1. (a) The provision of all services is subject to the availability of funds.

2. (b) In order to conform to budgetary limitations, emergency care for persons below age 19 is the first priority of the treatment program. Private providers are bound by the guidelines for participation as set forth in the State Dental Care Program Manual for Providers, which lists the emergency dental procedures for which payment will be made. Private providers may provide more comprehensive dental care to persons below 19 or emergency care to persons age 19 or older only with prior written approval of the regional dental director, or in his/her absence, the regional medical director. More comprehensive dental care may be provided to persons below 19 or emergency care may be provided to persons age 19 or older by nonprivate providers or directly by the department when the attending dentist or physician believes such care is warranted and when the provision of such services will not preclude eligible individuals under age 19 who need emergency care from receiving services.

   1. (1) The department adopts by reference the department's document entitled State Dental Care Program Manual for Providers of Services.
   2. (2) A copy is indexed and filed in the Bureau of Dental Health, Texas Department of Health, 1100 West 49th Street, Austin, and is available for public inspection during regular business hours.
3. (c) Occasionally, an individual cannot be treated in a dental office or will require special treatment for aesthetic reasons or to restore mastication. Examples include very young persons with rampant dental caries who must be treated under general anesthesia or children whose front teeth must be extracted and who need partials to prevent serious problems that could be caused by their edentulous appearance. The program allows for such services, subject to budgetary limitations. Approval of such services shall be determined on a case by case basis by the bureau chief. The attending dentist or physician shall submit a special handling request form to the regional dental director, or in his/her absence, the regional medical director, which includes a treatment plan, cost estimate of treatment, and a recommendation as to the special dental needs necessitating the request. The regional dental director, or in his/her absence, the regional medical director, will add a recommendation in the appropriate space before forwarding the request to the department for consideration. Payment will not be made for services provided prior to the bureau chief's approval.
4. (d) Program services are available in every public health region of the state. Program administration is carried out through the department's public health regions. Due to budgetary limitations, each regional dental director establishes the priority areas to be served and the method for serving those areas based on resources and manpower available within the region and the region's demographic data.

Source Note:The provisions of this §49.3 adopted to be effective September 9, 1986, 11 TexReg 3793.