TITLE 25.HEALTH SERVICES

Part 2. TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Chapter 404. PROTECTION OF CLIENTS AND STAFF

Subchapter B. ABUSE, NEGLECT, AND EXPLOITATION OF PEOPLE SERVED BY PROVIDERS OF LOCAL AUTHORITIES

25 TAC §§404.41 - 404.55

(Editor's note: The text of the following sections proposed for repeal will not be published.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

The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes the repeals of §§404.41 - 404.55 of Chapter 404, Subchapter B, concerning abuse, neglect, and exploitation of people served by providers of local authorities. New §§414.551 - 414.564 of new Chapter 414, Subchapter L, concerning abuse, neglect, and exploitation in local authorities and community centers, which would replace the repealed sections, are contemporaneously proposed in this issue of the Texas Register .

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

The subchapter is proposed for repeal as part of the reorganization of the TDMHMR rule base to reflect current operational and organizational relationships. 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.

Cindy Brown, chief financial officer, has determined that for each year of the first five years the proposed repeals are in effect, the proposed repeals do not have foreseeable significant implications relating to cost or revenue of the state or local governments.

Pam Carley, director, Consumer Services and Rights Protection - Ombudsman, has determined that, for each year of the first five years the proposed repeals are in effect, the public benefit expected as a result of the adoption of the new rules is the promulgation of rules that clearly delineate the requirements for reporting allegations of abuse, neglect, and exploitation of persons served in community centers, local authorities, and their contractors; ensuring the safety and protections of persons served involved in allegations; facilitating investigations; and ensuring proper disciplinary or other action is taken when abuse, neglect, or exploitation is confirmed. It is anticipated that there would be no economic cost to persons required to comply with the new rules.

It is anticipated that the proposed repeals will not affect a local economy.

It is anticipated that the proposed repeals will not have an adverse economic effect on small businesses or micro businesses because new rules, which would not significantly alter requirements for small business or micro businesses (i.e., contractors of community centers and local authorities), are proposed to replace the repealed rules.

Written comments on the proposal may be sent to Linda Logan, director, Policy Development, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668, within 30 days of publication.

These sections are proposed for repeal under the Texas Health and Safety Code, §532.015, which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority; the Texas Human Resources Code, Chapter 48, which requires the reporting and investigations of abuse, neglect, and exploitation of elderly and disabled persons; §48.255(c), which requires TDMHMR and TDPRS to develop joint rules to facilitate the investigations in community centers and local authorities; the Texas Family Code, Chapter 261, which requires the reporting and investigations of abuse and neglect of a child; and the Texas Civil Practice and Remedies Code, §81.006, which requires the reporting of alleged sexual exploitation by a mental health services provider to the county prosecuting attorney.

These proposed sections would affect the Texas Health and Safety Code, §532.015, the Texas Human Resources Code, Chapter 48, the Texas Family Code, Chapter 261, and the Texas Civil Practice and Remedies Code, §81.006.

§404.41.Purpose.

§404.42.Application.

§404.43.Definitions.

§404.44.Responsibilities of Local Authority.

§404.45.Reporting Abuse and Safeguarding Persons and Evidence.

§404.46.Facilitating the Investigation and Resolution of Related Issues.

§404.47.Information To Be Provided to Alleged Victim and Others.

§404.48.Peer Review.

§404.49.Disciplinary and Other Action.

§404.50.Reporting Responsibilities.

§404.51.Staff Training.

§404.52.Departmental Oversight Responsibilities.

§404.53.Exhibits.

§404.54.References.

§404.55.Distribution.

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 January 26, 2001.

TRD-200100465

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: March 11, 2001

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


Chapter 409. MEDICAID PROGRAMS

Subchapter L. MENTAL RETARDATION LOCAL AUTHORITY (MRLA) PILOT PROGRAM

25 TAC §409.531, §409.541

The Texas Department of Mental Health and Mental Retardation (department) proposes amendments to §§409.531 and 409.541 of Chapter 409, Subchapter L, concerning mental retardation local authority (MRLA) program.

The proposed amendments correspond to new rules being proposed by the Texas Department of Protective and Regulatory Services (TDPRS), which is the investigative authority for allegations of abuse, neglect, and exploitation of individuals receiving services through the Mental Retardation Local Authority (MRLA) Program.

The proposed amendments to §409.531 revise the Program Principles for Program Providers. New P6.1 requires the program provider to implement and maintain a plan for initial and periodic training of personnel. Revisions to P29 require that the initial and periodic training must assure program personnel are knowledgeable of how to identify, report, and prevent acts of abuse, neglect, or exploitation. Principle 32.2, which requires the program provider to ensure that program personnel are instructed to report immediately all incidents of abuse, neglect, or exploitation to TDPRS, is amended to specify that the report must be made immediately but no later than one hour after personnel have knowledge or suspicion of such an incident. P32.3 is reworded for clarity. Revisions to P32.4 require the program provider to provide TDPRS with access to all records pertinent to an investigation of alleged abuse, neglect, or exploitation, and to preserve and protect all evidence related to the allegation as directed by TDPRS. P32.6 is revised to extend from 10 to 14 calendar days the timeframe during which the program provider must report to the department its response to the findings of a TDPRS investigation. Other revisions to P32.6 require the program provider to notify the alleged victim or the LAR of the investigative finding, the corrective action taken by the program provider, the process to appeal the investigative finding, and the process for requesting a copy of the investigative report. P 32.6 also requires the program provider to provide the alleged victim or LAR with a de-identified copy of TDPRS's investigative report, if the alleged victim or LAR requests a copy of the report. Revised P41 adds the requirement for the program provider to search the Employee Misconduct Registry and Nurse Aid Registry maintained by the Texas Department of Human Services prior to employing or contracting with direct service personnel and refrain from employing a person designated on either registry as having abused, neglected or exploited a person receiving services.

The proposed amendments to §409.541 revise the Program Principles for Mental Retardation Authorities. New A21.1 requires that the MRA determine if a program provider implements and maintains a plan for initial and periodic training of personnel. Revisions to A23 requires that the MRA determine if a program provider's initial and periodic training assure program personnel are knowledgeable of how to identify, report, and prevent acts of abuse, neglect, or exploitation. Revisions to A26 specify that the MRA determine that the program provider implements procedures that are in compliance with Program Provider Principle 32.1-32.7 relating to allegations of abuse, neglect, or exploitation.

Bill Campbell, deputy commissioner, Finance and Administration, has determined that for each year of the first five years the proposed amendments are in effect, the enforcement or administering of the amendments does not have foreseeable implications relating to costs or revenues of state or local government.

Ernest McKenney, director, Medicaid Administration, has determined that for each year of the first five-year period the amendments are in effect, the public benefit expected is consistency across department programs in how alleged victims or their LARs are notified of the results of TDPRS investigations, and the provision of increased protection of individuals from abuse, neglect, and exploitation. In addition, requirements related to training of program personnel are more clearly specified. It is not anticipated that the proposed amendments will have an adverse economic effect on small businesses or micro-businesses because these changes do not impose any measurable cost to program providers. It is not anticipated that there will be an economic cost to persons required to comply with the amendments. It is not anticipated that the amendments will affect a local economy.

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

The amendments are proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide the Texas Health and Human Services Commission (THHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Texas Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of THHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program. THHSC has delegated to the department the authority to operate the MRLA Program.

The proposed amendments affect Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a) and (c).

§409.531.Certification Status.

(a)

MRLA program providers contracting with TDMHMR for participation in the MRLA Program must be in continuous compliance with the MRLA Program Principles for Program Providers as described in Mental Retardation Local Authority Program Principles for Program Providers. Each MRLA program provider participating in the MRLA Program will receive a certification review conducted by TDMHMR or its designee at least annually in order to maintain certification status.

Figure: 25 TAC §409.531(a)

(1)

TDMHMR personnel will conduct all certification reviews of MRLA program providers operated by the local MRA.

(2)

TDMHMR or its designee will conduct all certification reviews of non-MRA operated program providers.

(b)

Certification review corrective actions required from the program provider as determined by prior reviews under the HCS or MRLA Consumer Principles for Certification and related timelines remain in effect until the first certification review as an MRLA program provider.

§409.541.Compliance with MRLA Program Principles for Mental Retardation Authorities (MRAs).

(a)

MRAs participating in the MRLA Program must be in continuous compliance with the MRLA Program Principles for Authorities as described in Mental Retardation Local Authority Program Principles for Mental Retardation Authority.

Figure: 25 TAC §409.541(a)

(b)

Each MRA participating in the MRLA Program will receive a compliance review conducted by TDMHMR at least annually.

(c)

If any item of non compliance remains uncorrected by the MRA at the time of the review exit conference, the MRA will develop a plan of correction, with timelines, to be implemented after approval by TDMHMR. TDMHMR may take action as specified in the performance contract between the local MRA and TDMHMR if the MRA fails to develop or implement an approved plan of correction.

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 January 29, 2001.

TRD-200100525

Andrew Hardin

Chair, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: March 11, 2001

For further information, please call: (512) 206-5232


Chapter 414. PROTECTION OF CONSUMERS AND CONSUMER RIGHTS

Subchapter L. ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS

25 TAC §§414.551 - 414.564

The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes new §§414.551 - 414.564 of new Chapter 414, Subchapter L, concerning abuse, neglect, and exploitation in local authorities and community centers. The repeals of §§404.41 - 404.55 of Chapter 404, Subchapter B, concerning abuse, neglect, and exploitation of people served by providers of local authorities, which the new sections would replace, are contemporaneously proposed in this issue of the Texas Register .

The subchapter would describe the requirements for reporting allegations of abuse, neglect, and exploitation of persons served in community centers, local authorities, and their contractors; ensuring the safety and protections of persons served involved in allegations; facilitating investigations; and ensuring proper disciplinary or other action is taken when abuse, neglect, or exploitation is confirmed. Portions of the subchapter would be reorganized for clarity. The provisions relating to allegations involving the clinical practice of a physician or nurse and the provisions relating to peer review would be modified for consistency with companion rules of the Texas Department of Protective and Regulatory Services (TDPRS), which are contemporaneously proposed. A section relating to confidentiality of the investigative process and reports would be added for consistency with TDPRS's proposed companion rules. The section relating to staff competency and training would be modified for consistency with other TDMHMR's rules.

The new subchapter is proposed as part of the reorganization of the TDMHMR rule base to reflect current operational and organizational relationships. 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.

Cindy Brown, chief financial officer, has determined that for each year of the first five years the proposed new rules are in effect, enforcing or administering the rules does not have foreseeable significant implications relating to cost or revenue of the state or local governments because the proposed new rules are not substantially different from the rules proposed for repeal.

Pam Carley, director, Consumer Services and Rights Protection - Ombudsman, has determined that, for each year of the first five years the proposed new rules are in effect, the public benefit expected is the promulgation of rules that clearly delineate the requirements for reporting allegations of abuse, neglect, and exploitation of persons served in community centers, local authorities, and their contractors; ensuring the safety and protections of persons served involved in allegations; facilitating investigations; and ensuring proper disciplinary or other action is taken when abuse, neglect, or exploitation is confirmed. It is anticipated that there would be no additional economic cost to persons required to comply with the proposed rules because they do not impose additional requirements on such persons.

It is anticipated that the proposed new rules will not affect a local economy because the rules do not significantly alter the requirements contained in the rules proposed for repeal, which did not affect a local economy.

It is anticipated that the proposed new rules will not have an adverse economic effect on small businesses or micro businesses because the rules do not significantly alter the requirements that contractors of community centers and local authorities are already required to comply with under the rules proposed for repeal.

Written comments on the proposal may be sent to Linda Logan, director, Policy Development, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668, within 30 days of publication.

These sections are proposed under the Texas Health and Safety Code, §532.015, which provides the Texas Mental Health and Mental Retardation Board with broad rulemaking authority; the Texas Human Resources Code, Chapter 48, which requires the reporting and investigations of abuse, neglect, and exploitation of elderly and disabled persons; §48.255(c), which requires TDMHMR and TDPRS to develop joint rules to facilitate the investigations in community centers and local authorities; the Texas Family Code, Chapter 261, which requires the reporting and investigations of abuse and neglect of a child; and the Texas Civil Practice and Remedies Code, §81.006, which requires the reporting of alleged sexual exploitation by a mental health services provider to the county prosecuting attorney.

These proposed sections would affect the Texas Health and Safety Code, §532.015, the Texas Human Resources Code, Chapter 48, the Texas Family Code, Chapter 261, and the Texas Civil Practice and Remedies Code, §81.006.

§414.551.Purpose.

The purpose of this subchapter is to implement §48.255(c) of the Human Resources Code, which requires TDMHMR to develop joint rules with the Texas Department of Protective and Regulatory Services (TDPRS) to facilitate investigations in local authorities and community centers and to describe the requirements for:

(1)

reporting allegations of abuse, neglect, and exploitation of persons served;

(2)

ensuring the safety and protections of persons served involved in allegations;

(3)

facilitating investigations; and

(4)

ensuring proper disciplinary or other action is taken when abuse, neglect, or exploitation is confirmed.

§414.552.Application.

(a)

This subchapter applies to local authorities and community centers. However, local authorities and community centers that are Medicaid providers of a home and community-based services waiver program must comply with TDMHMR rules governing the home and community-based services waiver program when addressing abuse, neglect, and exploitation in the home and community-based services waiver program.

(b)

Local authorities and community centers are responsible for amending their contracts to ensure contractors' compliance with this subchapter.

§414.553.Definitions.

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

(1)

Abuse - For purposes of reporting allegations, the term is defined by the investigatory agency. For purposes of classifying allegations as part of the TDMHMR Client Abuse and Neglect Reporting System (CANRS), the term is defined in CANRS Definitions, which is referenced as Exhibit A of §414.562 of this title (relating to Exhibits).

(2)

Administrator - The individual in charge of a local authority or community center, or designee.

(3)

Agent - Any individual not employed by a local authority, community center, or contractor, but working under the auspices of the local authority, community center, or contractor (e.g., student, volunteer).

(4)

Allegation - A report by an individual suspecting or having knowledge that a person served has been or is in a state of abuse, neglect, or exploitation as defined by the investigatory agency or in CANRS Definitions, which is referenced as Exhibit A in §414.562 of this title (relating to Exhibits).

(5)

Clinical practice - Relates to the demonstration of professional competence by a licensed professional.

(6)

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

(7)

Confirmed - The finding of an investigation if there is a preponderance of credible evidence to support that abuse, neglect, or exploitation occurred.

(8)

Contractor - Any organization, entity, or individual who contracts with a local authority or community center to provide mental health or mental retardation services to a person served. The term includes a local independent school district with which a local authority or community centers has a memorandum of understanding (MOU) for educational services.

(9)

Contractor CEO - The individual in charge of a contractor that has one or more employees excluding the CEO.

(10)

Exploitation - For purposes of reporting allegations, the term is defined by the investigatory agency. For purposes of classifying allegations as part of the TDMHMR CANRS, the term is defined in CANRS Definitions, which is referenced as Exhibit A in §414.562 of this title (relating to Exhibits.

(11)

Investigatory agency - An agency with statutory authority to investigate abuse, neglect, and exploitation of a person served by a local authority, community center, or contractor (e.g., Texas Department of Protective and Regulatory Services investigates allegations in local authorities, community centers, and all contractors except psychiatric hospitals; Texas Department of Health (TDH) investigates allegations in psychiatric hospitals; Texas Department of Human Services (TDHS) investigates allegations in intermediate care facilities for the mentally retarded or persons with a related condition (ICF/MR or ICF/MR/RC)).

(12)

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

(13)

Neglect - For purposes of reporting allegations, the term is defined by the investigatory agency. For purposes of classifying allegations as part of the TDMHMR CANRS, the term is defined in CANRS Definitions, which is referenced as Exhibit A in §414.562 of this title (relating to Exhibits).

(14)

Perpetrator - An individual who has committed an act of abuse, neglect, or exploitation.

(15)

Person served - Any person receiving services from a local authority or community center who is registered or assigned in the Client Assignment and Registration (CARE) system.

(16)

Professional review - A review of clinical and/or professional practice(s) by peer professionals.

(17)

Retaliatory action - Any action intended to inflict emotional or physical harm or inconvenience on an employee, agent, or person served that is taken because he or she has reported abuse, neglect, or exploitation. Retaliatory action includes, but is not limited to, harassment, disciplinary measures, discrimination, reprimand, threat, and criticism.

§414.554.Responsibilities of Local Authorities, Community Centers, and Contractors.

(a)

Promulgate and implement policies and procedures. Each local authority and community center shall promulgate and implement policies and procedures that meet the requirements of this section.

(b)

Prohibition of abuse, neglect, and exploitation. Each local authority, community center, and contractor shall ensure that its employees and agents are informed of the prohibition of abuse, neglect, and exploitation of persons served.

(c)

Identifying programs and investigatory agencies.

(1)

Each local authority, community center, and contractor shall ensure that the name and phone number of the investigatory agency are clearly identified and displayed for its employees and agents at each of its program and service delivery sites.

(2)

Each local authority and community center shall provide to each investigatory agency a list of the names and addresses of its contracted and non-contracted program and service delivery sites in the investigatory agency's purview, including the name of the staff who will serve as contact for investigators, as required in subsection (g)(1) of this section.

(d)

Reporting abuse, neglect, and exploitation and securing evidence.

(1)

Each local authority, community center, and contractor shall require its employees and agents who suspect or have knowledge of abuse, neglect, or exploitation of a person served to:

(A)

make a verbal report to the investigatory agency immediately, but in no case more than one hour after suspicion or knowledge of the abuse, neglect, or exploitation, in compliance with existing state laws, rules, memorandums of understanding, and this subchapter;

(B)

as needed, assist any individual in making a report when the individual alleging abuse, neglect, or exploitation is not an employee or agent, (e.g., a person served, a guest); and

(C)

secure evidence related to the allegation in accordance with "Guidelines for Securing Evidence" referenced as Exhibit B in §414.562 of this title (relating to Exhibits).

(2)

Failure to make reports of abuse, neglect, or exploitation immediately without sufficient justification is considered a violation of this section and makes the employee or agent subject to disciplinary or other appropriate action and possible criminal prosecution.

(3)

In addition to the reporting requirement described in paragraph (1)(A) of this subsection, reports regarding alleged sexual exploitation committed by a mental health services provider are made to the prosecuting attorney in the county in which the alleged sexual exploitation occurred and any state licensing board that has responsibility for the mental health services provider's licensing in accordance with the Texas Civil Practice and Remedies Code, §81.006. A copy of the Texas Civil Practice and Remedies Code, §81.006, and §81.001, which includes the definitions of "sexual exploitation" and "mental health services provider," is referenced as Exhibit C in §414.562 of this title (relating to Exhibits).

(e)

Notifying contractor CEO. If the administrator is notified of an allegation involving a contractor, then the administrator must immediately notify the contractor CEO of the allegation unless the contractor CEO is the alleged perpetrator. If the contractor CEO is the alleged perpetrator, then the administrator shall ensure the activities described in subsections (f), (h), and (i) are accomplished.

(f)

Safeguarding the alleged victim. Immediately upon notification of an allegation by the investigatory agency the administrator or contractor CEO shall ensure necessary measures are taken to secure the safety of the alleged victim(s) involved in the allegation, including:

(1)

ensuring immediate and on-going medical and psychological attention is provided to the alleged victim(s), as necessary; and

(2)

separating the alleged victim(s) from the alleged perpetrator(s) until an investigation has been completed.

(g)

Prohibiting retaliatory action. Any employee or agent, or any individual affiliated with an employee or agent is prohibited from engaging in retaliatory action against an employee, agent, or person served who in good faith reports an allegation. Any employee or agent found to have engaged in retaliatory action is subject to disciplinary or other appropriate action.

(1)

Any employee or agent who believes he or she is being subjected to retaliatory action upon making a report of abuse, neglect, or exploitation, or who believes an allegation has been ignored without cause, should immediately contact the administrator or contractor CEO and may also contact the Office of Consumer Services and Rights Protection - Ombudsman at TDMHMR's Central Office, at the toll free number 1-800-252-8154.

(2)

Retaliatory action against a person served which might be considered abuse, neglect, or exploitation must be reported in accordance with this section.

(h)

Facilitating investigations.

(1)

Administrators and contractor CEOs shall ensure the designation of a contact staff at each program and service delivery site who will be responsible for coordinating with the investigator to ensure the availability of and access to private interview space, private telephones, and employees, agents, and persons served.

(2)

Administrators and contractor CEOs shall require employees and agents to cooperate with investigators so that investigators are afforded immediate access to persons served, employees, agents, records of persons served, and other documents requested by the investigator.

(3)

Falsification of fact during an investigation is considered a violation of this section and makes the employee or agent subject to disciplinary or other appropriate action and possible criminal prosecution.

(i)

Referring allegations involving clinical practice. If the investigator refers to the administrator or contractor CEO an allegation involving the clinical practice of a licensed professional, then the administrator or contractor CEO shall refer the allegation for professional review or, if the local authority, community center, or contractor does not have a professional review process, the administrator or contractor CEO shall refer the allegation to the appropriate licensing authority. The administrator or contractor CEO shall ensure relevant conclusions of a professional review are submitted to the appropriate licensing authority.

(j)

Facilitating resolution of other issues.

(1)

Administrators and contractor CEOs shall ensure that general complaints and administrative issues that are referred to them by an investigator are reviewed and resolved in a timely manner.

(2)

Local authorities, community centers, and contractors shall afford TDMHMR immediate access to persons served, employees, agents, records of persons served, and other documents when TDMHMR responds to a complaint that the health, welfare, or safety of a person served may be jeopardized.

§414.555.Information To Be Provided to Victim or Alleged Victim and Others.

(a)

Each local authority and community center shall promulgate and implement policies and procedures that meet the requirements of this section.

(b)

As soon as possible, but no later than 24 hours following notification of an allegation by the investigatory agency, the administrator or contractor CEO shall notify the alleged victim (if appropriate) and the alleged victim's guardian or parent (if the alleged victim is a minor) of the allegation.

(c)

The administrator or contractor CEO shall ensure that the victim or alleged victim, guardian, or parent (if the victim or alleged victim is a minor) is notified of:

(1)

the finding and any decisions made after review and/or appeal of the finding;

(2)

the method to appeal the finding, if any;

(3)

how to receive a copy of the investigative report; and

(4)

if the allegation is confirmed, the disciplinary or other action taken against the perpetrator.

§414.556.Investigations Conducted by the Texas Department of Protective and Regulatory Services (TDPRS).

(a)

TDPRS submits a copy of the investigative report to the administrator or contractor CEO or both in accordance with Chapter 711 of Title 40 (relating to Investigations in TDMHMR Facilities and Related Programs).

(b)

The administrator or contractor CEO may not change a confirmed finding made by a TDPRS investigator. The administrator or contractor CEO may request a review of the finding or the methodology used to conduct the investigation in accordance with Chapter 711 of Title 40 (relating to Investigations in TDMHMR Facilities and Related Programs).

§414.557.Disciplinary and Other Action.

(a)

Each local authority and community center shall promulgate and implement policies and procedures that meet the requirements of this section.

(b)

Administrators and contractor CEOs must take appropriate disciplinary or other action in confirmed cases of abuse, neglect, and exploitation involving employees and agents.

(1)

If the investigatory agency has a process by which the administrator or contractor CEO can request a review of the finding and a review is requested, then the outcome of the review is final and forms the basis for disciplinary action.

(2)

If the investigatory agency does not have a process by which the administrator or contractor CEO can request a review of the finding, the investigatory agency's finding is final and forms the basis for disciplinary action.

(c)

Nothing in this subchapter precludes an administrator or contractor CEO from taking disciplinary or other appropriate action pending investigation, including termination of employment. If disciplinary or other action is taken before the investigation is complete, then the executive director or CEO shall notify the investigator of such action and the investigation continues.

(d)

Administrators and contractor CEOs shall ensure that disciplinary or other appropriate action, including seeking criminal prosecution as appropriate, is taken when an employee or agent fails to make reports immediately without sufficient justification or an employee or agent is found to have made a false statement of fact during an investigation.

§414.558.Data Reporting Responsibilities.

If the perpetrator or alleged perpetrator is an employee or agent of a local authority, community center, or contractor, or the perpetrator is unknown, then the administrator shall ensure that a Client Abuse and Neglect Reporting form (AN-1-A) is completed within 14 calendar days of the receipt of the investigative report or decision made after review or appeal using the CANRS Definitions and the CANRS Classifications. (The Client Abuse and Neglect Reporting form (AN-1-A), the CANRS Definitions, and the CANRS Classifications are referenced as Exhibits E, A, and D, respectively, in §414.562 of this title (relating to Exhibits).) Within one working day after completion of the AN-1-A form, the administrator shall ensure that:

(1)

the information contained in the completed AN-1-A is entered into the Client Abuse and Neglect Reporting System (CANRS); or

(2)

if access to CANRS is unavailable, a copy of the completed AN-1-A is forwarded for data entry to the Office of Consumer Services and Rights Protection - Ombudsman, TDMHMR, P.O. Box 12668, Austin, TX 78711-2668.

§414.559.Confidentiality of Investigative Process and Report.

(a)

The reports, records, and working papers used by or developed in the investigative process by an investigatory agency, and the investigatory agency's resulting investigative report, are confidential and may be disclosed only as allowed by law or rule.

(b)

Upon request, the administrator or contractor CEO will provide a copy of the investigative report to the victim or alleged victim or guardian with the identities of other persons served and any information determined confidential by law concealed. The administrator or contractor CEO may charge a reasonable fee for providing a copy of the investigative report.

(c)

Advocacy, Inc. is entitled to access the records of persons served in accordance with 42 USC §10806 or §6042(a)(2)(I) (Protection and Advocacy of Individuals with Mental Illness and Protection and Advocacy of Individuals with Developmental Disabilities).

§414.560.Competency of Employees and Agents.

(a)

Each local authority, community center, and contractor shall ensure that all employees and agents demonstrate a thorough understanding of the relevant elements of reporting, investigating, and preventing abuse, neglect, and exploitation, before contact with persons served and annually thereafter. The relevant elements of reporting, investigating, and preventing abuse, neglect, and exploitation include:

(1)

the acts and signs of possible abuse, neglect, and exploitation;

(2)

the prohibition of abuse, neglect, and exploitation of persons served;

(3)

the disciplinary consequences for:

(A)

committing abuse, neglect, and exploitation;

(B)

failing to report abuse, neglect, or exploitation; and

(C)

failing to cooperate with an investigation;

(4)

the procedures for reporting allegations of abuse, neglect, and exploitation;

(5)

the prohibition of retaliatory action and the consequences for engaging in retaliatory action;

(6)

the methods for preventing abuse, neglect, and exploitation; and

(7)

memoranda of understanding and rules of investigatory agencies.

(b)

Each local authority, community center, and contractor shall ensure that employees and agents who will routinely perform any job duty in proximity to persons served demonstrate competency in the safe management of verbally and physically aggressive behavior before contact with persons served and annually thereafter.

(c)

Each local authority, community center, and contractor shall ensure that documentation of the competencies of its employees and agents is maintained.

§414.561.TDMHMR Oversight Responsibilities.

The Office of Consumer Services and Rights Protection - Ombudsman in TDMHMR's Central Office is responsible for the maintenance of systems that provide statistical trends in abuse, neglect, and exploitation in local authorities and community centers.

§414.562.Exhibits.

The following exhibits are referenced in this subchapter:

(1)

Exhibit A - CANRS Definitions;

(2)

Exhibit B - "Guidelines for Securing Evidence";

(3)

Exhibit C - a copy of the Texas Civil Practice and Remedies Code, §81.001 and §81.006;

(4)

Exhibit D - CANRS Classifications; and

(5)

Exhibit E - Client Abuse and Neglect Report form (AN-1-A).

§414.563.References.

Reference is made to the following statutes:

(1)

Texas Health and Safety Code, Title 7, Chapter 534, Subchapter A; and

(2)

Texas Civil Practices and Remedies Code, Chapter 81.

§414.564.Distribution.

(a)

This subchapter shall be distributed to:

(1)

members of the Texas MHMR Board;

(2)

investigatory agencies;

(3)

executive, management, and program staff of Central Office;

(4)

administrators of all local authorities and community centers; and

(5)

advocacy organizations.

(b)

Each administrator is responsible for disseminating copies of this subchapter to:

(1)

employees and agents;

(2)

contractors; and

(3)

any person served or other individual desiring a copy.

(c)

Each contractor CEO is responsible for disseminating copies of this subchapter to all employees and agents.

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 January 26, 2001.

TRD-200100464

Andrew Hardin

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: March 11, 2001

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


Chapter 419. MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES

Subchapter D. HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM

25 TAC §419.177, §419.178

The Texas Department of Mental Health and Mental Retardation (department) proposes amendments to §§419.177 and 419.178 of Chapter 419, Subchapter D, concerning home and community-based services (HCS) program.

The proposed amendments correspond to new rules being proposed by the Texas Department of Protective and Regulatory Services (TDPRS), which is the investigative authority for allegations of abuse, neglect, and exploitation of individuals receiving services through the Home and Community-based Services (HCS) Program.

The proposed amendments to §419.177 contain more specific requirements with regard to a program provider's responsibility to implement and maintain a plan for initial and periodic training of personnel. New language specifically requires training that assures program personnel are knowledgeable of how to identify, report, and prevent acts of abuse, neglect, or exploitation. The proposal would add the requirement for the program provider to search the Employee Misconduct Registry and Nurse Aid Registry maintained by the Texas Department of Human Services prior to employing or contracting with direct service personnel and refrain from employing a person designated on either registry as having abused, neglected or exploited a person receiving services.

The amendments to §419.178 would require a program provider and its consumer/advocacy advisory committee to review all allegations of abuse, neglect, and exploitation and to review the program provider's practices for preventing the occurrence or reoccurrence of abuse, neglect, or exploitation. The current requirement for the program provider to ensure that program personnel are instructed to report immediately all incidents of abuse, neglect, or exploitation to TDPRS is amended to further specify that the report must be made immediately but no later than one hour after personnel have knowledge or suspicion of such an incident. The proposal would require the program provider to provide TDPRS with access to all records pertinent to an investigation of alleged abuse, neglect, or exploitation, and to preserve and protect all evidence related to the allegation as directed by TDPRS. The proposed amendments would extend from 10 to 14 calendar days the timeframe during which the program provider must report to the department its response to the findings of a TDPRS investigation. The proposed amendments would require the program provider to notify the alleged victim or the LAR of the investigative finding, the corrective action taken by the program provider, the process to appeal the investigative finding, and the process for requesting a copy of the investigative report. The program provider also would be required to provide the alleged victim or LAR with a de-identified copy of TDPRS's investigative report, if the alleged victim or LAR requests a copy of the report.

Bill Campbell, deputy commissioner, Finance and Administration, has determined that for each year of the first five years the proposed amendments are in effect, the enforcement or administering of the amendments does not have foreseeable implications relating to costs or revenues of state or local government.

Ernest McKenney, director, Medicaid Administration, has determined that for each year of the first five-year period the amendments are in effect, the public benefit expected is consistency across department programs in how alleged victims or their LARs are notified of the results of TDPRS investigations, and the provision of increased protection of individuals from abuse, neglect, and exploitation. In addition, requirements related to training of program personnel are more clearly specified. It is not anticipated that the proposed amendments will have an adverse economic effect on small businesses or micro-businesses because these changes do not impose any measurable cost to program providers. It is not anticipated that there will be an economic cost to persons required to comply with the amendments. It is not anticipated that the amendments will affect a local economy.

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

The amendments are proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide the Texas Health and Human Services Commission (THHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Texas Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of THHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program. THHSC has delegated to the department the authority to operate the HCS Program.

The proposed amendments affect Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a) and (c).

§419.177.Certification Principles: Personnel Operations.

(a) - (b)

(No change.)

(c)

The program provider must implement and maintain a plan for initial and periodic [ continuous ] training of personnel that assures personnel are: [ with periodic updates as required or indicated by the needs of the individuals. ]

(1)

qualified to deliver services as required by the current needs and characteristics of the individuals to whom they deliver services; and

(2)

knowledgeable of:

(A)

acts that constitute abuse, neglect, or exploitation of an individual, as defined in 40 TAC Chapter 711, Subchapter A;

(B)

the requirement to report acts of abuse, neglect, or exploitation, or suspicion of such acts, to the Texas Department of Protective and Regulatory Services (TDPRS) in accordance with §419.178(j) of this title (relating to Certification Principles: Quality Assurance); and

(C)

methods to prevent the occurrence of abuse, neglect, and exploitation.

(d) - (m)

(No change.)

(n)

The program provider must take the following actions regarding applicants for employment, contractors, and employees of the program provider whose duties involve or would involve direct contact with an individual:

(1)

in accordance with Texas Health and Safety Code, Chapter 250, Nurse Aide Registry and Criminal History Checks of Employees and Applicants for Employment in Certain Facilities Serving the Elderly or Persons with Disabilities, obtain criminal history record information that relates to the applicant, contractor, or employee and refrain from employing or contracting with persons who have been convicted of an offense listed under §250.006 of the Texas Health and Safety Code; and

(2)

search the Employee Misconduct Registry and the Nurse Aid Registry maintained by the Texas Department of Human Services to determine whether the applicant, contractor, or employee is designated in either registry as having abused, neglected, or exploited a resident or consumer of a facility or misappropriated a resident's or consumer's property, and refrain from employing or contracting with persons who are designated in either registry.

[(n)

The program provider shall comply with Chapter 250, Nurse Aide Registry and Criminal History Checks of Employees and Applicants for Employment in Certain Facilities Serving the Elderly or Persons with Disabilities.]

§419.178.Certification Principles: Quality Assurance.

(a) - (e)

(No change.)

(f)

The program provider shall establish an on-going consumer/advocate advisory committee composed of individuals, individuals' LARs, community representatives, and family members that will meet at least quarterly. The committee will assist the program provider to perform the following activities at least annually:

(1)

evaluating and addressing the satisfaction of individuals or individuals' LARs with the program provider's services;

(2)

soliciting, addressing, and reviewing complaints from individuals or their LARs about the operations of the program provider; [ and ]

(3)

reviewing all allegations of abuse, neglect, and exploitation alleged to have been committed by program provider personnel against individuals and the program provider's practices for preventing the occurrence or reoccurrence of abuse, neglect, and exploitation; and

(4)

[ (3) ] participating in a continuous quality improvement review of the program provider's operations and offering recommendations for improvement of program operations for action by the program provider as necessary.

(g) - (i)

(No change.)

(j)

The program provider must ensure that:

(1)

the individual and the LAR are informed of how to report allegations of abuse, neglect, or exploitation to TDPRS [ the Texas Department of Protective and Regulatory Services (DPRS) ] and are provided with the TDPRS [ DPRS ] toll-free telephone number (1-800-647-7418) in writing; and

(2)

all program provider personnel are:

(A)

instructed to report to TDPRS immediately, but not later than one hour after having knowledge or suspicion, that an individual has been or is being abused, neglected, or exploited; and

(B)

provided with the TDPRS toll-free telephone number (1-800-647-7418) in writing; and

[(2)

all service provider personnel are instructed to immediately report suspected abuse, neglect, or exploitation to DPRS and are provided with the DPRS toll-free telephone number (1-800-647-7418) in writing; and]

(3)

all program [ service ] provider personnel report suspected abuse, neglect or exploitation as instructed.

(k)

If the program provider suspects an individual has been or is being abused, neglected, or exploited or is notified of an allegation of abuse, neglect or exploitation, the program provider shall take necessary actions to secure the safety of the alleged victim [ victim(s) involved in the allegation ], including but not limited to:

(1)

obtaining immediate and on-going medical or psychological services for the alleged victim as necessary;

(2)

[ securing the safety of the alleged victim and, ] if necessary, restricting access by the alleged perpetrator of the abuse, neglect or exploitation to the alleged victim or other individuals pending investigation of the allegation; and

(3)

notifying the alleged victim and the alleged victim's [ individual's ] LAR of the allegation .

(l)

The program provider personnel shall cooperate with the TDPRS [ DPRS ] investigation of an allegation of abuse, neglect, or exploitation, including but not limited to:

(1)

providing complete access to all HCS Program service sites owned, operated, or controlled by the program provider; [ and ]

(2)

providing complete access to individuals and program provider personnel;

(3)

providing access to all records pertinent to the investigation of the allegation; and

(4)

preserving and protecting any evidence related to the allegation in accordance with TDPRS instructions.

(m)

(No change.)

(n)

The program provider must:

(1)

report the program provider's response to the finding of all TDPRS [ DPRS ] investigations of abuse, neglect, or exploitation to the department in accordance with department procedures within 14 [ 10 ] calendar days of the program provider's receipt of the investigation findings; and

(2)

promptly, but not later than five calendar days from the program provider's receipt of the TDPRS investigation finding, notify the alleged victim or LAR of:

(A)

the investigation finding;

(B)

the corrective action taken by the program provider if TDPRS confirms that abuse, neglect, or exploitation occurred;

(C)

the process to appeal the investigation finding as described in 40 TAC Chapter 711, Subchapter M (relating to Requesting an Appeal if You are the Reporter, Alleged Victim, Legal Guardian or with Advocacy, Incorporated); and

(D)

the process for requesting a copy of the investigative report from the program provider; and

[(2)

notify the individual and the individual's LAR that the TDPRS investigation has been completed and that the individual or LAR may contact TDPRS regarding the results of the investigation and the process for appealing the findings within 10 calendar days of the program provider's receipt of the investigation findings].

(3)

upon request of the alleged victim or LAR, provide to the alleged victim or LAR a copy of the TDPRS investigative report after concealing any information that would reveal the identity of the reporter or of any individual who is not the alleged victim.

(o)

If abuse, neglect, or exploitation is confirmed by the TDPRS [ DPRS ] investigation, the program provider shall take appropriate action to prevent the reoccurrence of abuse, neglect or exploitation including, when warranted, disciplinary action against or termination of the employment of program provider personnel confirmed by the TDPRS [ DPRS ] investigation to have committed abuse, neglect, and exploitation.

(p) - (w)

(No 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 January 29, 2001.

TRD-200100527

Andrew Hardin

Chair, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: March 11, 2001

For further information, please call: (512) 206-5232


Subchapter P. HOME AND COMMUNITY-BASED SERVICES--OBRA (HCS-O) PROGRAM

25 TAC §419.673, §419.674

The Texas Department of Mental Health and Mental Retardation (department) proposes amendments to §§419.673 and 419.674 of Chapter 419, Subchapter P, concerning home and community-based services - OBRA (HCS-O) program.

The proposed amendments correspond to new rules being proposed by the Texas Department of Protective and Regulatory Services (TDPRS), which is the investigative authority for allegations of abuse, neglect, and exploitation of individuals receiving services through the Home and Community-based Services - OBRA (HCS-O) Program.

The proposed amendments to §419.673 contain more specific requirements with regard to a program provider's responsibility to implement and maintain a plan for initial and periodic training of personnel. New language specifically requires training that assures program personnel are knowledgeable of how to identify, report, and prevent acts of abuse, neglect, or exploitation. The proposal would add the requirement for the program provider to search the Employee Misconduct Registry and Nurse Aid Registry maintained by the Texas Department of Human Services prior to employing or contracting with direct service personnel and refrain from employing a person designated on either registry as having abused, neglected or exploited a person receiving services.

The amendments to §419.674 would require a program provider and its consumer/advocacy advisory committee to review all allegations of abuse, neglect, and exploitation and to review the program provider's practices for preventing the occurrence or reoccurrence of abuse, neglect, or exploitation. The current requirement for the program provider to ensure that program personnel are instructed to report immediately all incidents of abuse, neglect, or exploitation to TDPRS is amended to further specify that the report must be made immediately but no later than one hour after personnel have knowledge or suspicion of such an incident. The proposal would require the program provider to provide TDPRS with access to all records pertinent to an investigation of alleged abuse, neglect, or exploitation, and to preserve and protect all evidence related to the allegation as directed by TDPRS. The proposed amendments would extend from 10 to 14 calendar days the timeframe during which the program provider must report to the department its response to the findings of a TDPRS investigation. The proposed amendments would require the program provider to notify the alleged victim or the LAR of the investigative finding, the corrective action taken by the program provider, the process to appeal the investigative finding, and the process for requesting a copy of the investigative report. The program provider also would be required to provide the alleged victim or LAR with a de-identified copy of TDPRS's investigative report, if the alleged victim or LAR requests a copy of the report.

Bill Campbell, deputy commissioner, Finance and Administration, has determined that for each year of the first five years the proposed amendments are in effect, the enforcement or administering of the amendments does not have foreseeable implications relating to costs or revenues of state or local government.

Ernest McKenney, director, Medicaid Administration, has determined that for each year of the first five-year period the amendments are in effect, the public benefit expected is consistency across department programs in how alleged victims or their LARs are notified of the results of TDPRS investigations, and the provision of increased protection of individuals from abuse, neglect, and exploitation. In addition, requirements related to training of program personnel are more clearly specified. It is not anticipated that the proposed amendments will have an adverse economic effect on small businesses or micro-businesses because these changes do not impose any measurable cost to program providers. It is not anticipated that there will be an economic cost to persons required to comply with the amendments. It is not anticipated that the amendments will affect a local economy.

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

The amendments are proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide the Texas Health and Human Services Commission (THHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Texas Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of THHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; and the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program. THHSC has delegated to the department the authority to operate the HCS-O Program.

The proposed amendments affect Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a) and (c).

§419.673.Certification Principles: Personnel Operations.

(a) - (b)

(No change.)

(c)

The program provider must implement and maintain a plan for initial and periodic [ continuous ] training of personnel that assures that personnel are: [ with periodic updates as required or indicated by the needs of the individuals. ]

(1)

qualified to deliver services as required by the current needs and characteristics of the individuals to whom they deliver services; and

(2)

knowledgeable of:

(A)

acts that constitute abuse, neglect, or exploitation of an individual, as defined in 40 TAC Chapter 711, Subchapter A,

(B)

the requirement to report acts of abuse, neglect, or exploitation, or suspicion of such acts, to the Texas Department of Protective and Regulatory Services (TDPRS) in accordance with §419.647(j) of this title (relating to Certification Principles: Quality Assurance), and

(C)

methods to prevent the occurrence of abuse, neglect, and exploitation.

(d) - (k)

(No change.)

(l)

The program provider must take the following actions regarding applicants for employment, contractors, and employees of the program provider whose duties involve or would involve direct contact with an individual:

(1)

in accordance with Texas Health and Safety Code, Chapter 250, Nurse Aide Registry and Criminal History Checks of Employees and Applicants for Employment in Certain Facilities Serving the Elderly or Persons with Disabilities, obtain criminal history record information that relates to the applicant, contractor, or employee and refrain from employing or contracting with persons who have been convicted of an offense listed under §250.006 of the Texas Health and Safety Code; and

(2)

search the Employee Misconduct Registry and the Nurse Aid Registry maintained by the Texas Department of Human Services to determine whether the applicant, contractor, or employee is designated in either registry as having abused, neglected, or exploited a resident or consumer of a facility or misappropriated a resident's or consumer's property, and refrain from employing or contracting with persons who are designated in either registry.

[(l)

The program provider shall comply with Texas Health and Safety Code, Chapter 250, Nurse Aide Registry and Criminal History Checks of Employees and Applicants for Employment in Certain Facilities Serving the Elderly or Persons with Disabilities.]

§419.674.Certification Principles: Quality Assurance.

(a) - (e)

(No change.)

(f)

The program provider shall establish an on-going consumer/advocate advisory committee composed of individuals, individuals' LARs, community representatives, and family members that will meet at least quarterly. The committee will assist the program provider to perform the following activities at least annually:

(1)

evaluating and addressing the satisfaction of individuals or individuals' LARs with the program provider's services;

(2)

soliciting, addressing, and reviewing complaints from individuals or their LARs about the operations of the program provider; [ and ]

(3)

reviewing all allegations of abuse, neglect, and exploitation alleged to have been committed by program provider personnel against individuals and the program provider's practices for preventing the occurrence or reoccurrence of abuse, neglect and exploitation; and

(4)

[ (3) ] participating in a continuous quality improvement audit of the program provider's operations and offering recommendations for improvement of program operations for action by the program provider as necessary.

(g) - (i)

No change.

(j)

The program provider must ensure that:

(1)

the individual and the LAR are informed of how to report allegations of abuse, neglect, or exploitation to TDPRS [ the Texas Department of Protective and Regulatory Services (TDPRS) ] and are provided with the TDPRS toll-free telephone number (1-800-647-7418) in writing; [ and ]

(2)

all program provider personnel are:

(A)

instructed to report to TDPRS immediately, but not later than one hour after having knowledge or suspicion, that an individual has been or is being abused, neglected, or exploited; and

(B)

provided with the TDPRS toll-free telephone number (1-800-647-7418) in writing; and

[(2)

all service provider personnel are instructed to immediately report suspected abuse, neglect, or exploitation to TDPRS and are provided with the TDPRS toll-free telephone number (1-800-647-7418) in writing; and]

(3)

all program [ service ] provider personnel report suspected abuse, neglect, or exploitation as instructed.

(k)

If the program provider suspects an individual has been or is being abused, neglected, or exploited or is notified of an allegation of abuse, neglect or exploitation, the program provider shall take necessary actions to secure the safety of the alleged victims [ victim(s) involved in the allegation ], including but not limited to:

(1)

obtaining immediate and on-going medical or psychological services for the alleged victim as necessary;

(2)

[ securing the safety of the alleged victim and, ] if necessary, restricting access by the alleged perpetrator of the abuse, neglect or exploitation to the alleged victim or other individuals pending investigation of the allegation; and

(3)

notifying the alleged victim and the alleged victim's [ individual's ] LAR of the allegation .

(l)

The program provider personnel shall cooperate with the TDPRS investigation of an allegation of abuse, neglect, or exploitation, including but not limited to:

(1)

providing complete access to all HCS-O program service sites owned, operated, or controlled by the program provider; [ and ]

(2)

providing complete access to individuals and program provider personnel;

(3)

providing access to all records pertinent to the investigation of the allegation; and

(4)

preserving and protecting any evidence related to the allegation in accordance with TDPRS instructions.

(m)

(No change.)

(n)

The program provider must:

(1)

report the program provider's response to the finding of all TDPRS investigations of abuse, neglect, or exploitation to the department in accordance with department procedures within 14 [ 10 ] calendar days of the program provider's receipt of the investigation findings; and

(2)

promptly, but not later than five calendar days from the program provider's receipt of the TDPRS investigative report and finding, notify the alleged victim or the LAR of:

(A)

the investigation finding;

(B)

the corrective action taken by the program provider if TDPRS confirms that abuse, neglect, or exploitation occurred;

(C)

the process to appeal the investigation finding as described in 40 TAC Chapter 711, Subchapter M (relating to Requesting an Appeal if You are the Reporter, Alleged Victim, Legal Guardian, or with Advocacy, Incorporated); and

(D)

the process for requesting a copy of the investigative report from the program provider; and

[(2)

notify the individual and the individual's LAR that the TDPRS investigation has been completed and that the individual or LAR may contact TDPRS regarding the results of the investigation and the process for appealing the findings within 10 calendar days of the program provider's receipt of the investigation findings.]

(3)

upon request of the alleged victim or LAR, provide to the alleged victim or LAR a copy of the TDPRS investigation report after concealing any information that would reveal the identity of the reporter or of any individual who is not the alleged victim.

(o) - (w)

(No 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 January 29, 2001.

TRD-200100526

Andrew Hardin

Chair, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Earliest possible date of adoption: March 11, 2001

For further information, please call: (512) 206-5232