Part 1.
TEXAS DEPARTMENT OF HUMAN SERVICES
Chapter 79.
LEGAL SERVICES
Subchapter Q. FORMAL APPEALS
40 TAC §79.1603, §79.1605
The Texas Department of Human Services (DHS) adopts amendments
to §§79.1603 and §79.1605 without changes to the proposed text
published in the February 11, 2000, issue of the
Texas Register
(25 TexReg 1046).
Justification for the medication aide amendment is to make it easier for
the aide to attend their hearing. The justification for the amendment requiring
certain information when requesting an administrative hearing is to meet the
requirements of the State Office of Administrative Hearings. The justification
for the amendment to the arbitration rule is to correctly cite the reference
to the Human Resources Code.
The amendments will function by clarifying the venue for medication aide
appeals, clarifying requirements for requesting an appeal, and correcting
a rule citation.
No comments were received regarding the adoption.
The amendments are adopted under the Human Resources Code, Title
2, Chapters 22, 31, and 103; and Health and Safety Code, Chapters 142, 242,
247, 252, and 253. These chapters authorize the department to administer the
programs affected by the amendments. The amendments implement these laws.
The amendments implement the Human Resources Code, §§22.001-22.030
and §§31.001-31.0325.
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 April 10, 2000.
TRD-200002505
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: February 11, 2000
For further information, please call: (512) 438-3108
The Texas Department of Human Services (DHS) adopts amendments to §§90.13,
90.16, 90.17, 90.42, 90.61, 90.63, 90.64, 90.65, 90.74, 90.192, 90.211, 90.212,
90.233, 90.236, and 90.321; and adopts new 90.240 and 90.241. DHS adopts §§90.13,
90.16, 90.17, 90.61, 90.63, 90.64, 90.65, 90.74, 90.192, 90.211, 90.212, 90.233,
and 90.321; and adopts new §90.240 and §90.241 without changes to
the proposed text published in the January 21, 2000, issue of the
Texas Register
(25 TexReg 362). DHS adopts §90.42 and §90.236
with changes.
Justification for the amendments and new sections is to implement legislation
from Senate Bill 196 passed in the 76th legislative session. In reviewing
violations of standards cited against facilities, the department found oft-cited
violations in the areas of client rights and abuse, which were not addressed
in the administrative penalties. These standards are critical to the care
and safety of facility residents. The department believes that it is necessary
to address these violations in the administrative penalties to encourage facilities
to stay in compliance with the standards. The department convened a workgroup
of providers, the Private Providers Association, and advocates to consult
in drafting the rules. The rules are the result of the consultation with the
workgroup.
The amendments and new sections will function by implementing legislation
passed in the 76th legislative session. The rules include revisions to clarify
life safety code regulations, improve disaster evacuation plans, clarify facility
requirements for change of ownership, define terms used in the licensing rules,
expand the federal conditions of participation as criteria for assessment
of administrative penalties, add rules on administrative penalties, create
of a new administrative penalty schedule, and define facility responsibilities
relating to a new employee misconduct registry.
The department received comments regarding the adoption of the amendments
and new sections from the Private Provider Association of Texas and Advocacy,
Inc.
One comment requested that the implementation of the rule change not occur
until providers have received training. The department agreed with this request,
postponed the effective date of the rules until May 1, 2000, and plans to
conduct provider training in conjunction with the Private Providers Association
in April.
One commenter stated that it was important that providers have access to
the Appendix Q of the State Operation Manual. The department has agreed to
make Appendix Q available by mailing a hard copy to all providers, having
a copy available for electronic downloading on the Long Term Care Policy Web
Site, and having Appendix Q available at the provider training. The providers
will also have training available on Appendix Q at the April provider training.
One commenter expressed concern about the department's system to ensure
standard and consistent application of penalties across the state. The department
has put mechanisms into place to ensure consistency including training, monitoring
of reports, and an analysis of the administrative penalties applied. The state
will also continue to work in partnership with HCFA on the State Agency Quality
Improvement Program to promote continuous quality improvement in the state's
performance of survey and certification activities. The department will continue
it's dialogue with stakeholders regarding strengths and challenges in regard
to the survey process in this large state.
One commenter wanted assurances that the department will take into account
the provisions of Senate Bill 196 that offers providers the right to correct
and amelioration of violations. Amelioration and the right to correct were
included in the proposed rules. The commissioner of DHS will determine when
the department will allow a facility to use the option of applying the penalties
to ameliorate conditions within the facility. The department will monitor
the assessment of administrative penalties to ensure they are applied in accordance
with the regulations.
One commenter noted that the department could not classify the assessment
of a late license fee as anything but an administrative penalty. The commenter
requested that the department request a statutory change in the next legislative
session to change this authority. The commenter may wish to lobby for a change
in the statutory language to exclude the application of late license fees
as an administrative penalty and include it as a late fee.
One commenter noted that administrative penalties are not assessed against
public facilities and that public facilities are not required to enter employee
misconduct in the employee misconduct registry. The department acknowledges
that there are different rules governing public and private providers. However,
the department does not have the statutory authority to require public providers
to use the employee misconduct registry. The commenter reiterated the importance
of offering providers the right to correct or to apply administrative penalties
towards ameliorating violations. The department is committed to allowing providers
the right to correct in accordance with 40 TAC §90.240.
One commenter stated that alternative sanctions for private and public
ICFs/MR should be pursued with the Texas Department of Mental Health and Mental
Retardation (TDMHMR). The department concurs. The department will be reviewing
the efficacy of the administrative penalties and continue discussion with
an array of approaches to improving the overall quality of the ICF/MR program
in Texas. The department will reconvene the group of stakeholders that developed
the proposed rules to continue discussions relating to other rule revisions
and quality improvement initiatives that can occur in the ICF/MR program.
The same commenter requested that the stakeholder group convene in a timely
manner to discuss other issues in the ICF/MR program. The department will
hold another stakeholder meeting in the spring to discuss other issues across
stakeholders.
Another commenter noted that the rules developed by the stakeholder group
were developed within the guidelines determined by legislation. The commenter
notes the inherent problems of developing a graduated schedule of administrative
penalties with a right to correct period of 45 days. The commenter felt that
it was impossible to set up a true system of graduated penalties for the second
and third occurrence of a violation because of the retrospective nature of
a penalty. Because the right to correct extends to the second and third occurrence
of the violation, the penalties, if applied, would occur after the 45 day
right to correct period. In any case, after the right to correct period of
45 days, any violation (first, second, or third violation) would already reach
the maximum statutory monetary limit before any penalty was applied.
The department corrected the section title "Standards for Facilities for
Persons with Mental Retardation or Related Conditions" to "Standards for Facilities
Serving Persons with Mental Retardation or Related Conditions" in §90.42
and §90.236.
Subchapter B. APPLICATION PROCEDURES
40 TAC §§90.13, 90.16, 90.17
The amendments are adopted under the Health and Safety Code,
Chapter 252, which authorizes the department to license intermediate care
facilities for the mentally retarded.
The amendments implement the Health and Safety Code, §§252.001
- 252.186.
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 April 7, 2000.
TRD-200002482
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
40 TAC §90.42
The amendment is adopted under the Health and Safety Code,
Chapter 252, which authorizes the department to license intermediate care
facilities for the mentally retarded.
The amendment implements the Health and Safety Code, §§252.001
- 252.186.
§90.42. Standards for Facilities Serving Persons with Mental Retardation or Related Conditions.
(a)
Purpose. The purpose of this section is to promote the
public health, safety, and welfare by providing for the development, establishment,
and enforcement of standards:
(1)
for the habilitation of persons based on an active treatment
program in institutions defined and covered in this section; and
(2)
for the establishment, construction, maintenance,
and operation of such institutions which view mental retardation and other
developmental disabilities within the context of a developmental model in
accordance with the principle of normalization.
(b)
Philosophy. Facilities regulated by the standards in this
section are known as facilities for persons with mental retardation and related
conditions in Texas (MR facilities). Persons in these facilities have the
same civil rights, equal liberties, and due process of law as other individuals,
plus the right to receive active treatment and habilitation. Facilities shall
provide and promote services that enhance the development of such individuals,
maximize their achievement through an interdisciplinary approach based on
developmental principles, and create an environment, to the extent possible,
that is normalized and normalizing.
(c)
Standards. Each facility serving persons with mental retardation
or related conditions shall comply with regulations promulgated by the United
States Department of Health and Human Services in Title 42, Code of Federal
Regulations, Part 483, Subpart I, §§483.400 - 483.480, titled, "Conditions
of Participation for Intermediate Care Facilities for the Mentally Retarded."
Additionally, the Texas Department of Human Services (DHS) adopts by reference
the federal regulations governing conditions of participation for the ICF/MR
program as specified in 42 Code of Federal Regulations, part 483, Subpart
I §483.410, §483.420, §483.430, §483.440, §483.450, §483.460, §483.470,
and §483.480 as licensing standards.
(d)
Precertification training conference for new providers
of service. Each new provider must attend the precertification/prelicensure
training conference prior to licensing by the Texas Department of Human Services
(DHS). The purpose of the training is to assure that providers of services
are familiar with the licensing requirements and to facilitate the delivery
of quality services to residents in facilities serving persons with mental
retardation or related conditions.
(1)
A new provider is an entity which has not had at least
one year of administering services in a facility serving persons with mental
retardation or related conditions in Texas. All new providers must attend
a precertification training conference prior to the life safety code survey.
(2)
Each new provider must designate at least one individual
who will be involved with the direct management of the facility to attend
the training conference prior to a health survey being scheduled.
(3)
Each new provider will be given a training schedule.
DHS will schedule training sessions, and the date, time, and location of the
training will be indicated on the schedule.
(e)
Additional requirements.
(1)
The facility must develop and implement policies and procedures
regarding injuries, accidents, and unusual incidents which involve or affect
residents. These policies and procedures must include the following provisions.
(A)
An investigation and report must be completed and maintained
as a separate record which describes the circumstances of the injury, accident,
or incident and its cause, the results of the investigation, and recommended
actions. Serious injuries, accidents, or unusual incidents must be reported
to the resident's responsible parties and to the department, as described
in §90.212 of this title (relating to Incidents of Abuse and Neglect
Investigated and Reported by Facilities to the Texas Department of Human Services
(DHS)).
(B)
The provider or facility must conduct a criminal history
check, as outlined in §90.321 of this title (relating to Investigation
of Facility Employees), in compliance with the Health and Safety Code, Title
4, Chapter 250, which requires DHS to perform criminal history checks on persons
employed by certain types of facilities.
(2)
In the area of cardiopulmonary resuscitation
(CPR), the following apply:
(A)
At least one staff person per shift and on duty must be
trained by a CPR instructor certified by an organization such as the American
Heart Association or the Red Cross.
(B)
The facility must ensure that staff maintain their certification
as recommended by such organizations.
(3)
In the area of behavior management, seclusion
of residents may not be used. Seclusion is defined as placement of a resident
in a room without staff present from which egress is prevented by a locked
door.
(4)
In the area of physical restraints, the following
applies.
(A)
When physical restraints (mechanical and/or manual) are
used as an integral part of an individual program plan that is intended to
lead to less restrictive means of managing and eliminating the behavior for
which the restraint is applied, a physician must participate on the interdisciplinary
team that authorizes the use of restraint and must concur with the team's
decision concerning its use.
(B)
When physical restraints are used as an emergency measure
to protect the resident or others from injury, a physician must authorize
its use or the extension of its use.
(5)
In the area of pharmacy services, the following
applies.
(A)
All pharmacy services must comply with the Texas State
Board of Pharmacy requirements, the Texas Pharmacy Act, and rules adopted
thereunder, the Texas Controlled Substances Act, and Health and Safety Code,
Chapter 483 (relating to Dangerous Drugs).
(B)
All medications must be ordered in writing by a physician,
dentist, or podiatrist. Verbal orders may be taken only by a licensed nurse,
pharmacist, or another physician, and must be immediately transcribed and
signed by the individual taking the order. Verbal orders must be signed by
the physician, dentist, or podiatrist within seven working days.
(C)
The facility, with input from the consultant pharmacist
and physician, must develop and implement policies and procedures regarding
automatic stop orders for medications. These procedures must be utilized when
the order for a medication does not specify the number of doses to be given
or the time for discontinuance or re-order.
(6)
Specialized nutrition support (delivery of parenteral
nutrients and enteral feedings by nasogastric, gastrostomy, or jejunostomy
tubes, etc.) must be given in accordance with physician's orders by a registered
or licensed nurse. Proper technique must be utilized when giving nutritional
support.
(7)
In the area of administration of medication, the
following applies.
(A)
Medications may be administered only by physicians, licensed
nursing personnel, permitted medication aides, or persons who are exempt from
licensure or permit requirements pursuant to the Health and Safety Code, §242.1511.
These persons must function in accordance with the memorandum of understanding
(MOU) between DHS and the Board of Nurse Examiners. DHS adopts the MOU by
reference and copies are available for review at DHS's Long-Term Care Regulatory,
701 West 51st Street, Austin, Texas 78714-9030.
(i)
The licensed or certified individual who removes the medication
dose from the container in which it was dispensed must administer the dose.
(ii)
The individual who administers the medication must record
the dose after it is administered and during the shift in which it was given.
(B)
Residents who have demonstrated the competency for self-administration
of medications must have access to and maintain their own medications. They
must have an individual storage space that permits them to store their medications
under lock and key.
(C)
Residents may participate in a self-administration of
medication habilitation training program if the interdisciplinary team determines
that self-administration of medications is an appropriate objective. Residents
participating in a self-administration of medication habilitation training
program must have training in coordination with and as part of the resident's
total active treatment program. The resident's training plan must be evaluated
as necessary by a licensed nurse. The supervision and implementation of a
self-administration of medication habilitation program may be conducted by
nonlicensed personnel and is not limited to personnel who have completed an
approved training program in medication administration.
(D)
A facility may maintain a supply of controlled substances
in an emergency medication kit for a resident's emergency medication needs,
as outlined under §90.324 and §90.325 of this title (relating to
Emergency Medication Kit and Controlled Substances).
(8)
In the area of communicable diseases, the facility
must have written policies and procedures for the control of communicable
diseases in employees and residents. When any reportable communicable disease
becomes evident, the facility must report in accordance with Communicable
Disease and Prevention Act, Health and Safety Code, Chapter 81, or as specified
in 25 TAC §§97.1 - 97.13 (relating to Control of Communicable Diseases)
and 25 TAC §§97.131 - 97.136 (relating to Sexually Transmitted Diseases)
and in the publication titled, "Reportable Diseases in Texas," Publication
6-101a (Revised 1987). The local health authority should be contacted to assist
the facility in determining the transmissibility of the disease and, in the
case of employees, the ability of the employee to continue performing his
duties. The facility must have written policies and procedures for infection
control, which include implementation of universal precautions as recommended
by the Centers for Disease Control (CDC).
(9)
In the area of water activities, the facility must
assure the safety of all individuals who participate in facility-sponsored
events. For the purpose of this section, a water activity is defined as an
activity which occurs in or on water that is knee deep or deeper on the majority
of individuals participating in the event. To assure the safety of all individuals
who participate, the requirements in subparagraphs (A)-(F) apply.
(A)
The facility must develop a policy statement regarding
the water sites utilized by the facility. Water sites include, but are not
limited to, lakes, amusement parks, and pools.
(B)
A minimum of one staff person with demonstrated proficiency
in cardiopulmonary resuscitation (CPR) must be on duty and at the site when
individuals are involved in water activities.
(C)
A minimum of one person with demonstrated proficiency
in water life saving skills must be on duty and at the site when activities
take place in or on water that is deep enough to require swimming for life
saving retrieval. This person must maintain supervision of the activity for
its duration.
(D)
A sufficient number of staff or a combination of staff
and volunteers must be available to meet the safety requirements of the group
and/or specific individuals.
(E)
Each individual's program plan must address each person's
needs for safety when participating in water activities including, but not
necessarily limited to, medical conditions; physical disabilities and/or behavioral
needs which could pose a threat to safety; the ability to follow directions
and instructions pertaining to water safety; the ability to swim independently;
and, when called for, special precautions.
(F)
If the interdisciplinary team recommends the use of a
flotation device as a precaution for any individual to engage in water activities,
it must be identified and precautions outlined in the individual program plan.
The device must be approved by the United States Coast Guard or be a specialized
therapy flotation device utilized in the individual's therapy program.
(10)
In the area of communication, a facility may
not prohibit a resident or employee from communicating in the person's native
language with another resident or employee for the purpose of acquiring or
providing care, training, or treatment.
(11)
In the area of physical exams, a facility shall
ensure that a resident is given at least one physical exam on a yearly basis
by a medical doctor.
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 April 7, 2000.
TRD-200002483
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
40 TAC §§90.61, 90.63 - 90.65, 90.74
The amendments are adopted under the Health and Safety Code,
Chapter 252, which authorizes the department to license intermediate care
facilities for the mentally retarded.
The amendments implement the Health and Safety Code, §§252.001
- 252.186.
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 April 7, 2000.
TRD-200002484
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
40 TAC §90.192
The amendment is adopted under the Health and Safety Code,
Chapter 252, which authorizes the department to license intermediate care
facilities for the mentally retarded.
The amendment implements the Health and Safety Code, §§252.001
- 252.186.
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 April 7, 2000.
TRD-200002485
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
40 TAC §90.211, §90.212
The amendments are adopted under the Health and Safety Code,
Chapter 252, which authorizes the department to license intermediate care
facilities for the mentally retarded.
The amendments implement the Health and Safety Code, §§252.001
- 252.186.
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 April 7, 2000.
TRD-200002486
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
40 TAC §§90.233, 90.236, 90.240, 90.241
The amendments and new sections are adopted under the Health
and Safety Code, Chapter 252, which authorizes the department to license intermediate
care facilities for the mentally retarded.
The amendments and new sections implement the Health and Safety Code, §§252.001
- 252.186.
§90.236. Administrative Penalties.
(a)
The Texas Department of Human Services (DHS) may assess
administrative penalties against a facility that violates the Health and Safety
Code, Chapter 252, or any rule adopted under this chapter, as provided in
this section.
(b)
Definitions:
(1)
For purposes of this chapter a "violation" is defined
as any noncompliance with the Health and Safety Code, Chapter 252, or any
rule under this chapter, as provided in this section.
(2)
For purposes of this chapter "immediate and serious
threat" means a situation in which there is a high probability that serious
harm or injury to residents could occur at any time or has already occurred
and may occur again if individuals are not protected effectively from the
harm or if the threat is not removed. Immediate and serious threat" is described
in Appendix Q of the State Operations Manual, "Guidelines for Determining
Immediate and Serious Threat to Patient Health and Safety."
(3)
For the purposes of this chapter, "serious harm"
is any condition or situation that could result in severe, temporary or permanent
injury, or death, or harm to the mental or physical condition of an individual.
(4)
For the purposes of this chapter "previous history"
means any violation that resulted in the recommendation of an administrative
penalty documented against the facility in the past 24-month period.
(c)
Failure to meet the requirements of §90.42(c) of
this title (relating to Standards for Facilities Serving Persons with Mental
Retardation or Related Conditions) is a cause to assess an administrative
penalty.
(d)
When a violation cited by DHS is determined to be within
the scope, severity, and description of the penalty schedules as stated in
subsection (m) of this section, the violation may be cause for assessment
of a penalty as described in this section and as listed in subsection (m)
of this section. In determining which violations warrant penalties, DHS will
consider:
(1)
the seriousness of the violation, including the nature,
circumstances, extent, and gravity of the violation and the hazard of the
violation to the health and safety of the clients; and
(2)
whether the affected facility had identified the
violation as part of its internal quality assurance process and had made appropriate
progress on correction.
(e)
No facility will be penalized because of a physician's
or consultant's nonperformance beyond the facility's control or if documentation
clearly indicates the violation is beyond the facility's control.
(f)
An offense is defined as a sum of the licensure violations
found during an inspection. The first offense violations carry the penalty
shown in the "first offense" column under subsection (m) of this section.
The second offense violations carry the penalty shown in the "second offense"
column. The third offense violations carry the penalty shown in the "third
offense" column. An offense is counted against the facility even if the facility
corrected the prior violation and an administrative penalty was not actually
imposed.
(g)
The progression of offenses described in subsection (f)
of this section applies to facilities regardless of license renewals; however,
when a facility has not had an offense for a period of two years, the facility's
next offense will be in the "first offense" column under subsection (m) of
this section. A suspension of a license and subsequent reinstatement does
not interrupt the progression.
(h)
The administrative penalty begins on the date DHS first
established the deficiency existed. Administrative penalties will not be imposed
on minor infractions. Penalties will be imposed on a per diem basis for those
infractions in the administrative penalty schedule, as outlined under subsection
(m) of the section. If DHS determines that a violation has occurred that will
result in an administrative penalty, the penalty for a facility with fewer
than 60 beds will be not less than $100 or more than $1,000 for each violation.
The penalty for a facility with 60 beds or more will not be less than $100
or more than $5,000 for each violation. The total amount of the penalty assessed
for a violation continuing or occurring on separate days under this subsection
may not exceed $5,000 for a facility with fewer than 60 beds or $25,000 for
a facility with 60 beds or more.
(i)
A per diem penalty ceases on the date a violation has
been corrected, and the facility:
(1)
notifies DHS in writing that the violation has been corrected;
and
(2)
provides the date of the correction; and
(3)
evidences later that the violation was corrected.
(j)
If DHS determines that a violation has occurred and that
an administrative penalty will be recommended, DHS will give written notice
of the recommendation to proceed with an administrative penalty to the person
designated by the facility to receive notice. The notice will include:
(1)
a brief summary of the alleged violation;
(2)
a statement of the amount of the proposed penalty
based on the factors listed in subsections (d) and (m) of this section; and
(3)
a statement of the person's right to a hearing on
the occurrence of the violation, the amount of the violation, the amount of
the penalty, or both the occurrence of the violation and the amount of the
penalty.
(k)
A facility that has been recommended to be assessed an
administrative penalty has a right to request an appeal as outlined in subsection
(l) of this section.
(l)
Within 20 calendar days after the date on which written
notice to pay an administrative penalty is received by a facility, the facility
must give DHS written consent to the penalty or make a written request for
a hearing. If the facility does not make a response within the 20 calendar
day period, DHS will assess the penalty. Failure of the facility to file a
notice to request a formal hearing within 20 calendar days constitutes a waiver
of the right to a hearing. Hearings will be held in accordance with the formal
hearing procedures in Chapter 79 of this title (relating to Legal Services).
(m)
Scope, severity, and assessments for violations warranting
administrative penalties for licensed facilities are as follows:
Figure: 40 TAC §90.236(m)
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 April 7, 2000.
TRD-200002487
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
40 TAC §90.321
The amendment is adopted under the Health and Safety Code,
Chapter 252, which authorizes the department to license intermediate care
facilities for the mentally retarded.
The amendment implements the Health and Safety Code, §§252.001
- 252.186, and Chapter 250.
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 April 7, 2000.
TRD-200002488
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2000
Proposal publication date: January 21, 2000
For further information, please call: (512) 438-3108
Chapter 90.
INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION OR RELATED CONDITIONS
Subchapter C. STANDARDS FOR LICENSURE
Subchapter D. GENERAL REQUIREMENTS FOR FACILITY CONSTRUCTION
Subchapter F. INSPECTIONS, SURVEYS, AND VISITS
Subchapter G. ABUSE, NEGLECT, AND EXPLOITATION; COMPLAINT AND INCIDENT REPORTS AND INVESTIGATIONS
Subchapter H. ENFORCEMENT
Subchapter L. PROVISIONS APPLICABLE TO FACILITIES GENERALLY
Chapter 93.
EMPLOYEE MISCONDUCT REGISTRY