TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Chapter 370. LICENSE RENEWAL

40 TAC §370.1

The Texas Board of Occupational Therapy Examiners proposes an amendment to §370.1, concerning License Renewal. The amendment will add language for online renewal and continuing education requirements for reservist called to active service in the military.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be clarification of the OT rules. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas, 78701, (512) 305-6900, or through email: augusta.gelfand@mail.capnet.state.tx.us

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

§370.1.License Renewal.

(a) Licensees are required to renew their licenses every two years by the end of their birth month. A licensee may not provide occupational therapy services without a current license or renewal certificate in hand. If a license expired after all required items are submitted but before the licensee received the renewal certificate, the licensee may not provide occupational therapy services until the renewal certificate is in hand.

(1) General Requirements. The renewal application is not complete until the board receives all required items. The components required for license renewals are:

(A) Signed renewal application form or online equivalent verifying completion of 30 hours of continuing education, see Chapter 367 of this title (relating to Continuing Education);

(B) - (C) (No change.)

(2) Notification of license expiration. The Board will send notification [ mail an application ] to each licensee at least 30 days prior to the license expiration date. However, the licensee is responsible for ensuring that the license is renewed. [ Licensees should contact the board if they do not receive a renewal application approximately 30 days prior to the expiration date. ]

(3) Late Renewals. A renewal application is late if all required materials are not postmarked prior to the expiration date of the license. Licensees who do not complete the renewal process prior to the expiration date are subject to late fees as described.

(A) - (D) (No change.)

(E) A reserve status licensee who is called into active military service will have 6 additional months after release from active military service to submit proof of completion of the 30 required CE hours.

(b) - (c) (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 August 5, 2005.

TRD-200503270

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: September 18, 2005

For further information, please call: (512) 305-6900


Chapter 372. PROVISION OF SERVICES

40 TAC §372.1

The Texas Board of Occupational Therapy Examiners proposes an amendment to §372.1, concerning Provision of Services. The amendment will delete the requirement for co-signature of COTA notes and move the language concerning aides to the section concerning Supervision of Non-Licensed Personnel.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be clarification of the OT rules. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas, 78701, (512) 305-6900, or through email: augusta.gelfand@mail.capnet.state.tx.us

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

§372.1.Provision of Services.

(a) - (d) (No change.)

(e) Plan of Care.

(1) - (7) (No change.)

[ (8) It is the OTR's or LOT's responsibility to ensure that all documentation which becomes part of the patient's/client's permanent record is approved and co-signed by the OTR or LOT and signed on the bottom of each page. Non-licensed personnel may not write or sign occupational therapy documents in the permanent record. However, non-licensed personnel may record quantitative data for tasks delegated by the supervising OTR, LOT, COTA or LOTA. Any documentation reflecting activities by non-licensed personnel must identify the name and title of that person and the name of the supervising OTR, LOT, COTA or LOTA.]

(8) [ (9) ] Except where otherwise restricted by rule, the supervising OTR or LOT may only delegate to a COTA, LOTA or temporary licensee tasks that they both agree are within the competency level of that COTA, LOTA or temporary licensee.

(9) [ (10) ] The COTA or LOTA must include the name of his or her supervising OTR or LOT in each treatment note. If there is not a current supervising OTR or LOT, the COTA or LOTA cannot treat.

(f) (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 August 5, 2005.

TRD-200503271

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: September 18, 2005

For further information, please call: (512) 305-6900


Chapter 373. SUPERVISION

40 TAC §373.1

The Texas Board of Occupational Therapy Examiners proposes an amendment to §373.1, concerning Supervision of Non-Licensed Personnel. The amendment will add language for when aides may or may not enter data into the patient's medical record.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect the public benefit anticipated as a result of enforcing the rule will be clarification of the OT rules. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the rule as proposed.

Comments on the proposed rule may be submitted to Augusta Gelfand, OT Coordinator, Texas Board of Occupational Therapy Examiners, 333 Guadalupe, Suite 2-510, Austin, Texas, 78701, (512) 305-6900, or through email: augusta.gelfand@mail.capnet.state.tx.us

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

§373.1.Supervision of Non-Licensed Personnel.

(a) - (e) (No change.)

(f) The non-licensed personnel may not:

(1) - (3) (No change.)

(4) write or sign occupational therapy documents in the permanent record. However, non-licensed personnel may record quantitative data for tasks delegated by the supervising OTR, LOT, COTA or LOTA. Any documentation reflecting activities by non-licensed personnel must identify the name and title of that person and the name of the supervising OTR, LOT, COTA or LOTA.

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 August 5, 2005.

TRD-200503272

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: September 18, 2005

For further information, please call: (512) 305-6900


Part 19. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES

Chapter 700. CHILD PROTECTIVE SERVICES

Subchapter J. RELATIVE AND OTHER DESIGNATED CAREGIVER PROGRAM

40 TAC §§700.1001, 700.1003, 700.1005, 700.1007, 700.1009, 700.1011, 700.1013, 700.1015, 700.1017

The Health and Human Services Commission proposes, on behalf of the Department of Family and Protective Services (DFPS), new §§700.1001, 700.1003, 700.1005, 700.1007, 700.1009, 700.1011, 700.1013, 700.1015, and 700.1017, concerning the Relative and Other Designated Caregiver Program, in its Child Protective Services chapter. Senate Bill 6 of the 79th Legislature required implementation of a Relative and Other Designated Caregiver Program by March 1, 2006, to provide initial transitional payments, annual reimbursements for expenses, and support services to certain non-licensed individuals who provide care to children in their extended family. Traditionally, relatives who provide placement services for children in DFPS custody have not received specific financial compensation from the State, although some families and children have qualified for assistance under other criteria in other agencies. These rules outline the eligibility for these services, maximize the benefit to those most in need, and ensure that the provision of such services does not exceed the available dollars appropriated for the biennium.

Cindy Brown, Chief Financial Officer of DFPS, has determined that for the first five-year period the proposed sections will be in effect there will be fiscal implications for state government as a result of enforcing or administering the sections. The estimated cost to the state as a result of the change will be $2,927,506 for fiscal year 2006; $5,910,552 for fiscal year 2007; $6,383,397 for fiscal year 2008; $6,894,068 for fiscal year 2009; and $7,445,594 for fiscal year 2010. Over time, it is anticipated that foster care expenses will be reduced as more children reside with relative or other designated caregivers rather than in paid foster care. At this time, cost savings are unable to be determined. All payments, reimbursements, and support services are subject to available funds. There will be no fiscal implications for local government.

Ms. Brown also has determined that for each year of the first five years the sections are in effect the public benefit anticipated as a result of enforcing the sections will be that relatives and other designated caregivers will receive some reimbursement for their care of children in DFPS conservatorship. There will be no effect on large, small, or micro-businesses because the proposed changes do not impose new requirements on any business and do not require the purchase of any new equipment or any increased staff time in order to comply. There is no anticipated economic cost to persons who are required to comply with the proposed sections.

Questions about the content of the proposal may be directed to Audrey Deckinga at (512) 438-3238 in DFPS's Child Protective Services Division. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-336, Department of Family and Protective Services E-611, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

HHSC has determined that the proposed new sections do not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under §2007.043, Government Code.

The new sections are proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services (DFPS); Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The new sections implement the Family Code, Chapter 264, as amended by §1.62 of Senate Bill 6, 79th Legislature.

§700.1001.What is the Relative and Other Designated Caregiver Program?

The Relative and Other Designated Caregiver Program is an array of services designed to promote continuity and stability for children in the conservatorship of DFPS. The program is effective March 1, 2006, and includes support services and limited financial assistance for eligible caregivers who assume caretaking responsibility for children in DFPS conservatorship. Subject to availability of funds and eligibility requirements, caregiver assistance may include case management services, training, referrals to appropriate services and assistance programs, family counseling, child-care services, limited cash assistance, and other support services. Funding for this program is limited to the state and federal funds allocated to DFPS for this program.

§700.1003.What are the eligibility requirements for caregiver assistance?

(a) The children to be placed must be in the conservatorship of DFPS.

(b) The caregiver must:

(1) be related to the children or have a longstanding and significant relationship with the children;

(2) be formally approved by DFPS as a caregiver;

(3) sign and abide by a written caregiver assistance agreement, which includes a commitment to:

(A) be available as a continuing placement for the children for at least six months;

(B) participate in specialized kinship training as recommended and provided by DFPS;

(C) comply with DFPS requirements limiting or facilitating contact between the parents and the children;

(D) apply for other forms of assistance, including financial and medical, for which the children may be eligible; and

(E) comply with any other child specific requirements or limitations; and

(4) not be a licensed or verified foster home or group foster home.

§700.1005.What types of cash assistance are available?

(a) Subject to the availability of funds, eligible caregivers may receive two types of cash assistance:

(1) an initial, one-time cash payment of not more than $1,000 per sibling group to defray costs incurred for essential child care items at the time of placement; and

(2) an annual reimbursement of not more than $500 per child for DFPS approved child-related expenses. To receive this reimbursement the caregiver must provide verification of the expenditures in the form of receipts.

(b) DFPS may further clarify in policy specific conditions or criteria caregivers must meet to receive this cash assistance or any other services or benefits in connection with this program, including what costs incurred for essential child care items may be defrayed, what expenditures are appropriate for reimbursement, and situations where the full initial, one-time payment may not be awarded.

§700.1007.Are there additional eligibility restrictions for the initial, one-time cash payment?

Yes, caregivers meeting the eligibility requirements specified in §700.1003 of this title (relating to What are the eligibility requirements for caregiver assistance?) are eligible only if:

(1) there have been no other caregivers paid under this provision on behalf of the same children;

(2) the caregiver is not eligible for supplemental financial assistance under the Grandparents Program, Human Resources Code, §31.0041;

(3) the household income of the caregiver does not exceed 300% of poverty, as determined by federal poverty guidelines; and

(4) the placement of the children by DFPS with the caregiver is made after March 1, 2006.

§700.1009.Who is eligible for the annual reimbursement?

Caregivers meeting the eligibility requirements specified in §700.1003 of this title (relating to What are the eligibility requirements for caregiver assistance?) are eligible, including:

(1) caregivers that are entitled to the initial, one-time cash payment;

(2) subsequent caregivers that didn't qualify for the initial, one-time cash payment because a different caregiver was previously paid under this provision on behalf of the same children;

(3) caregivers that didn't qualify for the initial, one-time cash payment because the caregiver was eligible for supplemental financial assistance under the Grandparents Program; and

(4) caregivers with whom DFPS placed the children before March 1, 2006.

§700.1011.Are there additional eligibility restrictions for the annual reimbursement?

(a) Yes:

(1) the household income of the caregiver must not exceed 300% of poverty, as determined by federal poverty guidelines;

(2) the caregiver must continue to comply with the signed caregiver assistance agreement; and

(3) the children:

(A) must continue to be in the conservatorship of DFPS or the caregiver must be awarded permanent managing conservatorship after March 1, 2006, of children that were previously in the conservatorship of DFPS;

(B) must be in the caregiver's care at the time the expense is incurred; and

(C) must continue to be placed with the caregiver.

(b) The following limitations also apply to the reimbursements:

(1) If the annual reimbursement is paid to a previous caregiver on behalf of the same children, a subsequent caregiver is not eligible for reimbursement for the remainder of the year.

(2) If the placement occurred before March 1, 2006, the reimbursement is limited to expenses incurred after March 1, 2006.

(3) Caregivers subsequently appointed as permanent managing conservator are only eligible for three additional annual reimbursement payments, assuming all other eligibility requirements and restrictions are met.

§700.1013.Who is eligible for child-care services?

(a) To the extent funds are available, DFPS may provide child-care services to a caregiver who meets the requirements in §700.1003 of this title (relating to What are the eligibility requirements for caregiver assistance?) if:

(1) all appropriate caregivers work outside the home 40 hours per week or more; and

(2) the caregiver is a resident of Texas.

(b) To monitor the spending of funds, a priority system among caregivers will also be established in policy. The priority system will be based upon need, but at a minimum will require:

(1) a determination by DFPS that the provision of child-care services is critical to maintaining the placement of the child with the caregiver; and

(2) at least one child placed by DFPS is under six years of age, or at least one child placed by DFPS has a developmental delay (including physical, emotional, and cognitive or language) or physical disability.

§700.1015.What rates will DFPS use to pay for child-care services?

The rates of child-care assistance will be determined by the established local rates set by Child Care Management Services.

§700.1017.Who is eligible for support services?

To qualify for available support services, a caregiver must meet the eligibility requirements in §700.1003 of this title (relating to What are the eligibility requirements for caregiver assistance?) and be a resident of Texas.

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 August 8, 2005.

TRD-200503291

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Chapter 720. 24-HOUR CARE LICENSING

The Health and Human Services Commission proposes, on behalf of the Department of Family and Protective Services (DFPS), amendments to §§720.66, 720.233, 720.335, 720.406, and 720.905, concerning serious incident reporting requirements, reports and records, emergency reports and records in the independent foster group homes, and administrative reports and records, in its 24-Hour Care Licensing chapter. The proposed changes are the result of requirements in Senate Bill (SB) 6, 79th Legislature. The bill directs the Executive Commissioner to adopt rules to implement drug-testing requirements for residential child-care facilities. The proposed amendments change the former Department's name to reflect the Licensing Division, and require residential child-care facilities to inform Licensing after learning of an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

Cindy Brown, Chief Financial Officer of DFPS, has determined that for the first five- year period the proposed sections will be in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the sections.

Ms. Brown also has determined that for each year of the first five years the sections are in effect the public benefit anticipated as a result of enforcing the sections will be that the protection of children will be enhanced and the quality of care of children will improve. There will be no effect on large, small, or micro-businesses because the proposed changes do not impose new requirements on any business and do not require the purchase of any new equipment or any increased staff time in order to comply. There is no anticipated economic cost to persons who are required to comply with the proposed sections.

Questions about the content of the proposal may be directed to Lizet Alaniz at (512) 438-4538 in DFPS's Licensing Division. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-333, Department of Family and Protective Services E-611, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

HHSC has determined that the proposed amendments do not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under §2007.043, Government Code.

Subchapter A. STANDARDS FOR CHILD-PLACING AGENCIES

40 TAC §720.66

The amendment is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The amendment implements the HRC §42.063, as amended by §1.106 of Senate Bill 6, 79th Legislature.

§720.66.Serious Incident Reporting Requirements.

(a) The child-placing agency must report the following types of serious incidents to the Licensing Division [ Texas Department of Protective and Regulatory Services (PRS's) licensing division ] and the child's parents or managing conservator within 24 hours [ by the next workday ]:

(1) any incident where there are indications that a child in care may have been abused or neglected as defined by the Family Code;

(2) abusive activity among children in care including:

(A) non-consensual sexual activity between children of any age;

(B) consensual sexual activity between children with more than 24 months difference in age or when there is a significant difference in size or developmental level of the children;

(C) child to child behavior that results in observable physical injury and causes material impairment;

(3) abusive treatment by caregiver including non-accidental caregiver action which if chronic or intensified, could cause substantial harm to a child, such as a slap to the face, sexual verbalizations; exposing the anus, breast, or any part of the genitals; inappropriate kissing; provision of sexually oriented material to a child other than that used for appropriate sex education and counseling; touching a child in inappropriate ways; and providing drugs or alcohol to a child;

(4) incidents that result in critical injury or permanent disability of a child. A "critical injury" is defined as any life-threatening injury or one that results in hospital intensive care or the need for life-resuscitation methods. It includes any injury that is labeled as "critical" by appropriate medical personnel;

(5) a suicide attempt meaning any attempt by a child to take his own life using means or methods capable of causing serious injury or means or methods that the child believes capable of causing serious injury.

(b) The child-placing agency must report to the Licensing Division within 24 hours after learning of an allegation that a person who directly cares for or has access to a child has abused drugs within the past seven days.

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 August 8, 2005.

TRD-200503284

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Subchapter E. STANDARDS FOR FOSTER FAMILY HOMES

40 TAC §720.233

The amendment is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The amendment implements the HRC §42.063, as amended by §1.106 of Senate Bill 6, 79th Legislature.

§720.233.Reports and Records.

(a) (No change.)

(b) The foster family home shall complete written incident reports concerning serious occurrences involving staff members, foster parents, or children. Each report shall include the date and time of occurrence, the staff members, foster parents, [ member ] or children involved, the nature of the incident, and the circumstances surrounding it. A copy of the report shall be filed at the foster family home, and shall be available for review by [ to the staff of the ] Licensing staff [ Branch ].

(c) The following serious occurrences shall be reported to the Licensing Division [ Branch ] within 24 hours [ or the next working day ]:

(1) - (4) (No change.)

(d) (No change.)

(e) Disasters or emergency situations which require closure of the foster home, such as those caused by fire or severe weather, shall be reported to the Licensing Division [ Branch ] within 24 hours [ or the next working day ].

(f) The foster family home must report to the Licensing Division within 24 hours after learning of an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

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 August 8, 2005.

TRD-200503285

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Subchapter F. STANDARDS FOR FOSTER GROUP HOMES

40 TAC §720.335

The amendment is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The amendment implements the HRC §42.063, as amended by §1.106 of Senate Bill 6, 79th Legislature.

§720.335.Emergency Reports and Records in the Independent Foster Group Homes.

(a) (No change.)

(b) The foster group home shall complete written incident reports concerning serious occurrences involving staff members, foster parents, or children. Each report shall include the date and time of occurrence, the staff members, [ member ] foster parents, or children involved, the nature of the incident, and the circumstances surrounding it. A copy of the report shall be filed at the foster group home and shall be available for review by [ the ] Licensing staff [ of the Licensing Branch ].

(c) The following types of serious occurrences shall be reported to [ the ] Licensing Division [ Branch ] within 24 hours [ or the next working day ]: suicide attempts, incidents of cruel or abusive treatment, incidents which critically injure or permanently disable a child, and death of a client.

(d) (No change.)

(e) Disasters or emergency situations which require closure of the living unit, such as fires or severe weather, shall be reported to the Licensing Division [ Branch of the department ] within 24 hours [ or the next working day ].

(f) The foster group home shall submit reports to the Licensing Division [ Branch ] of the department concerning:

(1) - (2) (No change.)

(g) The foster group home shall allow the Licensing Division [ department ] to visit and inspect the foster group home at all reasonable times (Texas Human Resources Code, Chapter 42).

(h) The foster group home's records shall be available and open for review by [ the ] Licensing staff [ Branch ].

(i) (No change.)

(j) The foster group home must report to the Licensing Division within 24 hours after learning of an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

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 August 8, 2005.

TRD-200503286

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Subchapter H. CONSOLIDATED STANDARDS FOR 24-HOUR CARE FACILITIES

40 TAC §720.406

The amendment is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The amendment implements the HRC §42.063, as amended by §1.106 of Senate Bill 6, 79th Legislature.

§720.406.Administrative Reports and Records.

(a) Written reports must be completed for any serious incident involving staff or children. The date and time of the incident, the name(s) of the staff member(s) or [ and/or ] child(ren) involved, the nature of the incident, and the circumstances surrounding it must be included in the report. A copy of the report must be filed at the facility and available for Licensing [ licensing ] staff to review.

(b) The following types of serious incidents must be reported to the Licensing Division [ licensing ] and the child's parent or managing conservator within 24 hours [ by the next workday ]: suicide attempts; abusive treatment, including alleged abuse; incidents that critically injure or permanently disable a child; and a child's death.

(c) The facility must have current written policies and procedures to follow when a child is absent without permission. These policies and procedures must include:

(1) (No change.)

(2) actions staff members take to locate the child;

(3) procedures (including timeframes) staff members must follow to notify the parents or managing conservator and the appropriate law enforcement agency.

(d) If a child is not located [ found ], the absence without permission must be reported to the parent or managing conservator and to the appropriate law enforcement agency.

(e) (No change.)

(f) Disasters or emergencies that require any living unit to close must be reported to the Licensing Division within 24 hours [ licensing by the next workday ].

(g) The Licensing Division must be informed of any impending change of administrator and any impending change necessitating a change in the conditions of the license.

(h) The facility must report to the Licensing Division within 24 hours after learning of an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

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 August 8, 2005.

TRD-200503287

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Subchapter M. STANDARDS FOR EMERGENCY SHELTERS

40 TAC §720.905

The amendment is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The amendment implements the HRC §42.063, as amended by §1.106 of Senate Bill 6, 79th Legislature.

§720.905.Reports and Records.

(a) (No change.)

(b) The emergency shelter must complete written reports concerning serious occurrences involving staff members or children. The emergency shelter must ensure that each report includes the date and time of occurrence, the staff members or children involved, the nature of the incident, and the circumstances. The emergency shelter must file a copy of the report at the shelter and make it available for review by Licensing staff [ of the licensing branch ].

(c) The emergency shelter must report the following types of serious occurrences to the Licensing Division [ licensing branch ] within 24 hours [ or the next workday ]:

(1) - (2) (No change.)

(3) incidents which critically injure or permanently disable a child; [ and ]

(4) death of a child ; and [ . ]

(5) an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

(d) The emergency shelter must have written policies and procedures to be followed when a child is absent without permission, including the following:

(1) specific actions staff members must take to locate the child;

(2) procedures staff members must follow to notify parents or managing conservators and the appropriate law enforcement agency.

(e) If a child is absent without permission, the shelter must report his absence to the appropriate law enforcement agency and managing conservator or parents, if the emergency shelter knows the managing conservator's or parents' identity and how to contact them.

(1) The shelter must consider the absence of a child under 10 years old (chronological or developmental age, whichever is less) as absence without permission as soon as staff members responsible for the child's care do [ does ] not know where he is. The shelter must consider the absence of a child 10 years old or older as absence without permission when staff members responsible for the child's care do [ does ] not know his whereabouts for three hours.

(2) (No change.)

(f) (No change.)

(g) The emergency shelter must report to the Licensing Division [ licensing branch ] within 24 hours [ or the next work day ] disasters or emergency situations, such as fires or severe weather, requiring closure of a living unit in the emergency shelter.

(h) The administrator of the emergency shelter must submit reports to the Licensing Division [ licensing branch ] concerning any:

(1) - (2) (No change.)

(i) The emergency shelter must allow Licensing [ department ] staff to [ visit and ] inspect the emergency shelter at reasonable times.

(j) The emergency shelter must make records available for review at the facility by Licensing staff [ of the licensing branch ].

(k) (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 August 8, 2005.

TRD-200503288

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Chapter 727. LICENSING OF MATERNITY FACILITIES

Subchapter A. STRUCTURE OF A MATERNITY HOME

40 TAC §727.111

The Health and Human Services Commission proposes, on behalf of the Department of Family and Protective Services (DFPS), an amendment to §727.111, concerning serious incident reports, in its Licensing of Maternity Facilities chapter. The proposed change will conform this chapter to the requirements imposed on residential child-care facilities as a result of Senate Bill (SB) 6, 79th Legislature. The bill directs the Executive Commissioner to adopt rules to implement drug-testing requirements for residential child-care facilities. The proposed amendment changes the former Department's name to reflect the Licensing Division, and requires the maternity homes to inform Licensing after learning of an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

Cindy Brown, Chief Financial Officer of DFPS, has determined that for the first five-year period the proposed section will be in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section.

Ms. Brown also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be that the protection of children will be enhanced and the quality of care of children will improve. There will be no effect on large, small, or micro-businesses because the proposed changes do not impose new requirements on any business and do not require the purchase of any new equipment or any increased staff time in order to comply. There is no anticipated economic cost to persons who are required to comply with the proposed section.

Questions about the content of the proposal may be directed to Lizet Alaniz at (512) 438-4538 in DFPS's Licensing Division. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-333, Department of Family and Protective Services E-611, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

HHSC has determined that the proposed amendment does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under §2007.043, Government Code.

The amendment is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The amendment implements the HRC §42.063, as amended by §1.106 of Senate Bill 6, 79th Legislature.

§727.111.Serious Incident Reports.

The maternity home must :

(1) complete written reports for serious incidents involving facility staff members or clients within 24 hours of learning about the occurrence. Each report must include the date and time of the occurrence, the staff members or clients involved, the nature of the incident, and the surrounding circumstances.

(2) report the following types of serious incidents to the Licensing Division [ Texas Department of Protective and Regulatory Services (TDPRS) ] and to a minor client's parent or managing conservator within 24 hours [ by the next workday ]:

(A) - (E) (No change.)

(3) have written policies and procedures to follow when a client is absent without permission. These policies and procedures must include:

(A) (No change.)

(B) actions that maternity home staff members must take to locate the client; and

(C) procedures, including time frames, that maternity home staff members must follow to notify the parents or managing conservator of a minor client and the appropriate law enforcement agency.

(4) report when a minor client is not located [ found ]. Absence without permission must be reported to the client's parents or managing conservator and to the appropriate law enforcement agency.

(5) (No change.)

(6) report to the Licensing Division within 24 hours [ TDPRS, by the next workday ], disasters or emergencies, such as fires or severe weather, that requires any part of the facility in which clients reside to close.

(7) report to the Licensing Division within 24 hours after learning of an allegation that a person who directly cares for or has access to a child in care has abused drugs within the past seven days.

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 August 8, 2005.

TRD-200503289

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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


Chapter 745. LICENSING

Subchapter H. RESIDENTIAL CHILD-CARE MINIMUM STANDARDS

6. DRUG TESTING

40 TAC §745.4151

The Health and Human Services Commission proposes, on behalf of the Department of Family and Protective Services (DFPS), new §745.4151, concerning what drug testing policy must my residential child-care operation have, in its Licensing chapter. The proposed change is the result of requirements in Senate Bill (SB) 6, 79th Legislature. The bill directs the Executive Commissioner to adopt rules to implement drug-testing requirements for residential child-care facilities. New §745.4151 adds the drug testing provisions of SB 6, including a model drug testing policy. The model drug testing policy applies to employees that have direct contact with children in care. This policy does not apply to foster parents that are verified by child-placing agencies. Mandatory drug testing is required for (1) pre-employment, and the individual cannot have access to children until the drug test results are available; (2) all employees on a random and unannounced basis; and (3) employees who are alleged to be abusing drugs.

Cindy Brown, Chief Financial Officer of DFPS, has determined that for the first five-year period the proposed section will be in effect there will be fiscal implications for state government as a result of enforcing or administering the section. The effect on state government for the first five-year period the section will be in effect is an estimated cost of $6,250 for fiscal year 2006, $6,250 for fiscal year 2007, $6,250 for fiscal year 2008, $6,250 for fiscal year 2009, and $6,250 for fiscal year 2010. DFPS operates 11 certified child-placing agencies. Of approximately 400 DFPS staff that provide regulated child-placing activities, an average of 125 DFPS staff would require initial and random drug testing each year at a cost of $50 per test. There will be an annual cost of $6,250 to DFPS. These costs can be absorbed with existing resources. The rules will not require additional staff. There will be no fiscal implications for local government as a result of enforcing or administering the section.

An additional cost to the state may also result because residential child-care providers will have increased allowable expenses to be submitted on required cost reports. The additional costs may result in pressure to raise current provider rates that are paid by the state.

Ms. Brown also has determined that for each year of the first five years the section is in effect the public benefit anticipated as a result of enforcing the section will be that the protection of children will be enhanced and the quality of care of children will improve. For each of the first five years that the proposed section will be in effect, DFPS has determined that there will be increased costs to residential child-care operations. The variables impacting the cost of drug testing for an individual provider include the number of staff hired in a year, the number of staff caring for children and the number of staff that will be subject to drug testing as a result of specific allegations or evidence of drug use. The costs for drug testing per employee can range from $20 - $65 for a urine drug test, $23 - $60 for a saliva drug test, or $46 - $250 for a hair drug test. The additional costs could potentially impact rates charged to the public by these residential child-care operations, but that impact cannot be estimated by DFPS as child-care rates charged to the public are set at the discretion of the residential child-care providers.

Individuals may incur testing expenses and possible medical fees if an employee elects to challenge a drug test result.

Questions about the content of the proposal may be directed to Lizet Alaniz at (512) 438-4538 in DFPS's Licensing Division. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-333, Department of Family and Protective Services E-611, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

HHSC has determined that the new section does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under §2007.043, Government Code.

The new section is proposed under Government Code §531.0055, which provides that the Health and Human Services Executive Commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including the Department of Family and Protective Services; Human Resources Code (HRC) §40.021, which provides that the Family and Protective Services Council shall study and make recommendations to the executive commissioner and the commissioner regarding rules governing the delivery of services to persons who are served or regulated by the department; and HRC, §40.029, which authorizes DFPS to propose and adopt rules to facilitate implementation of Department programs.

The new section implements the HRC §42.057, as amended by §1.104 of Senate Bill 6, 79th Legislature.

§745.4151.What drug testing policy must my residential child-care operation have?

(a) The Department of Family and Protective Services is required to adopt a model drug testing policy for residential child-care operations under the Human Resources Code, §42.057. Your residential child-care operation must either adopt the model drug Although this policy only covers drugs, coverage of alcohol may be included. The department recommends that an operation obtain legal advice before adopting and implementing any drug testing policy.

(b) Residential child-care operations must pay for any required drug tests, except as provided in subsection (c)(7) of this section.

(c) The mandatory criteria for the Model Drug Testing Policy For Residential Child-Care Operations follow.

(1) Purpose. (Name of residential child-care operation) has a vital interest in ensuring the safety of resident children through the appropriate drug testing of employees, while also protecting the rights of the employees.

(2) Scope. This policy applies to all employees of residential child-care operations, including child-placing agencies that have direct contact with children in care. It also applies to volunteers and contracted employees that have direct contact with children in care. This policy does not apply to foster parents that are verified by child-placing agencies.

(3) Definitions. The following definitions apply to this section.

(A) Abusing drugs--The use of any:

(i) Drug or substance defined by the Texas Controlled Substances Act, Texas Health and Safety Code, Chapter 481; or

(ii) Prescription or non-prescription drug that is not being used for the purpose for which it was prescribed or manufactured.

(B) Drug testing--The scientific analysis of urine, blood, breath, saliva, hair, tissue, and other specimens for detecting a drug.

(C) Random drug testing--A testing cycle that varies the frequency and intervals that specimens are collected for testing and selects employees in a random manner that does not eliminate already tested employees from future testing. The testing should ensure all employees are subject to random testing on a continuing basis.

(D) Good cause to believe the employee may be abusing drugs--A reasonable belief based on facts sufficient to lead a prudent person to conclude that the employee may be abusing drugs. Sufficient facts may include direct observations of the employee using or possessing drugs, or exhibiting physical symptoms, including but not limited to slurred speech or difficulty in maintaining balance; erratic or marked changes in behavior, including a decrease in the quality or quantity of the employee's productivity, judgment, reasoning, and concentration and psychomotor control, accidents, and deviations from safe working practices; or any other reliable information.

(4) Mandatory drug testing.

(A) All applicants that are intended to be hired for employment are subject to pre-employment testing, and may not provide direct care or have access to a child in care until the drug test results are available;

(B) All employees are subject to random, unannounced drug testing;

(C) Any employee that is the subject of a child abuse or neglect investigation, when DFPS determines there is "good cause to believe the employee may be abusing drugs", must be drug tested within 24 hours of notification by DFPS to the residential child-care operation;

(D) Any employee who is alleged to be abusing drugs must be tested within 24 hours, if there is "good cause to believe the employee may be abusing drugs."

(5) Drug testing procedures. All drug testing will:

(A) At a minimum screen for marijuana, cocaine, opiates, amphetamines, and phencyclidine (PCP);

(B) Use one of the following drug-testing methods:

(i) A drug test performed by a certified laboratory;

(ii) A testing kit with proven rates of false positives below 2% and false negatives below 8% on all drugs screened; or

(iii) Another testing method for which there is scientific proof of accuracy comparable to either of the first two choices, such as saliva, hair, or spray drug testing;

(C) Ensure the integrity and identity of the specimen collected from the time of collection to the time of disposal to minimize the opportunity for an employee to adulterate or substitute a specimen; and

(D) Preserve the privacy and rights of the person tested. This includes safeguarding the results of any test and maintaining them, so they remain confidential and free from unauthorized access.

(6) Discipline.

(A) An applicant or employee's consent to submit to drug testing is required as a condition of employment, and the refusal to consent may result in refusal to hire the applicant and disciplinary action, including discharge, against the employee for a refusal;

(B) An employee who is tested because there is "good cause to believe the employee may be abusing drugs," may be suspended pending receipt of written test results and further inquiries that may be required;

(C) An employee determined through drug testing to have abused drugs is subject to discipline, up to and including discharge;

(D) An applicant for employment or an employee determined through drug testing to have abused drugs may not be employed in a position with direct contact with children in care if the employee presents a risk of harm to children; and

(E) An employee determined through drug testing to have abused drugs may be offered the opportunity to complete a rehabilitation program at the employee's expense.

(7) Appeal. An applicant or employee whose drug test is positive may, at the employee's expense:

(A) Have an opportunity to explain and offer written documentation why there is another cause for the positive drug test;

(B) Request that the remaining portion of the sample that yielded the positive results, if available, be submitted for an additional independent test, including second tests to rule out false positive results; and/or

(C) Submit the written test result for an independent medical review.

(8) Documentation.

(A) All applicants that are intended to be hired for employment and employees must be provided a copy of this policy and must sign a document consenting to these terms and conditions of employment.

(B) All drug test results will be kept for one year after an employee's last work day with the residential child-care operation, or until any investigation involving the person is resolved, whichever is later. The results must be available for review by Licensing Division within 24 hours of the request.

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 August 8, 2005.

TRD-200503290

Gerry Williams

General Counsel

Department of Family and Protective Services

Earliest possible date of adoption: September 18, 2005

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