The Texas Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §68.101, concerning application; §68.102, concerning definitions; and §68.103, concerning use and availability of EVV system, in Chapter 68, Electronic Visit Verification (EVV) System.

BACKGROUND AND PURPOSE

The purpose of the proposed amendments is to implement a portion of Senate Bill (SB) 7, 82nd Legislature, First Called Session, 2011, relating to Electronic Visit Verification (EVV). EVV is a telephone- and computer-based system that electronically verifies that service visits occur and documents the precise time that the provision of services begins and ends.

Currently, EVV is used to track and document the delivery of attendant-like services in select community-based programs. The proposal amends the rules in Chapter 68 to add nursing services as a type of service that is documented with EVV as applicable to each program. Additional proposed amendments update program references and definitions.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §68.101 adds nursing services as services to which Chapter 68 applies in the following programs: the Community Living Assistance and Support Services (CLASS) Program, and the Deaf Blind with Multiple Disabilities Program. Additionally, the amendment deletes references to the Consolidated Waiver Program because the program no longer exists. The term "adjunct services" has been replaced with "flexible family support services" to accurately reflect terminology in the Medically Dependent Children Program waiver.

The proposed amendment to §68.102 deletes the definition of "CDSA--Consumer directed services agency" and adds a definition for "Financial Management Services Agency (FMSA)," to reflect terminology used with the consumer directed services option.

The proposed amendment to §68.103 changes "CDSA" to "FMSA." As amended, subsection (b) allows the use of an EVV system certified by HHSC under a process to be implemented by that agency. Currently, the rule only allows the use of a system approved by DADS. The amendment deletes references to EVV being used in specific areas because the limitations are unnecessary. Subsection (f) is reworded to clarify that a contractor, an FMSA, or a CDS option participant must allow DADS access to an EVV system.

FISCAL NOTE

James Jenkins, DADS Chief Financial Officer, has determined that, for each year of the first five years the proposed amendments are in effect, there are foreseeable implications relating to costs or revenues of state government. There are no foreseeable implications relating to costs or revenues of local governments.

The effect on state government for each year of the first five years the proposed amendments are in effect is an estimated reduction in cost of $46,243 in fiscal year (FY) 2014; $191,689 in FY 2015; $194,046 in FY 2016; $194,967 in FY 2017; and $195,891 in FY 2018 due to the reduction in the number of nursing units that will be billed and paid.

SMALL BUSINESS AND MICRO-BUSINESS IMPACT ANALYSIS

DADS has determined that the proposed amendments will not have an adverse economic effect on small businesses or micro-businesses, because the proposed rules do not result in costs to providers. Providers are currently using the EVV system and there are no additional costs incurred to verify nursing services in the EVV system.

PUBLIC BENEFIT AND COSTS

Chris Adams, DADS Deputy Commissioner for the Center for Program Coordination, has determined that, for each year of the first five years the amendments are in effect, the public benefit expected as a result of enforcing the amendments is a reduction of timekeeping errors and a more accurate verification of nursing service delivery.

Mr. Adams anticipates that there will not be an economic cost to persons who are required to comply with the amendments. The amendments will not affect a local economy.

TAKINGS IMPACT ASSESSMENT

DADS has determined that this proposal does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code, §2007.043.

PUBLIC COMMENT

Questions about the content of this proposal may be directed to Jennifer Morrison at (512) 438-3383 in DADS Center for Program Coordination. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-13R24, Department of Aging and Disability Services W-615, P.O. Box 149030, Austin, Texas 78714-9030 or street address 701 West 51st St., Austin, Texas 78751; faxed to (512) 438-5759; or e-mailed to rulescomments@dads.state.tx.us. To be considered, comments must be submitted no later than 30 days after the date of this issue of the Texas Register. The last day to submit comments falls on a Sunday; therefore, comments must be: (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered to DADS before 5:00 p.m. on DADS last working day of the comment period; or (3) faxed or e-mailed by midnight on the last day of the comment period. When faxing or e-mailing comments, please indicate "Comments on Proposed Rule 13R24" in the subject line.

STATUTORY AUTHORITY

The amendments are proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program.

The amendments affect Texas Government Code, §531.0055 and §531.021, and Texas Human Resources Code, §161.021