Emergency Sections An agency may adopt a new or amended section or repeal an existing section on an emergency basis if it determines that such action is necessary for the public health, safety, or welfare of this state. The section may become effective immediately upon filing with the Texas Register, or on a stated date less than 20 days after filing, for no more than 120 days. The emergency action is renewable once for no more than 60 days. Symbology in amended emergency sections. New language added to an existing section is indicated by the use of bold text. [Brackets] indicate deletion of existing material within a section. TITLE 25. HEALTH SERVICES Part II. Texas Department of Mental Health and Mental Retardation Chapter 401. System Administration Subchapter G. Community Mental Health and Mental Retardation Centers 25 TAC sec.401.464 The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts on an emergency basis new sec.401.464 of Chapter 401, Subchapter G, concerning community mental health and mental retardation centers. This section replaces the current sec.401.464 of the same title which was previously adopted on an emergency basis effective September 1, 1993. The new section adopted on an emergency basis is contemporaneously proposed for public comment in this issue of the Texas Register. The previous proposal of this section, published in the August 6, 1993, issue of the Texas Register (18 TexReg 5190), has been withdrawn. Public comment and the department's response regarding the proposal is available for inspection in the Office of Policy Development at TXMHMR (4405 North Lamar Boulevard, Room 411, Austin). The section adopted on a emergency basis broadens the scope of the appeals process to include any concern or dissatisfaction a consumer may have. The purpose of the emergency adoption is to provide a more comprehensive and workable process when complying with the Texas Health and Safety Code, sec.534. 0675, which calls for the establishment of uniform procedures for each local mental health or mental retardation authority to use when notifying consumers in writing of the denial, involuntary reduction, or termination of services and of the right to appeal those decisions. The new section is adopted on an emergency basis under Texas Civil Statutes, Article 6252-13a, sec.5(d), which provides emergency rulemaking power; and under the Texas Health and Safety Code, Title 7, sec.532.015, which provides the Texas Board of Mental Health and Mental Retardation with rulemaking powers. sec.401.464. Notification and Appeals Process. (a) The TXMHMR service system is dedicated to providing mental health and mental retardation services/supports which are viewed as satisfactory by persons receiving those services/supports. Therefore, local MHMR authorities and their contractors shall take steps to assure that these persons: (1) have a method to express their concerns or dissatisfaction; (2) are assisted to do so in a constructive way; and (3) have their concerns or dissatisfaction addressed through a review process. (b) A request to review decisions described in this section may be made by the person requesting or receiving services/supports, the person's legal representative, or any other individual with the person's consent. (c) At the time of admission into services and on an annual basis thereafter, the local MHMR authority and its contractors shall provide to persons who receive services/supports written notification of the local MHMR authority's and its contractor's policy for addressing concerns or dissatisfaction with services/supports. The notification shall explain: (1) an easily understood process for persons to request a review of their concerns or dissatisfaction by the local MHMR authority or its contractor, if appropriate; (2) how the person may receive assistance in requesting the review; (3) the timeframes for the review; and (4) the method by which the person is informed of the outcome of that review. (d) Local MHMR authorities and their contractors shall notify persons in writing of the following decisions and of the process to appeal by requesting a review of those decisions: (1) a decision to deny the person services/supports at the conclusion of a local MHMR authority's procedure which determines whether the person meets the criteria for the priority population; and (2) a decision to terminate services/supports and follow-along from the local MHMR authority or its contractor, if appropriate. (e) The written notification must: (1) be given or mailed to the person within ten working days of the date the decision was made; (2) state the reason for the decision; (3) explain that the person may contact either the local MHMR authority or its contractor, whichever is appropriate, within 30 days of receipt of notification if dissatisfied with the decision and request that the decision be reviewed in accordance with subsection (g) of this section; and (4) include name(s), phone number(s) and address(es) of one or more accessible staff to contact during office hours. (f) If a person believes that the local MHMR authority or its contractor has made a decision to involuntarily reduce services by changing the amount, duration, or scope of services/supports provided and is dissatisfied with that decision, then the person may request in writing that the decision be reviewed in accordance with subsection (g) of this section. (g) The review by the local MHMR authority or its contractor shall: (1) begin within ten working days of receipt of the request for a review and be completed within ten working days of the time it begins unless an extension is granted by the CEO of the local MHMR authority or its contractor, if appropriate; (2) begin immediately upon receipt of the request and be completed within five working days if the decision is related to a crisis service; (3) be conducted by an individual who was not involved in the initial decision; (4) include a review of the original decision which led to the person's dissatisfaction; (5) result in a decision to uphold, reverse, or modify the original decision; and (6) provide the person an opportunity to express his or her concerns in person or by telephone to the individual reviewing the decision. The review shall also allow the person to: (A) have a representative talk with the reviewer, or (B) submit his or her concerns in writing, on tape, or in some other fashion. (h) Following a review, either the local MHMR authority or its contractor, whichever is appropriate, shall explain to the person in writing and in person or by telephone, if requested, the action it will take or, if no action will be taken, why it will not change the decision or believes such action would not be in the person's best interest. This is the final step in the review process. (i) The notification and review process described in this section: (1) is applicable only to services/supports funded by TXMHMR and provided or contracted for by its local MHMR authorities; (2) does not preclude a person's right to reviews, appeals, or other actions that accompany other funds administered through a local MHMR authority or its contractors, or to other appeals processes provided for by other state and federal laws, e.g., Texas Health and Safety Code, Title 7, Chapter 593 (Persons with Mental Retardation Act); 42 United States Code sec.1396 (Medicaid statute); and Texas Human Resources Code, Chapter 73 (Texas Administrative Code, Title 25, Chapter 621), Early Childhood Intervention programs as funded by the Texas Interagency Council for Early Childhood Intervention. Issued in Austin, Texas, on November 19, 1993. TRD-9332432 Ann Utley Chairman Texas Board of Mental Health and Mental Retardation Effective date: December 1, 1993 Expiration date: April 1, 1994 For further information, please call: (512) 206-4670