TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 19. TEXAS DEPARTMENT OF PROTECTIVE AND REGULATORY SERVICES

Chapter 700. CHILD PROTECTIVE SERVICES

The Texas Department of Protective and Regulatory Services (TDPRS) adopts amendments to §§700.316, 700.324, 700.328, 700.330, 700.1322, 700.1733, 700.1736, 700.2501, and 700.2502; adopts the repeal of §§700.2301-700.2310 and 700.2401-700.2407; and adopts new §§700.2301, 700.2303, 700.2321, 700.2323, 700.2341, 700.2343, 700.2361, and 700.2363, concerning levels of care, in its Child Protective Services chapter. New §§700.2301, 700.2303, 700.2321, 700.2323, 700.2341, 700.2343, 700.2361, and 700.2363 are adopted with changes to the proposed text published in the October 10, 2003, issue of the Texas Register (28 TexReg 8831). The amendments to §§700.316, 700.324, 700.328, 700.330, 700.1322, 700.1733, 700.1736, 700.2501, and 700.2502; and the repeal of §§700.2301-700.2310 and 700.2401-700.2407 are adopted without changes to the proposed text and will not be republished. In addition, TDPRS is withdrawing §§700.2302, 700.2322, 700.2342, and 700.2362, which were also proposed in the October 10, 2003, issue of the Texas Register (28 TexReg 8831). The information contained in those sections has been consolidated with other sections and is explained later in the preamble.

The justification for the amendments, repeals, and new sections is to describe the four service levels into which the six levels of care and additional special definitions for medical fragility and developmental delays, substance abuse, and mental retardation have been merged and to eliminate redundancy. The new rules describe the needs and characteristics of children at each service level. The four service levels are: Basic Services; Moderate Services; Specialized Services; and Intense Services.

The sections will function by ensuring that the needs and characteristics of children in TDPRS care are better described in a manner that is easier to understand, and thus more effectively applied by caseworkers, providers, and others involved in the reviewing and monitoring of the care of TDPRS children.

During the comment period, TDPRS received 184 comments from 19 entities and 30 individuals. The following businesses, organizations, associations, and other entities submitted comments: Advocacy, Inc.; Austin Toxicology; ARC of Texas; Center for BrainHealth; EveryChild, Inc.; Greater Texas Community Partners; Handle with Care, CPA; Harris County Foster Parents Association; Houston's Therapeutic Equestrian Center; Kaufman County Welfare Board; Lutheran Social Services of the South; NCMHMR; Safe Havens of Kornerstone CPA; Southwest Chapter of Autism Society of America; Tarrant County Foster Parent Association; Texas Alliance of Child and Family Services; Texas Center for Disability Studies; Texas Council for Developmental Disabilities; Texas Foster Family Association; and The Center for Health Care Services. A summary of the comments and responses follows:

Comments concerning §700.2301: Five commenters suggested we remove the word "normal".

Response: TDPRS is adopting this section with changes due to public comments. The word "normal" is deleted and the phrase "preferably in a family" is added to be consistent with the other service levels. On occasion, children need placement in an emergency shelter that is not a family. Also, the needs of the child, which were included in proposed §700.2302, have been consolidated with §700.2301.

Comments concerning §700.2303: Four commenters stated this section makes no reference to children with primary medical needs. The commenters assume this means that children with primary medical needs would not be included in this category.

Response: Children with primary medical needs as defined in Residential Child Care Licensing Minimum Standards for Child Placing Agencies Appendix H require more than basic services. However, TDPRS is adopting this section with format changes that make it consistent with the remaining service levels.

Comments concerning §700.2321: Four commenters suggested we replace "family-like" with "family."

Response: TDPRS is adopting this section with changes due to public comment. The section now reads: "The Moderate Service Level consists of a structured supportive setting, preferably in a family, in which most activities are designed to improve the child's functioning." Also, the needs of the child, which were included in proposed §700.2322, have been consolidated with §700.2321. In addition, format changes are made for clarification and consistency.

Comments concerning §700.2323: (1) Three commenters suggested generalized descriptors such as frequent, occasional, and moderate are all used without parameters of what constitutes each.

Response: The descriptors frequent, occasional, and moderate are consistent with the Level of Care system that has been in place since 1990. We are confident that our third party reviewer has consistently applied these terms in Level of Care authorizations as evidenced by their quality assurance measures that include quarterly inter-rater reliability testing along with on going training and supervision.

(2) TDPRS received four additional comments regarding this section in reference to children with disabilities. The commenters stated this standard does not address the risk to children with primary medical needs related to their medical condition or diagnosis.

Response: The risk of harm for children with primary medical needs is addressed in paragraph (4).

However, TDPRS is adopting this section with format changes that make it consistent with the remaining service levels.

Comments concerning §700.2341: Four commenters suggested the term "treatment setting" should be changed to "preferably a family."

Response: TDPRS is adopting this section with changes due to public comment. The sentence is revised to "a treatment setting, preferably a family, in which caregivers have specialized training to provide therapeutic, habilitative and medical support and interventions." Also, the needs of the child, which were included in proposed §700.2342, have been consolidated with §700.2341. In addition, format changes are made for clarification.

Comments concerning §700.2342: Four commenters would like to have the word "supervision" defined.

Response: TDPRS is withdrawing this section because the needs of the child were consolidated with §700.2341. Supervision is already defined in the childcare licensing rules (refer to §720.570 (30) of this title (relating to Definitions)).

Comments concerning §700.2343: (1) TDPRS received 11 comments regarding this section, specifically subsection (e) regarding children with primary medical needs. The commenters suggest that "constant access" is too limiting and "medically skilled caregiver" is not defined.

Response: TDPRS is adopting this section with changes due to public comment. Format changes are made for clarification. Subsection (e)(4) is now subparagraph (4)(D), and is revised to read: "constant access to on-site, medically skilled caregiver with demonstrated competencies in the interventions needed by the child in their care."

(2) The commenters also suggest the standard speak to difficulties that address the risk to children with primary medical needs.

Response: The risk of harm for children with primary medical needs is addressed in paragraph (4).

Comments concerning §700.2361: (1) TDPRS received four comments regarding this section, all regarding the children with disabilities. The commenters suggest adding "preferably a family."

Response: TDPRS is adopting this section with changes due to public comment. The section is revised to read: "The Intense Service Level consists of a high degree of structure, preferably in a family, to limit the child's access to environments as necessary to protect the child. The caregivers have specialized training to provide intense therapeutic, habilitative, and medical supports and interventions with limited outside access."

(2) The commenters also suggest that children with medical/developmental disabilities do not need to have limited access to the environment.

Response: Children with medical/developmental disabilities that would require this level of service are often medically fragile and they may need to be protected from infection and/or an over stimulating environment.

Also, the needs of the child, which were included in proposed §700.2362, have been consolidated with §700.2361. In addition, format changes are made for clarification.

Comments concerning §700.2362: TDPRS received three comments regarding the developmental disability and primary medical needs section of this rule. The commenters suggest that the portion of the sentence that reads, "professionally designed and supervised" is not clear that a foster parent, who has demonstrated competency, can be designated as the person to provide medical supervision.

Response: TDPRS is withdrawing this section because the needs of the child were consolidated with §700.2361. The sentence is revised to read: "(b) The child with developmental delays or mental retardation needs professionally directed, designed, and monitored interventions to enhance mobility, communication, sensory, motor, and cognitive development, and self-help skills."

Comments concerning §700.2363: Three commenters suggested the standard speak to difficulties that address the risk to children with primary medical needs.

Response: TDPRS is adopting this section with changes due to public comment. Children needing intense services present an imminent and critical risk of harm to self or others. Risk is addressed for children with primary medical needs in paragraph (4). However, for further clarification, the description was expanded.

Comments concerning §700.2402: PRS received 14 comments regarding the repeal of this rule and the increased training hour requirements.

Response: TDPRS is repealing this section because it was a Level of Care indicator that was replaced with a Service Level indicator in the residential care contract. This issue was addressed by residential contracts. Training hours for Basic homes are now 20 hours per home per year as required by Minimum Standards.

Comments concerning §§700.2404, 700.2405, 700.2406, and 700.2407: TDPRS received three comments opposing the repeal of these rules and 16 specific comments regarding the Service Level indicators that are now a part of the residential child care contract.

Response: TDPRS is adopting the rule repeals because they were LOC indicators that were replaced with Service Level indicators in the residential care contract. Comments received will be forwarded to Contract Management Division for consideration in the Fiscal Year 2005 service contracts.

General Comments: Three comments disagreed with changing from six levels of care to four service levels.

Response: TDPRS was required by the 78th Legislative session in HB 1, Rider 21, to consolidate the Level of Care system no later than October 1, 2003. The revisions represent the work of internal and external stakeholders.

TDPRS received additional comments that cannot be tied to these specific rule revisions and are outside the scope of this proposal. Forty-four comments were received regarding the rate structure. There is strong advocacy for a home-based rate at the Intense Service Level, which has since been set. Nine comments reflected a lack of confidence in our third party reviewer and their abilities to accurately assess the needs of children in our care.

Subchapter C. ELIGIBILITY FOR CHILD PROTECTIVE SERVICES

40 TAC §§700.316, 700.324, 700.328, 700.330

The amendments are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The amendments implement the Human Resources Code, §40.029.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400571

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Subchapter M. SUBSTITUTE-CARE SERVICES

40 TAC §700.1322

The amendment is adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The amendment implements the Human Resources Code, §40.029.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400572

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Subchapter Q. PURCHASED PROTECTIVE SERVICES

40 TAC §700.1733, §700.1736

The amendments are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The amendments implement the Human Resources Code, §40.029.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400573

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Subchapter W. DEFINITIONS OF LEVELS OF CARE

40 TAC §§700.2301 - 700.2310

The repeals are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The repeals implement the Human Resources Code, §40.029.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400574

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Subchapter W. LEVEL-OF-CARE SERVICE SYSTEM

1. BASIC SERVICE LEVEL

40 TAC §700.2301, §700.2303

The new sections are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The new sections implement the Human Resources Code, §40.029.

§700.2301.What is the description of the Basic Service Level?

The Basic Service Level consists of a supportive setting, preferably in a family that is designed to maintain or improve the child's functioning including:

(1) routine guidance and supervision to ensure the child's safety and sense of security;

(2) affection, reassurance, and involvement in activities appropriate to the child's age and development to promote the child's well-being;

(3) contact, in a manner that is deemed in the best interest of the child, with family members and other persons significant to the child to maintain a sense of identity and culture; and

(4) access to therapeutic, habilitative, and medical intervention and guidance from professionals or para-professionals, on an as needed basis, to help the child maintain functioning appropriate to the child's age and development.

§700.2303.What are the characteristics of a child that needs the Basic Service Level?

A child needing basic services is capable of responding to limit setting or other interventions. The children needing basic services may include:

(1) a child whose characteristics include one or more of the following:

(A) transient difficulties and occasional misbehavior;

(B) acting out in response to stress, but episodes of acting out are brief; and

(C) behavior that is minimally disturbing to others, but the behavior is considered typical for the child's age and can be corrected.

(2) a child with developmental delays or mental retardation whose characteristics include minor to moderate difficulties with conceptual, social, and practical adaptive skills.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400575

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


2. MODERATE SERVICE LEVEL

40 TAC §700.2321, §700.2323

The new sections are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The new sections implement the Human Resources Code, §40.029.

§700.2321.What is the description of the Moderate Service Level?

(a) The Moderate Service Level consists of a structured supportive setting, preferably in a family, in which most activities are designed to improve the child's functioning including:

(1) more than routine guidance and supervision to ensure the child's safety and sense of security;

(2) affection, reassurance, and involvement in structured activities appropriate to the child's age and development to promote the child's well-being;

(3) contact, in a manner that is deemed in the best interest of the child, with family members and other persons significant to the child to maintain a sense of identity and culture; and

(4) access to therapeutic, habilitative, and medical intervention and guidance from professionals or para-professionals to help the child attain or maintain functioning appropriate to the child's age and development.

(b) In addition to the description in subsection (a) of this section, a child with primary medical or habilitative needs may require intermittent interventions from a skilled caregiver who has demonstrated competence.

§700.2323.What are the characteristics of a child that needs the Moderate Service Level?

A child needing moderate services has problems in one or more areas of functioning. The children needing moderate services may include:

(1) a child whose characteristics include one or more of the following:

(A) frequent non-violent, anti-social acts;

(B) occasional physical aggression;

(C) minor self-injurious actions; and

(D) difficulties that present a moderate risk of harm to self or others.

(2) a child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include one or more of the following:

(A) substance abuse to the extent or frequency that the child is at-risk of substantial problems; and

(B) a historical diagnosis of substance abuse or dependency with a need for regular community support through groups or similar interventions.

(3) a child with developmental delays or mental retardation whose characteristics include:

(A) moderate to substantial difficulties with conceptual, social, and practical adaptive skills to include daily living and self-care; and

(B) moderate impairment in communication, cognition, or expressions of affect.

(4) a child with primary medical or habilitative needs, whose characteristics include one or more of the following:

(A) occasional exacerbations or intermittent interventions in relation to the diagnosed medical condition;

(B) limited daily living and self-care skills;

(C) ambulatory with assistance; and

(D) daily access to on-call, skilled caregivers with demonstrated competency.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400576

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


3. SPECIALIZED SERVICE LEVEL

40 TAC §700.2341, §700.2343

The new sections are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The new sections implement the Human Resources Code, §40.029.

§700.2341.What is the description of the Specialized Service Level?

(a) The Specialized Service Level consists of a treatment setting, preferably in a family in which caregivers have specialized training to provide therapeutic, habilitative, and medical support and interventions including:

(1) 24-hour supervision to ensure the child's safety and sense of security, which includes close monitoring and increased limit setting;

(2) affection, reassurance, and involvement in therapeutic activities appropriate to the child's age and development to promote the child's well-being;

(3) contact, in a manner that is deemed in the best interest of the child, with family members and other persons significant to the child to maintain a sense of identity and culture; and

(4) therapeutic, habilitative, and medical intervention and guidance that is regularly scheduled and professionally designed and supervised to help the child attain functioning appropriate to the child's age and development.

(b) In addition to the description in subsection (a) of this section, a child with primary medical or habilitative needs may require regular interventions from a caregiver who has demonstrated competence.

§700.2343.What are the characteristics of a child that needs the Specialized Service Level?

A child needing specialized services has severe problems in one or more areas of functioning. The children needing specialized services may include:

(1) a child whose characteristics include one or more of the following:

(A) unpredictable non-violent, anti-social acts;

(B) frequent or unpredictable physical aggression;

(C) being markedly withdrawn and isolated;

(D) major self-injurious actions to include recent suicide attempts; and

(E) difficulties that present a significant risk of harm to self or others.

(2) a child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include one or more of the following:

(A) severe impairment because of the substance abuse; and

(B) a primary diagnosis of substance abuse or dependency.

(3) a child with developmental delays or mental retardation whose characteristics include one or more of the following:

(A) severely impaired conceptual, social, and practical adaptive skills to include daily living and self-care;

(B) severe impairment in communication, cognition, or expressions of affect;

(C) lack of motivation or the inability to complete self-care activities or participate in social activities;

(D) inability to respond appropriately to an emergency; and

(E) multiple physical disabilities including sensory impairments.

(4) a child with primary medical or habilitative needs whose characteristics include one or more of the following:

(A) regular or frequent exacerbations or interventions in relation to the diagnosed medical condition;

(B) severely limited daily living and self-care skills;

(C) non-ambulatory or confined to a bed; and

(D) constant access to on-site, medically skilled caregivers with demonstrated competencies in the interventions needed by children in their care.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400577

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


4. INTENSE SERVICE LEVEL

40 TAC §700.2361, §700.2363

The new sections are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The new sections implement the Human Resources Code, §40.029.

§700.2361.What is the description of the Intense Service Level?

(a) The Intense Service Level consists of a high degree of structure, preferably in a family, to limit the child's access to environments as necessary to protect the child. The caregivers have specialized training to provide intense therapeutic and habilitative supports and interventions with limited outside access, including:

(1) 24-hour supervision to ensure the child's safety and sense of security, which includes frequent one-to-one monitoring with the ability to provide immediate on site response;

(2) affection, reassurance, and involvement in therapeutic activities appropriate to the child's age and development to promote the child's well-being;

(3) contact, in a manner that is deemed in the best interest of the child, with family members and other persons significant to the child, to maintain a sense of identity and culture;

(4) therapeutic, habilitative, and medical intervention and guidance that is frequently scheduled and professionally designed and supervised to help the child attain functioning more appropriate to the child's age and development; and

(5) consistent and frequent attention, direction, and assistance to help the child attain stabilization and connect appropriately with the child's environment.

(b) In addition to the description in subsection (a) of this section, a child with developmental delays or mental retardation needs professionally directed, designed, and monitored interventions to enhance mobility, communication, sensory, motor, and cognitive development, and self-help skills.

(c) In addition to the description in subsection (a) of this section, a child with primary medical or habilitative needs requires frequent and consistent interventions. The child may be dependent on people or technology for accommodation and require interventions designed, monitored, or approved by an appropriately constituted interdisciplinary team.

§700.2363.What are the characteristics of a child that needs the Intense Service Level?

A child needing intense services has severe problems in one or more areas of functioning that present an imminent and critical danger of harm to self or others. The children needing intense services may include:

(1) a child whose characteristics include one or more of the following:

(A) extreme physical aggression that causes harm;

(B) recurring major self-injurious actions to include serious suicide attempts;

(C) other difficulties that present a critical risk of harm to self or others; and

(D) severely impaired reality testing, communication skills, cognitive, affect, or personal hygiene.

(2) a child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include a primary diagnosis of substance dependency in addition to being extremely aggressive or self-destructive to the point of causing harm.

(3) a child with developmental delays or mental retardation whose characteristics include one or more of the following:

(A) impairments so severe in conceptual, social, and practical adaptive skills that the child's ability to actively participate in the program is limited and requires constant one- to-one supervision for the safety of self or others; and

(B) a consistent inability to cooperate in self-care while requiring, constant one-to-one supervision for the safety of self or others.

(4) a child with primary medical or habilitative needs that present an imminent and critical medical risk whose characteristics include one or more of the following:

(A) frequent acute exacerbations and chronic, intensive interventions in relation to the diagnosed medical condition;

(B) inability to perform daily living or self-care skills; and

(C) medical supervision, 24-hour on-site, to sustain life support.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400578

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Subchapter X. LEVEL-OF-CARE STANDARDS FOR FOSTER CAREGIVERS

40 TAC §§700.2401 - 700.2407

The repeals are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The repeals implement the Human Resources Code, §40.029.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400579

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Subchapter Y. CONTRACTING WITH LICENSED RESIDENTIAL CHILD-CARE PROVIDERS

40 TAC §700.2501, §700.2502

The amendments are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The amendments implement the Human Resources Code, §40.029.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400580

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: October 10, 2003

For further information, please call: (512) 438-3437


Chapter 700. CHILD PROTECTIVE SERVICES

Subchapter H. ADOPTION ASSISTANCE PROGRAM

The Texas Department of Protective and Regulatory Services (PRS) adopts amendments to §§700.801, 700.820, and 700.821; adopts the repeal of §700.863; and adopts new §700.863, without changes to the proposed text published in the December 19, 2003, issue of the Texas Register (28 TexReg 11240).

The justification for the sections is to clarify definitions and jurisdictional requirements. In 2001, the rules pertaining to adoption assistance were revised to simplify the language. Since adoption of the rules, changes needed to further clarify the requirements have been identified. Also, adoption of the clarifications will reflect the department's compliance with federal law and policy.

The sections will function by providing additional clarity to the rules and requirements in the adoption assistance program.

No comments were received regarding adoption of the sections.

1. PROGRAM DESCRIPTION AND DEFINITIONS

40 TAC §700.801

The amendment is adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The amendment implements the Texas Family Code, Chapter 162, Subchapter D, Adoption Assistance Program, and Title IV-E of the Social Security Act (42 U.S.C. §673), which require that the department implement an adoption assistance program for special needs children.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400587

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: December 19, 2003

For further information, please call: (512) 438-3437


2. TITLE IV-E ELIGIBILITY REQUIREMENTS

40 TAC §700.820, §700.821

The amendments are adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The amendments implement the Texas Family Code, Chapter 162, Subchapter D, Adoption Assistance Program, and Title IV-E of the Social Security Act (42 U.S.C. §673), which require that the department implement an adoption assistance program for special needs children.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400588

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: December 19, 2003

For further information, please call: (512) 438-3437


4. CHANGES IN CIRCUMSTANCES

40 TAC §700.863

The repeal is adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The repeal implements the Texas Family Code, Chapter 162, Subchapter D, Adoption Assistance Program, and Title IV-E of the Social Security Act (42 U.S.C. §673), which require that the department implement an adoption assistance program for special needs children.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400589

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: December 19, 2003

For further information, please call: (512) 438-3437


40 TAC §700.863

The new section is adopted under the Human Resources Code, §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs.

The new section implements the Texas Family Code, Chapter 162, Subchapter D, Adoption Assistance Program, and Title IV-E of the Social Security Act (42 U.S.C. §673), which require that the department implement an adoption assistance program for special needs children.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400590

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: December 19, 2003

For further information, please call: (512) 438-3437


Chapter 746. MINIMUM STANDARDS FOR CHILD-CARE CENTERS

Subchapter D. PERSONNEL

4. PROFESSIONAL DEVELOPMENT

40 TAC §746.1315, §746.1329

The Texas Department of Protective and Regulatory Services (PRS) adopts amendments to §746.1315 and §746.1329, without changes to the proposed text published in the December 19, 2003, issue of the Texas Register (28 TexReg 11242).

Current minimum standards for child day-care operations require that CPR training be conducted by the American Red Cross (ARC), American Heart Association (AHA) or by a training program that has been approved by the local Emergency Medical Services Authority, or is offered through the local hospital. Training offered by persons with instructor certification from the ARC or AHA or training approved by the Texas Department of Health-Bureau of Emergency Management for EMS certification will also comply. The standards regarding CPR training were written to ensure that instructors know and train caregivers on up-to-date techniques and information, from organizations recognized as setting, or which subscribe to, the national standards for emergency cardiac care. Although the organizations listed in the minimum standard are readily available and easily recognized in all parts of Texas, the list narrowed the variety of resources for CPR training. As a result, a number of concerns have been expressed by businesses that operate outside the parameters of the current rules but want to continue offering CPR training to caregivers. In response to these concerns, the rules are amended to broaden the scope of acceptable sources for CPR training, and facilitate the availability of these businesses to the child-care community, while still meeting the purpose of the standard. Additionally, rules addressing the verification of CPR/first-aid training are revised to allow a photocopy of the training certification card or letter to be maintained in the personnel record, rather than the original. Many caregivers prefer to carry the original certification card with them at all times. Adding the phrase "college credit hours" will make §746.1329 consistent with existing §746.1321, which allows college courses to count toward annual training requirements.

The amendments will function by increasing the variety of resources available for child-care operators to select from for CPR training when meeting the minimum standards.

During the comment period, PRS received comments from the American Safety and Health Institute, EMS Safety Services, the National Safety Council, and one individual. A summary of the comments and responses follows:

Comments concerning §746.1315: PRS received four comments supporting the proposed change. Two of the commenters support proposed changes to the rule with recommendations. One proposed change requested the organization's name be added to the rule. The other proposed change noted a conflict between §746.1315 and §746.1329 regarding the documentation of training.

Response: PRS is adopting this section without change. Names of organizations offering CPR training were removed from the rule to broaden the scope of acceptable sources. Section 746.1315 and §746.1329 do not conflict with one another because §746.1315 specifically addresses CPR and first aid training, and §746.1329 addresses documentation for all types of training, including some training that can be self-instructional.

The amendments are adopted under the Human Resources Code (HRC), §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs; HRC §42.042, which requires the department to make rules and promulgate minimum standards to carry out the provisions of the HRC, Chapter 42; and HRC §42.002, which gives the department primary responsibility for regulating child care operations.

The amendments implement the Human Resources Code, §42.042 and §42.0426.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400585

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: December 19, 2003

For further information, please call: (512) 438-3437


Chapter 747. MINIMUM STANDARDS FOR CHILD-CARE HOMES

Subchapter D. PERSONNEL

4. PROFESSIONAL DEVELOPMENT

40 TAC §747.1313, §747.1327

The Texas Department of Protective and Regulatory Services (PRS) adopts amendments to §747.1313 and §747.1327, in its Minimum Standards for Child-Care Homes chapter. The amendment to §747.1327 is adopted with changes to the proposed text published in the December 19, 2003, issue of the Texas Register (28 TexReg 11243). The amendment to §747.1313 is adopted without changes to the proposed text and will not be republished.

Current minimum standards for child day-care operations require that CPR training be conducted by the American Red Cross (ARC), American Heart Association (AHA) or by a training program that has been approved by the local Emergency Medical Services Authority, or is offered through the local hospital. Training offered by persons with instructor certification from the ARC or AHA or training approved by the Texas Department of Health-Bureau of Emergency Management for EMS certification will also comply. The standards regarding CPR training were written to ensure that instructors know and train caregivers on up-to-date techniques and information, from organizations recognized as setting, or which subscribe to, the national standards for emergency cardiac care. Although the organizations listed in the minimum standard are readily available and easily recognized in all parts of Texas, the list narrowed the variety of resources for CPR training. As a result, a number of concerns have been expressed by businesses that operate outside the parameters of the current rules but want to continue offering CPR training to caregivers. In response to these concerns, the rules are amended to broaden the scope of acceptable sources for CPR training, and facilitate the availability of these businesses to the child-care community, while still meeting the purpose of the standard. Additionally, rules addressing the verification of CPR/first-aid training are revised to allow a photocopy of the training certification card or letter to be maintained in the personnel record, rather than the original. Many caregivers prefer to carry the original certification card with them at all times. Adding the phrase "college credit hours" will make §747.1327 consistent with existing §747.1319, which allows college courses to count toward annual training requirements.

The amendments will function by increasing the variety of resources available for child-care operators to select from for CPR training when meeting the minimum standards.

During the comment period, PRS received a comment from an individual concerning §747.1327. The commenter thinks there is a contradiction in §747.1313(d), stating that first aid training must not be obtained from self-instructional training, and in §747.1327(a)(4), the trainer's name, or the source of the training for self-instructional training is required. Section 747.1313 and §747.1327 do not conflict with one another, because §747.1313 specifically addresses CPR and first aid training and §747.1329 addresses documentation for all types of training, including some training that can be self-instructional. PRS is, however, changing the word "employee" to "caregiver" in §747.1327(b) for clarification.

The amendments are adopted under the Human Resources Code (HRC), §40.029, which authorizes the department to adopt rules that facilitate the implementation of department programs; HRC §42.042, which requires the department to make rules and promulgate minimum standards to carry out the provisions of the HRC, Chapter 42; and HRC §42.002, which gives the department primary responsibility for regulating child care operations.

The amendments implement the Human Resources Code, §42.042 and §42.0426.

§747.1327.What documentation must I provide to Licensing to verify that training requirements have been met?

(a) Except as provided in this section, you must maintain original certificates documenting training in each caregiver's personnel record at your child-care home. To be counted toward compliance with the minimum standards, the trainer or training source must provide the participant with an original certificate or letter showing:

(1) The participant's name;

(2) Date of the training;

(3) Title/subject of the training;

(4) The trainer's name, or the source of the training for self-instructional training; and

(5) Length of the training specified in clock hours, CEUs, or college credit hours, as appropriate.

(b) Documentation of CPR/first-aid training must include the same information in subsection (a) of this section, and must also include the expiration date of the training, as determined by the organization providing the training. A photocopy of the original CPR/first-aid certificate or letter may be maintained in the personnel record, as long as the caregiver can provide an original document upon request by Licensing.

(c) You may obtain a signed statement stating the caregiver has received the orientation or you may use original certificates, as specified in this division.

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

Filed with the Office of the Secretary of State on January 29, 2004.

TRD-200400586

C. Ed Davis

Deputy Director, Legal Services

Texas Department of Protective and Regulatory Services

Effective date: March 1, 2004

Proposal publication date: December 19, 2003

For further information, please call: (512) 438-3437