Texas

Texas Supreme Court to Decide Whether Stock Options Can Support Noncompete Agreements

The Texas Supreme Court will rule in an upcoming case on whether a noncompetition agreement supported only by stock options as consideration is enforceable.

Additional Resources
SmartHRManager.

Chapter 817. Child Labor

Subchapter A. GENERAL PROVISIONS

Section 817.1. Title and Purpose

(a) Title. These rules may be cited as the Texas Child Labor Rules.

(b) Purpose. The purpose of these rules is to implement and interpret the provisions of the Texas Labor Code, Chapter 51, Employment of Children.

Source Note: The provisions of this §817.1 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.2. Definitions

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.

(1) Applicant--A child or the child's parent, legal guardian, legal custodian, or prospective employer.

(2) Child--An individual under 18 years of age.

(3) Child actor--A child under the age of 14 who is to be employed as an actor or other performer.

(4) Commission--Texas Workforce Commission.

(5) Executive director--The executive director of the Texas Workforce Commission or the executive director's designee.v

Source Note: The provisions of this §817.2 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.3. Employment of Children

Employment of children not permitted by Subchapter B of this chapter (relating to Limitations on the Employment of Children), Subchapter C of this chapter (relating to Employment of Child Actors), or the Texas Labor Code, Chapter 51, is prohibited.

Source Note: The provisions of this §817.3 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.4. Statement of Commission Intent

(a) In adopting §817.21 of this title (relating to Limitations on the Employment of 14 and 15 Year Old Children) and §817.23 of this title (relating to Limitations on the Employment of 16 and 17 Year Old Children), the Commission intends for the federal child labor laws to govern the employment of children in Texas, unless a provision of this chapter or Texas Labor Code, Chapter 51, clearly indicates otherwise. The Commission so intends only to the extent the federal laws are consistent with Texas Labor Code, Chapter 51.

(b) In adopting §817.24 of this title (relating to Limitations on the Employment of Children to Solicit), the Commission recognizes and hereby implements the legislative intent of Texas Labor Code §51.0145 to apply to the employment of children to sell or solicit products or services usually in a door-to-door manner, but which occasionally takes other forms, such as in parking lots or other common areas. The activity that is the subject of this regulation has been variously labeled over the years as candy sales, door-to-door sales, youth peddling, traveling youth crews, and other names. The activity usually involves one or more recruiters or drivers and at least one product supplier. The operation may involve taking children from lower income neighborhoods to sell in higher income neighborhoods, using a name and presentation that suggests the activity is aimed primarily at keeping the children out of gangs and off drugs.

Source Note: The provisions of this §817.4 adopted to be effective January 12, 1998, 23 TexReg 150; amended to be effective April 22, 1999, 24 TexReg 3111; amended to be effective November 18, 1999, 24 TexReg 10140

Section 817.5. Certificate of Age

(a) To request a certificate of age, an applicant must submit the following:

(1) a completed application on a form provided by the Commission;

(2) a recent photograph (color or black and white) approximately 1 1/2 inches by 1 1/2 inches, showing a full head shot of the applicant; and

(3) proof of age. A copy of one of the following documents is required as proof of age:

(A) birth certificate;

(B) baptismal certificate showing the date of birth;

(C) life insurance policy insuring the life of the child reflecting the date of birth;

(D) passport or certificate of arrival in the United States issued not more than one year prior to the date of application for certificate; or

(E) the school record or the school-census record of the age of the child, together with the sworn statement of a parent, guardian, or person having custody of the child as to the age of the child and also a certificate signed by a physician specifying his opinion as to the age of the child, and the height, weight, and other facts relating to development upon which his opinion concerning age is based.

(b) Certificates of age are effective from the date of their issuance until the applicant reaches 18 years of age. No renewal is necessary, but lost certificates may be reissued upon new application.

Source Note: The provisions of this §817.5 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.6. Appeals

Hearings conducted under Texas Labor Code, Chapter 51, are subject to the rules and hearing procedures set out in the Unemployment Insurance Rules at 40 TAC Chapter 815, except to the extent that such sections are clearly inapplicable or contrary to provisions set out under the Texas Child Labor Rules or under Texas Labor Code, Chapter 51.

Source Note: The provisions of this §817.6 adopted to be effective November 6, 2000, 25 TexReg 11104

Subchapter B. LIMITATIONS ON THE EMPLOYMENT OF CHILDREN

Section 817.21. Limitations on the Employment of 14 and 15 Year Old Children

The Commission adopts by reference §§570.31 through 570.34 and §§570.70 through 570.72 of Title 29 of the Code of Federal Regulations, to the extent that they are consistent with the Fair Labor Standards Act (FLSA), 29 United States Code §201, et seq.. In the event of any inconsistency between federal regulations and the FLSA, the FLSA shall take precedence. The Commission adopts these regulations as state rules governing the employment of 14 and 15 year old children in Texas. These rules will apply to such employment whether or not that employment is subject to the federal Fair Labor Standards Act (FLSA), 29 United States Code §201, et seq. The application of this rule is limited to the extent it is consistent with Texas Labor Code, Chapter 51.

Source Note: The provisions of this §817.21 adopted to be effective January 12, 1998, 23 TexReg 150; amended to be effective April 22, 1999, 24 TexReg 3111

Section 817.2. Hardship Waiver of Hours Requirements for 14 and 15 Year Old Children

(a) An applicant applying for a hardship waiver from the limitations on hours worked for 14 and 15 year old children must obtain a certificate of age under the provisions of §817.5 of this title (relating to Certificate of Age) and file a hardship application. The applicant may file both applications concurrently.

(b) A hardship application must contain:

(1) full details of the prospective employment and the proposed hours to be worked;

(2) a written statement that it is necessary for the child to work to support himself or his immediate family, with supporting information;

(3) a written statement from the principal of the school in which the child is enrolled as to the advisability of allowing the child to work the hours identified; and

(4) a written statement from the prospective employer. The prospective employer's statement shall provide:

(A) that the child will be employed; and

(B) full details of the work, including rate of pay, hours to be worked, and expected duration of employment.

(c) A hardship application may contain any other information the applicant believes would support the granting of the waiver.

(d) All waivers shall be valid for one year unless established for a shorter period and may be extended at the sole discretion of the executive director.

(e) After all pertinent information has been reviewed by the Commission, the waiver will be granted or denied. If additional information is needed before a decision is made, the Commission may gather additional facts and schedule a conference to review the merits of the application with interested persons.

(f) At any conference the Commission will be represented by an employee designated by the executive director who shall make a written report to the executive director within 20 working days following the conference. The report shall contain a determination as to whether or not the waiver should be granted. Unless changed by the executive director, the initial determination shall remain in full force and effect. All interested parties will be advised in writing of the final determination of the Commission as soon as practicable. No appeal to the Commissioners is authorized.

(g) This proceeding is not a contested case under the Texas Government Code, Chapter 2001, Administrative Procedure Act.

Source Note: The provisions of this §817.22 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.23. Limitations on the Employment of 16 and 17 Year Old Children

The Commission adopts by reference §§570.50 through 570.68 of Title 29 of the Code of Federal Regulations, to the extent that they are consistent with the Fair Labor Standards Act (FLSA), 29 United States Code §201, et seq.. In the event of any inconsistency between federal regulations and the FLSA, the FLSA shall take precedence. The Commission adopts these regulations as state rules governing the employment of 16 and 17 year old children in Texas. These rules will apply to such employment whether or not that employment is subject to the federal Fair Labor Standards Act (FLSA), 29 United States Code §201, et seq. The application of this rule is limited to the extent it is consistent with Texas Labor Code, Chapter 51.

Source Note: The provisions of this §817.23 adopted to be effective January 12, 1998, 23 TexReg 150; amended to be effective April 22, 1999, 24 TexReg 3111

Section 817.24. Limitations on the Employment of Children to Solicit

(a) A person may not begin the employment of a child to solicit as defined in Texas Labor Code §51.0145 and as described in §817.4(b) of this Chapter (relating to Statement of Commission Intent), until the Commission's Labor Law Department has received:

(1) a copy of the signed Parental Consent Form approved by the Commission; and

(2) the information required by statute to be provided to the individual who gives consent.

(b) A copy of the Parental Consent Form may be obtained from the Commission's Labor Law Department.

(c) A person employing a child under Texas Labor Code §51.0145 shall limit each solicitation trip to within a radius of no greater than thirty miles from the child's home, unless the parent or other person identified in Texas Labor Code §51.0145(c)(1) signs a Parental Consent Form in advance of the solicitation trip specifically approving a greater distance.

Source Note: The provisions of this §817.24 adopted to be effective November 18, 1999, 24 TexReg 10140

Subchapter C. EMPLOYMENT OF CHILD ACTORS

Section 817.31. Child Actor Authorization

(a) A child under 14 years of age may be employed in Texas as a child actor only by compliance with the provisions of this subchapter.

(b) Every person applying for child actor authorization must submit:

(1) an application for authorization on a form provided by the Commission and signed by a parent, guardian, or person having custody of the child;

(2) proof of age; and

(3) a photograph that complies with §817.5 of this title (relating to Certificate of Age).

(c) An authorization is effective when issued and expires when the child reaches 14 years of age, unless the Commission establishes a shorter time period. Lost authorization certificates may be reissued upon new application.

Source Note: The provisions of this §817.31 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.32. Application Exceptions

(a) Special authorization for child actors to be employed as extras is granted without the need for filing an application if the employer or its agent:

(1) communicates with the Commission prior to the actual work being performed, identifying the employer, the project, the approximate number of extras intended to be employed on the particular project, and the anticipated dates of employment;

(2) prior to employment, uses reasonable efforts to establish that each prospective child actor extra is under 14 years of age;

(3) secures the written consent of a parent, guardian, or person having custody of the child to his or her employment as an extra on the particular project;

(4) notifies all affected school principals of the intent to employ their students as extras, furnishing such details concerning the nature and duration of the work as to give school authorities reasonable information concerning the proposed use of their students in the particular project; and

(5) submits a written post-production report to the Commission, within 10 days following the last day extras are employed, identifying the name, social security number, date of birth, and inclusive dates of employment for each child actor so employed, certifying compliance with Texas Labor Code, Chapter 51 and this chapter (relating to Child Labor).

(b) Special authorizations for extras are deemed effective upon employment and expire as soon as one of the following events occurs:

(1) the child reaches age 14;

(2) the child receives a Child Actor Authorization;

(3) the parent, guardian, or person having custody of the child revokes consent in writing; or

(4) the child's employment on the particular project by that employer ends.

Source Note: The provisions of this §817.32 adopted to be effective January 12, 1998, 23 TexReg 150.

Section 817.33. Limitations on Employment of Child Actors

No child actor under 14 years of age may be employed:

(1) in a manner that results in a failure to receive class credits because of unexcused class absences, or any violation of the State Compulsory School Attendance Law, Texas Education Code, §25.085, either as it is presently worded or may hereafter be amended to read, or of any rules promulgated thereunder;

(2) in a position declared hazardous by the Commission;

(3) during hours that would not be within the limits set by Texas Labor Code, §51.013, for 14 and 15 year old children, except that the child is permitted, with parental consent, to work during otherwise prohibited hours, so long as the child does not work again for the same employer within 12 hours after completing work for the particular session and does not by being so employed work in excess of eight hours in one day or 48 hours in one week;

(4) where the child is required to use a dressing room that is simultaneously occupied by an adult or by a child of the opposite sex;

(5) where the child is not provided with a suitable place to rest or play;

(6) where the child is sent to wardrobe, makeup, or hair-dressing, unless the child is under the general supervision of the child's parent, guardian, or person having custody of the child if the parent, guardian or person having custody is physically present at the place of employment;

(7) where the child's parent, guardian, or person having custody of the child is prevented from being present at the place of employment while the child is working;

(8) where the child's parent, guardian, or person having custody of the child is prevented from being within sight and sound of the child at any time during employment; or

(9) for more than two consecutive school days during a school year in which the child is legally required to attend school without being furnished a tutor for the child's continuing education. The tutor shall be certified to teach in Texas by the Texas Education Agency or the State Board for Educator Certification, and shall make reasonable efforts to coordinate subjects and assignments with the child's classroom teachers.

Source Note: The provisions of this §817.33 adopted to be effective January 12, 1998, 23 TexReg 150.

Chapter 802. Integrity of the Texas Workforce System

Subchapter A. GENERAL PROVISIONS

Section 802.1. Purpose and General Provisions

(a) The purpose of the rules contained in this subchapter is to implement Texas Government Code, §2308.264 and §2308.267, including provisions relating to directly delivering services, Local Workforce Development Board (Board) contracting guidelines, and other conflict of interest provisions.

(b) It is the intent of the Commission that these rules strengthen the confidence of the public in the Texas workforce system.

(c) A Board may set local policies that are more restrictive than those set forth in this subchapter.

(d) A Board shall develop the policies and procedures required by this subchapter.

(e) A Board member with an existing contract for workforce services shall comply with this subchapter no later than the earliest of the following:

(1) the expiration of the contract;

(2) the contract renewal date; or

(3) the expiration of the Board member's term or the Board member's resignation.

(f) Pursuant to Texas Government Code, Chapter 551 (Open Meetings Act), a Board shall:

(1) post appropriate notice;

(2) ensure that all public business or public policy over which the Board has supervision or control is discussed, considered, or acted upon during a properly posted and convened open meeting; and

(3) prepare and retain minutes or tape recordings of each open meeting of the Board. The minutes shall:

(A) state the subject of each deliberation; and

(B) indicate each vote, order, decision, or other action taken.

Source Note: The provisions of this §802.1 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.2. Definitions

In addition to the definitions contained in §800.2 and §801.23 of this title, the following words or terms shall have the following meanings, unless the context clearly indicates otherwise.

(1) Agency grantees--Grantees that receive funding from the Agency, such as Skills Development Fund, Wagner-Peyser 7(b), and Workforce Investment Act (WIA) statewide, to provide workforce services.

(2) Appearance of a conflict of interest--A circumstance in which the action of a Board member, Board employee, workforce service provider, or workforce service provider employee in a decision-making position appears to be:

(A) influenced by considerations of one or more of the following: gain to the person, entity, or organization for which the person has an employment interest, substantial financial interest, or other interest, whether direct or indirect (other than those consistent with the terms of the contract); or

(B) motivated by design to gain improper influence over the Commission, the Agency, or the Board.

(3) Board decision-making position--A position with a Board that has final decision-making authority or final recommendation authority on matters that directly affect workforce service providers. A Board decision-making position is one that performs the function of a Board's executive director, deputy executive director, chief financial officer, lead contract manager, or lead contract monitor.

(4) Conflict of interest--A circumstance in which a Board member, Board employee, workforce service provider, or workforce service provider's employee is in a decision-making position and has a direct or indirect interest, particularly a substantial financial interest, that influences the individual's ability to perform job duties and fulfill responsibilities.

(5) Corrective Action Plan--A plan developed and imposed by the Agency that requires a Board or Agency grantee to take Agency-identified actions within a specified time frame designed to correct specific instances of noncompliance or other failures.

(6) Hearing--An informal, orderly, and readily available proceeding held before an impartial hearing officer at which a party or hearing representative may present evidence to show that the Agency's determination of sanctions shall be reversed, affirmed, or modified.

(7) Hearing officer--An Agency employee designated to conduct hearings and issue proposals for decision.

(8) Hearing representative--Any individual authorized by a party to assist the party in presenting the party's appeal. A hearing representative may be legal counsel or another individual. Each party may have a hearing representative to assist in presenting the party's appeal.

(9) Level-one sanction--A sanction imposed by the Agency on a Board or Agency grantee for significant inability or failure to perform as required by the Agency, including performing or failing to perform due to a sanctionable act as described in this subchapter. A level-one sanction may be associated with the imposition of one or more penalties as referenced in this chapter.

(10) Level-two sanction--A higher sanction than level one imposed by the Agency on a Board or Agency grantee for severe inability or failure to perform as required by the Agency, including performing or failing to perform due to a sanctionable act as described in this chapter. A level-two sanction may be associated with the imposition of more severe penalties than those imposed on a Board or Agency grantee under a level-one sanction.

(11) Level-three sanction--The highest sanction level imposed by the Agency on a Board or Agency grantee for extreme inability or failure to perform as required by the Agency, including performing or failing to perform due to a sanctionable act as described in this chapter. A level-three sanction may be associated with the imposition of the most severe penalties imposed on the Board or Agency grantee.

(12) Particular matter--A specific investigation, application, request for a ruling or determination, rulemaking proceeding, administrative proceeding, contract, claim, or judicial proceeding, or any other proceeding as defined in Texas Government Code §572.054(h)(2).

(13) Party--The person or entity with the right to participate in a hearing authorized by applicable statute or rule.

(14) Substantial financial interest--An interest in a business entity in which a person:

(A) owns 10 percent or more of the stock, shares, fair market value, or other interest in the business entity;

(B) owns more than $5,000 of the fair market value of the business entity;

(C) owns real property if the interest is an equitable or legal ownership with a fair market value of $2,500 or more used for the business entity;

(D) receives funds from the business entity that exceed 10 percent of the person's gross income for the previous year;

(E) is a compensated member of the board of directors or other governing board of the business entity;

(F) serves as an elected officer of the business entity; or

(G) is related to a person in the first degree by consanguinity or affinity, as determined under Texas Government Code, Chapter 573, who has a substantial financial interest in the business entity, as listed in subparagraphs (A) through (F) of this section. First degree of consanguinity or affinity means the person's parent, child, adopted child, or spouse.

(15) Workforce service provider--An entity or individual under contract with a Board to operate:

(A) one or more Workforce Solutions Offices; or

(B) one or more programs (e.g., child care) or components of one or more programs (e.g., issuing checks for youth participating in summer employment or performing child care billing).

(16) Workforce service provider employee in a decision-making position--A position with a workforce service provider that includes the ability to commit or bind the provider to a particular course of action with respect to carrying out the provider's duties and activities under the contract.

Source Note: The provisions of this §802.2 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter B. CONTRACTING

Section 802.21. Board Contracting Guidelines

(a) Fiscal Integrity Provisions.

(1) A Board shall develop fiscal integrity evaluation indicators designed to appraise the fiscal integrity of its workforce service providers.

(2) A Board shall assess its workforce service providers to ensure the providers meet the requirements of the Board's fiscal integrity evaluation based on the following schedule:

(A) contracts under $100,000--the fiscal indicators must be verified prior to the award of the contract and at each renewal of the contract;

(B) contracts between $100,000 and $500,000--the fiscal indicators must be verified prior to the award of the contract, at each renewal of the contract, and not less than biennially; and

(C) contracts over $500,000--the fiscal indicators must be verified prior to the award of the contract, at each renewal of the contract, and not less than once annually.

(3) The fiscal integrity evaluation shall include the following provisions for ensuring that workforce service providers are meeting performance measures in compliance with requirements contained in:

(A) federal and state statutes and regulations and directives of the Commission or Agency;

(B) Office of Management and Budget (OMB) circulars applicable to the entity, such as OMB Circulars A-21, A-87, or A-122, and the Office of the Governor's Uniform Grant Management Standards; and

(C) any other safeguards a Board has identified that are designed to ensure the proper and effective use of funds placed under the control of its workforce service providers.

(4) The fiscal integrity evaluation shall also include the review and consideration of the prospective or renewing workforce service provider's prior three-year financial history before the Board awards or renews a workforce service contract. The review shall include any adverse judgments or findings, such as administrative audit findings; Commission, Agency, or Board monitor findings; or sanctions by a Board or court of law.

(5) The fiscal integrity evaluation may include provisions such as accounting for program income in accordance with federal regulations, resolving questioned costs and the repayment of disallowed costs in a timely manner, and safeguarding fixed assets, as well as those referenced in the Agency's Financial Manual for Grants and Contracts.

(b) Bonding, Insurance, and Other Methods of Securing Funds to Cover Losses.

(1) A Board shall ensure that at least 10 percent of the funds subject to the control of the workforce service providers is protected through bonds, insurance, escrow accounts, cash on deposit, or other methods to secure the funds consistent with this subchapter. A Board and its workforce service providers may, consistent with this section, use any method or combination of methods to meet this requirement. At the Board's discretion, the Board may pay for the bonding, insurance, or other protection methods or require its workforce service providers, to the extent allowable under state and federal law, to pay for such protection.

(2) In conducting the fiscal integrity evaluation required in this section, a Board may determine that more than 10 percent of the funds subject to the control of its workforce service providers shall be secured through bonds, insurance, escrow accounts, or other methods consistent with this subchapter.

(3) Escrow of funds may also be used to satisfy the requirements of this subsection provided that:

(A) the funds placed in escrow require the signature of persons other than the persons with signatory authority for the Board's workforce service providers;

(B) the funds do not lapse due to requirements for timely expenditure of funds; and

(C) this provision does not conflict with any provision in contract, rule, or statute for the timely expenditure of funds.

(4) If a bond is used, a Board shall ensure that the bond is executed by a corporate surety or sureties holding certificates of authority, authorized to do business in the state of Texas.

(5) A Board shall ensure, based on the schedule referenced in subsection (a)(2) of this section, that each of its workforce service providers is required to verify that:

(A) the insurance or bond policy is valid, premiums are paid to date, the company is authorized to provide the bonding or insurance, and the company is not in receivership, bankruptcy, or some other status that would jeopardize the ability to draw upon the policy;

(B) the escrow account balances are at an appropriate level;

(C) the method of securing the funds has not been withdrawn, drawn upon, obligated for another purpose, or is no longer valid for use as the method of security; and

(D) other such protections as are applicable and relied upon by the Board are verified as in force.

(6) A Board shall ensure that the workforce service providers are required to disclose any changes in and circumstances regarding the method of securing or protecting the funds under the workforce service providers' control.

(c) Standards of Conduct. A Board shall ensure that the workforce service providers:

(1) comply with federal and state statutes and regulations regarding standards of conduct and conflict of interest provisions including, but not limited to, the following:

(A) 29 C.F.R. §97.36(b)(3), which includes requirements from the Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments;

(B) professional licensing requirements, when applicable; and

(C) applicable OMB circular requirements and the Office of the Governor's Uniform Grant Management Standards.

(2) avoid any conflict of interest or any appearance of a conflict of interest; and

(3) refrain from using nonpublic information gained through a relationship with the Commission, an Agency employee, a Board, or a Board employee, to seek or obtain financial gains that would be a conflict of interest or the appearance of a conflict of interest.

(d) Disclosures. A Board shall require its workforce service providers to disclose the following:

(1) Matters Subject to Disclosure. A Board shall ensure that its workforce service providers promptly disclose in writing the following:

(A) A substantial financial interest that the workforce service provider, or any of its workforce service provider employees in decision-making positions, have in a business entity that is a party to any business transaction with a Board member or Board employee who is in a Board decision-making position;

(B) A gift greater than $50 in value given to a Board member or Board employee by a workforce service provider or its employees; and

(C) the existence of any conflict of interest and any appearance of a conflict of interest, or the lack thereof.

(2) Content of Disclosure. A Board shall ensure that its workforce service providers' written disclosures contain the following:

(A) information describing the conflict of interest; and

(B) information describing the appearance of a conflict of interest, and actions the workforce service provider and its employees will take in order to prevent any conflict of interest from occurring.

(3) Frequency of Disclosure. A Board shall ensure that its workforce service providers disclose:

(A) at least annually, and as frequently as necessary, any conflict of interest and any appearance of a conflict of interest;

(B) within 10 days of giving a gift greater than $50 in value as referenced in this section; and

(C) at least annually that no conflict of interest and no appearance of a conflict of interest exists.

(4) Matters Not Subject to Disclosure. This provision does not apply to:

(A) a financial transaction performed in the course of a contract with the Board; or

(B) a transaction or benefit that is made available to the general public under the same terms and conditions.

Source Note: The provisions of this §802.21 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter C. LOCAL WORKFORCE DEVELOPMENT BOARD RESTRICTIONS

Section 802.41. Board Member Conflicts of Interest

(a) Pursuant to WIA §117(g) (29 U.S.C.A. §2832(g)), this section sets forth the state's Board conflict of interest requirements for disclosure and declaration of a conflict of interest by a Board member.

(b) A Board member may not vote on any matter that would provide direct financial benefit to the member or the member's immediate family, or on matters of the provision of services by the member or the entity the member represents. No Board member may participate in a decision in which the member has a direct or indirect interest, particularly a financial interest, which is in substantial conflict with the discharge of the duties of the Board.

(c) A Board member shall avoid even the appearance of a conflict of interest. Prior to taking office, Board members must provide to the Board Chair a written declaration of all substantial business interests or relationships they, or their immediate families, have with all businesses or organizations that have received, currently receive, or are likely to receive contracts or funding from the Board. Such declarations shall be updated within 30 days to reflect any changes in such business interests or relationships. The Board shall appoint an individual to timely review the disclosure information and advise the Board Chair and appropriate members of potential conflicts.

(d) Prior to a discussion, vote, or decision on any matter before a Board, if a member, or a person in the immediate family of such member, has a substantial interest in or relationship to a business entity, organization, or property that would be pecuniarily affected by any official Board action, that member shall disclose the nature and extent of the interest or relationship and shall abstain from voting on or in any other way participating in the decision on the matter. All such abstentions shall be recorded in the minutes of the Board meeting.

(e) Each Board must include in its organizational plan or bylaws, or in a separate code of conduct, provisions for penalties, sanctions, or other disciplinary actions for any direct violations of the Board conflict of interest policy. The following definitions must be incorporated into those provisions.

(1) Immediate family--Any person related within the first degree of affinity (marriage) or consanguinity (blood) to the person involved.

(2) Substantial interest--A person has a substantial interest:

(A) in a business entity if:

(i) the person owns 10 percent or more of the voting stock or shares of the business, owns 10 percent or more, or owns $5,000 or more, of the fair market value of a business; or

(ii) funds received by the person from the business exceed 10 percent of the person's gross income for the previous year;

(B) in real property if the interest is an equitable or legal ownership with a fair market value of $2,500 or more; or

(C) if the Board member is related to a person in the first degree of affinity or consanguinity who has a substantial interest as defined in subparagraph (A) or (B) of this paragraph.

Source Note: The provisions of this §802.41 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.42. Employment of Former Board Employees by Workforce Service Providers

(a) Post-Employment Restriction. In order to avoid a conflict of interest, a Board shall ensure that the Board's workforce service providers shall not employ or otherwise compensate a former Board employee who:

(1) was in a Board decision-making position as defined in §802.2 of this chapter; and

(2) was employed or compensated by the Board anytime during the previous 12 months.

(b) Exceptions. Where there is no actual conflict of interest, but there is an appearance of such a conflict, a Board in an open meeting may provide for an exception to the period described in subsection (a) of this section by a vote of two-thirds of the membership present. In making such a determination, the Board shall assess all relevant factors, including, but not limited to, whether there is a critical need for the skills involved, the relative cost and availability of alternatives, and the need to protect the integrity and stability of the Texas workforce system. In such an instance, the Board shall impose whatever terms and conditions it deems necessary to mitigate the appearance of a conflict of interest.

(c) Corrective Actions. A Board shall ensure that its contracts with workforce service providers require compliance with this section and provide effective enforcement mechanisms allowing it to impose corrective actions, up to and including contract termination, for violation of this section.

(d) Particular Matter. A Board shall ensure that its workforce service providers shall not employ or otherwise compensate a former Board employee to work on a particular matter that the employee worked on for the Board, as defined in §802.2 of this chapter. Nothing in this section shall prohibit a Board's workforce service provider from employing or otherwise compensating a former employee of the Board who worked on a particular matter for the Board as long as the former Board employee never works on that same particular matter once employed or otherwise compensated by the Board's workforce service provider.

Source Note: The provisions of this §802.42 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.43. Prohibition against Directly Delivering Services

(a) A Board shall ensure, through the oversight and management of Board policies, that it does not directly deliver or determine eligibility for workforce services in its local workforce development area (workforce area) or contract with the following persons or entities to deliver or determine eligibility for workforce services:

(1) A Board member;

(2) A business, organization, or institution that a Board member represents on the Board;

(3) A Board member's business, organization, or institution in which a Board member has a substantial financial interest; or

(4) A Board employee.

(b) The prohibitions in this section do not apply to public education agencies, such as community colleges and independent school districts, that have Board members who fulfill the requirements set forth in Texas Government Code §2308.256(a)(3)(A).

(c) A Board may grant a one-year exception to the prohibitions described in subsection (a) of this section for a community-based organization that fulfills the requirements set forth in Texas Government Code §2308.256(a)(2). The exception can be granted only by a two-thirds vote of the members present in an open meeting and cannot be granted for contracts for the operation of Workforce Solutions Offices.

(d) A Board shall ensure that the Board, its members, or its employees do not directly control the daily activities of its workforce service providers. The Agency shall review a Board's compliance through an examination of the Board's exercise of direction and control over its workforce service providers. The Agency may use the factors for testing the employment status as set out in §821.5 of this title.

(e) Nothing in this section restricts a Board member or a Board member's organization from receiving Texas workforce system services and thereby being a customer of a Board's workforce service providers' services.

Source Note: The provisions of this §802.43 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.44. Service Delivery Waiver Requests

(a) Purpose of Rule. Texas Government Code §2308.264, §2308.267, and §2308.312 set forth prohibitions regarding service delivery, Board staffing, and developmental services. Only under circumstances that fit the criteria specified in those statutes will requests for waivers be granted.

(b) Boards may submit a waiver request of the following provisions:

(1) Independent Service Delivery. A Board is prohibited from directly providing workforce training and services, including operational functions normally associated with such services such as intake, eligibility determination, assessment, and referral, unless a waiver is obtained.

(2) Separate Staffing. Board staff shall be employed separately and independently of any person who provides workforce training and services, as described in paragraph (1) of this subsection, unless the Board arranges for independent evaluation of any other workforce services provided by the staffing organization and obtains a waiver.

(3) Developmental Services. A person who provides one-stop services at a Workforce Solutions Office shall not also provide developmental services unless a waiver is obtained.

(c) Requesting a Waiver.

(1) Waiver requests shall be submitted to the Commission and contain detailed justification as specified in the respective statutes. The Commission shall review and forward a recommendation to the Texas Workforce Investment Council (TWIC) for consideration. TWIC will forward its recommendation to the Governor for approval.

(2) In recommending action on such requests, the Commission shall apply only the criteria specified in the respective statutes.

(d) Duration of Waiver.

(1) A waiver may be granted for a period less than, but not to exceed, the effective term of an approved plan and budget.

(2) A waiver may be conditioned upon the Board's completion of steps taken to eliminate the need for a waiver.

Source Note: The provisions of this §802.44 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter D. AGENCY MONITORING ACTIVITIES

Section 802.61. Purpose

(a) The purpose of this subchapter is to set forth the Agency's monitoring provisions and respective responsibilities of Boards, workforce service providers, and Agency grantees.

(b) The rules contained in this subchapter apply in addition to any program-specific rules to all programs administered by the Agency, except that to the extent of any conflict, the program-specific rules will govern.

Source Note: The provisions of this §802.61 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.62. Program and Fiscal Monitoring

(a) Boards, workforce service providers, and Agency grantees shall cooperate with the Agency's program and fiscal monitoring activities, site visits, reviews of documentation, and requests for information. The Agency is committed to ensuring the accountability of Boards, workforce service providers, and Agency grantees. Therefore, monitoring activities have been developed to:

(1) ensure programs achieve intended results;

(2) ensure resources are efficiently and effectively used for authorized purposes and are protected from waste, fraud, and abuse; and

(3) ensure reliable and timely information is captured and reported to serve as the basis to improve decision-making.

(b) The Agency shall conduct comprehensive monitoring activities to assess the following for Boards, workforce service providers, and Agency grantees:

(1) Progress in achieving program goals and maintaining fiscal accountability. Program and fiscal monitoring activities include site visits, desk reviews, and analyses of both financial and program outcomes to help identify potential weaknesses before such weaknesses result in substandard performance or questioned costs;

(2) Compliance with applicable laws, regulations, provisions of contracts and Board plans, and official directives and circulars including, but not limited to, U.S. Department of Labor (DOL) Training and Employment Guidance Letters, DOL Training and Employment Notices, U.S. Department of Health and Human Services guidance letters, Commission rules contained in Part 20 of this title (relating to the Texas Workforce Commission), Texas Workforce Commission Workforce Development (WD) Letters, the Agency's Financial Manual for Grants and Contracts, and other Agency guidance; and

(3) Compliance with the appropriate uniform administrative requirements for grants and agreements applicable to the type of entity receiving funds, as promulgated in the OMB circulars or rules. Monitoring activities shall encompass both financial and programmatic monitoring and shall be evaluated on a periodic basis. Monitoring reviews result in recommendations that provide practical solutions used to take immediate corrective action.

(c) Boards, workforce service providers, and Agency grantees are subject to audit and review by the Agency. The Agency may audit and review all relevant records or a sample of the records as needed to determine Board, workforce service provider, and Agency grantee performance.

(d) Failure to comply with this subchapter shall result in corrective action and possible sanctions pursuant to Subchapter G of this chapter (relating to Corrective Actions).

Source Note: The provisions of this §802.62 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.63. Program Monitoring Activities

The Agency shall conduct program monitoring activities to ensure that programs achieve intended results. Processes and procedures used to determine Board, workforce service provider, and Agency grantee performance may include review and evaluation of one or more of the following:

(1) Program results or outcomes

(2) Performance measures

(3) Reporting accuracy

(4) Record keeping and file maintenance

(5) Monitoring functions

(6) Self-monitoring activities

(7) Service delivery

(8) Automated systems and reporting

(9) Human resources

(10) Policies and procedures

Source Note: The provisions of this §802.63 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.64. Fiscal Monitoring Activities

(a) The Agency shall conduct fiscal monitoring activities to ensure that resources are efficiently and effectively used for authorized purposes and are protected from waste, fraud, and abuse. Processes and procedures used to determine Board, workforce service provider, and Agency grantee performance may include the review and evaluation of one or more of the following:

(1) Accounting and reporting systems

(2) Budget methodologies

(3) Cash management practices

(4) Cost allocation plans and processes

(5) Cash disbursement compliance and documentation

(6) Program income identification and reporting

(7) Insurance coverage and risk exposure

(8) Oversight and monitoring functions

(9) Payroll administration

(10) Purchasing and procurement processes and procedures

(11) Property accountability and safeguarding

(b) Processes and procedures used to determine Board, workforce service provider, and Agency grantee performance shall include a review, evaluation, and determination regarding compliance with the appropriate uniform administrative requirements for grants and agreements as well as the appropriate cost principles applicable for the type of entity receiving funds as listed in OMB circulars or rules.

(c) Processes and procedures used to determine Board, workforce service provider, and Agency grantee performance shall include a review, evaluation, and determination regarding compliance with the applicable requirements regarding cost categories and cost limitations.

Source Note: The provisions of this §802.64 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.65. Agency Monitoring Reports and Resolution

(a) Monitoring Reports. The Agency's monitoring department shall issue the following monitoring reports summarizing the results of monitoring activities. The reports may include the observations, findings, and recommendations of the monitoring team and Board, workforce service provider, or Agency grantee responses to the observations, findings, and recommendations.

(1) Management Letter. If there are no findings (i.e., administrative findings and/or questioned costs), a management letter is issued.

(2) Draft Monitoring Report. If there are findings, a draft monitoring report is issued, which sets forth a specified period in which to respond.

(3) Final Monitoring Report. A final monitoring report is issued, which may include responses to the findings and recommendations.

(b) Initial Resolution. Based on the final monitoring report, the Agency's audit resolution department shall issue an initial resolution, which notifies a Board, workforce service provider, or Agency grantee of administrative findings and questioned costs and a specific time period for response.

(1) Administrative Findings.

(A) If the administrative findings set forth in the initial resolution are resolved, a closure letter is issued.

(B) If the administrative findings set forth in the initial resolution are not resolved, the findings remain open until the following year's audit to ensure follow-up.

(2) Questioned Costs.

(A) If the questioned costs set forth in the initial resolution are resolved, a closure letter is issued.

(B) If the questioned costs set forth in the initial resolution are not resolved, an initial determination is issued.

(c) Initial Determination. The Agency's audit resolution department shall issue an initial determination notifying a Board, workforce service provider, or Agency grantee of the following:

(1) The unresolved questioned costs; and

(2) The 60-day period, from issuance of the initial determination, to submit a response, including providing evidence or documentation of the appropriate actions taken.

(d) Final Determination. If the questioned costs remain unresolved at the end of the 60-day period, the Agency's audit resolution department shall issue a final determination to notify a Board, workforce service provider, or Agency grantee of allowed or disallowed costs and to establish debts.

(e) If the administrative findings or questioned costs remain unresolved, the Agency's Regulatory Integrity Division may request a sanction, as set forth in §802.125 of this chapter (relating to Sanction Determination).

(f) Appeal Process

(1) Only final determinations regarding questioned costs issued by the Agency may be appealed, pursuant to §802.142 of this chapter (relating to Appeal).

(2) Failure by a Board, workforce service provider, or Agency grantee to timely request a hearing waives the right to a hearing. The final determination shall constitute final Agency action and is not subject to further review.

(3) If an appeal is requested and approved, a hearing officer is designated and the collection of debt is pending until final decision of the hearing.

Source Note: The provisions of this §802.65 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.66. Access to Records

(a) Right of Access

(1) Agency. All books, documents, papers, computer records, or other records prepared by Boards, workforce service providers, or Agency grantees that are pertinent to the use of any funds administered by the Agency are Agency property. Boards, workforce service providers, or Agency grantees in possession of such records shall be responsible for their secure and proper maintenance. The Agency or its authorized representatives have the right of timely and unrestricted access to any such records in order to conduct monitoring, audits, and examinations, and to make excerpts, transcripts, and photocopies of such documents.

(2) Board or Agency grantee. A Board or its authorized representatives, and an Agency grantee or its executive leadership, have the right of timely and unrestricted access to any books, documents, papers, computer records, or other records of workforce service providers that are pertinent to the use of any funds administered by the Agency, in order to conduct monitoring, audits, and examinations; and to make excerpts, transcripts, and photocopies of such documents.

(b) The right of access also includes timely and unrestricted access to Board, workforce service provider, and Agency grantee personnel for the purpose of interviews and discussions related to such documents.

(c) The right of access is not limited to any required record retention period but shall last as long as the records are retained.

(d) When a Board's relationship with the workforce service provider is terminated, the Board's responsibility for maintenance and retention of records as well as the Agency's right to access does not end.

(e) Custody of Records.

(1) The Agency or the Board may request custody of records if either determines that:

(A) the records possess long-term retention value; or

(B) the workforce service provider is unable or unwilling to physically retain them.

(2) The Agency may request custody of records from an Agency grantee if the Agency determines that:

(A) the records possess long-term retention value; or

(B) the Agency grantee is unable or unwilling to physically retain them.

(f) To comply with single audit requirements:

(1) the workforce service provider shall retain the right of access to records in the custody of the Agency or the Board; and

(2) the Agency grantee shall retain the right of access to records in the custody of the Agency.

Source Note: The provisions of this §802.66 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.67. Commission Evaluation of Board Oversight Capacity

(a) This section outlines the process and criteria used by the Commission to evaluate Board capacity to oversee and manage local funds and the delivery of local workforce services.

(b) The Commission shall use oversight methods outlined in this chapter and elsewhere in statute and rules to evaluate each Board's performance and compliance with applicable laws, regulations, provisions of contracts and Board plans, and official directives and circulars including, but not limited to, DOL Training and Employment Guidance Letters, DOL Training and Employment Notices, U.S. Department of Health and Human Services guidance letters, Commission rules contained in Part 20 of this title, Texas Workforce Commission WD Letters, the Agency's Financial Manual for Grants and Contracts, and other Agency guidance. In particular, the Commission shall evaluate and make findings as appropriate relating to Board fulfillment of responsibilities relating to:

(1) developing, maintaining, and upgrading comprehensive fiscal management and accountability systems;

(2) hiring, training, and retaining qualified staff to carry out the Board's oversight activities;

(3) selecting and overseeing workforce service providers to improve delivery of workforce services;

(4) overseeing and improving operation of Workforce Solutions Offices in the workforce area served by the Board;

(5) managing workforce service providers' performance across multiple Board programs and achieving required performance targets; and

(6) identifying and resolving long-standing oversight problems of the Board and performance problems of workforce service providers.

(c) The Commission shall rate each Board's capacity as "above standards," "within standards," or "below standards." The following criteria shall be used to set the rating.

(1) A Board will be rated as above standards if:

(A) the Board meets its targets as defined in §800.2(13) of this title on 90 percent of its measures; and

(B) the Board does not miss the target on any single measure by more than 10 percent of target;

(C) there are no disallowed costs since the prior evaluation; and

(D) there are no repeat findings.

(2) A Board will be rated as within standards if:

(A) the Board meets its targets as defined in §800.2(13) of this title on 80 percent of its measures; and

(B) the Board does not miss the target on any single measure by more than 15 percent of target;

(C) disallowed costs do not exceed 1 percent of allocation; and

(D) there are no repeat findings.

(3) A Board will be rated as below standards if the Board is:

(A) found to not be above or within standards or if there are significant findings; or

(B) under a level-one, -two, or -three sanction as defined in §802.123 of this chapter.

(4) For the purpose of calculating "disallowed costs" as used in this section, do not include such costs that meet the following three criteria: discovered, quantified, and self-reported to the Commission by a Board unless the Commission finds the disallowed costs were the result of gross mismanagement or other significant violation of Board responsibilities;

(5) Notwithstanding any other provision of this section:

(A) The Commission may consider any extraordinary situation related to any of the factors identified in subsection (b) of this section.

(B) The Commission may exclude from consideration under this section performance on measures:

(i) related to new Board responsibilities; or

(ii) for which the Commission finds good cause exists for failure to meet the target.

(d) At least annually, the Commission shall post the results of its evaluation of each Board and each Board's performance on its Web site with explanation of the rating, rating criteria, and performance measures in a format that is readily accessible to and understandable by a member of the public.

(1) The explanation shall include specifically how each of the criteria were applied for each Board and how that affected the overall rating.

(2) Evaluations shall be performed using information at the Commission's disposal at the time of the evaluation. If no updated information is available, the Commission is not obligated to schedule a review or visit to confirm or obtain new information.

(3) The Commission may update the Board ratings when new information becomes available but does not intend to update them more often than quarterly.

Source Note: The provisions of this §802.67 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter E. BOARD AND WORKFORCE SERVICE PROVIDER MONITORING ACTIVITIES

Section 802.81. Scope and Purpose

(a) The purpose of this subchapter is to set forth the provisions governing the monitoring responsibilities of Boards and workforce service providers.

(b) The rules contained in this subchapter apply in addition to any program-specific rules to all programs administered by the Agency, except that to the extent of any conflict, the program-specific rule will govern.

Source Note: The provisions of this §802.81 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.82. Board and Workforce Service Provider Monitoring

(a) Boards and workforce service providers shall ensure that regular oversight of their own activities and regular monitoring of the activities of their workforce service providers that receive public funds administered by the Agency, are conducted and completed. Monitoring shall include monitoring of both the fiscal and program performance of the workforce service providers administering and delivering services. These monitoring activities shall be designed to ensure programs achieve intended results and resources are efficiently and effectively used for authorized purposes and are protected from waste, fraud, and abuse. Monitoring activities shall be planned to focus on areas of highest risk to help ensure the most effective use of monitoring resources.

(b) Monitoring activities shall assess a workforce service provider's compliance with applicable laws, regulations, provisions of contracts and Board plans, and official directives and circulars including, but not limited to, DOL Training and Employment Guidance Letters, DOL Training and Employment Notices, U.S. Department of Health and Human Services guidance letters, Commission rules contained in Part 20 of this title, Texas Workforce Commission WD Letters, the Agency's Financial Manual for Grants and Contracts, and other Agency guidance. The Board shall assess the workforce service provider's compliance with the appropriate uniform administrative requirements for grants and agreements applicable to the type of entity receiving funds, as promulgated in OMB circulars or rules. These activities shall encompass both financial and programmatic monitoring and shall be evaluated on a periodic basis. Each Board and workforce service provider shall conduct regular oversight and monitoring of its workforce service providers in order to:

(1) determine that expenditures have been charged to the cost categories and within the cost limitations specified in the applicable laws and regulations;

(2) determine whether or not there is compliance with other provisions of applicable laws and regulations; and

(3) provide technical assistance as necessary and appropriate.

(c) The monitoring function shall include the development and implementation of:

(1) a risk assessment tool;

(2) a monitoring plan;

(3) a monitoring program, including established policies and procedures; and

(4) reporting and resolution processes.

(d) The Board and workforce service provider shall develop and implement written policies and procedures that describe and support the monitoring process.

Source Note: The provisions of this §802.82 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.83. Risk Assessment

(a) Boards and workforce service providers shall include the use of a risk assessment tool in their monitoring functions.

(b) The risk assessment tool shall identify high-risk workforce service providers and high areas of risk within an individual workforce service provider's operation. The entity responsible for including the risk assessment tool in their monitoring functions shall be responsible for determining what constitutes high risk or an area of high risk.

(c) Boards and workforce service providers shall establish monitoring schedules and monitoring programs that best use monitoring resources. Boards and workforce service providers shall quantify, as much as possible, and document areas of risk identified for assessment.

Source Note: The provisions of this §802.83 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.84. Monitoring Plan

(a) Boards and workforce service providers shall develop their own local-level monitoring plan based on the results of the risk assessment. This monitoring plan shall incorporate the following:

(1) a schedule or timetable for monitoring Agency-funded activities; and

(2) identification of the type of review planned, such as on-site review, comparative financial analysis, desk review, staff analysis, or other type of appropriate review.

(b) Boards and workforce service providers may perform monitoring reviews either formally or informally, but shall incorporate the risk assessment results in scheduling decisions.

Source Note: The provisions of this §802.84 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.85. Controls over Monitoring

To ensure comprehensive and effective monitoring, Boards and workforce service providers shall:

(1) require periodic reports from their workforce service providers outlining monitoring reviews, noncompliance issues, and the status of corrective actions;

(2) ensure that a briefing regarding monitoring activities and findings is provided to the Board or appropriate Board subcommittee at regularly scheduled meetings;

(3) require an annual evaluation of the monitoring function to determine its effectiveness, by a person or entity independent of the monitoring function; and

(4) develop a written monitoring procedure to be used in monitoring both program and fiscal operations.

Source Note: The provisions of this §802.85 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.86. Reporting and Resolution Requirements

(a) Boards and workforce service providers shall ensure that monitoring reports identify instances of noncompliance with federal and state laws and regulations and Agency policies, and provide recommendations for corrective action and program quality enhancements.

(b) Boards and workforce service providers shall ensure that timelines are established for the completion of corrective actions, based on the severity of the deficiency, and shall work with the workforce service providers to ensure implementation of corrective actions.

(c) Boards and workforce service providers shall ensure that a copy of monitoring reports is provided to Board members.

Source Note: The provisions of this §802.86 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.87. Independent Audit Requirements

Boards, workforce service providers, and Agency grantees are subject to the following and shall ensure that an annual audit or program-specific audit is obtained in accordance with the following:

(1) Single Audit Act Amendments of 1996 (Public Law 104-156);

(2) OMB Circular A-133 and Compliance Supplement;

(3) Government Auditing Standards (U.S. Government Accountability Office); and

(4) State of Texas Single Audit Circular within the Uniform Grant Management Standards Act (Texas Government Code, Chapter 783).

Source Note: The provisions of this §802.87 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter F. PERFORMANCE AND ACCOUNTABILITY

Section 802.101. Scope and Purpose

(a) The purpose of this subchapter is to:

(1) ensure accountability of Boards, workforce service providers, and Agency grantees, in meeting the needs of Workforce Solutions customers;

(2) ensure performance targets are met or exceeded; and

(3) describe the Commission policies for noncompliance.

(b) The Agency may review financial, administrative, and performance data to evaluate a Board, workforce service provider, or Agency grantee to determine the need for sanctions.

(c) To accomplish the purposes of this subchapter, the Agency may require at any point during the year that a Board, workforce service provider, or Agency grantee cooperates with remedial actions, including, but not limited to, entering into a technical assistance plan and other performance review and assistance activities.

Source Note: The provisions of this §802.101 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.102. Performance Requirements and Expectations

(a) A Board shall meet or exceed expenditure and performance targets as set forth in its contracts. The Commission shall determine the Boards' performance targets based on federal and state performance standards and by using factors that may be necessary to achieve the mission of the Commission and reflect local conditions. The Commission approves individual Board performance targets annually, which may be adjusted based on local conditions including, but not limited to, specific economic conditions and demographic characteristics of the workforce area.

(b) An Agency grantee shall meet or exceed expenditure and performance targets as set forth in its contracts.

(c) A Board and Agency grantee shall comply with the following:

(1) applicable laws, regulations, provisions of contracts and Board plans, and official directives and circulars including, but not limited to, DOL Training and Employment Guidance Letters, DOL Training and Employment Notices, U.S. Department of Health and Human Services guidance letters, Commission rules contained in Part 20 of this title, Texas Workforce Commission Workforce WD Letters, the Agency's Financial Manual for Grants and Contracts, and other Agency guidance;

(2) appropriate uniform administrative requirements for grants and agreements applicable for the type of entity receiving funds as promulgated in OMB's Uniform Grant Management Standards circulars or rules; and

(3) Agency-Board agreements and applicable program contracts.

(d) A Board's achievement of high levels of performance may result in the Commission providing incentives for the Board as set forth in Subchapter I of this chapter (relating to Incentive Awards). In addition, the Commission may adopt additional performance incentives.

(e) The failure of Boards or Agency grantees to meet minimum levels of performance as referenced in their contracts may result in corrective actions, other performance review and assistance activities, or sanctions as specified in:

(1) Part 20 of this title, including this chapter;

(2) the contract with the Agency; or

(3) federal or state statute or rule.

(f) A Board may submit to the Commission a request for a performance target adjustment in the format prescribed by the Agency.

(g) The Commission may determine what constitutes a necessary adjustment to local performance targets and may consider specific economic conditions and demographic characteristics to be served in the workforce area and other factors the Commission deems appropriate including the anticipated impact of the adjustment on the state's performance.

Source Note: The provisions of this §802.102 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.103. Performance Review and Assistance

(a) The Commission's intent is to define the role of performance review and assistance provided by the Agency. The role of performance review and assistance is to work with Boards, workforce service providers, and Agency grantees to:

(1) ensure successful service delivery outcomes; and

(2) provide accountability through technical assistance and contract management.

(b) The Agency offers a sequence of interventions including the development of technical assistance plans, on-site reviews, staff training, and continued contract management and oversight.

(c) Boards, workforce service providers, and Agency grantees shall ensure cooperation and compliance with the Agency's performance review and assistance activities and services.

Source Note: The provisions of this §802.103 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.104. Performance Improvement Actions

(a) The Agency may assist Boards, workforce service providers, and Agency grantees with strategies for improving compliance or performance.

(b) A technical assistance plan, which may be jointly developed by the Agency with Boards or Agency grantees, may include, but is not limited to:

(1) identification of one or more specific performance improvement issues;

(2) assessment of specific technical assistance or training needs;

(3) selection of one or more specific technical assistance or training activities to be implemented;

(4) identification of the appropriate entities to provide the technical assistance or training, including the Board, the Agency, other Boards, or other entities;

(5) identification of a timeline for completion of the technical assistance or training; and

(6) specific dates for reassessment of technical assistance or training needs and completion of the specific technical assistance or training.

Source Note: The provisions of this §802.104 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter G. CORRECTIVE ACTIONS

Section 802.121. Imposition of Corrective Actions and Corrective Action Plans

(a) At any time, the Agency may impose corrective actions for failure by a Board or Agency grantee to ensure compliance with the following:

(1) one or more contracted performance measures;

(2) one or more contract provisions; or

(3) one or more of the items listed in §802.102(c) of this chapter.

(b) The Agency may impose corrective actions for failure by a Board or Agency grantee to appropriately oversee of the delivery of services and ensure the effective and efficient use of funds.

(c) Failure to cooperate and comply with the Agency's performance improvement actions, including technical assistance plans, may subject a Board or Agency grantee to corrective actions.

(d) The Agency may impose, in nonsequential order, the following corrective actions on a Board or Agency grantee:

(1) Intent to Sanction

(2) Level-One Sanction

(3) Level-Two Sanction

(4) Level-Three Sanction

(e) The Agency may impose a higher level of sanction on a Board or Agency grantee, if a sanction is currently imposed when another sanctionable act occurs or is discovered.

(f) Corrective Action Plan. To assist in correcting any deficiencies, a Board or Agency grantee upon whom an intent to sanction or a sanction is imposed must enter into a corrective action plan. A corrective action plan is developed by the Agency and may include the elements of a technical assistance plan, as outlined in §802.104(b) of this chapter. In addition, the Agency may require:

(1) participation in technical and quality assurance activities;

(2) mandatory participation in training;

(3) on-site visits by the Agency to oversee and assist with daily operations of a Board or Agency grantee;

(4) submission of additional or more detailed financial or performance reports;

(5) modification of the Board's local plan;

(6) issuing a notice of intent to revoke all or part of the affected local plan;

(7) designation as a high-risk Board or an Agency grantee requiring additional monitoring visits;

(8) appearances by the Board's executive director, other administrative officer, or the Agency grantee's executive leadership, to report on activities and progress in Commission meetings until performance is satisfactory;

(9) meetings with the workforce area's chief elected officials, Board chair, Board members, Board executive director, or Agency grantee's executive leadership;

(10) formal Agency presentation to chief elected officials, Board members, or Agency grantee's executive leadership;

(11) Agency oversight and management of problem situations, such as the appointment of a steward;

(12) Agency approval of specified Board or Agency grantee actions (i.e., prohibition against entering into specific contracts or engaging in certain activities without explicit prior approval of the Agency);

(13) prohibition against a Board using designated workforce service providers, including state agencies and Workforce Solutions Office operators;

(14) payment by reimbursement only, with required supporting documentation;

(15) delay, suspension, or denial of contract payments;

(16) reduction or deobligation of funds;

(17) ineligibility for additional discretionary or other funds, including incentive awards;

(18) contract cancellation or termination; and

(19) other actions deemed appropriate by the Agency to assist the Board or subrecipient of the Agency in correcting deficiencies.

Source Note: The provisions of this §802.121 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.122. Intent to Sanction

(a) The Agency may issue an intent to sanction to set forth:

(1) a corrective action plan and performance review and assistance activities;

(2) a specific timeline for the implementation of the corrective action plan by a Board or Agency grantee; and

(3) an opportunity to cure the sanctionable acts.

(b) There shall be no appeal to an intent to sanction.

Source Note: The provisions of this §802.122 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.123. Sanctions

(a) Level-One Sanction. The Agency may impose a level-one sanction on a Board or Agency grantee for sanctionable acts. Sanctionable acts that occur during the program, grant, fiscal, contract, or calendar year include, but are not limited to, the following:

(1) failure to submit timely and accurate required financial or performance reports;

(2) failure to take corrective actions to resolve findings identified during monitoring, investigative, or program reviews, including failure to comply with a technical assistance plan developed by the Agency;

(3) failure to rectify or resolve all independent audit findings or questioned costs within required time frames;

(4) failure to submit required annual audits;

(5) breach of administrative and service contract requirements;

(6) failure to retain required service delivery and financial records; or

(7) failure to meet the target on any contracted performance measure by more than 10 percent of target.

(b) Level-Two Sanction. The Agency may impose a level-two sanction on a Board or Agency grantee for sanctionable acts. Sanctionable acts that occur during the program, grant, fiscal, contract, or calendar year include, but are not limited to, the following:

(1) failure to rectify a level-one sanction within six months of notice;

(2) committing a second sanctionable act;

(3) failure to rectify reported threats to health and safety of program participants within 30 days of notice. Rectifying health and safety may include investigating a complaint, taking appropriate corrective actions, or making referrals to appropriate authorities; or

(4) failure to meet the target on any contracted performance measure by more than 25 percent of target.

(c) Level-Three Sanction. The Agency may impose a level-three sanction on a Board or Agency grantee for sanctionable acts. Sanctionable acts that occur during the program, grant, fiscal, contract, or calendar year include, but are not limited to, the following:

(1) failure to rectify a level-one sanction within one year of notice;

(2) failure to rectify a level-two sanction within six months of notice;

(3) committing multiple sanctionable acts;

(4) failure to rectify reported threats to health and safety of program participants within 60 days of notice. Rectifying health and safety may include investigating a complaint, taking appropriate corrective action, or making referrals to appropriate authorities; or

(5) failure to meet the target on any contracted measure by more than 25 percent of target for two consecutive years.

Source Note: The provisions of this §802.123 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.124. Penalties for Noncompliance with Requirements

(a) The Agency may impose penalties on a Board or Agency grantee based on the following criteria as determined appropriate by the Agency given the totality of the circumstances surrounding the occurrence of the sanctionable act or acts:

(1) Severity, nature, duration, and extent;

(2) Previous occurrences of sanctionable acts; and

(3) Efforts by the Board, workforce service provider, or Agency grantee to prevent the occurrence of the sanctionable act, including efforts to:

(A) obtain technical assistance, training, or other assistance from the Agency;

(B) resolve monitoring findings; and

(C) prevent potential sanctionable acts.

(b) The Agency may impose penalties for sanctionable acts listed in this subchapter. Notwithstanding the list of sanctionable acts appearing after each specific level of sanction in §802.123 of this subchapter, the Agency may assign a higher or lower sanction level based on the severity or mitigating circumstances surrounding the sanctionable acts.

(c) The Commission may recommend to TWIC pursuant to Texas Government Code, Chapter 2308, that one or more of the following be imposed on Boards:

(1) A reorganization plan under Texas Government Code §2308.268 for the workforce area;

(2) A restructuring of the Board, including decertification of the current Board and appointment and certification of a new Board;

(3) A merger of the workforce area into one or more other workforce areas; or

(4) Any other penalty deemed appropriate by the Commission.

(d) More than one corrective action may be imposed in response to one occurrence of a sanctionable act. The corrective actions imposed for one or more occurrences of sanctionable acts may correlate with the sanction level imposed on a Board or Agency grantee.

(e) A Board's or Agency grantee's failure to complete the corrective actions described in this subchapter within the specified time limits may result in the Agency imposing penalties under this subchapter and withholding contract payments to the Board or Agency grantee.

(f) Penalties for Second-Year WIA Nonperformance. If a Board fails to meet its targets on 25 percent of its contracted measures by more than 20 percent of target for two consecutive program years, the Commission shall review the performance deficiencies and shall make a recommendation to TWIC that it impose a reorganization plan for the workforce area. The Commission's recommendation to TWIC for reorganization of a workforce area may include one or more of the corrective actions or penalties included in this subchapter. Notwithstanding this subsection, the Commission may take other action deemed appropriate as consistent with federal law.

(g) Penalties for Failures Regarding the One-Stop Service Delivery Network. Failure of a Board to ensure the continued operation of a one-stop service delivery network as required by WIA §121 and Chapter 801, Subchapter B, One-Stop Service Delivery Network of this title, including failure to properly certify Workforce Solutions Offices as defined in §801.24 of this title, may result in the imposition of penalties as provided in this subchapter, and the Agency's withholding of payment for any administrative expenses until the Board demonstrates to the satisfaction of the Agency that all of the required elements of a one-stop service delivery network are operational.

Source Note: The provisions of this §802.124 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.125. Sanction Determination

(a) The director of Agency's Workforce Development Division determines whether a sanction shall be imposed, including whether it is appropriate to impose a sanction level on the Board or Agency grantee and whether it is appropriate to assign a penalty.

(b) The Commission shall work in concert with TWIC, as appropriate, to impose sanctions as required by Texas Government Code §2308.268 and §2308.269.

(c) The Agency shall send a written notice of sanction determination (sanction determination) to the following:

(1) Board:

(A) The Board's executive director or administrative officer;

(B) The Board's chair; and

(C) The lead chief elected official of the workforce area; or

(2) The Agency grantees' executive leadership.

(d) The sanction determination date of notice shall be the date the sanction determination is sent by certified mail. All sanction determinations shall be sent by electronic transmission and by certified mail, return receipt requested.

(e) The sanction determination shall include the following information:

(1) the sanctionable act upon which the sanction was based;

(2) the sanction level in which the Board or Agency grantee is placed and the conditions under which the sanction may be removed;

(3) the penalty and the effective date of the penalty;

(4) the corrective action required, including the timeline for completing the corrective action; and

(5) the technical assistance contact from the Agency or other entity to assist in completing the corrective action.

(f) The Agency shall send the sanction determination at least 10 working days in advance of the effective date of the sanction.

Source Note: The provisions of this §802.125 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter H. REMEDIES

Section 802.141. Informal Conferences and Informal Dispositions

An informal conference is defined as an informal meeting between a Board or Agency grantee and designee of the director of the Agency's Workforce Development Division, held for the purpose of agreeing on a proposed informal disposition of a sanctionable act. An informal conference shall be voluntary and shall not be a prerequisite to a hearing in an appeal of a penalty.

Source Note: The provisions of this §802.141 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.142. Appeal

(a) A Board or Agency grantee may appeal a final determination or sanction determination; however, a recommendation to another entity by the Agency or Commission under Subchapter G of this chapter (relating to Corrective Actions), cannot be appealed.

(b) A request for appeal of a final determination or sanction determination shall be filed within 10 working days following the receipt of the determination. The appeal shall be in writing and filed with the General Counsel, Texas Workforce Commission, 101 East 15th Street, Austin, Texas 78778. Failure by a Board, workforce service provider, or Agency grantee to timely request a hearing waives the right to a hearing.

(c) The Agency shall refer the request for appeal to an impartial hearing officer for a hearing.

(d) The Agency shall mail a notice of hearing to the Board or Agency grantee as provided in §802.125(c) of this chapter, and to their representatives, if any. The notice of hearing shall be in writing and include:

(1) a statement of the date, time, place, and nature of the hearing;

(2) a statement of the legal authority under which the hearing is to be held; and

(3) a short and plain statement of the issues to be considered during the hearing.

Source Note: The provisions of this §802.142 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.143. Hearing Procedures

(a) The sanction determination hearing shall be conducted in person in Austin, Texas, unless the parties agree to a telephonic hearing or request a different location.

(b) The hearing shall be conducted informally and in such manner as to ascertain the substantial rights of the parties. All issues relevant to the appeal shall be considered and addressed, and may include:

(1) Presentation of Evidence. The parties to an appeal may present evidence that is material and relevant, as determined by the hearing officer. In conducting a hearing, the hearing officer shall actively develop the record on the relevant circumstances and facts to resolve all issues. To be considered as evidence in a decision, any document or physical evidence must be entered as an exhibit at the hearing.

(2) Examination of Parties and Witnesses. The hearing officer shall examine parties and any witnesses, and shall allow cross-examination to the extent the hearing officer deems necessary to afford the parties due process.

(3) Additional Evidence. The hearing officer, with or without notice to any of the parties, may take additional evidence as deemed necessary, provided that a party shall be given an opportunity to rebut the evidence if it is to be used against the party's interest.

(4) Appropriate Hearing Behavior. All parties shall conduct themselves in an appropriate manner. The hearing officer may expel any individual, including a party, who fails to correct behavior the hearing officer identifies as disruptive. After expulsion, the hearing officer may proceed with the hearing and render a decision.

(c) Records.

(1) The hearing record shall include the audio recording of the proceeding and any other relevant evidence relied on by the hearing officer, including documents and other physical evidence entered as exhibits.

(2) The hearing record shall be maintained in accordance with federal and state law.

(3) Confidentiality of information contained in the hearing record shall be maintained in accordance with federal and state law.

Source Note: The provisions of this §802.143 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.144. Postponements, Continuances, and Withdrawals

(a) The hearing officer may grant a postponement of a sanction determination hearing for good cause at a party's request.

(b) A continuance of a hearing may be ordered at the discretion of the hearing officer to consider additional, necessary evidence or for any other reason the hearing officer deems appropriate.

(c) A Board or Agency grantee may withdraw an appeal at any time prior to the issuance of the final decision.

Source Note: The provisions of this §802.144 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.145. Evidence

(a) Evidence Generally. Evidence, including hearsay evidence, shall be admitted if it is relevant and if in the judgment of the hearing officer it is the kind of evidence on which reasonably prudent persons are accustomed to rely in the conduct of their affairs. However, the hearing officer may exclude evidence if its probative value is outweighed by the danger of unfair prejudice, by confusion of the issues, or by reasonable concern for undue delay, waste of time, or needless presentation of cumulative evidence.

(b) Exchange of Exhibits. Any documentary evidence to be presented during a telephonic hearing shall be exchanged with all parties and a copy shall be provided to the hearing officer in advance of the hearing. Any documentary evidence to be presented at an in-person hearing shall be exchanged at the hearing.

(c) Stipulations. The parties, with the consent of the hearing officer, may agree in writing to relevant facts. The hearing officer may decide the appeal based on such stipulations or, at the hearing officer's discretion, may set the appeal for hearing and take such further evidence as the hearing officer deems necessary.

(d) Experts and Evaluations. If relevant and useful, testimony from an independent expert or a professional evaluation from a source satisfactory to the parties and the Agency may be ordered by hearing officers, on their own motion, or at a party's request. Any such expert or evaluation shall be at the expense of one or more of the parties.

(e) Subpoenas.

(1) The hearing officer may issue subpoenas to compel the attendance of witnesses and the production of records. A subpoena may be issued either at the request of a party or on the hearing officer's own motion.

(2) A party requesting a subpoena shall state the nature of the information desired, including names of any witnesses and the records that the requestor feels are necessary for the proper presentation of the case.

(3) The request shall be granted only to the extent the records or the testimony of the requested witnesses appears to be relevant to the issues on appeal.

(4) A denial of a subpoena request shall be made in writing or on the record, stating the reasons for such denial.

Source Note: The provisions of this §802.145 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.146. Hearing Officer Independence and Impartiality

(a) A hearing officer presiding over a hearing shall have all powers necessary and appropriate to conduct a full, fair, and impartial hearing. Hearing officers shall remain independent and impartial in all matters regarding the handling of any issues during the pendency of a case and in issuing their written proposals for decision.

(b) A hearing officer shall be disqualified if the hearing officer has a personal interest in the outcome of the appeal or if the hearing officer directly or indirectly participated in the determination on appeal. Any party may present facts to the Agency in support of a request to disqualify a hearing officer.

(c) The hearing officer may withdraw from a hearing to avoid the appearance of impropriety or partiality.

(d) Following any disqualification or withdrawal of a hearing officer, the Agency shall assign an alternate hearing officer to the case. The alternate hearing officer shall not be bound by any findings or conclusions made by the disqualified or withdrawn hearing officer.

Source Note: The provisions of this §802.146 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.147. Ex Parte Communications

(a) The hearing officer shall not participate in ex parte communications, directly or indirectly, in any matter in connection with any substantive issue, with any interested person or party. Likewise, no person shall attempt to engage in ex parte communications with the hearing officer on behalf of any interested person or party.

(b) If the hearing officer receives any such ex parte communication, the other parties shall be given an opportunity to review any such ex parte communication.

(c) Nothing shall prevent the hearing officer from communicating with parties or their representatives about routine matters such as requests for continuances or opportunities to inspect the file.

(d) The hearing officer may initiate communications with an impartial Agency employee who has not participated in a hearing or any determination in the case for the limited purpose of using the special skills or knowledge of the Agency and its staff in evaluating the evidence.

Source Note: The provisions of this §802.147 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.148. Hearing Decision

(a) Following the conclusion of the hearing, the hearing officer shall promptly prepare a written proposal for decision.

(b) The proposal for decision shall be based exclusively on the evidence of record in the hearing and on matters officially noticed in the hearing. The decision shall include:

(1) a list of the individuals who appeared at the hearing;

(2) the findings of fact and conclusions of law reached on the issues; and

(3) the affirmation, reversal, or modification of the sanctions.

(c) The proposal for decision shall be submitted to the Agency's executive director for issuance of a written decision on behalf of the Agency.

(d) Unless a party files a timely motion for rehearing, the Agency may assume continuing jurisdiction to modify or correct a decision until the expiration of 30 calendar days from the mailing date of the decision.

Source Note: The provisions of this §802.148 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.149. Motion for Reopening

(a) If a party does not appear for a hearing, the party may request a reopening of the hearing within 30 calendar days from the date the decision is mailed.

(b) The motion for reopening shall be in writing and detail the reason for failing to appear at the hearing.

(c) The hearing officer may schedule a hearing on whether to grant the reopening.

(d) The motion may be granted if the hearing officer determines that the party has shown good cause for failing to appear at the hearing.

Source Note: The provisions of this §802.149 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.150. Motion for Rehearing

(a) A Board or Agency grantee may file a motion for rehearing for the presentation of new evidence within 30 days from the date the decision is mailed. A rehearing shall be granted only for the presentation of new evidence.

(b) A motion for rehearing shall be in writing and allege the new evidence to be considered.

(c) If the hearing officer determines that the alleged new evidence warrants a rehearing, a rehearing shall be scheduled at a reasonable time and place.

(d) The hearing officer shall issue a written proposal for decision in response to a timely filed motion for rehearing. The proposal for decision shall be submitted to the Agency's executive director for issuance of a final decision.

Source Note: The provisions of this §802.150 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.151. Finality of Decision

(a) The decision of the executive director is the final administrative decision of the Agency after the expiration of 30 calendar days from the mailing date of the decision, unless within that time:

(1) a request for reopening is filed with the Agency;

(2) a request for rehearing is filed with the Agency; or

(3) the Agency assumes continuing jurisdiction to modify or correct the decision.

(b) Any decision issued in response to a request for reopening or rehearing or a modification or correction issued by the Agency shall be final on the expiration of 30 calendar days from the mailing date of the decision, modification, or correction.

Source Note: The provisions of this §802.151 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.152. Repayment

(a) The Board and chief elected officials shall be jointly and severally liable for repayment to the Agency from nonfederal funds for expenditures in the workforce area that are found by the Agency not to have been expended in accordance §802.102 of this chapter.

(b) An Agency grantee shall be liable for repayment to the Agency from nonfederal funds for expenditures that are found by the Agency not to have been expended in accordance with §802.102 of this chapter.

Source Note: The provisions of this §802.152 adopted to be effective February 7, 2011, 36 TexReg 604

Subchapter I. INCENTIVE AWARDS

Section 802.161. Scope and Purpose

The purpose of incentive awards is to reward Boards that meet or exceed the performance benchmarks identified in each incentive award and accomplish the Commission's goals to fulfill the workforce needs of employers and to put Texans to work. The Board is responsible for providing strategic and operational planning for its workforce area. The development of an integrated and coherent workforce development system at the local level is the primary focus of Boards. Thus, this policy seeks to recognize Boards for achieving high performance as a system, as well as high performance on behalf of employers and the populations annually targeted by the Commission during the budget process. Incentives will emphasize accountability, high performance, and continuous improvement and support the state in achieving workforce development goals.

Source Note: The provisions of this §802.161 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.162. Definitions

The following words and terms when used in this chapter shall have the following meanings, unless the context clearly indicates otherwise.

(1) Allocation of Funds--The total yearly funds initially identified for allocation to a Board for all programs. This does not include consideration of adjustments in funding made to a specific program(s) by the Commission for purposes of reallocating or redistributing those funds. This may include new allocations or distributions made during a year that result from changes in law or new funding made available to the Boards during a year.

(2) Classification--Grouping of Boards with one or more common characteristics (e.g., size) for the purpose of evaluating performance and giving incentive awards.

(3) Extraordinary Circumstances--Conditions that may have an impact on the determination of which Boards may receive or be excluded from receiving incentive awards, which may include, but are not limited to, matters such as serious unforeseen events, unresolved audit or monitoring findings, sanctions, unanticipated changes in economic conditions, the occurrence of a disaster, or legislative changes having a direct impact on the Commission or Boards.

(4) Local Coordination--Boards fostering leadership and cooperation to achieve the most effective customer service results for their employers and residents through one or more of the following:

(A) Memoranda of Understanding with required partners that achieve active implementation and integration of related services;

(B) Memoranda of Understanding with partners required by WIA §121(b)(1) but not required by §801.27(b) of this title that include active implementation and integration of related services;

(C) ongoing and regular communication and training on the best practices and benchmarks in building systems or delivering services; or

(D) demonstrating local coordination through other means as determined by the Commission, such as by demonstrating coordination with demonstration grants, youth opportunity grants, self-sufficiency grants, and skills development grants.

(5) Regional Cooperation--Boards working together as a cooperative unit in a region to provide excellence in customer service through one or more of the following:

(A) submitting joint plans or agreements;

(B) engaging in ongoing and regular communication regarding the best practices and working together to implement those practices by sharing ideas, data, staff, and other resources;

(C) providing opportunities for joint training, conferences, and staff interaction; or

(D) demonstrating regional cooperation through other means as determined by the Commission.

(6) Workforce development programs--Job-training, employment, and employment-related educational programs and functions as listed in Texas Labor Code §302.021.

Source Note: The provisions of this §802.162 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.163. Types of Awards

The following are the two types of incentive awards:

(1) Nonmonetary awards, which may be awarded annually based on high-performance achievement and/or continuous improvement in meeting performance measures and may include plaques, certificates of achievement, or other formalized recognition accolades.

(2) Monetary awards, which include:

(A) performance awards issued under §802.166 of this subchapter;

(B) WIA local incentive awards issued under §802.167 of this subchapter;

(C) job placement incentive awards issued under §802.168 of this subchapter; and

(D) other awards designated by the Commission.

Source Note: The provisions of this §802.163 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.164. Data Collection

(a) Boards are responsible for complete and accurate data entry prior to Commission-established deadlines.

(b) The Commission reserves the right not to consider data submitted after the deadline or data that it finds to be inaccurate in its evaluation of performance for awards.

Source Note: The provisions of this §802.164 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.165. Board Classification

(a) The Commission may group Boards in classifications for comparison purposes such as for awarding incentives.

(b) In classifying Boards, the Commission may group Boards based on similarities or differences among the Boards relating to:

(1) allocations of funds;

(2) prior performance; or

(3) demographic, economic, or other characteristics of the individual workforce areas.

Source Note: The provisions of this §802.165 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.166. Performance Awards

(a) The Commission may determine the amount of funds for use to reward performance annually.

(b) Incentive awards for performance may be given in each classification and the Commission may give more than one award in each classification.

(c) The Commission may use any combination of existing state or federal performance measures and may develop its own measures to evaluate performance.

(1) If the Commission includes a measure that does not already have a target, the Commission may:

(A) set an incentive target for the sole purpose of evaluating eligible Boards for the incentive awards (failure to meet an incentive target does not subject the Board to sanction);

(B) rate performance based on each Board's "relative improvement" in performance from the prior year; or

(C) compare exhibited performance among the Boards in a classification if the measure allows comparability across Boards of different sizes. (For example, the "percent of job orders timely posted" allows performance to be measured across Boards of different sizes, but the "number of job orders timely posted" does not.)

(2) The Commission may use a measure and a subset of a measure in the same year. For example, the Commission could include one measure that considers employers with job postings in the job matching system and another measure that considers employers with job postings in targeted occupations.

(d) If the Commission is considering issuing awards under this section, the Commission shall notify Boards of the method by which performance shall be evaluated for the purpose of giving awards under this rule for that year.

(1) The notice required under this subsection shall be provided to the Boards concurrent with their yearly contracts.

(2) The notice may include:

(A) a listing of the Boards assigned to each classification;

(B) a listing of awards;

(C) a listing of the performance measures to be included in each evaluation category including:

(i) the period of evaluation for each performance measure; and

(ii) the method of evaluation for each performance measure;

(D) the weightings to be used to aggregate the performance measures to allow each Board's overall performance to be ranked and also encourage an emphasis on employer-focused measures;

(E) the anticipated amount of funds available to be awarded; and

(F) other criteria to be used to identify superior performance.

(e) The Commission shall rank a Board's performance for each performance measure as follows.

(1) For measures that have performance targets, the Commission shall determine each Board's "success rate" by dividing the Board's actual performance by its target for the measure.

(2) For measures that have no performance targets, the Commission shall determine each Board's actual performance (or change in performance if that was the method identified as the method for evaluation) and call this the "performance rate."

(3) For each measure, the Commission shall replace the "success rate" or the "performance rate" with a ranking. The Board with the "best" ranking in its classification shall be ranked "1," the second best ranked "2," etc. If two Boards in a classification are tied for a position, such as second place, both shall be ranked "2" and the Board with the next "best" ranking shall be ranked "4."

(f) The Commission shall assign each Board a final rank as follows.

(1) The Commission shall use the weightings identified in subsection (d)(2)(D) of this section to determine the weighted rank of the performance rankings assigned under subsection (e) of this section.

(2) Each Board's weighted rank shall be converted to an overall ranking within the Board's classification. That is, the Board with the lowest weighted rank in a classification is ranked "1," the second lowest ranked "2," etc. If two Boards are tied for a position such as second place, both shall be ranked "2" and the next "best" Board will be ranked "4."

(g) The award for each classification shall be given to the Board in the classification with the best overall ranking. If the Commission is assigning more than one award in a classification, the Boards with the highest rankings shall receive the award.

(h) Boards that receive a performance award shall use the incentive award to carry out workforce activities as allowed by state and federal laws.

(i) The Commission may modify the assignment of awards based on factors that the Commission identifies as extraordinary circumstances.

Source Note: The provisions of this §802.166 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.167. Workforce Investment Act Local Incentive Awards

(a) The Commission shall determine annually the total amount of funds to be awarded from funds available through the WIA §128(a) and §133(a)(1) for local incentive awards.

(b) WIA local incentive awards may be awarded for one or more of the following:

(1) regional cooperation among workforce areas;

(2) local coordination of activities carried out under WIA; and

(3) exemplary performance on performance measures.

(c) The application for WIA local incentive awards shall be as follows.

(1) Only those Boards submitting a written application shall be eligible for WIA local incentive awards (other than awards for exemplary performance, which do not require a written application).

(2) The Commission shall issue instructions annually identifying the amount of funds available for awards, the maximum number of awards, and instructions for submitting applications for WIA local incentive awards.

(d) Awards may be made based on consideration of various factors consistent with WIA goals such as:

(1) identified changes in economic conditions, population characteristics, and the service delivery system in the workforce area;

(2) reported performance for each contract performance measure relative to other Boards;

(3) demonstrated performance in the elements considered most critical in accomplishing overall system goals, which includes performance related to each of the items listed in §802.168(b) of this subchapter;

(4) improved performance relative to the preceding year;

(5) demonstrated compliance with all expenditure requirements as required by §800.63(h) of this title; and

(6) finalized monitoring reports and resolution activities.

(e) Boards that receive a WIA local incentive award shall use the award to carry out workforce activities as allowed by state and federal laws.

(f) The Commission may modify the assignment of awards based on factors that the Commission identifies as extraordinary circumstances.

Source Note: The provisions of this §802.167 adopted to be effective February 7, 2011, 36 TexReg 604

Section 802.168. Job Placement Incentive Awards

(a) The Commission may set aside an amount of funds for job placement incentive awards during the annual budget process or at other times during the year as deemed appropriate by the Commission based on the funds available to meet the objectives of the Commission. For the purposes of this section, the term "Choices eligible" shall have the same meaning as set forth in §811.2 of this title.

(b) Administration through Boards shall be as follows.

(1) The Commission shall administer the job placement incentive awards through the Boards by distributing funds to Boards that demonstrate the highest percentage of increase in employment of Choices eligibles in higher wage jobs. Awards may be given in each classification and the Commission may give more than one award in each classification.

(2) Boards receiving a distribution of funds shall establish policies and procedures to create incentives for their workforce service providers. The Boards shall determine how the local awards of funds are expended to provide incentives to workforce service providers within the workforce area for effective employment of Choices eligibles in higher wage jobs. The Boards shall ensure that workforce service providers receiving the job placement incentive awards use the funds for expenses relating to education, training, and support services as necessary to prepare, place, and maintain Choices eligibles in employment leading to self-sufficiency.

(c) The criteria for distributing award funds to Boards shall be the same as the measure of higher wage jobs. The measure of higher wage jobs shall use the most recent available in unemployment insurance (UI) wages reported quarterly by employers for Choices eligibles in employment and be determined by:

(1) each workforce area's baseline average quarterly reported UI wages for all Choices eligibles in employment during a 12-month period designated by the Commission;

(2) each workforce area's average quarterly UI wages for all Choices eligibles in employment during the 12-month period subsequent to the baseline measurement period; and

(3) comparing the average quarterly UI wages for all Choices eligibles in employment for the two measurement periods to determine Boards that have achieved the highest percent increase in overall wages to Choices eligibles.

(d) The Commission may modify the assignment of awards based on factors that the Commission identifies as extraordinary circumstances.

Source Note: The provisions of this §802.168 adopted to be effective February 7, 2011, 36 TexReg 604

Chapter 127. Designated Doctor Procedures and Requirements

Subchapter A. DESIGNATED DOCTOR SCHEDULING AND EXAMINATIONS

Section 127.1. Requesting Designated Doctor Examinations

(a) At the request of the insurance carrier, an injured employee, the injured employee's representative, or on its own motion, the division may order a medical examination by a designated doctor to resolve questions about the following:

(1) the impairment caused by the injured employee's compensable injury;

(2) the attainment of maximum medical improvement (MMI);

(3) the extent of the injured employee's compensable injury;

(4) whether the injured employee's disability is a direct result of the work-related injury;

(5) the ability of the injured employee to return to work; or

(6) issues similar to those described by paragraphs (1) - (5) of this subsection.

(b) To request a designated doctor examination a requestor must:

(1) provide a specific reason for the examination;

(2) explain any change of condition if the requestor indicates that the injured employee's medical condition has changed since a previous designated doctor examination on the same claim;

(3) report the injured employee's current medical condition and the type of health care the injured employee is currently receiving;

(4) provide a list of all injuries determined to be compensable by the division or accepted as compensable by the insurance carrier;

(5) provide general information regarding the identity of the requestor, injured employee, employer, treating doctor, insurance carrier, as well as the statutory date of maximum medical improvement, if any;

(6) submit the request on the form prescribed by the division under this section. A copy of the prescribed form can be obtained from:

(A) the division's website at www.tdi.state.tx.us/wc/indexwc.html; or

(B) the Texas Department of Insurance, Division of Workers' Compensation, 7551 Metro Center Drive, Suite 100, Austin, Texas 78744 or any local division field office location;

(7) provide all information listed below applicable to the type of examination the requestor seeks:

(A) if the requestor seeks an examination on the attainment of MMI, include the date of MMI if any; the date of certification of MMI if any; and the name of the certifying doctor, if any, and whether the certifying doctor was a treating doctor, required medical examination doctor, or referral doctor;

(B) if the requestor seeks an examination on the impairment rating of the injured employee, include the date of MMI, if any, the date of certification of MMI and prior assigned impairment rating, if any, and the name of the certifying doctor, if any, and whether the certifying doctor was a treating doctor, required medical examination doctor, or referral doctor;

(C) if the requestor seeks an examination on the extent of the compensable injury or an examination regarding the causation of the claimed injury, include a description of the accident or incident that caused the claimed injury; and a list of all injuries in question;

(D) if the requestor seeks an examination on whether the injured employee's disability is a direct result of the work-related injury, include the beginning and ending dates for the claimed periods of disability; state if the injured employee is either not working or is earning less than pre-injury wages as defined by Labor Code §401.011(16); and list all injuries determined to be compensable by the division or accepted as compensable by the insurance carrier;

(E) if the requestor seeks an examination regarding the injured employee's ability to return to work in any capacity and what activities the injured employee can perform, include the beginning and ending dates for the periods to be addressed and a job description for job offers the employer intends to offer the injured employee;

(F) if the requestor seeks an examination to determine whether or not an injured employee entitled to supplemental income benefits may return to work in any capacity for the identified period, include the beginning and ending dates for the periods to be addressed and whether or not this period involves the ninth quarter or a subsequent quarter of supplemental income benefits;

(G) if the requestor seeks an examination on topics under subsection (a)(6) of this section, specify the issue in sufficient detail for the doctor to answer the question(s); and

(8) provide a signature to attest that every reasonable effort has been made to ensure the accuracy and completeness of the information provided in the request.

(c) If a party submits a request for a designated doctor examination under subsection (b) of this section that would require the division to schedule an examination within 60 days of a previous examination of the injured employee that party must provide good cause for scheduling that designated doctor examination in order for the division to approve the party's request. For the purposes of this subsection, the commissioner or the commissioner's designee shall determine good cause on a case by case basis and will require at a minimum:

(1) if that requestor also requested the previous examination, a showing by the requestor that the submitted questions could not have reasonably been included in the prior examination and a designated doctor examination is reasonably necessary to resolve the submitted question(s) and will affect entitlement to benefits; or

(2) if that requestor did not request the previous examination, a showing by the requestor a designated doctor examination is reasonably necessary to resolve the submitted question(s) and will affect entitlement to benefits.

(d) The division shall deny a request for a designated doctor examination:

(1) if the request does not comply with any of the requirements of subsections (b) or (c) of this section;

(2) if the request would require the division to schedule an examination in violation of Labor Code §§408.0041, 408.123, or 408.151; or

(3) if the commissioner or the commissioner's designee determines the request to be frivolous because it lacks either any legal or any factual basis that would merit approval.

(e) A party may dispute the division's approval or denial of a designated doctor request through the dispute resolution processes outlined in Chapters 140 - 144 and 147 of this title (relating to Dispute Resolution processes, proceedings, and procedures). Additionally, a party is entitled to seek an expedited contested case hearing under §140.3 of this title (relating to Expedited Proceedings) to dispute an approved request for a designated doctor examination. The division, upon receipt and approval of the request for expedited proceedings, shall stay the disputed examination pending the decision and order of the expedited contested case hearing. Parties seeking expedited proceedings and the stay of an ordered examination must file their request for expedited proceedings with the division within three days of receiving the order of designated doctor examination under §127.5(a) of this title (relating to Scheduling Designated Doctor Appointments).

(f) This section becomes effective on February 1, 2011.

Source Note: The provisions of this §127.1 adopted to be effective February 1, 2011, 35 TexReg 11324

Section 127.5. Scheduling Designated Doctor Appointments

(a) The division, within 10 days after approval of a valid request, shall issue an order that assigns a designated doctor and shall notify the designated doctor, the treating doctor, the injured employee, the injured employee's representative, if any, and the insurance carrier that the designated doctor will be directed to examine the injured employee. The order shall:

(1) indicate the designated doctor's name, license number, examination address and telephone number, and the date and time of the examination or the date range for the examination to be conducted;

(2) explain the purpose of the designated doctor examination;

(3) require the injured employee to submit to an examination by the designated doctor;

(4) require the designated doctor to perform the examination at the indicated examination address; and

(5) require the treating doctor, if any, and insurance carrier to forward all medical records in compliance with §127.10(a)(3) of this title (relating to General Procedures for Designated Doctor Examinations).

(b) The examination address indicated on the order in subsection (a)(4) of this section may not be changed by any party or by an agreement of any parties without good cause and the approval of the division.

(c) Except as provided in subsection(d) of this section, the division shall select the next available doctor on the designated doctor list for a medical examination requested under §127.1 of this title (relating to Requesting Designated Doctor Examinations). A designated doctor is available to perform an examination at any address the doctor has filed with the division if the doctor:

(1) does not have any disqualifying associations as described in §180.21 of this title (relating to Division Designated Doctor List);

(2) has credentials appropriate to the issue in question, the injured employee's medical condition, and as required by Labor Code §§408.0043, 408.0044, 408.0045, and applicable rules;

(3) is on the designated doctor list on the day the examination is offered; and

(4) has not treated or examined the injured employee in a non-designated doctor capacity within the past 12 months and has not examined or treated the injured employee in a non-designated doctor capacity with regard to a medical condition being evaluated in the designated doctor examination.

(d) If the division has previously assigned a designated doctor to the claim at the time a request is made, the division may use that doctor again if the doctor meets the requirements of subsection (c)(1) - (4) of this section. Examinations under this subsection must be conducted at the same examination address as the designated doctor's previous examination of the claimant or at another examination address approved by the division.

(e) The designated doctor's office and the injured employee shall contact each other if there exists a scheduling conflict for the designated doctor appointment. The designated doctor or the injured employee who has the scheduling conflict must make the contact at least 24 hours prior to the appointment. The 24-hour requirement will be waived in an emergency situation. The rescheduled examination shall be set to occur within 21 days of the originally scheduled examination. Within 24 hours of rescheduling, the designated doctor shall contact the division's field office, the injured employee or the injured employee's representative, if any, and the insurance carrier with the time and date of the rescheduled examination. If the examination cannot be rescheduled within 21 days of the originally scheduled examination, the designated doctor shall notify the division immediately, and the division may select a new designated doctor.

(f) This section becomes effective on February 1, 2011.

Source Note: The provisions of this §127.5 adopted to be effective February 1, 2011, 35 TexReg 11324

Section 127.10. General Procedures for Designated Doctor Examinations

(a) The designated doctor is authorized to receive the injured employee's confidential medical records and analyses of the injured employee's medical condition, functional abilities, and return-to-work opportunities to assist in the resolution of a dispute under this subchapter without a signed release from the injured employee. The following requirements apply to the receipt of medical records and analyses by the designated doctor:

(1) The treating doctor and insurance carrier shall provide to the designated doctor copies of all the injured employee's medical records in their possession relating to the medical condition to be evaluated by the designated doctor. For subsequent examinations with the same designated doctor, only those medical records not previously sent must be provided. The cost of copying shall be reimbursed in accordance with §134.120 of this title (relating to Reimbursement for Medical Documentation).

(2) The treating doctor and insurance carrier may also send the designated doctor an analysis of the injured employee's medical condition, functional abilities, and return-to-work opportunities. The analysis may include supporting information such as videotaped activities of the injured employee, as well as marked copies of medical records. If the insurance carrier sends an analysis to the designated doctor, the insurance carrier shall send a copy to the treating doctor, the injured employee, and the injured employee's representative, if any. If the treating doctor sends an analysis to the designated doctor, the treating doctor shall send a copy to the insurance carrier, the injured employee, and the injured employee's representative, if any. The analysis sent by any party may only cover the injured employee's medical condition, functional abilities, and return-to-work opportunities as provided in §408.0041.

(3) The treating doctor and insurance carrier shall ensure that the required records and analyses (if any) are received by the designated doctor no later than three working days prior to the date of the designated doctor examination. If the designated doctor has not received the medical records or any part thereof at least three working days prior to the examination, the designated doctor shall report this violation to the division and reschedule the examination. The doctor shall conduct the rescheduled examination regardless of whether or not the injured employee's complete medical records have been timely received.

(b) The designated doctor shall review the injured employee's medical records, including any analysis of the injured employee's medical condition, functional abilities and return to work opportunities provided by the insurance carrier and treating doctor in accordance with subsection (a) of this section, as well as the injured employee's medical condition and history as provided by the injured employee, and shall perform a complete physical examination. The designated doctor shall give the medical records reviewed the weight the doctor determines to be appropriate.

(c) The designated doctor shall perform additional testing when necessary to resolve the issue in question. The designated doctor may also refer an injured employee to other health care providers when the referral is necessary to resolve the issue in question and the designated doctor is not qualified to fully resolve the issue in question. Any additional testing or referral required for the evaluation is not subject to preauthorization requirements or retrospective review requirements in accordance with the Labor Code §408.027 and §413.014, Insurance Code Chapter 1305, or Chapters 10, 19, 133, or 134 of this title (relating to Workers' Compensation Health Care Networks, Agent's Licensing, General Medical Provisions, and Benefits--Guidelines for Medical Services, Charges, and Payments, respectively) but is subject to the requirements of §180.24 of this title (relating to Financial Disclosure). Any additional testing or referral examination and the designated doctor's report must be completed within 15 working days of the designated doctor's physical examination of the injured employee.

(d) A designated doctor who determines the injured employee has reached maximum medical improvement (MMI) or who assigns an impairment rating, or who determines the injured employee has not reached MMI, shall complete and file the report as required by §130.1 and §130.3 of this title (relating to Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment and Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by a Doctor Other than the Treating Doctor, respectively).

(e) A designated doctor who examines an injured employee pursuant to any question relating to return to work is required to file a Work Status Report that meets the required elements of these reports described in §129.5 of this title (relating to Work Status Reports) and a narrative report within seven working days of the date of the examination of the injured employee. This report shall be filed with the treating doctor, the division, and the insurance carrier by facsimile or electronic transmission. In addition, the designated doctor shall file the reports with the injured employee and the injured employee's representative (if any) by facsimile or by electronic transmission if the designated doctor has been provided with a facsimile number or email address for the recipient, otherwise, the designated doctor shall send the report by other verifiable means.

(f) A designated doctor who resolves questions on issues other than those listed in subsections (d) and (e) of this section, shall file a report within seven working days of the date of the examination of the injured employee. This report shall be filed with the treating doctor, the division, and the insurance carrier by facsimile or electronic transmission. In addition, the designated doctor shall provide the report to the injured employee and the injured employee's representative (if any) by facsimile or by electronic transmission if the designated doctor has been provided with a facsimile number or email address for the recipient, otherwise, the designated doctor shall send the report by other verifiable means. Reports under this subsection must be filed in the form and manner prescribed by the division and must contain at a minimum:

(1) identification of the question(s) addressed by the designated doctor evaluation;

(2) general information regarding the identity of the designated doctor, injured employee, employer, treating doctor, insurance carrier, as well as the identity of the certified workers' compensation health care network, if applicable;

(3) general information regarding the designated doctor's evaluation, including the date and address where the examination took place;

(4) a summary of any additional testing conducted as part of the evaluation, including the identity of any referral health care providers utilized to perform additional testing, the types of tests conducted and the dates the testing occurred;

(5) a narrative description of the physical examination itself as well as a description of what medical records or other information the designated doctor reviewed as part of the evaluation; and

(6) a summary of the designated doctor's response(s) to each of the questions addressed during the designated doctor's evaluation, including an explanation of the findings and conclusions used to support the designated doctor's response;

(7) a statement that there is no known disqualifying association as described in §180.21 of this title (relating to Division Designated Doctor List) between the designated doctor and the injured employee, the injured employee's treating doctor, the insurance carrier or the insurance carrier's certified workers' compensation health care network, if applicable; and

(8) a certification by the designated doctor of the date that the report was sent to all of the recipients as required by this subsection and that the report was sent in the manner required by this subsection.

(g) The report of the designated doctor is given presumptive weight regarding the issue(s) in question the designated doctor was properly appointed to address, unless the preponderance of the evidence is to the contrary.

(h) The insurance carrier shall pay all benefits, including medical benefits, in accordance with the designated doctor's report for the issue(s) in dispute. For medical benefits, the insurance carrier shall have 21 days from receipt of the designated doctor's report to reprocess all medical bills previously denied for reasons inconsistent with the findings of the designated doctor's report. By the end of this period, insurance carriers shall tender payment on these medical bills in accordance with the Act and Chapters 133 and 134 of this title. For all other benefits, the insurance carrier shall tender payment no later than five days after receipt of the report.

(i) The designated doctor shall maintain accurate records for, at a minimum, five years from the anniversary date of the date of the designated doctor's last examination of the injured employee. This requirement does not reduce or replace any other record retention requirements imposed upon a designated doctor by an appropriate licensing board. These records shall include the injured employee's medical records, any analysis submitted by the insurance carrier or treating doctor (including supporting information), reports generated by the designated doctor as a result of the examination, and narratives provided by the insurance carrier and treating doctor, to reflect:

(1) the date and time of any designated doctor appointments scheduled with an injured employee;

(2) the circumstances regarding a cancellation, no-show or other situation where the examination did not occur as initially scheduled or rescheduled and, if applicable, documentation of the notice that the doctor provided to the division and the insurance carrier within 24 hours of rescheduling an appointment;

(3) the date of the examination;

(4) the date medical records were received from the treating doctor or any other person;

(5) the date reports described in subsections (d), (e) and (f) of this section were submitted to all required parties and documentation that these reports were submitted to the division, treating doctor, and insurance carrier by facsimile or electronic transmission and to other required parties by verifiable means;

(6) the name(s) of any referral health care providers used by the designated doctor, if any; the date of appointments by referral health care providers; and the reason for referral by the designated doctor; and

(7) the date, if any, the doctor contacted the division for assistance in obtaining medical records from the insurance carrier or treating doctor.

(j) Parties may dispute any entitlement to benefits affected by a designated doctor's report through the dispute resolution processes outlined in Chapters 140 - 144 and 147 of this title (relating to Dispute Resolution processes, proceedings, and procedures).

(k) This section becomes effective on February 1, 2011.

Source Note: The provisions of this §127.10 adopted to be effective February 1, 2011, 35 TexReg 11324

Section 127.15. Undue Influence on a Designated Doctor

(a) To avoid undue influence on the designated doctor:

(1) except as provided by §127.10(a) of this title (relating to General Procedures for Designated Doctor Examinations), only the injured employee or appropriate division staff may communicate with the designated doctor prior to the examination of the injured employee by the designated doctor regarding the injured employee's medical condition or history;

(2) after the examination is completed, communication with the designated doctor regarding the injured employee's medical condition or history may be made only through appropriate division staff; and

(3) the designated doctor may initiate communication with any health care provider who has previously treated or examined the injured employee for the work-related injury or with a peer review doctor identified by the insurance carrier who reviewed the injured employee's claim or any information regarding the injured employee's claim.

(b) The insurance carrier, treating doctor, injured employee, or injured employee's representative, if any, may contact the designated doctor's office to ask about administrative matters, including but not limited to whether the designated doctor received the records, whether the exam took place, or whether the report has been filed, or other similar matters.

(c) This section becomes effective on February 1, 2011.

Source Note: The provisions of this §127.15 adopted to be effective February 1, 2011, 35 TexReg 11324

Section 127.20. Requesting a Letter of Clarification Regarding Designated Doctor Reports

(a) Parties may file a request with the division for clarification of the designated doctor's report. A copy of the request must be provided to the opposing party. The division may contact the designated doctor if it determines that clarification is necessary to resolve an issue regarding the designated doctor's report. Parties may only request clarification on issues already addressed by the designated doctor's report or on issues that the designated doctor was ordered to address but did not address.

(b) Requests for clarification must:

(1) include the name of the designated doctor, the reason for the designated doctor's examination, the date of the examination, and the name and signature of the requestor;

(2) explain why clarification of the designated doctor's report is necessary and appropriate to resolve a future or pending dispute;

(3) include questions for the designated doctor to answer that are neither inflammatory nor leading; and

(4) provide any medical records that were not previously provided to the designated doctor and explain why these records are necessary for the designated doctor to respond to the request for clarification.

(c) The division, at its discretion, may also request clarification from the designated doctor on issues the division deems appropriate.

(d) To respond to the request for clarification, the designated doctor must be on the division's designated doctor list at the time the request is received by the division. The designated doctor shall respond, in writing, to the request for clarification within five working days of receipt and send copies of the response to the parties listed in §127.10(f) of this title (relating to General Procedures for Designated Doctor Examinations). If, in order to respond to the request for clarification, the designated doctor has to reexamine the injured employee, the doctor shall:

(1) respond, in writing, to the request for clarification advising of the need for an additional examination within five working days of receipt of the request and provide copies of the response to the parties specified in §127.10(f) of this title;

(2) if the division orders the reexamination, conduct the reexamination within 21 days from the date the order is issued by the division at the same examination address as the original examination; and

(3) respond, in writing, to the request for clarification based on the additional examination within seven working days of the examination and provide copies of the response to the parties specified in §127.10(f) of this title.

(e) Any refusal or failure by a designated doctor to conduct a reexamination that is necessary to respond to a request for clarification is an administrative violation.

(f) This section becomes effective on February 1, 2011.

Source Note: The provisions of this §127.20 adopted to be effective February 1, 2011, 35 TexReg 11324

Section 127.25. Failure to Attend a Designated Doctor Examination

(a) An insurance carrier may suspend temporary income benefits (TIBs) if an injured employee, without good cause, fails to attend a designated doctor examination.

(b) In the absence of a finding by the division to the contrary, an insurance carrier may presume that the injured employee did not have good cause to fail to attend the examination if by the day the examination was originally scheduled to occur the injured employee has both:

(1) failed to submit to the examination; and

(2) failed to contact the designated doctor's office to reschedule the examination.

(c) If, after the insurance carrier suspends TIBs pursuant to this subsection, the injured employee contacts the designated doctor to reschedule the examination, the designated doctor shall schedule the examination to occur as soon as possible, but not later than the 21st day after the injured employee contacted the doctor. The insurance carrier shall reinstate TIBs effective as of the date the injured employee submitted to the examination unless the report of the designated doctor indicates that the injured employee has reached MMI or is otherwise not eligible for income benefits. The re-initiation of TIBs shall occur no later than the seventh day following:

(1) the date the insurance carrier was notified that the injured employee submitted to the examination; or

(2) the date that the insurance carrier was notified that the division found that the injured employee had good cause for not attending the examination.

(d) An injured employee is not entitled to TIBs for a period during which the insurance carrier suspended benefits pursuant to this subsection unless the injured employee later submits to the examination and the division finds or the insurance carrier determines that the injured employee had good cause for failure to attend the examination.

(e) This section becomes effective on February 1, 2011.

Source Note: The provisions of this §127.25 adopted to be effective February 1, 2011, 35 TexReg 11324

Chapter 506. Miscellaneous Provisions Applicable to Government Employees

Sec. 506.001. LATE PAYMENT OF JUDGMENT BY THE STATE.

(a) In a workers' compensation case in which a claimant is awarded a judgment against the state or a political subdivision of the state under Chapter 501, 502, 503, 504, or 505, the state or political subdivision shall comply with the judgment not later than the 30th day after the judgment is entered.

(b) If the state or a political subdivision of the state fails or refuses to comply with a judgment as provided under Subsection (a) and the claimant secures a mandamus order against the state or political subdivision to force compliance with the judgment, the claimant is also entitled to an award of:

(1) a penalty of 12 percent of the amount of compensation recovered in the judgment; and

(2) reasonable attorney's fees for prosecution of the mandamus action.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 506.002. REIMBURSEMENT FROM NON-TREASURY FUNDS.

(a) An agency or other instrumentality of state government that, with funds that are held outside the state treasury, reimburses the general revenue fund for workers' compensation payments made out of the general revenue fund to former or current employees of the agency or other instrumentality shall reimburse the general revenue fund by writing a check to the comptroller:

(1) for deposit into the appropriate account in the general revenue fund; and

(2) not later than 30 days after receiving the statement of amounts due.

(b) The workers' compensation division of the office of the attorney general shall send to the comptroller and the state auditor a copy of each statement of amounts due from an agency or other instrumentality of state government that, with funds that are held outside the state treasury, reimburses the general revenue fund for workers' compensation payments made out of the general revenue fund.

(c) An agency or other instrumentality of state government affected by this section may allocate appropriate funds to a revolving account on its books to receive contributions from funds other than general revenue funds, based on an assessment it determines to be appropriate for the purpose of reimbursing the general revenue fund for the workers' compensation payments made to its current or former employees.

(d) The state auditor may review affected entities for compliance with this section, subject to a risk assessment performed by the state auditor and to the legislative audit committee's approval of including the review in the audit plan under Section 321.013, Government Code.

Added by Acts 1999, 76th Leg., ch. 1499, Sec. 1.40, eff. Sept. 1, 1999. Amended by Acts 2003, 78th Leg., ch. 785, Sec. 64, eff. Sept. 1, 2003.

Chapter 505. Workers' Compensation Insurance Coverage for Employees of Texas Department of Transportation

Subchapter A. GENERAL PROVISIONS

Sec. 505.001. DEFINITIONS.

(a) In this chapter:

(1) Repealed by Acts 2005, 79th Leg., Ch. 265, Sec. 7.01(32), eff. September 1, 2005.

(2) "Department" means the Texas Department of Transportation.

(3) "Employee" means a person in the service of the department under an appointment or express contract of hire and whose name appears on the department's payroll.

(4) "Legal beneficiary" has the meaning assigned to that term under Section 401.011.

(b) A reference in this chapter to an employee who has been injured includes the employee's legal beneficiary if the injured employee is dead.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 7.01(32), eff. September 1, 2005.

Sec. 505.002. APPLICATION OF GENERAL WORKERS' COMPENSATION LAWS; LIMIT ON ACTIONS AND DAMAGES.

(a) The following provisions of Subtitles A and B apply to and are included in this chapter except to the extent that they are inconsistent with this chapter:

(1) Chapter 401, other than Section 401.012, defining "employee";

(2) Chapter 402;

(3) Chapter 403, other than Sections 403.001-403.005;

(4) Chapters 404 and 405;

(5) Subchapters B, D, E, and H, Chapter 406, other than Sections 406.071-406.073, and 406.075;

(6) Chapter 408, other than Sections 408.001(b) and (c);

(7) Chapters 409 and 410;

(8) Subchapters A and G, Chapter 411, other than Sections 411.003 and 411.004;

(9) Chapters 412-417; and

(10) Chapter 451.

(b) For the purpose of applying the provisions listed by Subsection (a) to this chapter, "employer" means "department."

(c) Neither this chapter nor Subtitle A authorizes a cause of action or damages against the department or an employee of the department beyond the actions and damages authorized by Chapter 101, Civil Practice and Remedies Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.323, eff. September 1, 2005.

Subchapter B. COVERAGE

Sec. 505.011. WORKERS' COMPENSATION COVERAGE FOR DEPARTMENT EMPLOYEES.

The department shall pay benefits as provided by this chapter to an employee with a compensable injury.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 505.012. AUTHORITY TO SELF-INSURE.

The department may self-insure.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 505.013. INDIVIDUALS EMPLOYED BY SUBCONTRACTORS.

(a) Except as provided by Subsection (b), an individual employed by a subcontractor performing work under contract with the department is not considered an employee for purposes of this chapter.

(b) The department shall treat a person leasing a tractor, a truck, mowing or cutting machinery, or other equipment to the department and using the equipment to perform work under a contract with the department:

(1) as an independent contractor, and the department shall require the person, while performing the contract, to provide life, health and accident, and disability insurance for the person and any individual employed by the person to perform the contract in an amount and with coverage approved by the Texas Department of Insurance as substantially the same as provided for under workers' compensation insurance;

(2) as an employee of the state for workers' compensation purposes, and the department shall require the person to provide workers' compensation insurance for each individual employed by the person to perform the contract, in which case this chapter applies to the person and the individuals employed by the person without regard to the number of individuals employed; or

(3) as an employee of the state for workers' compensation purposes, and each individual employed by that person to perform the contract as an employee of the state for workers' compensation purposes.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Subchapter C. ADMINISTRATION

Sec. 505.051. ADMINISTRATION; RULES; FORMS.

(a) The department shall administer this chapter.

(b) Process and procedure under this chapter shall be as summary as possible.

(c) The department may:

(1) adopt rules and prescribe and furnish forms necessary to effectively administer this chapter; and

(2) adopt and enforce necessary rules for the prevention of accidents and injuries.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 505.052. PERCENTAGE OF PAYROLL SET ASIDE FOR WORKERS' COMPENSATION EXPENSES; ACCOUNT; REPORTS.

(a) The department may set aside from its available appropriations, other than itemized appropriations, an amount not exceeding three and one-half percent of the department's annual payroll for the payment of administrative expenses, charges, benefits, and awards under this chapter.

(b) The amount set aside under Subsection (a) shall be set up in a separate account in the department's records. The balance of the account at any time may not exceed an amount equal to three and one-half percent of the department's annual payroll.

(c) The account shall show the disbursements authorized by this chapter. A statement of the amount set aside for the account and the disbursements from the account shall be included in the reports made to the governor and the legislature as required by law.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 505.053. CERTIFIED COPIES OF DIVISION DOCUMENTS.

(a) The division of workers' compensation shall furnish a certified copy of an order, award, decision, or paper on file with the division to a person entitled to the copy on written request and payment of the fee for the copy. The fee shall be the same as that charged for similar services by the secretary of state's office.

(b) The department may obtain certified copies under this section without charge.

(c) A fee or salary may not be paid to an employee of the division of workers' compensation for making the copies that exceeds the fee charged for the copies.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.324, eff. September 1, 2005. Acts 2005, 79th Leg., Ch. 265, Sec. 3.325, eff. September 1, 2005.

Sec. 505.054. PREEMPLOYMENT PHYSICAL REQUIRED; EXAMINING PHYSICIANS.

(a) An individual may not be certified as an employee of the department under this chapter until the individual:

(1) submits to a physical examination as provided by this section; and

(2) is certified by the examining physician to be physically fit to perform the duties and services to which the individual is to be assigned.

(b) Absence of a physical examination under this section does not bar recovery.

(c) The department shall designate a convenient number of regularly licensed practicing physicians to make physical examinations of individuals employed by or to be employed by the department to determine if the individuals are physically fit to be classified as department employees.

(d) A physician designated under Subsection (c) who conducts an examination shall file with the department a complete transcript of the examination on a form furnished by the department. The department shall maintain all reports under this subsection as part of the department's permanent records. A report under this subsection is admissible in evidence before the division of workers' compensation and in an appeal from a final award or ruling of the commissioner of workers' compensation in which the individual named in the examination is a claimant for compensation under this chapter. A report under this subsection that is admitted is prima facie evidence of the facts stated in the report.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.326, eff. September 1, 2005.

Sec. 505.055. REPORTS OF INJURIES.

(a) A report of an injury filed with the division of workers' compensation under Section 409.005, in addition to the information required by commissioner of workers' compensation rules, must contain:

(1) the name, age, sex, and occupation of the injured employee;

(2) the character of work in which the employee was engaged at the time of the injury;

(3) the place, date, and hour of the injury; and

(4) the nature and cause of the injury.

(b) In addition to subsequent reports of an injury filed with the division of workers' compensation under Section 409.005(e), the department shall file a subsequent report on a form obtained for that purpose:

(1) on the termination of incapacity of the injured employee; or

(2) if the incapacity extends beyond 60 days.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.327, eff. September 1, 2005.

Sec. 505.056. REQUIRED EXAMINATION OF INJURED EMPLOYEE; REFUSAL TO SUBMIT TO EXAMINATION.

(a) The division of workers' compensation may require an employee who claims to have been injured to submit to an examination by the division or a person acting under the division's authority at a reasonable time and place in this state.

(b) An employee is not entitled to compensation during or for a period in which the employee refuses to submit to an examination under Subsection (a) or Section 408.004.

(c) The department may have an injured employee examined at a reasonable time and at a place suitable to the employee's condition and convenient and accessible to the employee by a physician selected by the department. The department shall pay for an examination under this subsection and for the employee's reasonable expenses incident to the examination.

(d) On the request of an employee or the department, the employee or the department is entitled to have a physician selected by the employee or the department present to participate in an examination under Subsection (a) or Section 408.004. The employee is entitled to have a physician selected by the employee present to participate in an examination under Subsection (c). The department shall pay the fee set by the commissioner of workers' compensation of a physician selected by the employee under this subsection.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.328, eff. September 1, 2005.

Sec. 505.057. REFUSAL TO SUBMIT TO MEDICAL TREATMENT.

(a) The commissioner of workers' compensation may order or direct the department to reduce or suspend the compensation of an injured employee if the employee:

(1) persists in insanitary or injurious practices that tend to imperil or retard the employee's recovery; or

(2) refuses to submit to medical, surgical, or other remedial treatment recognized by the state that is reasonably essential to promote the employee's recovery.

(b) Compensation may not be reduced or suspended under this section without reasonable notice to the employee and an opportunity to be heard.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.329, eff. September 1, 2005.

Sec. 505.058. POSTPONEMENT OF HEARING.

If an injured employee is receiving benefits under this chapter and the department is providing hospitalization or medical treatment to the employee, the division of workers' compensation may postpone the hearing of the employee's claim. An appeal may not be taken from an order of the commissioner of workers' compensation under this section.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.330, eff. September 1, 2005.

Sec. 505.059. NOTICE OF APPEAL; NOTICE OF TRIAL COURT JUDGMENT; OFFENSE.

(a) In each case appealed from the division of workers' compensation to a county or district court:

(1) the clerk of the court shall mail to the division:

(A) not later than the 20th day after the date the case is filed, a notice containing the style, number, and date of filing of the case; and

(B) not later than the 20th day after the date the judgment is rendered, a certified copy of the judgment; and

(2) the attorney preparing the judgment shall file the original and a copy of the judgment with the clerk.

(b) An attorney's failure to comply with Subsection (a)(2) does not excuse the failure of a county or district clerk to comply with Subsection (a)(1)(B).

(c) The duties of a county or district clerk under Subsection (a)(1) are part of the clerk's ex officio duties, and the clerk is not entitled to a fee for the services.

(d) A county or district clerk who violates this section commits an offense. An offense under this section is a misdemeanor punishable by a fine not to exceed $250.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.331, eff. September 1, 2005.

Sec. 505.060. EFFECT OF SICK LEAVE; ANNUAL LEAVE.

(a) An employee may elect to use accrued sick leave before receiving income benefits. If an employee elects to use sick leave, the employee is not entitled to income benefits under this chapter until the employee has exhausted the employee's accrued sick leave.

(b) An employee may elect to use all or any number of weeks of accrued annual leave after the employee's accrued sick leave is exhausted. If an employee elects to use annual leave, the employee is not entitled to income benefits under this chapter until the elected number of weeks of leave have been exhausted.

Added by Acts 2001, 77th Leg., ch. 706, Sec. 1, eff. Sept. 1, 2001; Acts 2001, 77th Leg., ch. 1017, Sec. 2.01, eff. Sept. 1, 2002; Acts 2001, 77th Leg., ch. 1456, Sec. 14.03, eff. June 17, 2001.

Chapter 504. Workers' Compensation Insurance Coverage for Employees of Political Subdivisions

Subchapter A. GENERAL PROVISIONS

Sec. 504.001. DEFINITIONS.

In this chapter, unless a different meaning is plainly required by the context:

(1) "Division" means the division of workers' compensation of the Texas Department of Insurance.

(2) "Employee" means:

(A) a person in the service of a political subdivision who has been employed as provided by law; or

(B) a person for whom optional coverage is provided under Section 504.012 or 504.013.

(3) "Political subdivision" means a county, municipality, special district, school district, junior college district, housing authority, community center for mental health and mental retardation services established under Subchapter A, Chapter 534, Health and Safety Code, or any other legally constituted political subdivision of the state.

(4) "Pool" means two or more political subdivisions collectively self-insuring under an interlocal contract under Chapter 791, Government Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.318, eff. September 1, 2005.

Sec. 504.002. APPLICATION OF GENERAL WORKERS' COMPENSATION LAWS; LIMIT ON ACTIONS AND DAMAGES.

(a) The following provisions of Subtitles A and B apply to and are included in this chapter except to the extent that they are inconsistent with this chapter:

(1) Chapter 401, other than Section 401.011(18) defining "employer" and Section 401.012 defining "employee";

(2) Chapter 402;

(3) Chapter 403, other than Sections 403.001-403.005;

(4) Chapters 404 and 405;

(5) Sections 406.006-406.009 and Subchapters B and D-G, Chapter 406, other than Sections 406.033, 406.034, 406.035, 406.091, and 406.096;

(6) Chapter 408, other than Sections 408.001(b) and (c);

(7) Chapters 409-412;

(8) Chapter 413, except as provided by Section 504.053;

(9) Chapters 414-417; and

(10) Chapter 451.

(b) For the purpose of applying the provisions listed by Subsection (a) to this chapter, "employer" means "political subdivision."

(c) Neither this chapter nor Subtitle A authorizes a cause of action or damages against a political subdivision or an employee of a political subdivision beyond the actions and damages authorized by Chapter 101, Civil Practice and Remedies Code.

(d) For the purpose of applying the provisions listed by Subsection (a), "written notice" to a political subdivision that self-insures, either individually or collectively through an interlocal agreement as described by Section 504.011, occurs only on written notice to the intergovernmental risk pool or other entity responsible for administering the claim.

Added by Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1999, 76th Leg., ch. 954, Sec. 6, eff. Sept. 1, 1999; Acts 2003, 78th Leg., ch. 939, Sec. 2, eff. Sept. 1, 2003.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.319, eff. September 1, 2005.

Sec. 504.003. ELECTION OF REMEDIES.

A person may not bring an action for wrongful discharge under both Chapter 451 and Chapter 554, Government Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(77), eff. Sept. 1, 1995.

Subchapter B. COVERAGE

Sec. 504.011. METHOD OF PROVIDING COVERAGE.

A political subdivision shall extend workers' compensation benefits to its employees by:

(1) becoming a self-insurer;

(2) providing insurance under a workers' compensation insurance policy; or

(3) entering into an interlocal agreement with other political subdivisions providing for self-insurance.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.012. OPTIONAL COVERAGES.

(a) A political subdivision may cover volunteer fire fighters, police officers, emergency medical personnel, and other volunteers that are specifically named. A person covered under this subsection is entitled to full medical benefits and the minimum compensation payments under the law. Notwithstanding any other law, the governing body of the political subdivision may elect to provide compensation payments to a person covered under this subsection that are greater than the minimum benefits provided under this title.

(b) By majority vote of the members of the governing body of a political subdivision, the political subdivision may cover as employees:

(1) an elected official;

(2) persons paid for jury service; or

(3) persons paid for service in the conduct of an election.

(c) A political subdivision may cover a child who is in a program established by the political subdivision to assist children in rendering personal services to a charitable or educational institution under Section 54.041(b), Family Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1999, 76th Leg., ch. 1426, Sec. 18, eff. Sept. 1, 1999.

Sec. 504.013. COVERAGE FOR TRUSTEES AND STAFF OF SELF-INSURANCE FUND.

By majority vote of the board of trustees of a self-insurance fund created under this chapter, the fund may cover:

(1) members of the board of trustees;

(2) staff of the fund, including persons with whom the fund has contracted to perform staff functions; or

(3) any other self-insurance fund created under Chapter 791, Government Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.014. EXCLUSIONS.

A person is not an employee and is not entitled to compensation under this chapter if the person:

(1) is in the service of a political subdivision and is paid on a piecework basis or on a basis other than by the hour, day, week, month, or year;

(2) is a patient or client of a political subdivision involved in vocational training;

(3) is a prisoner incarcerated by a political subdivision; or

(4) performs services that may benefit a political subdivision, or is employed by or under contract with a performer providing those services, but does not receive payment from the political subdivision for the performance of the services, if the services are performed in connection with the operation or production of:

(A) a stock show;

(B) a rodeo;

(C) a carnival;

(D) a circus;

(E) a musical, vocal, or theatrical performance;

(F) a professional baseball league or game;

(G) a professional hockey league or game;

(H) a wrestling event or match;

(I) a vehicle or motorcycle event; or

(J) another entertainment event.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 2003, 78th Leg., ch. 841, Sec. 1, eff. Sept. 1, 2003.

Sec. 504.015. MUNICIPAL UTILITIES.

(a) This section applies to a municipal utility operated by a board of trustees established under Section 1502.070, Government Code, or a similar law.

(b) The board of trustees of a utility has the authority of the governing body of the municipality under this chapter to:

(1) adopt a self-insurance program or take out a policy of workers' compensation insurance; and

(2) adopt resolutions, give notices, and do all things concerning workers' compensation regarding the utility's employees that the governing body of the municipality would be authorized to do regarding other municipal employees or groups of employees.

(c) Funds set aside or spent for the purpose of workers' compensation insurance are considered operating expenses of the utility. Funds set aside or paid by the board of trustees for self-insurance or for premiums on insurance policies shall be paid out of utility revenues. A provision for self-insurance or an obligation incurred under an insurance policy is not a general liability of the municipality but is payable only out of utility revenues.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 8.282, eff. Sept. 1, 2001.

Sec. 504.016. JOINT INSURANCE FUND.

(a) Two or more political subdivisions may establish a joint insurance fund as provided by this section.

(b) A political subdivision may pay into the fund its proportionate part as due and may contract for the fund, by and through its directors, to make the payments due under this chapter to employees of the political subdivision.

(c) The fund may be operated under the rules and bylaws established by the participating political subdivisions.

(d) A joint insurance fund created under this section may provide to the Texas Department of Insurance loss data in the same manner as an insurance company writing workers' compensation insurance. The State Board of Insurance shall use the loss data as provided by Subchapter D, Chapter 5, Insurance Code.

(e) Except as provided by Subsection (d), a joint insurance fund created under this section is not considered insurance for purposes of any state statute and is not subject to State Board of Insurance rules.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.017. FEDERAL AND STATE FUNDED TRANSPORTATION ENTITIES.

An entity is eligible to participate under Section 504.016 or Chapter 791 or 2259, Government Code, if the entity provides transportation subsidized in whole or in part by and provided to clients of:

(1) the Department of Assistive and Rehabilitative Services;

(2) the Department of State Health Services;

(3) the Cancer Prevention and Research Institute of Texas;

(4) the Texas Department of Housing and Community Affairs;

(5) the Health and Human Services Commission;

(6) the Department of Aging and Disability Services; or

(7) the Texas Youth Commission.

Amended by: Acts 2007, 80th Leg., R.S., Ch. 266, Sec. 5, eff. November 6, 2007.

Sec. 504.018. NOTICE TO DIVISION AND EMPLOYEES; EFFECT ON COMMON-LAW OR STATUTORY LIABILITY.

(a) A political subdivision shall notify the division of the method by which its employees will receive benefits, the approximate number of employees covered, and the estimated amount of payroll.

(b) A political subdivision shall notify its employees of the method by which the employees will receive benefits and the effective date of the coverage. Employees of a political subdivision are conclusively considered to have accepted the compensation provisions instead of common-law or statutory liability or cause of action, if any, for injuries received in the course of employment or death resulting from injuries received in the course of employment.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.320, eff. September 1, 2005. Acts 2005, 79th Leg., Ch. 265, Sec. 3.321, eff. September 1, 2005.

Subchapter C. BENEFITS AND OFFSETS

Sec. 504.051. OFFSET AGAINST PAYMENTS FOR INCAPACITY.

(a) Benefits provided under this chapter shall be offset:

(1) to the extent applicable, by any amount for incapacity received as provided by:

(A) Chapter 143, Local Government Code; or

(B) any other statute in effect on June 19, 1975, that provides for the payment for incapacity to work because of injury on the job that is also covered by this chapter; and

(2) by any amount paid under Article III, Section 52e, of the Texas Constitution, as added in 1967.

(b) If benefits are offset, the employer may not withhold the offset portion of the employee's wages until the time that benefits under this chapter are received.

(c) If an employee's wages are offset, the employee and employer shall contribute to the pension fund on the amount of money by which the employee's wages were offset. An employee's pension benefit may not be reduced as a result of the employee's injuries or any compensation received under this chapter unless the reduction results from a pension revision passed by a majority vote of the affected members of a pension system.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.052. SICK LEAVE BENEFITS.

(a) The governing body of a political subdivision, by majority vote, may provide that while an employee of the political subdivision is receiving benefits under this chapter, the employee may elect to receive previously accrued sick leave benefits, whether statutory or contractual, in an amount equal to the difference between the benefits under this chapter and the weekly compensation that the employee was receiving before the injury that resulted in the claim.

(b) Sick leave benefits received under Subsection (a) shall be deducted proportionately from the employee's sick leave balance.

(c) This section does not limit the medical benefits to be paid to the employee. A sick leave plan may not require an employee to take sick leave benefits before receiving benefits under this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.053. ELECTION.

(a) A political subdivision that self-insures either individually or collectively shall provide workers' compensation medical benefits to the injured employees of the political subdivision through a workers' compensation health care network certified under Chapter 1305, Insurance Code, if the governing body of the political subdivision determines that provision of those benefits through a network is available to the employees and practical for the political subdivision. A political subdivision may enter into interlocal agreements and other agreements with other political subdivisions to establish or contract with networks under this section.

(b) If a political subdivision or a pool determines that a workers' compensation health care network certified under Chapter 1305, Insurance Code, is not available or practical for the political subdivision or pool, the political subdivision or pool may provide medical benefits to its injured employees or to the injured employees of the members of the pool:

(1) in the manner provided by Chapter 408, other than Sections 408.001(b) and (c) and Section 408.002, and by Subchapters B and C, Chapter 413; or

(2) by directly contracting with health care providers or by contracting through a health benefits pool established under Chapter 172, Local Government Code.

(c) If the political subdivision or pool provides medical benefits in the manner authorized under Subsection (b)(2), the following do not apply:

(1) Sections 408.004 and 408.0041, unless use of a required medical examination or designated doctor is necessary to resolve an issue relating to the entitlement to or amount of income benefits under this title;

(2) Subchapter B, Chapter 408, except for Section 408.021;

(3) Chapter 413, except for Section 413.042; and

(4) Chapter 1305, Insurance Code, except for Sections 1305.501, 1305.502, and 1305.503.

(d) If the political subdivision or pool provides medical benefits in the manner authorized under Subsection (b)(2), the following standards apply:

(1) the political subdivision or pool must ensure that workers' compensation medical benefits are reasonably available to all injured workers of the political subdivision or the injured workers of the members of the pool within a designed service area;

(2) the political subdivision or pool must ensure that all necessary health care services are provided in a manner that will ensure the availability of and accessibility to adequate health care providers, specialty care, and facilities;

(3) the political subdivision or pool must have an internal review process for resolving complaints relating to the manner of providing medical benefits, including an appeal to the governing body or its designee and appeal to an independent review organization;

(4) the political subdivision or pool must establish reasonable procedures for the transition of injured workers to contract providers and for the continuity of treatment, including notice of impending termination of providers and a current list of contract providers;

(5) the political subdivision or pool shall provide for emergency care if an injured worker cannot reasonably reach a contract provider and the care is for medical screening or other evaluation that is necessary to determine whether a medical emergency condition exists, necessary emergency care services including treatment and stabilization, and services originating in a hospital emergency facility following treatment or stabilization of an emergency medical condition;

(6) prospective or concurrent review of the medical necessity and appropriateness of health care services must comply with Article 21.58A, Insurance Code;

(7) the political subdivision or pool shall continue to report data to the appropriate agency as required by Title 5 of this code and Chapter 1305, Insurance Code; and

(8) a political subdivision or pool is subject to the requirements under Sections 1305.501, 1305.502, and 1305.503, Insurance Code.

(e) Nothing in this chapter waives sovereign immunity or creates a new cause of action.

Added by Acts 2005, 79th Leg., Ch. 265, Sec. 3.322, eff. September 1, 2005.

Sec. 504.054. CONTESTED CASE HEARING ON AND JUDICIAL REVIEW OF INDEPENDENT REVIEW.

(a) A party to a medical dispute that remains unresolved after the review described by Section 504.053(d)(3) is entitled to a contested case hearing. A hearing under this subsection shall be conducted by the division in the same manner as a hearing conducted under Section 413.0311.

(b) The hearing officer conducting the contested case hearing under Subsection (a) shall consider any treatment guidelines adopted by the political subdivision or pool that provides medical benefits under Section 504.053(b)(2) if those guidelines meet the standards provided by Section 413.011(e).

(c) A party that has exhausted all administrative remedies under Subsection (a) and is aggrieved by a final decision of the division may seek judicial review of the decision.

(d) Judicial review under Subsection (c) shall be conducted in the manner provided for judicial review of a contested case under Subchapter G, Chapter 2001, Government Code, and is governed by the substantial evidence rule.

(e) A decision of the independent review organization is binding during the pendency of a dispute.

Added by Acts 2011, 82nd Leg., R.S., Ch. 1162, Sec. 36, eff. September 1, 2011.

Sec. 504.055. EXPEDITED PROVISION OF MEDICAL BENEFITS FOR CERTAIN INJURIES SUSTAINED BY FIRST RESPONDER IN COURSE AND SCOPE OF EMPLOYMENT.

(a) In this section, "first responder" means:

(1) an individual employed by a political subdivision of this state who is:

(A) a peace officer under Article 2.12, Code of Criminal Procedure;

(B) a person licensed under Chapter 773, Health and Safety Code, as an emergency care attendant, emergency medical technician, emergency medical technician-intermediate, emergency medical technician-paramedic, or licensed paramedic; or

(C) a firefighter subject to certification by the Texas Commission on Fire Protection under Chapter 419, Government Code, whose principal duties are firefighting and aircraft crash and rescue; or

(2) an individual covered under Section 504.012(a) who is providing volunteer services to a political subdivision of this state as:

(A) a volunteer firefighter, without regard to whether the volunteer firefighter is certified under Subchapter D, Chapter 419, Government Code; or

(B) an emergency medical services volunteer, as defined by Section 773.003, Health and Safety Code.

(b) This section applies only to a first responder who sustains a serious bodily injury, as defined by Section 1.07, Penal Code, in the course and scope of employment. For purposes of this section, an injury sustained in the course and scope of employment includes an injury sustained by a first responder providing services on a volunteer basis.

(c) The political subdivision, division, and insurance carrier shall accelerate and give priority to an injured first responder's claim for medical benefits, including all health care required to cure or relieve the effects naturally resulting from a compensable injury described by Subsection (b).

(d) The division shall accelerate, under rules adopted by the commissioner of workers' compensation, a contested case hearing requested by or an appeal submitted by a first responder regarding the denial of a claim for medical benefits, including all health care required to cure or relieve the effects naturally resulting from a compensable injury described by Subsection (b). The first responder shall provide notice to the division and independent review organization that the contested case or appeal involves a first responder.

(e) Except as otherwise provided by this section, a first responder is entitled to review of a medical dispute in the manner provided by Section 504.054.

Added by Acts 2011, 82nd Leg., R.S., Ch. 1162, Sec. 36, eff. September 1, 2011.

Sec. 504.056. INTENT OF EXPEDITED PROVISION OF MEDICAL BENEFITS FOR CERTAIN INJURIES SUSTAINED BY FIRST RESPONDER IN COURSE AND SCOPE OF EMPLOYMENT.

The purpose of Section 504.055 is to ensure that an injured first responder's claim for medical benefits is accelerated by a political subdivision, insurance carrier, and the division to the full extent authorized by current law.

Added by Acts 2011, 82nd Leg., R.S., Ch. 1162, Sec. 36, eff. September 1, 2011.

Subchapter D. ADMINISTRATION

Sec. 504.071. RULES; FORMS.

A political subdivision may:

(1) adopt and publish rules and prescribe and furnish forms necessary to effectively administer this chapter; and

(2) adopt and enforce necessary rules for the prevention of accidents and injuries.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.072. APPROPRIATIONS FOR DISBURSEMENTS; ACCOUNT; REPORT.

(a) A political subdivision may set aside from available appropriations, other than itemized salary appropriations, an amount sufficient to pay all costs, administrative expenses, benefits, insurance, and attorney's fees authorized by this chapter.

(b) The amount set aside under Subsection (a) shall be set up in a separate account in the political subdivision's records showing the disbursements authorized by this chapter. A statement of the amount set aside for disbursements from the account shall be included in an annual report made to the political subdivision's governing body and its treasurer.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 504.073. REPRESENTATION IN LEGAL PROCEEDINGS.

(a) Except as provided by Subsection (b), in a proceeding in connection with workers' compensation benefits provided by a political subdivision as a self-insurer, the political subdivision may be represented by:

(1) the political subdivision's attorney or that attorney's assistants; or

(2) outside counsel.

(b) In a proceeding involving workers' compensation for employees of a municipal utility operated by a board of trustees established under Section 1502.070, Government Code, or a similar law, if the board of trustees is a self-insurer, the municipality shall be represented by the regularly employed attorney or outside counsel of the board of trustees.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 8.284, eff. Sept. 1, 2001.

Chapter 503. Workers' Compensation Insurance Coverage for Employees of the University of Texas System and Employees of Institutions of the University of Texas System

Subchapter A. GENERAL PROVISIONS

Sec. 503.001. DEFINITIONS.

In this chapter:

(1) "Commissioner" means the commissioner of workers' compensation.

(1-a) "Division" means the division of workers' compensation of the Texas Department of Insurance.

(2) "Employee" means a person employed in the service of the system under an appointment or oral or written express contract for hire whose name appears on the system's payroll.

(3) "Institution" means an institution of higher education or agency under the direction of the board of regents of The University of Texas System.

(4) "System" has the meaning assigned by Section 65.01(1), Education Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.305, eff. September 1, 2005.

Sec. 503.002. APPLICATION OF GENERAL WORKERS' COMPENSATION LAWS; LIMIT ON ACTIONS AND DAMAGES.

(a) The following provisions of Subtitle A apply to and are included in this chapter except to the extent that they are inconsistent with this chapter:

(1) Chapter 401, other than Section 401.012 defining "employee";

(2) Chapter 402;

(3) Chapter 403, other than Sections 403.001-403.005;

(4) Chapters 404 and 405;

(5) Sections 406.031-406.033; Subchapter D, Chapter 406; Sections 406.092 and 406.093;

(6) Chapter 408, other than Sections 408.001(b) and (c);

(7) Chapters 409 and 410;

(8) Subchapters A and G, Chapter 411, other than Sections 411.003 and 411.004; and

(9) Chapters 412-417.

(b) For the purpose of applying the provisions listed by Subsection (a) to this chapter, "employer" means "the institution," and "system" means the insurance carrier under Section 503.022.

(c) Neither this chapter nor Subtitle A authorizes a cause of action or damages against the system or any institution or employee of the system or institution beyond the actions and damages authorized by Chapter 101, Civil Practice and Remedies Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.306, eff. September 1, 2005.

Sec. 503.003. LEGAL BENEFICIARY OF DECEASED EMPLOYEE.

(a) A reference in this chapter to an injured employee includes the legal beneficiaries of the employee if the injured employee is dead.

(b) In this section, "legal beneficiary" has the meaning assigned to that term under Section 401.011.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Subchapter B. COVERAGE

Sec. 503.021. WORKERS' COMPENSATION COVERAGE FOR SYSTEM AND INSTITUTION EMPLOYEES.

(a) The system shall pay benefits as provided by this chapter to an employee with a compensable injury.

(b) A benefit under this section for an employee who is employed on less than a full workday basis may not exceed 60 percent of the employee's average weekly wage as computed under Section 408.042.

(c) A benefit shall be paid weekly as it accrues directly to the person entitled to it unless the liability is redeemed as provided by this chapter.

(d) In this section, "average weekly wage" has the meaning assigned to that term by Subchapter C, Chapter 408.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.307, eff. September 1, 2005.

Sec. 503.022. AUTHORITY TO SELF-INSURE.

An institution may self-insure as part of a system insurance plan.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.308, eff. September 1, 2005.

Sec. 503.023. INSURANCE REQUIREMENT.

The board of regents of the system may require each person employed by the system or an institution other than by appointment or express contract for hire, as a condition of employment, to acquire protection under a group life and accident insurance plan approved by the board.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 503.024. WAIVER OF RIGHTS.

An agreement by an employee to waive the employee's rights under this chapter is valid if made in writing by the employee before becoming an employee.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 503.025. COVERAGE FOR OUT-OF-STATE EMPLOYEES.

(a) An employee who performs services outside this state is entitled to benefits under this chapter even if the person:

(1) is hired or not hired in this state;

(2) does not work in this state;

(3) works both in this state and out of state;

(4) is injured outside this state; or

(5) has been outside this state for more than one year.

(b) An employee who elects to pursue remedies provided by this state where the injury occurred is not entitled to benefits under this chapter.

Added by Acts 2003, 78th Leg., ch. 1266, Sec. 4.03, eff. June 20, 2003.

Subchapter C. OFFSETS

Sec. 503.041. EXHAUSTION OF ANNUAL AND SICK LEAVE.

(a) An employee may elect to use accrued sick leave before receiving income benefits. If an employee elects to use sick leave, the employee is not entitled to income benefits under this chapter until the employee has exhausted the employee's accrued sick leave.

(b) An employee may elect to use all or any number of weeks of accrued annual leave after the employee's accrued sick leave is exhausted. If an employee elects to use annual leave, the employee is not entitled to income benefits under this chapter until the elected number of weeks of leave have been exhausted.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.309, eff. September 1, 2005.

Subchapter D. ADMINISTRATION

Sec. 503.061. ADMINISTRATION AND RULES.

(a) The system shall administer this chapter.

(b) Process and procedure under this chapter shall be as summary as possible.

(c) The system may:

(1) adopt and publish rules and prescribe and furnish forms necessary for the administration of this chapter; and

(2) adopt and enforce rules necessary for the prevention of accidents and injuries.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.310, eff. September 1, 2005.

Sec. 503.062. PERCENTAGE OF PAYROLL SET ASIDE FOR WORKERS' COMPENSATION EXPENSES; ACCOUNT; REPORTS.

(a) An institution may set aside from its available appropriations, other than itemized salary appropriations, an amount not to exceed two percent of the institution's annual payroll for the payment of administrative expenses, charges, benefits, and awards under this chapter.

(b) The amount set aside under Subsection (a) shall be set up in a separate account in the institution's records. The balance of the account at any time may not exceed an amount equal to two percent of the institution's annual payroll.

(c) The account must show the disbursements authorized by this chapter. A statement of the amount set aside for the account and the disbursements from the account shall be included in the reports made to the governor and the legislature as required by law.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 503.063. CERTIFIED COPIES OF DIVISION DOCUMENTS.

(a) The division shall furnish a certified copy of an order, award, decision, or paper on file in the division's office to a person entitled to the copy on written request and payment of the fee for the copy. The fee is the same as that charged for similar services by the secretary of state's office.

(b) The system or the institution may obtain certified copies under this section without charge.

(c) A fee or salary may not be paid to an employee of the division for making a copy under Subsection (a) that exceeds the fee charged for the copy.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.311, eff. September 1, 2005.

Sec. 503.064. EXAMINING PHYSICIANS.

(a) The institution shall designate a convenient number of licensed practicing physicians to perform physical examinations of individuals employed or to be employed by the institution to determine if an individual is physically fit to be classified as an employee.

(b) A physician designated under Subsection (a) who conducts an examination shall file with the institution a complete transcript of the examination. The transcript must be sworn to on a form provided by the institution.

(c) The institution shall maintain all reports under this section as part of the institution's permanent records.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 503.065. REPORTS OF INJURIES.

(a) In addition to a report of an injury filed with the division under Section 409.005(a), an institution shall file a supplemental report that contains:

(1) the name, age, sex, and occupation of the injured employee;

(2) the character of work in which the employee was engaged at the time of the injury;

(3) the place, date, and hour of the injury; and

(4) the nature and cause of the injury.

(b) The institution shall file the supplemental report on a form obtained for that purpose:

(1) on the termination of incapacity of the injured employee; or

(2) if the incapacity extends beyond 60 days.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.312, eff. September 1, 2005.

Sec. 503.066. REQUIRED EXAMINATION OF INJURED EMPLOYEE; REFUSAL TO SUBMIT TO EXAMINATION.

(a) The division may require an employee who claims to have been injured to submit to an examination by the division or a person acting under the division's authority at a reasonable time and place in this state.

(b) On the request of an employee, the system, or the institution, the employee, the system, or the institution is entitled to have a physician selected by the employee, the system, or the institution, as appropriate, present to participate in an examination under Subsection (a) or Section 408.004.

(c) An employee is not entitled to compensation during or for a period in which the employee refuses to submit to an examination under Subsection (a) or Section 408.004.

(d) The system or the institution may have an injured employee examined at a reasonable time and at a place suitable to the employee's condition and convenient and accessible to the employee by a physician selected by the system or the institution. The system or the institution shall pay for an examination under this subsection and for the employee's reasonable expenses incident to the examination. The employee is entitled to have a physician selected by the employee present to participate in an examination under this subsection.

(e) The system or the institution shall pay the fee, as set by the division, of a physician selected by the employee under Subsection (b) or (d).

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.313, eff. September 1, 2005.

Sec. 503.067. REFUSAL TO SUBMIT TO MEDICAL TREATMENT.

(a) The commissioner may order or direct the system or the institution to reduce or suspend the compensation of an injured employee who:

(1) persists in insanitary or injurious practices that tend to imperil or retard the employee's recovery; or

(2) refuses to submit to medical, surgical, or other remedial treatment recognized by the state that is reasonably essential to promote the employee's recovery.

(b) Compensation may not be reduced or suspended under this section without reasonable notice to the employee and an opportunity to be heard.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.314, eff. September 1, 2005.

Sec. 503.068. POSTPONEMENT OF HEARING.

If an injured employee is receiving benefits under this chapter and the system or the institution is providing hospitalization or medical treatment to the employee, the division may postpone the hearing on the employee's claim. An appeal may not be taken from a commissioner order under this section.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.315, eff. September 1, 2005.

Sec. 503.069. NOTICE OF APPEAL; NOTICE OF TRIAL COURT JUDGMENT; OFFENSE.

(a) In each case appealed from the division to a county or district court:

(1) the clerk of the court shall mail to the division:

(A) not later than the 20th day after the date the case is filed, a notice containing the style, number, and date of filing of the case; and

(B) not later than the 20th day after the date the judgment is rendered, a certified copy of the judgment; and

(2) the attorney preparing the judgment shall file the original and a copy of the judgment with the clerk.

(b) An attorney's failure to comply with Subsection (a)(2) does not excuse the failure of a county or district clerk to comply with Subsection (a)(1)(B).

(c) The duties of a county or district clerk under Subsection (a)(1) are part of the clerk's ex officio duties, and the clerk is not entitled to a fee for the services.

(d) A county or district clerk who violates this section commits an offense. An offense under this section is a misdemeanor punishable by a fine not to exceed $250.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.316, eff. September 1, 2005.

Sec. 503.070. VENUE FOR JUDICIAL REVIEW.

(a) A party who does not consent to abide by the final decision of the commissioner shall file notice with the division as required by Section 410.253 and bring suit in the county in which the injury occurred to set aside the final decision of the commissioner.

(b) If a suit under this section is filed in a county other than the county in which the injury occurred, the court, on determining that it does not have jurisdiction to render judgment on the merits of the suit, shall transfer the case to a proper court in the county in which the injury occurred.

(c) Notice of the transfer of a suit under Subsection (b) shall be given to the parties. A suit transferred under Subsection (b) shall be considered for all purposes the same as if originally filed in the court to which it is transferred.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.317, eff. September 1, 2005.

Sec. 503.071. ATTORNEY GENERAL AS LEGAL REPRESENTATIVE.

The attorney general is the institution's legal representative and may bring and defend all suits and hearings necessary to carry out the purposes of this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Chapter 502. Workers' Compensation Insurance Coverage for Employees of the Texas A&M University System and Employees of Institutions of the Texas A&M University System

Subchapter A. GENERAL PROVISIONS

Sec. 502.001. DEFINITIONS.

In this chapter:

(1) "Division" means the division of workers' compensation of the Texas Department of Insurance.

(2) "Employee" means a person employed in the service of an institution whose name appears on the institution's payroll.

(3) "Institution" means an institution of higher education or agency under the direction or governance of the board of regents of The Texas A&M University System.

(4) "System" has the meaning assigned by Section 85.01(1), Education Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.293, eff. September 1, 2005.

Sec. 502.002. APPLICATION OF GENERAL WORKERS' COMPENSATION LAWS; LIMIT ON ACTIONS AND DAMAGES.

(a) The following provisions of Subtitle A apply to and are included in this chapter except to the extent that they are inconsistent with this chapter:

(1) Chapter 401, other than Section 401.012 defining "employee";

(2) Chapter 402;

(3) Chapter 403, other than Sections 403.001-403.005;

(4) Chapters 404 and 405;

(5) Sections 406.031-406.033; Subchapter D, Chapter 406; Sections 406.092 and 406.093;

(6) Chapter 408, other than Sections 408.001(b) and (c);

(7) Chapters 409 and 410;

(8) Subchapters A and G, Chapter 411, other than Sections 411.003 and 411.004; and

(9) Chapters 412-417.

(b) For the purpose of applying the provisions listed by Subsection (a) to this chapter, "employer" means "the institution," and "system" means the insurance carrier under Section 502.022.

(c) Neither this chapter nor Subtitle A authorizes a cause of action or damages against the system or any institution or employee of the system or institution beyond the actions and damages authorized by Chapter 101, Civil Practice and Remedies Code.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.294, eff. September 1, 2005.

Sec. 502.003. LEGAL BENEFICIARY OF DECEASED EMPLOYEE.

(a) A reference in this chapter to an injured employee includes the legal beneficiaries of the employee if the injured employee is dead.

(b) In this section, "legal beneficiary" has the meaning assigned to that term under Section 401.011.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Subchapter B. COVERAGE

Sec. 502.021. WORKERS' COMPENSATION COVERAGE FOR INSTITUTION EMPLOYEES.

(a) The system shall pay benefits as provided by this chapter to an employee with a compensable injury.

(b) A benefit under this section for an employee who is employed on less than a full workday basis may not exceed 60 percent of the employee's average weekly wage as computed under Section 408.042.

(c) A benefit shall be paid weekly as it accrues directly to the person entitled to it unless the liability is redeemed as provided by this chapter.

(d) In this section, "average weekly wage" has the meaning assigned to that term by Subchapter C, Chapter 408.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.295, eff. September 1, 2005.

Sec. 502.022. AUTHORITY TO SELF-INSURE.

An institution may self-insure.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 502.023. INSURANCE REQUIREMENT.

(a) The board of regents of the system may require each employee, as a condition of employment, to acquire protection under a group life and accident insurance plan approved by the board.

(b) This section does not apply to an employee who is paid on a piece-work basis or on any basis other than by the hour, day, week, month, or year.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 502.024. PREEXISTING DISQUALIFYING CONDITION.

(a) An institution may certify as an employee a person who indicates a preexisting disqualifying physical condition in a medical history obtained under Section 502.064 or who is found to have a preexisting disqualifying medical condition in a physical examination under Section 502.064 on the condition that the person execute in writing a waiver of coverage under this chapter for the preexisting disqualifying physical condition before becoming an employee of the institution.

(b) A waiver under Subsection (a) is valid and binding on the employee who executes the waiver. Compensation or death benefits may not be paid to the employee or the employee's beneficiaries for an injury or death of the employee that is attributable to the condition for which coverage was waived.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 502.025. COVERAGE FOR OUT-OF-STATE EMPLOYEES.

(a) An employee who performs services outside this state is entitled to benefits under this chapter even if the person:

(1) is hired or not hired in this state;

(2) does not work in this state;

(3) works both in this state and out of state;

(4) is injured outside this state; or

(5) has been outside this state for more than one year.

(b) An employee who elects to pursue remedies provided by this state where the injury occurred is not entitled to benefits under this chapter.

Added by Acts 2003, 78th Leg., ch. 1266, Sec. 4.02, eff. June 20, 2003.

Subchapter C. OFFSETS

Sec. 502.041. EXHAUSTION OF ANNUAL AND SICK LEAVE.

(a) An employee may elect to use accrued sick leave before receiving income benefits. If an employee elects to use sick leave, the employee is not entitled to income benefits under this chapter until the employee has exhausted the employee's accrued sick leave.

(b) An employee may elect to use all or any number of weeks of accrued annual leave after the employee's accrued sick leave is exhausted. If an employee elects to use annual leave, the employee is not entitled to income benefits under this chapter until the elected number of weeks of leave have been exhausted.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.296, eff. September 1, 2005.

Subchapter D. ADMINISTRATION

Sec. 502.061. ADMINISTRATION AND RULES.

(a) The system shall administer this chapter.

(b) Process and procedure under this chapter shall be as summary as possible.

(c) The system may:

(1) adopt and publish rules and prescribe and furnish forms necessary for the administration of this chapter; and

(2) adopt and enforce rules necessary for the prevention of accidents and injuries.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.297, eff. September 1, 2005.

Sec. 502.062. PERCENTAGE OF PAYROLL SET ASIDE FOR WORKERS' COMPENSATION EXPENSES; ACCOUNT; REPORTS.

(a) An institution may set aside from its available appropriations, other than itemized salary appropriations, an amount not to exceed two percent of the institution's annual payroll for the payment of administrative expenses, charges, benefits, and awards under this chapter.

(b) The amount set aside under Subsection (a) shall be set up in a separate account in the institution's records. The balance of the account at any time may not exceed an amount equal to two percent of the institution's annual payroll.

(c) The account must show the disbursements authorized by this chapter. A statement of the amount set aside for the account and the disbursements from the account shall be included in the reports made to the governor and the legislature as required by law.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 502.063. CERTIFIED COPIES OF DIVISION DOCUMENTS.

(a) The division shall furnish a certified copy of an order, award, decision, or paper on file in the division's office to a person entitled to the copy on written request and payment of the fee for the copy. The fee is the same as that charged for similar services by the secretary of state's office.

(b) The system or an institution may obtain certified copies under this section without charge.

(c) A fee or salary may not be paid to an employee of the division for making a copy under Subsection (a) that exceeds the fee charged for the copy.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.298, eff. September 1, 2005.

Sec. 502.064. PREEMPLOYMENT PHYSICAL REQUIRED; EXAMINING PHYSICIANS; INSTITUTION RECORDS.

(a) An institution may obtain and record on a form prescribed by the institution the medical history of a person to be employed by the institution.

(b) The institution may require that an individual may not be certified as an employee of the institution under this chapter until the individual:

(1) submits to a physical examination as provided by this section; and

(2) is certified by the examining physician or chiropractor to be physically fit to perform the duties and services to which the individual is to be assigned.

(c) The institution may designate a convenient number of licensed practicing physicians and chiropractors to perform physical examinations under this section.

(d) A physician or chiropractor designated under Subsection (c) who conducts an examination shall file with the institution a complete transcript of the examination. The transcript must be sworn to on a form provided by the institution.

(e) The institution shall maintain all reports and medical histories filed with the institution under this section as part of the institution's permanent records.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 502.065. REPORTS OF INJURIES.

(a) In addition to a report of an injury filed with the division under Section 409.005(a), an institution shall file a supplemental report that contains:

(1) the name, age, sex, and occupation of the injured employee;

(2) the character of work in which the employee was engaged at the time of the injury;

(3) the place, date, and hour of the injury; and

(4) the nature and cause of the injury.

(b) The institution shall file the supplemental report on a form obtained for that purpose:

(1) on the termination of incapacity of the injured employee; or

(2) if the incapacity extends beyond 60 days.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.299, eff. September 1, 2005.

Sec. 502.066. REQUIRED EXAMINATION OF INJURED EMPLOYEE; REFUSAL TO SUBMIT TO EXAMINATION.

(a) The division may require an employee who claims to have been injured to submit to an examination by the division or a person acting under the division's authority at a reasonable time and place in this state.

(b) On the request of an employee or the system, the employee, the institution, or the system is entitled to have a physician or chiropractor selected by the employee, the institution, or the system, as appropriate, present to participate in an examination under Subsection (a) or Section 408.004.

(c) An employee is not entitled to compensation during or for a period in which the employee refuses to submit to an examination under Subsection (a) or Section 408.004.

(d) The system or the institution may have an injured employee examined at a reasonable time and at a place suitable to the employee's condition and convenient and accessible to the employee by a physician or chiropractor selected by the system or the institution. The system or the institution shall pay for an examination under this subsection and for the employee's reasonable expenses incident to the examination. The employee is entitled to have a physician or chiropractor selected by the employee present to participate in an examination under this subsection.

(e) The system or the institution shall pay the fee set by the division for the services of a physician or chiropractor selected by the employee under Subsection (b) or (d).

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.300, eff. September 1, 2005.

Sec. 502.067. REFUSAL TO SUBMIT TO MEDICAL TREATMENT.

(a) The commissioner of workers' compensation may order or direct the system or the institution to reduce or suspend the compensation of an injured employee who:

(1) persists in insanitary or injurious practices that tend to imperil or retard the employee's recovery; or

(2) refuses to submit to medical, surgical, chiropractic, or other remedial treatment recognized by the state that is reasonably essential to promote the employee's recovery.

(b) Compensation may not be reduced or suspended under this section without reasonable notice to the employee and an opportunity to be heard.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.301, eff. September 1, 2005.

Sec. 502.068. POSTPONEMENT OF HEARING.

If an injured employee is receiving benefits under this chapter and the system or the institution is providing hospitalization, medical treatment, or chiropractic care to the employee, the division may postpone the hearing on the employee's claim. An appeal may not be taken from a division order under this section.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.302, eff. September 1, 2005.

Sec. 502.069. NOTICE OF APPEAL; NOTICE OF TRIAL COURT JUDGMENT; OFFENSE.

(a) In each case appealed from the division to a county or district court:

(1) the clerk of the court shall mail to the division:

(A) not later than the 20th day after the date the case is filed, a notice containing the style, number, and date of filing of the case; and

(B) not later than the 20th day after the date the judgment is rendered, a certified copy of the judgment; and

(2) the attorney preparing the judgment shall file the original and a copy of the judgment with the clerk.

(b) An attorney's failure to comply with Subsection (a)(2) does not excuse the failure of a county or district clerk to comply with Subsection (a)(1)(B).

(c) The duties of a county or district clerk under Subsection (a)(1) are part of the clerk's ex officio duties, and the clerk is not entitled to a fee for the services.

(d) A county or district clerk who violates this section commits an offense. An offense under this section is a misdemeanor punishable by a fine not to exceed $250.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.303, eff. September 1, 2005.

Sec. 502.070. ATTORNEY GENERAL AS LEGAL REPRESENTATIVE.

The attorney general is the institution's legal representative and may bring and defend all suits and hearings necessary to carry out the purposes of this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Chapter 501. Workers' Compensation Insurance Coverage for State Employees, Including Employees Under the Direction of or Control of the Board of Regents of Texas Tech University

Subchapter A. GENERAL PROVISIONS

Sec. 501.001. DEFINITIONS.

In this chapter:

(1) "Division" means the division of workers' compensation of the Texas Department of Insurance.

(2) "Compensable injury" has the meaning assigned to that term under Subtitle A.

(3) "Director" means the director of the State Office of Risk Management.

(4) "Office" means the State Office of Risk Management.

(5) "Employee" means a person who is:

(A) in the service of the state pursuant to an election, appointment, or express oral or written contract of hire;

(B) paid from state funds but whose duties require that the person work and frequently receive supervision in a political subdivision of the state;

(C) a peace officer employed by a political subdivision, while the peace officer is exercising authority granted under:

(i) Article 2.12, Code of Criminal Procedure; or

(ii) Articles 14.03(d) and (g), Code of Criminal Procedure;

(D) a member of the state military forces, as defined by Section 431.001, Government Code, who is engaged in authorized training or duty; or

(E) a Texas Task Force 1 member, as defined by Section 88.301, Education Code, who is activated by the Texas Division of Emergency Management or is injured during training sponsored or sanctioned by Texas Task Force 1.

(6) "State agency" includes a department, board, commission, or institution of this state.

(7) "Board" means the risk management board.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1997, 75th Leg., ch. 1098, Sec. 2, eff. Sept. 1, 1997; Acts 1999, 76th Leg., ch. 1205, Sec. 5, eff. Sept. 1, 1999; Acts 2001, 77th Leg., ch. 1456, Sec. 14.02, eff. June 17, 2001; Acts 2003, 78th Leg., ch. 644, Sec. 3, eff. June 20, 2003.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.288, eff. September 1, 2005. Acts 2009, 81st Leg., R.S., Ch. 1146, Sec. 2B.09, eff. September 1, 2009.

Sec. 501.002. APPLICATION OF GENERAL WORKERS' COMPENSATION LAWS; LIMIT ON ACTIONS AND DAMAGES.

(a) The following provisions of Subtitles A and B apply to and are included in this chapter except to the extent that they are inconsistent with this chapter:

(1) Chapter 401, other than Section 401.012 defining "employee";

(2) Chapter 402;

(3) Chapter 403, other than Sections 403.001-403.005;

(4) Chapters 404 and 405;

(5) Subchapters B and D through H, Chapter 406, other than Sections 406.071(a), 406.073, and 406.075;

(6) Chapter 408, other than Sections 408.001(b) and (c);

(7) Chapters 409 and 410;

(8) Subchapters A and G, Chapter 411, other than Sections 411.003 and 411.004;

(9) Chapters 412-417; and

(10) Chapter 451.

(b) For the purposes of this chapter and Chapter 451, the individual state agency shall be considered the employer.

(c) For the purpose of applying the provisions listed by Subsection (a) to this chapter, "insurer" or "employer" means "state," "office," "director," or "state agency," as applicable.

(d) Neither this chapter nor Subtitle A authorizes a cause of action or damages against the state, a state agency, or an employee of the state beyond the actions and damages authorized by Chapter 101, Civil Practice and Remedies Code.

(e) For the purposes of this chapter and Chapter 451, the adjutant general is considered the employer of a member of the state military forces while engaged in authorized training or duty.

(f) For purposes of this chapter and Subchapter D, Chapter 88, Education Code, the Texas Engineering Extension Service of The Texas A&M University System shall perform all duties of an employer in relation to a Texas Task Force 1 member who is injured and receives benefits under this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1995, 74th Leg., ch. 980, Sec. 2.01, eff. Sept. 1, 1995; Acts 1997, 75th Leg., ch. 1098, Sec. 3, eff. Sept. 1, 1997; Acts 1999, 76th Leg., ch. 1205, Sec. 6, eff. Sept. 1, 1999; Acts 2003, 78th Leg., ch. 644, Sec. 4, eff. June 20, 2003.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.289, eff. September 1, 2005.

Sec. 501.003. LEGAL BENEFICIARY OF DECEASED EMPLOYEE.

(a) The provisions of this chapter and the rules of the board affecting an employee also apply to the legal beneficiary of a deceased employee.

(b) In this section, "legal beneficiary" has the meaning assigned to that term under Section 401.011.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1997, 75th Leg., ch. 1098, Sec. 4, eff. Sept. 1, 1997.

Subchapter B. COVERAGE

Sec. 501.021. WORKERS' COMPENSATION COVERAGE FOR EMPLOYEES.

An employee with a compensable injury is entitled to compensation by the director as provided by this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 501.022. EMPLOYEES OF COMPONENT INSTITUTIONS OF TEXAS TECH UNIVERSITY SYSTEM.

(a) An eligible employee of Texas Tech University, Texas Tech University Health Sciences Center, Angelo State University, or another agency under the direction and control of the board of regents of Texas Tech University System is entitled to participate in the workers' compensation program for state employees provided under this chapter.

(b) For purposes of this chapter, Texas Tech University is a state agency and shall act in the capacity of employer.

(c) For purposes of this chapter, Texas Tech University Health Sciences Center is a state agency and shall act in the capacity of employer.

(d) For purposes of this chapter, Angelo State University is a state agency and shall act in the capacity of employer.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1995, 74th Leg., ch. 980, Sec. 2.02, eff. Sept. 1, 1995.

Amended by: Acts 2007, 80th Leg., R.S., Ch. 179, Sec. 12, eff. September 1, 2007.

Sec. 501.024. EXCLUSIONS FROM COVERAGE.

The following persons are excluded from coverage as an employee under this chapter:

(1) a person performing personal services for the state as an independent contractor or volunteer;

(2) a person who at the time of injury was performing services for the federal government and who is covered by some form of federal workers' compensation insurance;

(3) a prisoner or inmate of a prison or correctional institution, other than a work program participant participating in a Texas Correctional Industries contract described by Section 497.006, Government Code;

(4) a client or patient of a state agency;

(5) a person employed by the Texas Department of Transportation who is covered under Chapter 505;

(6) a person employed by The University of Texas System who is covered by Chapter 503; and

(7) a person employed by The Texas A&M University System who is covered by Chapter 502.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1999, 76th Leg., ch. 1188, Sec. 1.45, eff. Sept. 1, 1999; Acts 1999, 76th Leg., ch. 1205, Sec. 7, eff. Sept. 1, 1999.

Sec. 501.025. COVERAGE FOR OUT-OF-STATE EMPLOYEES.

(a) An employee who performs services outside the state is entitled to benefits under this chapter even if the person:

(1) is hired or not hired in this state;

(2) does not work in this state;

(3) works both in this state and out of state;

(4) is injured outside this state; or

(5) has been outside this state for more than one year.

(b) An employee who elects to pursue remedies provided by the state where the injury occurred is not entitled to benefits under this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 501.026. COVERAGE FOR CERTAIN SERVICES PROVIDED BY VOLUNTEERS.

(a) In this section, "disaster" means an occurrence in which the governor has issued a declaration of a state of disaster under Chapter 418, Government Code, or another occurrence that initiates the state emergency management plan.

(b) A person not otherwise covered by workers' compensation insurance for the services performed under this section who performs volunteer services for the state in a disaster or in scheduled emergency response training under the direction of an officer or employee of the state is entitled to medical benefits under this chapter for an injury sustained by the person in the course of providing those services. For purposes of this subsection, an injury is not sustained in the course of providing services in a disaster unless the injury occurs while the state of disaster may reasonably be considered to be in existence.

(c) A person employed by a political subdivision who is injured in the course of providing services described by Subsection (b) is entitled to benefits as provided by that subsection only if the services are performed outside the jurisdiction of the political subdivision by which the person is employed.

(d) A person entitled to benefits under this section may receive the benefits only if the person seeks medical attention from a doctor for the injury not later than 48 hours after the occurrence of the injury or after the date the person knew or should have known the injury occurred. The person shall comply with the requirements of Section 409.001 by providing notice of the injury to the division or the state agency with which the officer or employee under Subsection (b) is associated.

Added by Acts 1999, 76th Leg., ch. 985, Sec. 1, eff. June 18, 1999.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.290, eff. September 1, 2005.

Subchapter C. ADMINISTRATION

Sec. 501.0431. COMPILATION OF STATISTICS RELATING TO FRAUD.

The director shall maintain statistics on the number, type, and disposition of fraudulent claims for medical benefits under this chapter.

Added by Acts 1997, 75th Leg., ch. 1153, Sec. 6.02(b), eff. Sept. 1, 1997.

Sec. 501.044. EFFECT OF SICK LEAVE; ANNUAL LEAVE.

(a) An employee may elect to use accrued sick leave before receiving income benefits. If an employee elects to use sick leave, the employee is not entitled to income benefits under this chapter until the employee has exhausted the employee's accrued sick leave.

(b) An employee may elect to use all or any number of weeks of accrued annual leave after the employee's accrued sick leave is exhausted. If an employee elects to use annual leave, the employee is not entitled to income benefits under this chapter until the elected number of weeks of leave have been exhausted.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1999, 76th Leg., ch. 953, Sec. 2, eff. Sept. 1, 1999.

Sec. 501.045. EFFECT OF EMERGENCY LEAVE.

(a) Payments for emergency leave authorized by the administrative head of a state agency in accordance with the General Appropriations Act for an employee receiving income benefits under this chapter may not:

(1) exceed for a month the amount computed by subtracting the amount of income benefits received for the month from the basic monthly wage of the employee; and

(2) be paid for a period longer than six months after the date on which benefits begin.

(b) The administrative head authorizing the emergency leave payments shall review the merits of each case individually.

(c) If payment for emergency leave is authorized, the state agency shall attach a statement of the reasons for the authorization to its duplicate payroll voucher for the first payroll period affected by the leave.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 501.046. REPORTS OF TERMINATION OR CONTINUATION OF INJURIES.

In addition to other reports required by the board, the director shall file a subsequent report not later than the 10th day after the date of the termination of the injured employee's incapacity. If the employee's incapacity extends beyond 60 days, the director shall file a subsequent report before the 70th day after the date the employee's incapacity began.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1997, 75th Leg., ch. 1098, Sec. 5, eff. Sept. 1, 1997.

Sec. 501.048. STATE AGENCY SUMMARY IN BUDGET REQUESTS.

Each state agency shall submit in the administrative statement of its biennial budget request a summary containing:

(1) the number of first reports of injury filed by the agency during the preceding biennium;

(2) the amount of workers' compensation indemnity and medical benefits paid to or for employees during the preceding biennium;

(3) the number of on-the-job injuries per 100 of its employees during each year of the preceding biennium; and

(4) a description of the efforts made by the agency to increase job safety and to reduce job injuries, including the participation of the head of the agency and the executive staff of the agency in training programs offered by the division and others.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 501.050. NOTICE OF APPEAL; NOTICE OF TRIAL COURT JUDGMENT; OFFENSE.

(a) In each case appealed from the division to a county or district court:

(1) the clerk of the court shall mail to the division:

(A) not later than the 20th day after the date the case is filed, a notice containing the style, number, and date of filing of the case; and

(B) not later than the 20th day after the date the judgment is rendered, a certified copy of the judgment; and

(2) the attorney preparing the judgment shall file the original and a copy of the judgment with the clerk.

(b) An attorney's failure to comply with Subsection (a)(2) does not excuse the failure of a county or district clerk to comply with Subsection (a)(1)(B).

(c) The clerk is not entitled to a fee for the services.

(d) A county or district clerk who violates this section commits an offense. An offense under this subsection is a misdemeanor punishable by a fine not to exceed $250.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by: Acts 2005, 79th Leg., Ch. 265, Sec. 3.291, eff. September 1, 2005.

Sec. 501.051. PAYMENT OF MEDICAL AND INDEMNITY BENEFITS.

Medical benefit and income benefit payments made by the office are subject to this subtitle and are exempt from Chapter 2251, Government Code.

Added by Acts 1999, 76th Leg., ch. 953, Sec. 3, eff. Sept. 1, 1999.

Syndicate content