TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. DEPARTMENT OF AGING AND DISABILITY SERVICES

Chapter 2. MENTAL RETARDATION AUTHORITY RESPONSIBILITIES

Subchapter F. CONTINUITY OF SERVICES--STATE MENTAL RETARDATION FACILITIES

The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §2.253, concerning definitions, §§2.264 - 2.269, concerning admission and commitment, and §2.274, concerning living options for individuals residing in state mental retardation facilities (state MR facilities); new §2.283, concerning mental retardation authority (MRA) and state MR facility responsibilities; and the repeal of §2.283 and §2.284, concerning references and distribution, in Chapter 2, Subchapter F, Continuity of Services--State Mental Retardation Facilities.

Background and Purpose

The purpose of the amendments and new section is to implement Senate Bill (SB) 40 and House Bill (HB) 2579, 79th Legislature, Regular Session, 2005, which amended the Texas Government Code, Chapter 531, Subchapter D-1, governing permanency planning for individuals under 22 years of age. For an individual under 22 years of age for whom admission to an institution is sought or who is receiving services in an institution, SB 40 requires DADS to delegate the development of a permanency plan to an MRA, to a private entity other than an entity providing long-term institutional care, or to DADS personnel. For state MR facilities, DADS has chosen to delegate these responsibilities to the designated MRA for the individual. HB 2579 requires that DADS ensure that an individual's legally authorized representative (LAR) is fully informed of all available community-based services for which the individual may be eligible, the benefits to the individual of living in a family or community setting, that the placement is considered temporary, and that an ongoing permanency planning process is required. HB 2579 also requires DADS to require an LAR to provide detailed contact information and agree to make reasonable efforts to participate in the individual's life and planning activities.

The amendments and new section are also proposed to update and clarify permanency planning requirements. The proposed amendments correct rule cross-references and agency names that were rendered incorrect from the consolidation of several state agencies, including the Texas Department of Human Services and part of the Texas Department of Mental Health and Mental Retardation, to create DADS.

The purpose of the repeal is to make this subchapter more consistent with the majority of DADS rules, which do not include sections about references and distribution.

Section-by-Section Summary

The amendment to §2.253 adds or updates the following acronyms: CARE, CRCG, DADS, ICAP, and MRA. The amendment also updates other definitions in the section to correct agency names and mailing addresses.

The amendments to §§2.264 - 2.269 and 2.274 make minor clarifications and remove the permanency planning requirements in these sections in order to incorporate all permanency planning requirements in new §2.283. The amendments also correct agency names, rule cross references, and mailing addresses.

New §2.283 details the responsibilities of an MRA and a state MR facility for permanency planning for an individual under 22 years of age by referencing rules governing the Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) Program. These rules are proposed elsewhere in this issue of the Texas Register under Chapter 9, Mental Retardation Services--Medicaid State Operating Agency Responsibilities, Subchapter E, ICF/MR Programs--Contracting. Specifically, an MRA must inform an LAR of the benefits of living in a family setting, that the placement is temporary, and that the MRA will continue ongoing permanency planning. In addition, an MRA must provide information to the LAR in accordance with the notification requirements in the ICF/MR Program, take or ensure actions are taken to conduct permanency planning, take actions regarding a volunteer advocate, and conduct the permanency planning review. A state MR facility must, upon admission of an individual under 22 years of age, request from and encourage the LAR to provide detailed contact information, make notifications in accordance with the notification requirements in the ICF/MR Program, and incorporate permanency planning as an integral part of the initial individual program plan (IPP). A state MR facility must, for an individual under 22 years of age who resides in the facility, incorporate permanency planning as an integral part of the IPP, take action to assist the individual's MRA in conducting permanency planning, and request from and encourage the LAR to provide detailed contact information. A state MR facility must also provide notice to the LAR of the annual review meeting of the IPP, attempt to notify the LAR of an emergency situation, attempt to locate the LAR if the LAR does not respond to the notification, and notify DADS if the LAR cannot be located. If DADS cannot locate the LAR within one year after the facility's request, DADS will refer the case to the Department of Family and Protective Services. A state MR facility must make reasonable accommodations to promote participation of the LAR and document compliance with the requirements of permanency planning in the individual's record.

The repeal of §2.283 and §2.284 will make this subchapter more consistent with the majority of DADS rules that do not include references and distribution for information within the rules.

Fiscal Note

Gordon Taylor, DADS Chief Financial Officer, has determined that, for the first five years the proposed amendments, new section, and repeal are in effect, there are foreseeable implications relating to costs or revenues of local governments. There are no foreseeable implications relating to costs or revenues of state government.

The effect on local governments for the first five years the proposed amendments, new section, and repeal are in effect is an estimated additional cost of $33,482 in fiscal year (FY) 2006; $36,087 in FY 2007; $38,689 in FY 2008; $41,292 in FY 2009; and $43,895 in FY 2010. These costs are based on the requirement that an MRA conduct the permanency planning process, including regularly convening a permanency planning meeting and developing a permanency plan for an individual every six months after the initial plan is developed.

Small Business and Micro-business Impact Analysis

DADS has determined that there is no adverse economic effect on small businesses or micro-businesses or on businesses of any size as a result of enforcing or administering the amendments, new section, and repeal, because the proposal places no new requirements on businesses that would have a significant cost to businesses.

Public Benefit and Costs

Barry Waller, DADS Assistant Commissioner for Provider Services, has determined that, for each year of the first five years the amendments, new section, and repeal are in effect, the public benefit expected as a result of enforcing the amendments, new section, and repeal is that having an MRA conduct the permanency planning process helps ensure that no conflict of interest exists in developing an individual's permanency plan. In addition, the amendments, new section, and repeal will ensure that a state MR facility cooperates with the individual's designated MRA and will encourage the LAR to be involved and participate in the life of an individual residing in the state MR facility.

Mr. Waller anticipates that there will be an economic cost to MRAs as explained in the fiscal note above. The amendments, new section, and repeal will not affect a local economy.

Takings Impact Assessment

DADS has determined that this proposal 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, does not constitute a taking under Texas Government Code, §2007.043.

Public Comment

Questions about the content of this proposal may be directed to Christy Dees at (512) 438-3162 in the Policy Development and Oversight Unit of DADS' Center for Policy and Innovation. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-011, Department of Aging and Disability Services W-615, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

1. GENERAL PROVISIONS

40 TAC §2.253

Statutory Authority

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, Chapter 531, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendment implements Texas Government Code, §§531.0055, 531.1521, and 531.166, and Texas Human Resources Code, §161.021.

§2.253.Definitions.

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

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

(3) CARE-- DADS' Client Assignment and Registration System, a database with demographic and other data about an individual who is receiving services and supports or on whose behalf services and supports have been requested. [ The department's Client Assignment and Registration System, an on-line data entry system that provides demographic and other data about individuals served by the department. ]

(4) Commissioner--The commissioner of DADS [ the department ].

[(5) Community Resource Coordination Group (CRCG)--A local interagency group composed of public and private agencies that develops service plans for individuals whose needs can be met only through interagency coordination and cooperation. The role and responsibilities of the involved agencies, including MRAs, school districts, and providers, are described in §411.56 of this title (relating to Memorandum of Understanding (MOU) on Coordinated Services to Children and Youths).]

(5) [ (6) ] Consensus--A negotiated agreement that all parties can and will support in implementation. The negotiation process involves the open discussion of ideas with all parties encouraged to express opinions.

(6) CRCG (Community Resource Coordination Group)--A local interagency group composed of public and private agencies that develops service plans for individuals whose needs can be met only through interagency coordination and cooperation. The group's role and responsibilities are described in the Memorandum of Understanding on Coordinated Services to Persons Needing Services from More Than One Agency, available on the Health and Human Services Commission website at www.hhsc.state.tx.us/crcg/crcg.htm.

(7) DADS--The Department of Aging and Disability Services.

(8) [ (7) ] Dangerous behavior--Behavior exhibited by an individual who is physically aggressive, self-injurious, sexually aggressive, or seriously disruptive and requires a written behavioral intervention plan to prevent or reduce serious physical injury to the individual or others.

(9) [ (8) ] Department--[ The Texas ] Department of Aging and Disability Services [ Mental Health and Mental Retardation ].

(10) [ (9) ] Designated MRA--The MRA assigned to an individual in CARE.

(11) [ (10) ] Discharge--The release by DADS [ the department ] of an individual voluntarily admitted or committed by court order for residential mental retardation services from the custody and care of a state MR facility and termination of the individual's assignment to the state MR facility in CARE.

(12) [ (11) ] Emergency admission/discharge agreement--A written agreement between the state MR facility, the individual or LAR, and the designated MRA, sample copies of which are available from the Department of Aging and Disability Services, Provider Services Division, State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714-9030 [ , Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711 ], that describes [ the ]:

(A) the purpose of the emergency admission, including the circumstances that precipitated the need for the admission and the expected outcomes from the admission;

(B) the responsibilities of each party regarding the care, treatment, and discharge of the individual, including how the terms of the agreement will be monitored;

(C) the length of time of the emergency admission, which is that amount of time necessary to accomplish the purpose of the admission; and

(D) the anticipated date of discharge.

(13) [ (12) ] Facility of record--The facility that serves the local service area(s) assigned to the individual's designated MRA.

(14) [ (13) ] Family-based alternative [ Family-Based Alternative ]--A family setting in which the family provider or providers are specially trained to provide support and in-home care for children with disabilities or children who are medically fragile.

(15) [ (14) ] Head of the facility--The superintendent or director of a state MR facility [ of a state school or the director of a state center ].

(16) ICAP (Inventory for Client and Agency Planning)--A validated, standardized assessment that measures the level of supervision an individual requires and, thus, the amount and intensity of services and supports the individual needs.

(17) [ (15) ] ICAP [ (Inventory for Client and Agency Planning) ] service level--A designation that [ which ] identifies the level of services needed by an individual as determined by the ICAP [ assessment instrument ]. [ (For information on how to obtain a copy of the ICAP assessment instrument contact TDMHMR, Office of Medicaid Administration, P.O. Box 12668, Austin, Texas 78711-2668.) ]

[(16) Individual--A person who has or is believed to have mental retardation.]

(18) [ (17) ] IDT ( Interdisciplinary team ) [ (IDT) ]--Mental retardation professionals and paraprofessionals and other concerned persons, as appropriate, who assess an individual's treatment, training, and habilitation needs and make recommendations for services, including recommendations of whether the individual is best served in a facility or in a community setting.

(A) Team membership always includes:

(i) the individual;

(ii) the individual's LAR, if any; and

(iii) persons specified by an MRA or a state MR facility, as appropriate, who are professionally qualified and/or certified or licensed with special training and experience in the diagnosis, management, needs, and treatment of individuals with mental retardation.

(B) Other participants in IDT meetings may include:

(i) other concerned persons whose inclusion is requested by the individual or the LAR;

(ii) at the discretion of the MRA or state MR facility, persons who are directly involved in the delivery of mental retardation services to the individual; and

(iii) if the individual is school eligible, representatives of the appropriate school district.

(19) Individual--A person who has or is believed to have mental retardation.

(20) [ (18) ] Interstate transfer--The admission of an individual to a state MR facility directly from a similar facility in another state.

(21) [ (19) ] IQ (intelligence quotient)--A score reflecting the level of an individual's intelligence as determined by the administration of a standardized intelligence test.

(22) [ (20) ] LAR (legally authorized representative)--A person authorized by law to act on behalf of an individual [ a person ] with regard to a matter described in this subchapter, and may include a parent, guardian, or managing conservator of a minor, or the guardian of an adult.

(23) [ (21) ] Legally adequate consent--Consent given by a person when each of the following conditions has been met:

(A) legal status: The individual giving the consent:

(i) is 18 years of age or older, or younger than 18 years of age and is or has been married or had his or her disabilities removed for general purposes by court order as described in the Texas Family Code, Chapter 31; and

(ii) has not been determined by a court to lack capacity to make decisions with regard to the matter for which consent is being sought;

(B) comprehension of information: The individual giving the consent has been informed of and comprehends the nature, purpose, consequences, risks, and benefits of and alternatives to the procedure, and the fact that withholding or withdrawal of consent shall not prejudice the future provision of care and services to the individual with mental retardation; and

(C) voluntariness: The consent has been given voluntarily and free from coercion and undue influence.

(24) [ (22) ] Less restrictive setting--A setting which allows the greatest opportunity for the individual to be integrated into the community.

(25) [ (23) ] Local service area--A geographic area composed of one or more Texas counties delimiting the population which may receive services from a local MRA.

(26) [ (24) ] Mental retardation--Consistent with THSC, §591.003, significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

(27) [ (25) ] Minor--An individual under the age of 18.

(28) [ (26) ] MRA (mental retardation authority)-- An entity to which the Health and Human Services Commission's authority and responsibility described in THSC, §531.002(11) has been delegated. [ As defined in THSC, §531.002, an entity to which the Texas Mental Health and Mental Retardation Board delegates its authority and responsibility within a specified region for planning, policy development, coordination, and resource development and allocation, and for supervising and ensuring the provision of mental retardation services to persons in one or more local service areas. ]

(29) [ (27) ] Natural support network--Those persons, including family members, church members, neighbors, and friends, who assist and sustain an individual with supports that occur naturally within the individual's environment and that are not reimbursed or purposely developed by a person or system.

(30) [ (28) ] Ombudsman--Consistent with THSC, §533.039, an employee of DADS [ in the department's Central Office ] who is responsible for assisting an individual or LAR if the [ of an ] individual is [ who has been ] denied a service by DADS [ the department ], a DADS [ department ] program or facility, or an MRA. The ombudsman must explain and provide information on DADS [ department ] and MRA services, facilities, and programs, and the rules, procedures, and guidelines applicable to the individual denied services, and assist the individual in gaining access to an appropriate program or in placing the individual on an appropriate waiting list. [ The director of the Office of Consumer Services and Rights Protection/Ombudsman is the department's ombudsman and can be contacted by calling 1-800-252-8154. ]

(31) [ (29) ] Permanency planning--A philosophy and planning process that focuses on the outcome of family support for an individual under 22 years of age by facilitating a permanent living arrangement in which the primary feature is an enduring and nurturing parental relationship.

(32) [ (30) ] Planning team--A group organized by the MRA and composed of:

(A) the individual;

(B) the individual's legally authorized representative (LAR), if any;

(C) actively-involved family members or friends of the individual who has neither the ability to provide legally adequate consent nor an LAR;

(D) other concerned persons whose inclusion is requested by the individual with the ability to provide legally adequate consent or the LAR;

(E) a representative from the designated MRA; and

(F) a representative from the individual's provider.

(33) [ (31) ] PMRA--Persons with Mental Retardation Act, Texas Health and Safety Code, Title 7, Subtitle D.

(34) [ (32) ] Provider--A public or private entity that delivers community-based residential services and supports for individuals, including, but not limited to, an intermediate care facility for individuals with mental retardation (ICF/MR) or a nursing facility. The term also includes a public or private entity that provides waiver services.

(35) [ (33) ] Related services--Services for school eligible individuals as described in 19 TAC §89.1060 (relating to Definitions of Certain Related Services).

(36) [ (34) ] Respite admission/discharge agreement--A written agreement between the state MR facility, the individual or LAR, and MRA, sample copies of which are available from the Department of Aging and Disability Services, Provider Services Division, State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714-9030 [ , Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711 ], that describes:

(A) the purpose of the respite admission including the circumstances that precipitated the need for the admission and the expected outcomes from the admission;

(B) the length of time the individual will receive respite services from the state MR facility; and

(C) the responsibilities of each party regarding the care, treatment, and discharge of the individual.

(37) [ (35) ] School eligible--A term describing those individuals between the ages of three and 22 who are eligible for public education services.

(38) [ (36) ] Service delivery system--All facility and community-based services and supports operated or contracted for by DADS [ the department ].

(39) [ (37) ] Services and supports--Programs and assistance for persons with mental retardation that may include a determination of mental retardation, interdisciplinary team recommendations, education, special training, supervision, care, treatment, rehabilitation, residential care, and counseling, but does not include those services or programs that have been explicitly delegated by law to other state agencies.

(40) [ (38) ] Significantly subaverage general intellectual functioning--Consistent with THSC, §591.003, measured intelligence on standardized general intelligence tests of two or more standard deviations (not including standard error of measurement adjustments) below the age-group mean for the tests used.

(41) [ (39) ] State MH facility (state mental health facility)--A state hospital.

(42) [ (40) ] State MR facility (state mental retardation facility)--A state school or a state center with a mental retardation residential component.

(43) [ (41) ] THSC--Texas Health and Safety Code.

(44) [ (42) ] Waiver services--Home and community-based services provided through a Medicaid waiver program approved by Centers for Medicare and Medicaid Services (CMS)[ , formerly Health Care Financing Administration (HCFA), ] as described in §1915(c) of the Social Security Act. [ Medicaid waiver programs operated by the department include Home and Community-based Services (HCS) Program, Home and Community-based Waiver Services-OBRA (HCS-O) Program, and Mental Retardation Local Authority (MRLA) Program. Other waiver programs for which an individual applying to an MRA for services and supports might be eligible that are operated by other state agencies include Community Living and Support Services (CLASS); the Deaf-Blind Multiple Disability Waiver programs; the Medically Dependent Children Program; and the Community-Based Alternatives Waiver. ]

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602839

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


2. ADMISSION AND COMMITMENT

40 TAC §§2.264 - 2.269

Statutory Authority

The amendments are proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, Chapter 531, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendments implement Texas Government Code, §§531.0055, 531.1521, and 531.166, and Texas Human Resources Code, §161.021.

§2.264.MRA IDT Recommendation Concerning the Commitment of an Adult or a Minor or the Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA.

[ (a) ] The IDT at an MRA must do the following in making a report of its findings and recommendations as described in §2.255(a)(5) [ §412.255(a)(5) ] and (b)(1)(B) of this subchapter [ title ] (relating to Criteria for Commitment and Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA), §2.256(b)(3)(E) [ §412.256(b)(3)(E) ], (c)(3)(E), (e)(3)(E), and (f)(3)(E) of this subchapter [ title ] (relating to Criteria for Commitment of an Adult under the Texas Code of Criminal Procedure), and §2.257(a)(5) [ §412.257(a)(5) ] of this subchapter [ title ] (relating to Criteria for Commitment of a Minor to a State MR Facility Under the PMRA):

(1) in accordance with THSC, §593.013:

(A) interview the individual or the individual's LAR;

(B) review the individual's:

(i) social and medical history;

(ii) medical assessment, which must include an audiological, neurological, and vision screening;

(iii) psychological and social assessment, including the ICAP; and

(iv) determination of adaptive behavior level;

(C) determine the individual's need for additional assessments, including educational and vocational assessments;

(D) obtain any additional assessment(s) necessary to plan services;

(E) identify the individual's or LAR's habilitation and service preferences and the individual's needs;

(F) recommend services to address the individual's needs that consider the individual's or LAR's interests, choices, and goals and, for an [ the ] individual under 22 years of age, the individual's [ include ] permanency planning [ as a ] goal;

(G) encourage the individual and the individual's LAR to participate in IDT meetings;

(H) if desired, use a previous assessment, social history, or other relevant record from a school district, public or private agency, or appropriate professional if the IDT determines that the assessment, social history or record is valid;

(I) prepare a written report of its findings and recommendations that is signed by each IDT member and send a copy of the report within 10 working days to the individual or LAR, as appropriate; and

(J) if the individual is being considered for commitment to the state MR facility, submit the IDT report promptly to the court, as ordered, and to the individual or LAR, as appropriate; and

(2) determine whether:

(A) the individual, because of mental retardation:

(i) represents a substantial risk of physical impairment or injury to self or others; or

(ii) is unable to provide for and is not providing for the individual's most basic personal physical needs;

(B) the individual cannot be adequately and appropriately habilitated in an available, less restrictive setting; and

(C) the state MR facility provides habilitative services, care, training and treatment appropriate to the individual's needs.

[(b) For the individual under 22 years of age, the MRA will ensure that permanency planning is included as an integral part of service planning, as required in subsection (a)(1)(F) of this section, with an emphasis on identifying:]

[(1) the family's natural supports and strengths that, supplemented by activities and supports provided or facilitated by the MRA, will enable the individual under 18 years of age to remain in the family home;]

[(2) a family-based alternative that will secure for an individual under 18 years of age a consistent, nurturing environment that supports a continued relationship with the individual's family to the extent possible and, if necessary, provide an enduring, positive relationship with a specific adult who will be an advocate for the individual; or]

[(3) the natural supports and strengths of an individual from 18 to 22 years of age that, when supplemented by activities and supports provided or facilitated by the MRA, will result in the individual having a consistent and nurturing environment as defined by the individual and LAR.]

[(c) The MRA must take the following actions to facilitate permanency planning:]

[(1) discuss with the individual or LAR the problems or issues that led the individual or LAR to request admission to a state MR facility;]

[(2) discuss with the family or LAR of an individual under 18 years of age the barriers to having the individual reside in the family home or discuss with an individual 18 to 22 years of age and LAR the barriers to moving to a consistent and nurturing environment as determined by the individual and LAR;]

[(3) identify natural supports and family strengths that will accomplish permanency planning outcomes; and]

[(4) identify activities and supports that can be provided by the family, LAR, or MRA that will prepare the individual for a family-based alternative, if the individual and LAR choose that option.]

[(d) If the individual is under 22 years of age, the MRA must explain to the individual and LAR that:]

[(1) before the individual is admitted to the state MR facility, the commissioner or designee must approve the admission; and]

[(2) the individual's residency at a state MR facility will last no longer than six months unless the commissioner or designee approves a six-month extension.]

[(e) If an individual is under 22 years of age, the MRA must inform the individual and LAR that they may request a volunteer advocate to assist in permanency planning. The individual or LAR may:]

[(1) select a person who is not employed by or under contract with the MRA or a state MR facility; or]

[(2) request the MRA to designate a volunteer advocate.]

[(f) If the individual or LAR requests that the MRA designate a volunteer advocate or the MRA cannot locate the individual's LAR, the MRA must attempt to designate a volunteer advocate to assist in permanency planning who is, in order of preference:]

[(1) an adult relative who is actively involved with the individual;]

[(2) a person who:]

[(A) is part of the individual's natural support network; and]

[(B) is not employed by or under contract with the MRA or a state MR facility; or]

[(3) a person or a child advocacy organization representative who:]

[(A) is knowledgeable about community services and supports;]

[(B) is familiar with the permanency planning philosophy and processes; and]

[(C) is not employed by or under contract with the MRA or state MR facility.]

[(g) If the MRA is unable to locate a volunteer advocate locally, the MRA must request assistance from a statewide advocacy organization in identifying an available volunteer advocate who meets the requirements described in subsection (e)(3) of this section. If the statewide advocacy organization is unable to assist the MRA in identifying a volunteer advocate, the MRA must document all efforts to designate a volunteer advocate in accordance with subsection (f) of this section.]

§2.265.MRA Referral of an Applicant to a State MR Facility.

(a) If an individual or LAR requests residential services in a state MR facility, the designated MRA [ serving the local service area in which the individual lives or, in the case of an interstate transfer, the MRA serving the local service area in which the individual's LAR or family lives or intends to live ] must provide an oral and written explanation as described in §5.159(c) [ §415.159(c) ] of this title (relating to Assessment of Individual's Need for Services and Supports).

(b) If the MRA's IDT determines that an applicant meets the criteria described in §2.255 [ §412.255 ] of this subchapter [ title ] (relating to Criteria for Commitment and Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA) or §2.257 [ §412.257 ] of this subchapter [ title ] (relating to Criteria for Commitment of a Minor to a State MR Facility Under the PMRA), the MRA will:

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

(3) contact the [ department's ] interstate compact coordinator at the Health and Human Services Commission , if the applicant is requesting an interstate transfer;

(4) - (5) (No change.)

(c) If the MRA's IDT determines that the applicant does not meet the criteria for commitment or regular voluntary admission to a state MR facility as described in this subchapter, the MRA will:

(1) notify the applicant or LAR in writing of the determination and explain the procedure for the applicant or LAR to request a review of the IDT's determination by the MRA in accordance with §2.46 [ §401.464 ] of this chapter [ title ] (relating to Notification and Appeals Process); or

(2) if the applicant was requesting an interstate transfer, notify the [ department's ] interstate compact coordinator in writing of the determination.

(d) If a review by the MRA of the IDT's determination results in the determination being upheld, the MRA will inform the applicant or LAR in writing that a request for a review by DADS' [ the department's ] ombudsman may be made in writing to the Department of Aging and Disability Services, Consumer Rights and Services Division, P.O. Box 149030, Mail Code E-249, Austin, Texas 78714-9030 [ Consumer Services and Rights Protection, Ombudsman, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas, 78711-2668 ], or by calling 1-800-458-9858 [ 1-800-252-8154 ].

(e) If the applicant or LAR requests a review, DADS' [ the department's ] ombudsman will review relevant documentation provided by the applicant and LAR, the IDT, and the MRA, and determine whether the processes described in this subchapter were followed.

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

(f) If the MRA determines that an applicant meets the criteria described in §2.261 [ §412.261 ] of this subchapter [ title ] (relating to Criteria for Emergency Admission of an Adult or a Minor to a State MR Facility Under the PMRA) or §2.262 [ §412.262 ] of this subchapter [ title ] (relating to Criteria for Admission of an Adult or a Minor to a State MR Facility for Respite Care Under the PMRA), the MRA will:

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

(3) request the applicant's enrollment in the ICF/MR Program as described in §9.244(e) [ §419.244(e) ] of this title (relating to Applicant Enrollment in the ICF/MR Program ), if appropriate.

(g) A complete application packet, as referenced in subsection (b)(4) of this section, must include:

(1) (No change.)

(2) a completed Application for Admission including signature of the applicant or the applicant's LAR (copies of the Application for Admission are available by contacting the Department of Aging and Disability Services, Provider Services Division, [ Office of ] State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714- 9030 [ , Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668 ]);

(3) a DMR report with statement that the applicant has mental retardation, as described in §5.155(g) [ §415.155(g) ] of this title (relating to Determination of Mental Retardation (DMR));

(4) (No change.)

(5) an IDT report completed as described in §2.264 [ §412.264(a) ] of this subchapter [ title ] (relating to MRA IDT Recommendation Concerning the Commitment of an Adult or a Minor or the Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA) recommending the commitment or regular voluntary admission of the applicant to a state MR facility;

(6) - (16) (No change.)

(17) for the applicant who is a minor, results of the CRCG staffing held as described in §2.257(c) [ §412.257(c) ] of this subchapter [ title (relating to Criteria for Commitment of a Minor to a State MR Facility Under the PMRA) ];

(18) for the applicant under 22 years of age, results of the MRA's permanency planning process as described in §2.283(a) of this subchapter (relating to MRA and State MR Facility Responsibilities) [ §412.264(b) of this title ]; and

(19) (No change.)

(h) A complete application packet for emergency admission of an individual, as referenced in subsection (f)(2) of this section, must include:

(1) a completed Application for Admission including signature of the applicant or the applicant's LAR (copies of the Application for Admission are available by contacting the Department of Aging and Disability Services, Provider Services Division, [ Office of ] State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714- 9030 [ , Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668 ]);

(2) - (11) (No change.)

(12) for the applicant who is a minor, the results of the CRCG staffing held as described in §2.257(c) [ §412.257(c) ] of this subchapter [ title ];

(13) for the applicant under 22 years of age, results of the MRA's permanency planning process as described in §2.283(a) [ §412.264(b) ] of this subchapter [ title ];

(14) - (15) (No change.)

(16) if requested by DADS [ the department ]:

(A) a DMR report with a statement that the applicant has mental retardation, as described in §5.155(g) [ §415.155(g) ] of this title, if requested by DADS [ the department ]; and

(B) (No change.)

(i) A complete application packet for admission of an individual for respite care, as referenced in subsection (f)(2) of this section, must include:

(1) a completed Application for Admission including signature of the applicant or the applicant's LAR (copies of the Application for Admission are available by contacting the Department of Aging and Disability Services, Provider Services Division, [ Office of ] State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714- 9030 [ , Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668 ]);

(2) - (12) (No change.)

(13) if requested by DADS [ the department ]:

(A) a DMR report with a statement that the applicant has mental retardation, as described in §5.155(g) [ §415.155(g) ] of this title, if requested by DADS [ the department ]; and

(B) (No change.)

§2.266.Process for Admission of an Adult or a Minor Who Has Been Committed to a State MR Facility Under the PMRA.

(a) (No change.)

(b) The MRA must retain a copy of the application packet, as described in §2.265(g) [ §412.265(g) ] of this subchapter [ title ] (relating to MRA Referral of an Applicant to a State MR Facility) and send the original application packet to the admission coordinator of the state MR facility.

(c) DADS [ The department ] will determine when a vacancy exists in a state MR facility and which individuals are appropriate to fill the vacancy, based on the information in the application packets.

(d) Upon notification from DADS [ the department ] that an appropriate vacancy in a state MR facility is available, the MRA will contact the LAR or family of each individual identified by DADS [ the department ] as appropriate to fill the vacancy and will:

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

(e) The state MR facility will offer admission under the commitment order to one of those individuals identified by DADS [ the department ] as appropriate to fill the vacancy and who the MRA has determined would accept the proposed admission to the state MR facility.

(f) If the applicant or the applicant's LAR accepts the proposed admission, the MRA must request enrollment of the applicant in the ICF/MR Program as described in §9.244 [ §419.244 ] of this title (relating to Applicant Enrollment in the ICF/MR Program ), if appropriate.

(g) - (i) (No change.)

[(j) Within three days of the admission of an individual under 22 years of age, the state MR facility must make the notifications described in §419.222(c) and (d) of this title (relating to Permanency Planning for Individuals Under 22 Years of Age).]

§2.267.Process for the Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA.

(a) (No change.)

(b) If the MRA IDT recommends that the applicant be admitted to a state MR facility for regular voluntary services, the MRA must retain a copy of the application packet, as described in §2.265(g) [ §412.265(g) ] of this subchapter [ title ] (relating to MRA referral of an Applicant to a State MR Facility) and send the original application packet to the admission coordinator of the state MR facility.

(c) DADS [ The department ] will determine when a vacancy exists in a state MR facility and which individuals are appropriate to fill the vacancy, based on the information in the application packets.

(d) Upon notification from DADS [ the department ] that an appropriate vacancy in a state MR facility is available, the MRA will contact each individual identified by DADS [ the department ] as appropriate to fill the vacancy and will:

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

(e) The state MR facility will offer admission to one of those individuals identified by DADS [ the department ] as appropriate to fill the vacancy and who the MRA has determined would accept the proposed admission to the state MR facility.

(f) If the applicant or the applicant's LAR accepts the proposed admission, the MRA must request enrollment of the applicant in the ICF/MR Program as described in §9.244 [ §419.244 ] of this title (relating to Applicant Enrollment in the ICF/MR Program ), if appropriate.

(g) (No change.)

[(h) Within three days of the admission of an individual under 22 years of age, the state MR facility must make the notifications described in §419.222(c) and (d) of this title (relating to Permanency Planning for Individuals Under 22 Years of Age).]

§2.268.Process for Placement of a Minor under the Texas Family Code in a State MR Facility.

(a) If DADS [ the department ] is notified by a juvenile court that a placement order for a minor has been issued under Texas Family Code, §55.33 or §55.52, DADS [ the department ] will notify the appropriate MRA of the placement order.

(b) - (c) (No change.)

(d) Within 30 calendar days after the minor is admitted to the state MR facility, the state MR facility will schedule an IDT meeting to develop an individual program plan (IPP) [ IPP ] for the minor. [ In accordance with §419.222 of this title (relating to Permanency Planning for Individuals Under 22 Years of Age), the IPP will be developed using permanency planning. ]

(e) Not later than the 75th calendar day after the date the court issues a placement order under Texas Family Code, §55.33, the state MR facility will submit to the court a report that:

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

(3) if the state MR facility believes the minor is unfit to proceed, states whether the minor meets the commitment criteria described in §2.257 [ §412.257 ] of this subchapter [ title ] (relating to Criteria for Commitment of a Minor to a State MR Facility Under the PMRA).

(f) If the state MR facility believes that the minor is unfit to proceed and meets the commitment criteria described in §2.257 [ §412.257 ] of this subchapter [ title ], the state MR facility will submit an affidavit to the court stating the conclusions reached as a result of the diagnosis.

(g) Not later than the 75th calendar day after the date the court issues a placement order under Texas Family Code, §55.52, the state MR facility will submit to the court a report that:

(1) (No change.)

(2) states whether the state MR facility believes the minor has mental retardation [ is mentally retarded ]; and

(3) if the state MR facility believes the minor has mental retardation [ is mentally retarded ], states whether the minor meets the commitment criteria described in §2.257 [ §412.257 ] of this subchapter [ title ].

(h) If the state MR facility believes that the minor has mental retardation [ is mentally retarded ] and meets the commitment criteria described in §2.257 [ §412.257 ] of this subchapter [ title ], the state MR facility will submit an affidavit to the court stating the conclusions reached as a result of the diagnosis.

[(i) Within three days of the admission of the minor, the state MR facility must make the notifications described in §419.222(c) and (d) of this title.]

§2.269.Process for the Emergency Admission of an Adult or a Minor to a State MR Facility Under the PMRA.

(a) (No change.)

(b) If the MRA determines that an individual meets the criteria for emergency admission under §2.261 [ §412.261 ] of this subchapter [ title ] (relating to Criteria for Emergency Admission of an Adult or a Minor to a State MR Facility Under the PMRA), the MRA must retain a copy of the application packet, as described in §2.265(h) [ §412.265(h) ] of this subchapter [ title ] (relating to MRA Referral of an Applicant to a State MR Facility) and send the original application packet to the admission coordinator of the state MR facility.

(c) DADS [ The department ] will determine when a vacancy exists in a state MR facility and which individuals are appropriate to fill the vacancy, based on the information in the application packets.

(d) Upon notification from DADS [ the department ] that an appropriate vacancy in a state MR facility is available, the MRA will contact each individual identified by DADS [ the department ] as appropriate to fill the vacancy and will:

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

(e) The state MR facility will offer emergency admission to one of those individuals identified by DADS [ the department ] as appropriate to fill the vacancy and who the MRA has determined would accept the proposed emergency admission to the state MR facility.

(f) Prior to admission of the individual, the MRA must:

(1) (No change.)

(2) send a copy of the completed Emergency Admission/Discharge Agreement to the individual or LAR, the state MR facility , and the Department of Aging and Disability Services, Provider Services Division, [ department's Office of ] State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714-9030 [ , P.O. Box 12668, Austin, Texas 78711-2668 ]; and

(3) (No change.)

(g) If the individual is under 22 years of age, the Emergency Admission/Discharge Agreement must incorporate elements of the individual's permanency plan, as appropriate, [ be developed using permanency planning, as described in §419.222 of this title (relating to Permanency Planning for Individuals Under 22 Years of Age) ] and [ must ] specify that the individual is to be admitted for no longer than six months to receive emergency services in the state MR facility.

(h) - (i) (No change.)

(j) Within 30 calendar days after the individual is admitted, the state MR facility will arrange for:

(1) a DMR to be conducted in accordance with §5.155 [ §415.155 ] of this title (relating to Determination of Mental Retardation (DMR)); and

(2) an IDT at the state MR facility to make findings and recommendations in accordance with the process described [ required ] for an MRA IDT [ as described ] in §2.264 [ §412.264(a) ] of this subchapter [ title ] (relating to MRA IDT Recommendation Concerning the Commitment of an Adult or a Minor or the Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA).

(k) - (l) (No change.)

(m) If DADS [ the department ] determines that the terms of the Emergency Admission/Discharge Agreement cannot be met, the MRA may initiate commitment proceedings under the PMRA.

[(n) Within three days of the admission of an individual under 22 years of age, the state MR facility must make the notifications described in §419.222(c) and (d) of this title.]

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602840

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


4. MOVING FROM A STATE MR FACILITY TO AN ALTERNATIVE LIVING ARRANGEMENT

40 TAC §2.274

Statutory Authority

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, Chapter 531, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendment implements Texas Government Code, §§531.0055, 531.1521, and 531.166, and Texas Human Resources Code, §161.021.

§2.274.Consideration of Living Options for Individuals Residing in State MR Facilities.

(a) A state MR facility must discuss living options with the individual or the individual's LAR using the State MR Facility Living Options instrument at least annually or upon request by an individual or LAR. Copies of the State MR Facility Living Options instrument may be obtained from the Department of Aging and Disability Services, Provider Services Division, State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714-9030 [ are available on the department's website at www.mhmr.state.tx.us or by contacting the Office of State Mental Retardation Facilities, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711 ]. At the conclusion of a meeting during which living options have been discussed, the individual's IDT will document the:

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

(5) IDT's conclusions as to whether or not the permanency planning goal [ goals ] for an individual under 22 years of age has been accomplished [ have been met ].

[(b) If the review of living options for an individual under 22 years of age results in an IDT conclusion that the individual's permanency planning goals have not been met and that the individual should remain at the state MR facility, the IDT must request approval for the individual's continued residence as described in §419.222(g) of this title (relating to Permanency Planning for Individuals Under 22 Years of Age).]

(b) [ (c) ] The state MR facility will ensure that the individual and LAR receive adequate notice of a meeting at which the state MR facility anticipates that living options are likely to be discussed.

(1) The individual with the ability to provide legally adequate consent or the LAR of an individual who does not have the ability to provide legally adequate consent may choose to:

(A) invite other family members, friends, or other interested persons to the meeting; or

(B) exclude any and all family members, friends, or other interested persons from attending the meeting.

(2) The state MR facility must:

(A) encourage the attendance and participation in the meeting by those persons invited by the individual or LAR;

(B) make a reasonable attempt to schedule the meeting at a time that is convenient for the individual's LAR and those family members, friends, or other persons invited by the individual or LAR; and

(C) notify the designated MRA of the meeting at the same time the individual and LAR are notified and request from the MRA the information about alternative living arrangements and community services and supports in the MRA's local service area that the IDT will need before making a recommendation as described in subsection (a)(4) of this section.

[(3) If the individual is under 22 years of age, the state MR facility must inform the individual and LAR that they may request a volunteer advocate to assist in permanency planning. The individual or LAR may:]

[(A) select a person who is not employed by or under contract with the state MR facility; or]

[(B) request the state MR facility to designate a volunteer advocate.]

[(4) If the individual or LAR requests that the state MR facility designate a volunteer advocate or the state MR facility cannot locate the individual's LAR, the state MR facility must attempt to designate a volunteer advocate to assist in permanency planning who is, in order of preference:]

[(A) an adult relative who is actively involved with the individual;]

[(B) a person who:]

[(i) is part of the individual's natural support network; and]

[(ii) is not employed by or under contract with the state MR facility; or]

[(C) a person or a child advocacy organization representative who:]

[(i) is knowledgeable about community services and supports;]

[(ii) is familiar with the permanency planning philosophy and processes; and]

[(iii) is not employed by or under contract with the state MR facility.]

[(5) If the state MR facility is unable to locate a volunteer advocate locally, the state MR facility must request assistance from a statewide advocacy organization in identifying an available volunteer advocate who meets the requirements described in paragraph (4)(C) of this subsection. If the statewide advocacy organization is unable to assist the state MR facility in identifying a volunteer advocate, the state MR facility must document all efforts to designate a volunteer advocate in accordance with paragraph (4) of this subsection.]

[(d) If the individual is a minor and:]

[(1) parental rights have not been terminated, the IDT recommendation regarding living arrangements will be based on the minor's permanency planning needs for services and supports which will:]

[(A) enable the minor to return to the family home if the LAR chooses to do so; or]

[(B) secure a family-based alternative that provides a consistent, nurturing environment for the minor and supports a continued relationship with the minor's family to the extent possible and, if necessary, provide an enduring, positive relationship with a specific adult who will be an advocate for the minor; or]

[(2) parental rights have been terminated, the IDT recommendation will be based on the permanency planning needs for support and services that will enable the minor to move to a family-based alternative living arrangement that will secure a consistent, nurturing environment that supports a continued relationship with the minor's family to the extent possible and an enduring, positive relationship with a specific adult who will be an advocate for that minor.]

[(e) If the individual is between 18 and 22 years of age, the IDT recommendation regarding living arrangements will be based on the individual's natural supports and strengths that, when supplemented by activities and supports provided or facilitated by a provider or MRA, will result in the individual having a consistent and nurturing alternative living arrangement as defined by the applicant and LAR.]

(c) [ (f) ] The designated MRA shall ensure that the state MR facility has the information about alternative living arrangements and community services and supports needed to assist the IDT in making a recommendation described in subsection (a)(4) of this section.

(d) [ (g) ] Communication devices and techniques (including the use of sign language) will be utilized, as appropriate, to facilitate the involvement of the individual and the LAR during the meeting.

(e) [ (h) ] If the individual or the individual's LAR expresses an interest in an alternative living arrangement during a meeting or at any other time, the state MR facility will ensure that the individual or LAR is informed of the range of alternative living arrangements, including community-based ICF/MR programs, waiver services, those services and supports provided or contracted by an MRA, and any other services that may be appropriate.

(f) [ (i) ] An individual with the ability to provide legally adequate consent or the LAR may choose for the individual to remain a resident of a state MR facility if the individual has been determined to have mental retardation in accordance with §5.155 [ §415.155 ] of this title (relating to Determination of Mental Retardation (DMR)).

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602841

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


7. REFERENCES AND DISTRIBUTION

40 TAC §2.283, §2.284

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

Statutory Authority

The repeal is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; and Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS.

The repeal implements Texas Government Code, §531.0055, and Texas Human Resources Code, §161.021.

§2.283.References.

§2.284.Distribution.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602842

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


7. PERMANENCY PLANNING AND LAR NOTIFICATION REQUIREMENTS FOR AN INDIVIDUAL UNDER 22 YEARS OF AGE

40 TAC §2.283

Statutory Authority

The new section is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, Chapter 531, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The new section implements Texas Government Code, §§531.0055, 531.1521, and 531.166, and Texas Human Resources Code, §161.021.

§2.283.MRA and State MR Facility Responsibilities.

(a) MRA responsibilities.

(1) Except for a request for admission for respite care, when admission to a state MR facility is requested for an individual under 22 years of age, the designated MRA must:

(A) before the individual is admitted to the facility, inform the LAR:

(i) of the benefits of living in a family or community setting;

(ii) that the individual's stay in the facility is considered temporary; and

(iii) that an ongoing permanency planning process is required;

(B) take or ensure that the actions described in §9.244(f) of this title (relating to Applicant Enrollment in the ICF/MR Program) are taken to conduct permanency planning; and

(C) take the actions described in §9.244(g) - (i) of this title regarding a volunteer advocate.

(2) An MRA does not have to comply with paragraph (1)(A) of this subsection if the individual has been committed to a state MR facility under Chapter 46B, Code of Criminal Procedure, or Chapter 55, Family Code.

(3) For an individual under 22 years of age who resides in a state MR facility, the designated MRA must conduct a permanency planning review in accordance with §9.250 of this title (relating to Permanency Planning Reviews).

(b) State MR facility responsibilities.

(1) Upon the admission of an individual under 22 years of age to a state MR facility, a state MR facility:

(A) requests from and encourages the LAR to provide the information described in §9.222(e) of this title (relating to Permanency Planning and LAR Participation for Individuals Under 22 Years of Age);

(B) makes notifications as described in §9.222(c) and (d) of this title; and

(C) incorporates permanency planning as an integral part of the individual's initial individual program plan (IPP) and identifies information in the IPP as described in §9.222(a) of this title.

(2) For an individual under 22 years of age who resides in a state MR facility, a state MR facility:

(A) incorporates permanency planning as an integral part of the individual's IPP and identifies information in the IPP as described in §9.222(a) of this title;

(B) takes the actions described in §9.222(b) of this title to assist the individual's designated MRA in conducting permanency planning;

(C) requests from and encourages the LAR to provide the information described in §9.222(e) of this title;

(D) provides notice to the individual and LAR of a meeting to conduct the annual review of the individual's IPP as described in §9.222(g) of this title;

(E) attempts to notify the LAR of an emergency situation as described in §9.222(h) of this title;

(F) attempts to locate the LAR as described in §9.222(i) of this title, if the LAR does not respond to a notification by the state MR facility; and

(G) notifies DADS as described in §9.222(j) of this title if the LAR cannot be located.

(3) A state MR facility makes reasonable accommodations to promote the participation of the LAR as described in §9.222(f) of this title.

(4) A state MR facility documents compliance with the requirements of this subsection in the individual's record.

(c) DADS referral. If, within one year of the date DADS receives the notification described in subsection (b)(2)(G) of this section, DADS is unable to locate the LAR, DADS refers the case to:

(1) the Child Protective Services Division of the Department of Family and Protective Services if the individual is under 18 years of age; or

(2) the Adult Protective Services Division of the Department of Family and Protective Services if the individual is 18-22 years of age.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602843

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


Chapter 9. MENTAL RETARDATION SERVICES--MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES

Subchapter E. ICF/MR PROGRAMS--CONTRACTING

The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §9.203, concerning definitions, §9.222, concerning permanency planning for individuals under 22 years of age, and §9.244, concerning applicant enrollment; and proposes new §9.250, concerning permanency planning reviews, in Chapter 9, Mental Retardation Services--Medicaid State Operating Agency Responsibilities, Subchapter E, ICF/MR Programs--Contracting.

Background and Purpose

The purpose of the amendments and new section is to implement Senate Bill (SB) 40 and House Bill (HB) 2579, 79th Legislature, Regular Session, 2005, which amended the Texas Government Code, Chapter 531, Subchapter D-1, governing permanency planning for individuals under 22 years of age. For an individual under 22 years of age for whom admission to an institution is sought or who is receiving services in an institution, SB 40 requires DADS to delegate the development of a permanency plan to a mental retardation authority (MRA), to a private entity other than an entity providing long-term institutional care, or to DADS personnel. DADS has chosen to delegate these responsibilities to the MRA for the local service area in which the individual or legally authorized representative (LAR) resides. HB 2579 requires that DADS ensure that an individual's LAR is fully informed of all available community-based services for which the individual may be eligible, the benefits to the individual of living in a family or community setting, that the placement is considered temporary, and that an ongoing permanency planning process is required. HB 2579 also requires DADS to require an LAR to provide detailed contact information and agree to make reasonable efforts to participate in the individual's life and planning activities.

The amendments and new section are also proposed to update and clarify permanency planning requirements. The proposed amendments correct rule cross-references and agency names that were rendered incorrect from the consolidation of several state agencies, including the Texas Department of Human Services and part of the Texas Department of Mental Health and Mental Retardation, to create DADS.

Section-by-Section Summary

The amendment to §9.203 adds definitions for the following terms and acronyms: DADS, emergency situation, and MR/RC Assessment. The amendment also updates other definitions in the section and corrects agency names and rule cross-references.

The amendment to §9.222(a) provides clarification about what must be included in an individual program plan (IPP) regarding the permanency planning goal for an individual under 22 years of age. The amendment to §9.222(b) requires a program provider to assist an MRA in conducting permanency planning for an individual under 22 years of age, as required by SB 40, including participation in permanency planning meetings and encouraging contact between and participation by the LAR and the individual. The program provider must refrain from providing the LAR with inaccurate or misleading information regarding the risks of moving the individual to another facility or community setting. The amendment to §9.222(e) requires the program provider to request from and encourage the LAR to provide detailed contact information that includes the contact information for a relative or other person that the program provider may contact in an emergency situation, as required by HB 2579. The LAR must notify the program provider of any changes to the contact information and make reasonable efforts to participate in the individual's life. The amendment to §9.222(f) requires the program provider to make reasonable accommodations to promote the LAR's participation in the planning and decision-making regarding the individual's care. The amendment to §9.222(g) - (i) requires the program provider to provide written notice of an IPP review meeting and request the LAR to respond to the notice of the IPP meeting and, if an emergency situation occurs, respond to the situation. The amendment to §9.222(j) and (k) requires a program provider to request that DADS initiate a search for the LAR if the program provider is unable to locate the LAR and states that DADS will refer the individual's case to the Department of Family and Protective Services if DADS cannot locate the LAR within a year of the program provider's request. The amendment to §9.222(l) requires the program provider to attempt to obtain consent from the LAR to transfer an individual to another facility. The amendment to §9.222(m) requires the program provider to document compliance with the requirements of permanency planning in the individual's record.

The amendment to §9.244(d) requires an MRA to inform an LAR: (1) of the benefits of living in a family or community setting, (2) that the placement is considered temporary, and (3) that the MRA will continue ongoing permanency planning. The MRA must notify the LAR of this information before the placement of the individual in the facility or not later than the 14th working day after notification unless the LAR extends the time period. The amendment to §9.244(f) requires an MRA to convene a permanency planning meeting before an individual is admitted to a facility or not later than the 14th working day after the date the MRA is notified of the admission, and review the applicant's records before the meeting. The meeting must include choosing the applicant's permanency planning goal with discussion and identification of the issues and barriers to accomplishing that goal. The MRA must make reasonable accommodations to promote the participation of the LAR in developing the permanency plan.

New §9.250 requires an MRA to complete a permanency plan every six months after the initial permanency planning meeting. The MRA must notify the LAR no later than 21 days before the meeting date and complete the same steps as required for the initial permanency planning meeting.

Fiscal Note

Gordon Taylor, DADS Chief Financial Officer, has determined that, for the first five years the proposed amendments and new section are in effect, there are foreseeable implications relating to costs or revenues of local governments. There are no foreseeable implications relating to costs or revenues of state government.

The effect on local governments for the first five years the proposed amendments and new section are in effect is an estimated additional cost of $62,182 in fiscal year (FY) 2006; $67,018 in FY 2007; $71,852 in FY 2008; $76,689 in FY 2009; and $81,519 in FY 2010. These costs are based on the requirement that an MRA conduct the permanency planning process, including regularly convening a permanency planning meeting and developing a permanency plan for an individual every six months after the initial plan is developed.

Small Business and Micro-business Impact Analysis

DADS has determined that there is no adverse economic effect on small businesses or micro-businesses or on businesses of any size as a result of enforcing or administering the amendments and new section, because the proposal deletes the requirement for a program provider to conduct permanency planning for an individual under 22 years of age.

Public Benefit and Costs

Veronda Durden, DADS Assistant Commissioner for Regulatory Services, has determined that, for each year of the first five years the amendments and new section are in effect, the public benefit expected as a result of enforcing the amendments and new section is that having an MRA conduct the permanency planning process helps ensure that no conflict of interest exists in developing an individual's permanency plan. In addition, the amendments and new section will ensure that the program provider cooperates with the MRA and will encourage the LAR to be involved and participate in the life of the individual residing in the facility.

Ms. Durden anticipates that there will be an economic cost to MRAs as explained in the fiscal note above. The amendments and new section will not affect a local economy.

Takings Impact Assessment

DADS has determined that this proposal 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, does not constitute a taking under Texas Government Code, §2007.043.

Public Comment

Questions about the content of this proposal may be directed to Christy Dees at (512) 438-3162 in the Policy Development and Oversight Unit of DADS' Center for Policy and Innovation. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-013, Department of Aging and Disability Services W-615, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

1. GENERAL REQUIREMENTS

40 TAC §9.203

Statutory Authority

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program; and Texas Government Code, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendment affects Texas Government Code, §531.0055, §531.021, §531.1521, and §531.166, and Texas Human Resources Code, §161.021.

§9.203.Definitions.

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

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

(4) Applied income--The portion of an individual's cost of care that the individual is responsible for paying. The amount of an individual's applied income is determined by the policies and procedures authorized by the Health and Human Services Commission [ TDHS ] and depends on the individual's earned and unearned income.

(5) - (8) (No change.)

(9) CARE-- DADS' Client Assignment and Registration System, a database with demographic and other data about an individual who is receiving services and supports or on whose behalf services and supports have been requested. [ The department's Client Assignment and Registration System, an on-line data entry system that provides demographic and other data about individuals served by the department. ]

(10) - (12) (No change.)

(13) CRCG (Community Resource Coordination Group)--A local interagency group composed of public and private agencies that develops service plans for individuals whose needs can be met only through interagency coordination and cooperation. The group's role and responsibilities are described in the Memorandum of Understanding on Coordinated Services to Persons Needing Services from More Than One Agency, available on the Health and Human Services Commission website at www.hhsc.state.tx.us/crcg/crcg.htm. [ The role and responsibilities of the involved agencies, including MRAs, school districts, and providers, are described in §411.56 of this title (relating to Memorandum of Understanding (MOU) on Coordinated Services to Children and Youths). ]

(14) DADS--The Department of Aging and Disability Services.

(15) [ (14) ] Day--Calendar day, unless otherwise specified.

(16) [ (15) ] Department--[ The Texas ] Department of Aging and Disability Services [ Mental Health and Mental Retardation ].

(17) [ (16) ] Discharge--The absence, for a full day or more, of an individual from the facility in which the individual resides, if such absence is not during a therapeutic, extended, or special leave, as described in §9.226 [ §419.226 ] of this subchapter [ title ] (relating to Leaves).

(18) [ (17) ] DPoC (directed plan of correction)--A plan developed by DADS' [ the department's ] sanction team that requires a program provider to take specified actions within specified time frames to correct the program provider's failure to meet one or more federal standards of participation (SoPs) or conditions of participation (CoPs) or lack of compliance with one or more state rules.

(19) Emergency situation--An unexpected situation involving an individual's health, safety, or welfare, of which a person of ordinary prudence would determine that the LAR should be informed, such as:

(A) an individual needing emergency medical care;

(B) an individual being removed from his residence by law enforcement;

(C) an individual leaving his residence without notifying staff and not being located; and

(D) an individual being moved from his residence to protect the individual (for example, because of a hurricane, fire, or flood).

(20) [ (18) ] Excluded--Temporarily or permanently prohibited by a state or federal authority from participating as a provider in a federal health care program, as defined in 42 USC §1302a-7b(f) [ 42 USC§1302a-7b(f) ].

(21) [ (19) ] Facility--An intermediate care facility for persons with mental retardation or a related condition.

(22) [ (20) ] Family-based alternative--A family setting in which the family provider or providers are specially trained to provide support and in-home care for children with disabilities or children who are medically fragile.

(23) [ (21) ] Full day--A 24-hour period extending from midnight to midnight.

[ (22) HCFA (Health Care Financing Administration)--The federal agency that administers Medicaid programs. ]

(24) [ (23) ] Hospice--An entity that is primarily engaged in providing care to terminally ill individuals and is approved by DADS [ TDHS ] to participate in the Medicaid Hospice Program in accordance with §30.30 of this title (relating to General Contracting Requirements) [ 40 TAC §30.30 (relating to Requirements for Participation as a Medicaid Hospice Provider) ].

(25) [ (24) ] ICAP (Inventory for Client and Agency Planning)--A validated, standardized assessment that measures the level of supervision an individual requires and, thus, the amount and intensity of services and supports an individual needs.

(26) [ (25) ] ICF/MR Program--The Intermediate Care Facilities for Persons with Mental Retardation Program, which provides Medicaid-funded residential services to individuals with mental retardation or a related condition.

(27) [ (26) ] IDT (interdisciplinary team)--A group of people assembled by the program provider who possess the knowledge, skills, and expertise to assess an individual's needs and make recommendations for the individual's IPP. The group includes the individual, LAR, mental retardation professionals and paraprofessionals and, with approval from the individual or LAR, other concerned persons.

(28) [ (27) ] IPP (individual program plan)--A plan developed by an individual's IDT that identifies the individual's training, treatment, and habilitation needs and describes services to meet those needs.

(29) [ (28) ] Individual--A person enrolled in the ICF/MR Program.

(30) [ (29) ] IQ (intelligence quotient)--A score reflecting the level of an individual's intelligence as determined by the administration of a standardized intelligence test.

(31) [ (30) ] LAR (legally authorized representative)--A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, and may include a parent, guardian, managing conservator of a minor individual, a guardian of an adult individual, or legal representative of a deceased individual.

(32) [ (31) ] LOC (level of care)--A determination given by DADS [ the department ] to an individual as part of the eligibility process based on data submitted on the MR/RC Assessment.

(33) [ (32) ] LON (level of need)--An assignment given by DADS [ the department ] to an individual upon which reimbursement for ICF/MR Program [ program ] services is based. The LON assignment is derived from the service level score obtained from the administration of the ICAP [ Inventory for Client and Agency Planning (ICAP) ] to the individual and from selected items on the MR/RC Assessment.

(34) [ (33) ] Long Term Care Plan for People with Mental Retardation and Related Conditions--The plan required by THSC, §533.062, which is developed by DADS [ the department ] and specifies, in part, the capacity of the ICF/MR Program in Texas.

(35) [ (34) ] MRA (mental retardation authority)-- An entity to which the Health and Human Services Commission's authority and responsibility described in THSC, §531.002(11) has been delegated. [ Consistent with THSC, §533.035, an entity designated by the commissioner to which the Texas Mental Health and Mental Retardation Board delegates its authority and responsibility for planning, policy development, coordination, and resource allocation, and resource development for and oversight of services and supports in one or more local service areas. ]

(36) MR/RC Assessment--A form used by DADS for LOC determination and LON assignment.

(37) [ (35) ] Mental retardation--Significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

(38) [ (36) ] Natural support network--Those persons, including family members, church members, neighbors, and friends, who assist and sustain an individual with supports that occur naturally within the individual's environment and that are not reimbursed or purposely developed by a person or system.

(39) [ (37) ] NHIC-- Formerly, this term referred to the National Heritage Insurance Company ; it now refers to the Texas Medicaid and Health Partnership .

(40) [ (38) ] Non-state operated facility--A facility for which the program provider is an entity other than DADS, [ the department ] such as a community MHMR center or private organization.

(41) [ (39) ] PDP (person-directed plan)--A plan of services and supports developed under the direction of an individual or LAR with the support of MRA or program provider staff and other people chosen by the individual or LAR.

(42) [ (40) ] Permanency planning--A philosophy and planning process that focuses on the outcome of family support for an individual under 22 years of age by facilitating a permanent living arrangement in which the primary feature is an enduring and nurturing parental relationship.

(43) [ (41) ] Permanency Planning Review Screen--A screen in CARE that, when completed by an MRA [ or program provider ], identifies community supports needed to achieve an individual's permanency planning outcomes and provides information necessary for approval of the individual's initial and continued residence in a facility.

(44) [ (42) ] Personal funds--The funds that belong to an individual, including earned income, social security benefits, gifts, and inheritances.

(45) [ (43) ] Petty cash fund--Personal funds managed by a program provider that are maintained for individuals' cash expenditures.

(46) [ (44) ] Pooled account--A trust fund account containing the personal funds of more than one individual.

(47) [ (45) ] Professional--A person who is licensed or certified by the State of Texas in a health or human services occupation or who meets DADS' [ department ] criteria to be a case manager, service coordinator, qualified mental retardation professional, or TDMHMR-certified psychologist as defined in §5.161 [ §415.161 ] of this title (relating to TDMHMR-certified psychologist).

(48) [ (46) ] Program provider--An entity with whom DADS [ the department ] has a provider agreement.

(49) [ (47) ] Provider agreement--A written agreement between DADS [ the department ] and a program provider that obligates the program provider to deliver ICF/MR Program services.

(50) [ (48) ] Provider applicant--An entity seeking to participate as a program provider.

(51) [ (49) ] Related condition--As defined in the Code of Federal Regulations (CFR), Title 42, §435.1009, a severe and chronic disability that:

(A) is attributed to:

(i) cerebral palsy or epilepsy; or

(ii) any other condition, other than mental illness, found to be closely related to mental retardation because the condition results in impairment of general intellectual functioning or adaptive behavior similar to that of individuals with mental retardation, and requires treatment or services similar to those required for individuals with mental retardation;

(B) is manifested before the individual reaches age 22;

(C) is likely to continue indefinitely; and

(D) results in substantial functional limitation in at least three of the following areas of major life activity:

(i) self-care;

(ii) understanding and use of language;

(iii) learning;

(iv) mobility;

(v) self-direction; and

(vi) capacity for independent living.

(52) [ (50) ] Sales receipt--A written statement issued by the seller that includes:

(A) the date it was created; and

(B) the cost of the item or service.

(53) [ (51) ] Sanction team--A group of professionals assembled and employed by DADS [ the department ] that is overseen by the Health and Human Services Commission to ensure consistency in its determinations.

(54) [ (52) ] Separate account--A trust fund account containing the personal funds of only one individual.

(55) [ (53) ] Specially constituted committee--The committee designated by the program provider in accordance with 42 CFR §483.440(f)(3) that consists of staff, LARs, individuals (as appropriate), qualified persons who have experience or training in contemporary practices to change an individual's inappropriate behavior, and persons with no ownership or controlling interest in the facility. The committee is responsible, in part, for reviewing, approving, and monitoring individual programs designed to manage inappropriate behavior and other programs that, in the opinion of the committee, involve risks to individuals' safety and rights.

(56) [ (54) ] State-operated facility--A facility for which DADS [ the department ] is the program provider.

(57) [ (55) ] TAC (Texas Administrative Code)--A compilation of state agency rules published by the Texas Secretary of State in accordance with Texas Government Code, Chapter 2002, Subchapter C.

(58) [ (56) ] TDHS-- Formerly, this term referred to the Texas Department of Human Services ; it now refers to DADS, unless the context concerns Medicaid eligibility. Medicaid eligibility was formerly the responsibility of TDHS; it now is the responsibility of the Health and Human Services Commission .

(59) [ (57) ] THSC (Texas Health and Safety Code)--Texas statutes relating to health and safety.

(60) [ (58) ] Trust fund account--An account at a financial institution in the program provider's control that contains personal funds.

(61) [ (59) ] Unclaimed personal funds--Personal funds managed by the program provider that have not been transferred to the individual or LAR within 30 days after the individual's discharge.

(62) [ (60) ] Unidentified personal funds--Personal funds managed by the program provider for which the program provider cannot identify ownership.

(63) [ (61) ] USC (United States Code)--A compilation of statutes enacted by the United States Congress.

(64) [ (62) ] Vendor hold--Temporary suspension of ICF/MR payments from DADS [ the department ] to a program provider.

(65) [ (63) ] Working day--A day when an MRA's administrative offices are open.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602830

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


4. PROVIDER SERVICE REQUIREMENTS

40 TAC §9.222

Statutory Authority

The amendment is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program; and Texas Government Code, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendment affects Texas Government Code, §531.0055, §531.021, §531.1521, and §531.166, and Texas Human Resources Code, §161.021.

§9.222.Permanency Planning and LAR Participation for Individuals Under 22 Years of Age [ Children ].

(a) As required by Texas Government Code, §531.153, a program provider must incorporate permanency planning as an integral part of the IPP for each individual under 22 years of age residing in the facility. In order to accomplish the permanency planning goal in accordance with §9.244(f) of this subchapter (relating to Applicant Enrollment in the ICF/MR Program), the [ The ] program provider must [ will ] identify in the IPP, as appropriate to the individual's needs:

(1) for [ the natural supports and strengths of the family of ] an individual under 18 years of age , the [ that, when supplemented by ] activities , [ and ] supports , and services that, when provided or facilitated by the program provider or MRA, will enable the individual to live with a family [ return to the family home ]; or

[ (2) a family-based alternative that will secure for an individual under 18 years of age a consistent, nurturing environment that supports a continued relationship with the individual's family to the extent possible and, if necessary, provide an enduring, positive relationship with a specific adult who will be an advocate for the individual; or ]

(2) [ (3) ] for [ the natural supports and strengths of ] an individual age 18 to 22 years of age , the [ that, when supplemented by ] activities , [ and ] supports , and services that, when provided or facilitated by the program provider or MRA, will result in the individual having a consistent and nurturing environment in the least restrictive setting , as defined by the individual and LAR.

(b) A [ The ] program provider must take the following actions to assist an MRA in conducting [ facilitate ] permanency planning for an individual under 22 years of age :

(1) cooperate with the MRA responsible for conducting permanency planning by:

(A) allowing access to an individual's records or providing other information in a timely manner as requested by the MRA or the Health and Human Services Commission;

(B) participating in meetings to review the individual's permanency plan; and

(C) identifying, in coordination with the individual's MRA, activities, supports, and services that can be provided by the family, LAR, program provider, or the MRA to prepare the individual for an alternative living arrangement;

[ (1) discuss with the individual or LAR the problems or issues that led to the individual's admission to the program provider's facility; ]

[ (2) discuss with the family or LAR of an individual under 18 years of age the barriers to having the individual reside in the family home or discuss with an individual 18 to 22 years of age and LAR the barriers to moving to a consistent and nurturing environment as determined by the individual and LAR; ]

[ (3) identify natural supports and family strengths that will accomplish permanency planning outcomes; ]

[ (4) identify, in coordination with the individual's MRA, activities and supports that can be provided by the family, LAR, program provider, or the MRA to prepare the individual for an alternative living arrangement; ]

(2) [ (5) ] encourage regular contact between the individual and [ the individual's ] LAR and, if desired by the individual and LAR, between the individual and [ life-long ] advocates and friends in the community to continue supportive and nurturing relationships;

(3) [ (6) ] encourage participation in IDT meetings by the [ individual's ] LAR, and, if desired by the individual or LAR, by family members, [ life-long ] advocates, and friends in the community; [ and ]

(4) [ (7) ] provide the IPP summary to the individual's MRA ; [ . ]

(5) keep a copy of the individual's current permanency plan in the individual's record; and

(6) refrain from providing the LAR with inaccurate or misleading information regarding the risks of moving the individual to another facility or community setting.

(c) Within three days after [ of ] the admission of an individual under 22 years of age, a [ the ] program provider must notify the following entities of such admission and provide information in accordance with subsection (d) of this section:

(1) the MRA in whose local service area the facility is located (see www.dads.state.tx.us/contact/mra/index.cfm [ http://www.mhmr.state.tx.us/CentralOffice/PublicInformationOffice/DirectoryOfServicesWHAT.ht ml ] for a listing of MRAs by county or city);

(2) the CRCG [ community resource coordination group (CRCG) ] for the county in which the LAR [ applicant's parent or guardian ] lives (see www.hhsc.state.tx.us/crcg/crcg.htm for a listing of CRCG chairpersons by county); and

(3) the local school district for the area in which the facility is located, if the individual is at least three years of age, or the early childhood intervention (ECI) program for the county in which the facility is located, if the individual is less than three years of age (see www.dars.state.tx.us/ecis/index.shtml [ www.eci.state.tx.us ] or call 1-800-250-2246 for a listing of ECI programs by county) . [ ; ]

(d) (No change.)

(e) A program provider must:

(1) request from and encourage an LAR to provide the following information for an individual during the annual IPP meeting and, for an applicant, upon admission:

(A) the LAR's:

(i) name;

(ii) address;

(iii) telephone number;

(iv) driver license number and state of issuance or personal identification card number issued by the Department of Public Safety; and

(v) place of employment and the employer's address and telephone number;

(B) the name, address, and telephone number of a relative of the individual or other person whom DADS or the program provider may contact in an emergency situation, a statement indicating the relationship between that person and the individual, and at the LAR's option:

(i) that person's driver license number and state of issuance or personal identification card number issued by the Department of Public Safety; and

(ii) the name, address, and telephone number of that person's employer; and

(C) a signed acknowledgement of responsibility stating that the LAR agrees to:

(i) notify the program provider of any changes to the contact information submitted; and

(ii) make reasonable efforts to participate in the individual's life and in planning activities for the individual; and

(2) inform the LAR that if the information described in paragraph (1) of this subsection is not provided or is not accurate and the program provider and DADS are unable to locate the LAR as described in subsections (j) and (k) of this section, DADS refers the case to the Department of Family and Protective Services.

(f) For an individual under 22 years of age, a program provider must:

(1) make reasonable accommodations to promote the participation of the LAR in all planning and decision-making regarding the individual's care, including participating in:

(A) the initial development and annual review of the individual's IPP;

(B) decision-making regarding the individual's medical care;

(C) routine IDT meetings; and

(D) decision-making and other activities involving the individual's health and safety; and

(2) ensure that reasonable accommodations include:

(A) conducting a meeting in person or by telephone, as mutually agreed upon by the program provider and the LAR;

(B) conducting a meeting at a time and, if the meeting is in person, at a location that is mutually agreed upon by the program provider and the LAR;

(C) if the LAR has a disability, providing reasonable accommodations in accordance with the Americans with Disabilities Act, including providing an accessible meeting location or a sign language interpreter, if appropriate; and

(D) providing a language interpreter, if appropriate.

(g) For an individual under 22 years of age, a program provider must provide written notice to the LAR of a meeting to conduct an annual review of the individual's IPP no later than 21 days before the meeting date and request a response from the LAR.

(h) If an emergency situation occurs, a program provider must attempt to notify the LAR as soon as the emergency situation allows and request a response from the LAR.

(i) If an LAR does not respond to a notice of the individual's IPP review meeting, a request for the LAR's consent, or an emergency situation, the program provider must attempt to locate the LAR by contacting a person identified by the LAR in the contact information described in subsection (e) of this section.

(j) No later than 30 days after the date a program provider determines that it is unable to locate the LAR, the program provider must notify DADS of that determination and request that DADS initiate a search for the LAR.

(k) If, within one year of the date DADS receives the notification described in subsection (j) of this section, DADS is unable to locate the LAR, DADS refers the case to:

(1) the Child Protective Services Division of the Department of Family and Protective Services if the individual is under 18 years of age; or

(2) the Adult Protective Services Division of the Department of Family and Protective Services if the individual is 18-22 years of age.

(l) Before an individual who is under 18 years of age, or who is 18-22 years of age and for whom an LAR has been appointed, is transferred to another facility operated by the transferring program provider, the program provider must attempt to obtain consent for the transfer from the LAR unless the transfer is made because of a serious risk to the health and safety of the individual or another person.

[ (e) The program provider must inform the individual and LAR that they may request a volunteer advocate to assist in permanency planning. The individual or LAR may: ]

[ (1) select a person who is not employed by or under contract with the program provider; or ]

[ (2) request the program provider to designate a volunteer advocate. ]

[ (f) If an individual or LAR requests that the program provider designate a volunteer advocate or the program provider cannot locate the individual's LAR, the program provider must attempt to designate a volunteer advocate to assist in permanency planning who is, in order of preference: ]

[ (1) an adult relative who is actively involved with the individual; ]

[ (2) a person who: ]

[ (A) is part of the individual's natural support network; and ]

[ (B) is not employed by or under contract with the program provider; or ]

[ (3) a person or a child advocacy organization representative who: ]

[ (A) is knowledgeable about community services and supports; ]

[ (B) is familiar with the permanency planning philosophy and processes; and ]

[ (C) is not employed by or under contract with program provider. ]

[ (g) If the program provider is unable to locate a volunteer advocate locally, the program provider must request assistance from a statewide advocacy organization in identifying an available volunteer advocate who meets the requirements described in subsection (f)(3) of this section. If the statewide advocacy organization is unable to assist the program provider in identifying a volunteer advocate, the program provider must document all efforts to designate a volunteer advocate in accordance with subsection (f) of this section. ]

[ (h) For an individual under 22 years of age, the individual's residence in a facility is temporary and must be approved every six months. If the individual's IDT determines that an individual's permanency planning outcomes have not been met, the program provider must: ]

[ (1) no later than five months after an individual under 22 years of age is admitted to the facility, submit a Permanency Planning Review to the department and obtain approval for continued residence from the department commissioner or designee; and ]

[ (2) every six months thereafter, submit a Permanency Planning Review to the department and obtain approval for continued residence from the commissioner of the Health and Human Services Commission or designee to extend an individual's residence in the facility. ]

(m) [ (i) ] A [ The ] program provider must document compliance with the requirements of this section in the individual's record.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602831

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


5. ELIGIBILITY, ENROLLMENT AND REVIEW

40 TAC §9.244, §9.250

Statutory Authority

The amendment and new section are proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program; and Texas Government Code, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendment and new section affect Texas Government Code, §531.0055, §531.021, §531.1521, and §531.166, and Texas Human Resources Code, §161.021.

§9.244.Applicant Enrollment in the ICF/MR Program .

(a) Except as provided in subsection (b) of this section, only an MRA may request enrollment of an applicant by DADS [ the department ].

(b) A program provider may request enrollment of an applicant by DADS in accordance with subsection (k) of this section [ the department ] if the applicant:

(1) has received ICF/MR services from a non-state operated facility during the 180 days before [ prior to ] the enrollment request; and

(2) (No change.)

(c) An MRA must request an applicant's enrollment if:

(1) the program provider selected by the applicant or [ the applicant's ] LAR notifies the MRA in writing that admission to the program provider's facility has been offered to the applicant; and

(2) the applicant or LAR notifies the MRA that the applicant or LAR chooses to accept the admission offered by the program provider.

(d) If an MRA receives the notifications described in subsection (c) of this section, the MRA must comply with §5.159(c) [ §415.159(c) ] of this title (relating to Assessment of Individual's Need for Services and Supports) including providing an explanation to the applicant or LAR of the services and supports for which the applicant may be eligible. For an applicant under 22 years of age, an MRA must also comply with the following requirements:

(1) Except as provided in paragraphs (2) and (3) of this subsection, before placement of an applicant in a facility, the MRA must inform the LAR:

(A) of the benefits of living in a family or community setting;

(B) that the placement of the applicant is considered temporary; and

(C) that an ongoing permanency planning process is required.

(2) If an MRA is notified of a request for enrollment after the applicant is admitted to the facility, the MRA must provide the information described in paragraph (1) of this subsection to the LAR not later than the 14th working day after the date the MRA is notified of the request for the enrollment, unless this time period is extended by the LAR.

(3) An MRA does not have to comply with paragraph (1) or (2) of this subsection if the applicant has been committed to a facility under Chapter 46B, Code of Criminal Procedure, or Chapter 55, Family Code.

(e) To request an applicant's enrollment, an MRA must, within 15 working days after the MRA receives both notifications described in subsection (c) of this section:

(1) (No change.)

(2) obtain an ICAP score for the applicant by:

(A) (No change.)

(B) administering the ICAP if an ICAP score for the applicant does not exist, is not available, or is not endorsed by the MRA; and

(3) request or review an LOC determination and LON for the applicant by:

(A) (No change.)

(B) reviewing the existing MR/RC Assessment for the applicant if the applicant has a current LOC determination and:

(i) (No change.)

(ii) if the MRA endorses the existing MR/RC Assessment, notifying the selected program provider in writing that no changes to the current LOC or LON are recommended . [ ; and ]

[ (4) if the applicant is under 22 years of age, complete a Permanency Planning Review Screen and electronically submit the information from that screen to the department. ]

(f) Upon notification of a request for enrollment of an applicant under 22 years of age, an MRA must take or ensure that the following actions are taken to conduct permanency planning:

(1) The MRA must convene a permanency planning meeting with the LAR and, if possible, the applicant before admission or, if notified of a request for enrollment after the applicant's admission, not later than the 14th working day after the date the MRA is notified of the request.

(2) Before the permanency planning meeting, the MRA staff must review the applicant's records and, if possible, meet the applicant.

(3) During the permanency planning meeting, the meeting participants must discuss and choose one of the following goals:

(A) for an applicant under 18 years of age:

(i) to live in the applicant's family home where the natural supports and strengths of the applicant's family are supplemented, as needed, by activities and supports provided or facilitated by the MRA or program provider; or

(ii) to live in a family-based alternative in which a family other than the applicant's family:

(I) has received specialized training in the provision of support and in-home care for an individual under 18 years of age with mental retardation;

(II) will provide a consistent and nurturing environment in a family home that supports a continued relationship with the applicant's family to the extent possible; and

(III) if necessary, will provide an enduring, positive relationship with a specific adult who will be an advocate for the applicant; or

(B) for an applicant 18-22 years of age, to live in a setting chosen by the applicant or LAR in which the applicant's natural supports and strengths are supplemented by activities and supports provided or facilitated by the MRA or program provider, and to achieve a consistent and nurturing environment in the least restrictive setting, as defined by the applicant and LAR.

(4) To accomplish the goal chosen in accordance with paragraph (3) of this subsection, the meeting participants must discuss and identify:

(A) the problems or issues that led the applicant or LAR to request admission to a facility;

(B) the applicant's daily support needs;

(C) for an applicant under 18 years of age:

(i) barriers to having the applicant reside in the family home;

(ii) supports that would be necessary for the applicant to remain in the family home; and

(iii) actions that must be taken to overcome the barriers and provide the necessary supports;

(D) for an applicant 18-22 years of age, the barriers to the applicant moving to a consistent and nurturing environment as defined by the applicant and LAR;

(E) the importance for the applicant to live in a long-term nurturing relationship with a family;

(F) alternatives to the applicant living in an institutional setting;

(G) the applicant's and LAR's need for information and preferences regarding those alternatives;

(H) how, after admission to the facility, to facilitate regular contact between the applicant and the applicant's family, and, if desired by the applicant and family, between the applicant and advocates and friends in the community to continue supportive and nurturing relationships;

(I) natural supports and family strengths that will assist in accomplishing the identified permanency planning goal;

(J) activities and supports that can be provided by the family, MRA, or program provider to achieve the permanency planning goal;

(K) assistance needed by the applicant's family:

(i) in maintaining a nurturing relationship with the applicant; and

(ii) preparing the family for the applicant's eventual return to the family home or move to a family-based alternative; and

(L) action steps, both immediate and long term, for achieving the permanency plan goal.

(5) The MRA must make reasonable accommodations to promote the participation of the LAR in a permanency planning meeting, including:

(A) conducting a meeting in person or by telephone, as mutually agreed upon by the MRA and LAR;

(B) conducting a meeting at a time and, if the meeting is in person, at a location that is mutually agreed upon by the MRA and LAR;

(C) if the LAR has a disability, providing reasonable accommodations in accordance with the Americans with Disabilities Act, including providing an accessible meeting location or a sign language interpreter, if appropriate; and

(D) providing a language interpreter, if appropriate.

(6) The MRA must develop a permanency plan using, as appropriate:

(A) the Permanency Planning Instrument for Children Under 18 Years of Age; or

(B) the Permanency Planning Instrument for Individuals 18-22 Years of Age.

(7) The MRA must:

(A) complete the Permanency Planning Review Screen in CARE before an applicant is admitted to a facility unless the MRA is not given prior notice of the admission;

(B) keep a copy of the Permanency Planning Review Approval Status View Screen from CARE in the applicant's record; and

(C) provide a copy of the permanency plan to the program provider, the applicant, and the LAR.

[ (f) The MRA must incorporate permanency planning as an integral part of the initial plan for services and supports developed in accordance with §415.159(b) of this title (relating to Assessment of Individual's Need for Services and Supports) for the applicant under 22 years of age. The MRA will identify in the initial plan for services and supports, as appropriate to the individual's needs: ]

[ (1) the natural supports and strengths of the family of an individual under 18 years of age that, when supplemented by activities and supports provided or facilitated by the MRA, will enable the individual to return to the family home; ]

[ (2) a family-based alternative that will secure for an applicant under 18 years of age a consistent, nurturing environment that supports a continued relationship with the applicant's family to the extent possible and, if necessary, provide an enduring, positive relationship with a specific adult who will be an advocate for the individual; or ]

[ (3) the natural supports and strengths of an applicant from 18 to 22 years of age that, when supplemented by activities and supports provided or facilitated by the MRA, will result in the applicant having a consistent and nurturing environment, as defined by the applicant and LAR. ]

[ (g) The MRA must take the following actions to facilitate permanency planning: ]

[ (1) discuss with the applicant or LAR the problems or issues that led applicant or LAR to request enrollment in the ICF/MR Program; ]

[ (2) discuss with the family or LAR of an applicant under 18 years of age the barriers to having the applicant reside in the family home or discuss with an applicant 18 to 22 years of age and LAR the barriers to moving to a consistent and nurturing environment as determined by the applicant and LAR; ]

[ (3) in the case of an individual's imminent move from the family home, encourage regular contact between the individual and the individual's LAR, and, if desired by the individual and LAR, between the individual and life-long advocates and friends in the community to continue supportive and nurturing relationships; ]

[ (4) identify natural supports and family strengths that will accomplish permanency planning outcomes; and ]

[ (5) identify activities and supports that can be provided by the family, LAR, or MRA that will prepare the applicant for a family-based alternative, if the applicant and LAR choose that option. ]

(g) [ (h) ] If an applicant is under 22 years of age, the MRA must inform the applicant and LAR that they may request a volunteer advocate to assist in permanency planning. The applicant or LAR may:

(1) select a person who is not employed by or under contract with the MRA or a program provider; or

(2) request the MRA to designate a volunteer advocate.

(h) [ (i) ] If an [ the ] applicant or LAR requests that the MRA designate a volunteer advocate or the MRA cannot locate the [ applicant's ] LAR, the MRA must attempt to designate a volunteer advocate to assist in permanency planning who is, in order of preference:

(1) an adult relative who is actively involved with the applicant;

(2) a person who:

(A) is part of the applicant's natural support network; and

(B) is not employed by or under contract with the MRA or a program provider; or

(3) a person or a child advocacy organization representative who:

(A) is knowledgeable about community services and supports;

(B) is familiar with the permanency planning philosophy and processes; and

(C) is not employed by or under contract with the MRA or a program provider.

(i) [ (j) ] If the MRA is unable to locate a volunteer advocate locally, the MRA must request assistance from a statewide advocacy organization in identifying an available volunteer advocate who meets the requirements described in subsection (h) [ (g)(3) ] of this section. If the statewide advocacy organization is unable to assist the MRA in identifying a volunteer advocate, the MRA must document all efforts to designate a volunteer advocate in accordance with subsection (h) [ (g) ] of this section.

(j) [ (k) ] If DADS [ the department ] notifies an MRA that it has authorized an applicant's LOC, the MRA must immediately notify the applicant or LAR of such authorization and provide the selected program provider with copies of all enrollment documentation and associated supporting documentation including relevant assessment results and recommendations and the applicant's ICAP booklet and, if available, the applicant's service plan.

(k) [ (l) ] To request an applicant's enrollment as permitted by subsection (b) of this section , a program provider must ensure that the applicant has a current LOC [ determination and, if the applicant is under 22 years of age, complete and electronically submit a Permanency Planning Review to the department ].

(1) If an applicant does not have a current LOC [ determination ], the program provider must complete and electronically submit an MR/RC Assessment to DADS [ the department ].

(2) If the program provider submits an MR/RC Assessment, DADS notifies [ the department will notify ] the program provider electronically if the LOC is authorized or sends [ send ] written notification to the program provider and the applicant or LAR if the LOC is denied.

(l) [ (m) ] An applicant's enrollment is complete if:

(1) DADS [ the department ] has authorized an LOC for the applicant;

(2) the Social Security Administration has determined that the applicant is eligible for SSI or the Health and Human Services Commission [ TDHS ] determines the applicant is financially eligible for Medicaid;

(3) the program provider has electronically submitted a completed Client Movement Form to DADS [ the department ]; and

(4) admission to the facility has been approved by the DADS [ department ] commissioner or designee for the applicant who is under 22 years of age, based on information submitted as described in subsection (f) [ (e)(4) ] of this section.

(m) [ (n) ] A program provider must maintain a paper copy of the completed MR/RC Assessment with all the necessary signatures and documentation supporting the recommended LOC and LON [ and the Permanency Planning Review Screen in the applicant's record ].

§9.250.Permanency Planning Reviews.

An MRA must, within six months after the initial permanency planning meeting and every six months thereafter until an individual either turns 22 years of age or leaves the facility to live in a family setting:

(1) provide written notice to the LAR of a meeting to conduct a review of the individual's permanency plan no later than 21 days before the meeting date and include a request for a response from the LAR;

(2) convene a meeting to review the individual's permanency plan in accordance with §9.244(f)(2) - (5) of this subchapter (relating to Applicant Enrollment in the ICF/MR Program), with an emphasis on changes or additional information gathered since the last permanency plan was developed;

(3) develop a permanency plan in accordance with §9.244(f)(6) of this subchapter;

(4) perform actions regarding a volunteer advocate as described in §9.244(g) - (i) of this subchapter;

(5) complete the Permanency Planning Review Screen in CARE within 10 days after the meeting;

(6) ensure that approval for the individual to continue to reside in the facility is obtained every six months from the DADS commissioner and the Health and Human Services Commission executive commissioner;

(7) keep a copy of the Permanency Planning Review Approval Status View Screen from CARE in the individual's record; and

(8) provide a copy of the permanency plan to the program provider, the individual, and the LAR.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602832

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


Chapter 17. PILOT PROGRAM FOR MONITORING CERTAIN UNLICENSED LONG-TERM CARE FACILITIES

40 TAC §§17.101, 17.103, 17.105

The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), new Chapter 17, consisting of §§17.101, 17.103, and 17.105, Pilot Program for Monitoring Certain Unlicensed Long-Term Care Facilities.

Background and Purpose

The purpose of the new chapter is to establish rules governing a pilot program to use local task forces to identify and monitor certain long-term care facilities. Section 2.20 of Senate Bill (SB) 6, 79th Legislature, Regular Session, 2005, required the executive commissioner of HHSC to adopt rules that develop and implement a pilot program to monitor certain unlicensed long-term care facilities. The pilot program uses local task forces composed of health care providers, representatives from governmental entities, and local government officials to (1) identify and report to DADS or local law enforcement agencies a long-term care facility that is not providing disclosures required by state law or that is operating without a license, and (2) assist a long-term care facility, whenever possible, to obtain the appropriate license or make the appropriate disclosure.

DADS asks local government officials to participate in the pilot program. Local officials who choose to participate in the pilot program create the local task force. DADS Regulatory Services administers the pilot program. DADS designates staff to work with each local task force.

DADS provides no funding to the local task force.

Section-by-Section Summary

Proposed new §17.101 defines "long-term care facility" as a nursing facility, an assisted living facility, or an intermediate care facility for persons with mental retardation as defined by Texas Health and Safety Code, §531.002.

Proposed new §17.103 defines a local task force, describes how DADS administers the pilot program, and states that DADS provides no funding to the local task force.

Proposed new §17.105 describes how local officials who choose to participate in the pilot program create the local task force, who makes up the local task force, and the roles and responsibilities of the local task force.

Fiscal Note

Gordon Taylor, DADS Chief Financial Officer, has determined that, for the first five years the proposed new chapter is in effect, enforcing or administering the new chapter does not have foreseeable implications relating to costs or revenues of state or local governments.

Small Business and Micro-business Impact Analysis

DADS has determined that there is no adverse economic effect on small businesses or micro-businesses or on businesses of any size as a result of enforcing or administering the new chapter, because the pilot program will identify and assist people and facilities who are currently unlicensed or otherwise in violation of applicable state or local law to obtain the appropriate licenses and comply with applicable regulatory requirements.

Public Benefit and Costs

Veronda Durden, DADS Assistant Commissioner for Regulatory Services, has determined that, for each year of the first five years the new chapter is in effect, the public benefit expected as a result of enforcing the new chapter is the taking of proactive measures to ensure that a long-term care facility providing personal care, health-related services, or other care to elderly or disabled persons complies with required state licensing rules for operating a long term-care facility.

Ms. Durden anticipates that there will not be an economic cost to persons who are required to comply with the new chapter. The new chapter will not affect a local economy.

Takings Impact Assessment

DADS has determined that this proposal 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, does not constitute a taking under Texas Government Code, §2007.043.

Public Comment

Questions about the content of this proposal may be directed to Jennifer Clay at (512) 438-3529 in DADS' Regulatory Services section. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-018, Department of Aging and Disability Services W-615, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

The new chapter is proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; and Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS.

The new chapter implements Texas Government Code, §531.0055, and Texas Human Resources Code, §161.021.

§17.101.Purpose.

This chapter establishes a pilot program to use local task forces to identify and monitor certain long-term care facilities. In this chapter "long-term care facility" means:

(1) a nursing facility as defined in Texas Health and Safety Code, Chapter 242;

(2) an assisted living facility as defined in Texas Health and Safety Code, §247.002; or

(3) an intermediate care facility for persons with mental retardation as defined by Texas Health and Safety Code, §531.002.

§17.103.Department of Aging and Disability Services Responsibilities.

(a) The Department of Aging and Disability Services (DADS) administers the pilot program through an existing program that works with local officials to create task forces. The pilot program ends on September 1, 2007, unless extended by law. When the pilot program ends, DADS may choose to continue a local task force.

(b) DADS Regulatory Services administers the pilot program. All coordination with DADS is through the state office or regional DADS Regulatory Services staff. DADS designates staff to work with each local task force. DADS asks local government officials to participate in the pilot program.

(c) DADS provides no funding to the local task force.

§17.105.Local Officials and Task Force Responsibilities.

(a) Local officials who choose to participate in the pilot program create a local task force. To the extent possible, local officials include health care providers, representatives from governmental entities, and local government officials. The local task force designates contact persons to work with Department of Aging and Disability (DADS) Regulatory Services.

(b) The local task force coordinates efforts and resources to:

(1) identify and report to DADS or local law enforcement agencies:

(A) a long-term facility operating without a license; or

(B) a long-term care facility that is not providing disclosures required by state law; and

(2) assist a long-term care facility, whenever possible, to obtain the appropriate license or make the appropriate disclosure.

(c) The local task force cooperates with DADS to provide any information necessary for reports required by the Texas Health and Human Services Commission.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 19, 2006.

TRD-200602844

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734


Chapter 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

Subchapter I. RESIDENT ASSESSMENT

40 TAC §19.802, §19.805

The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §19.802, concerning comprehensive care plans, and §19.805, concerning permanency planning for a resident under 22 years of age, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification.

Background and Purpose

The purpose of the amendments is to implement Senate Bill (SB) 40 and House Bill (HB) 2579, 79th Legislature, Regular Session, 2005, which amended the Texas Government Code, Chapter 531, Subchapter D-1, governing permanency planning for children under 22 years of age. For a child under 22 years of age for whom admission to an institution is sought or who is receiving services in an institution, SB 40 requires DADS to determine the entity that will develop the permanency plan for a child and requires a nursing facility (facility) to cooperate with the entity responsible for developing the permanency plan. The facility must provide access to the child's records, participate in meetings to review permanency plans, and refrain from providing the child's legally authorized representative (LAR) with inaccurate or misleading information regarding the risks of moving the child to another facility or community setting. HB 2579 requires that DADS ensure that a child's LAR is fully informed of all available community-based services for which the child may be eligible, the benefits to the child of living in a family or community setting, that the placement is considered temporary, and that an ongoing permanency planning process is required. HB 2579 requires a rule that a facility annually request a written reauthorization of the plan of care from the LAR. The facility is required to cooperate in permanency planning, make reasonable accommodations, and attempt to notify the LAR about the annual care plan meeting and in an emergency situation. HB 2579 also requires DADS to require an LAR to provide detailed contact information and agree to make reasonable efforts to participate in the child's life and planning activities.

The amendments are also proposed to update and clarify permanency planning requirements, update agency names, and correct rule cross-references.

Section-by-Section Summary

The amendment to §19.802(b) requires the facility and LAR to annually review the comprehensive care plan for a resident under 22 years of age, including a review of the LAR's contact information and the resident's comprehensive assessment, educational status, and permanency plan. The amendment to §19.802(c) provides clarification about what must be included in a comprehensive care plan for a resident under 22 years of age. The amendment to §19.802(e) requires the facility to provide written notice to the LAR no later than 21 days before the annual review meeting date of the resident's comprehensive care plan and request a response from the LAR.

The amendment to §19.805(a) adds or updates definitions for the following terms and acronyms: CRCG, emergency situation, LAR, and permanency planner. The definitions reflect the new permanency planning procedures for a child who resides in a facility. The amendment to §19.805(b)(5)(A) - (C) requires a facility to cooperate with the permanency planner by allowing access to the child's records, participating in the permanency planning meetings, and identifying supports and activities to prepare a child for an alternate living arrangement, to encourage participation in plan meetings by the LAR and the child, and to encourage contact between the LAR and child. The amendment to §19.805(b)(5)(D) and (E) requires a facility to make reasonable accommodations to promote the LAR's participation in the planning and decision-making regarding the child's care. The amendment to §19.805(b)(5)(F) requires a facility to request from and encourage the LAR to provide detailed contact information that includes the contact information for a relative or other person that the facility may contact in an emergency situation, as required by HB 2579. The facility must request the LAR sign an acknowledgement agreeing to notify the facility of any changes to the contact information and to make reasonable efforts to participate in the child's life. The amendment to §19.805(b)(5)(G) requires a facility to refrain from providing the LAR with inaccurate or misleading information regarding the risks of moving the child to another facility or community setting. The amendment to §19.805(b)(5)(H) and (I) requires a facility to attempt to notify the LAR in an emergency situation and to attempt to locate an LAR who does not respond to a notice of an annual care meeting, request for consent, or emergency situation. The amendment to §19.805(b)(5)(J) requires a facility to request that DADS initiate a search for the LAR if the facility is unable to locate the LAR. The amendment to §19.805(b)(5)(K) requires a facility to attempt to obtain consent from the LAR to transfer a child to another facility. The amendment to §19.805(b)(5)(L) requires a facility to document compliance with the requirements of permanency planning in the child's record. The amendment to §19.805(c) states that DADS will refer the child's case to the Department of Family and Protective Services if DADS cannot locate the LAR within a year of the facility's request.

Fiscal Note

Gordon Taylor, DADS Chief Financial Officer, has determined that, for the first five years the proposed amendments are in effect, enforcing or administering the amendments does not have foreseeable implications relating to costs or revenues of state or local governments. The potential cost related to HB 2579 due to DADS personnel conducting permanency planning for residents under 22 years of age would not be significant and could be absorbed within existing resources.

Small Business and Micro-business Impact Analysis

DADS has determined that there is no adverse economic effect on small businesses or micro-businesses or on businesses of any size as a result of enforcing or administering the amendments, because the proposal places no new requirements on businesses that would have a significant cost to businesses.

Public Benefit and Costs

Veronda Durden, DADS Assistant Commissioner for Regulatory Services, has determined that, for each year of the first five years the amendments are in effect, the public benefit expected as a result of enforcing the amendments is that having DADS personnel conduct the permanency planning process helps ensure that no conflict of interest exists in developing the child's permanency plan. The amendments will ensure that the facility cooperates with DADS personnel and encourage the LAR to be involved and participate in the life of the child residing in the facility.

Ms. Durden anticipates that there will not be an economic cost to persons who are required to comply with the amendments. The amendments will not affect a local economy.

Takings Impact Assessment

DADS has determined that this proposal 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, does not constitute a taking under Texas Government Code, §2007.043.

Public Comment

Questions about the content of this proposal may be directed to Christy Dees at (512) 438-3162 in the Policy Development and Oversight Unit of DADS' Center for Policy and Innovation. Written comments on the proposal may be submitted to Texas Register Liaison, Legal Services-012, Department of Aging and Disability Services W-615, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Statutory Authority

The amendments are proposed under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; Texas Health and Safety Code, Chapter 242, which authorizes DADS to license and regulate nursing facilities; and Texas Government Code, Chapter 531, Subchapter D-1, which provides that the HHSC executive commissioner shall adopt rules for implementation of a process by which DADS informs legally authorized representatives of all community-based services before persons are admitted to an institution and rules regarding the transfer of persons from an institution in an emergency situation.

The amendments implement Texas Government Code, §§531.0055, 531.1521, and 531.166, Texas Human Resources Code, §161.021, and Texas Health and Safety Code, §242.0373.

§19.802.Comprehensive Care Plans.

(a) A [ The ] facility must develop a comprehensive care plan for each resident that includes measurable short-term and long-term objectives and timetables to meet a resident's medical, nursing, [ and ] mental , and psychosocial needs that are identified in the comprehensive assessment. If a child is [ children are ] admitted to the facility, the comprehensive care plan must be based on the [ each ] child's individual needs. The comprehensive care plan must describe the following:

(1) (No change.)

(2) any services that would otherwise be required under §19.901 of this title but are not provided due to the resident's exercise of rights, including the right to refuse treatment under §19.402(g) of this title (relating to Exercise of Rights).

(b) The comprehensive care plan must be:

(1) (No change.)

(2) prepared by an interdisciplinary team that includes the attending physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident's needs, and, to the extent practicable, with the participation of the resident, the resident's family or legal representative; [ and ]

(3) periodically reviewed and revised by a team of qualified persons after each assessment ; and [ . ]

(4) for a resident under 22 years of age, annually reviewed at a comprehensive care plan meeting between the facility and the resident's LAR as defined in §19.805(a)(5) of this title (relating to Permanency Planning for a Resident Under 22 Years of Age), which includes a review of:

(A) the LAR's contact information as required by §19.805(b)(5)(F) of this title;

(B) the resident's comprehensive assessment;

(C) the resident's educational status; and

(D) the resident's permanency plan.

(c) A comprehensive care plan must include:

(1) for a resident under 18 years of age, the activities, supports, and services that, when provided or facilitated by the facility, will enable the resident to live with a family; or

(2) for a resident 18-22 years of age, the activities, supports, and services that, when provided or facilitated by the facility, will result in the resident having a consistent and nurturing environment in the least restrictive setting, as defined by the resident and LAR as defined in §19.805(a)(5) of this title.

(d) [ (c) ] A comprehensive care plan may include a palliative plan of care. This plan may be developed only at the request of the resident, surrogate decision maker or legal representative for residents with terminal conditions, end stage diseases or other conditions for which curative medical interventions are not appropriate. The plan of care must have goals that focus on maintaining a safe, comfortable and supportive environment in providing care to a resident at the end of life.

(e) For a resident under 22 years of age, the facility must provide written notice to the LAR, as defined in §19.805(a)(5) of this title, of a meeting to conduct an annual review of the resident's comprehensive care plan no later than 21 days before the meeting date and request a response from the LAR.

(f) [ (d) ] The services provided or arranged by the facility must:

(1) meet professional standards of quality; and

(2) be provided by qualified persons in accordance with each resident's written plan of care.

(g) [ (e) ] The comprehensive care plan must be made available to all direct care staff.

§19.805.Permanency Planning for a Resident Under 22 Years of Age [ Pediatric Residents ].

(a) Definitions. The following words and terms, when used in this subchapter [ section ], have the following meanings, unless the context clearly indicates otherwise.

(1) (No change.)

(2) Child--A person with a developmental disability who is under [ younger than ] 22 years of age.

(3) CRCG (Community resource coordination group)--A local interagency group composed of public and private agencies that develops service plans for individuals whose needs can be met only through interagency coordination and cooperation. The group's role and responsibilities are described in the Memorandum of Understanding on Coordinated Services to Persons Needing Services from More Than One Agency, available on the Health and Human Services Commission website at www.hhsc.state.tx.us/crcg/crcg.htm.

(4) Emergency situation--An unexpected situation involving a child's health, safety, or welfare, of which a person of ordinary prudence would determine that the LAR should be informed, such as:

(A) a child needing emergency medical care;

(B) a child being removed from his residence by law enforcement;

(C) a child leaving his residence without notifying staff and not being located; and

(D) a child being moved from his residence to protect the child (for example, because of a hurricane, fire, or flood).

(5) LAR (legally authorized representative)--A person authorized by law to act on behalf of a resident with regard to a matter described in this subchapter, which may include a parent, guardian, managing conservator of a minor individual, a guardian of an adult individual, or legal representative of a deceased individual.

(6) Permanency planner--A person assigned by DADS to conduct permanency planning activities for a child who resides in a facility.

[(3) Community resource coordination group (CRCG)--A coordination group established under the memorandum of understanding adopted under the Family Code, §264.003.]

(b) Facility responsibilities regarding permanency planning.

(1) A facility must request a Preadmission Screening and Resident Review (PASARR) [ must be requested ] on every child who is a potential admission to a [ nursing ] facility, as well as on all children currently residing in a [ nursing ] facility who have not had a previous PASARR completed. Documentation regarding the request for or completion of a PASARR must be kept in the chart.

(2) A facility must notify the following entities of the child's admission not later than the third day after a child is initially placed in a facility:

(A) the DADS [ DHS ] pediatric nurse specialist via fax. Information must include the child's full name, date of birth, date of admission, social security number, Medicaid number (if available), the facility name and address, and the name, address, and telephone number of the child's LAR [ parent or guardian ];

(B) the CRCG in the county where the LAR [ parent or guardian ] resides (see www.hhsc.state.tx.us/crcg/crcg.htm for a listing of CRCG chairpersons by county) ; and

(C) the local office of the Early Childhood Intervention (ECI) Program, if a child is less than three years of age (see www.dars.state.tx.us/ecis/index.shtml or call 1-800-250-2246 for a listing of ECI programs by county), or the local school district, if a child is at least three years of age [ for children from birth to age three ], with which the facility must coordinate educational opportunities (See §19.1934 of this title (relating to Educational Requirements for Persons under Age 22)). [ ; and ]

[(D) the local school district for children from ages three to younger than 22 years of age, with which the facility must coordinate educational opportunities. See §19.1934 of this title (relating to Educational Requirements for Persons Under 22).]

(3) A [ The ] facility must notify the DADS [ DHS ] pediatric nurse specialist within 14 days if there is a significant change of condition in a child residing in the facility.

(4) A [ The ] facility must keep documentation regarding [ all ] the [ above ] notifications required in paragraphs (2) and (3) of this subsection and a copy of the [ most ] current permanency plan [ documentation ] in a separate section in the front of each child's records.

(5) A [ Each ] facility [ in which a child resides ] must:

(A) cooperate with the permanency planner by:

(i) allowing access to a child's records or providing other information in a timely manner as requested by the permanency planner or the Health and Human Services Commission;

(ii) participating in meetings to review the child's permanency plan; and

(iii) identifying, in coordination with the permanency planner, activities, supports, and services that can be provided by the family, LAR, facility, or the permanency planner to prepare the child for an alternative living arrangement;

(B) encourage regular contact between the child and LAR and, if desired by the child and LAR, between the child and advocates and friends in the community to continue supportive and nurturing relationships;

(C) encourage participation in the comprehensive care plan meetings by the LAR, and, if desired by the child or LAR, by family members, advocates, and friends in the community;

(D) make reasonable accommodations to promote the participation of the LAR in all planning and decision-making regarding the child's care, including participating in:

(i) the initial development and annual review of the child's comprehensive care plan;

(ii) decision-making regarding the child's medical care;

(iii) routine interdisciplinary team meetings; and

(iv) decision-making and other activities involving the child's health and safety;

(E) ensure that reasonable accommodations include:

(i) conducting a meeting in person or by telephone, as mutually agreed upon by the facility and the LAR;

(ii) conducting a meeting at a time and, if the meeting is in person, at a location that is mutually agreed upon by the facility and the LAR;

(iii) if the LAR has a disability, providing reasonable accommodations in accordance with the Americans with Disabilities Act, including providing an accessible meeting location or a sign language interpreter, if appropriate; and

(iv) providing a language interpreter, if appropriate;

(F) upon admission and annually thereafter:

(i) request from and encourage an LAR to provide the following information for a child during the annual comprehensive care plan meeting and, for an applicant, upon admission:

(I) the LAR's:

(-a-) name;

(-b-) address;

(-c-) telephone number;

(-d-) driver license number and state of issuance or personal identification card number issued by the Department of Public Safety; and

(-e-) place of employment and the employer's address and telephone number;

(II) the name, address, and telephone number of a relative of the child or other person whom DADS or the facility may contact in an emergency situation, a statement indicating the relation between that person and the child, and at the LAR's option:

(-a-) that person's driver license number and state of issuance or personal identification card number issued by the Department of Public Safety; and

(-b-) the name, address, and telephone number of that person's employer; and

(III) a signed acknowledgement of responsibility stating that the LAR agrees to:

(-a-) notify the facility of any changes to the contact information submitted; and

(-b-) make reasonable efforts to participate in the child's life and in planning activities for the child; and

(ii) inform the LAR that if the information described in clause (i) of this subparagraph is not provided or is not accurate and the facility and DADS are unable to locate the LAR as described in subparagraph (J) of this paragraph, DADS refers the case to the Department of Family and Protective Services, in accordance with subsection (c) of this section;

(G) refrain from providing the LAR with inaccurate or misleading information regarding the risks of moving the child to another facility or community setting;

(H) if an emergency situation occurs, attempt to notify the LAR as soon as the emergency situation allows and request a response from the LAR;

(I) if an LAR does not respond to a notice of the child's annual comprehensive care plan meeting, a request for the LAR's consent, or an emergency situation, attempt to locate the LAR by contacting a person identified by the LAR in the contact information described in subparagraph (F) if this paragraph;

(J) no later than 30 days after the date the facility determines that it is unable to locate the LAR, notify DADS of that determination and request that DADS initiate a search for the LAR;

(K) before a child who is under 18 years of age, or who is 18-22 years of age and for whom an LAR has been appointed, is transferred to another facility operated by the transferring facility, attempt to obtain consent for the transfer from the LAR, unless the transfer is made because of a serious risk to the health and safety of the child or another person; and

(L) document compliance with the requirements of this paragraph in the child's records.

[(A) allow appropriate health and human services agencies and the individuals designated by DHS access to the child's records; and]

[(B) add the permanency planning goal to the care plan.]

(6) (No change.)

(7) Paragraphs (3) - (6) of this subsection do not apply to short-stay care of less than 14 days; however, the facility must notify the DADS [ DHS ] pediatric nurse specialist, the CRCG, and ECI or the local school district as required in paragraph (2)(A) - (C) [ (2)(A) - (D) ] of this subsection.

(c) If, within one year of the date DADS receives the notification described in subsection (b)(5)(J) of this section, DADS is unable to locate the LAR, DADS refers the case to:

(1) the Child Protective Services Division of the Department of Family and Protective Services if the child is under 18 years of age; or

(2) the Adult Protective Services Division of the Department of Family and Protective Services if the child is 18-22 years of age.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 18, 2006.

TRD-200602825

Marianne Reat

Interim General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: July 2, 2006

For further information, please call: (512) 438-3734