Texas Register, Volume 34, Number 20, Pages 2847-3034, May 15, 2009 Page: 2,864
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ernment Code. "Major environmental rule" is defined to mean a
rule the specific intent of which is to protect the environment or
reduce risk to human health from environmental exposure and
that may adversely affect, in a material way, the economy, a sec-
tor of the economy, productivity, competition, jobs, the environ-
ment or the public health and safety of a state or a sector of the
state. This proposed rule is not specifically intended to protect
the environment or reduce risks to human health from environ-
Questions about the content of this proposal may be directed
to Cheryl Jablonski in the HHSC Rate Analysis Department by
telephone at (512) 491-1764. Written comments on the pro-
posal may be submitted to Ms. Jablonski by facsimile at (512)
491-1998, by e-mail to firstname.lastname@example.org, or by
mail to HHSC Rate Analysis, Mail Code H-400, P.O. Box 85200,
Austin, Texas 78708-5200, within 30 days of publication of this
proposal in the Texas Register.
The amendment is proposed under the Texas Government
Code, 531.033, which provides the Executive Commis-
sioner of HHSC with broad rulemaking authority; and the
Human Resource Code 32.021 and Texas Government Code
531.021 (a), which provide HHSC with the authority to adminis-
ter the federal medical assistance (Medicaid) program in Texas.
The proposed amendment affects the Human Resources Code
Chapter 32, and the Texas Government Code Chapter 531. No
other statutes, articles, or codes are affected by this proposal.
355.455. Payments to Non-State Operated Facilities.
(a) HHSC or its designee [TDMHMR] will pay to non-state-
operated facilities modeled rates that will vary by class of facility and
a resident's [client's] level-of-need.
(b) The non-state operated facility modeled rates include pay-
ment for both residential and day program services. Residents [Individ
uals] receive medical and dental services through the Medicaid identi-
fication card. Any medical expenses other than Medicaid-covered ser-
vices are the responsibility of the ICF/MR provider.
(c) With a limit of $5,000 per resident [client] per year, HHSC
or its designee [TDMHMR] will pay a provider for the actual cost of a
resident's [client's] durable medical equipment, excluding augmenta-
tive communication devices, if:
(1) the cost of the equipment exceeds $1,000;
(2) the facility receives approval from HHSC or its de-
signee [TDMHMR] to purchase the equipment;
(3) the provider submits a voucher to HHSC or its designee
[TDMHMR] for the cost of the equipment; and
(4) the resident [client] is eligible for Medicare benefits and
the provider has submitted a Medicare claim and received a response
to the claim prior to requesting payment from HHSC or its designee
(d) Reimbursement for augmentative communication devices
is governed by 40 TAC 9.228, relating to Augmentative Communica-
tion Device Systems. [There are modeled rates for each level of need
for each class of non-state operated facilities.]
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal author-
ity to adopt.
Filed with the Office of the Secretary of State on April 29, 2009.
Texas Health and Human Services Commission
Earliest possible date of adoption: June 14, 2009
For further information, please call: (512) 424-6900
TITLE 22. EXAMINING BOARDS
TEXAS BOARD OF NURSING
CHAPTER 216. CONTINUING EDUCATION
22 TAC 216.1 - 216.11
(Editor's note: The text of the following sections proposed for repeal
will not be published. The sections may be examined in the offices of
the Texas Board of Nursing or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Board of Nursing (Board) proposes the repeal of
Chapter 216, 216.1 - 216.11, concerning Continuing Educa-
tion. This repeal is necessary because the Board is proposing
a new chapter for adoption that promotes a comprehensive
approach to continuing competency in nursing. Traditionally,
nurses have primarily demonstrated continuing competency
through the completion of continuing education courses. The
requirements of the proposed new chapter, however, permit
nurses to demonstrate continuing competency through other
means. It is anticipated that this new approach to continuing
competency will provide necessary flexibility to nurses while
ensuring the ongoing delivery of safe nursing care. Ultimately,
the proposed new chapter is designed to protect the public
health, safety, and welfare by requiring nurses to maintain a skill
level appropriate for their practice areas. The proposed new
chapter is also published in this edition of the Texas Register.
Katherine Thomas, Executive Director, has determined that for
each year of the first five years the proposed repeal will be in
effect, there will be no fiscal impact to state or local governments
as a result of the enforcement or administration of the proposal.
There will be no anticipated effect on local employment or the
local economy as a result of the proposed repeal.
Ms. Thomas has also determined that for each year of the first
five years the proposed repeal is in effect, the anticipated public
benefit will be the repeal of outdated requirements and the adop-
tion of new requirements that will promote a comprehensive ap-
proach to continuing competency in nursing, provide nurses with
additional options for meeting continuing competency require-
ments; and ensure the protection of the public health, safety and
welfare through the demonstration of competent, quality nursing
care. There are no anticipated economic costs to persons who
are required to comply with the proposed repeal.
As required by the Government Code 2006.002(c) and (f), the
Board has determined that the proposed repeal will not have
an adverse economic effect on any small or micro business be-
cause there are no anticipated economic costs to any person
who is required to comply with the proposed repeal.
The Board has determined that no private real property interests
are affected by this proposed repeal and that this proposed re-
peal does not restrict or limit an owner's right to property that
34 TexReg 2864 May 15, 2009
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Texas. Secretary of State. Texas Register, Volume 34, Number 20, Pages 2847-3034, May 15, 2009, periodical, May 15, 2009; Austin, Texas. (texashistory.unt.edu/ark:/67531/metapth90852/m1/17/: accessed July 20, 2017), University of North Texas Libraries, The Portal to Texas History, texashistory.unt.edu; crediting UNT Libraries Government Documents Department.