ADOPTED RULES An agency may take final action on a section 30 days after a proposal has been published in the Texas Register. The section becomes effective 20 days after the agency files the correct document with the Texas Register, unless a later date is specified or unless a federal statute or regulation requires implementation of the action on shorter notice. If an agency adopts the section without any changes to the proposed text, only the preamble of the notice and statement of legal authority will be published. If an agency adopts the section with changes to the proposed text, the proposal will be republished with the changes. TITLE 22. EXAMINING BOARDS Part I. Texas Board of Architectural Examiners Chapter 1. Architecture Subchapter B. Registration 22 TAC sec.1.25 The Texas Board of Architectural Examiners adopts an amendment to sec.1.25, regarding Processing, without changes to the proposed text as published in the April 5, 1996, issue of the Texas Register (21 TexReg 2901) and will not be republished. The text addresses application deadlines for examinations. The agency is adopting the rule to delete the August 1 application deadline for the December examination as there will no longer be a December examination. No comments were received regarding the adoption of this amendment. The amendment is adopted under the Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with authority to promulgate rules. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas on May 8, 1996. TRD-9606431 Cathy L. Hendricks, ASID/IIDA Executive Director Texas Board of Architectural Examiners Effective date: May 29, 1996 Proposal publication date: April 5, 1996 For further information, please call: (512) 305-8535 Subchapter E. Fees 22 TAC sec.1.84 The Texas Board of Architectural Examiners adopts an amendment to sec.1.84, regarding Annual Registration and Renewal Fees without changes to the proposed text as published in the March 29, 1996, issue of the Texas Register (21 TexReg 2522) and will not be republished. The text addresses guidelines for penalties. The agency is adopting the rule to clarify guidelines concerning the amount of penalties incurred from failure to renew annual renewal payment by deadline dates. No comments were received regarding the adoption of this amendment. The amendment is adopted under the Texas Civil Statutes, Article 249a, which provide the Texas Board of Architectural Examiners with authority to promulgate rules. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606432 Cathy L. Hendricks ASID/IIDA Executive Director Texas Board of Architectural Examiners Effective date: May 29, 1996 Proposal publication date: March 29, 1996 For further information, please call: (512) 305-8535 Chapter 3. Landscape Architecture Subchapter E. Fees 22 TAC sec.3.84 The Texas Board of Architectural Examiners adopts an amendment to sec.3.84, regarding Annual Registration and Renewal Fees without changes to the proposed text as published in the March 29, 1996, issue of the Texas Register (21 TexReg 2523) and will not be republished. The text addresses guidelines for penalties. The agency is adopting the rule to clarify guidelines concerning the amount of penalties incurred from failure to renew annual renewal payment by deadline dates. No comments were received regarding the adoption of this amendment. The amendment is adopted under the Texas Civil Statutes, Article 249c, which provide the Texas Board of Architectural Examiners with authority to promulgate rules. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606433 Cathy L. Hendricks ASID/IIDA Executive Director Texas Board of Architectural Examiners Effective date: May 29, 1996 Proposal publication date: March 29, 1996 For further information, please call: (512) 305-8535 Chapter 5. Interior Design Subchapter E. Fees 22 TAC sec.5.95 The Texas Board of Architectural Examiners adopts an amendment to sec.5.95, regarding Annual Registration and Renewal Fees without changes to the proposed text as published in the March 29, 1996, issue of the Texas Register (21 TexReg 2524) and will not be republished. The text addresses guidelines for penalties. The agency is adopting the rule to clarify guidelines concerning the amount of penalties incurred from failure to renew annual renewal payment by deadline dates. No comments were received regarding the adoption of this amendment. The amendment is adopted under the Texas Civil Statutes, Article 249e, which provide the Texas Board of Architectural Examiners with authority to promulgate rules. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas on May 8, 1996. TRD-9606434 Cathy L. Hendricks ASID/IIDA Executive Director Texas Board of Architectural Examiners Effective date: May 29, 1996 Proposal publication date: March 29, 1996 For further information, please call: (512) 305-8535 TITLE 37. PUBLIC SAFETY AND CORRECTIONS Part 1. Texas Department of Public Safety Chapter 1. Organization and Administration Personnel and Employment Policies 37 TAC sec.1.30 The Texas Department of Public Safety adopts an amendment to sec.1.30 concerning personnel and employment policies without changes to the proposed text as published in the March 19, 1996, issue of the Texas Register (21 TexReg 2205). The justification for this section will be clarification of department policy. The amendment allows for further screening of applicants by the division chief or his authorized assistant or special section heads before interviews and final selections are made. No comments were received regarding adoption of the amendment. The amendment is adopted under Texas Government Code sec.411.006(4) which provides the director with the authority to adopt rules, subject to commission approval, considered necessary for the control of the department. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas on April 25, 1996. TRD-9606460 James R. Wilson Director Texas Department of Public Safety Effective date: May 30, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 424-2890 TITLE 40. SOCIAL SERVICES AND ASSISTANCE Part I. Texas Department of Human Services Chapter 3. Income Assistance Services The Texas Department of Human Services (DHS) adopts the repeal of sec.sec.3. 6001-3.6003; amendments to sec.sec.3.301, 3.501, 3.603, 3.902, 3.1104, 3.1801, 3. 1901, 3.3909; and new sec.sec.3.2209, and 3.6001-3.6003. The amendments to sec. sec.3. 301, 3.603, and 3.1901 are adopted with changes to the proposed text published in the March 19, 1996, issue of the Texas Register (21 TexReg 2205). The repeals of sec.sec.3.6001-3.6003, the amendments to sec.sec.3.501, 3.902, 3.1104, 3.1801, 3.3909, and new sec.sec.3.2209, and 3.6001-3.6003 are adopted without changes and will not be republished. The justification for the amendments, repeals, and new sections is to implement new policies required by Human Resources Code, sec.sec.31.0031-31.0033, 31.0035, and 31.0065. The amendments and new sections establish new requirements that Aid to Families with Dependent Children (AFDC) program recipients must comply with in order to become eligible for AFDC and to continue receiving the maximum amount of AFDC financial benefits. The new responsibility agreement requirements are related to school attendance, medical screening, and immunizations for children, abuse of alcohol and illegal drugs, voluntarily quitting employment, employment services, child support cooperation, and parenting skills training. The other new policies are related to requiring proof of citizenship, time limits on AFDC benefits, and transitional Medicaid and child care benefits for recipients who exhaust their AFDC eligibility due to the time limits. The amendments and new sections will function by ensuring that the department will be implementing the welfare reform initiative passed by the legislature in House Bill 1863 of the 1995 Regular Session of the 74th Texas Legislature. During the public comment period, DHS received two sets of comments regarding adoption of the repeals, amendments, and new sections. The commenters were Legal Aid of Central Texas and Houston Welfare Rights Organization. The following are summaries of the comments and DHS's response to the comments. Comment: A comment regarding sec.3.301(a)-(d) suggests that all the client responsibilities should be in writing with a copy going to the client, in addition to being verbally explained to ensure that recipients understand their responsibilities. Response: DHS will provide a written copy of the Personal Responsibility Agreement (PRA) to the client. In addition, staff will be required to explain the terms and conditions contained in the PRA to the client at either a group informing session or individually by the worker. Comment: A comment regarding sec.3.301(a)(4) alleges that, prior to adoption of this rule, DHS falsely required a recipient to sign the PRA as a condition of eligibility. As a result, the commenter requests that DHS obtain an "affirmative" from DHS staff that all aspects of the PRA are true before the recipient is asked to sign the PRA. Response: DHS investigated the allegation referenced by the commenter and found that the allegation was unfounded. Therefore, DHS declines to make any changes as a result of this comment. Comment: A comment regarding sec.3.301(d) states that the rule is one-sided and does not list the state's responsibilities, only the client's. The commenter proposes that the rules be revised to include the state's responsibilities. Response: DHS agrees with the commenter and has revised the proposed section to incorporate the state's responsibilities. Comment: A comment regarding sec.3.301(d)(2) requests the proposed rule be modified to require staff to accurately verify that the recipient accurately understands, either verbally or in writing, the PRA and that the recipient was asked if they have any questions and that the questions were answered to the satisfaction of the recipient. Response: DHS has developed informing materials, including videos and scripts for staff to use, in advising recipients of the requirements of the PRA. DHS routinely attempts to ensure that these materials are produced using wording which can be understood by the general client population. Staff conducting group informing sessions on the PRA will be instructed to periodically ask the recipient if there are any questions on the materials covered. Therefore, DHS does not intend to make any changes in the proposed rule. Comment: A comment regarding sec.3.301(d)(3)(A)(i) states that the client should not be penalized for incorrect information or lack of information from a third party verification source. Response: DHS is changing the reference to the EPSDT program to Texas Health Steps as a result of a decision by the Texas Department of Health (TDH) to change that program's name. DHS intends to allow the client to provide verification from the TDH worker before imposing a penalty when no information or incorrect information has been received from TDH's computer records and the client advises that they have complied with the Texas Health Steps requirement(s). Therefore, DHS does not intend to modify the wording of the proposed rule. Comment: A comment regarding sec.3.301(d)(3)(A)(ii) states that the client should not be penalized for school attendance until DHS verifies with the school that the individual is not meeting attendance requirements. Response: DHS is proposing to make the client primarily responsible for obtaining proof of school attendance. DHS is also intending to accept report cards and attendance records as proof of attendance if in the client's possession. If these documents are not readily available, DHS is developing a form which the client can take to the school to have completed. The Texas Education Agency has offered to notify school districts informing them of the school attendance requirements for AFDC recipients. Therefore, DHS does not intend to modify its proposed rule. Comment: A comment regarding sec.3.301(d)(3)(B)(iii) suggests that the proposed rule be revised to be in compliance with statutory language contained in HB-1863 (i.e., to remove references to violations of local or federal laws). One commenter also suggests that the proposed rule be revised to ensure that only recipients are penalized for convictions involving drug and alcohol offenses. Response: DHS agrees with the commenters' suggestion and revised the rule accordingly. Comment: A comment regarding sec.3.301(d)(3)(D) and sec.3.301(d)(4) suggests that no negative action be taken against the entire AFDC household for failure of one member to sign the agreement, but rather a penalty or sanction should be taken only against the non-signing person. Response: The statute allowed DHS to determine appropriate sanctions or penalties for failure or refusal to sign the PRA. It is DHS's position that denial of the entire AFDC household is in keeping with legislative intent. Therefore, DHS does not intend to modify the proposed rule. Comment: A comment regarding sec.3.301(d)(5) suggests that no penalty in excess of 1% of the AFDC grant should be imposed for failure to comply. The commenter also suggests that no penalty or sanction be imposed without first giving the recipient an opportunity to cure the noncompliance. Response: DHS is allowed, by statute, to determine appropriate sanctions or penalties for failure to comply with the terms of the PRA. The Job Opportunities and Basic Skills (JOBS), child support, and immunization sanctions proposed are consistent with current financial penalties for noncompliance. The $25 sanction for other requirements of the PRA is consistent with current immunization sanctions and DHS's Board has previously indicated that the amount of the penalty should be sufficient to influence the client's behavior. Therefore, DHS does not intend to modify the proposed rule. Comment: A comment regarding sec.3.301(d)(5)(D) states that the proposed rule does not specify how DHS intends to determine when the penalty period begins. A second commenter states that the statute does not specify a six month penalty for noncompliance with the PRA requirement related to drugs and alcohol. This commenter suggests that this penalty be removed from the proposed rule. Response: In response to the first comment, DHS agrees to modify the rule language to address the commenter's concern. In response to the second commenter's concern, the statute requires DHS to adopt rules governing sanctions and penalties for failure to comply with each requirement of the PRA. DHS believes it is legislative intent that a penalty or sanction apply for each such failure. Therefore, DHS does not propose to modify the language of the rule. Comment: A comment regarding sec.3.301(d)(5)(D)(iv) suggests that unexcused absences from parenting skills training be defined as objectively as possible and that allowing individuals to make this determination will lead to inconsistent treatment of recipients. Response: The proposed rule will be modified to reflect the current JOBS requirements which allow the case manager to make a determination of noncompliance rather than the trainer. Comment: A comment regarding sec.3.301(d)(5)(F) requests that the rule be clarified to specify whether the responsible household member must be a member of the AFDC certified group and that the responsible member be willing and able to provide the child care. Response: DHS agrees to modify the proposed rule language to specify that the responsible member must be both willing and able to provide the care. DHS intends to specify in its instructions to workers that the responsible member must be someone living in the home but not necessarily a member of the AFDC certified group. Comment: A comment regarding sec.3.301(d)(6)(E) suggests that the rule be removed. The commenter does not want recipients to be penalized for failure to comply with the PRA requirements related to drugs and alcohol; therefore, no good cause would be necessary. Response: The statute requires DHS to adopt rules governing penalties, sanctions and good cause for each of the requirements of the PRA. Therefore, DHS does not propose to make any changes to the proposed rule. Comment: Comments regarding sec.3.301(d)(6)(H) suggest that the rule be reworded to ensure that the client's right to appeal is not impeded. Response: DHS agrees to modify the proposed rule to address the commenters' concerns. Comment: Comments to sec.3.501(b)(3)(B) requests DHS include in the proposed rule the definition of severe personal hardship or local economic hardship. Response: DHS intends to propose rules at a later date to define severe personal hardship and local economic hardship. No client will be subject to hardship exceptions before July 1997. Comment: A comment regarding sec.3.501(b)(3)(C)(i) suggests that the rule be revised to add a statement that DHS will inform clients at application, reviews and 60 days before expiration of their time limit of the specific definitions of severe personal hardship and local economic hardship in language consistent with their literacy level. The commenter also suggests that the definition of severe personal hardship be broadened to address situations where an individual who has complied with all requirements exhausts his time limit and is unable to find a job that provides remuneration equal to the federal poverty income limit for his family size. Response: DHS will be proposing rules at a later date which define severe personal hardship and local economic hardship. DHS does not believe it is advisable to inform clients of the hardship criteria until they have almost reached the end of their time limit. Doing so could result in clients manipulating the system, thereby impacting the evaluation results. Comment: A comment regarding sec.3.603(a)(1) states that the requirement goes beyond federal laws and a waiver has not been requested. The commenter states that the rules should include guidelines that staff can use to determine whether citizenship is questionable and should require verification only if questionable. Response: Existing federal regulations allow the state to impose additional conditions of eligibility if consistent with the purposes of the Social Security Act. DHS has confirmed with the U.S. Department of Health and Human Services that this requirement can be imposed at the state's option without a federal waiver. DHS is proposing to verify citizenship any time an individual claims to be a U.S. citizen, not just when citizenship is questionable. Therefore, DHS does not intend to modify the proposed rule language. Comment: A comment regarding sec.3.603(a)(2) suggests that the rule be revised to specify the criteria DHS will use in determining good cause. Response: DHS agrees with the commenter and will modify the proposed rule language. Comment: Comments regarding sec.3.1901 suggests that the proposed rule language be clarified to speak to home schooling for children without disabilities. Response: DHS intends to allow home schooling to meet school attendance requirements for all children, not just disabled children. Therefore, DHS agrees to modify its rule to incorporate the commenters' suggestion. Comment: A comment regarding sec.3.2209 suggests that the proposed rule be revised to advise clients that there may also be eligibility for TP55, Medically Needy. Response: DHS's position is that the services for TP29 and TP55 are the same. Because TP29 has fewer requirements which the client must meet to receive Medicaid services, DHS sees no benefit in modifying the rule in accordance with the commenter's suggestion. The client has the option to apply for TP55 benefits at the end of the TP29 period. Therefore, DHS does not intend to modify its proposed rule. Comment: A comment regarding sec.sec.3.6001-3.6003 states that the proposed rules should not be used because they are inconsistent with the Social Security Act. The commenter further states that if DHS chooses to implement the rules as filed, then DHS should revise its rules to increase the recognizable needs amount to 50% of the current budgetary needs amount. Response: HB-1863 mandated DHS to seek a waiver whenever provisions in the bill were not allowable under existing federal laws and regulations. The waiver which DHS obtained allows the state to implement the policies contained in these rules. Therefore, DHS does not intend to withdraw the rules as filed. DHS's ability to increase the recognizable needs amount is dependent upon approval of such a request in its Legislative Appropriations Request. DHS has no plans, at this time, to request such a change. DHS has made minor editorial changes to sec.sec.3.6001-3.6003 to clarify changes that result from adding household members. General Comments Comment: A commenter suggests that DHS include rules to address the removal of the 100 hour rule and work history requirements for AFDC-Unemployed Parent (UP). Response: DHS intends to implement this change in October 1996, and will file applicable rules at a later date. Comment: A commenter suggests that DHS inform clients of their experimental status and of the nature of the experiment to which he will be subject in a manner consistent with the individual's actual literacy level at application, review and any time the nature of the experiment changes. Response: Experimental and control clients will be informed of the policies which will apply to them. DHS agrees with the commenter and will develop a method to inform clients as to which group they are assigned. Comment: A commenter takes issue with the language in the preamble to the proposed rules which indicate that there is no economic cost to clients and no effect on local governments as a result of enforcing or administering the proposed rule. Response: As we understand it, when proposed rules involve a sanction which results in reduction of the AFDC grant, the reduction in the benefit is not considered as a cost to the client. Regarding the comment related to local governments, there is no expectation by DHS that local governments be responsible for administering or enforcing the requirements of the proposed rules. Subchapter C. The Application Process 40 TAC sec.3.301 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. sec.3.301. Responsibilities of Clients and the Texas Department of Human Services (DHS). (a) To apply, clients must complete the application process. Clients must: (1) fill out and sign an application. Clients must answer the questions on the application before DHS can certify them. (2) give the application to DHS. Except for households with all SSI recipients, clients must file their applications at the office DHS designates. Applications may be filed in person, by mail, or through an authorized representative. Clients may file an application anytime during office hours and on the same day they get the form. (3) participate in an interview. DHS does not require clients to be interviewed before they file their application. (4) sign a responsibility agreement as specified in subsection (d) of this section. (5) provide proof of any eligibility factor specified in Chapter 3 of this title (relating to Income Assistance Services). Clients have the primary responsibility for providing proof needed by DHS to determine their eligibility and benefits. DHS allows clients 10 calendar days to provide requested proof. (b)-(c) (No change.) (d) Additional state and client responsibilities are explained by eligibility staff to households as a condition of Aid to Families with Dependent Children (AFDC) eligibility in Texas as specified in paragraphs (1) -(6) of this subsection. (1) Affected areas. The rules in this section apply to recipients statewide except those designated by DHS as members of the State Welfare Reform Control Group as described in sec.3.6001 of this title (relating to Applicability of Aid to Families with Dependent Children (AFDC) Policies Resulting from Human Resources Code, sec.31.0031, Relating to the Personal Responsibility Agreement). (2) Requirements. (A) State requirements. The state will: (i) provide recipients with help in finding employment and necessary support services within available resources; (ii) provide support services to strengthen the family such as life skills and parenting skills training; (iii) ensure that programs administered are efficient, fraud-free and easily accessible; (iv) gather accurate client information; (v) promote the development of community resources; (vi) promote clear and tangible goals for recipients; (vii) enable parents to provide for their children's basic necessities in a time-limited benefits program; (viii) promote education, job training and workforce development; and (ix) give communities the opportunity to develop alternative programs that meet the unique needs of local recipients. (B) Client requirements. DHS requires each adult AFDC recipient, including minor parents applying as a caretaker/second parent, as a condition of eligibility to sign a personal responsibility agreement as specified in Human Resources Code, sec.31.0031(a). Unless exempted by Human Resources Code, sec.31.0031(f), regarding unavailability of funding for support services, DHS requires household members to comply with requirements listed in Human Resources Code, sec.31.0031(d) after the agreement has been signed by an adult recipient, or the household is subject to a penalty as described in paragraph (5) of this subsection. Additionally, the requirements and penalties related to immunizations specified in Human Resources Code, sec.31.0031(d)(2) apply to cases in which the adult caretaker relative is not a certified recipient. (3) Establishing compliance. Compliance with Human Resources Code, sec.31.0031(d) is established in the following manner: (A) Recipients must provide proof of compliance with provisions in Human Resources Code, sec.31.0031(d)(2),(6), and (7) at each periodic review. DHS accepts the following as proof of compliance: (i) Human Resources Code, sec.31.0031(d)(2). For Texas Health Steps medical screens, DHS uses information from National Heritage Insurance Company's (NHIC's) paid claims system; or verification provided by staff of TDH as a backup. For the immunization requirement, DHS accepts immunization records completed by a doctor or other medical professional licensed to perform immunization services indicating that a child's immunizations are current or if not current that the medical provider has established an alternate schedule for the child. DHS also accepts verification of school attendance at a public school in Texas, or proof that a child is current for Texas Health Steps as proof for purposes of meeting the immunization requirement. (ii) Human Resources Code, sec.31.0031(d)(6) and (7). DHS accepts written or verbal proof from the school that each household member, unless exempted under Human Resource Code, sec.31.0031(d)(6) is attending school regularly (as determined by the school). (B) Recipients are considered to be in compliance related to the sections of the Human Resource Code, described in clauses (i)-(iv) of this subparagraph unless noncompliance is determined. (i) Human Resources Code, sec.31.0031(d)(4) and (8) unless noncompliance is determined pursuant to sec.3.1104 of this title (relating to Failure to Comply with the Job Opportunities and Basic Skills (JOBS) Program); (ii) Human Resources Code, sec.31.0031(d)(3) unless DHS verifies the recipient voluntarily quit a job; (iii) Human Resources Code, sec.31.0031(d)(5) unless DHS determines the recipient since signing the Personal Responsibility Agreement, has committed and been convicted of, or has a deferred adjudication for: (I) using, selling, or possessing marijuana or any other controlled substance in violation of Health and Safety Code, Chapter 481, or (II) the abuse of alcohol; or (iv) Human Resources Code, sec.31.0031(d)(1) unless noncompliance is determined pursuant to sec.3.1801 of this title (relating to Aid to Families with Dependent Children Child Support Requirements). (4) Failure to sign the agreement. If a member of the household who is required to sign the agreement fails or refuses to sign, the application or case for the entire AFDC household is denied. (5) Penalties for noncompliance with requirements. Failure to comply results in the penalties specified in subparagraphs (A)-(D) of this paragraph. (A) Penalty amounts for noncompliance with Human Resources Code, sec.31. 0031(d)(1) and (4). Noncompliance results in a financial penalty of the grant amount equal to the recognizable needs figure of: (i) a single parent if one adult fails to comply; or (ii) a caretaker and second parent if two adults are subject to a noncompliance penalty in the same month. (B) Penalty amounts for noncompliance with each of the remaining requirements specified in Human Resources Code, sec.31.0031(d). Noncompliance results in a monthly financial penalty of $25 for each separate determination of noncompliance until the penalty has ended, subject to the caps specified in subparagraph (C) of this paragraph. (C) Penalty caps. The maximum penalty is $75 when three or more penalties as described in subparagraph (B) of this paragraph apply for the same month. If penalties pursuant to subparagraphs (A) and (B) of this paragraph are applicable for the same month, DHS applies only the penalty or penalties pursuant to subparagraph (A) of this paragraph. (D) Penalty periods. DHS starts penalty periods beginning with the earliest month benefits can be adjusted. The penalty for noncompliance with Human Resources Code, sec.31.0031(d)(4) is imposed for the time period specified in sec.3.1104 and sec.3.1105 of this title (relating to Failure to Comply with the Job Opportunities and Basic Skills (JOBS) Program and Establishing Eligibility). The penalty for noncompliance with Human Resources Code, sec.31.0031(d)(3) is imposed for three consecutive months, or fewer than three months, if the recipient returns to that job or another comparable job, according to the regulations applicable to the Food Stamp Program, as specified in 7 Code of Federal Regulation sec.273.7(n)(5)(ii), relating to voluntary quit. The penalty for noncompliance with Human Resources Code, sec.31. 0031(d)(5) is imposed for six consecutive months. The penalties for noncompliance with requirements specified in Human Resources Code, sec.31. 0031(d)(1), (2), (6), (7), and (8) remain in effect until the month after the noncompliance ends. DHS considers noncompliance with these requirements to have ended as specified in: (i) Human Resources Code, sec.31.0031(d)(1). DHS is notified by the Title IV-D agency of the parent's compliance with child support requirements. (ii) Human Resources Code, sec.31.0031(d)(2). Medical screening for the child is completed, treatments are completed, or the recipient has shown good faith effort because treatments are initiated by the medical provider. Immunizations are current or the recipient has shown good faith effort because an immunization schedule is established by the medical provider. (iii) Human Resources Code, sec.31.0031(d)(6) and (7). The recipient has shown a good faith effort because he or she provides verification from the school that the required student has attended school without an unexcused absence (as determined by the school) for one calendar month. (iv) Human Resources Code, sec.31.0031(8). For recipients participating in the JOBS program, the case manager monitors and ensures the client participates and completes the parenting skills program. The case manager determines noncompliance. (E) Delayed penalties. If a particular penalty cannot be imposed initially due to the penalty cap explained in subparagraph (C) of this paragraph, it will be imposed later during the penalty period if the removal of another penalty makes it possible to do so without exceeding the penalty cap. For purposes of counting months of penalty pursuant to Human Resources Code, sec.31.0031(d)(3) and (5), a month in which a penalty is applicable counts even if the penalty cannot be imposed because of the penalty cap specified in subparagraph (C) of this paragraph. (6) Good cause. Good cause for noncompliance as specified in Human Resources Code, sec.31.0033 is established for the requirements listed in Human Resources Code, sec.31.0031(d) as explained in the following subparagraphs. (A) Human Resources Code, sec.31.0033(d)(1). Good cause is established as specified in 45 Code of Federal Regulations (CFR) sec.sec.232.40-232.47, regarding child support. (B) Human Resources Code, sec.31.0033(d)(2). Good cause is established for recipients who are exempt under the provisions in Health and Safety Code, sec.161.004(d), regarding immunizations. (C) Human Resources Code, sec.31.0033(d)(3). Good cause is established according to the regulations applicable to the Food Stamp Program as specified in 7 CFR sec.273.7(n)(3), regarding voluntary quit. (D) Human Resources Code, sec.31.0031(d)(4). Good cause is established as specified in 45 CFR sec.250.35 and Human Resources Code, sec.31.0031(f), regarding employment education and training activities. (E) Human Resources Code, sec.31.0031(d)(5). Good cause cannot be established for this requirement. (F) Human Resources Code, sec.31.0031(d)(6) and (7). Good cause is established as specified in Human Resources Code, sec.31.0031(f) regarding lack of funding for support services. Regarding child care or day care, good cause is established if child care for a child under the age of 12 years (or day care for any incapacitated individual) living in the same home as the recipient is necessary for an individual to attend school, and such care is not available and outside funding is not available to provide such care. If there is another responsible household member in the home who is willing and able to provide such care, good cause does not apply. Good cause is also established if a student is expelled from school and the school system verifies it does not offer an alternative educational program. (G) Human Resources Code, sec.31.0031(d)(8). Good cause is established as specified in 45 CFR sec.250.35 and Human Resources Code, sec.31.0031(f), regarding parenting skills training. (H) Good cause noncompliance hearings. As required by the Human Resources Code, sec.31.0033, if the recipient claims good cause during the 13-day period after notice of adverse action concerning the noncompliance penalty is sent, DHS either makes a determination on the claim before the 13-day period expires or files the claim as a fair hearing pursuant to DHS's rules. The recipient retains the right to request a fair hearing within 90 days of agency action pursuant to Chapter 79 of this title (relating to Legal Services). This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606377 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter E. Household Determination 40 TAC sec.3.501 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606378 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter F. Citizenship 40 TAC sec.3.603 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. sec.3.603. Disqualification because Verification of Citizenship Is Pending. (a) Aid to Families with Dependent Children. (1) An applicant must not be certified for benefits until proof of citizenship is received, unless good cause exists. The Texas Department of Human Services (DHS) obtains proof for persons born in Texas through an automated inquiry process with the Texas Bureau of Vital Statistics when possible. If good cause exists at application, the person is certified and must provide proof by the next periodic review or be disqualified until proof is provided. (2) Good cause exists if the applicant or recipient has made a good faith effort to provide the proof and DHS verified that circumstances beyond the applicant's or recipient's control exist which prevented the applicant or recipient from being able to provide the proof, such as delays in receiving the proof from a person or organization from which the proof has been requested. (b) Food stamps. (1) A person with a questionable citizenship claim must not be certified for benefits until proof of citizenship is received. (2) DHS disqualifies a person with a questionable claim and counts the disqualified person's pro rata share of income and all resources as household income and resources. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606379 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter I. Income 40 TAC sec.3.902 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606380 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter K. Employment Services 40 TAC sec.3.1104 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31 which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606392 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter R. Child Support 40 TAC sec.3.1801 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606393 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter S. School Attendance 40 TAC sec.3.1901 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. sec.3.1901. Aid to Families with Dependent Children (AFDC) School Attendance Requirements. AFDC clients must meet school attendance requirements as stipulated in 45 Code of Federal Regulations sec.233.90(b)(2) and (3). Children with disabilities may attend fewer hours than other students or receive instructions from a visiting teacher at home. Additionally, AFDC children who are home schooled are considered as meeting school attendance requirements specified in sec.3.301(d) of this title (relating to Responsibilities of Clients and the Texas Department of Human Services (DHS)). This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606394 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter V. Medicaid Eligibility 40 TAC sec.3.2209 The new section is adopted under the Human Resources Code, Title 2, Chapters 22 and 31 which provides the department with the authority to administer public and financial assistance programs. The new section implements the Human Resources Code, sec.22.001 and sec.31. 003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606395 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter MM. Aid to Families with Dependent Children - Unemployed Parent Program 40 TAC sec.3.3909 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The amendment implements the Human Resources Code, sec.22.001 and sec.31.003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606396 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter PP. Immunization Requirements 40 TAC sec.sec.3.6001-3.6003 The repeals are adopted under the Human Resources Code, Title 2, Chapters 22 and 31, which provides the department with the authority to administer public assistance and financial assistance programs. The repeals implement the Human Resources Code, sec.22.001 and sec.31.003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606381 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Subchapter PP. Applicability of Policies Resulting from Texas House Bill 1863 40 TAC sec.sec.3.6001-3.6003 The new sections are adopted under the Human Resources Code, Title 2, Chapters 22 and 31 which provides the department with the authority to administer public assistance and financial assistance programs. The new sections implement the Human Resources Code, sec.22.001 and sec.31. 003. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606397 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: May 29, 1996 Proposal publication date: March 19, 1996 For further information, please call: (512) 438-3765 Chapter 15. Medicaid Eligibility Subchapter G. Application for Medicaid 40 TAC sec.sec.15.609-15.611, 15.617 The Texas Department of Human Services (DHS) adopts amendments to sec.sec.15. 609-15.611 and 15.617, concerning applicants and their allowed representatives, allowed signatures, and denials, in its Medicaid Eligibility rule chapter, without changes to the proposed text published in the March 12, 1996, issue of the Texas Register (21 TexReg 2004). The justification for the amendments is to ensure Qualified Medicare Beneficiary/Specified Low-Income Medicare Beneficiaries (QMB/SLMB) benefits are received by entitled clients and limit who can apply for Medicaid on behalf of a deceased client if no bona fide agent was appointed before the client's death. The amendments will function by ensuring that a client will receive all benefits he is entitled to receive. The limit on who may apply on behalf of a deceased client complies with state law. The Texas Health Care Association submitted one comment regarding sec.15. 610(d)(4)(C), which limits the individuals who can file for Medicaid benefits on behalf of a deceased client. The comment stated that nursing facilities might refuse to admit patients who do not have bona fide agents and recommended that exceptions to the list of bona fide agents be allowed on a case-by-case basis. DHS does not agree with the comment because the proposed rule concerns deceased clients only. A nursing facility, at the time of the client's admission, could obtain a signed statement naming the nursing facility administrator or another staff member who obtained admission information as bona fide agent to file for Medicaid, if needed. DHS accepts that documentation. DHS adopts the rule without change. The amendments are adopted 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 Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendments implement the Human Resources Code sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606462 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: June 1, 1996 Proposal publication date: March 12, 1996 For further information, please call: (512) 438-3765 Chapter 19. Nursing Facility Requirements for Licensure and Medicaid Certification The Texas Department of Human Services (DHS) adopts the repeal of sec.sec.19. 300-19.315, 19.1612, 19.1701-19.1727, and 19.2105; amendments to sec.sec.19.202, 19.204, 19.402, 19.416, 19.1210, 19.1807, 19.1918, 19.2208, 19.2324, 19.2326, 19.2403; and adopts new sec.sec.19.300-19.326, 19.330-19.343, 19.1701, and 19.2412. New sec.sec.19.305, 19.309, 19.319, 19.330, 19.331, and 19.342 are adopted with changes to the proposed text. DHS adopts the repeal of sec.sec.19.300-19.315, 19. 1612, 19.1701-19.1727, and 19.2105; amendments to sec.sec.19.202, 19.204, 19.402, 19.416, 19.1210, 19.1807, 19.1918, 19.2208, 19.2324, 19.2326, 19.2403; and new sec.sec.19.300-19.304, 19.306-19.308, 19.310- 19.318, 19.320-19.326, 19.332-19.341, 19.343, 19.1701, and 19.2412 without changes to the proposed text as published in the February 13, 1996, issue of the Texas Register (21 TexReg 1035) and the text will not be republished. Section 19.1921 was withdrawn in the April 12, 1996, issue of the Texas Register (21 TexReg 3163). Justification for the repeals, amendments, and new sections is clear and correct rules. The repeal of sec.sec.19.300-19.315 will function by modifying the facility construction requirements. The repeal of sec.19.1612 will function by deleting rules incorrectly placed in this subchapter and which are now being correctly placed in new sec.19.2412. The repeal of sec.sec.19.1701-19.1727 will function by transferring the facility construction requirements to sec.sec.19.300-19.326. The repeal of sec.19.2105 will function by deleting outdated rules. The amendments will function by stating correct references and clarifying the rules through other minor corrections. The new sections will function by combining the physical plant and environment requirements with the facility construction requirements. The department received comments from the Texas Health Care Association regarding the adoption of the proposed rules. Summaries of the comments and DHS's responses follow. Comment: Regarding sec.19.305 (2)(B), the language is repetitious, as this requirement is stated verbatim in the preceding paragraph. Response: DHS agrees and has deleted "a clean, comfortable mattress with a moisture-proof cover, and a comfortable pillow" from sec.19.305(2)(A) and moved it under sec.19.305(2)(B). Comment: Regarding sec.19.305(2)(D), the federal standards for new construction reference 22 inches of hanging space; the reference to 16 inches of hanging space in this paragraph may be an inadvertent reference to a state requirement that was "grandfathered" in for existing facilities, not new construction. Verify that the hanging space requirements listed in this paragraph are appropriately referencing new construction. Response: This paragraph applies to existing facilities only and not to new construction. Please note that sec.19.334(a)(9) contains the hanging space requirement of 22 inches for new construction. DHS has deleted "new and" from sec.19.300(b) in response to the comment. Comment: Regarding sec.19.309(1)(C)-(D), wording from each of these paragraphs was printed incorrectly. Edit the paragraphs to ensure that the requirements mirror those of the existing regulations, as was obviously the original intent. Response: The wording has been corrected. Comment: Regarding sec.19.319(4), the existing regulations state that grab bars must be 1-1/4" to 1-1/2" in diameter. Obviously a typographical error that was overlooked prior to publication, the proposed rule references 1/4" to 1/2" diameters for grab bars. Response: The error has been corrected. Comment: Regarding sec.19.323 - sec.19.326, these requirements, though worthy and important, have nothing to do with the construction of new buildings. Move these sections, in their entirety, to more relevant sections of the licensure standards, such as Administration and/or Physical Plant and Environment. Response: No change is required. The section pertains to general requirements, i.e., construction, equipment, and maintenance of existing facilities. Comment: Regarding sec.19.330, the elimination of the plan review requirements shifts responsibility from the DHS Long Term Care Regulatory Architectural Division to both providers and the DHS regional staff regarding the correct and/or consistent interpretation of regulations governing the proper construction of a new facility. Subsequently, interpretation of these regulations by DHS regional staff can vary from region to region, a fact well known by providers who operate in more than one DHS region. Currently, when providers appeal a decision or rule interpretation by DHS regional staff, the appeal is many times officiated by the same staff that originally rendered the decision or interpretation. In the absence of a central appeals mechanism at the state level, this means that there could very easily be several different interpretations of the same regulation in existence at the same time. At a minimum, the proposed rules should establish a central appeals mechanism for an objective third party review at the state level to ensure consistent rule interpretation and enforcement throughout the state. Response: Matters of consistent application or interpretations of construction requirements are addressed through on-going training and communications with DHS surveyors. Interpretation of the regulation governing the construction of new facilities is part of the license application process. If a license application is denied, a formal appeal is available. No change is necessary. Comment: Regarding sec.19.330(b), although the providers involved in new construction have the referenced documents readily available, there should be no need for these documents at the state level because there is no longer a plan review mechanism or requirement in place. Removing the requirement for the submission of these documents would reduce the volume of paperwork for both the agency and the industry. Remove this requirement in its entirety. Response: The documents must be provided to the surveyor conducting the initial survey to assure him or her that the facility was, in fact, constructed in accordance with the requirements. Only the final set of documents is required by the surveyor upon approval of the completed construction and must be made a part of the initial survey packet for the facility file. No change is necessary. Comment: Regarding sec.19.330(c)(3), this requirement does nothing but increase paperwork for the agency and the industry, and in many cases, irritate the "local authorities." For example, fire marshalls are already required to sign certificates of occupancy at the local level. Requiring these local fire marshalls to provide a letter of approval (for DHS) that is above and beyond what is required at the local level is a needless paperwork requirement that is viewed by providers and local authorities alike as a pointless bureaucratic step. Either delete the requirement for "written approval of local authorities" or insert language that states that documentation of local approval that is already on file (i.e., certificates of occupancy) is sufficient. Response: DHS clarified the section by stating that "A copy of" the written approval be provided. DHS is not requiring a separate letter of approval, but simply a copy of the certificate of occupancy and other such documents that the local authorities have already provided to the facility. Comment: Regarding sec.19.330(c)(3)(G), although the intent of this proposed rule is a worthy one, the wording "he certifies" may actually be too restrictive. Reputable architects and engineers, for liability reasons, carry "error and omissions" insurance as protection against an oversight or omission on their part. Since letters of certification imply absolute perfection on the part of the architect or engineer, most error/omissions insurance policies will not cover such a letter. Hence, architects and engineers will be extremely hesitant to submit and providers will find very difficult to obtain these types of "certification letters". Delete the words "he certifies" from the requirement. Doing so would make the necessary documentation much easier to obtain while keeping intact the architect and/or engineer's liability that the building was constructed to code. TDHS should also check with the Texas Society of Professional Engineers and the American Institute of Architects for additional guidance before this rule is finalized. Response: "To certify" implies that reliable assurance is being provided that the facility is in substantial conformance with the construction requirements, as stated in the standards, which is not "absolute perfection." Based on telephone conversations with staff at the Texas State Board of Registration for Professional Engineers, DHS staff determined that statements of certification are customarily provided. DHS made no change. Comment: Section 19.334(e)(1) references Figure 1 for 40 TAC sec.19.334(e)(1) for the appropriate sizes of social-diversional spaces, which appears to be an incorrect reference. Verify that the reference to 40 TAC is correct. Response: Figure 1 for 40 TAC sec.19.334(e)(1) can be found on page 1187 of the February 13, 1996, issue of the Texas Register under Tables and Graphics, Part II-Volume 21, Number 12. Comment: Regarding sec.19.342(7), the existing regulations state that grab bars must be 1-1/4" to 1-1/2" in diameter. Obviously a typographical error that was overlooked prior to publication, the proposed rule references 1/4" to 1/2" diameters for grab bars. Edit the paragraphs to ensure that the requirements mirror those of the existing regulations, as was obviously the original intent. Response: The error has been corrected. Comment: Regarding sec.19.2403 and sec.19.2412, the TILE rules are too vague and much of the information in the instructions needs to be processed through the APA. After the Texas Nurses Foundation report is completed, rules for the TILE program need to be reexamined. Response: DHS agrees that the TILE rules need to be re-examined in light of the TNF report; however, DHS will make these changes now. The change in sec.19. 2403 is simply correcting an error in a reference and the new sec.19.2412 is merely being moved from an incorrect location. Comment: Section 19.2412(b)(2) lacks details on the review process and should be revised and expanded. Response: DHS plans to revise the section at a later date. In addition, DHS has made the following changes. In sec.19.330(a)(1) "Architectural Section" is now "Long Term Care-Regulatory." In sec.19.330(c)(1) "architectural section" is now "architectural inspecting surveyor." In sec.19. 331(b) "Any conflicts must be made known to DHS for appropriate resolution" is now "Any conflicts must be made known to DHS respective Long Term Care- Regulatory office." Subchapter C. Nursing Facility Licensure Application Process 40 TAC sec.19.202, sec.19.204 The amendments are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendments implement the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606520 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter D. Facility Construction 40 TAC sec.sec.19.300-19.315 The repeals are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The repeals implement the Human Resources Code, sec.sec.22.001-22.03024 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606521 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 40 TAC sec.sec.19.300-19.326, 19.330-19.343 The new sections are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The new sections implement the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. sec.19.305. Resident Rooms. Resident rooms must be designed and equipped for adequate nursing care, comfort, and privacy of residents. (1) Bedrooms must: (A) accommodate no more than four residents. The total number of beds in ward rooms with three or more beds must not exceed 50% of the total facility capacity in existing facilities unless approved by the Texas Department of Human Services (DHS). (B) measure at least 80 square feet per resident in multiple resident bedrooms and at least 100 square feet in single resident rooms. (C) have direct access to an exit corridor. (D) be designed or equipped to assure full visual privacy for each resident. Appropriate measures must be taken through the use of cubicle curtains, screens, or procedures to protect the privacy and dignity of the residents. Curtains and screens must be rendered and maintained flame-retardant. (E) in facilities initially certified after March 31, 1992, except in private rooms, have ceiling-suspended curtains for each bed, which extend around the bed to provide total visual privacy, in combination with adjacent walls and curtain (see paragraph (4) of this section) . (F) have at least one operable window to the outside which can readily be opened from the inside without the use of tools. The height of the window sill (opening) must not exceed 36 inches above the floor. The minimum area of windows in each bedroom must equal at least 8.0% of the room area. Operable window sections may be restricted to not more than six nor less than four inches for security or safety reasons if approved in writing by DHS. Each window must be provided with a flame-retardant shade, curtain, or blind. (G) have a floor at or above grade level. (2) The facility must provide each resident with: (A) a separate bed of proper size and height for the convenience of the resident. The bed will be a minimum of 36 inches wide with a headboard of sturdy construction. Each bed must be provided with suitable bedspreads and blankets to assure the comfort and warmth of each resident, and must not be passed from resident to resident without first being laundered. The bed of each resident with physician's orders for bedrails must have bedrails affixed to both sides of the bed; (B) a clean, comfortable mattress with a moisture-proof cover, and a comfortable pillow; (C) bedding appropriate to the weather and climate; and (D) functional furniture appropriate to the resident's needs including a comfortable chair, bedside cabinet, and individual closet space in the resident bedroom with at least 16 inches of hanging space, shelves for personal belongings accessible to the resident, and closeable door(s). Each bedroom must be provided with at least one noncombustible wastebasket. (3) DHS may permit variations in requirements specified in paragraph (1)(A) and (B) of this section relating to rooms in individual cases when the facility demonstrates in writing that the variations: (A) are required by the special needs of the residents; and (B) will not adversely affect residents' health and safety. (4) The width and length of bedrooms and the arrangement of furniture must assure appropriate resident circulation, especially in relation to emergency evacuation and to usual wheelchair movement. Bedrooms should not be less than 10 feet in the smallest dimension. There must be at least 36 inches between beds and should be at least 18 inches between any bed and the adjacent parallel wall that restricts access by the resident (that is, bed sides should not have to be placed against a wall to meet other spacing requirements). Beds must not extend into the bedroom door opening, nor must any other piece of furnishing or equipment be located where it might preclude or inhibit the removal of any bed or closing and latching of the bedroom door in an emergency. (5) Each bed must have access to a nurse-call device that is part of an electrical nurse-call system. (6) Each bed must be provided with an appropriate, safe, durable, nonglare, permanently bed-mounted or wall-mounted reading-light fixture. The fixture must be wired in accordance with National Fire Protection Association (NFPA) 70. These fixtures should be mounted at least five feet, six inches above the floor. The switch must be within reach of a resident in the bed. (7) At least one duplex receptacle must be provided for each bed. Other duplex receptacles must be provided as needed and/or as required by NFPA 70. (8) Each bedroom must be assured of having general lighting, either by means of appropriate combination reading light or by means of separate fixture. (9) For emergency separation from fire and smoke, bedroom doors must be maintained to close completely without dragging or binding, to latch securely, and to fit reasonably tight in the frame. The gap between the floor and the bottom of the closed door must not exceed 3/4 inch. (10) Vacant bedrooms may not be used for hazardous activities or hazardous storage, unless specifically approved by DHS in writing. (11) Bedrooms must be identified with a raised or recessed unique number placed on or near the door. Refer to sec.19.319(c) of this title (relating to Provisions for Persons with Disabilities) and sec.19.301(c)(5) of this title (relating to Applicable Codes and Standards). (12) Residents must be permitted and encouraged to have personal possessions in their rooms that do not interfere with their care, treatment, or well-being, or that of other residents. Pediatric resident's rooms should be decorated and furnished in accordance with the age and developmental level of the children and as an expression of their individual preferences. (13) Locks on bedroom doors are permitted when they meet definite patient needs, including the following situations: (A) married couples whose rights of privacy could be infringed upon unless bedroom door locks are permitted; (B) residents for whom the attending physician wants bedroom door locks to enhance their sense of security; and (C) residents for whom restraint through confinement to their own rooms is necessary for their own and/or other persons' safety. (14) In situations such as those listed in paragraph (13) of this section, the following guidelines must be met: (A) bedroom door locks for other than restraining purposes must be of the type which the occupant can unlock at will from inside the room; (B) all bedroom door locks must be of the type which can be unlocked from the corridor side; (C) attendants must carry keys which will permit ready accessibility to the locked bedrooms when entrance becomes necessary; (D) bedroom doors which are locked for resident restraining purposes must be dutch-doors, with only the lower section locked. The upper part of the doorway must be open to permit visual supervision of the residents from the corridor. The dutch door should be easily unlocked by nurses and attendants. Resident restraints of any nature cannot be applied without orders from the attending physician. See sec.19.601 of this title (relating to Resident Behavior and Facility Practice). (E) locking of bedroom doors by residents for privacy or security or by nursing facility staff for restraint (dutch door) will not be permitted except when specifically included in the attending physician's written orders or authorized by the nursing facility administrator. sec.19.309. Other Environmental Conditions. The facility must provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public. (1) The facility must: (A) establish procedures to ensure that water is available to essential areas when there is a loss of normal water supply; (B) have adequate outside ventilation by means of windows, mechanical ventilation, or a combination of the two; (C) maintain an effective pest control program so that the facility is free of pests and rodents; and (D) equip corridors with firmly secured handrails on each side on all walls 18 inches or greater. These rails must be substantially anchored to withstand downward force and must be mounted 33 to 36 inches from the floor. (2) No occupancies or activities undesirable to the health, safety, or well- being of residents will be located in the facility. (3) For pediatric residents, the environment must be the least restrictive allowable while remaining within the parameters of safety. All areas of the facility accessible to children must be "child proof" for safety hazards. This type of safety proofing is above the normal level of hazard control maintained for adult residents and includes the addition of safety covers on electrical outlets not in use which are accessible to children. (4) In operations where there is a chance of cross-contamination, clean and soiled operations must be separated to lessen the chance of cross-contamination by facility employees, residents, and others. This separation must be in relation to traffic flow, air currents, air exhaust, water flow, vapors, and other conditions. (5) An electric water cooler or water fountain must be accessible to residents. When new drinking fountains are provided, at least one must be installed to be accessible to persons in wheelchairs. (6) Public toilet(s) with sanitary handwashing and drying provisions must be provided or designated. (7) If deodorant is used for air-freshening purposes, the following procedures must apply: (A) deodorants or air fresheners are permitted provided the dispensing device is located where it is inaccessible to residents and patients; (B) these products are not used to cover odors resulting from poor housekeeping practices or unsanitary conditions; (C) these products are not used in excess; (D) there is no contra-indication on the label of the product indicating that the product should not be used in the presence of aged or ill persons; and (E) devices, such as ozone generators, ultra-violet generators, and smoke eliminators, must be approved by the Texas Department of Human Services. sec.19.319. Provisions for Persons with Disabilities. New facilities and additions must meet the requirements of the Texas Department of Licensing and Regulation, Elimination of Architectural Barriers Section. Existing facilities must meet the requirements of the Americans with Disabilities Act and must, at a minimum, comply with the following: (1) The facility must provide and mark at least one parking space for persons with disabilities. (2) The facility must provide wheelchair access into the building by use of ramps and curb breaks. Ramps must not slope more than 1:12 (one unit of rise to 12 units of run). (3) Room identification signs or letters must be installed four feet six inches to five feet above finished floor and located on the corridor walls adjacent to the latch side of the door jamb. Letters or numbers on signs must be raised or recessed at least 1/32 inch minimum. Characters must be at least 5/8 inch in height and no higher than two inches. (4) Grab bars at toilet and bathing units must be 1-1/4 inch to 1-1/2 inch in diameter. (5) Toilet facilities must be available and of sufficient size to accommodate wheelchairs. There must be at least one public wheelchair-accessible restroom. (6) Water closet seat height in toilet facilities for persons with disabilities must be 17 to 19 inches from floor. (7) Mirrors and dispensers for persons with disabilities must be no higher than 40 inches above the floor. (8) Drinking fountains or coolers must meet American National Standards Institute (ANSI) A117.1 (that is, up front spout and controls no more than 36 inches from floor maximum). Fountains existing at the time of this publication do not have to be altered. (9) Public telephones, if provided, must meet ANSI A117.1. Mounting height must not exceed 48 inches to coin slot. sec.19.330. Construction and Initial Survey of Completed Construction. (a) Construction phase. (1) The Texas Department of Human Services (DHS), Long Term Care-Regulatory in Austin, Texas, must be notified in writing of construction start. (2) All construction must be done in accordance with minimum licensing requirements. It is the sponsor's responsibility to employ qualified personnel to prepare the contract documents for construction of a new facility or remodeling of an existing facility. Contract documents for additions and remodeling and for the construction of an entirely new facility must be prepared by an architect licensed by the Texas State Board of Architectural Examiners. Drawings must bear the seal of the architect. Certain parts of final plans, designs, and specifications must bear the seal of a registered professional engineer approved by the State Board of Registration for Professional Engineers to operate in Texas. These certain parts include sheets and sections covering structural, electrical, mechanical, and sanitary engineering. (A) Remodeling is the construction, removal, or relocation of walls and partitions, the construction of foundations, floors, or ceiling-roof assemblies, the expanding or altering of safety systems (including, but not limited to, sprinkler, fire alarm, and emergency systems), or the conversion of space in a facility to a different use. (B) General maintenance and repairs of existing material and equipment, repainting, applications of new floor, wall, or ceiling finishes, or similar projects are not included as remodeling, unless as a part of new construction. DHS must be provided flame spread documentation for new materials applied as finishes. (b) Contract documents. (1) Site plan documents must include grade contours; streets (with names); north arrow; fire hydrants; fire lanes; utilities, public or private; fences; unusual site conditions, such as ditches, low water levels, other buildings on- site; and indications of buildings five feet or less beyond site property lines. Site plan documents for nursing facilities may include the developed landscaping plan for resident use as called for in sec.19.332(f) of this title (relating to Location and Site) . (2) Foundation plan documents must include general foundation design and details. (3) Floor plan documents must include room names, numbers, and usages; resident care areas; doors (numbered) including swing; windows; legend or clarification of wall types; dimensions; fixed equipment; plumbing fixtures; and kitchen basic layout; and identification of all smoke barrier walls (outside wall to outside wall) or fire walls. (4) For both new construction and additions or remodeling to existing buildings, an overall plan of the entire building must be drawn or reduced to fit on an 8-1/2 inch by 11 inch sheet. (5) Schedules must include door materials, widths, types; window materials, sizes, types; room finishes; and special hardware. (6) Elevations and roof plan must include, but is not limited to, exterior elevations, including material note indications and any roof top equipment, roof slopes, drains, and gas piping, and interior elevations where needed for special conditions. (7) Details must include wall sections as needed (especially for special conditions); cabinet and built-in work, basic design only; cross sections through buildings as needed; and miscellaneous details and enlargements as needed. (8) Building structure documents must include structural framing layout and details (primarily for column, beam, joist, and structural frame building); roof framing layout (when this cannot be adequately shown on cross section); cross sections in quantity and detail to show sufficient structural design and structural details as necessary to assure adequate structural design, also calculated design loads. (9) Electrical documents must include electrical layout, including lights, convenience outlets, equipment outlets, switches, and other electrical outlets and devices; service, circuiting, distribution, and panel diagrams; exit light system (exit signs and emergency egress lighting); emergency electrical provisions (such as generators and panels); fire alarm and similar systems (such as control panel, devices, and alarms); a nurse call system; and sizes and details sufficient to assure safe and properly operating systems. (10) Plumbing documents must include plumbing layout with pipe sizes and details sufficient to assure safe and properly operating systems, water systems, sanitary systems, gas systems, other systems normally considered under the scope of plumbing, fixtures, and provisions for combustion air supply. (11) Heating, ventilation, and air-conditioning (HVAC) documents must include sufficient details of HVAC systems and components to assure a safe and properly operating installation including, but not limited to, heating, ventilating, and air-conditioning layout, ducts, protection of duct inlets and outlets, combustion air, piping, exhausts, and duct smoke and/or fire dampers; and equipment types, sizes, and locations. (12) Sprinkler system documents must include plans and details of National Fire Protection Association (NFPA) designed systems; plans and details of partial systems provided only for hazardous areas; electrical devices interconnected to the alarm system. (13) Other layouts, plans, or details as may be necessary for a clear understanding of the design and scope of the project; including plans covering private water or sewer systems must be reviewed by the local health or wastewater authority having jurisdiction. (14) Specifications must include installation techniques, quality standards and/or manufacturers, references to specific codes and standards, design criteria, special equipment, hardware, painting, and any others as needed to amplify drawings and notes. (c) Initial survey of completed construction. (1) Upon completion of construction, including grounds and basic equipment and furnishings, a final construction inspection (initial survey) of the facility, including additions or remodeled areas, is required to be performed by DHS's architectural inspecting surveyor prior to occupancy. A minimum of three weeks advance notice is needed. The completed construction must have the written approval of the local authorities having jurisdiction, including the fire marshal and building inspector. (2) After the completed construction has been surveyed by a representative of DHS's architectural section and found acceptable, this information will be conveyed to the licensing officer as part of the information needed to issue a license to the facility. In the case of additions or remodeling of existing facilities, a revision or modification to an existing license may be necessary. Note that the building, grades, drives, parking, and grounds must be essentially 100% complete at the time of this initial survey visit for occupancy approval and licensing, including basic furnishings and operational needs. (3) A copy of the following documents must be provided to DHS's architectural inspecting surveyor at the time of the survey of the completed building: (A) written approval of local authorities as called for in paragraph (1) of this subsection; (B) written certification of the fire alarm system by the installing agent (the Texas State Fire Marshal's Fire Alarm Installation Certificate); (C) documentation of materials used in the building which are required to have a specific limited fire or flame spread rating including, but not limited to, special wall finishes or floor coverings, flame retardant curtains (including cubicle curtains), and rated ceilings. This must include a signed letter from the installer verifying that the material installed, such as carpeting, is the same material named in the laboratory test document; (D) approval of the completed sprinkler system installation by the Texas Department of Insurance or the designing engineer. A copy of the material list and test certification must be available; (E) service contracts for maintenance and testing of systems, including, but not limited to, alarm systems and sprinkler systems; (F) a copy of gas test results of the facility's gas lines from the meter; (G) a written statement from an architect and/or engineer stating that he certifies that the building was constructed to meet NFPA 101, Life Safety Code, and all locally applicable codes, and that the facility is in substantial conformance with minimum licensing requirements; and (H) the contract documents specified in subsection (b) of this section. (d) Nonapproval of new construction. (1) If, during the survey of completed construction, the surveyor finds certain basic requirements not met, DHS will not license the facility or approve it for occupancy. Such basic items may include the following: (A) construction which does not meet minimum code or licensure standards for basic requirements such as corridor widths being less than eight feet clear width, ceilings installed at less than the minimum seven feet six inches height, resident bedroom dimensions less than required width, and other similar features which would disrupt or otherwise adversely affect the residents and staff if corrected after occupancy; (B) no written approval by local authorities; (C) fire protection systems not completely installed or not functioning properly including, but not limited to, fire alarm systems, emergency power and lighting, and sprinkler systems; (D) required exits are not all usable according to Life Safety Code requirements; (E) telephone not installed or not properly working; (F) sufficient basic furnishings, essential appliances and equipment are not installed or not functioning; and (G) any other basic operational or safety feature which the surveyor, as the authority having jurisdiction, encounters which in his judgment would preclude safe and normal occupancy by residents on that day. (2) If the surveyor encounters deficiencies that do not affect the health and safety of the residents, licensure may be recommended based on an approved written plan of correction by the facility's administrator. (3) Copies of reduced size floor plan on an 8-1/2 inch by 11 inch sheet must be submitted in duplicate to DHS for record and/or file use and for the facility to use in evacuation planning and fire alarm zone identification. The plan must contain basic legible information such as overall dimensions, room usage names, actual bedroom numbers, doors, windows, and any other pertinent information. sec.19.331. Construction Standards for Additions, Remodeling, and New Nursing Facilities. (a) This subchapter is written for, and applies to, new construction, including conversions, additions, and remodelings. The requirements of the Life Safety Code, Standard 101 of the National Fire Protection Association (NFPA), as required under Health and Safety Code, sec.242.039, and other applicable NFPA codes and standards referenced in NFPA 101 will apply unless otherwise noted or modified in this subchapter. The provisions of the chapter or subchapter and the provisions of the New Health Care Occupancies of the Life Safety Code are applicable. (1) Life Safety Code, NFPA 101, is a registered trademark of the National Fire Protection Association, Inc., Quincy, Massachusetts 02269. (2) The definitions listed in sec.19.101 of this title (relating to Definitions) also apply to this subchapter. (3) In addition to the Life Safety Code and the standards referenced therein, this subchapter is subject to the codes, standards, and requirements established by the following: Underwriters Laboratories, Inc.; the American National Standards Institute, Inc. (ANSI) ; the National Electrical Code (NFPA 7O); the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE); and the American Society for Testing Materials (ASTM). Various references to these entities will be made throughout these sections. (b) All applicable local, state, or national codes and ordinances must be met as determined by the authority having jurisdiction for those codes and ordinances and by the Texas Department of Human Services (DHS). Any conflicts must be made known to DHS Long Term Care-Regulatory office for appropriate resolution. (c) The design of structural systems must be done by or under the direction of a professional engineer who is currently registered by the Texas State Board of Registration for Professional Engineers. (d) If an existing licensed facility plans building additions or remodeling which includes construction of additional resident beds, then the ratio of bathing units must be reevaluated to meet minimum standards and the square footage of dining and living areas must be reevaluated by DHS at a minimum of 19 square feet per bed. Conversion of existing living, dining, or activity areas to resident bedrooms must not reduce these functions to a total area of less than 19 square feet per bed. The dietary department must be evaluated by the facility's registered or licensed dietitian or architect having knowledge in the design of food service operations. This evaluation must be provided to DHS. (e) No building may be occupied by residents prior to inspection and approval to occupy by DHS. (f) The words "shall" or "must" are requirements. The word "should" is a recommendation which is expected to be followed unless there is valid reason not to do so. (g) Nothing in sec.sec.19.332-19.343 of this title ((relating to Location and Site, General Considerations, Architectural Space Planning and Utilization, Exit Provisions, Smoke Compartmentation (Subdivision of Building Spaces), Fire Protection Systems, Hazardous Areas, Structural Requirements, Mechanical Requirements, Electrical Requirements, Miscellaneous Details, and Elevators)) may be construed as prohibiting a better type of building or construction, more space, services, features, or greater degree of safety than the minimum requirements. sec.19.342. Miscellaneous Details. (a) Safety related details. A high degree of safety for the occupants is needed to minimize accidents which are more apt to occur with the elderly and/or infirm residents in a nursing facility. Consideration must be given to the fact that many will have impaired vision, hearing, spatial perception, and ambulation. (1) Hazards such as sharp corners and edges and unexpected steps must be avoided. (2) Items such as drinking fountains, telephone booths, vending machines, and portable equipment must be located so as not to restrict corridor traffic or reduce corridor width. (3) Windows must be designed to prevent residents from accidentally falling through the windows. (4) Doors which normally stay open or are frequently used must not swing out into the corridor unless otherwise needed or required. Alcoves may be provided for doors which must swing outward toward a corridor or way of egress. (5) The proper use of safety glass must be adhered to in applicable locations and conditions. (6) Thresholds and expansion joint covers must be made essentially flush with the floor surface to facilitate use of wheelchairs and carts. See sec.19.340(a)(8) of this title (relating to Mechanical Requirements) for requirements for such items as shower curbs, surfaces, and doors. (7) Grab bars must be provided at all residents' toilets, showers, tubs, and sitz baths. The bars must be 1-1/4 to 1-1/2 inches in diameter and must have 1/2 inch clearance to walls. Bars must have sufficient strength and anchorage to sustain a concentrated load of 250 pounds. Grab bar standards must comply with standards adopted under the Americans with Disabilities Act of 1990. (8) Handrails must be provided on both sides of corridors used by residents. A clear distance of 1/2 inches must be provided between the handrail and the wall. Handrails must be securely mounted to withstand downward forces of 250 pounds. Handrails may be omitted on wall segments less than 18 inches. Handrails must be mounted 33 inches to 36 inches above the floor, and must comply with standards adopted under the Americans with Disabilities Act. (9) Ends of handrails and grab bars must be constructed to prevent snagging the clothes of residents (that is, return ends to wall). (10) Ceiling fan blades must be at least seven feet above the floor and be located so as not to interfere with the operation of any ceiling-mounted smoke detectors. (b) General details. (1) Concrete floors, whether finished by sealant, or similar product, must not be used as the finished floor unless specifically approved in writing by the Texas Department of Human Services. An exception is mechanical equipment rooms and maintenance or similar areas. (2) Sound separation must be provided in corridor walls and resident room party walls; Minimum Sound Transmission Coefficient 30 per American Society for Testing Material E-90. (3) Illumination and a safe platform in the attic must be provided at all attic access panels. (4) Attic access must be provided for building maintenance. Access panels must be prime coated steel flush panels where required to maintain fire rating of ceiling-roof/ceiling-floor assemblies. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606519 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter E. Resident Rights 40 TAC sec.19.402, sec.19.416 The amendments are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendments implement the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606523 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter M. Physician Services 40 TAC sec.19.1210 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendment implements the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606524 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter Q. Infection Control 40 TAC sec.19.1612 The repeal is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The repeal implements the Human Resources Code, sec.sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606525 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter R. Physical Plant and Environment 40 TAC sec.sec.19.1701-19.1727 The repeals are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The repeals implement the Human Resources Code, sec.sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606526 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 40 TAC sec.19.1701 The new section is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The new section implements the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. store This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606527 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter S. Reimbursement Methodology for Nursing Facilities 40 TAC sec.19.1807 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendment implements the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606528 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter T. Administration TAC Section Number(s) 40 TAC sec.19.1918 The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendment implements the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606529 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter V. Federal Requirements 40 TAC sec.19.2105 The repeal is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The repeal implements the Human Resources Code, sec.sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606530 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter W. Certification of Facilities for Care of Persons with Alzheimer's Disease and Related Disorders The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendment implements the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606531 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter X. Requirements for Medicaid-Certified Facilities 40 TAC sec.19.2324, sec.19.2326 The amendments are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendments implement the Human Resources Code, sec. sec.22.001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606532 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Subchapter Y. Medical Review and Re-evaluation 40 TAC sec.19.2403, sec.19.2412 The amendment and new section are adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs; and under Texas Government Code, sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendment and new section implement the Human Resources Code, sec.sec.22. 001-22.030 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606533 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: July 1, 1996 Proposal publication date: February 13, 1996 For further information, please call: (512) 438-3765 Chapter 48. Community Care for Aged and Disabled Program for All-inclusive Care for the Elderly (PACE) 40 TAC sec.48.2811 The Texas Department of Human Services (DHS) adopts an amendment to sec.48. 2811, without changes to the proposed text published in the March 26, 1996, issue of the Texas Register (21 TexReg 2460). Justification for the amendment is an accurate understanding of the reimbursement methodology. The amendment will function by revising the methodology to comply with federal regulations. No comments were received no comments regarding adoption of the amendment. The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs, and under Texas Government Code sec.531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds. The amendment implements the Human Resources Code, sec. sec.22.001-22.024 and sec.sec.32.001-32.042. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's authority. Issued in Austin, Texas, on May 8, 1996. TRD-9606461 Glenn Scott General Counsel, Legal Services Texas Department of Human Services Effective date: June 1, 1996 Proposal publication date: March 26, 1996 For further information, please call: (512) 438-3765