Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003 Page: 2,872
2821-2988 p. ; 28 cm.View a full description of this periodical.
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The department provides health services to women and chil-
dren in Texas under the authority of the Health and Safety Code,
Chapter 32; the State Appropriations Act; and the Social Security
Act, Title V. The Targeted Case Management Program for High
Risk Pregnant Women and High Risk Infants was established un-
der the authority of the Social Security Act, Title XIX, 1915(g).
Section 1915(g) authorized states to provide case management
as a distinct service to targeted populations, through a waiver
from the Health Care Financing Administration (HCFA), now the
Centers for Medicare and Medicaid Services or CMS. The Health
and Human Services Commission (HHSC) provides authority to
the department to propose rules to administer certain Medicaid
program services in Texas. Human Resources Code, 22.0031,
mandates case management for high-risk pregnant women and
high-risk children to age one as provided under 1915(g) of the
federal Social Security Act (42 U.S.C. 1396n). Case manage-
ment for children up to age 21 is authorized under 42 U.S.C.
1396d.
The Government Code, 531.021, provides HHSC with the au-
thority to propose rules to administer the state's medical assis-
tance program. The current rules were submitted by the depart-
ment under its agreement with HHSC to operate the Early and
Periodic Screening, Diagnosis and Treatment (EPSDT) program,
and as authorized under 1.07, Acts of the 72nd Legislature,
First Called Session (1991), Chapter 15, as amended by the Acts
of the 73rd Legislature, Chapter 747, 2. The purpose of these
sections is to make available medically necessary medical case
management services mandated by EPSDT program. In Texas,
the EPSDT program is known as Texas Health Steps (THSteps).
The proposed new rules for Case Management for Children
and Pregnant Women will provide case management services
to Medicaid eligible women of all ages who have a high risk
pregnancy and to children with a health condition/health risk
from birth to 21 years of age. Two programs, Medicaid Case
Management for High Risk Pregnant Women and High Risk
Infants, and the Texas Health Steps Medical Case Manage-
ment, will become one program in the proposed new sections of
Chapter 27 and the repeal of 32.301-32.305, 32.307, 33.501
- 33.506, and 37.81 - 37.86. The new program will provide a
greater continuity of services for all eligible recipients.
Ravi Rupsingh, M.P.A., Actuary, Actuary Analysis, HHSC, has
determined for the first five years the repeals are in effect, there
will be cost savings to the state through the combination of the
two programs as described in this preamble. Total cost savings
per year are $1,724,820, $6,153,493, $6,348,526, $6,549,411
and $6,745,893 in state fiscal years 2003, 2004, 2005, 2006 and
2007, respectively, for a total of $27,522,143 over these five state
fiscal years. There will be no impact on local government.
Duane Thomas, Ph.D., Texas Department of Health, Director of
Regional Case Management has also determined that for each
of the first five years the repeals are in effect, anticipated pub-
lic benefits include better access to primary care providers, pre-
ventative health services, other health services and community
resources for children and pregnant women accessing the ser-
vices. There will be costs to small businesses and micro-busi-
nesses. This was determined after concluding that the elimina-
tion of the Intake as a billable contact for Targeted Case Manage-
ment for Pregnant Women and Infants providers will decrease
the amount of reimbursement that these providers currently re-
ceive. The cost to small and micro-businesses for the first year
of implementation is estimated to be $7,327 while the cost to
large businesses for the first year of implementation is estimatedto be $7,281. The estimated costs are based on the assumption
that 70% of Targeted Case Management for Pregnant Women
and Infants providers are large businesses and 30% of providers
are small or micro-businesses. There will be no anticipated eco-
nomic costs to persons who receive the services. The depart-
ment has determined that the proposed repeals do not restrict or
limit an owner's right to their property that would otherwise exist
in the absence of governmental action and therefore does not
constitute a taking under Government Code, 2007.043.
Comments on the proposal may be submitted to Cossy Hough,
LMSW-ACP, Texas Department of Health, 1100 West 49th
Street, Austin, Texas 78756, (512) 458-7111, extension 6664.
Comments will be accepted for 30 days following publication of
the proposal in the Texas Register.
A public hearing regarding this repeal will be held on April 8,
2003, from 1:00 p.m. to 4:00 p.m. at the Texas Department of
Health, Board of Health Room, M739, 1100 West 49th Street,
Austin, Texas 78756.
The repeals are proposed under the Health and Safety Code,
12.001, which provides the Board of Health (board) with the
authority to adopt rules to implement every duty imposed by law
on the board, the department and the commissioner of health;
and under the Health and Safety Code, Chapter 32, which
provides the board with the authority to establish maternal and
infant health improvement services programs in the department
to serve eligible recipients; the Human Resources Code,
22.0031, which mandates a program of case management for
high risk pregnant women and high risk infants; the Human Re-
sources Code, Chapter 32, which enables the state to provide
medical assistance; the Government Code, 531.021, which
provides HHSC with the authority to propose rules to administer
the state's medical assistance program and are submitted by
the Texas Department of Health under its agreement with HHSC
to operate the EPSDT program, and as authorized under 1.07
of the Acts of the 72nd Legislature, First Called Session (1991),
Chapter 15, as amended by the Acts of the 73rd Legislature,
Chapter 747, 2.
The proposed repeals affect the Health and Safety Code, Chap-
ter 32, the Human Resources Code, 22.0031 and Chapter 32.
37.81. Introduction.
37.82. Definitions.
37.83. Case Management Services.
37.84. Provider Qualifications.
37.85. Application and Review Process.
37.86. Documents Adopted by Reference.
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 March 21, 2003.
TRD-200301864
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: May 4, 2003
For further information, please call: (512) 458-723628 TexReg 2872 April 4, 2003 Texas Register
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Texas. Secretary of State. Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003, periodical, April 4, 2003; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth101027/m1/51/: accessed May 27, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.