TITLE 25.HEALTH SERVICES

Part 2. TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Chapter 405. CLIENT (PATIENT) CARE

Subchapter D. DETERMINATION OF MENTAL RETARDATION AND APPROPRIATENESS FOR ADMISSION TO MENTAL RETARDATION SERVICES

25 TAC §§405.81 - 405.92

(Editor's note: The text of the following sections proposed for repeal will not be published. The sections may be examined in the offices of the Texas Department of Mental Health and Mental Retardation or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Texas Department of Mental Health and Mental Retardation (department) proposes the repeal of §§405.81 - 405.92 of Chapter 405, Subchapter D, concerning determination of mental retardation and appropriateness for admission to mental retardation services.

The repeal is part of a comprehensive reorganization of chapters and subchapters within the department's portion of the Texas Administrative Code in conjunction with the sunset review of agency rules required by Texas Government Code, §2001.039 (as added by Senate Bill 178, Section 1.11, 76th Legislature).

The subject matter of the repealed subchapter is addressed in new §§415.151 - 415.163 of Chapter 415, Subchapter D, concerning diagnostic eligibility for services and supports--mental retardation priority population and related conditions, which is proposed contemporaneously in this issue of the Texas Register for public review and comment.

William R. Campbell, deputy commissioner, Finance and Administration, has determined that for each year of the first five years the proposed repeal is in effect, enforcing or administering the repeal does not have foreseeable implications relating to costs or revenues of the state or local governments.

Barry Waller, director, Long Term Services and Supports, has determined that for each year of the first five years the repeal is in effect, the public benefit is expected to be a comprehensive, system-wide approach to determining whether an individual is diagnostically eligible to receive services and supports as part of the department's mental retardation priority population or as a result of having a related condition. It is not anticipated that the repeal will have an adverse economic effect on small businesses or micro businesses because the repeal does not result in additional requirements on them. It is not anticipated that the proposed repeal will affect a local economy.

Comments concerning this proposal must be submitted in writing to Linda Logan, director, Policy Development, Texas Department of Mental Health and Mental Retardation, by mail to P.O. Box 12668, Austin, Texas 78711, or by fax to (512) 206-4750, within 30 days of publication of this notice.

The repeal of the subchapter is proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority, §591.004 provides the board with authority to adopt rules implementing the Persons with Mental Retardation Act (PMRA), §592.002, which requires the board to adopt rules ensuring the implementation of rights guaranteed in the PMRA, including the right to a DMR (§592.018) and the right to an administration hearing to contest the findings of a DMR (§592.019).

Texas Health and Safety Code, §§532.015, 591.004, 592.002, 592.108, 592.019, and Chapter 593, Subchapter A are affected by the proposed repeal.

§405.81.Purpose.

§405.82.Application.

§405.83.Definitions.

§405.84.Certification of Associate Psychologists by the Department.

§405.85.Determination of Mental Retardation.

§405.86.Admission to Community-Based Services.

§405.87.Admission or Commitment to a Residential Care Facility.

§405.88.General Provisions.

§405.89.Charges for Determination of Mental Retardation and Admissions Eligibility.

§405.90.Report Formats.

§405.91.Distribution.

§405.92.References.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on August 7, 2000.

TRD-200005486

Charles Cooper

Chair, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: September 17, 2000

For further information, please call: (512) 206-4516


Chapter 415. PROVIDER CLINICAL RESPONSIBILITIES

Subchapter D. DIAGNOSTIC ELIGIBILITY FOR SERVICES AND SUPPORTS--MENTAL RETARDATION PRIORITY POPULATION AND RELATED CONDITIONS

25 TAC §§415.151 - 415.163

The Texas Department of Mental Health and Mental Retardation (department) proposes new §§415.151 - 415.163 of Chapter 415, Subchapter D, concerning diagnostic eligibility for services and supports--mental retardation priority population and related conditions. The new subchapter will replace existing Chapter 405, Subchapter D, concerning determination of mental retardation and appropriateness for admission to mental retardation services, the repeal of which is proposed contemporaneously for public review and comment in this issue of the Texas Register .

The new subchapter is part of a comprehensive reorganization of chapters and subchapters within the department's portion of the Texas Administrative Code in conjunction with the sunset review of agency rules required by Texas Government Code, §2001.039 (as added by Senate Bill 178, §1.11, 76th Legislature).

The new subchapter describes the: criteria and process to be followed by psychologists licensed to practice in Texas, TDMHMR-certified psychologists, and physicians licensed to practice in Texas when conducting a determination of mental retardation (DMR); process to be followed by a mental retardation authority (MRA) when reviewing a DMR conducted by another entity; process to be followed by an MRA when assessing whether an individual meets the criteria for a diagnosis of pervasive development disorder (PDD) or a related condition; process to be followed by an MRA when assessing an individual's service and support needs; criteria and process to be followed by an MRA when assessing an individual's appropriateness for services in a state mental retardation facility (state MR facility); and criteria and process to be followed by the department when designating an employee of an MRA, state facility, or the department's Central Office as a TDMHMR-certified psychologist.

William R. Campbell, deputy commissioner, Finance and Administration, has determined that for each year of the first five years the proposed new subchapter is in effect, enforcing or administering the new subchapter does not have foreseeable implications relating to costs or revenues of the state or local governments.

Barry Waller, director, Long Term Services and Supports, has determined that for each year of the first five years the new subchapter is in effect, the public benefit is expected to be a comprehensive, system-wide approach to determining whether an individual is diagnostically eligible to receive services and supports as part of the department's mental retardation priority population or as a result of having a related condition. It is not anticipated that the new section will have an adverse economic effect on small businesses or micro businesses because the new subchapter does not place requirements on them. It is not anticipated that the proposed new subchapter will affect a local economy.

Comments concerning this proposal must be submitted in writing to Linda Logan, Director, Policy Development, Texas Department of Mental Health and Mental Retardation, by mail to P.O. Box 12668, Austin, Texas 78711, or by fax to (512) 206-4750, within 30 days of publication of this notice.

The new sections are proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority, §591.004 provides the board with authority to adopt rules implementing the Persons with Mental Retardation Act (PMRA), §592.002, which requires the board to adopt rules ensuring the implementation of rights guaranteed in the PMRA, including the right to a DMR (§592.018) and the right to an administration hearing to contest the findings of a DMR (§592.019).

Texas Health and Safety Code, §§532.015, 591.004, 592.002, 592.108, 592.019, and Chapter 593, Subchapter A are affected by the proposed new subchapter.

§415.151.Purpose.

The purpose of this subchapter is to describe the:

(1)

criteria and process to be followed by psychologists licensed to practice in Texas, TDMHMR-certified psychologists, and physicians licensed to practice in Texas when conducting a determination of mental retardation (DMR);

(2)

process to be followed by a mental retardation authority (MRA) when reviewing a DMR conducted by another entity;

(3)

process to be followed by an MRA when assessing whether an individual meets the criteria for a diagnosis of pervasive development disorder (PDD) or a related condition;

(4)

process to be followed by an MRA when assessing an individual's service and support needs;

(5)

criteria and process to be followed by an MRA when assessing an individual's appropriateness for services in a state mental retardation facility (state MR facility); and

(6)

criteria and process to be followed by the department when designating an employee of an MRA, state facility, or the department's Central Office as a TDMHMR-certified psychologist.

§415.152.Application.

This subchapter applies to:

(1)

mental retardation authorities (MRAs);

(2)

psychologists and physicians licensed to practice in Texas who conduct DMRs;

(3)

TDMHMR-certified psychologists;

(4)

state facilities; and

(5)

employees of MRAs, state facilities, and the department's Central Office who seek certification by the department as TDMHMR-certified psychologists as described in §415.161 of this title (relating to TDMHMR-certified Psychologist).

§415.153.Definitions.

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

(1)

Adaptive behavior--The effectiveness with or degree to which an individual meets the standards of personal independence and social responsibility expected of the individual's age and cultural group as assessed by a standardized measure.

(2)

Community center--A community mental health and mental retardation center established under the THSC, Chapter 534.

(3)

Commissioner--The commissioner of the department.

(4)

Department--The Texas Department of Mental Health and Mental Retardation.

(5)

Developmental period--Birth to 18 years of age.

(6)

Diagnostic assessment--An assessment, including a DMR, conducted to determine if an individual has mental retardation, a pervasive developmental disorder, or a related condition.

(7)

DMR (determination of mental retardation)--An assessment conducted as described in §415.155 of this title (relating to Determination of Mental Retardation (DMR)) by a TDMHMR-certified psychologist, a psychologist licensed to practice in Texas, or a physician licensed to practice in Texas to determine if an individual has mental retardation.

(8)

DSM--The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders .

(9)

Individual--A person who is the focus of a diagnostic eligibility assessment or who has been determined to be in the mental retardation priority population.

(10)

IDT (interdisciplinary team)--A group of people assembled by an MRA that assesses the treatment, training, and habilitation needs of an individual and makes recommendations for services and supports. The group typically includes:

(A)

the individual;

(B)

the individual's LAR, if any;

(C)

other concerned persons, with the approval of the individual or LAR; and

(D)

mental retardation professionals and paraprofessionals designated by the MRA.

(11)

LAR (legally authorized representative)--A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, and may include a parent, guardian, or managing conservator of a minor individual, a guardian of an adult individual, or a personal representative of a deceased individual.

(12)

Mental retardation--Consistent with THSC, §591.003, significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

(13)

Mental retardation priority population--Those individuals who meet one or more of the following criteria:

(A)

have mental retardation;

(B)

have a pervasive developmental disorder (PDD);

(C)

have a related condition and be eligible for services in a Medicaid program operated by the department;

(D)

be a nursing facility resident who is eligible for specialized services for mental retardation or a related condition pursuant to §1919(e)(7) of the Social Security Act;

(E)

be a child who is eligible for early childhood intervention (ECI) services provided in accordance with Chapter 621 of this title (relating to Early Childhood Intervention Services).

(14)

MRA (mental retardation authority)--Consistent with THSC, §533.035, an entity designated by the commissioner to which the Texas Mental Health and Mental Retardation Board delegates its authority and responsibility for planning, policy development, coordination, and resource allocation, and resource development for and oversight of services and supports in one or more local service areas.

(15)

Permanency planning--A philosophy and planning process that focuses on the outcome of family support by facilitating a permanent living arrangement with the primary feature of an enduring and nurturing parental relationship.

(16)

Pervasive developmental disorder (PDD)--As described in the most current edition of the DSM, a severe and pervasive impairment in the developmental areas of reciprocal social interaction skills or communication skills, or the presence of stereotyped behaviors, interests, and activities manifested during the developmental period, usually before 10 years of age.

(17)

Related condition--As defined in the Code of Federal Regulations (CFR), Title 42, §435.1009, a severe and chronic disability that:

(A)

is attributable to:

(i)

cerebral palsy or epilepsy; or

(ii)

any other condition, other than mental illness, found to be closely related to mental retardation because the condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with mental retardation, and requires treatment or services similar to those required for those persons with mental retardation;

(B)

is manifested before the person reaches age 22; and

(C)

is likely to continue indefinitely; and

(D)

results in substantial functional limitation in three or more of the following areas of major life activity:

(i)

self-care;

(ii)

understanding and use of language;

(iii)

learning;

(iv)

mobility;

(v)

self-direction; and

(vi)

capacity for independent living.

(18)

Services and supports--Programs and assistance funded through the department that are provided or contracted for by an MRA or state MR facility for the mental retardation priority population. As described in THSC, §593.003, the programs or assistance may include a DMR, interdisciplinary team recommendations, education, special training, supervision, care, treatment, rehabilitation, residential care, and counseling, but does not include those services or programs that have been explicitly delegated by law to other state agencies.

(19)

State facility--A state school, state hospital, or state center operated by the department.

(20)

State MR facility (state mental retardation facility)--A state school or state center operated by the department that provides residential services to persons with mental retardation.

(21)

Significantly subaverage general intellectual functioning--Consistent with THSC, §591.003, measured intelligence on standardized general intelligence tests of two or more standard deviations (not including standard error of measurement adjustments) below the age-group mean for the tests used.

(22)

TDMHMR-certified psychologist--An employee of an MRA, state facility, or the department's Central office who is certified by the department as described in §415.161 of this title (relating to TDMHMR-certified Psychologist).

(23)

THSC--Texas Health and Safety Code.

§415.154.General Provisions.

(a)

Except as described in subsection (c) of this section, an individual must have been determined to be in the mental retardation priority population before receiving services and supports.

(b)

An MRA or state facility must make appropriate accommodations when conducting a diagnostic assessment for an individual:

(1)

who does not speak English;

(2)

for whom English is a second language; or

(3)

for whom communication devices and/or techniques (including sign language) are necessary.

(c)

An individual may receive the following services and supports without being in the mental retardation priority population:

(1)

emergency services provided in accordance with Texas Health and Safety Code (THSC), §593.027 or §593.0275;

(2)

respite care in a residential care facility provided in accordance with THSC, §593.028;

(3)

in-home and family support services as described in Chapter 401, Subchapter L of this title (relating to In-Home and Family Support Program); and

(4)

services in a state MR facility ordered in accordance with Texas Family Code, §55.33 or §55.52.

§415.155.Determination of Mental Retardation (DMR).

(a)

An individual or the individual's LAR may make a written request for a DMR to:

(1)

the MRA serving the area in which the individual resides;

(2)

a psychologist licensed to practice in Texas; or

(3)

a physician licensed to practice in Texas.

(b)

An individual receiving services from a state facility may have a DMR conducted by a psychologist employed by or contracting with that state facility or a TDMHMR-certified psychologist employed by that state facility.

(c)

A DMR must be conducted as described in this subsection.

(d)

At an MRA or state facility, the DMR must be conducted by a:

(1)

psychologist licensed to practice in Texas who is employed by or contracting with the MRA or state facility; or

(2)

TDMHMR-certified psychologist who is employed by the MRA or state facility.

(e)

The psychologist, TDMHMR-certified psychologist, or physician who conducts a DMR must:

(1)

interview the individual; and

(2)

perform a professional assessment that, at a minimum, includes:

(A)

a standardized measure of the individual's intellectual functioning using the most appropriate test for the characteristics of the individual;

(B)

a standardized measure of the individual's adaptive behavior level;

(C)

a review of evidence supporting the origination of mental retardation during the individual's developmental period, which should include, as available:

(i)

reports concerning the cause of the suspected mental retardation;

(ii)

results of several or all previous assessments that are representative of the individual's typical functioning;

(iii)

types of services the individual has received or is receiving that are indicative of mental retardation;

(iv)

reports by other people, including the individual's family members and friends; and

(v)

educational history and classifications; and

(D)

a review of the individual's psychological and psychiatric treatments and diagnoses.

(f)

The interview and assessment described in subsection (e) of this section must be conducted using diagnostic techniques adapted to the individual's age, cultural background, ethnic origins, language, and physical or sensory disabilities.

(g)

A previous assessment, social history, or relevant record from another entity, including a school district, public or private agency, or another psychologist, TDMHMR-certified psychologist, or physician may be used as part of a DMR if the person who conducts the DMR considers the assessment, social history, or relevant record to be a valid reflection of the individual's current level of functioning.

(h)

Within 30 days of completing the interview and assessment described in subsection (e) of this section, the person who conducted the DMR must provide the person who requested the DMR with a written report that is dated, signed, and includes the licensure/certification number of the person who conducted the DMR. The written report must contain:

(1)

background information summarizing the individual's:

(A)

developmental history, including a description of the evidence of origination of mental retardation during the individual's developmental period; and

(B)

psychological and psychiatric treatments and diagnoses;

(2)

results of current intellectual and adaptive behavior assessments with:

(A)

instrument names and scores;

(B)

overall intellectual and adaptive behavior levels; and

(C)

individual scale scores, if available;

(3)

a narrative description of:

(A)

test results, including relative strengths and weaknesses;

(B)

testing conditions; and

(C)

any relevant negative impact on the test results because of the individual's:

(i)

cultural background;

(ii)

primary language;

(iii)

communication style;

(iv)

physical or sensory impairments;

(v)

motivation;

(vi)

attentiveness; and

(vii)

emotional factors; and

(4)

conclusions, diagnoses (to include DSM codes), and recommendations, including a statement of:

(A)

whether the individual meets the criteria for mental retardation; and

(B)

if the individual does not meet the criteria for mental retardation, whether individual meets the criteria for PDD or a related condition.

(i)

If a DMR is conducted at an MRA or state facility, the MRA or state facility must:

(1)

inform the person who applied for the DMR of the right to an:

(A)

additional, independent DMR to be conducted at the person's expense if the person questions the validity or results of the DMR; and

(B)

administrative hearing to contest the findings as described in Chapter 403, Subchapter N of this title (relating to Administrative Hearings Arising under the Persons with Mental Retardation Act); and

(2)

document that the person who applied for the DMR was informed orally and in writing of these rights.

(j)

If a DMR has been ordered by a court for guardianship proceedings, the person who conducts the DMR:

(1)

should submit the written findings and recommendations as specified in the court's order; and

(2)

may submit a current capacity assessment of the individual conducted as described in §411.61 of this title (relating to Memorandum of Understanding Concerning Capacity Assessment for Self Care and Financial Management).

(k)

An MRA must charge for a DMR in accordance with the provisions of Chapter 403, Subchapter B of this title (related to Charges for Community-based Services).

§415.156.Review and Endorsement of a DMR.

(a)

If an individual has been determined to have mental retardation by a person who is not employed by or contracting with an MRA at which the individual or the individual's LAR seeks services and supports, the DMR must be reviewed by a:

(1)

psychologist employed by or contracting with that MRA; or

(2)

TDMHMR-certified psychologist employed by that MRA.

(b)

A psychologist who contracts with the MRA to review DMRs or is employed by the MRA must not review a DMR conducted by that psychologist outside the psychologist's role as a contractor or employee of the MRA.

(c)

If a DMR reviewed as described in subsection (a) of this section is endorsed by the psychologist or TDMHMR-certified psychologist, the MRA shall:

(1)

prepare a report documenting the outcome of the review;

(2)

inform the individual or the individual's LAR orally and in writing of the outcome of the review;

(3)

assess the individual's appropriateness for services and supports as described in §415.159 this title (relating to Assessment of Individual's Need for Services and Supports); and

(4)

if services in a state MR facility are requested by the individual or the individual's LAR, convene an interdisciplinary team (IDT) as described in §415.160 of this title (relating to IDT Assessment of Whether Individual Can Be Served Most Appropriately in a State Mental Retardation Facility).

(d)

If a DMR reviewed as described in subsection (a) of this section is not endorsed by the psychologist or TDMHMR-certified psychologist, the MRA shall:

(1)

prepare a report documenting the outcome of the review; and

(2)

inform the individual or the individual's LAR orally and in writing of the:

(A)

outcome of the review; and

(B)

opportunity to have the MRA conduct a DMR at no expense to the individual or the individual's LAR.

(e)

The written report documenting the outcome of the review must be provided to the individual or the individual's LAR within 30 calendar days after the review is completed.

§415.157.Pervasive Developmental Disorder (PDD).

(a)

If an individual requesting services and supports or for whom services and supports are requested is determined not to have mental retardation, information from the DMR may be used to diagnose the individual as having a pervasive development disorder (PDD) by a psychologist employed by or contracting with an MRA or a TDMHMR-certified psychologist using criteria from the current edition of the DSM.

(b)

At a minimum, a diagnosis of PDD must be based on:

(1)

the individual exhibiting severe and pervasive impairment in the developmental areas of:

(A)

reciprocal social interaction skills;

(B)

communication skills; or

(C)

stereotyped behaviors, interests, and activities;

(2)

qualitative impairments that define these conditions which are distinctly different relative to the individual's developmental age or mental age; and

(3)

evidence of onset before 10 years of age which will include, as available:

(A)

results of previous assessments that are representative of the individual's typical functioning;

(B)

types of services the individual has received or is receiving which are indicative of a PDD; and

(C)

reports by other people, including the individual's family members and friends, that indicate a developmental history of a PDD.

(c)

If an individual has been diagnosed as having PDD by person who is not employed by or contracting with the MRA at which the individual or the individual's LAR seeks services and supports, the diagnosis must be reviewed by a:

(1)

psychologist employed by or contracting with that MRA; or

(2)

TDMHMR-certified psychologist employed by that MRA.

(d)

A psychologist who contracts with the MRA to review diagnoses of PDD or is employed by the MRA will not be permitted to review a diagnosis made by that psychologist outside of the psychologist's role as a contractor or employee of the MRA.

(e)

If a diagnosis reviewed as described in subsection (c) of this section is endorsed by the psychologist or TDMHMR-certified psychologist, the MRA shall:

(1)

document the outcome of the review in the individual's record;

(2)

inform the individual or the individual's LAR orally and in writing of the outcome of the review;

(3)

assess the individual's appropriateness for services and supports as described in §415.159 this title (relating to Assessment of Individual's Service and Support Needs).

(f)

If a diagnosis reviewed as described in subsection (c) of this section is not endorsed by the psychologist or TDMHMR-certified psychologist, the MRA shall:

(1)

document the outcome of the review in the individual's record; and

(2)

inform the individual or the individual's LAR orally and in writing of the outcome of the review

(g)

An individual who is diagnosed as having PDD may be eligible for services and supports funded by general revenue appropriations from the Texas Legislature.

§415.158.Related Condition (RC).

If an individual requesting services and supports or for whom services and supports are requested is found not to have mental retardation, information from the DMR may be used to establish eligibility for services and supports based on the existence of a related condition, as described in Chapter 406, Subchapter E of this title (relating to Eligibility and Review).

§415.159.Assessment of Individual's Need for Services and Supports.

(a)

A representative of the MRA serving the area in which an individual resides must ascertain the types of services and supports being requested and the individual's interests, choices, and needs by interviewing the:

(1)

individual and the individual's LAR; or

(2)

persons actively involved with the individual, if the individual does not have an LAR and the MRA representative believes the individual does not have the ability to understand the process and its ramifications.

(b)

The MRA representative along with the individual or the individual's LAR or persons actively involved with the individual, at a minimum, function as a planning team to develop an initial plan for services and supports. The plan may include referrals by the MRA to other appropriate service agencies.

(c)

If the individual or LAR is seeking residential mental retardation services, the MRA representative must provide both an oral and written explanation to the individual or LAR of the services and supports for which the individual may be eligible.

(1)

As required by THSC, §533.038, the explanation must address:

(A)

Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) Program services--both state mental retardation facilities and community-based facilities;

(B)

waiver services under §1915(c) of the Social Security Act; and

(C)

other community-based services and supports that may meet the individual's needs.

(2)

A copy of the written explanation must be given to the individual or LAR and the original retained in the record of the individual. The written explanation must:

(A)

describe the program and service preferences of the individual or LAR; and

(B)

be signed and dated by the individual or LAR to indicate that the explanation was provided.

(3)

If the services and supports requested by the individual or LAR are not available, the MRA must:

(A)

assist the individual or LAR in gaining access to alternative services and supports and appropriate waiting lists;

(B)

document efforts undertaken by the MRA to obtain the requested services and supports, including the names and addresses of programs and facilities to which the individual or LAR was referred; and

(C)

document the services and supports for which the individual is waiting.

§415.160.IDT Assessment of Whether Individual Can Be Served Most Appropriately in a State Mental Retardation Facility.

(a)

As required by THSC, §593.013, an individual will not be admitted for voluntary services or committed to a state MR facility unless an IDT convened by the MRA serving the area in which the individual resides:

(1)

assesses the individual's appropriateness for services in the state MR facility; and

(2)

recommends the admission or commitment.

(b)

The IDT shall:

(1)

interview the individual or the individual's LAR;

(2)

review the individual's:

(A)

social and medical history;

(B)

medical assessment, which shall include an audiological, neurological, and vision screening;

(C)

psychological and social assessment; and

(D)

assessment of adaptive behavior level;

(3)

assess the individual's need for additional assessments, including educational and vocational assessments;

(4)

obtain any additional assessments necessary to plan services;

(5)

recommend services to address the individual's needs that consider the individual's interests, choices, and goals, and, for the individual who is a child, include permanency planning as a goal; and

(6)

prepare a written report of its findings and recommendations that is signed by each team member and sent within 30 calendar days to the individual or LAR, as appropriate.

(c)

If the individual is being considered for court commitment to a state MR facility, the IDT report must have been completed within six months prior to the date of the court hearing. An IDT report ordered by a court shall be submitted promptly to the:

(1)

court as directed in the court's order; and

(2)

individual or the individual's LAR.

(d)

An individual may be admitted to a state MR facility on an emergency basis without a DMR and an IDT recommendation under the provisions of the THSC, §593.027(c). However, within 30 days of an admission for emergency services:

(1)

a DMR must be performed as described in §415.155 of this title (relating to Determination of Mental Retardation (DMR)); and

(2)

an IDT must assess the individual and make a recommendation as described in this section.

§415.161.TDMHMR-certified Psychologist.

(a)

An employee of an MRA, state facility, or the department's Central Office who is not a licensed psychologist may apply to become a TDMHMR-certified psychologist by submitting:

(1)

a written request for certification to the department's commissioner or designee, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668; and

(2)

documentation of:

(A)

current employment by an MRA, state facility, or in Central Office;

(B)

provisional licensure as a psychologist or licensure as a psychological associate or specialist in school psychology;

(C)

successful completion of graduate course work in individual intellectual assessment;

(D)

supervised experience in adaptive behavior assessment; and

(E)

one year of employment in the field of mental retardation.

(b)

The department's commissioner or designee will review the documentation submitted as described in subsection (a) of this section. If the documentation is determined to be acceptable, the department's commissioner or designee will issue a certificate designating the person as a TDMHMR-certified psychologist.

(c)

A person certified as an associate psychologist and employed by an MRA, state facility, or Central Office as of the effective date of this subchapter will be designated as a TDMHMR-certified psychologist without the submission of the documentation required in subsection (a)(2) of this section, if a written request to do so is submitted by the person's supervisor. The department will issue a new certificate designating that person as a TDMHMR-certified psychologist.

(d)

A TDMHMR-certified psychologist is permitted to conduct DMRs only while functioning as an employee of an MRA, state facility, or the department's Central Office.

(e)

A person's designation as a TDMHMR-certified psychologist will become ineffective if the person fails to maintain active licensure status as described in subsection (a)(2)(B) of this section, unless the person's designation was granted as described in subsection (c) of this section.

§415.162.References.

Reference is made in this subchapter to the following statutes, federal regulations, rules of the department and of other state agencies, and other relevant documents:

(1)

Social Security Act, §1915(b);

(2)

Code of Federal Regulations, Title 42, §435.1009;

(3)

THSC, Chapter 534, §§533.038, 591.003, 592.018, 593.003, 593.013, 593.027, 593.0275, 593.028;

(4)

Texas Family Code, §55.33 or §55.52;

(5)

Chapter 401, Subchapter L of this title (relating to In-Home and Family Support Program);

(6)

Chapter 403, Subchapter B of this title (related to Charges for Community-based Services);

(7)

Chapter 403, Subchapter N of this title (relating to Administrative Hearings Arising Under the Persons with Mental Retardation Act);

(8)

Chapter 406, Subchapter E of this title (relating to Eligibility and Review);

(9)

§411.61 of this title (relating to Memorandum of Understanding Concerning Capacity Assessment for Self Care and Financial Management);

(10)

Chapter 621 of this title (relating to Early Childhood Intervention Services); and

(11)

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders .

§415.163.Distribution.

(a)

This subchapter is distributed to:

(1)

members of the Texas Mental Health and Mental Retardation Board;

(2)

executive, management, and program staff in the department's Central Office;

(3)

superintendents/directors of state facilities;

(4)

executive directors of state-operated community services;

(5)

chairs of boards of trustees of community centers;

(7)

executive directors of mental retardation authorities;

(8)

interested advocates and advocacy organizations

(9)

all county and juvenile court judges; and

(10)

commissioners of the following state agencies:

(A)

Texas Department of Health;

(B)

Texas Department of Human Resources;

(C)

Texas Department of Protective and Regulatory Services;

(D)

Texas Health and Human Services Commission;

(E)

Texas Education Agency;

(F)

Texas Rehabilitation Commission; and

(G)

Texas Youth Commission.

(b)

The superintendent/director of each state facility and the executive director of each MRA is responsible for distributing copies of this subchapter to appropriate staff.

(c)

A copy of this subchapter will be provided to any person who requests it.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on August 7, 2000.

TRD-200005487

Charles Cooper

Chair, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: September 17, 2000

For further information, please call: (512) 206-4516