Part 1.
TEXAS DEPARTMENT OF HUMAN SERVICES
Chapter 45.
COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES
Subchapter E. SUPPORT FAMILY SERVICES
The Texas Department of Human Services (DHS) proposes new Subchapter
E, Support Family Services, consisting of Division 1, concerning introduction, §§45.501,
45.503, and 45.505; Division 2, concerning support family agency, §§45.521
- 45.525; and Division 3, concerning support families, §45.531 and §45.533,
in its Community Living Assistance and Support Services chapter.
The purpose of the new rules is to add support family services (SFS) as
a Community Living Assistance and Support Services (CLASS) waiver service.
This new subchapter contains the eligibility rules and rules for provider
agencies contracting to provide support family services. The goal of SFS is
to assist children under 18 years of age to obtain or retain residence in
a family home environment. If a child leaving a nursing facility cannot return
to his natural home, SFS allows payment to an alternate family to care for
him in another home. If a child currently enrolled in CLASS is at risk of
institutionalization because his family can no longer support him physically
or emotionally, SFS is available to avoid placement in an institution. The
support family agency recruits, trains, and monitors families to be available
to provide SFS to CLASS children. These rules include requirements for contracting
and delivering SFS.
Gordon Taylor, Chief Financial Officer, has determined that, for the first
five-year period the proposed new sections are in effect, there are no fiscal
implications for state or local government as a result of enforcing or administering
the sections. There is no net fiscal impact on state government because the
cost of providing this service will be offset by a corresponding reduction
in the cost of providing habilitation services.
Bettye M. Mitchell, Deputy Commissioner for Long Term Care, has determined
that, for each year of the first five years the proposed new sections are
in effect, the public benefit anticipated as a result of enforcing the sections
is that children who receive services from the CLASS Program will have the
option of accessing this new service to assist them in residing in a home
environment in the community and to prevent institutionalization. There is
no adverse economic effect on small or micro businesses as a result of enforcing
or administering the new sections, because businesses of any size will be
able to apply to be a contracted provider of these new services. There is
no anticipated economic cost to persons who are required to comply with the
proposed new sections. There is no anticipated effect on local employment
in geographic areas affected by these new sections.
Questions about the content of this proposal may be directed to Pam Stroman
at (512) 438-3078 in DHS's Community Care Provider Services section. Written
comments on the proposal may be submitted to Supervisor, Rules Unit-127, Texas
Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the
Texas Register
.
Under §2007.003(b) of the Government Code, DHS has determined that
Chapter 2007 of the Government Code does not apply to these rules. The changes
these rules make do not implicate a recognized interest in private real property.
Accordingly, DHS is not required to complete a takings impact assessment regarding
these rules.
These rules are proposed by DHS, subject to the subsequent transfer of
rulemaking authority to HHSC. DHS is currently scheduled to transition sometime
in 2004 into two successor agencies, the existing Texas Health and Human Services
Commission (HHSC) and a new agency, the Texas Department of Aging and Disability
Services (DADS).
This reorganization is mandated by House Bill 2292, 78th Legislature, Regular
Session (2003). At the inception of operations at DADS, the authority to adopt
all rules for the operation and provision of health and human services by
DADS will reside with HHSC. These changes may result in the migration of these
rules from one title of the Texas Administrative Code to another or other
changes.
1.
INTRODUCTION
40 TAC §§45.501, 45.503, 45.505
The new sections are proposed under the Human Resources Code,
Chapters 22 and 32, which authorizes DHS to administer public and medical
assistance programs, and under Government Code, §531.021, which provides
the Texas Health and Human Services Commission with the authority to administer
federal medical assistance funds.
The new sections affect the Human Resources Code, §§22.0001 -
22.040 and §§32.001 - 32.067; and the Government Code, §531.060.
§45.501.Purpose.
This subchapter establishes the requirements for:
(1)
agencies contracting with the Texas Department of Human
Services to provide support family services (SFS) to eligible Community Living
Assistance and Support Services clients;
(2)
SFS client eligibility; and
(3)
support families participating in SFS.
§45.503.Contracting Requirements.
(a)
The support family agency must contract with the Texas
Department of Human Services (DHS) to provide support family services to eligible
Community Living Assistance and Support Services clients.
(b)
The support family agency must be licensed as:
(1)
a child-placing agency through the Texas Department of
Family and Protective Services; or
(2)
a home and community support services agency licensed by
DHS to provide home health services.
(c)
The support family agency must meet all provisions described
in this chapter and Chapter 49 of this title (relating to Contracting for
Community Care Services).
§45.505.Client Eligibility.
(a)
To be eligible for support family services, the child must
be:
(1)
under 18 years of age; and
(2)
a Community Living Assistance and Support Services client.
(b)
The child who receives support family services is not authorized
to receive:
(1)
habilitation services, except as provided by the support
family; or
(2)
funding or reimbursement for transportation expenses.
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 May 3, 2004.
TRD-200402965
Carey Smith
Deputy Commissioner, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 438-3734
40 TAC §§45.521 - 45.525
The new sections are proposed under the Human Resources Code,
Chapters 22 and 32, which authorizes DHS to administer public and medical
assistance programs, and under Government Code, §531.021, which provides
the Texas Health and Human Services Commission with the authority to administer
federal medical assistance funds.
The new sections affect the Human Resources Code, §§22.0001 -
22.040 and §§32.001 - 32.067; and the Government Code, §531.060.
§45.521.Support Family Agency Functions.
The support family agency must provide ongoing recruitment, support,
training, and monitoring of its support family services (SFS) including:
(1)
ensuring that support families are available to serve eligible
children;
(2)
helping children transition from institutional services
to SFS;
(3)
supporting children in support families to prevent placement
breakdown or institutionalization;
(4)
providing an alternative support family when the child's
placement with a support family is no longer available or appropriate;
(5)
establishing a safe and permanent placement for the child
as authorized by the interdisciplinary team (IDT);
(6)
training the support family to complete tasks the IDT assigns
and as documented on the individual service plan and the individual program
plan of the individual child; and
(7)
monitoring and reporting to the case manager about the
child's placement, as often as needed but at least monthly, as outlined in §45.524(5)
of this subchapter (relating to Ongoing Support) and §45.525 of this
subchapter (relating to Monthly Monitoring).
§45.522.Pre-Placement Activities.
(a)
Upon referral from the Community Living Assistance and
Support Services (CLASS) case manager for support family services, the support
family agency must:
(1)
meet with the child and the child's parents or legally
authorized representative;
(2)
identify the activities and supports necessary to meet
the child's needs;
(3)
obtain any evaluations, written records, or other necessary
information about the child;
(4)
determine the criteria for a support family that will meet
the specific needs of the child;
(5)
locate a support family; and
(6)
keep the CLASS case manager informed of placement progress.
(b)
Before placement, the support family agency must:
(1)
ensure that the support family obtains the required verification
through a child-placing agency licensed by the Texas Department of Family
and Protective Services;
(2)
provide orientation, training, or both to the support family
in the specific tasks the child needs;
(3)
introduce the child's parents or legally authorized representative,
the support family, and the child to each other in person; and
(4)
obtain the child's parents' or legally authorized representative's
agreement to the placement.
(c)
The support family agency must facilitate written agreements
and authorizations between the child's parents or legally authorized representative,
the support family, and the support family agency. The written documents must
include:
(1)
designation of who will participate in decisions about
services, including any necessary delegation of authority for decisions by
the legally responsible party;
(2)
documentation of how visits between the child and the child's
parents or legally authorized representative will be arranged;
(3)
designation of who has the authority to make health care
decisions for the child, such as consenting to medical treatment, including
any necessary delegation of this authority by the person with the legal responsibility
to make health care decisions;
(4)
preferences agreed upon for:
(A)
religious issues;
(B)
cultural practices;
(C)
problem resolution processes; and
(D)
the type and amount of involvement by the child's parents
or legally authorized representative;
(5)
plans for routine and emergency communication and information
exchange, including both oral and written communication; and
(6)
documentation of the financial responsibilities of all
parties.
§45.523.Placement.
Upon completion of the authorizations and agreements listed in §45.522(c)
of this subchapter (relating to Pre-Placement Activities), the support family,
the child's parents or legally authorized representative, and the support
family agency must:
(1)
participate in the initial interdisciplinary team to develop:
(A)
the transition plan;
(B)
the individual service plan;
(C)
the individual program plan; and
(D)
non-waiver resources;
(2)
provide copies of the agreements and authorizations listed
in §45.522(c) of this subchapter to the Community Living Assistance and
Support Services case manger;
(3)
provide orientation, training, or both to the support family
in the specific tasks the child needs; and
(4)
assume the responsibility for moving the child and his
possessions into the support family home.
§45.524.Ongoing Support.
After the child is placed into the support family, the support family
agency must:
(1)
ensure continued compliance with §45.503 of this subchapter
(relating to Contracting Requirements);
(2)
provide the support family with information on how to contact
support family agency staff at any time;
(3)
ensure accurate documentation of service delivery in accordance
with the individual service plan;
(4)
assist the support family and the child in accessing school
and preschool services;
(5)
provide monthly progress notes to the Community Living
Assistance and Support Services (CLASS) case manager, including monthly summaries
of:
(A)
habilitation activities;
(B)
socialization activities;
(C)
use of non-waiver services; and
(D)
other services included on the individual program plan;
(6)
provide additional training to the support family as identified
by the interdisciplinary team (IDT);
(7)
participate in the IDT meetings as requested by the CLASS
case manager, the child's parents or legally authorized representative, the
support family agency, or the direct services agency; and
(8)
provide to the CLASS case manager documentation of any
changes to the agreements or authorizations listed in §45.522(c) of this
subchapter (relating to Pre-Placement Activities) within seven days of when
the change occurs.
§45.525.Monthly Monitoring.
(a)
The support family agency must visit the support family's
home at least once a month to verify that:
(1)
placement remains beneficial to client;
(2)
the environment remains healthy and safe; and
(3)
the rights of the child are being protected. In order to
ensure that the child's rights are being protected, the support family agency
must verify that:
(A)
there is no evidence of child abuse or neglect;
(B)
the child participates in community functions;
(C)
the child has adequate personal belongings; and
(D)
there are no restrictions on the child's personal property,
including money.
(b)
The support family agency must document each monthly visit,
including verification of each item listed in subsection (a) of this section,
and submit this documentation to the Community Living Assistance and Support
Services (CLASS) case manager within seven days of the visit.
(c)
The support family agency must inform the CLASS case manager
of any changes needed to the individual program plan within five days of the
date the agency became aware of the need for change.
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 May 3, 2004.
TRD-200402966
Carey Smith
Deputy Commissioner, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: June 13, 2004
For further information, please call: (512) 438-3734
2.
SUPPORT FAMILY AGENCY
3.
SUPPORT FAMILIES