The Texas Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §97.2 and §97.527, in Chapter 97, Licensing Standards for Home and Community Support Services Agencies.

BACKGROUND AND PURPOSE

The purpose of the amendments is to make terminology used in Chapter 97 consistent with terminology used in Title 42, Code of Federal Regulations, Part 488, Subparts I and J. Specifically, the proposed amendments replace the term "informal review of deficiencies" (IRoD) with the term "informal dispute resolution" (IDR). Currently, IRoD is available for all violations and deficiencies, but the proposed amendments provide that that IDR is available for violations and only for deficiencies that rise to the condition level, which are deficiencies that substantially limit the capacity of a home and community support services agency to furnish adequate care or that adversely affect the health or safety of patients. Additional amendments provide that DADS does not grant an agency's request for IDR if DADS cited the violation or deficiency at the agency's immediately preceding survey and DADS has cited the violation or deficiency again, with no new findings.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §97.2 deletes the definition of "IRoD" and adds a definition for "IDR" to conform with 42 CFR §488.745. The amendment also replaces the defined terms "alternate delivery site," "end stage renal disease," "legally authorized representatives," and "registered nurse," with acronyms and puts the acronyms in alphabetical order.

The proposed amendment to §97.527 replaces the term "IRoD" with "IDR." The amendment provides that IDR is available to an agency for condition-level deficiencies, violations, or both, and that the agency receives instructions for requesting IDR with written notification of the survey findings. The amendment states that DADS does not grant an agency's request for IDR if DADS cited the same violation or deficiency at the agency's immediately preceding survey and DADS has cited the violation or deficiency again, with no new findings. This change is made to ensure that an agency's and DADS resources for IDR are used in a cost effective and efficient manner. The proposed amendment makes editorial changes for clarity and consistency.

FISCAL NOTE

David Cook, DADS Chief Financial Officer, has determined that, for the first five years the proposed amendments are in effect, enforcing or administering the amendments does not have foreseeable implications relating to costs or revenues of state or local governments.

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 there is no cost to comply with the amendments.

PUBLIC BENEFIT AND COSTS

Mary T. Henderson, DADS Assistant Commissioner for Regulatory Services, 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 that agencies will have an opportunity to have an IDR to address serious deficiencies and state resources will be used efficiently.

Ms. Henderson 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 Christy Parks at (512) 438-3791 in DADS Regulatory Services. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-13R28, 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 13R28" in the subject line.

STATUTORY AUTHORITY

The amendment is 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, and Texas Health and Safety Code, §142.0011 which authorizes the HHSC executive commissioner to adopt rules relating to the licensing and regulation of home and community support services agencies.

The amendment implements Texas Government Code, §531.0055, and Texas Health and Safety Code, Chapter 142.