Proposed Sections Before an agency may permanently adopt a new or amended section, or repeal an existing section, a proposal detailing the action must be published in the Texas Register at least 30 days before any action may be taken. The 30-day time period gives interested persons an opportunity to review and make oral or written comments on the section. Also, in the case of substantive sections, a public hearing must be granted if requested by at least 25 persons, a governmental subdivision or agency, or an association having at least 25 members. Symbology in proposed amendments. New language added to an existing section is indicated by the use of bold text. [Brackets] indicate deletion of existing material within a section. TITLE 4. AGRICULTURE Part III. Texas Feed and Fertilizer Control Service Chapter 65. Commercial Fertilizer Rules Labeling 4 TAC sec.65.24 The Texas Feed and Fertilizer Control Service proposes an amendment to sec.65.24, concerning commercial fertilizer rules-"Warnings or Cautionary Statements Required" to denote % sign in amount of boron in water-soluble boron for clarification of rule under sec.65.24(a). George W. Latimer, Jr., Texas State Chemist, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. Dr. Latimer also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be editorial correction for clarification of rule. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed. Comments on the proposal may be submitted to George W. Latimer, Jr., Texas State Chemist, P.O. Box 3160, College Station, Texas 77841-3160. The amendment is proposed under the Texas Agriculture Code, Chapter 63, sec.63.004, which provides the Texas Feed and Fertilizer Control Service with the authority to adopt rules relating to the distribution of commercial fertilizers. sec.65.24. Warnings or Cautionary Statements Required.
    A warning or cautionary statement of the following form is required on any fertilizer product containing: (1) 0.10%
      [0.10] or more boron in water soluble form. The statement shall include: (A) the word "Warning" or "Caution" conspicuously displayed; (B) a statement of the crop(s) for which the fertilizer is recommended; and (C) a statement that the use of the fertilizer on any crop(s) other than those recommended may result in serious injury to the crop(s); (2) 0.001% or more of molybdenum. The statement shall include: (A) the word "Warning" or "Caution" conspicuously displayed; and (B) a statement that the application of fertilizers containing molybdenum may result in forage crops containing levels of molybdenum which are toxic to ruminant animals. This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in College Station, Texas, on January 28, 1993. TRD-9318334 George W. Latimer, Jr. Texas State Chemist Texas Feed and Fertilizer Control Service Earliest possible date of adoption: March 8, 1993 For further information, please call: (409) 845-1121 4 TAC sec.65.26 The Texas Feed and Fertilizer Control Service proposes an amendment to sec.65.26, concerning commercial fertilizer rules-"Organic and Organic Base Nitrogen Fertilizer to insert the word "to" and to denote quotation marks around organic nitrogen in sec.65.26(a) for editorial purposes only. George W. Latimer, Jr., Texas State Chemist, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. Dr. Latimer also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be editorial corrections for clarification of rule. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed. Comments on the proposal may be submitted to George W. Latimer, Jr., Texas State Chemist, P.O. Box 3160, College Station, Texas 77841-3160. The amendment is proposed under the Texas Agriculture Code, Chapter 63, sec.63.004, which provides the Texas Feed and Fertilizer Control Service with the authority to adopt rules relating to the distribution of commercial fertilizers. sec.65.26. Organic and Organic Base Nitrogen Fertilizer. (a) In addition to conforming to
        the definitions, the terms "nitrogen- containing organic," "organic," and "organic nitrogen"
          [organic nitrogen] when used on the label of commercial fertilizer, shall refer only to substances: (1) in which the water insoluble nitrogen content is at least 60% of the total nitrogen provided by the organic material; and (2) in which the water insoluble nitrogen is at least 15% of the total nitrogen guaranteed in the product. (b)-(c) (No change.) This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in College Station, Texas, on January 29, 1993. TRD-9318333 George W. Latimer, Jr. Texas State Chemist Texas Feed and Fertilizer Control Service Earliest possible date of adoption: March 8, 1993 For further information, please call: (409) 845-1121 4 TAC sec.65.31 The Texas Feed and Fertilizer Control Service proposes an amendment to sec.65.31, concerning commercial fertilizer rules-"Net Weight" to change the word "sales" to "scales" in sec.65.31(a)(1) to correct the wording and to delete "sec.65.15(a)(2)" and insert "this chapter" for editorial purposes only. George W. Latimer, Jr., Texas State Chemist, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. Dr. Latimer also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be editorial correction for clarification of rule. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed. Comments on the proposal may be submitted to George W. Latimer, Jr., Texas State Chemist, P.O. Box 3160, College Station, Texas 77841-3160. The amendment is proposed under the Texas Agriculture Code, Chapter 63, sec.63.004, which provides the Texas Feed and Fertilizer Control Service with the authority to adopt rules relating to the distribution of commercial fertilizers. sec.65.31. Net Weight. (a) Net weight may be determined and reported from data obtained: (1) by scales
            [sales] for packaged, bulk, dry and liquid; (2) by calculation from volume and specific gravity/density for bulk liquids only. (b) Conformance to weight guarantee shall be judged solely by use of certified scale defined in accordance with Texas Department of Agricultural Standards. (c) Dip sticks, uncalibrated meters or sight gauges shall not be used for estimation of volume in this chapter
              [sec.65.15(a)(2)]. Scales not certified in accordance with the Texas Department of Agriculture Standards shall not be used for net weights. This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in College Station, Texas, on January 29, 1993. TRD-9318332 George W. Latimer, Jr. Texas State Chemist Texas Feed and Fertilizer Control Service Earliest possible date of adoption: March 8, 1993 For further information, please call: (409) 845-1121 TITLE 22. EXAMINING BOARDS Part VI. Texas State Board of Registration for Professional Engineers Chapter 131. Practice and Procedure Education 22 TAC sec.131.92 The Texas State Board of Registration for Professional Engineers proposes an amendment to sec.131.92, concerning education. The section is amended to clarify which applicants must have foreign degrees evaluated. Charles E. Nemir, P.E., executive director, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. Mr. Nemir also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be a clearer understanding of which applicants must have their foreign degrees evaluated by a commercial evaluation service selected by the board. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed. Comments on the proposal may be submitted to Charles E. Nemir, P.E., Executive Director, Texas State Board of Registration for Professional Engineers, P.O. Drawer 18329, Austin, Texas 78760. The amendment is proposed under Texas Civil Statutes, Article 3271a, sec.8(a) , which provide the board with the authority to make and enforce all rules and regulations necessary for the performance of its duties. sec.131.92. Foreign Degrees. (a) (No change.) (b) Applicants having foreign degree(s), with the exception of those covered by subsection (a)(2)
                [who do not meet the requirements of subsection (a)(1) or (2)] of this section,
                  must furnish at their own expense an evaluation of their foreign degree(s) from a commercial evaluation service selected by the board. The degree evaluation must be sent directly to the board by the evaluation service. Applicants must submit with their applications complete certified copies or documented proof of all engineering degrees, diplomas, certificates, etc., showing the type of engineering degree awarded (B.S., M.S., Ph.D.), date awarded, branch of engineering, dates attended, and scores, grades, or honors awarded. Documents written in languages other than English shall be accompanied by a certified English translation. This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in Austin, Texas, on January 29, 1993. TRD-9318325 Charles E. Nemir, P.E. Executive Director Texas State Board of Registration for Professional Engineers Proposed date of adoption: April 21, 1993 For further information, please call: (512) 440-7723 TITLE 28. INSURANCE Part I. Texas Department of Insurance Chapter 1. General Administration Subchapter C. Maintenance Taxes 28 TAC sec.1.413 The State Board of Insurance of the Texas Department of Insurance proposes new 28 TAC sec.1.413, concerning assessment of maintenance taxes for the Texas Workers' Compensation Commission and the Texas Workers' Compensation Research Center as set by the Texas Workers' Compensation Commission, assessment of a maintenance tax surcharge which will be used to service the bond debt for the Texas Workers' Compensation Insurance Fund, and a tax form with instructions for filing and paying the taxes. This section is being submitted for republication to include the maintenance tax rate for the Texas Workers' Compensation Research Center, which was not set out in the original publication, as well as to clarify the payment due dates. The section originally was published in the December 25, 1992, issue of the Texas Register (17 TexReg 9085). The section is proposed to provide a method of assessment and to record the rate of assessment for taxes due in 1993 on the basis of gross premium receipts for calendar year 1992, as well as to provide insurers with a form and instructions for filing and paying the taxes. The Texas Workers' Compensation Commission annually establishes and certifies to the State Board of Insurance the rate of assessment for the maintenance taxes which are authorized to pay the cost of administering the Texas Workers' Compensation Act. Proposed sec.1.413 sets a rate of assessment which applies to workers' compensation insurance companies. Timely and accurate payment of maintenance taxes is necessary for support of regulatory functions. The new section adopts a form and instructions which facilitate compliance with statutory requirements for reporting and payment of maintenance taxes to the department for the Texas Workers' Compensation Commission and the Texas Workers' Compensation Research Center. Michael Davis, the director of accounting, has determined that for the first five-year period the proposed section is in effect the anticipated fiscal impact on state government is as follows: an estimated income of $36, 009,130 which is generated from the Texas Workers' Compensation Commission maintenance tax, an estimated income of $423,600 of maintenance tax collected on behalf of the Texas Workers' Compensation Research Center, and an estimated income of $38,000,223 generated from the maintenance tax surcharge which will be used to pay bond debt service for the $300 million in bonds issued by the Texas Public Finance Authority on behalf of the Texas Workers' Compensation Insurance Fund. Mr. Davis also has determined that for the same time period there will be no fiscal implications for local government as a result of enforcing or administering the section, and there will be no effect on local employment or the local economy. Mr. Davis also has determined that for each year of the first five-years the proposed section is in effect, the public benefit anticipated as a result of enforcing the section will be the facilitation in the collection of a maintenance tax assessment for the Texas Workers' Compensation Commission and the Texas Workers' Compensation Research Center and a maintenance tax surcharge assessment for the Texas Workers' Compensation Insurance Fund. The anticipated cost to small businesses required to comply with this section is the amount each business will pay based on the rates provided in the section and the administrative cost of completing the forms and following the instructions. There is no difference in the rate of assessment between large and small businesses. There is no anticipated economic cost to persons as the assessment is imposed on business entities. Comments on the proposal must be submitted in writing within 30 days after publication of the proposed section in the Texas Register to Linda K. von Quintus-Dorn, Chief Clerk, P.O. Box 149104, Mail Code #113-2A, Austin, Texas 78714-9104. An additional copy of the comment should be submitted to Michael Davis, Director of Accounting, Mail Code #108-3A, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104. Requests for a public hearing on this proposal should be submitted separately to the Chief Clerk's Office. The new section is proposed under the Insurance Code, Articles 5.76-5, 5. 76-3, 5.68 and 1.04(b), and Texas Revised Civil Statutes, Articles 8308-2.22, 8308- 2.23, 8308-11.09, and 6252-13a, sec.4 and sec.5. The Insurance Code, Article 5.76-5 establishes the maintenance tax surcharge. Article 5.76-3 establishes the Texas Workers' Compensation Insurance Fund. Article 5.68 establishes the maintenance tax based on premiums for workers' compensation coverage. Article 1.04(b), authorizes the State Board of Insurance to determine rules and regulations in accordance with the laws of this state for uniform application. Texas Civil Statutes, Articles 8308-2.22, 8308-2.23, and 8308-11.09 establish the maintenance tax for workers' compensation insurance companies. Article 6252- 13a, sec.4 and sec.5 authorize and require each state agency to adopt rules of practice setting forth the nature and requirement of available procedures, and prescribe the procedures for adoption of rules by a state administrative agency. The proposed new section affects regulation relating to workers' compensation insurance maintenance taxes and the maintenance tax surcharge for 1993, under the Insurance Code, Article 5.76-5 and under the Texas Civil Statutes, Articles 8308-2.22, 8308-2.23, and 8308-11. 09. sec.1.413. Maintenance Tax Assessment for the Texas Workers' Compensation Commission and for the Texas Workers' Compensation Research Center; Maintenance Tax Surcharge for the Texas Workers' Compensation Insurance Fund, 1993. (a) The maintenance taxes and the maintenance tax surcharge are assessed against each insurance company writing workers' compensation insurance in this state in the following manner: (1) the maintenance tax as set by the Texas Workers' Compensation Commission at the rate of .85% of the correctly reported gross workers' compensation insurance premiums for the calendar year 1992; (2) the maintenance tax as set by the Texas Workers' Compensation Commission on behalf of the Texas Workers' Compensation Research Center at the rate of .01% of the correctly reported gross workers' compensation insurance premiums for the calendar year 1992; (3) the maintenance tax surcharge at the rate of .897% of the correctly reported gross workers' compensation insurance premiums for the calendar year 1992 to cover debt service for bonds issued on behalf of the Texas Workers' Compensation Insurance Fund. (b) The maintenance taxes assessed under subsection (a)(1) and (2) of this section shall be due and payable to the Texas Department of Insurance in April 15, 1993. (c) The maintenance tax surcharge assessed under subsection (a)(3) of this section shall be due and payable to the Texas Department of Insurance in accordance with the provisions of paragraphs (1), (2), or (3) of this subsection, as applicable to particular insurers. (1) Insurers for which maintenance tax liability for the previous tax year under the Insurance Code, Article 5.68 was less than $2,000 must remit 100% of the 1992 assessed maintenance tax and any surcharges on April 15, 1993. (2) Insurers which are not required to remit taxes and surcharges in accordance with paragraph (1) of this subsection may remit the maintenance tax surcharge as follows: 50% on April 15, 1993 and the remaining 50% no later than October 15, 1993. (3) Any insurer addressed in paragraph (2) of this subsection may at its option pay the entire maintenance tax surcharge on April 15, 1993. (d) A separate tax form with instructions for the filing and payment of maintenance taxes to the Texas Department of Insurance for the 1992 calendar year is adopted by reference. A copy of such form has been filed with and is available for inspection at the Office of the Secretary of State, Texas Register Division. This form with instructions is published by the Texas Department of Insurance and copies may be obtained from Tax Administration of the Texas Department of Insurance, Tower I, Room 860, 333 Guadalupe Street, Austin, Texas 78701-3938. Each insurer shall follow such instructions and use such form as appropriate for reporting the results of its operation. This tax form with instructions is more particularly identified as the "1992 Maintenance Taxes for the Workers' Compensation Commission and the Workers' Compensation Research Center." This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in Austin, Texas, on January 29, 1993. TRD-9318346 Linda von Quintus-Dorn Chief Clerk Texas Department of Insurance Earliest possible date of adoption: March 8, 1993 For further information, please call: (512) 463-6327 TITLE 40. SOCIAL SERVICES AND ASSISTANCE Part I. Texas Department of Human Services Chapter 15. Medicaid Eligibility Subchapter B. Medicare and Third-party Resources The Texas Department of Human Services (DHS) proposes amendments to sec.15. 201 and sec.15.305, concerning Medicaid income eligibility limits for the Qualified Medicare Beneficiary Program and the deletion of a duplicate rule concerning three months prior Medicaid coverage for SSI applicants in its Medicaid Eligibility chapter. The purpose of the amendments is to clarify the income limit for coverage of Medicare premiums, deductibles, and coinsurance charges paid by DHS for clients who have income equal to or less than 100% of the federal poverty level and to delete a rule concerning three months prior Medicaid coverage that is located in another section in greater detail. Burton F. Raiford, commissioner, has determined that for the first five-year period the sections are in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the sections. Mr. Raiford also has determined that for each year of the first five years the sections are in effect the public benefit anticipated as a result of enforcing the sections will be that more individuals will be eligible for the Qualified Medicare Beneficiary Program and the Medicaid Eligibility rules will be more efficient by the removal of a duplicate rule. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the proposed sections. Questions about the content of the proposal may be directed to Judy Coker at (512) 450-3227 in DHS's Long-Term Care Program. Comments on the proposal may be submitted to Nancy Murphy, Agency Liaison, Policy and Document Support-008, Texas Department of Human Services E-503, P.O. Box 149030, Austin, Texas 78714- 9030, within 30 days of publication in the Texas Register. 40 TAC sec.15.201 The amendment is proposed under the Human Resources Code, Title 2, Chapters 22 and 32, which provides the department with the authority to administer public and medical assistance programs and under Texas Civil Statutes, Article 4413 (502), sec.16, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. B. Medicare and Third- party Resources. sec.15.201. Qualified Medicare Beneficiaries (Type Program 24). (a) Public Law 100-360, the Medicare Catastrophic Coverage Act of 1988, requires the department to pay Medicare premiums, deductibles, and coinsurance for certain clients. Effective January 1, 1989, the department pays Medicare premiums, deductibles, and coinsurance premiums for clients who: (1) (No change.) (2) have income that is equal to or less than
                    [below]: (A)-(D) (No change.) (3) (No change.) (b)-(g) (No change.) This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in Austin, Texas, on January 28, 1993. TRD-9318261 Nancy Murphy Agency Liaison, Policy and Document Support Texas Department of Human Services Proposed date of adoption: April 1, 1993 For further information, please call: (512) 450-3765 Subchapter C. Basic Program Requirements 40 TAC sec.15.305 The amendment is proposed under the Human Resources Code, Title 2, Chapters 22 and 32, which provides the department with the authority to administer public and medical assistance programs and under Texas Civil Statutes, Article 4413 (502), sec.16, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. sec.15.305. Eligibility Requirements for the Aged, Blind, or Disabled. (a)-(c) (No change.) [(d) When the individual has been notified by SSA about his approval or denial for SSI benefits, he may apply for retroactive medical coverage for any unpaid covered Title XIX services provided during the three months before his date of application for SSI.] (d)
                      [(e)] As a condition of eligibility, the client must furnish the department with a Social Security number (SSN). If the client is married, he must also provide his spouse's SSN. Failure of the client or his representative to follow through and secure an SSN is grounds for denial at the first periodic review. (e)
                        [(f)] To be eligible, a client must file: (1)-(2) (No change.) (f)
                          [(g)] According to Public Law 96-272 a client who draws VA pension benefits grandfathered from December 31, 1978, is not required to apply for aid and attendance or any additional benefits under the 1979 VA pension plan. Clients who have changed to the 1979 pension plan or who initially obtain entitlement to a VA pension after January 1, 1979, are required to apply for aid and attendance or other potentially available benefits as a condition of eligibility. (g)
                            [(h)] A disabled individual under 65 must accept vocational rehabilitation services available to him. If he refuses to accept these services without good cause, he is ineligible for Medicaid benefits. This provision does not apply to clients whose eligibility is because of blindness. (h)
                              [(i)] An SSI client eligible because of disability and who is medically determined to be a drug addict or alcoholic must: (1) -(3) (No change.) (i)
                                [(j)] If the client does not comply with the requirements in subsection (i) of this section, he is ineligible for benefits. This provision does not apply to SSI clients whose eligibility is because of age or blindness. (j)
                                  [(k)] According to Public Law 101-508, a client is not required to accept, as a condition of eligibility, payments that a state may make as compensation to victims of crime. This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in Austin, Texas, on January 28, 1993. TRD-9318262 Nancy Murphy Agency Liaison, Policy and Document Support Texas Department of Human Services Proposed date of adoption: April 1, 1993 For further information, please call: (512) 450-3765 Part IX. Texas Department on Aging Chapter 274. Emergency Response Service Standards Statutes and Regulations 40 TAC sec.274.1 The Texas Department on Aging proposes new sec.274.1, concerning provision of emergency response services as a service authorized under the Older Americans Act, Title III, as amended. This section establishes definitions, policies, and procedures to be followed when area agencies contract for this service or when they monitor this service to determine its effectiveness in promoting the health and independence of the elderly of Texas. Ann Ammons, Director of Field Operations, Texas Department on Aging, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. Ms. Ammons also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be greater understanding of the processes required of area agencies on aging to assure proper components of this service are included in contract stipulations and that monitoring of contracting programs is based on clear requirements established by the department. There will be no effect on small businesses. The anticipated economic cost to persons who are required to comply with the section as proposed will be none. Request for public comments on the proposal may be submitted to Ann Ammons, Director of Field Operations, Texas Department on Aging, P.O. Box 12786, Austin, Texas 78711. The new section is proposed under the Human Resources Code, sec.101, which provides the Texas Department on Aging with the authority to promulgate rules governing the operation of the department. sec.274.1. Emergency Response Service Standards. (a) Purpose. This chapter establishes policies and procedures to be followed when area agencies on aging foresee the need to contract for and oversee the delivery of emergency response services in their planning and service area. (b) Definitions. The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Emergency response service-A service provided through an electronic monitoring system used by functionally impaired adults who live alone or who are functionally isolated in the community. In an emergency, the client can press a call button to signal for help. The electronic monitoring system, which has a 24-hour, seven-day-a-week monitoring capability, helps to ensure that the appropriate person or service agency responds to an alarm call from a client. (2) Unit of service-The unit of service for emergency response service is one calendar month. The service provider is eligible for payment for a full month of service if the client receives services for any part of the month. (3) Service objective-The purpose of the emergency response program is to enable aged and disabled adults to maintain self sufficiency by reducing or preventing dependency. This program can prevent or remedy neglect, abuse, or exploitation of adults unable to protect their own interests. (4) Target Group-The program shall be provided for persons 60 years of age or older with priority given to meeting the needs of persons with the greatest economic or social needs; and (A) live alone, be alone routinely for eight or more hours each day, or live with an incapacitated individual who could not call for help or otherwise assist in an emergency; (B) be mentally alert enough to operate the equipment properly, in the judgement of the case manager; (C) have a telephone with a private line, if the system requires a private line to function properly; (D) be willing to sign a release statement that allows the responder to make a forced entry into the client's home if he is asked to respond to an activated alarm call and has no other means of entering the home to respond; (E) live in a place other than a skilled institution, personal care home, foster care setting, or any other setting where 24-hour supervision is available. (c) Service Activities. The emergency response service provider will assure the basic services outlined are provided. (1) Coordination-The service provider oversees the management of the service, which includes the set up and follow through of the installation of the unit. (2) Installation-The installer goes to the client's home and after installing the unit, is assured the client understands the system. (3) Monitoring-The client must check the system each month to assure the equipment is operating properly. When the equipment does not function properly the service provider must fix or replace the unit within one day of notification of the problem. The service provider establishes a system whereby alarms are monitored. (4) Responders-Volunteers are solicited to check on the client when the alarm is activated. This could be a neighbor, friend, or family member who lives near the client and these two names are in addition to police, fire, and emergency medical services personnel. (d) Service Outcomes. The service provider will be responsible to ensure that services are delivered according to the established policies and procedures. (1) The client will be able to receive help with the push of a button. (2) Family members and other caregivers will have peace of mind knowing the electronic device is monitoring the client's situation. (3) The staff will be trained sufficiently to be sensitive to individualized client needs and flexible to handle structural obstacles. (4) Client's safety and accessibility needs will be considered throughout the installation process. (5) Responders will be informed and ready to assist the client when an alarm is sounded. (6) Case managers and area agencies on aging are responsible for seeing that clients get the best care possible at the most affordable cost. (e) Service Provider Eligibility. (1) The service provider must have a 24-hour, seven day-a-week emergency response monitoring capability; and (2) The service provider must be a public agency, or a private, non-profit or profit corporation that is either chartered with or authorized by the Secretary of State to transact business within the state. (3) The service provider must comply with all provisions of federal laws and regulations, applicable statutes, and any subsequent additions, deletions, and amendments to those rules. (4) Emergency response services may be purchased by performance based unit rate contracting, cost reimbursement contracting, or direct purchase of service contracting as detailed in sec.255.38 of this tltle (relating to Contract and Reimbursement Methodology for Area Agencies on Aging) or sec.255.40 of this title (relating to Direct Purchase of Services Program for Area Agencies on Aging). (f) Service Provider Requirements. The service provider must ensure that the following requirements are met. (1) Must connect the home unit equipment to the monitoring system and ensure that the equipment has an alternate power source if the power fails. The equipment at the response center must be equipped with a tape readout that prints the code number of the alarm, the unit/subscriber number, the date, and the time of the activated alarm. (2) Must respond to all alarm calls 24 hours a day, seven days a week. Failure to respond may result in contract termination. (3) Must notify the case manager of any client emergency that it responds to by the next work day. This is also necessary when the client's condition changes significantly. (4) Must conduct a monthly system check for each client or make a minimum of three attempts to reach the client on three different days during the month. These checks or attempts to contact the client must be documented. (5) Must repair or replace equipment within one day of becoming aware that the equipment malfunctioned. This malfunction and the action taken must be documented. (g) Staffing. The project will employ personnel sufficient to provide services to meet the needs of each client. Minimum requirements for staffing are a coordinator, an installer, one or more monitors, and one or more responders. Agency positions may be staffed with volunteers. If so, these persons must be able to perform the duties prescribed and meet the same level of competency. Duties are as follows. (1) The coordinator is responsible for the overall management of the service and to ensure that services are delivered according to established standards, policies, and procedures. The coordinator must document in the service provider's records that each installer and monitor is competent in performing his job responsibilities. (2) The installer must be able to communicate with clients and who are responsible for installing the equipment. This staff must be competent in all of the following areas: (A) installation procedures; (B) proper use of the equipment; (C) federal Communications requirements; and (D) proper identification methods. (3) Monitors must be retained who are able to communicate with clients and who are responsible for monitoring the service delivery 24 hours a day, seven days a week. Monitors must be competent in the following areas: (A) procedures for responding to activated claims; (B) monitoring and documenting an alarm call from the time the alarm is received to the time the client receives assistance and the case manager is notified; (C) conducting and documenting monthly systems checks; (D) recognizing client characteristics and needs; and (E) using the emergency response equipment properly. (4) Responders (other than emergency medical services, fire, police and sheriff's office) must be given written procedures that explain the service. The procedures must identify the responder's roles and responsibilities in delivering services. The service provider must have written documentation in the agency files that emergency medical service, sheriff, fire and or police department responders are notified that they have agreed to respond to emergencies when called upon by their service provider. (h) Records. The service provider will insure that client records, personnel records, financial records, and any miscellaneous records are maintained as may be required to adequately document service delivery. The service provider will ensure that the minimum requirements established following will be complied with. (1) Client records will contain at least the following information: (A) initial assessment (forms 2060 and 2059s); (B) card file information (includes name, address, telephone number, medical condition, physician's name and telephone number, responders' names, and telephone numbers; and (C) any additional useful information. (2) Personnel records must be kept in a central location in the facility. These records include staff qualifications, performance reports, attendance records, and staff development records. (3) Financial records will be kept in a central location, and will be maintained according to recognized fiscal and accounting procedures. These records should include details on charges and payments made on behalf of each client. These records should be kept up to date and be made available for review without notice by TDoA or any other authorized agency. (4) Miscellaneous records consisting of a monthly log of systems checks along with the documentation of why clients are unable to participate in the monthly systems check are required. (i) Client Eligibility Determination. (1) Determination of eligibility for emergency response services involves the cooperative efforts of the case manager and the service provider. The case manager makes a home visit to the prospective client to determine whether the client meets eligibility criteria, develops a service plan, refers the client to a service provider; and provides on-going case management for the client. In a face to face interview with the client, the case manager completes Form 2060 and p1 and p2 of Form 2059. (2) A referral process has been established in which, unless a client needs a verbal referral for care, service providers receive written referrals based on the following priorities: (A) client's choice; and (B) availability of eligible providers. (3) The case manager will send Form 2059 p1 and p2 to the service provider within seven working days, and come to an agreement of the service plan for the client. The case manager and service provider then establish the beginning date of coverage. (4) If services are denied, the client is entitled to receive written notification from the case manager. At the same time, the client should be informed about his right to appeal. (5) Verbal prior approval is initiated by contacting the service provider in person or by telephoning one working day after visiting the applicant and determining that a verbal prior approval is needed. In the verbal referral, give the service provider the following information, the follow up by sending the appropriate forms within seven days: (A) client identifying information; (B) form 2060, client needs assessment questionnaire score; and (C) the information that is covered in Form 2060. (6) Service provider response to verbal prior approval is required. If the service provider is unable to provide services within the required time frame needed to meet the client's needs, or fails to begin services according to the negotiated agreement, the case manager may select another service provider. (7) Case manager follow-up must be performed. In addition to providing ongoing case management services for the client, the case manager discusses and reports to the coordinator at the service provider, any apparent deficiencies noted in the agency's delivery of services. The service provider must ensure that a client is not without services for more than one day after service initiation. The case manager has the authority to change providers if the client is not served according to the agreed upon care plan. (8) Reassessment will be accomplished as needed but must be accomplished at least every six months. (9) Service Plan Changes must be reported. If the client's condition changes significantly, the service provider must report to the case manager within seven days of awareness. A significant change is an event in the client's status or condition that may require a change in the client's service authorization. Events include: (A) hospitalization; (B) changes in functional abilities (or ability to operate unit); (C) complaints of pain; (D) housing (eviction); (E) changes in household composition; (F) an emergency, in which the client is involved, that receives a response; and (G) three unsuccessful attempts to contact the client for monthly systems check. (j) Termination and Suspension of Services. The service provider must suspend services before the end of the authorization period and remove the equipment from the client's home, with or without obtaining case manager approval, if: (1) the client moves to another county where the provider agency does not provide services; (2) the client is admitted to an institution, personal care home, foster care setting, or any other setting where 24-hour supervision is available; (3) the client dies; or (4) the client requests that services end; (5) if the equipment is removed from the client's home, the service provider must notify the case manager by the next workday, and follow-up with written notification of service termination within seven days. (k) Special Reporting Considerations. The service provider must notify the case manager within one work day of awareness when the following circumstances occur: (1) client abuses the service by committing the following acts: (A) activating four false alarms which result in a response by emergency personnel within a six-month period; or (B) twenty false alarms of any kind within a six-month period; (2) the client is away from the home or is unable to participate in the service delivery for three consecutive months or more; (3) the client is no longer mentally alert enough to operate the equipment properly. (4) the client threatens the health or safety of others. This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in Austin, Texas, on January 29, 1993. TRD-9318299 Mary Sapp Executive Director Texas Department on Aging Earliest possible date of adoption: March 8, 1993 For further information, please call: (512) 444-2727 TITLE 43. TRANSPORTATION Part I. Texas Department of Transportation Chapter 17. Division of Motor Vehicle Titles and Registration Registration and Title System 43 TAC sec.17.54 The Texas Department of Transportation proposes an amendment to sec.17.54, concerning automated equipment which relates to the department's automated registration and title system (RTS). Section 17.54 allows the department, subject to certain terms and conditions, to provide automated equipment compatible with the RTS to the county tax assessor-collectors, as statutorily designated agents of the department for processing registration and title documents. The amended section deletes the requirement that a county designate a liaison with the department specifically for matters concerning the use and operation of the automated equipment. Considering that the Certificate of Title Act, Texas Civil Statutes, Article 6687-1, and the registration laws, Texas Civil Statutes, Articles 6675a-1, et seq, designate the county tax assessor-collectors as agents of the department for processing registration and title documents consistent with law, it is not necessary to require a county to designate a liaison specifically for the purposes of the RTS. Jerry L. Dike, Director, Division of Motor Vehicle Titles and Registration, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. Mr. Dike has certified that there will be no significant impact on local economies or overall employment as a result of enforcing or administering the proposed amended section. Mr. Dike also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be to promote a more uniform, efficient, and cost-effective system for registering and titling vehicles by enhancing the preparation and processing of related documents by the county tax assessor-collectors. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the section as proposed. Comments on the proposal may be submitted to Jerry L. Dike, Director, Division of Motor Vehicle Titles and Registration, Texas Department of Transportation, 40th Street and Jackson Avenue, Austin, Texas 78779-0001. The amendment is proposed under Texas Civil Statutes, Articles 6666, 6687-1, and 6675a-1, et seq, which provide the Texas Transportation Commission with the authority to establish rules for the conduct of the work of the Texas Department of Transportation, and for the orderly administration of statutory provisions relating to vehicle registration and certificates of titles. sec.17.54. Automated Equipment. (a) (No change.) (b) Conditions of availability. (1) A county must: [(A) designate an official or employee of the county as liaison with the department for matters concerning use and operation of the equipment;] (A)
                                    [(B)] meet electrical power supply criteria specified by the department prior to installation of the automated equipment; (B)
                                      [(C)] bear all costs incurred for 24-hour per day electrical power consumption for operation of the equipment; (C)
                                        [(D)] provide for the physical security and protection of the equipment and shall indemnify the department for any loss or damages to the equipment while in the custody and control of the county; (D)
                                          [(E)] provide the department's maintenance personnel access to the equipment during business hours of the involved county office; and (E)
                                            [(F)] notify the department not less than 30 working days prior to relocating or adding automation equipment, or of the closing or remodeling of an office, that may affect automated equipment operations. (2) (No change.) This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's authority to adopt. Issued in Austin, Texas, on January 28, 1993. TRD-9318264 Diane L. Northam Legal Administrative Assistant Texas Department of Transportation Earliest possible date of adoption: March 8, 1993 For further information, please call: (512) 463-8630