TITLE 25.HEALTH SERVICES

Part 2. TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Chapter 414. PROTECTION OF CONSUMERS AND CONSUMER RIGHTS

Subchapter K. CRIMINAL HISTORY CLEARANCES

25 TAC §§414.501 - 414.509

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts the repeals of §§414.501 - 414.509 of Chapter 414, Subchapter K, concerning criminal history clearances, without changes to the proposal as published in the October 5, 2001, issue of the Texas Register (26 TexReg 7796). New §§414.501 - 414.509 of Chapter 414, Subchapter K, concerning criminal history and registry clearances, which replace the repealed sections, are contemporaneously adopted in this issue of the Texas Register .

The repeals allow for the adoption of new sections governing the same matters.

The contemporaneous repeal and adoption of these subchapters would fulfill the requirements of the Texas Government Code, §2001.039, concerning the periodic review of agency rules.

No comment on the proposal was received.

These sections are adopted for repeal under the Texas Health and Safety Code, §532.015, which provides the Texas Mental Health and Mental Retardation Board (board) with broad rulemaking authority; §250.002(d), which authorizes a regulatory state agency to adopt rules relating to the processing of criminal history information; §533.007(b), which authorizes the board to adopt rules relating to the use of criminal history information; and the Texas Government Code, §411.115, which authorizes TDMHMR to obtain criminal history information from the Texas Department of Public Safety.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 17, 2002.

TRD-200200252

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Effective date: February 6, 2002

Proposal publication date: October 5, 2001

For further information, please call: (512) 206-5216


Subchapter K. CRIMINAL HISTORY AND REGISTRY CLEARANCES

25 TAC §§414.501 - 414.509

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts new §§414.501 - 414.509 of Chapter 414, Subchapter K, concerning criminal history and registry clearances. Sections 414.502 - 414.504, 414.507, 414.509 are adopted with changes to the proposed text as published in the October 5, 2001, issue of the Texas Register (26 TexReg 7796-7800). Sections 414.501, 414.505, 414.506, and 414.508 are adopted without changes. The repeals of existing §§414.501 - 414.509 of Chapter 414, Subchapter K, concerning criminal history clearances, which the new sections replace, are contemporaneously adopted in this issue of the Texas Register .

The new subchapter describes the process by which criminal history and registry clearances are conducted for applicants for employment and volunteer status with facilities, local authorities, community centers, and their respective contract providers of residential services. The subchapter also requires facilities, local authorities, community centers, and contract providers to have an effective self-reporting procedure for employees and volunteers.

The new subchapter applies to local authorities in the same manner as it applies to TDMHMR facilities and community MHMR centers. It implements Senate Bill 1245 and House Bill 1418 (77th Legislature), each of which amends the Texas Health and Safety Code, §250.006, to include as a bar to employment a conviction under the laws of another state, federal law, or the Uniform Code of Military Justice for an offense containing elements that are substantially similar to the elements of an offense otherwise listed in §250.006. House Bill 1418 additionally includes as a bar to employment a felony conviction for theft under the Penal Code, Chapter 31, which occurred within the previous five years. Because both bills allow a facility, local authority, or community center to obtain criminal history record information directly from the Texas Department of Public Safety (TDPS), the subchapter eliminates the requirement (as well as the option) to obtain criminal history record information through the IS Coordinator, Criminal History Records Information (CHRI), at TDMHMR Central Office. Additionally, the new subchapter bars from employment or volunteer status applicants who are listed as revoked in the Nurse Aide Registry and who are listed as unemployable in the Employee Misconduct Registry.

The contemporaneous adoption and repeal of these subchapters fulfill the requirements of the Texas Government Code, §2001.039, concerning the periodic review of agency rules.

Minor grammatical changes have been made throughout the subchapter for clarification. Reference to the city of Austin in §414.502(a)(1), §414.503(5), and §414.509(a)(2) as it relates to TDMHMR Central Office has been deleted. Psychiatry has been included as a professional degree program in the definition of "professional clinical intern." Language has been added to the definition of "volunteer" to be consistent with the definition of "volunteer" that is in the rules governing community relations (25 TAC Chapter 417, Subchapter G) and to clarify that "volunteer" does not include a professional clinical intern. Definitions for "visiting group" and "volunteer services council" have been added because the two terms are used in the revised definition of "volunteer." Language has been added to §414.504(c) clarifying that the written agreement with a university or college must state that background checks of professional clinical interns must ensure compliance with §414.504(d), which describes who may not serve as an employee, volunteer, or professional clinical intern, and that the written agreement must also include a description of how background checks will be conducted and funded. Language has been added to §414.504(d) to include professional clinical interns.

A provision has been added as a new subsection (a) in §414.507 requiring each facility, local authority, community center, and provider to initiate a registry check of all current employees and volunteers upon the effective date of the subchapter. The provision requires immediate discharge of an employee/volunteer who is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry. The self-reporting requirement in §414.507 has been expanded to include reporting of a subsequent listing in the Nurse Aide Registry or Employee Misconduct Registry. Language has been deleted in proposed §414.507(c)(2)(B) that allowed the employer to consider mitigating circumstances in cases in which the employer discovered that, after employment or assignment of volunteer status, an employee/volunteer's criminal history record information revealed a conviction for an offense determined to be a contraindication to employment or volunteer status. Language has been added allowing the employer to consider any contention by the employee/volunteer concerning errors of fact or identity in the criminal history record information; to permit the employee/volunteer to rectify the accuracy of the information; and to remove the employee/volunteer from direct contact with consumers while the employee/volunteer attempts to rectify the accuracy of the information. New language also states that if the employee/volunteer fails to rectify the accuracy of the information, as provided by Texas Health and Safety Code, §250.005(b), then the employer must immediately discharge the employee/volunteer. Language has been added to §414.507(d) that requires immediate discharge of an employee/volunteer who is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry.

The fiscal note for the proposed rules stated that there were no foreseeable significant fiscal implications because the proposed new rules were not substantially different from the rules proposed for repeal. However, a change in FBI charges and procedures has fiscal implications for facilities, community centers, local authorities, and providers related to the requirement to obtain criminal history information from the FBI for applicants who have lived outside the State of Texas at any time during the two years preceding the application. The cost of each FBI fingerprint check has increased by $15, from $24 to $39.

Written comment on the proposal was received from Spindletop MHMR Services, Beaumont; Texana MHMR Center, Rosenberg; Lubbock Regional MHMR, Lubbock; Parent Association for the Retarded of Texas, Austin; and the parent of a state school resident in Garland.

Two commenters acknowledged that the proposed rules prohibit a facility, local authority, or community center from hiring an applicant who is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry. The two commenters asked if facilities, local authorities, and community centers were supposed to check the registries to determine whether any current employee were listed and, if a current employee were listed, whether the employee should be discharged. One of the commenters asked if there was latitude for discretion. The two commenters expressed concern that since the definition of "reportable conduct" as it applies to the Employee Misconduct Registry has not been resolved, their organizations may be forced to discharge an employee for a minor incident. TDMHMR responds that language has been added requiring facilities, local authorities, community centers, and providers to initiate registry checks for all current employees and volunteers upon the effective date of the subchapter, and, as required by law (Texas Health and Safety Code, §250.003(c)), to immediately discharge any employee/volunteer who is listed in a registry as revoked or unemployable. Regarding the unresolved definition of "reportable conduct," TDMHMR notes that the Texas Health and Safety Code, §253.001(5), defines "reportable conduct" to include abuse or neglect that causes or may cause death or harm to a resident or consumer of a facility; sexual abuse of a resident or consumer of a facility; financial exploitation of a resident or consumer of a facility in an amount of $25 or more; and emotional, verbal, or psychological abuse that causes harm to a resident or consumer of a facility. ("Facility" is defined to mean a facility licensed by DHS or an adult foster care provider that contracts with DHS.) Additionally, the Texas Department of Protective and Regulatory Services (PRS) has recently proposed rules governing the Employee Misconduct Registry (40 TAC Chapter 711, Subchapter O), in which harm that is related to abuse or neglect is clarified as serious physical injury , and harm that is related to emotional or verbal abuse is clarified as substantial . TDMHMR also notes that PRS's proposed rules would apply only to local authority and community center employees who perform services for a Medicaid home and community-based services waiver program (i.e., HCS, HCS-O, and MRLA) and who are found to have committed reportable conduct.

One commenter questioned the proposal's fiscal note which stated there was no foreseeable significant implications relating to cost or revenue of the state or local governments. The commenter expressed concern that the charge increase for obtaining criminal history information from the Texas Department of Public Safety (DPS) from $1 to $3.15 is considered significant for the commenter's organization. TDMHMR responds that the charge for obtaining criminal history information from the Texas Department of Public Safety (DPS) did not increase; it remains at $1 per name check.

A commenter asked why the proposed rules did not recognize "that people do become rehabilitated at some point" and whether there was any possibility that persons whose names are listed in the registry for certain types of misconduct might be removed after 10 or 15 years. TDMHMR responds that it is not authorized to adopt rules governing the Employee Misconduct Registry or the Nurse Aide Registry. The registries are maintained by the Texas Department of Human Services (DHS), pursuant to the Texas Health and Safety Code, Chapters 250 and 253. Only DHS and PRS may adopt rules governing the submission of names to the registries.

Regarding the requirement for local authorities to require their contract providers of residential services to comply with the subchapter in §414.502(b), one commenter stated that the provision would require a change in the MRLA Provider Principles because MRLA providers contract with TDMHMR Central Office and are not currently held to the subchapter's standards. The commenter also stated that such a requirement "will be an issue for both those providers and for Survey/Certification at the local authority level." TDMHMR responds that there is no connection between the MRLA Provider Principles and this subchapter. TDMHMR notes that MRLA providers who contract with TDMHMR Central Office must conduct criminal history and registry checks of their employees, applicants, and contractors pursuant to Chapter 409, Subchapter L of this title (concerning Mental Retardation Local Authority (MRLA) Program), P41. of the MRLA Program Principles for Program Providers.

Regarding criminal history and registry clearances for interns in §414.504(c)(2), one commenter asked if there was a definition for intern and recommended that a definition include only those who serve more than 50 hours at the facility, local authority, or community center. The commenter stated that her community center provides experimental work sites for 80 to 100 students per year, with some students spending less than eight hours on site. The commenter expressed concern that the charge for criminal history information ($1 for a DPS check and approximately $40 for a FBI check) for every intern, regardless of the amount of time served on-site, could cause a center reduce the number of interns permitted to serve, which would severely limit the exposure of students to the behavioral health field. TDMHMR responds that a definition for "professional clinical intern" is contained in §414.503(8), and does not include a minimum number of hours of service. TDMHMR notes that language has been added to §414.504(c) clarifying that the written agreement with a university or college must state that background checks of professional clinical interns must ensure compliance with §414.504(d), which describes who may not serve as an employee, volunteer, or professional clinical intern, and that the written agreement must also include a description of how background checks will be conducted and funded. The rule does not preclude a facility, local authority, or community center from requiring the university or college to pay for the costs of conducting background checks.

Regarding obtaining criminal history information from the FBI for applicants who have lived outside the State of Texas any time during the past two years in §414.505(c), one commenter expressed concern that the approximately $40 charge could prove costly over time, particularly for volunteers who have a high rate of turnover. TDMHMR responds that state statute clearly intends for TDMHMR, local authorities, community centers, and contract providers of residential services to take reasonable steps to ensure the safety of individuals with mental illness and mental retardation in their care by conducting criminal history checks of applicants, employees, and volunteers. It is unfortunate that the charge for obtaining criminal history information through the FBI has increased so dramatically, but FBI checks have proven to be effective at revealing convictions that are absolute bars to employment/volunteer status. TDMHMR notes that if FBI checks for volunteers become too costly, the facility, local authority, community center, or provider has the option of limiting volunteer applicants to those individuals who have lived in the State of Texas during the past two years.

Regarding reassignment of an employee until resolution of matters relating to an arrest warrant or wanted person's notice in §414.507(c)(1), one commenter recommended establishing a reasonable timeframe for resolution. The commenter stated that a lengthy reassignment period could create a hardship for the employer. TDMHMR responds that reassignment of an employee until resolution of matters relating to an arrest warrant or wanted person's notice is permissive. Depending upon the matters related to the warrant or notice, the employer may choose to not reassign the employee pending resolution. TDMHMR notes that §414.507(c) requires each facility, local authority, community center, and provider to develop written policies and procedures consistent with this subchapter describing how it will respond to information obtained through self-reporting and subsequent criminal history and registry checks. These policies and procedures could establish a reasonable timeframe for reassignment or for resolution. TDMHMR also notes that the Texas Health and Safety Code, §533.007(b), prohibits adverse personnel action (e.g., discharge, demotion) based on arrest warrant or wanted persons information.

Regarding reassignment of an employee while the employee attempts to rectify the accuracy of criminal history information in §414.507(c)(2)(A), one commenter recommended establishing a reasonable timeframe for reassignment. The commenter stated that a lengthy reassignment period could create a hardship for the employer. TDMHMR responds that reassignment of an employee while the employee attempts to rectify the accuracy of criminal history information that indicates a conviction for an offense that is a bar to employment is permissive. The facility, local authority, community center, or provider may choose to immediately discharge the employee. TDMHMR notes that §414.507(c) requires each facility, local authority, community center, and provider to develop written policies and procedures consistent with this subchapter describing how it will respond to information obtained through self-reporting and subsequent criminal history and registry checks. These policies and procedures could establish a reasonable timeframe for reassignment or for rectifying inaccurate criminal history information.

Two commenters objected to use of the term "consumer" instead of "individual," which is used in the repealed rules. The commenter stated "there is no reason to change from 'individual'" and that "there is nothing wrong with using the term 'individual.'" TDMHMR responds that "individual" is a generic term used throughout this subchapter to describe several different kinds of people. To reduce the potential for confusion, "consumer" is defined to mean only those individuals receiving services from a facility, local authority, community center, or provider. TDMHMR notes that the definition of "volunteer" uses the term "individual," and individual is used to describe an elderly or disabled person in §414.504(g)(6).

Regarding the definition of "provider" in §414.503(7), two commenters asked why checks are conducted only for staff who deliver services to "individuals with mental illness or mental retardation who have been furloughed or discharged from a facility or community center as described in the Texas Government Code, §411.115(b)." The commenter asked if the rules applied to group homes and day programs and stated that individuals served in group homes and day programs need to be protected as well. TDMHMR responds that the language in the definition of provider comes from the Texas Government Code, §411.115(b)(1)(C), which entitles TDMHMR, a local authority, or a community center to obtain criminal history information for "an applicant for employment with or an employee of a business or person that contracts with the Texas Department of Mental Health and Mental Retardation, a local mental health or mental retardation authority, or a community center to provide residential services to patients with mental illness or clients with mental retardation who were furloughed or discharged from a Texas Department of Mental Health and Mental Retardation facility or community center ." Regarding group home and day programs, TDMHMR responds that it agrees with the commenter that persons served in group homes and day programs need to be protected; however, state statute does not authorize TDMHMR, local authorities, or community centers to obtain criminal history information for applicants and employees of contract providers that deliver non-residential services, such as day programs. Group homes are considered residential services; therefore, a group home provider that contracts with TDMHMR, a local authority, or a community center would be required to comply with this subchapter. Since day programs are not residential services this subchapter does not apply to day program providers that contract with TDMHMR, a local authority, or a community center. TDMHMR notes that the subchapter does not preclude TDMHMR, a local authority, or community center from requiring its contract providers of day programs to conduct criminal history and registry checks of the contractor's applicants and employees.

Regarding professional clinical interns in §414.504(c), two commenters asked why interns were exempted from criminal history and registry clearances. The commenter requested that the rule require interns to go through the same clearances as other applicants. TDMHMR responds that the subchapter does not exclude interns from criminal history checks. TDMHMR notes that language has been added requiring background checks of interns to comply with §414.504(d), which describes who may not serve as an employee, volunteer, or professional clinical intern.

Regarding the criminal convictions that constitute an absolute bar to employment in §414.504(g), two commenters requested that "assault" and "rape" be added. TDMHMR responds that the types of criminal offenses for which a conviction would bar employment is contained in state statute (Texas Health and Safety Code, §250.006). TDMHMR is not authorized to add offenses to the statutory list; however, state statute allows TDMHMR, local authorities, community centers, and providers to identify other offenses for which a conviction would be a contraindication to employment or volunteer status at that entity. TDMHMR notes that aggravated assault is a bar to employment as described in §414.504(g)(5), and rape, which is sexual assault, is a bar to employment as described in §414.504(g)(4).

Regarding criminal history checks through the FBI in §414.505(c), two commenters asked how the facility, local authority, or community center finds out if the applicant has lived outside the State of Texas within the past two years. TDMHMR responds that the employer finds out by asking the applicant, conducting a thorough review of the application, and calling references.

Regarding §414.507(c)(1) in which an employer may reassign an employee/volunteer to a non-direct care area, two commenters recommended that the rule require reassignment to a non-direct care area. TDMHMR responds that since the provision in §414.507(c)(1) relates to information pertaining to arrest warrants or wanted persons' notices, the decision to reassign the employee should depend on the matter that is associated with the warrant or notice, e.g., there should be no need to reassign an employee to a non-direct care area if the employee has an arrest warrant for an unpaid parking ticket.

Regarding proposed §414.507(c)(2)(B) in which the employer may consider mitigating circumstances, two commenters asked what could be considered "mitigating circumstances" and recommended deleting the subparagraph. TDMHMR responds language has been deleted that allowed the employer to consider mitigating circumstances in cases in which the employer discovered that, after employment or assignment of volunteer status, an employee/volunteer's criminal history record information revealed a conviction for an offense determined to be a contraindication to employment or volunteer status. Language has been added allowing the employer to consider any contention by the employee/volunteer concerning errors of fact or identity in the criminal history record information; to permit the employee/volunteer to rectify the accuracy of the information; and to remove the employee/volunteer from direct contact with consumers while the employee/volunteer attempts to rectify the accuracy of the information. New language also states that if the employee/volunteer fails to rectify the accuracy of the information, as provided by Texas Health and Safety Code, §250.005(b), then the employer must immediately discharge the employee/volunteer. TDMHMR notes that facilities, local authorities, community centers, and providers may consider mitigating circumstances in determining whether or not a conviction (for an offense not listed as a bar to employment) is a contraindication to employment or volunteer status.

Two commenters expressed concern that the proposed rules did not address how employees are reported to the Employee Misconduct Registry and the Nurse Aide Registry. The commenter suggested adding a section and asked what the guidelines were for reporting to the registries. TDMHMR responds that it is not authorized to adopt rules governing the Employee Misconduct Registry or the Nurse Aide Registry. The registries are maintained by the Texas Department of Human Services (DHS), pursuant to the Texas Health and Safety Code, Chapters 250 and 253. Only DHS and the Texas Department of Protective and Regulatory Services may adopt rules governing the submission of names to the registries.

One commenter asked if a state school employee who has committed abuse would be listed in the Employee Misconduct Registry. TDMHMR responds that, pursuant to the Texas Health and Safety Code, Chapter 253, only employees of a "facility" who have committed "reportable conduct" are listed in the Employee Misconduct Registry. "Facility" means a facility licensed by DHS or an adult foster care provider that contracts with DHS. "Reportable conduct" includes abuse or neglect that causes or may cause death or harm to a resident or consumer of a facility; sexual abuse of a resident or consumer of a facility; financial exploitation of a resident or consumer of a facility in an amount of $25 or more; and emotional, verbal, or psychological abuse that causes harm to a resident or consumer of a facility. Additionally, DHS rules (40 TAC, §93.4(b)) state that "Only acts of misconduct that occur on or after September 1, 1999, will be recorded in the registry."

These sections are adopted under the Texas Health and Safety Code, §532.015, which provides the Texas Mental Health and Mental Retardation Board (board) with broad rulemaking authority; §250.002(d), which authorizes a regulatory state agency to adopt rules relating to the processing of criminal history information; §533.007(b), which authorizes the board to adopt rules relating to the use of criminal history information; and the Texas Government Code, §411.115, which authorizes TDMHMR to obtain criminal history information from the Texas Department of Public Safety.

§414.502.Application.

(a) This subchapter applies to:

(1) facilities (which include TDMHMR Central Office);

(2) local authorities; and

(3) community centers.

(b) Facilities, local authorities, and community centers must require their contract providers of residential services, including residences certified by the intermediate care facilities for the mentally retarded or persons with a related condition (ICF/MR or ICF/MR/RC) program that are owned and operated by a local authority or community center, to comply with the applicable provisions of this subchapter.

(c) This subchapter does not apply to residences certified by the ICF/MR or ICF/MR/RC program that are owned by a local authority or community center but operated under contract by a private provider, or that are privately owned and operated. Criminal history and registry clearances are conducted for such residences in accordance with rules of the Texas Department of Human Services (TDHS) in 40 TAC §§76.101- 76.106.

§414.503.Definitions.

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

(1) Applicant--At the employer's discretion, either a person who is one of a select number of final candidates for a position as an employee or volunteer or a person to whom the employer intends to offer a position as an employee or volunteer. The term "applicant" does not include a member of the Texas MHMR Board, a member of a local authority's or community center's board of trustees, or a member of a facility's, local authority's, or community center's advisory committee that is not a public responsibility committee (PRC).

(2) Community center--A community mental health and mental retardation center established under the Texas Health and Safety Code, Title 7, Chapter 534, Subchapter A.

(3) Consumer--An individual receiving services from a facility, local authority, community center, or contract provider of residential services.

(4) Conviction--The adjudication of guilt, plea of guilty or nolo contendere, or the assessment of probation or community supervision for a violation of the Penal Code.

(5) Facility--Any state hospital, state school, or state center operated by TDMHMR, or TDMHMR Central Office.

(6) Local authority--An entity designated by the TDMHMR commissioner in accordance with the Texas Health and Safety Code, §533.035(a).

(7) Provider--Any entity or person who contracts with a facility, local authority, or community center to deliver residential services to individuals with mental illness or mental retardation who have been furloughed or discharged from a facility or community center as described in the Texas Government Code, §411.115(b). This does not include private ICF/MR or ICF/MR/RC providers.

(8) Professional clinical intern--A person who is enrolled in a formal clinical rotation at a university/college in a professional training program accredited by the appropriate licensing authority or board of examiners, or is engaged in a recognized graduate level, clinical professional degree program. Professional degree programs include, but are not limited to, clinical psychology, dentistry, medicine, nursing, occupational therapy, pharmacy, physical therapy, psychiatry, and social work.

(9) Registry--

(A) The Nurse Aide Registry maintained by the Texas Department of Human Services in accordance with §94.11 of Title 40 (relating to Registry, Findings, Inquiries); and

(B) the Employee Misconduct Registry maintained by the Texas Department of Human Services in accordance with the Texas Health and Safety Code, Chapter 253.

(10) Visiting group--A group of varying individuals associated with an organization (e.g., civic, fraternal, corporate, religious, social, service, or education), which is not affiliated with a facility, local authority, community center, or provider, that visits a facility, local authority, community center, or provider (e.g., tours) or participates in a special event and has constant and adequate staff supervision.

(11) Volunteer--An individual who is not part of a visiting group and who provides time or services to consumers, a facility, local authority, community center, volunteer services council, or provider without compensation from the facility, local authority, community center, volunteer services council, or provider other than reimbursement for actual expenses. The term does not include a professional clinical intern.

(12) Volunteer services council--A 501(c)(3) organization that is formed for the purpose of generating resources on behalf of a facility, local authority, or community center.

§414.504.Pre-employment and Pre-assignment Clearance.

(a) Each facility, local authority, community center, and provider must conduct:

(1) a pre-employment criminal history and registry clearance of all applicants (as defined) for employment; and

(2) a pre-assignment criminal history and registry clearance of all applicants for volunteer status.

(b) A provider that is required to conduct criminal history and registry clearances in accordance with the Texas Health and Safety Code, Chapter 250, must provide evidence of compliance with that law to the facility, local authority, or community center with which it contracts.

(c) For professional clinical interns, a written agreement must exist between the facility, local authority, or community center and the university/college. The written agreement must include:

(1) a statement that responsibility for the care of consumers is retained by the facility, local authority, or community center;

(2) a statement that background checks of professional clinical interns must ensure compliance with subsection (d) of this section; and

(3) a description of how background checks of professional clinical interns will be conducted and funded.

(d) The following individuals may not be employed by, assigned volunteer status at, or serve as a professional clinical intern at, a facility, local authority, community center, or provider:

(1) an individual who has been convicted of any of the criminal offenses listed in subsection (g) of this section;

(2) an individual who has been convicted of a criminal offense that the facility, local authority, community center, or provider has determined to be a contraindication to employment or volunteer status at that entity;

(3) an individual who is listed as revoked in the Nurse Aide Registry; or

(4) an individual who is listed as unemployable in the Employee Misconduct Registry.

(e) The facility, local authority, community center, or provider must inform applicants in writing at the time that application is made of the following:

(1) that a pre-employment/pre-assignment criminal history and registry clearance will be conducted;

(2) the types of criminal offenses for which a conviction would bar employment or volunteer status as required by law;

(3) that conviction of other types of criminal offenses may be considered a contraindication to employment or volunteer status at that entity; and

(4) that being listed as revoked in the Nurse Aide Registry or being listed as unemployable in the Employee Misconduct Registry would bar employment or volunteer status.

(f) An applicant who is not listed as revoked in the Nurse Aide Registry and who is not listed as unemployable in the Employee Misconduct Registry may be employed on a temporary or interim basis pending a criminal history clearance if an emergency exists in which there is a risk to the health and safety of consumers as a result of unfilled positions or in which the operations of the organization are severely impaired as determined by the chief executive officer of the facility, local authority, community center, or provider.

(1) The applicant must furnish the employer with an affidavit stating that the applicant has not been convicted of any of the criminal offenses listed in subsection (g) of this section or any criminal offense that the employer has determined is a contraindication to employment. The affidavit will be kept in the applicant's file. A sample affidavit may be obtained by contacting Human Resource Services, TDMHMR, P.O. Box 12668, Austin, Texas 78711-2668.

(2) Within 72 hours of the time the person is employed on a temporary or interim basis, the facility, local authority, community center, or provider must initiate a criminal history clearance of that person as described in §414.505 of this title (relating to Obtaining or Requesting Criminal History Record Information and Checking Registry).

(3) If the criminal history record information reveals a conviction for any of the criminal offenses listed in subsection (g) of this section or for any criminal offense that the employer has determined is a contraindication to employment, then the facility, local authority, community center, or provider must immediately discharge the person as unemployable.

(4) An applicant may not receive volunteer assignment on a temporary or interim basis pending a criminal history clearance.

(g) Consistent with the Texas Health and Safety Code, §250.006, convictions of criminal offenses which constitute an absolute bar to employment are:

(1) criminal homicide (Penal Code, Chapter 19);

(2) kidnapping and unlawful restraint (Penal Code, Chapter 20);

(3) indecency with a child (Penal Code, §21.11);

(4) sexual assault (Penal Code, §22.011);

(5) aggravated assault (Penal Code, §22.02);

(6) injury to a child, elderly individual, or disabled individual (Penal Code, §22.04);

(7) abandoning or endangering a child (Penal Code, §22.041);

(8) aiding suicide (Penal Code, §22.08);

(9) agreement to abduct from custody (Penal Code, §25.031);

(10) sale or purchase of a child (Penal Code, §25.08);

(11) arson (Penal Code, §28.02);

(12) robbery (Penal Code, §29.02);

(13) aggravated robbery (Penal Code, §29.03);

(14) a conviction under the laws of another state, federal law, or the Uniform Code of Military Justice for an offense containing elements that are substantially similar to the elements of an offense listed under paragraphs (1)-(13) of this subsection; and

(15) a felony conviction for theft (Penal Code, Chapter 31) which occurred within the previous five years.

§414.507.Self-Reporting and Subsequent Criminal History and Registry Checks.

(a) Upon the effective date of this subchapter, each facility, local authority, community center, and provider must initiate a registry check of all current employees and volunteers. If an employee/volunteer is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry, then the employer must immediately discharge the employee or volunteer.

(b) Following employment with or assignment of volunteer status at a facility, local authority, community center, or provider, all employees and volunteers must report to a person designated by that facility, local authority, community center, or provider:

(1) any subsequent convictions or offenses for which they are charged; and

(2) a subsequent listing as revoked in the Nurse Aide Registry or listing as unemployable in the Employee Misconduct Registry.

(c) A facility, local authority, community center, or provider may conduct subsequent criminal history and registry checks on any employee or volunteer at any time it deems appropriate.

(d) Each facility, local authority, community center, and provider must develop written policies and procedures consistent with this subchapter describing how it will respond to information obtained through self-reporting and subsequent criminal history and registry checks.

(1) Pursuant to the Texas Health and Safety Code, §533.007(b), adverse personnel action may not be taken if the information received pertains to arrest warrants or wanted persons' notices. However, the employer may reassign the employee/volunteer to a non-direct care area until resolution of the matters relating to the arrest warrant or wanted persons' notice.

(2) If the information reflects a conviction for an offense listed in §414.504(g) of this title (relating to Pre-employment and Pre-assignment Clearance), then consideration may be given to any contention by the employee/volunteer concerning errors of fact or identity in the criminal history record information. While the employee/volunteer is attempting to rectify the accuracy of the information, the employer must remove the employee/volunteer from direct contact with consumers. If the employee or volunteer fails to rectify the accuracy of the information, as provided by Texas Health and Safety Code, §250.005(b), then the employer must immediately discharge the employee or volunteer.

(3) If the information reflects a conviction for an offense determined to be a contraindication to employment or volunteer status, then consideration may be given to any contention by the employee/volunteer concerning errors of fact or identity in the criminal history record information. While the employee/ volunteer is attempting to rectify the accuracy of the information, the employer may remove the employee/volunteer from direct contact with consumers. If the employee or volunteer fails to rectify the accuracy of the information, as provided by Texas Health and Safety Code, §250.005(b), then the employer must immediately discharge the employee or volunteer.

(4) If the information indicates the employee/volunteer is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry, then the employer must immediately discharge the employee or volunteer.

§414.509.Distribution.

(a) This subchapter will be distributed to:

(1) members of the Texas MHMR Board;

(2) executive, management, and program staff at TDMHMR Central Office;

(3) chief executive officers of all facilities, local authorities, and community centers; and

(4) advocacy organizations.

(b) A copy of this subchapter will be made available upon request to:

(1) any person who applies for employment or volunteer status with TDMHMR, a local authority, community center, or provider;

(2) any employee or volunteer of TDMHMR, a local authority, community center, or provider;

(3) the counsel of record of an applicant, employee, or volunteer; and

(4) any interested person.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 17, 2002.

TRD-200200251

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Effective date: February 6, 2002

Proposal publication date: October 5, 2001

For further information, please call: (512) 206-5216


Chapter 415. PROVIDER CLINICAL RESPONSIBILITIES

Subchapter C. USE AND MAINTENANCE OF TDMHMR DRUG FORMULARY

25 TAC §§415.101 - 415.114

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts the repeals of §§415.101 - 415.114 of Chapter 415, Subchapter C, concerning use and maintenance of TDMHMR Drug Formulary , without changes to the proposal as published in the August 31, 2001, issue of the Texas Register (26 TexReg 6543). New §§415.101 - 415.114 of Chapter 415, Subchapter C, concerning the same, which replace the repealed sections, are contemporaneously adopted in this issue of the Texas Register .

The repeals allow for the adoption of new sections governing the same matters.

The contemporaneous repeal and adoption of these subchapters would fulfill the requirements of the Texas Government Code, §2001.039, concerning the periodic review of agency rules.

No comment on the proposal was received.

These sections are adopted for repeal under the Texas Health and Safety Code, §532.015(a), which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority, and §534.052, which requires the board to adopt rules it considers necessary and appropriate to ensure the adequate provision of community-based mental health and mental retardation services through a local authority.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 17, 2002.

TRD-200200254

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Effective date: February 6, 2002

Proposal publication date: August 31, 2001

For further information, please call: (512) 206-5216


25 TAC §§415.101 - 415.114

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts new §§415.101 - 415.114 of Chapter 415, Subchapter C, concerning use and maintenance of TDMHMR Drug Formulary . Section 415.102 is adopted with changes to the proposed text as published in the August 31, 2001, issue of the Texas Register (26 TexReg 6543-6547). Sections 415.101 and 414.103 - 415.114 are adopted without changes. The repeals of existing §§415.101 - 415.114 of Chapter 415, Subchapter C, concerning the same, which the new sections replace, are contemporaneously adopted in this issue of the Texas Register .

The new subchapter describes the policies and procedures governing the use and maintenance of the TDMHMR Drug Formulary in TDMHMR facilities and in community settings for mental health and mental retardation services that are funded by TDMHMR.

The contemporaneous adoption and repeal of these subchapters fulfill the requirements of the Texas Government Code, §2001.039, concerning the periodic review of agency rules.

Language has been modified in §415.102 clarifying that the use of the TDMHMR Drug Formulary is limited to only those medications and medication-related services that are funded by TDMHMR.

Written comment on the proposal was received from Lubbock Regional MHMR Center in Lubbock and the parent of a state school resident in Garland.

One commenter asked if the subchapter applies only to those services paid for with general revenue funds. As an example, the commenter asked if the formulary restrictions apply to medications prescribed by a practitioner for a consumer whose medications were paid for by a source other than general revenue funds. TDMHMR responds that language has been modified in §415.102 clarifying that the formulary's use is limited to only those medications and medication-related services that are funded by TDMHMR.

Regarding reporting adverse drug reactions in §415.111(a), one commenter asked whether the local authority or the prescribing practitioner should report adverse drug reactions to the Food and Drug Administration (FDA). The commenter also asked what format or process is used for reporting; whether there is a reporting requirement for practitioners who are not associated with a local authority; and what law or regulation dictates the reporting of adverse drug reactions to the FDA. TDMHMR responds that the local authority is responsible for determining the process for reporting adverse drug reactions to the FDA, including who should report and how the reports are made. There is no law requiring private practitioners to report adverse drug reactions. It is good practice to do so, so that other health care professionals can be warned about adverse effects.

Regarding the requirement to comply with all applicable laws, rules, and regulations relating to drug research in §415.104(e), one commenter stated that since the formulary rules apply to both mental health and mental retardation services, a reference to the subchapter governing standards and quality assurance for mental retardation community services and supports should be added. TDMHMR declines to add the reference because the subchapter governing standards and quality assurance for mental retardation community services and supports does not contain a provision related to drug research.

Regarding the position of TDMHMR associate medical director for mental retardation/developmental disability in §415.106(b)(9), one commenter suggested changing "developmental disability" to "related conditions" because "almost all Individuals with developmental disabilities, not already covered by TX Law's/TDMHMR's definition for 'Related Conditions,' have no cognitive disability." The commenters further stated that "TDMHMR does not have enough funding for all Individuals that are already included in their service population." TDMHMR declines to change the language as suggested because the term is part of a job title and has no bearing on TDMHMR's service population.

These sections are adopted under the Texas Health and Safety Code, §532.015(a), which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority, and §534.052, which requires the board to adopt rules it considers necessary and appropriate to ensure the adequate provision of community-based mental health and mental retardation services through a local authority.

§415.102.Application.

(a) This subchapter applies to TDMHMR facilities, Central Office, local authorities, and their respective contractors for medications and medication-related services funded by the Texas Department of Mental Health and Mental Retardation (TDMHMR). (The TDMHMR Drug Formulary in its entirety applies to all TDMHMR facilities in all circumstances except when an individual receives acute care services of limited duration in a general hospital.)

(b) TDMHMR facilities, Central Office, and local authorities are responsible for amending the contracts of their contractors that provide TDMHMR-funded medications and medication-related services to ensure their compliance with this subchapter.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 17, 2002.

TRD-200200253

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Effective date: February 6, 2002

Proposal publication date: August 31, 2001

For further information, please call: (512) 206-5216