented to the department [ at the next scheduled board meeting for full board review. All decisions will be made by majority vote ].

(e) The program requesting the waiver will be informed of the date of the waiver committee and department [ council ] meetings and invited to attend. Attendance is not expected or required.

(f) The program requesting the waiver will be notified by mail within five working days of the department's [ council's ] decision, including the effective date of the decision.

(g) - (h) (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 13, 2006.

TRD-200603252

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


Subchapter B. PROCEDURAL SAFEGUARDS AND DUE PROCESS PROCEDURES

40 TAC §§108.57, 108.59, 108.61, 108.63, 108.65

The amendments are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§108.57.Early Childhood Intervention [ Council ] Procedures for Resolving Complaints.

(a) An individual or organization may file a complaint with the Department of Assistive and Rehabilitative Services (DARS), Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention (council) ] alleging that a requirement of the Individuals with Disabilities Education Act, Part C (Act) or applicable federal and/or state regulations has been violated. The complaint must be in writing, be signed, and include a statement of the facts on which the complaint is based.

(b) A complaint may be filed directly with the department [ council ] without having been filed with the local provider.

(c) Procedures for receipt of complaint are as follows.

(1) All complaints received by the department concerning ECI services [ council ] shall be forwarded to the Assistant Commissioner, Division for Early Childhood Intervention Services [ deputy executive director ]. The Assistant Commissioner [ deputy executive director ] will log and assign all complaints, monitor the resolution of those complaints, and maintain a copy of all complaints for a five-year period.

(2) The department [ council ] will have the following information entered in the data file: name of complainant, name of program if applicable, date received, type of complaint, action taken, followup, and case-closed date. Letters of acknowledgment will be mailed by the Assistant Commissioner [ deputy executive director ] to the program and to the complainant or to the third party if the complaint was forwarded by someone other than the complainant, such as the governor's office.

(3) - (4) (No change.)

(d) Procedures for investigation and resolution of complaints.

(1) After receipt of the complaint, the Assistant Commissioner [ deputy executive director ] will assign a staff person to conduct an individual investigation, on-site if necessary, to make a recommendation to the Assistant Commissioner [ executive director ] for resolution of the complaint.

(A) - (B) (No change.)

(2) Within 60 days of the receipt of the complaint the Assistant Commissioner [ executive director ] must resolve the complaint.

(3) (No change.)

(4) Complainants shall be informed in writing of the final decision of the Assistant Commissioner [ executive director ] and of their right to request the secretary of the United States Department of Education to review the final decision of the executive director. The Assistant Commissioner's [ executive director's ] written decision to the complainant will address each allegation in the complaint and contain:

(A) - (B) (No change.)

(5) To ensure that effective implementation of the Assistant Commissioner's [ executive director's ] final decision, the Assistant Commissioner [ deputy executive director, ] will assign a staff person to provide technical assistance and appropriate followup to the parties involved in the complaint to achieve compliance with any corrective actions when necessary.

(6) In resolving a complaint in which it finds a failure to provide appropriate services, the Assistant Commissioner [ executive director ] will remediate the denial of those services, including, as appropriate, the awarding of monetary reimbursement or other corrective action appropriate to the needs of the child and the child's family; and appropriate future provision of services for all infants and toddlers with disabilities and their families.

(7) When a complaint [ compliant ] is filed, the Assistant Commissioner, Division for Early Childhood Intervention Services [ deputy executive director ] will offer mediation services as an alternative to proceeding with the complaint investigation. Mediation may be used when both parties agree. A parent's right to a due process hearing or complaint investigation will not be denied or delayed because they chose to participate in mediation. The complaint investigation will continue and be resolved within 60 days even if mediation is used as the resolution process.

§108.59.Confidentiality.

The department [ council ] and each ECI program providing comprehensive services have the following responsibilities in regard to confidentiality of information.

(1) Notice to parents.

(A) The department [ council ] shall develop a document which is adequate to fully inform parents about the following requirements:

(i) (No change.)

(ii) a description of the children on whom personally identifiable information is maintained, the types of information sought, the methods the department [ council ] intends to use in gathering the information (including the sources from whom information is gathered), and the uses to be made of the information;

(iii) - (iv) (No change.)

(B) (No change.)

(2) Confidentiality and procedural safeguards. Each program shall distribute the document developed by the department [ council ] to all parents and ensure that they are fully informed about requirements related to confidentiality and procedural safeguards.

(3) Access rights.

(A) The parents of a child eligible under this chapter must be afforded the opportunity to inspect and review any Early Childhood Intervention (ECI) records relating to evaluations and assessments, eligibility determination, development and implementation of Individualized Family Service Plan (IFSPs), individual complaints dealing with the child, and any other area under this part involving records about the child and the child's family. Records are the records covered by the Family Educational Rights and Privacy Act of 1974, Title 20, United States Code Annotated, section 1232g [ §123g ]. Any participating agency, institution, or program which collects, maintains, or uses personally identifiable information [ of ] from which information is obtained for the purpose of determining eligibility for or providing early intervention services will be subject to these provisions. The program shall comply with a request without unnecessary delay and before any meeting regarding an IFSP or hearing relating to the identification, evaluation, or placement of the child, and in no case, more than 45 days after the request has been made.

(B) - (C) (No change.)

(4) - (11) (No change.)

(12) Consent.

(A) (No change.)

(B) A provider may request that parents provide a release to share information with others for legitimate purposes. However, when such a release is sought:

(i) - (iv) (No change.)

(v) the release must be time-limited not to exceed one year; and

[(vi) for the purpose of eligibility screening, as a part of the Texas Eligibility Screening System (TESS), parents may consent to any information entered in the TESS system being released for a three-year period. Parents must be informed that participation in TESS is voluntary and their decision to participate shall have no effect on their ECI eligibility or service provision; and]

(vi) [ (vii) ] if the parent refuses to consent to the release of all or some personally identifiable information, the program will not release the information.

(C) (No change.)

(13) - (17) (No change.)

§108.61.Primary Referral Requirements.

All primary referral sources must refer a child under age three who may be in need of and/or qualify for comprehensive early intervention services. Referrals must be within two working days of identification, and must be made to a contracted provider for evaluation and assessment of the child. Primary referral sources include:

(1) - (3) (No change.)

(4) child [ day ] care programs;

(5) - (8) (No change.)

§108.63.Administrative Hearings Concerning Individual Child Rights.

(a) Purpose. This section is intended to bring the procedures for hearings of the department [ council ] into compliance with Part C of the Individuals with Disabilities Education Act, and the applicable federal regulations, 34 Code of Federal Regulations §303.1 et seq. This section supplements existing department [ council ] rules governing hearings and is intended to be applied together except where a conflict exists, in which case this section shall prevail.

(b) Definition. The term "public agency," when used in this section refers to the department [ council ] and any other political subdivision of the state responsible for providing early childhood services to eligible children and their families.

(c) (No change.)

(d) Request for hearing.

(1) (No change.)

(2) The request for hearing shall be in writing and filed with the ECI Assistant Commissioner [ council ]. The request for hearing shall be deemed filed when actually received by the ECI Assistant Commissioner [ council ].

(e) Impartial hearing officer.

(1) Hearings shall be conducted by an impartial hearing officer appointed by the ECI Assistant Commissioner [ Early Childhood Intervention (ECI) executive director ]. The hearing officer shall be a person who is licensed to practice law in the State of Texas, and who:

(A) - (D) (No change.)

(2) The person shall not be an employee of the department [ council ] or any program involved in the provision of services or care to the child or the child's family, or have a personal or professional interest which would conflict with his or her objectivity in the hearing.

(3) (No change.)

(f) (No change.)

(g) Hearing procedures.

(1) - (3) (No change.)

(4) The hearing shall be recorded by the hearing officer. A transcript of the recording will be provided to the parties upon request. [ a reporter who shall immediately prepare and transmit a written or electronic verbatim record of the evidence to the hearing officer with copies to the parties. The hearing officer shall instruct the reporter and the parties to delete all personally identifiable information from the transcription and from all evidence submitted. ]

(5) The hearing officer may issue subpoenas and commissions to take depositions pursuant to the Government Code, Chapter 2001. Subpoenas and commissions to take depositions shall be issued in the name of the department [ council ].

(6) - (7) (No change.)

(h) - (i) (No change.)

§108.65.Opportunities for Citizen Participation.

In addition to other procedures listed in §101.5607 [ §621.5 ] of this title (relating to Public Participation) and in §108.63 [ §621.46 ] of this title (relating to Administrative Hearings Concerning Individual Child Rights), citizens, including individuals with disabilities and parents of infants and toddlers with disabilities have the opportunity to:

(1) Participate [ voice concerns ] through [ public ] representation on the ECI Advisory Committee [ and board ];

(2) Attend and make public comments at ECI Advisory Committee meetings (notification of all Advisory Committee meetings and agenda items are published in the Texas Register ) [ attend and make public comments at board meetings (notification of all board meetings and agenda items are published in the Texas Register ) ];

(3) attend DARS Council meetings and provide public comment on all proposed rules; and

(4) submit a petition requesting the adoption of rules.

(A) All petitions proposing the adoption of [ ECI ] rules shall be submitted in writing to the Commissioner [ ECI executive director ]. The petition shall contain the following:

(i) - (iii) (No change.)

(B) Requests will be reviewed by the Department [ ECI ] staff and recommendation for action will be presented to the Commissioner [ board ] for action.

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 13, 2006.

TRD-200603253

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


Subchapter C. EARLY CHILDHOOD INTERVENTION ADVISORY COMMITTEE

40 TAC §§108.85, 108.87, 108.89, 108.91

The amendments are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§108.85.Purpose.

The purpose of these sections is to establish the size, composition, terms of office, duties, and procedures of an advisory committee to assist the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention board ] in its duties. The sections implement the provisions in:

(1) the Human Resources Code, §73.004, concerning an advisory committee to assist the department [ board ]; and

(2) the federal regulations covering an advisory committee to the department [ board ] in 34 Code of Federal Regulations, Part 303, Subpart G.

§108.87.Size, Composition, and Terms of Office.

(a) Size. The advisory committee shall consist of 24 members which the governor , or the governor's designee, shall appoint.

(b) Composition. The advisory committee shall be composed as follows.

(1) Official members must include:

(A) at least seven parents, including minority parents of infants or toddlers with developmental disabilities or delays or children with developmental disabilities or delays aged 12 or younger, with knowledge of, or experience with, programs for infants and toddlers with developmental disabilities. At least one such member shall be a parent of an infant or toddler with a developmental disability or delay or a child with a developmental disability or delay aged six or younger, and no parent may be an employee of an early childhood intervention funded program;

(B) - (D) (No change.)

(E) at least one representative from each of the following agencies and public program: the Health and Human Services Commission, The Department of Assistive and Rehabilitative Services, the Department of Aging and Disabled Services, the Department of State Health Services, the Department of Family and Protective Services [ the Texas Department of Public Health; the Texas Department of Mental Health and Mental Retardation; the Texas Department of Protective and Regulatory Services ]; the Texas Education Agency; the Texas Department of Insurance; the Texas Workforce Commission and Head Start. The representative must have sufficient authority to engage in policy planning and implementation on behalf of his or her agency. The Texas Education Agency representative must be responsible for preschool services to children with disabilities;

(F) - (H) (No change.)

(2) Ex officio members may be appointed by the department [ Board ] to perform specific, time-limited tasks as needed. The department [ Board ] determines voting status of ex officio members.

(c) - (d) (No change.)

§108.89.Advisory Committee Duties.

(a) The advisory committee shall:

(1) advise and assist the Department of Assistive and Rehabilitative Services, Division for Early Childhood Intervention Services [ Interagency Council on Early Childhood Intervention board ] in the development and implementation of the policies that constitute the statewide ECI system;

(2) advise and assist the state educational agency regarding appropriate services and the transition of toddlers with developmental disabilities to services provided under IDEA [ Public Law 102-119 ], Part B, 20 U.S.C. Sec. 1411 - 1419 to the extent such services are appropriate;

[(3) advise and assist the board and TEA regarding the provision of appropriate services for children aged birth to five, inclusive;]

(3) [ (4) ] assist the department [ council ] in achieving the full participation, coordination, and cooperation of all appropriate public agencies in the state; and

(4) [ (5) ] assist the department [ board ] in the effective implementation of the statewide system, by establishing a process that includes:

(A) seeking information from service providers, case managers (service coordinators [ coordinator ]), parents, and others about any federal, state, or local policies that impede timely service delivery; and

(B) taking steps to ensure that any [ identified ] policy problems identified in subparagraph (A) of this paragraph are resolved; and

(5) [ (6) ] to the extent appropriate, assist the department [ board ] in the resolution of disputes.

(b) The advisory committee shall advise and assist the department [ board ] in the:

(1) - (3) (No change.)

(c) The advisory committee shall advise and assist the department [ board ] in the preparation of applications under this chapter, and amendments to those applications.

(d) The advisory committee shall:

(1) with assistance from the department [ board ] prepare an annual report to the governor and to the secretary of the United States Department of Education (secretary) on the status of early intervention programs operated within the state for children eligible under this chapter and their families; and

(2) (No change.)

(e) (No change.)

(f) The committee may advise and assist the department and the Texas Education Agency regarding the provision of appropriate services for children aged birth to five, inclusive.

§108.91.Advisory Committee Procedures.

(a) Notice, frequency, and location of meetings.

(1) All advisory committee meetings are subject to the Government Code, Chapter 551 [ (Code) ]. Written notice of the date, time, place, and subject of each meeting shall be posted with the Texas Register Division, secretary of state's office, as required by the Code.

(2) The Assistant Commissioner [ executive director, Early Childhood Intervention Program, ] shall send a copy of the notice of each meeting to each advisory committee member at least one week prior to the meeting.

(3) Meetings will be held at least quarterly and generally will be held in Austin.

(b) - (g) (No change.)

(h) Absences from meetings. The Department of Assistive and Rehabilitative Services [ Interagency Council on Early Childhood Intervention ] may recommend to the governor the removal of any advisory committee member who is absent from more than half of the regularly scheduled meetings of the advisory committee that the member is eligible to attend during each calendar year or is absent from more than two consecutive regularly scheduled meetings that the member is eligible to attend.

(i) Eligibility. Official members must maintain the qualification for appointment specified in §108.87 of this title (relating to Size, Composition, and Terms of Office). The Chair shall notify the ECI Assistant Commissioner of the need to request a replacement appointed by the Governor. An official member's position becomes vacant if the member no longer meets the qualifications for appointment.

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 13, 2006.

TRD-200603254

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


Subchapter D. GENERAL PROVISIONS FOR CASE MANAGEMENT SERVICES FOR INFANTS AND TODDLERS WITH DEVELOPMENTAL DISABILITIES

40 TAC §§108.221, 108.223, 108.225, 108.227, 108.229, 108.231, 108.233

The amendments are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§108.221.Introduction.

Targeted Case Management Services for Infants and Toddlers with Developmental Disabilities are included in the Texas Medical Assistance Program (Medicaid). The general operation of the Texas Early Childhood Intervention (ECI) program is governed by the Department of Assistive and Rehabilitative Services [ Texas Interagency Council on Early Childhood Intervention Services ].

§108.223.Definitions.

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise:

(1) (No change.)

(2) Department [ Board ]--The entity designated as the lead agency by the Governor under 20 U.S.C. Sec. 1431-1444 [ Public Law 102-119 ]. The Department of Assistive and Rehabilitative Services [ Board ] has the final authority and responsibility for the administration, supervision, and monitoring of programs and activities under this system. The Department [ Board ] has the final authority for the obligation and expenditure of funds and compliance with all applicable laws and rules.

(3) - (4) (No change.)

(5) Case manager (service coordinator)--An Early Childhood Intervention (ECI) local program staff person who is assigned to a child and[ /or ] family, who is the single contact point for families, and who is responsible for assisting and empowering families in accessing services and coordinating those services.

(6) - (8) (No change.)

(9) Early Childhood Intervention (ECI) services--Individualized intervention services provided to children from birth to age three, and their families, as:

(A) (No change.)

(B) provided in accordance with the rules of the Department [ Texas Interagency Council on Early Childhood Intervention Services ] in Chapter 108 [ Chapter 621 ] of this title (relating to Early Childhood Intervention).

(10) - (19) (No change.)

§108.225.Reimbursable Services.

(a) Targeted Case management services are reimbursable to Medicaid providers who meet the conditions for provider participation as specified in §108.229 [ §621.125 ] of this title (relating to Conditions for Case Management Provider Participation). Reimbursable case management services include face-to-face and telephone contacts with the child's caregiver on behalf of the child, or with other service providers or professionals on behalf of the child, for the purpose of assisting that child in gaining access to needed medical, social, educational, developmental, and other appropriate services. Case management providers are paid one flat monthly rate each month in which at least one reimbursable case management contact occurred.

(b) (No change.)

§108.227.Recipient Eligibility for Early Childhood Intervention (ECI) Case Management Services.

In order to receive ECI case management services, the recipient must meet the following criteria:

(1) (No change.)

(2) have a developmental delay [ disability ], as defined in §108.223 [ §621.122 ] of this title (relating to Definitions). ECI providers must determine developmental delay [ disability ] based on the criteria described below:

(A) Children are eligible who have a medically diagnosed physical or mental condition that has a high probability of resulting in developmental delay and is included in the list of covered medical conditions approved by the Department. [ , including, but not limited to: ]

[(i) Down Syndrome and other chromosomal abnormalities;]

[(ii) sensory impairments, including vision and hearing;]

[(iii) inborn errors of metabolism;]

[(iv) microcephaly;]

[(v) failure to thrive;]

[(vi) seizure disorders;]

[(vii) fetal alcohol syndrome or fetal alcohol effects;]

[(viii) testing positive for the Human Immunodeficiency Syndrome (HIV) virus after 15 months of age.]

(B) (No change.)

(C) A qualified professional must observe and document atypical development during:

(i) Administration of an assessment tool [ device ], or

(ii) (No change.)

§108.229.Conditions for Case Management Provider Participation.

In order to be reimbursed for Early Childhood Intervention (ECI) services as specified in §108.225 [ §621.123 ] of this title (relating to Reimbursable Services), a provider must:

(1) - (2) (No change.)

(3) ensure that services are provided by appropriately qualified staff as specified in §108.231 [ §621.126 ] of this title (relating to Qualified Personnel);

(4) - (7) (No change.)

§108.231.Qualified Personnel.

Early Childhood Intervention (ECI) case management services must be provided by case managers who meet the educational and work experience requirements, commensurate with their job responsibilities, as specified in §108.227(c)(4) [ §621.24(c)(4) ] of this title (relating to Recipient Eligibility for Early Childhood Intervention (ECI) Case Management Services); Texas Early Childhood Intervention Staff Qualification Policies (ECI Policy III.8); and who have also completed the ECI Case Management Curriculum.

§108.233.Retention of Records.

Providers of Early Childhood Intervention (ECI) services must maintain and retain all necessary records and claims, as specified in §108.235 [ §621.128 ] of this title (relating to Provider Records), to fully document the services and supplies provided to a Medicaid recipient. These records must be made available promptly upon request to the Texas Early Childhood Intervention Program (ECI), the Texas attorney general's office, the Department's [ ECI's ] designee, and representatives of the United States Department of Health and Human Services. Upon request, the provider must submit copies of their records, at no cost, to representatives of the agencies specified in this section.

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 13, 2006.

TRD-200603255

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


40 TAC §108.237

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

The repeal is proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§108.237.Reviews and Administrative Hearings.

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 13, 2006.

TRD-200603256

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


Subchapter E. DEVELOPMENTAL REHABILITATION SERVICES

40 TAC §108.261, 108.263, 108.265

The amendments are proposed under the Government Code, Chapter 531, §531.0055(e), which provides the Executive Commissioner of the Health and Human Services Commission with the authority to promulgate rules for the operation and provision of health and human services by health and human services agencies.

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

§108.261.Reimbursable Services.

(a) Services that are covered under the Developmental Rehabilitation Services Program are reimbursable to Medicaid providers who meet the conditions for provider participation as specified in §108.265 [ §621.153 ] of this title (relating to Conditions for Developmental Rehabilitation Provider Participation). Developmental Rehabilitation Services are diagnostic, evaluative, and consultative services for the purposes of identifying or determining the nature and extent of, and rehabilitating an individual's medical or other health-related condition. They are medical and/or remedial services that integrate therapeutic interventions into the daily routines of the child and family in order to restore or maintain function and/or to reduce dysfunction resulting from a mental or physical disability or developmental delay. Services [ Developmental Rehabilitation services ] are designed to enhance development in the physical/motor, communication, adaptive, cognitive, social or emotional and sensory domains, or to teach compensatory skills for deficits that directly result from medical, developmental or other health-related conditions. Developmental Rehabilitation Services are provided as specified in the active Individualized Family Service Plan (IFSP) developed in accordance with §108.25(5)(A) - (K) [ §621.23(5)(A) - (K) ] of this title (relating to Service Delivery Requirements for Comprehensive Services). The services include:

(1) - (3) (No change.)

(b) - (c) (No change.)

§108.263.Recipient Eligibility for Services Funded by the Developmental Rehabilitation Services Program .

In order to receive Developmental Rehabilitation Services [ services, ] the recipient:

(1) - (2) (No change.)

(3) must demonstrate the need for these services as documented in an active Individualized Family Service Plan (IFSP) developed in accordance with §108.25(5)(A) - (K) [ §621.23(5)(A) - (K) ] of this title (relating to Service Delivery Requirements for Comprehensive Services).

§108.265.Conditions for Provider Participation in the Developmental Rehabilitation Services Program [ Provider Participation ].

(a) (No change.)

(b) In order to be reimbursed for developmental rehabilitation services as specified in §108.261 [ §621.151 ] of this title (relating to Reimbursable Services), a provider must:

(1) (No change.)

(2) sign a provider agreement with the Medicaid single state agency;

(3) be certified by the Department [ Texas Interagency Council on Early Childhood Intervention, the state program for infants and toddlers with developmental delays ];

(4) - (6) (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 13, 2006.

TRD-200603257

Sylvia F. Hardman

General Counsel

Department of Assistive and Rehabilitative Services

Earliest possible date of adoption: July 30, 2006

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


Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Chapter 367. CONTINUING EDUCATION

40 TAC §§367.1 - 367.3

The Texas Board of Occupational Therapy Examiners proposes amendments to §§367.1 - 367.3, concerning Continuing Education. The amendments will re-organized the chapter and add clarification.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the amendments are in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the amended rules.

Mr. Maline also has determined that for each year of the first five years the amendments are in effect the public benefit anticipated as a result of enforcing the amended rules will be clarification of the OT rules. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the amendments as proposed.

Comments on the proposed amendments may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas 78701, telephone: 305-6900, or through e-mail: augusta.gelfand@mail.capnet.state.tx.us.

The amendments are proposed under the Occupational Therapy Practice Act, Title 3, Chapter 454, Subchapter H Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Chapter 454, Subchapter H of the Occupations Code is affected by the amended sections.

§367.1.Continuing Education.

(a) The Act mandates licensee participation in a continuing education program for license renewal. All continuing education must be directly relevant to the profession of occupational therapy and meet the definition of Type 1 or Type 2 as outlined in this section . The licensee is solely responsible for keeping accurate documentation of all continuing education requirements.

(b) New licensees holding a regular license, issued for a period of less than two years, do not have a continuing education requirement until they receive a regular two-year license. [ Continuing education documentation includes, but is not limited to, a final official transcript, AOTA self-study completion certificates, copies of official sign-in or attendance sheets, course certificates of attendance, certificates of completion, and official correspondence from the board approving requesting credits. ]

(c) All licensees, except those addressed in subsection (b) of this section must complete a minimum of 30 hours of continuing education every two years during the period of time the license is current in order to renew the license, and provide this information as requested. [ The first regular license, which has a duration of less than 2 years, does not have a continuing education requirement. ]

(d) Those renewing a license more than 90 days late must submit proof of continuing education for the renewal. [ All licensees, except those addressed in subsection (c) of this section must complete 30 hours of continuing education every two years during the period of time the license is current in order to renew the license. Those renewing a license more than 90 days late must submit proof of continuing education for the renewal. ]

[(1) General information hereafter referred to as Type 1 continuing education is relevant to the profession of occupational therapy. Examples include but are not limited to: supervision, education, documentation, quality improvement, administration, reimbursement and other occupational therapy related subjects. (AOTA's Category 3)]

[(2) A minimum of 15 hours of continuing education must be in skills specific to occupational therapy practice with patients or clients hereafter referred to as Type 2. (AOTA's Category 1 or 2)]

[(A) Type 2 courses teach occupational therapy treatment and intervention with patients or clients.]

[(B) All continuing education hours may be in Type 2.]

(e) Types of Continuing Education [ Any continuing education submissions may be counted only one time. ]

(1) A minimum of 15 hours of continuing education must be in skills specific to occupational therapy practice with patients or clients hereafter referred to as Type 2. (AOTA's Category 1 or 2)

(A) Type 2 courses teach occupational therapy treatment and intervention with patients or clients.

(B) All continuing education hours may be in Type 2, but no less than 15 hours of Type 2 is acceptable.

(2) General information hereafter referred to as Type 1 continuing education is relevant to the profession of occupational therapy. Examples include but are not limited to: supervision, education, documentation, quality improvement, administration, reimbursement and other occupational therapy related subjects. (AOTA's Category 3)

(f) Continuing educational activities may be counted only one time in the licensee's career.

(g) [ (f) ] Effective January 1, 2003, Type 1 and Type 2 educational activities approved or offered by the American Occupational Therapy Association or the Texas Occupational Therapy Association are pre-approved by the board. The board will review its approval process and continuation thereof for educational activities by January 2005 and at least once each five-year period thereafter.

§367.2.Categories of Continuing Education.

(a) All continuing education must comply with Type 1 or Type 2 as outlined in §367.1 of this title (relating to Continuing Education). Continuing education undertaken by a licensee for renewal shall be acceptable if it falls in one or more of the following categories.

(1) Formal academic courses related to occupational therapy. Completion of course work at or through an accredited college or university shall be counted as follows: three CE hours for each credit hour of a course with a grade of A, B, C, and/or P (Pass). Thus a three-credit course counts for 9 credit hours of continuing education. All college course work must comply with Type 1 and Type 2 as outlined in §367.1 of this title (relating to Continuing Education) , no maximum.

(2) In-service educational programs, training programs, institutes, seminars, workshops, facility based courses, and conferences in occupational therapy. Hour for hour credit on program content only, no maximum.

(3) Development of publication, media materials or research/grant activities per two year renewal period : [ . ]

(A) Published scholarly work in a peer-review journal, 15 hours maximum.

(B) Principle investigator or co-principle investigator in grant or research proposals accepted for consideration. 10 hours maximum. [ Secondary author (second or other author), 7 hours maximum. ]

(C) Published book [ or book chapter(s) ], 10 hours maximum.

(D) Second or other author, 7 [ 6 ] hours maximum.

(E) Book chapter, 5 hours maximum. [ Other publications such as newsletter and trade magazines, 2 hours maximum. ]

(F) Other publications such as newsletter and trade magazines, 2 hours maximum. [ Principle investigator or co-principle investigator in grant or research proposals accepted for consideration. ]

(4) Home study courses, Internet-based courses, and videotape instruction , no maximum .

(A) Courses must fit the criteria for continuing education for Type 1 or Type 2.

(B) These courses must have a post-test and give a certificate of completion.

(C) Internet courses must reflect a pre-determined number of credit hours.

(5) Professional presentations by licensee

(A) Professional presentation, e.g. in-services, workshops, institutes: any presentations counted only one time. Hour for hour credit. 10 hour maximum.

(B) Community/Service organization presentation: any presentation counted once. Hour for hour credit. 10 hours maximum.

(6) Any deviation from the above continuing education categories will be reviewed on a case by case basis by the Coordinator of Occupational Therapy or by the Continuing Education Committee. A request for special consideration must be submitted in writing a minimum of 60 days prior to expiration of the license.

(b) Unacceptable Continuing Education Activities include but are not limited to :

(1) Any non-instructional time frames such as breaks, meals, introductions, and pre/post testing.

(2) Business meetings

(3) Exhibit hall attendance

(4) Reading journals

(5) Courses such as , but not limited to: grant writing, case management, massage therapy, general management and business, social work, defensive driving, water safety, team building, GRE, GMAT, MCAT preparation, cooking for health, weight management, women's health and stress management, reading techniques, geriatric anthology, general foreign languages.

(6) Facility-based annual required courses such as, but not limited to patient abuse, disposal of hazardous waste, patient privacy, HIPPA & FERPA, blood borne pathogens, and other annual facility required repetitive courses do not count toward continuing education.

(7) Program providers are prohibited from self-promotion of programs, products, and/or services during the presentation of the program.

§367.3.Continuing Education Audit.

(a) The board shall select for audit a random sample of licensees. The audit will cover a period for which the licensee has already completed the 30 hours required and has signed to that fact on the renewal form.

(b) Licensees randomly selected for the audit must provide to TBOTE appropriate documentation within 30 days of notification. Documentation submitted must specify whether they are Type 1 or Type 2.

(c) The licensee is solely responsible for keeping accurate documentation of all continuing education requirements. Continuing education documentation must be maintained for two years from the date of the last renewal for auditing purposes, or a total of four years.

[(1) The continuing education record card (blue card) will no longer be accepted as proof of continuing education activities, effective December 1, 2001.]

[(2) Documentation must identify the licensee by name and license number, and must include the date and title of the course, the signature of the authorized signer, and the number of CEUs or contact hours awarded for the course.]

(d) Continuing education documentation includes, but is not limited to: an official transcript, AOTA self-study completion certificates, copies of official sign-in or attendance sheets, course certificates of attendance, and certificates of completion. [ Knowingly providing false information or failure to respond during the audit process or the renewal process is grounds for disciplinary action. ]

(e) Documentation must identify the licensee by name and license number, and must include the date and title of the course, the signature of the authorized signer, and the number of CEUs or contact hours awarded for the course.

(f) Knowingly providing false information or failure to respond during the audit process or the renewal process is grounds for disciplinary action.

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 16, 2006.

TRD-200603343

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: July 30, 2006

For further information, please call: (512) 305-6900


Chapter 371. INACTIVE AND RETIRED STATUS

40 TAC §371.2

The Texas Board of Occupational Therapy Examiners proposes new Chapter 371, §371.2 for a new retired status. House Bill 2680 added the requirement for health professionals to have a retired status with reduced fees and reduced continuing education requirements for those who wish to volunteer for non-profit work without compensation.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be a new status of licensees with limited rights and privileges. There will be no effect on small businesses. There is a very small anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas 78701, telephone: 305-6900, or through e-mail: augusta.gelfand@mail.capnet.state.tx.us.

The new section is proposed under the Occupational Therapy Practice Act, Title 3, Chapter 454, Subchapter H, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Chapter 454, Subchapter H, of the Occupations Code is affected by the new section.

§371.2.Retired Status.

(a) The Retired Status is available for an occupational therapy practitioner whose only practice is the provision of voluntary charity care without monetary compensation.

(1) "voluntary charity care" means occupational therapy services provided as a volunteer with no compensation, for a charitable organization as defined in §84.003 of the Texas Civil Practice and Remedies Code. This includes any bona fine charitable, religious, prevention of cruelty to children or animals, youth sports and youth recreational, neighborhood crime prevention or patrol, or educational organization (excluding fraternities, sororities, and secret societies), or other organization organized and operated exclusively for the promotion of social welfare by being primarily engaged in promoting the common good and general welfare of the people in the community, including these type of organizations with a Section 501(c) 3 or (4) exemption from federal income tax, some Chambers of commerce, and volunteer centers certified by the Department of Public Safety.

(2) "compensation" means direct or indirect payment of anything of monetary value.

(3) The designation used by the retired status licensee is Occupational Therapist Registered, Retired (OTR, Ret) or Licensed Occupational Therapist, Retired, (LOT, Ret), or Certified Occupational Therapy Assistant, Retired (COTA, Ret) or Licensed Occupational Therapy Assistant, Retired (LOTA, Ret).

(b) To be eligible for retired status, a licensee must hold a current license on active or inactive status.

(c) Requirements for initial retired status are:

(1) a completed and notarized application form;

(2) a passing score on the jurisprudence exam;

(3) the completed continuing education for the current renewal period; and

(4) the retired status fee and any late fees which may be due.

(d) Requirements for renewal of retired status. A licensee on retired status must renew every two years before the expiration date. The retired occupational therapy practitioner shall submit:

(1) the retired status renewal form;

(2) a passing score on the jurisprudence exam;

(3) the retired renewal fee and any late fee which may be due; and

(4) completion of 6 hours of Type 2 continuing education each license renewal period, as described in §367.1 of this title (relating to Continuing Education).

(e) A licensee who has been on retired status less than one year must submit the regular license renewal fee and the late fee as described in §370.1 of this title (relating to License Renewal). A licensee who has been on retired status for more than one year must retake and pass the national examination to return the license to active status. The licensee must submit:

(1) a complete and notarized application;

(2) a passing score on the jurisprudence exam;

(3) a passing score on the recent retaking of the national examination; and

(4) the initial application fee.

(f) The occupational therapy practitioner may continue to renew the retired status license indefinitely.

(g) Licensees on retired status are subject to the audit of continuing education as described in §367.3 of this title (relating to Continuing Education Audit).

(h) A retired occupational therapy practitioner is subject to disciplinary action under the OT Practice Act.

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 16, 2006.

TRD-200603340

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: July 30, 2006

For further information, please call: (512) 305-6900


Chapter 373. SUPERVISION

40 TAC §373.2

The Texas Board of Occupational Therapy Examiners proposes an amendment to §373.2, concerning Supervision of a Temporary Licensee. The amendment will re-organized the section and add clarification.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the amendment is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the amended rule.

Mr. Maline also has determined that for each year of the first five years the amendment is in effect the public benefit anticipated as a result of enforcing the amended rule will be clarification of the OT rules. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the amendment as proposed.

Comments on the proposed amendment may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas 78701, telephone: 305-6900, or through e-mail: augusta.gelfand@mail.capnet.state.tx.us.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Chapter 454, Subchapter H Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Chapter 454, Subchapter H of the Occupations Code is affected by this amended section.

§373.2.Supervision of a Temporary Licensee.

(a) Requirements for all temporary licensees [ Supervision of an occupational therapist with a temporary license includes ]:

(1) A temporary licensee works under the supervision of a regular licensed occupational therapist, whose name and license number are on file on the Board's "Supervision of a Temporary Licensee" form. [ frequent communication between the supervising occupational therapist and the temporary licensee by telephone, written report or conference, including the review of progress of patients/clients assigned, plus ]

(2) All documentation completed by an individual holding a temporary license which becomes part of the patient's/client's permanent file, must be approved and co-signed by the supervising occupational therapist. [ encounters twice a month where the OTR or LOT directly observes the temporary licensee providing services to one or more patients/clients with face-to-face, real time interaction. ]

(3) Temporary licensees may not supervise anyone.

(4) A temporary licensee does not become a regular licensee with those privileges until the regular license is in hand.

(b) Supervision of an occupational therapy assistant with a temporary license includes : [ ; ]

(1) sixteen hours of supervision a month of which at least twelve hours are through telephone, written report or conference, including the review of progress of patients/clients assigned; plus

(2) four or more hours of supervision a month which are face-to-face, real time supervision with the temporary licensee providing services to one or more patients/clients.

(c) Supervision of an occupational therapist with a temporary license includes documentation regarding: [ Temporary licensees may not supervise anyone. ]

(1) frequent communication between the supervising occupational therapist and the temporary licensee by telephone, written report or conference, including the review of progress of patients/clients assigned, plus

(2) encounters twice a month where the OTR or LOT directly observes the temporary licensee providing services to one or more patients/clients with face-to-face, real time interaction.

[(d) All documentation completed by an individual holding a temporary license which becomes part of the patient's/client's permanent file, must be approved and co-signed by the supervising occupational therapist.]

[(e) A temporary licensee works under the supervision of an regular licensed occupational therapist, whose name and license number are on file on the board's "Supervision of a Temporary Licensee" form.]

[(f) A temporary licensee does not become a regular licensee with those privileges until the regular license is in hand.]

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 16, 2006.

TRD-200603344

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: July 30, 2006

For further information, please call: (512) 305-6900


Chapter 376. REGISTRATION OF FACILITIES

40 TAC §376.3

The Texas Board of Occupational Therapy Examiners proposes an amendment to §376.3, regarding Requirements for Registration Application. The section is proposed for amendment to remove the waiver for OT facilities where a PT facility was already registered by the same owner in the same location. A large number of waived OT facilities received all the agency services and privileges of a regular OT facility without paying any fee. A new discounted fee for this category will be created, which will allow the application to be through the state's TexasOnline process.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the amendment is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the amended rule.

Mr. Maline also has determined that for each year of the first five years the amendment is in effect the public benefit anticipated as a result of enforcing the amended rule will be the ability to apply for registration online at a discounted fee and use the state's TexasOnline process. There is a small anticipated economic costs to small businesses and persons who are required to comply with the amendment as proposed.

Comments on the proposed amendment may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas 78701, telephone: 305-6900, or through e-mail: augusta.gelfand@mail.capnet.state.tx.us.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Chapter 454, Subchapter H Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Chapter 454, Subchapter H of the Occupations Code is affected by this amended section.

§376.3.Requirements for Registration Application.

(a) - (e) (No change.)

(f) The Occupational Therapy Facility will be charged a registration fee(s) for the primary site and/or additional site(s) . In some cases an OT linked facility fee may apply. An OT linked facility is a facility in which PT services are already registered at the same location with the same owner(s). If the PT facility registration is not current, full OT registration must be paid. [ will be waived if the facility application is for both OT and PT services at the same location with the same owner(s). The waiver form must accompany the application form. ]

(g) The Occupational Therapy Facility registration fee(s) for the primary site and/or additional site(s) will be waived in circumstances which are temporary in nature, such as a natural disaster or events for special populations, such as the Special Olympics. [ Waiver from Occupational Therapy Facility registration fees does not nullify all other sections as set forth in the TBOTE Rules, Chapter 376. ]

(h) Waiver from Occupational Therapy Facility registration fees does not nullify all other sections as set forth in the TBOTE Rules, Chapter 376.

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 16, 2006.

TRD-200603341

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: July 30, 2006

For further information, please call: (512) 305-6900


40 TAC §376.6

The Texas Board of Occupational Therapy Examiners proposes an amendment to §376.6, regarding Renewal of Registration. The section is proposed for amendment to remove the waiver for currently waived facilities where the same owner at the same location has a PT facility registered. A large number of waived OT facilities received all the privileges of a regular OT facility without any fee and will now be able to renew the registration online. A largely discounted fee will be established.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the amendment is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the amended rule.

Mr. Maline also has determined that for each year of the first five years the amendment is in effect the public benefit anticipated as a result of enforcing the amended rule will be the ability to renew the registration online with a discounted fee using the state's TexasOnline process. There is a small anticipated economic costs to small businesses and persons who are required to comply with the amendment as proposed.

Comments on the proposed amendment may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas 78701, telephone: 305-6900, or through e-mail: augusta.gelfand@mail.capnet.state.tx.us.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Chapter 454, Subchapter H Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Chapter 454, Subchapter H of the Occupations Code is affected by this amended section.

§376.6.Renewal of Registration Application .

(a) (No change.)

(b) Requirements to renew a facility are:

(1) - (4) (No change.)

[(5) The waiver form must accompany the renewal form if the renewal is for an Occupational Therapy Facility where the same owner(s) at the same location are also currently registered for PT services.]

(c) The annual renewal date of a primary Occupational Therapy Facility registration is the last day of the month in which the registration was originally issued. The renewal date for an additional facility will be the same as the renewal date for the primary facility. The owner of the OT facilities may request that the renewal date of the OT facilities be synchronized with the PT facilities with which they are associated.

(d) - (f) (No change.)

(g) The registration renewal fee for an OT linked facility will be for OT primary and/or additional facility where the same owner has previously registered a PT facility at the same location. The PT facility registration must be current in order for the owner to pay the OT linked facility fee.

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 16, 2006.

TRD-200603342

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: July 30, 2006

For further information, please call: (512) 305-6900