Law:Title 2. Department Of Human Services And Department Of Protective And Regulatory Services. Subtitle B. Structure And Functions Of Department Of Human Services from Chapter 22. General Functions Of Department Of Human Services (Texas)

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Subtitle B. Structure And Functions Of Department Of Human Services

Contents

Chapter 22. General Functions Of Department Of Human Services

Section  22.0001.  Powers And Duties Of Commissioner Of Health And Human Services.

The commissioner of health and human services has the powers and duties relating to the board and commissioner as provided by Section 531.0055, Government Code. To the extent a power or duty given to the board or commissioner by this title or another law conflicts with Section 531.0055, Government Code, Section 531.0055 controls.

Added by Acts 1999, 76th Leg., ch. 1460, Sec. 2.03, eff. Sept. 1, 1999.



Section  22.001.  General Powers And Duties Of The Department.

(a) The department is responsible for administering the welfare functions authorized in this title.

(b)  The department shall administer assistance to needy persons who are aged, blind, or disabled and to needy families with dependent children. The department shall also administer or supervise general relief services. The department may administer state child day-care services.

(c)  The department shall assist other governmental agencies in performing services in conformity with the purposes of this title when so requested and shall cooperate with the agencies when expedient.

(d)  The department shall conduct research and compile statistics on public welfare programs in the state. The research must include all phases of dependency and delinquency and related problems. The department shall cooperate with other public and private agencies in developing plans for the prevention and treatment of conditions giving rise to public welfare problems.

(e)  Repealed by Acts 2007, 80th Leg., R.S., Ch. 268, Sec. 32(f), eff. September 1, 2008.

(f)  The department may solicit and accept gifts, grants, and donations of money or property from public or private sources for use in assisting needy persons or otherwise carrying out any of the department's functions.

Acts 1979, 66th Leg., p. 2340, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979. Amended by Acts 1987, 70th Leg., ch. 1052, Sec. 1.07, 1.08, eff. Sept. 1, 1987; Acts 1989, 71st Leg., ch. 1265, Sec. 1, eff. Sept. 1, 1989; Acts 1993, 73rd Leg., ch. 747, Sec. 61(3), eff. Sept. 1, 1993; Acts 1995, 74th Leg., ch. 76, Sec. 8.013, eff. Sept. 1, 1995; Acts 2003, 78th Leg., ch. 162, Sec. 1, eff. May 27, 2003; Acts 2003, 78th Leg., ch. 198, Sec. 2.129, eff. Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1325, Sec. 13.06, eff. Sept. 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 281, Sec. 4.04, eff. June 14, 2005.

Acts 2005, 79th Leg., Ch. 728, Sec. 23.001(54), eff. September 1, 2005.

Acts 2007, 80th Leg., R.S., Ch. 268, Sec. 32(f), eff. September 1, 2008.



Section  22.0011.  Definition.

In this chapter, except in Section 22.032, "long-term care services" means the provision of personal care and assistance related to health and social services given episodically or over a sustained period to assist individuals of all ages and their families to achieve the highest level of functioning possible, regardless of the setting in which the assistance is given.

Added by Acts 1999, 76th Leg., ch. 1505, Sec. 1.02, eff. Sept. 1, 1999.



Section  22.0015.  Evaluation And Improvement Of Programs.

The department shall conduct research, analysis, and reporting of its programs to evaluate and improve the programs. The department may contract with one or more independent entities to assist the department with the research, analysis, and reporting required by this section.

Added by Acts 1997, 75th Leg., ch. 323, Sec. 1, eff. Sept. 1, 1997.



Section  22.002.  Administration Of Federal Welfare Programs.

(a) The department is the state agency designated to cooperate with the federal government in the administration of Titles IV, XIX, and XX of the federal Social Security Act. The department shall administer other titles added to the act after January 1, 1979, unless another state agency is designated by law to perform the additional functions. The department shall cooperate with federal, state, and local governmental agencies in the enforcement and administration of the federal act, and shall promulgate rules to effect that cooperation.

(b)  The department shall cooperate with the United States Department of Health, Education, and Welfare and other federal agencies in a reasonable manner and in conformity with the provisions of this title to the extent necessary to qualify for federal assistance for persons entitled to benefits under the federal Social Security Act. The department shall make reports periodically in compliance with federal regulations.

(c)  The department may establish and maintain programs of assistance and services authorized by federal law and designed to help needy families and individuals attain and retain the capability of independence and self-care. Notwithstanding any other provision of law, the department may extend the scope of its programs to the extent necessary to ensure that federal matching funds are available, if the department determines that the extension of scope is feasible and within the limits of appropriated funds.

(d)  If the department determines that a provision of state welfare law conflicts with a provision of federal law, the department may promulgate policies and rules necessary to allow the state to receive and expend federal matching funds to the fullest extent possible in accordance with the federal statutes and the provisions of this title and the state constitution and within the limits of appropriated funds.

(e)  The department may accept, expend, and transfer federal and state funds appropriated for programs authorized by federal law. The department may accept, expend, and transfer funds received from a county, municipality, or public or private agency or from any other source, and the funds shall be deposited in the state treasury subject to withdrawal on order of the commissioner in accordance with the department's rules.

(f)  The department may enter into agreements with federal, state, or other public or private agencies or individuals to accomplish the purposes of the programs authorized in Subsection (c) of this section. The agreements or contracts between the department and other state agencies are not subject to the Interagency Cooperation Act (Article 4413(32), Vernon's Texas Civil Statutes).

(g)  In administering social service programs authorized by the Social Security Act, the department may prepay an agency or facility for expenses incurred under a contract with the department to provide a social service.

(h)  The department may set and charge reasonable fees for services provided in administering social service programs authorized by the Social Security Act. The department shall set the amount of each fee according to the cost of the service provided and the ability of the recipient to pay.

(i)  The department may not deny services administered under this section to any person because of that person's inability to pay for services.

Acts 1979, 66th Leg., p. 2340, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979. Amended by Acts 1981, 67th Leg., p. 2232, ch. 530, Sec. 1, eff. Aug. 31, 1981; Acts 1983, 68th Leg., p. 3872, ch. 616, Sec. 1, eff. Sept. 1, 1983.



Section  22.003.  Research And Demonstration Projects.

(a) The department may conduct research and demonstration projects that in the judgment of the commissioner will assist in promoting the purposes of the department's assistance programs. The department may conduct the projects independently or in cooperation with a public or private agency.

(b)  The department may use state or federal funds available for its assistance programs or for research and demonstration projects to support the projects. The projects must be consistent with the state and federal laws making the funds available.

Acts 1979, 66th Leg., p. 2341, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.



Section  22.0031.  Projects For High-risk Pregnant Women And High-risk Children. (a)

The department shall establish programs of case management for high-risk pregnant women and high-risk children to age one as provided under Section 1915(g) of the federal Social Security Act (42 U.S.C. Section 1396n).

(b)  Case management programs may be developed using contracts with public health entities, hospitals, community health clinics, physicians, or other appropriate entities which have the capacity to carry out the full scope of case management activities. The case manager shall assess the needs of the pregnant woman and the child and serve as a broker to assure that all needs as defined in this subsection are met to the greatest extent possible given existing services available in the project area. These activities shall include:

(1)  assuring that the pregnant woman seeks and receives early and appropriate prenatal care that conforms to prescribed medical regimes;

(2)  assisting the pregnant woman and child in gaining access to appropriate social, educational, nutritional, and other ancillary services as needed in accordance with federal Medicaid law; and

(3)  assuring appropriate coordination within the medical community.

(c)  The provisions of Subsection (b) of this section shall not be construed to allow a case manager to interfere with the physician-patient relationship and shall not be construed as conferring any authority to practice medicine.

(d)  The department shall use existing funds of the department or any other lawful source to fund and support the projects for high-risk pregnant women and high-risk children.

Added by Acts 1989, 71st Leg., ch. 1215, Sec. 2, eff. Sept. 1, 1989.



Section  22.0033.  Prohibited Activities By Former Officers Or Employees.

(a) For one year after the date on which a former officer or employee of the department terminates service or employment with the department, the individual may not, directly or indirectly, attempt or aid in the attempt to procure a contract with the department that relates to a program or service in which the individual was directly concerned or for which the individual had administrative responsibility.

(b)  This section does not apply to:

(1)  a former employee who is compensated on the last date of service or employment below the amount prescribed by the General Appropriations Act for step 1, salary group 17, of the position classification salary schedule, including a state employee who is exempt from the state's position classification plan; or

(2)  a former officer or employee who is employed by another state agency or a community center.

(c)  A former officer or employee of the department commits an offense if the former officer or employee violates this section. An offense under this section is a Class A misdemeanor.

Added by Acts 1991, 72nd Leg., ch. 76, Sec. 3, eff. Sept. 1, 1991.



Section  22.004.  Provision Of Legal Services.

(a) On request, the department may provide legal services to an applicant for or recipient of assistance at a hearing before the department.

(b)  The services must be provided by an attorney licensed to practice law in Texas or by a law student acting under the supervision of a law teacher or a legal services organization, and the attorney or law student must be approved by the department.

(c)  The department shall adopt a reasonable fee schedule for the legal services. The fees may not exceed those customarily charged by an attorney for similar services for a private client. The fees may be paid only from funds appropriated to the department for the purpose of providing these legal services.

Acts 1979, 66th Leg., p. 2341, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.



Section  22.005.  Funds.

(a) The children's assistance fund and the medical assistance fund are separate accounts in the general revenue fund. Money in the separate accounts may be expended only for the purposes for which the accounts were created or as otherwise provided by law.

(b)  The comptroller shall maintain a department of human services administration operating fund and a department of human services assistance operating fund as funds in the state treasury.

(c)  On authorization by the department, the comptroller may transfer funds appropriated for the operation of the department, current revenues, and balances on hand into the department of human services administration operating fund or the department of human services assistance operating fund. On authorization by the department, the comptroller shall transfer designated funds between the two operating funds.

(d)  With the approval of the comptroller, the department shall establish an internal accounting system, and the department's expenditures shall be allocated to the various funds according to the system. At the end of each fiscal biennium the department shall report to the comptroller the amount of the unencumbered balances in each of the department's operating funds that belongs to the children's assistance fund and the medical assistance fund, and those unencumbered balances shall be returned to the appropriate special fund.

(e)  If the department determines that a transfer among appropriated state funds is needed to match federal medical assistance funds, the department may authorize the comptroller in writing to transfer funds allocated to the children's assistance fund into the medical assistance fund, and the department may use the transferred funds to provide medical assistance to the greatest extent possible within the limits of state and federal law.

(f)  The comptroller is the designated custodian of all funds administered by the department and received by the state from the federal government or any other source for the purpose of implementing the provisions of the Social Security Act. The comptroller may receive the funds, pay them into the proper fund or account of the general fund of the state treasury, provide for the proper custody of the funds, and make disbursements of the funds on the order of the department and on warrant of the comptroller.

Acts 1979, 66th Leg., p. 2341, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979. Amended by Acts 1985, 69th Leg., ch. 264, Sec. 10, eff. Aug. 26, 1985; Acts 1987, 70th Leg., ch. 1052, Sec. 1.09, eff. Sept. 1, 1987. Amended by Acts 1991, 72nd Leg., ch. 599, Sec. 14, eff. Sept. 1, 1991; Acts 1995, 74th Leg., ch. 76, Sec. 8.137, eff. Sept. 1, 1995; Acts 1997, 75th Leg., ch. 1423, Sec. 9.01, eff. Sept. 1, 1997.



Section  22.007.  Public Information Contract Requirement.

(a) Each contract between the department and a provider of services must contain a provision that authorizes the department to display at the service provider's place of business public awareness information on services provided by the department.

(b)  Notwithstanding Subsection (a) of this section, the department may not require a physician to display in the physician's private offices public awareness information on services provided by the department.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.008.  Enforcement And Alteration Of Service Delivery Standards.

(a) The department shall develop enforcement guidelines for its community care program that relate to the service delivery standards required of persons who contract with the department to carry out its community care program. The department shall apply the guidelines consistently across the state.

(b)  At the same time the department sends written notice to a regional department office of a change or interpretation of a service delivery standard relating to the community care program, the department shall send a copy of the notice to each community care program contractor affected by the change or interpretation.

(c)  Each decision on whether to enter into a contract in the community care program that results from a department request for bids or proposals must be made by one or more persons employed at the department's state headquarters.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.009.  Advisory Committees.

(a) The board shall appoint advisory committees on the recommendation of the commissioner to assist the board in performing its duties.

(b)  The board shall appoint each advisory committee to provide for a balanced representation of the general public, providers, consumers, and other persons, state agencies, or groups with knowledge of and interest in the committee's field of work.

(c)  The board shall specify each advisory committee's purpose, powers, and duties and shall require each committee to report to the board in a manner specified by the board concerning the committee's activities and the results of its work.

(d)  The board shall establish procedures for receiving reports concerning activities and accomplishments of advisory committees established to advise the board or department. The board on the recommendation of the commissioner may appoint additional members to those committees and establish additional duties of those committees as the board determines to be necessary.

(e)  The board shall adopt rules to implement this section. Those rules must provide that during the development of rules relating to an area in which an advisory committee exists the committee must be allowed to assist in the development of and to comment on the rules before the rules are finally adopted. The rules may allow the department to bypass this procedure only in an emergency situation. However, the department shall submit emergency rules to the appropriate advisory committee for review at the first committee meeting that occurs after the rules are adopted.

(f)  A member of an advisory committee receives no compensation but is entitled to reimbursement for transportation expenses and the per diem allowance for state employees in accordance with the General Appropriations Act.

(g)  Subsections (c) through (f) of this section apply to each department advisory committee created under this section or under other law.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.010.  Advisory Committee For Services To Aged And Disabled Persons.

(a) The Advisory Committee for Services to Aged and Disabled Persons shall examine and review issues related to the delivery of departmental services to disabled persons, including:

(1)  the scope and range of services that the department should provide to disabled persons, including the coordination of a continuum of community-based services;

(2)  how the department may improve the data and information it collects and maintains relating to services to disabled persons;

(3)  how the department may improve the processes used to receive and refer requests for services from disabled persons; and

(4)  how the department may improve its organizational structure to administer the delivery of services to disabled persons.

(b)  The staff of the department's office responsible for strategic planning shall assist the committee in the examination and review of the issues.

(c)  The department shall consider the long-range recommendations of the committee in the department's planning efforts and in the budget requests submitted after the 1990-1991 fiscal biennium.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.011.  Memorandum Of Understanding On Services To Disabled Persons.

(a) The department, the Texas Department of Health, the Texas Department of Mental Health and Mental Retardation, the Texas Rehabilitation Commission, the Texas Commission for the Blind, the Texas Commission for the Deaf and Hard of Hearing, and the Texas Education Agency shall adopt a joint memorandum of understanding to facilitate the coordination of services to disabled persons. The memorandum shall:

(1)  clarify the financial and service responsibilities of each agency in relation to disabled persons; and

(2)  address how the agency will share data relating to services delivered to disabled persons by each agency.

(b)  These agencies in the formulation of this memorandum of understanding shall consult with and solicit input from advocacy and consumer groups.

(c)  Not later than the last month of each state fiscal year, the department and the other agencies shall review and update the memorandum.

(d)  Each agency by rule shall adopt the memorandum of understanding and all revisions to the memorandum.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987. Amended by Acts 1991, 72nd Leg., ch. 353, Sec. 7, eff. Sept. 1, 1991; Acts 1995, 74th Leg., ch. 835, Sec. 19, eff. Sept. 1, 1995; Acts 1997, 75th Leg., ch. 165, Sec. 6.52, eff. Sept. 1, 1997.



Section  22.013.  Memorandum Of Understanding On Public Awareness Information.

(a) The department, the Texas Department of Health, the Texas Department of Mental Health and Mental Retardation, and the Texas Rehabilitation Commission shall adopt a joint memorandum of understanding that authorizes and requires the exchange and distribution among the agencies of public awareness information relating to services provided by or through the agencies.

(b)  Not later than the last month of each state fiscal year, the department and the other agencies shall review and update the memorandum.

(c)  Each agency by rule shall adopt the memorandum of understanding and all revisions to the memorandum.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.014.  Memorandum Of Understanding On Hospital And Long-term Care Services.

(a) The department, the Texas Department of Health, and the Texas Department of Mental Health and Mental Retardation shall adopt a memorandum of understanding that:

(1)  clearly defines the responsibilities of each agency in providing, regulating, and funding hospital or long-term care services; and

(2)  defines the procedures and standards that each agency will use to provide, regulate, and fund hospital or long-term care services.

(b)  The memorandum must provide that no new rules or regulations that would increase the costs of providing the required services or would increase the number of personnel in hospital or long-term care facilities may be promulgated by either the department, the Department of Health, or the Department of Mental Health and Mental Retardation unless the commissioner of health certifies that the new rules or regulations are urgent as well as necessary to protect the health or safety of recipients of hospital or long-term care services.

(c)  The memorandum must provide that any rules or regulations proposed by the department, the Department of Health, or the Department of Mental Health and Mental Retardation which would increase the costs of providing the required services or which would increase the number of personnel in hospital or long-term care facilities must be accompanied by a fiscal note prepared by the agency proposing said rules and submitted to the department. The fiscal note should set forth the expected impact which the proposed rule or regulation will have on the cost of providing the required service and the anticipated impact of the proposed rule or regulation on the number of personnel in hospital or long-term care facilities. The memorandum must provide that in order for a rule to be finally adopted the department must provide written verification that funds are available to adequately reimburse hospital or long-term care service providers for any increased costs resulting from the rule or regulation. The department is not required to provide written verification if the commissioner of health certifies that a new rule or regulation is urgent as well as necessary to protect the health or safety of recipients of hospital or long-term care services.

(d)  The memorandum must provide that upon final adoption of any rule increasing the cost of providing the required services, the department must establish reimbursement rates sufficient to cover the increased costs related to the rule. The department is not required to establish reimbursement rates sufficient to cover the increased cost related to a rule or regulation if the commissioner of health certifies that the rule or regulation is urgent as well as necessary to protect the health or safety of recipients of hospital or long-term care services.

(e)  The memorandum must provide that Subsections (b) through (d) of this section do not apply if the rules are required by state or federal law or federal regulations.

(f)  These agencies in the formulation of this memorandum of understanding shall consult with and solicit input from advocacy and consumer groups.

(g)  Not later than the last month of each state fiscal year, the department and the other agencies shall review and update the memorandum.

(h)  Each agency by rule shall adopt the memorandum of understanding and all revisions to the memorandum.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.015.  Reporting Of Physician Misconduct Or Malpractice.

(a) If the department receives an allegation that a physician employed by or under contract with the department has committed an action that constitutes a ground for the denial or revocation of the physician's license under Section 164.051, Occupations Code, the department shall report the information to the Texas State Board of Medical Examiners in the manner provided by Section 154.051, Occupations Code.

(b)  The department shall provide the Texas State Board of Medical Examiners with a copy of any report or finding relating to an investigation of an allegation reported to the Texas State Board of Medical Examiners.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.812, eff. Sept. 1, 2001.



Section  22.016.  Special Purchasing Procedures.

The department shall comply with any special purchasing procedures requiring competitive review under Subtitle D, Title 10, Government Code.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987. Amended by Acts 1997, 75th Leg., ch. 165, Sec. 17.19(4), eff. Sept. 1, 1997.



Section  22.017.  Program Accessibility.

The department shall prepare and maintain a written plan that describes how persons who do not speak English or who have physical, mental, or developmental disabilities can be provided reasonable access to the department's programs.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987.



Section  22.018.  Cooperation With State Office Of Administrative Hearings.

(a) The department and the chief administrative law judge of the State Office of Administrative Hearings shall adopt a memorandum of understanding under which the State Office of Administrative Hearings, on behalf of the department, conducts all contested case hearings authorized or required by law to be conducted by the department under the administrative procedure law, Chapter 2001, Government Code.

(b)  The memorandum of understanding shall require the chief administrative law judge, the department, and the commissioner to cooperate in connection with a contested case hearing and may authorize the State Office of Administrative Hearings to perform any administrative act, including giving of notice, that is required to be performed by the department or commissioner.

(c)  The memorandum of understanding shall address whether the administrative law judge who conducts a contested case hearing for the State Office of Administrative Hearings on behalf of the department shall:

(1)  enter the final decision in the case after completion of the hearing; or

(2)  propose a decision to the department or the commissioner for final consideration.

(d)  The department by interagency contract shall reimburse the State Office of Administrative Hearings for the costs incurred in conducting contested case hearings for the department. The department may pay an hourly fee for the costs of conducting those hearings or a fixed annual fee negotiated biennially by the department and the State Office of Administrative Hearings to coincide with the department's legislative appropriations request.

(e)  A reference in law to the hearings division of the department is considered to be a reference to the State Office of Administrative Hearings when used in relation to a contested case hearing under the administrative procedure law, Chapter 2001, Government Code.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.11(a), eff. Sept. 1, 1987. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995; Acts 1999, 76th Leg., ch. 1505, Sec. 1.03, eff. Sept. 1, 1999.



Section  22.019.  Due Process Procedures.

(a) The department may not retroactively apply a rule, standard, guideline, or policy interpretation.

(b)  The department shall adopt any changes in departmental policy in accordance with the rule-making provisions of Chapter 2001, Government Code. The department shall use periodic bulletins and indexes to notify contractors of changes in policy and to explain the changes. The department may not adopt a change in departmental policy that takes effect before the date on which the department notifies contractors as prescribed by this subsection.

(c)  The board shall adopt a rule requiring the department to respond in writing to each written inquiry from a contractor not later than the 14th day after the date on which the department receives the inquiry.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.12(a), eff. Sept. 1, 1987. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995.



Section  22.020.  Audit Procedure.

At any time during an audit, the department shall permit a contractor to submit additional or alternative documentation to prove that services were delivered to an eligible client. Any recovery of costs by the department from the contractor for using additional or alternative documentation may not exceed the amount the contractor would otherwise be entitled to receive under the contract as administrative costs.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.12(a), eff. Sept. 1, 1987.



Section  22.021.  Distribution Of Funds.

(a) If funds are appropriated to the department for the general support or development of a service that is needed throughout the state, the department shall allocate those funds equitably across the state.

(b)  This section does not apply to funds appropriated for a research or demonstration program or for the purchase of direct services.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.12(a), eff. Sept. 1, 1991.



Section  22.022.  Residency Requirements.

To the extent permitted by law the department shall only provide services to legal residents of the United States or the State of Texas.

Added by Acts 1987, 70th Leg., ch. 1052, Sec. 1.12(a), eff. Sept. 1, 1987.



Section  22.023.  Payment For Certain Insurance Coverage.

(a) In this section, "AIDS" and "HIV" have the meanings assigned by Section 81.101, Health and Safety Code.

(b)  Subject to the limitations in Subsection (c) of this section, the department may purchase and pay the premiums for a conversion policy or other health insurance coverage for a person who is diagnosed as having AIDS, HIV, or other terminal or chronic illness and whose income level is less than 200 percent of the federal poverty level, based on the federal Office of Management and Budget poverty index in effect at the time coverage is provided, even though a person may be eligible for benefits under Chapter 32 of this code. Health insurance coverage for which premiums may be paid under this section includes coverage purchased from an insurance company authorized to do business in this state, a group hospital services corporation operating under Chapter 842, Insurance Code, a health maintenance organization operating under Chapter 843, Insurance Code, or an insurance pool created by the federal or state government or a political subdivision of the state.

(c)  If a person is eligible for benefits under Chapter 32 of this code, the department may not purchase or pay premiums for a health insurance policy under this section if the premiums to be charged for the health insurance coverage are greater than premiums paid for benefits under Chapter 32 of this code. The department may not purchase or pay premiums for health insurance coverage under this section for a person at the same time that that person is covered by benefits under Chapter 32 of this code.

(d)  The department shall pay for that coverage with money made available to it for that purpose.

(e)  The board by rule may adopt necessary rules, criteria, and plans and may enter into necessary contracts to carry out this section.

Added by Acts 1989, 71st Leg., ch. 1041, Sec. 5, eff. Sept. 1, 1989. Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 284(10), eff. Sept. 1, 1991; Acts 2003, 78th Leg., ch. 1276, Sec. 10A.534, eff. Sept. 1, 2003.



Section  22.024.  Development Of Service Plan For Elderly Or Disabled.

If the Texas Department of Human Services, Texas Department of Mental Health and Mental Retardation, Texas Commission for the Deaf and Hard of Hearing, Texas Department on Aging, or another agency funded in the General Appropriations Act under appropriations for health, welfare, and rehabilitation agencies receives funds to provide case management services to the elderly or disabled, the agency shall provide information to its staff concerning the services other agencies provide to those populations. The agency's staff shall use that information to develop a comprehensive service plan for its clients.

Added by Acts 1989, 71st Leg., ch. 1085, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 22.023 by Acts 1990, 71st Leg., 6th C.S., ch. 12, Sec. 2(10), eff. Sept. 6, 1990. Amended by Acts 1991, 72nd Leg., ch. 353, Sec. 8, eff. Sept. 1, 1991; Acts 1995, 74th Leg., ch. 835, Sec. 20, eff. Sept. 1, 1995.



Section  22.025.  Error-rate Reduction.

(a) The department shall:

(1)  set progressive goals for improving the department's error rates in the aid to families with dependent children and food stamp programs; and

(2)  develop a specific schedule to meet those goals.

(b)  Each fiscal quarter, the department shall prepare a report detailing the progress the department has made in reaching its goals. The report must include an analysis by region of the department's goals and performance relating to error-rate reduction. The department shall send a copy of the report to the governor's office, the legislative budget office, and any appropriate interagency task force having oversight responsibility over welfare fraud.

(c)  As appropriate, the department shall include in its employee evaluation process a rating system that emphasizes error-rate reduction and workload.

(d)  The department shall take appropriate action if a region has a higher than average error rate and that rate is not reduced in a reasonable period.

Added by Acts 1995, 74th Leg., ch. 655, Sec. 8.08(a), eff. Sept. 1, 1995.



Section  22.0251.  Timely Determination Of Overpayments.

(a) Subject to the approval of the commissioner of health and human services, the department shall:

(1)  determine and record the time taken by the department to establish an overpayment claim in the food stamp program or the program of financial assistance under Chapter 31;

(2)  set progressive goals for reducing the time described by Subdivision (1); and

(3)  adopt a schedule to meet the goals set under Subdivision (2).

(b)  The department shall submit to the governor, the Legislative Budget Board, and the Health and Human Services Commission a semiannual report detailing the department's progress in reaching its goals under Subsection (a)(2). The report may be consolidated with any other report relating to the same subject that the department is required to submit under other law.

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.01(a), eff. Sept. 1, 1997.



Section  22.0252.  Telephone Collection Program.

(a) The department shall use the telephone to attempt to collect reimbursement from a person who receives a benefit granted in error under the food stamp program or the program of financial assistance under Chapter 31.

(b)  The department shall submit to the governor, the Legislative Budget Board, and the Health and Human Services Commission a semiannual report on the operation and success of the telephone collection program. The report may be consolidated with any other report relating to the same subject that the department is required to submit under other law.

(c)  The department shall ensure that the telephone collection program attempts to collect reimbursement for all identified delinquent payments for which 15 days or more have elapsed since the initial notice of delinquency was sent to the recipient.

(d)  The department shall use an automated collections system to monitor the results of the telephone collection program. The system must:

(1)  accept data from the accounts receivable tracking system used by the department;

(2)  automate recording tasks performed by a collector, including providing access to department records regarding the recipient and recording notes and actions resulting from a call placed to the recipient;

(3)  automatically generate a letter to a recipient following a telephone contact that confirms the action to be taken regarding the delinquency;

(4)  monitor the receipt of scheduled payments from a recipient for repayment of a delinquency; and

(5)  generate reports regarding the effectiveness of individual collectors and of the telephone collection program.

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.01(a), eff. Sept. 1, 1997. Amended by Acts 1999, 76th Leg., ch. 206, Sec. 2, eff. Sept. 1, 1999.



Section  22.0253.  Participation In Federal Tax Refund Offset Program.

The department shall participate in the Federal Tax Refund Offset Program (FTROP) to attempt to recover benefits granted by the department in error under the food stamp program. The department shall submit as many claims that meet program criteria as possible for offset against income tax returns.

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.01(a), eff. Sept. 1, 1997.



Section  22.0254.  Prosecution Of Fraudulent Claims.

(a) The department shall keep a record of the dispositions of referrals made by the department to a district attorney concerning fraudulent claims for benefits under the food stamp program or the program of financial assistance under Chapter 31.

(b)  The department may:

(1)  request status information biweekly from the appropriate district attorney on each major fraudulent claim referred by the department;

(2)  request a written explanation from the appropriate district attorney for each case referred in which the district attorney declines to prosecute; and

(3)  encourage the creation of a special welfare fraud unit in each district attorney's office that serves a municipality with a population of more than 250,000, to be financed by amounts provided by the department.

(c)  The department by rule may define what constitutes a major fraudulent claim under Subsection (b)(1).

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.01(a), eff. Sept. 1, 1997.



Section  22.0255.  Returned-mail Reduction.

(a) The department shall develop and implement policies and procedures designed to improve the department's electronic benefits transfer cards used for federal and state entitlement programs administered by the department.

(b)  The department shall set an annual goal of reducing the amount of returned mail it receives under the programs described by Subsection (a) so that the percentage rate of returned mail is within one percent of the percentage rate of returned mail reported annually for the credit card and debit card industries.

(c)  The department shall submit a biennial report to the governor's office, the legislature, and the Legislative Budget Board detailing the progress the department has made in reaching its goals under this section.

Added by Acts 1997, 75th Leg., ch. 322, Sec. 1, eff. May 26, 1997.



Section  22.026.  Reduction Of Client Fraud.

The department shall:

(1)  ensure that errors attributed to client fraud are appropriate; and

(2)  take immediate and appropriate action to limit any client fraud that occurs.

Added by Acts 1995, 74th Leg., ch. 655, Sec. 8.08(a), eff. Sept. 1, 1995.



Section  22.027.  Fraud Prevention. (a) To (d)

Repealed by Acts 1997, 75th Leg., ch. 1153, Sec. 1.06(i), eff. Sept. 1, 1997.

(e)  The department and the comptroller shall coordinate their efforts to cross-train agency staff whose duties include fraud prevention and detection to enable the staff to identify and report possible fraudulent activity in programs, taxes, or funds administered by the other agency.

(f)  A local law enforcement agency that seizes an electronic benefits transfer (EBT) card issued by the department to a recipient of an entitlement program administered by the department shall immediately notify the department of the seizure and return the card to the department. The department shall send letters to local law enforcement agencies or post materials in the buildings in which those agencies are located to ensure that local law enforcement officials are aware of this requirement.

Added by Acts 1995, 74th Leg., ch. 655, Sec. 8.04(a), eff. Sept. 1, 1995. Amended by Acts 1997, 75th Leg., ch. 322, Sec. 2, eff. May 26, 1997.



Section  22.028.  Electronic Benefits Transfer: Monitoring.

(a) The private electronic benefits transfer (EBT) operator with which the department contracts to administer the EBT system, shall establish procedures to maintain records that monitor all debit transactions relating to EBT client accounts under this section. The EBT operator shall deliver copies of the records to the department and the comptroller not later than the first day of each month. The department shall immediately review the records and assess the propriety of the debit transactions.

(b)  After reviewing the records under Subsection (a), the department shall take necessary or advisable action to ensure compliance with EBT rules by the EBT operator, retailers, and clients.

(c)  No later than the first day of each month, the department shall send the comptroller a report listing the accounts on which enforcement actions or other steps were taken by the department in response to the records received from the EBT operator under this section, and the action taken by the department. The comptroller shall promptly review the report and, as appropriate, may solicit the advice of the Medicaid and Public Assistance Fraud Oversight Task Force regarding the results of the department's enforcement actions.

Added by Acts 1995, 74th Leg., ch. 655, Sec. 8.04(a), eff. Sept. 1, 1995. Amended by Acts 1997, 75th Leg., ch. 1153, Sec. 1.06(b), eff. Sept. 1, 1997.



Section  22.029.  Project For Fraud Detection And Prevention Through Data Matching.

(a) In order to enhance the state's ability to detect and prevent fraud in the payment of claims under federal and state entitlement programs, the Health and Human Services Commission shall implement a data matching project as described by Subsection (b). The costs of developing and administering the data matching project shall be paid entirely from amounts recovered by participating agencies as a result of potential fraudulent occurrences or administrative errors identified by the project.

(b)  The project shall involve the matching of database information among all agencies using electronic funds transfer and other participating agencies. The commission shall contract through a memorandum of understanding with each agency participating in the project. After the data has been matched, the commission shall furnish each participating agency with a list of potential fraudulent occurrences or administrative errors.

(c)  Each agency participating in a matching cycle shall document actions taken to investigate and resolve fraudulent issues noted on the list provided by the commission. The commission shall compile the documentation furnished by participating agencies for each matching cycle, and shall report the results of the project to the governor, lieutenant governor, speaker of the house of representatives, and Legislative Budget Board not later than December 1, 1996.

(d)  Agencies participating under Subsection (b) shall cooperate fully with the commission in the prompt provision of data in the requested format, for the identification of suspected fraudulent occurrences, or administrative errors as the commission may otherwise reasonably request in order to carry out the intent of this section.

(e)  The commission and participating agencies providing source data for the project shall take all necessary steps to protect the confidentiality of information provided as part of this project, in compliance with all existing state and federal privacy guidelines.

Added by Acts 1995, 74th Leg., ch. 655, Sec. 8.03, eff. Sept. 1, 1995. Amended by Acts 1997, 75th Leg., ch. 827, Sec. 2, eff. Sept. 1, 1997.



Section  22.0291.  Project For Identifying Persons Eligible For Benefits Through Data Matching.

(a) The Texas Department of Health shall implement a data matching project to locate individuals who qualify to participate in the federal special supplemental food program for women, infants, and children. The department shall notify eligible persons and encourage them to apply for the program.

(b)  The department shall identify other state agency databases that could be matched with the department's database for the federal special supplemental food program for women, infants, and children. The department shall contract through a memorandum of understanding with each agency participating in the project.

(c)  Agencies participating under Subsection (b) shall cooperate fully with the department and promptly provide data in the requested format.

(d)  The department and participating agencies providing source data for the project shall take all necessary steps to protect the confidentiality of information provided as part of this project, in compliance with all existing state and federal privacy guidelines.

(e)  The Texas Department of Health shall identify the databases for the matching project not later than December 30, 1997, and shall begin database matching not later than July 1, 1998.

Added by Acts 1997, 75th Leg., ch. 827, Sec. 3, eff. Sept. 1, 1997.



Section  22.0292.  Information Matching System Relating To Immigrants And Foreign Visitors.

(a) The department shall, through the use of a computerized matching system, compare department information relating to applicants for and recipients of food stamps and financial assistance under Chapter 31 with information obtained from the Department of State of the United States and the United States Department of Justice relating to immigrants and visitors to the United States for the purpose of preventing individuals from unlawfully receiving public assistance benefits administered by the department.

(b)  The department may enter into an agreement with the Department of State of the United States and the United States Department of Justice as necessary to implement this section.

(c)  The department and federal agencies sharing information under this section shall protect the confidentiality of the shared information in compliance with all existing state and federal privacy guidelines.

(d)  The department shall submit to the governor, the Legislative Budget Board, and the Health and Human Services Commission a semiannual report on the operation and success of the information matching system required by this section. The report may be consolidated with any other report relating to the same subject matter the department is required to submit under other law.

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.01(b), eff. Sept. 1, 1997. Renumbered from Sec. 22.0291 by Acts 1999, 76th Leg., ch. 62, Sec. 19.01(69), eff. Sept. 1, 1999.



Section  22.030.  Agreements For Purchase Of Services For Children.

(a) To ensure the maximum use of available federal matching funds for child care services and other support services under Section 31.010, the Department of Human Services shall enter into agreements with the appropriate local community organizations to receive donations to be used for the purchase of services for which matching federal funds are available.

(b)  The Department of Human Services shall cooperate with each local community organization to develop guidelines for the use of that community's donation to provide the services described in Subsection (a) of this section.

Added by Acts 1995, 74th Leg., ch. 655, Sec. 6.05, eff. Sept. 1, 1995.



Section  22.031.  Unannounced Inspections.

The department may make any inspection of a facility or program under the department's jurisdiction without announcing the inspection.

Added by Acts 1995, 74th Leg., ch. 531, Sec. 3, eff. Aug. 28, 1995. Renumbered from Human Resources Code Sec. 22.025 by Acts 1997, 75th Leg., ch. 165, Sec. 31.01(60), eff. Sept. 1, 1997.



Section  22.032.  Use Of Earned Federal Funds.

Subject to the General Appropriations Act, the department may use earned federal funds derived from recovery of amounts paid or benefits granted by the department as a result of fraud to pay the costs of the department's activities relating to preventing fraud.

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.02, eff. Sept. 1, 1997.



Section  22.034.  Work Group On Long-term Care Services.

(a) In this section, "long-term care services" includes community care services and support, and services provided by nursing facilities, assisted living facilities, group homes, intermediate care facilities for persons with mental retardation, and other institutional care facilities.

(b)  A work group is created to assist the department and the Texas Department of Mental Health and Mental Retardation in studying coordination of planning and services between the two agencies in providing long-term care services.

(c)  The work group is composed of the following 20 members:

(1)  two representatives of the department, appointed by the commissioner;

(2)  two representatives of the Texas Department of Mental Health and Mental Retardation, appointed by the commissioner of mental health and mental retardation;

(3)  two representatives of the Texas Department on Aging, appointed by the executive director of aging;

(4)  one representative of the Health and Human Services Commission, appointed by the commissioner of health and human services;

(5)  three consumers of long-term care services, jointly appointed by the commissioner and the commissioner of mental health and mental retardation;

(6)  two advocates for elderly individuals, appointed by the commissioner;

(7)  two advocates for persons with disabilities, appointed by the commissioner;

(8)  two advocates for people with mental retardation and mental illness, appointed by the commissioner of mental health and mental retardation; and

(9)  four long-term care services providers, jointly appointed by the commissioner and the commissioner of mental health and mental retardation, representative of the broadest array of settings listed in Subsection (a).

(d)  A member of the work group serves at the will of the appointing agency.

(e)  The members of the work group shall elect a presiding officer and any other necessary officers.

(f)  The work group shall meet at the call of the presiding officer.

(g)  A member of the work group receives no additional compensation for serving on the work group. Persons serving on the work group shall be reimbursed for travel and other expenses necessary for participation as provided in the General Appropriations Act.

(h)  The work group shall study and report on coordination of planning and services between the department and the Texas Department of Mental Health and Mental Retardation in providing long-term care services. As part of its study and report on coordination, the work group shall also study and make recommendations on the development of consistent and standardized:

(1)  regulation of residential and community long-term care services;

(2)  rate-setting processes for long-term care providers and services;

(3)  contractor monitoring for long-term care providers and services;

(4)  intake, assessment, referral, and coordinated case management procedures for long-term care services; and

(5)  administration of the In-Home and Family Support Program operated by the department and the Texas Department of Mental Health and Mental Retardation.

(i)  The work group shall report annually to the commissioner, the commissioner of health and human services, and the commissioner of mental health and mental retardation. The report must include any recommendations on subjects the work group has studied.

(j)  The work group is not subject to Chapter 2110, Government Code.

Added by Acts 1999, 76th Leg., ch. 1505, Sec. 1.04, eff. Sept. 1, 1999.



Section  22.035.  Children's Policy Council.

(a) A work group to be known as the Children's Policy Council shall assist the department, the commissioner of health and human services, the Texas Department of Health, the Texas Department of Mental Health and Mental Retardation, and the Department of Protective and Regulatory Services in developing, implementing, and administering family support policies and related long-term care and health programs for children.

(b)  The commissioner of health and human services shall appoint the members of the work group, which must include the following:

(1)  a person who is younger than 22 years of age and is a consumer of long-term care and health programs for children;

(2)  relatives of consumers of long-term care and health programs for children;

(3)  a representative from an organization that is an advocate for consumers of long-term care and health programs for children;

(4)  a representative from a state agency that provides long-term care and health programs for children;

(5)  a person from a private entity that provides long-term care and health programs for children;

(6)  a person from a public entity that provides long-term care and health programs for children;

(7)  a person with expertise in the availability of funding and the application of funding formulas for children's long-term care and health services;

(8)  a representative from a faith-based organization;

(9)  a representative from a nonspecialized community services organization; and

(10)  a representative from a business that is not related to providing services to persons with disabilities.

(c)  A majority of the members of the work group must be composed of relatives of consumers of long-term care and health programs for children.

(d)  A person may not be appointed as a relative of a consumer of long-term care and health programs for children if the person:

(1)  is an employee of a state agency that provides long-term care or health services for children; or

(2)  contracts with a state agency described by Subdivision (1) to provide long-term care or health services for children.

(e)  The department and the Texas Department of Health shall equally provide administrative support, including staff, to the work group.

(f)  A member of the work group serves at the will of the commissioner of health and human services.

(g)  The commissioner of health and human services shall appoint a member of the work group to serve as a presiding officer.

(h)  The work group shall meet at the call of the presiding officer.

(i)  A member of the work group receives no additional compensation for serving on the work group. Consumers and relatives of consumers serving on the work group shall be reimbursed for travel and other expenses necessary for participation as provided in the General Appropriations Act. Other members of the work group may not be reimbursed for travel or other expenses incurred while conducting the business of the work group. Reimbursement under this subsection shall be paid equally out of funds appropriated to the department and funds appropriated to the Texas Department of Health.

(j)  The work group shall study and make recommendations in the following areas:

(1)  access of a child or a child's family to effective case management services, including case management services with a single case manager, parent case managers, or independent case managers;

(2)  the transition needs of children who reach an age at which they are no longer eligible for services at the Texas Department of Health, the Texas Education Agency, and other applicable state agencies;

(3)  the blending of funds, including case management funding, for children needing long-term care and health services;

(4)  collaboration and coordination of children's services between the department, the Texas Department of Health, the Texas Department of Mental Health and Mental Retardation, and any other agency determined to be applicable by the work group;

(5)  budgeting and the use of funds appropriated for children's long-term care services and children's health services;

(6)  services and supports for families providing care for children with disabilities;

(7)  effective permanency planning for children who reside in institutions or who are at risk of placement in an institution;

(8)  barriers to enforcement of regulations regarding institutions that serve children with disabilities; and

(9)  the provision of services under the medical assistance program to children younger than 23 years of age with disabilities or special health care needs under a waiver granted under Section 1915(c) of the federal Social Security Act (42 U.S.C. Section 1396n(c)).

(k)  Not later than September 1 of each even-numbered year, the work group shall report on its findings and recommendations to the legislature and the commissioner of health and human services.

(l)  After evaluating and considering recommendations reported under Subsection (k), the Health and Human Services Commission shall adopt rules to implement guidelines for providing long-term care and health services to children.

(m)  The work group is not subject to Chapter 2110, Government Code.

Added by Acts 1999, 76th Leg., ch. 1505, Sec. 1.04, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 198, Sec. 1, eff. Sept. 1, 2001.



Section  22.036.  Programs For Deaf-blind Multihandicapped Individuals And Their Parents.

(a) The department shall establish programs to serve deaf-blind multihandicapped individuals by helping them attain self-sufficiency and independent living.

(b)  The department shall establish a program of parental counseling for the parents of deaf-blind multihandicapped individuals. The counseling program may be provided on an individual or group basis and must include programs, activities, and services necessary to foster greater understanding and to improve relationships among professionals, parents, and deaf-blind multihandicapped individuals.

(c)  The department shall establish a summer outdoor training program for deaf-blind multihandicapped individuals. The outdoor training program must be designed to help meet the unique needs of deaf-blind multihandicapped individuals for the purpose of broadening their educational experiences and improving their ability to function more independently.

(d)  The department shall establish regulations for implementing and administering the programs.

(e)  The department may contract for services or goods with private or public entities for purposes of this section.

(f)  From information collected from the programs, the department shall determine the need for related future services and the most efficient and effective method of delivering the future services.

Added by Acts 1985, 69th Leg., ch. 619, Sec. 14, eff. Sept. 1, 1985. Amended by Acts 1999, 76th Leg., ch. 1505, Sec. 1.05, eff. Sept. 1, 1999.



Section  22.037.  Pilot Program For Community-based Alternatives For Persons With Disabilities.

(a) In this section:

(1)  "Institution" means:

(A)  an ICF-MR, as defined by Section 531.002, Health and Safety Code;

(B)  a nursing facility; or

(C)  an institution for the mentally retarded licensed or operated by the Department of Protective and Regulatory Services.

(2)  "Legally authorized representative" has the meaning assigned by Section 241.151, Health and Safety Code.

(b)  The department, in cooperation with the Texas Department of Mental Health and Mental Retardation and the Department of Protective and Regulatory Services in accordance with the memorandum of understanding adopted under Section 22.038, shall develop and implement in at least three sites a pilot program to provide a system of services and support that fosters independence and productivity and provides meaningful opportunities for persons with disabilities to live in the community. The department shall determine the pilot sites, with one site in a rural area, one site in an urban area, and one site in a mixed urban and rural area. In determining the sites, the department shall consider the length of waiting lists for community-based services and support in each area and give preference to areas with the longest waiting lists.

(c)  The pilot program, subject to the availability of funds, shall include the following components:

(1)  a comprehensive system of improved policies and procedures to avoid inappropriately placing a person with a disability in an institution, including policies and procedures that require:

(A)  a preadmission screening for the person that includes the participation of hospital discharge staff and the person's physician; and

(B)  an analysis of the costs, benefits, and effectiveness of placing the person in a community-based alternative care setting;

(2)  a program under which physicians who treat persons with disabilities and hospital discharge staff are:

(A)  educated about the availability of community-based alternatives to institutionalization to reduce the number of persons inappropriately placed in an institution; and

(B)  required to inform a person with a disability and any other person required to be provided information under Section 531.042, Government Code, of all care and support options available to the person with the disability, including community-based care and support options, before that person makes a decision regarding a long-term care placement;

(3)  a program, including a program implemented through grants to community-based organizations, to provide a transition case manager to:

(A)  assist a person with a disability in making a transition from an institution to a community-based alternative care setting after that person or the person's legally authorized representative decides the person should make that transition; and

(B)  coordinate with the local mental health or mental retardation authority, as defined by Section 531.002, Health and Safety Code, in:

(i)  providing services to the person related to the assistance described by Paragraph (A), if applicable; and

(ii)  conducting outreach initiatives under Subdivision (4);

(4)  a program to provide grants to community-based organizations to conduct outreach initiatives to identify persons with disabilities who may inappropriately reside in an institution; and

(5)  a program under which presumptive eligibility is authorized for community-based care and support programs for a person with a disability.

(d)  The department shall implement each component of the pilot program described by Subsection (c) for which the legislature appropriates sufficient money. The department is not required to implement a component if the legislature does not appropriate sufficient money for that component.

(e)  Not later than January 15, 2005, the department shall submit a report concerning the effectiveness of the pilot program to the presiding officers of both houses of the legislature and to the governor. The report must include:

(1)  an evaluation of the strengths and weaknesses of each implemented component of the pilot program;

(2)  a recommendation regarding the feasibility of expanding the pilot program statewide; and

(3)  a recommendation regarding adopting improved policies and procedures with statewide applicability, as determined from the information obtained in operating the pilot program, to ensure appropriate care settings for persons with disabilities.

Added by Acts 2001, 77th Leg., ch. 1239, Sec. 4, eff. Sept. 1, 2001.



Section  22.038.  Memorandum Of Understanding On Pilot Program For Community-based Alternatives For Persons With Disabilities. (a)

The department, the Texas Department of Mental Health and Mental Retardation, and the Department of Protective and Regulatory Services shall adopt a memorandum of understanding to implement the pilot program under Section 22.037.

(b)  The memorandum of understanding must:

(1)  define the responsibilities of each agency in implementing the components of the pilot program; and

(2)  provide for interagency coordination and integration with respect to appropriate components of the pilot program, including any components:

(A)  that serve persons for whom each of the agencies otherwise provides services;

(B)  for which coordination and integration among the agencies will result in the more efficient accomplishment of the goals of the comprehensive, effectively working plan implemented under Section 531.0244, Government Code; or

(C)  that are recommended by the interagency task force under Section 531.02441, Government Code, for coordination and integration.

(c)  Not later than September 1 of each year, the department, the Texas Department of Mental Health and Mental Retardation, and the Department of Protective and Regulatory Services shall review and update the memorandum.

(d)  Each agency by rule shall adopt the memorandum of understanding and all revisions to the memorandum.

Added by Acts 2001, 77th Leg., ch. 1239, Sec. 4, eff. Sept. 1, 2001.



Section  22.039.  Training And Continuing Education Related To Certain Long-term Care Facilities.

(a) In this section:

(1)  "Long-term care facility" means a nursing institution, an assisted living facility, or an intermediate care facility for the mentally retarded licensed under Chapter 242, 247, or 252, Health and Safety Code.

(2)  "Provider" means an employee or agent of a long-term care facility.

(3)  "Surveyor" means an employee or agent of the department or another state agency responsible for licensing, inspecting, surveying, or investigating a long-term care facility in relation to:

(A)  licensing under Chapter 242, 247, or 252, Health and Safety Code; or

(B)  certification for participation in the medical assistance program in accordance with Chapter 32.

(b)  The department shall require a surveyor to complete a basic training program before the surveyor inspects, surveys, or investigates a long-term care facility. The training must include observation of the operations of a long-term care facility unrelated to the survey, inspection, or investigation process for a minimum of 10 working days within a 14-day period.

(c)  The department shall semiannually provide training for surveyors and providers on subjects that address at least one of the 10 most common violations by long-term care facilities under federal or state law.

(d)  Except as provided by Subsection (e), a surveyor who is a health care professional licensed under the laws of this state must receive a minimum of 50 percent of the professional's required continuing education credits, if any, in gerontology or care for individuals with cognitive or physical disabilities, as appropriate.

(e)  A surveyor who is a pharmacist must receive a minimum of 30 percent of the pharmacist's required continuing education credits in gerontology or care for individuals with cognitive or physical disabilities, as appropriate.

Added by Acts 2001, 77th Leg., ch. 1284, Sec. 7.01, eff. June 15, 2001. Renumbered from Human Resources Code, Sec. 22.037, by Acts 2003, 78th Leg., ch. 1275, Sec. 2(96), eff. Sept. 1, 2003.



Section  22.040.  Determination Of Eligibility For Community Care Services For Elderly Persons Or Persons With Disabilities.

The department by rule shall develop and implement a plan to assist elderly persons or persons with disabilities requesting community care services in receiving those services as quickly as possible when those services become available. The plan must require the department to:

(1)  forecast participant openings that will become available in a community care program serving the elderly person or person with a disability during the next fiscal quarter because of program expansion or case closures;

(2)  contact an individual on an interest list and begin the program eligibility determination process at least 30 days before an opening is forecasted to become available in the program; and

(3)  ensure that an individual determined to be eligible for services does not begin receiving services until after the opening actually becomes available.

Acts 2003, 78th Leg., ch. 1169, Sec. 11, eff. Sept. 1, 2003.



Section 22.041.  Third-party Information.

Notwithstanding any other provision of this code, the department may use information obtained from a third party to verify the assets and resources of a person for purposes of determining the person's eligibility and need for medical assistance, financial assistance, or nutritional assistance.  Third-party information includes information obtained from:

(1)  a consumer reporting agency, as defined by Section 20.01, Business & Commerce Code;

(2)  an appraisal district; or

(3)  the Texas Department of Motor Vehicles vehicle registration record database.

Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.85, eff. Sept. 1, 2003.

Renumbered from Human Resources Code, Section 22.040 by Acts 2005, 79th Leg., Ch. 728, Sec. 23.001(55), eff. September 1, 2005.

Amended by:

Acts 2009, 81st Leg., R.S., Ch. 933, Sec. 3G.01, eff. September 1, 2009.


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