reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.333 - Behavioral Support

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure that a behavioral support service provider:
(1) is licensed as a psychologist in
					 accordance with the Texas Occupations Code Chapter 501;
(2) is a provisional license holder licensed
					 in accordance with the Texas Occupations Code Chapter 501;
(3) is licensed as a psychological associate
					 in accordance with the Texas Occupations Code Chapter 501;
(4) is licensed as a licensed behavior
					 analyst in accordance with the Texas Occupations Code Chapter 506;
(5) is licensed as a clinical social worker
					 in accordance with the Texas Occupations Code Chapter 505;
(6) is licensed as a professional counselor
					 in accordance with the Texas Occupations Code Chapter 503; or
(7) is a behavior communication specialist
					 who has:
(A) a master's or a doctoral degree
					 in special education, psychology, or a related human services discipline from
					 an accredited university or college, and three years of experience providing
					 direct services to individuals who have deafblindness; or
(B) a bachelor's degree in psychology or
					 special education from an accredited university or college and seven years of
					 experience providing direct services to individuals who have deafblindness and
					 multiple disabilities.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.335 - Chore Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure that chore services are provided only when an individual
					 residing in a setting other than a residential setting described in
					 §260.351 of this division (relating to Residential Services) or another
					 person residing with the individual is not capable of performing or financially
					 providing for those chores. Examples of chore services include such heavy
					 household chores as:
(1) washing floors,
					 windows, and walls;
(2) tacking
					 down loose rugs and tiles; and
(3)
					 moving heavy items of furniture.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.337 - Case Management

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure that case management is provided in accordance with an
					 individual's IPP, IPC, and Appendix C of the DBMD Program waiver application
					 approved by CMS and available on the HHSC website, including:
(1) initiating and overseeing the process of
					 assessment and reassessment of the individual's LOC;
(2) initiating and overseeing the process of
					 the review of service plans at enrollment, annually, and as needed, including
					 if requested by the individual or LAR;
(3) observing the individual in the
					 individual's home and determining the intent and level of the individual's
					 communication;
(4) if necessary,
					 determining from the individual's non-verbal communication, the individual's
					 likes and dislikes;
(5) leading the
					 service planning team to use the person-centered planning process to develop a
					 service plan that optimizes the opportunities for the individual to use the
					 individual's abilities and to integrate in community settings;
(6) using the individual's knowledge of sign
					 language and other communication systems to make the individual as aware as
					 possible of the individual's service plan and options;
(7) communicating with service planning team
					 members to ensure that the service plan is carried out appropriately;
(8) monitoring the success of the service
					 plan by observing the individual at home and in the community;
(9) monitoring the provision of services
					 included in the service plan on an ongoing basis; and
(10) monitoring services that assist the
					 individual in gaining access to needed waiver and other state plan services,
					 including medical, social, educational, and non-wavier services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.339 - Dental Treatment

Current through Reg. 49, No. 28; July 12, 2024
(a) Dental treatment
					 consists of the following:
(1) emergency
					 dental treatments, which are procedures necessary to control bleeding, relieve
					 pain, and eliminate acute infection; operative procedures that are required to
					 prevent the imminent loss of teeth; and treatment of injuries to the teeth or
					 supporting structures;
(2) routine
					 preventative dental treatments, which are examinations, x-rays, cleanings,
					 sealants, oral prophylaxes, and topical fluoride applications;
(3) therapeutic dental treatments, which
					 include fillings, scaling, extractions, crowns, and pulp therapy for permanent
					 and primary teeth; restoration of carious permanent and primary teeth;
					 maintenance of space; and limited provision of removable prostheses when
					 masticatory function is impaired, when an existing prosthesis is unserviceable,
					 or when aesthetic considerations interfere with employment or social
					 development;
(4) orthodontic dental
					 treatments, which are procedures that include treatment of retained deciduous
					 teeth; cross-bite therapy; facial accidents involving severe traumatic
					 deviations; cleft palates with gross malocclusion that will benefit from early
					 treatment; and severe, handicapping malocclusions affecting permanent dentition
					 with a minimum score of 26 as measured on the Handicapping Labio-lingual
					 Deviation Index; and
(5) dental
					 sedation, which is sedation necessary to perform dental treatment including
					 non-routine anesthesia, (for example, intravenous sedation, general anesthesia,
					 or sedative therapy prior to routine procedures) but does not include the
					 administration of routine local anesthesia only.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.341 - Employment Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure that a service provider of employment assistance or a
					 service provider of supported employment meets the qualifications described in
					 §
											260.203(g) of
					 this chapter (relating to Qualifications of Program Provider Staff).
(b) Before including employment assistance on
					 an individual's IPC, a program provider must ensure and maintain documentation
					 in the individual's record that employment assistance is not available to the
					 individual under a program funded under §110 of the Rehabilitation Act of
					 1973 or under a program funded under the Individuals with Disabilities
					 Education Act (20 U.S.C.
					 §
												1401 et seq.).
(c) A program provider must ensure that
					 employment assistance:
(1) consists of a
					 service provider performing the following activities:
(A) identifying an individual's employment
					 preferences, job skills, and requirements for a work setting and work
					 conditions;
(B) locating
					 prospective employers offering employment compatible with an individual's
					 identified preferences, skills, and requirements;
(C) contacting a prospective employer on
					 behalf of an individual and negotiating the individual's employment;
(D) transporting the individual to help the
					 individual locate competitive employment in the community; and
(E) participating in service planning team
					 meetings;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.345 - Intervener

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure an intervener:
(1) works
					 with no more than one individual at a time;
(2) makes sights, sounds, and activities
					 accessible to the individual by learning the specific communication system of
					 the individual;
(3) provides
					 communication and information to an individual concerning the individual's
					 environment that otherwise would be available through vision and
					 hearing;
(4) develops and prepares
					 activities for the individual;
(5)
					 forms a working alliance with the individual's family members, neighbors,
					 employers, and professionals with whom the individual has contact;
(6) participates on the individual's service
					 planning team;
(7) transports the
					 individual to gain access to community services and resources required by the
					 IPP;
(8) instructs and supports the
					 individual in skills related to community involvement; and
(9) uses interpersonal communication,
					 including sign language, speech, tangible communication symbols, gestures,
					 calendars, and augmentative communication devices.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.347 - Nursing

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure that nursing:
(1) is
					 ordered or prescribed by a physician or other medical practitioner acting
					 within the scope of the practitioner's license; and
(2) is provided in accordance with:
(A) Texas Occupations Code Chapter
					 301;
(B) 22 TAC Chapter
					 217;
(C) 22 TAC Chapter 224;
					 and
(D) 22 TAC Chapter
					 225.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.349 - Orientation and Mobility

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure an orientation and mobility service provider:
(1) evaluates an individual's ability to use
					 existing senses to determine the individual's position within the environment,
					 including home, school, work, and other community settings;
(2) develops a plan that:
(A) identifies the individual's goals and
					 outcomes; and
(B) enables the
					 individual to acquire skills to safely move from one place to another within
					 the environment, including home, school, work, and other community settings;
					 and
(3) trains other
					 service providers to:
(A) create an
					 environment in home, school, work, and community settings that enhances the
					 individual's ability to move safely and efficiently; and
(B) carry through on goals and outcomes
					 identified in the plan.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.351 - Residential Services

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) A program provider may provide
					 residential services as:
(A) licensed assisted
					 living, either 18-hour or 24-hour; or
(B) licensed home health assisted living,
					 either 18-hour or 24-hour.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.353 - Respite

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) A program provider must ensure that
					 respite consists of the following:
(A)
					 assistance with ADLs;
(B)
					 assistance with functional living tasks;
(C) assistance with planning and preparing
					 meals;
(D) transportation or
					 assistance in securing transportation;
(E) assistance with ambulation and
					 mobility;
(F) reinforcement of
					 behavioral support or therapy activities;
(G) assistance with medications and the
					 performance of tasks delegated by an RN in accordance with state law;
(H) supervision of the individual's safety
					 and security; and
(I) activities
					 that facilitate the individual's:
(i)
					 inclusion in community activities;
(ii) use of natural supports and typical
					 community services;
(iii) social
					 interaction:
(iv) participation in
					 leisure activities; and
(v) daily
					 and functional living skills.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 3 - REQUIREMENTS FOR OTHER DBMD PROGRAM SERVICES › Section 260.355 - Therapies

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must provide or ensure the provision of the following therapies:
(1) occupational therapy;
(2) physical therapy;
(3) speech-language pathology;
(4) audiology; and
(5) dietary services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 4 - NON-BILLABLE TIME AND ACTIVITIES › Section 260.357 - Non-Billable Time and Activities

Current through Reg. 49, No. 28; July 12, 2024
A program provider must not bill for and HHSC does not
						reimburse for:
(1) services provided to
					 an individual before HHSC's approval of the individual's request for enrollment
					 in the DBMD Program;
(2)
					 supervision of service providers unless providing delegated tasks;
(3) phone calls, text messages, emails,
					 letters, or meetings with HHSC or community resources that do not directly
					 address an individual's services;
(4) administrative meetings or staff
					 meetings;
(5) in-service training,
					 general training, continuing education, or conferences;
(6) employee conferences or
					 evaluations;
(7) filing claims for
					 services;
(8) traveling to and from
					 an individual's residence, except when a day habilitation, transportation
					 provided as a residential habilitation activity, or in-home respite service
					 provider is transporting the individual;
(9) processing paperwork or completing
					 records or reports;
(10) services
					 not included on an approved IPC;
(11) services that are mutually
					 exclusive;
(12) other services and
					 activities not authorized, permitted, or allowed under this chapter;
(13) routine care and supervision that a
					 family member is legally obligated to provide;
(14) activities or supervision for which a
					 payment is made by a source other than Medicaid;
(15) room and board;
(16) any expense related to providing
					 transportation provided as a residential habilitation activity, nursing,
					 out-of-home respite in a camp, case management, adaptive aids, intervener
					 services, or CFC PAS/HAB outside the program provider's contracted service
					 delivery area, including costs for transportation or lodging;
(17) transportation provided as a residential
					 habilitation activity, nursing, out-of-home respite in a camp, case management,
					 adaptive aids, intervener services, or CFC PAS/HAB provided to an individual
					 outside the program provider's contracted service delivery area if the
					 individual has received services outside the program provider's contracted
					 service delivery during a period of more than 60 consecutive days;
(18) two or more services provided at the
					 same time by the same service provider; or
(19) an item or service provided to an
					 individual at the request of the individual or LAR that is not a reimbursable
					 item in the DBMD Program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter F - SERVICE DESCRIPTIONS AND REQUIREMENTS › Division 5 - CFC ERS › Section 260.359 - CFC ERS

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
					 provider must ensure that CFC ERS is provided only to an individual:
(1) who is not receiving licensed assisted
					 living or home health licensed assisted living; and
(2) who:
(A) lives alone, who is alone for significant
					 parts of the day, or has no regular caregiver for extended periods of time;
					 and
(B) would otherwise require
					 extensive routine supervision.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter G - PROGRAM PROVIDER-OWNED RESIDENTIAL SETTINGS › Section 260.401 - Residential Agreements

Current through Reg. 49, No. 28; July 12, 2024
(a) During a
				  service planning team meeting to develop an enrollment, a revised, or a renewal
				  IPP, a case manager must inform an individual or LAR of the following if the
				  individual is interested in receiving licensed assisted living:
(1) that if the individual or LAR selects
				  licensed assisted living, the individual or LAR will be responsible for paying
				  the cost of room and board in accordance with a residential agreement described
				  in subsections (b) and (c) of this section;
(2) that if the individual or LAR does not
				  pay room and board as required by a residential agreement, the individual's
				  program provider may evict the individual in accordance with the residential
				  agreement and state law; and
(3)
				  that if the program provider evicts the individual:
(A) the individual will not receive licensed
				  assisted living until the delinquent room and board is paid; and
(B) the IPC will be revised to own home or
				  family home if the delinquent room and board is not paid.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter G - PROGRAM PROVIDER-OWNED RESIDENTIAL SETTINGS › Section 260.403 - Requirements for Program Provider-Owned Residential Settings

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
				  provider must ensure that, except as provided in subsection (b) of this
				  section, in a residence in which licensed assisted living is provided:
(1) an individual has privacy in the
				  individual's bedroom;
(2) an
				  individual has the option not to share a bedroom with a roommate;
(3) an individual sharing a bedroom has a
				  choice of roommates;
(4) a lock is
				  installed on the individual's bedroom door at no cost to the individual, and
				  that:
(A) the lock is operable by the
				  individual; and
(B) only the
				  individual, a roommate of the individual, and staff designated by the program
				  provider have keys to the individual's bedroom door;
(5) an individual can furnish and decorate
				  the individual's bedroom;
(6) while
				  in the residence, an individual has the freedom and support:
(A) to control the individual's schedules and
				  activities that are not part of the IPP for licensed assisted living;
				  and
(B) to have access to food at
				  any time;
(7) an
				  individual may have visitors of the individual's choosing at any time;
				  and
(8) the residence is physically
				  accessible and free of hazards to the individual.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter H - DECLARATION OF DISASTER › Section 260.451 - Exceptions to Certain Requirements During Declaration of Disaster

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC may allow
				  a program provider to use one or more of the exceptions described in
				  subsections (c) - (n) of this section while an executive order or proclamation
				  declaring a state of disaster under Texas Government Code §
										418.014 is in effect.
				  HHSC notifies program providers:
(1) if HHSC
				  allows an exception to be used; and
(2) if an exception is allowed to be used,
				  the date the exception must no longer be used, which may be before the
				  declaration of a state of disaster expires.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.501 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this
					 subchapter, have the following meanings, unless the context clearly indicates
					 otherwise:
(1) Calendar day--Any day,
				  including weekends and holidays.
(2) Case manager--A service provider of case
				  management.
(3) CFC--Community
				  First Choice. A state plan option governed by Code of Federal Regulations,
				  Title 42, Chapter 441, Subpart K, regarding Home and Community-Based Attendant
				  Services and Supports State Plan Option (Community First Choice).
(4) Community setting--A setting accessible
				  to the general public within an individual's community.
(5) Day habilitation--A DBMD Program
				  service.
(6) DBMD Program--The Deaf
				  Blind with Multiple Disabilities Program.
(7) DFPS--Texas Department of Family and
				  Protective Services.
(8) HHSC--The
				  Texas Health and Human Services Commission.
(9) Hospital--A public or private institution
				  licensed or exempt from licensure in accordance with Texas Health and Safety
				  Code (THSC) Chapters 13, 241, 261, or 552.
(10) ID/RC Assessment--Intellectual
				  Disability/Related Conditions Assessment. An HHSC form HHSC uses to determine
				  the LOC for an individual.
(11)
				  Individual--A person seeking to enroll or who is enrolled in the DBMD
				  Program.
(12) Individualized skills
				  and socialization--A DBMD Program service described in this subchapter. The two
				  types of individualized skills and socialization are on-site individualized
				  skills and socialization and off-site individualized skills and
				  socialization.
(13) Individualized
				  skills and socialization provider--A legal entity licensed in accordance with
				  Chapter 559, Subchapter H of this title (relating to Individualized Skills and
				  Socialization Provider Requirements).
(14) IPC--Individual Plan of Care. A written
				  plan developed by an individual's service planning team and documented on the
				  HHSC Individual Plan of Care form. An IPC:
(A)
				  documents:
(i) the type and amount of each
				  DBMD Program service and each CFC service, except for CFC support management,
				  to be provided to the individual during an IPC year; and
(ii) if an individual will receive CFC
				  support management; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.503 - Description of Individualized Skills and Socialization

Current through Reg. 49, No. 28; July 12, 2024
(a) The two types
				  of individualized skills and socialization are on-site individualized skills
				  and socialization and off-site individualized skills and
				  socialization.
(b) A program
				  provider must ensure that individualized skills and socialization is provided
				  by an individualized skills and socialization provider. An individualized
				  skills and socialization provider must be the program provider or a contractor
				  of the program provider.
(c) An
				  individualized skills and socialization provider must ensure that
				  individualized skills and socialization:
(1)
				  provides person-centered activities related to:
(A) acquiring, retaining, or improving
				  self-help skills and adaptive skills necessary to live successfully in the
				  community and participate in home and community life; and
(B) gaining or maintaining independence,
				  socialization, community participation, current or future volunteer goals, or
				  employment goals consistent with achieving the outcomes identified in an
				  individual's IPP;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.505 - Provision of Individualized Skills and Socialization

Current through Reg. 49, No. 28; July 12, 2024
(a) A program
				  provider must make both on-site individualized skills and socialization and
				  off-site individualized skills and socialization available to an
				  individual.
(b) An individualized
				  skills and socialization provider must provide on-site individualized skills
				  and socialization and off-site individualized skills and socialization in
				  accordance with an individual's IPC and IPP.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.507 - Staffing Ratios

Current through Reg. 49, No. 28; July 12, 2024
(a) The ratio of
				  service providers of individualized skills and socialization to persons
				  receiving services:
(1) on-site must be no
				  higher than one service provider of individualized skills and socialization to
				  three individuals and other persons receiving individualized skills and
				  socialization or a similar service (1:3); and
(2) off-site must be no higher than one
				  service provider of individualized skills and socialization to two individuals
				  and other persons receiving individualized skills and socialization or a
				  similar service (1:2).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.509 - Discontinuation of Day Habilitation

Current through Reg. 49, No. 28; July 12, 2024
Notwithstanding other rules governing the DBMD Program,
					 effective March 1, 2023, day habilitation is not a service in the DBMD
					 Program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.511 - Including Individualized Skills and Socialization on an IPC

Current through Reg. 49, No. 28; July 12, 2024
A program provider must ensure that:
(1) a case manager includes individualized
				  skills and socialization on an individual's enrollment IPC in accordance with
				  the rules governing the DBMD Program;
(2) a case manager renews or revises an IPC
				  to include individualized skills and socialization in accordance with the rules
				  governing the DBMD Program;
(3) a
				  case manager ensures that:
(A) an enrollment
				  IPC or renewal IPC with an effective date on or after March 1, 2023 does not
				  include day habilitation; and
(B)
				  an IPC that is revised during the period of March 1, 2023 through February 29,
				  2024 includes only the amount of day habilitation that the program provider
				  provided to the individual before March 1, 2023; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.513 - Service Provider Qualifications and Training

Current through Reg. 49, No. 28; July 12, 2024
(a) A service
				  provider of individualized skills and socialization must meet the staff
				  qualifications described in §
										559.227(a)(2) of
				  this title (relating to Program Requirements).
(b) A service provider of individualized
				  skills and socialization who provides transportation must meet the staff
				  qualifications described in §
										559.227(a)(3) of
				  this title.
(c) A service provider
				  of individualized skills and socialization must complete the following training
				  in accordance with rules governing the DBMD Program:
(1) general orientation training;
(2) DBMD Program Service Provider
				  Training;
(3) training on needs of
				  an individual to whom the service provider is providing individualized skills
				  and socialization; and
(4) training
				  on delegated tasks, if the service provider is performing delegated tasks for
				  an individual receiving individualized skills and socialization.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter I - INDIVIDUALIZED SKILLS AND SOCIALIZATION › Section 260.515 - Contracting to Provide Individualized Skills and Socialization

Current through Reg. 49, No. 28; July 12, 2024
If a program provider contracts with an individualized
					 skills and socialization provider to provide individualized skills and
					 socialization to an individual, the program provider must:
(1) comply with 40 TAC §
										49.308(relating to
				  Subcontractors);
(2) ensure the
				  individualized skills and socialization provider complies with:
(A)
											§260.503(c) - (e) of this subchapter
				  (relating to Description of Individualized Skills and Socialization);
				  and
(B)
											§
											260.505 of this subchapter
				  (relating to Provision of Individualized Skills and Socialization);
				  and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter A - GENERAL REQUIREMENTS › Section 261.201 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this chapter is to describe:
(1) policies and procedures for the
				  Intermediate Care Facilities for the Mentally Retarded (ICF/MR) Program in
				  Texas;
(2) responsibilities of
				  program providers in the ICF/MR Program;
(3) rights and protections for persons
				  applying for and receiving ICF/MR Program services; and
(4) responsibilities of mental retardation
				  authorities (MRAs).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter A - GENERAL REQUIREMENTS › Section 261.202 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to provider applicants, program
					 providers, and MRAs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter A - GENERAL REQUIREMENTS › Section 261.203 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this
					 subchapter, have the following meanings, unless the context clearly indicates
					 otherwise:
(1) Active
				  treatment--Continuous, aggressive, consistent implementation of a program of
				  habilitation, specialized and generic training, treatment, health services, and
				  related services. Active treatment does not include services to maintain
				  generally independent individuals who are able to function with little
				  supervision or in the absence of a continuous active treatment program. The
				  program must be directed toward:
(A) the
				  acquisition or maintenance of the behaviors necessary for the individual to
				  function with as much self-determination and independence as possible;
				  and
(B) the prevention or
				  deceleration of regression or loss of current optimal functional
				  status.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter B - PROVIDER ENROLLMENT › Section 261.206 - Application Process

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  will accept an application for enrollment:
(1) from a provider applicant, if the
				  department determines that new or existing ICF/MR Program beds authorized in
				  the
Long Term Care Plan for People with Mental Retardation and Related
				  Conditions
are available for allocation to a program provider for a
				  new facility not to exceed a capacity of six;
(2) from an assignee, if the department
				  receives notice that a provider agreement is being assigned; or
(3) from a provider applicant, if the
				  provider applicant provides residential services funded with general revenue
				  that have been authorized by the department to be refinanced as ICF/MR Program
				  services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter B - PROVIDER ENROLLMENT › Section 261.207 - Certification and Licensure

Current through Reg. 49, No. 28; July 12, 2024
(a) To obtain a
				  provider agreement under §
										261.208 of this chapter (relating
				  to Provider Agreement), a provider applicant whose application for enrollment
				  is approved must receive licensure under THSC, Chapter 252, if applicable, and
				  certification as an ICF/IID by DADS within 270 days from the date DADS approves
				  the application, except as provided in subsection (b) of this
				  section.
(b) DADS may, for good
				  cause, grant an extension of the 270 day period described in subsection (a) of
				  this section for a period of time to be determined by DADS if a provider
				  applicant submits to DADS a written request for an extension, including
				  supporting documentation, prior to the expiration of the 270 day period. For
				  purposes of this subsection, good cause includes, but is not limited to:
(1) construction of the facility is delayed
				  for causes beyond the provider applicant's control, such as a natural
				  disaster;
(2) DADS is unable to
				  make an on-site visit to the facility within the 270 day period, through no
				  fault of the provider applicant; or
(3) construction of the facility is delayed
				  because of litigation regarding the construction or operation of the
				  facility.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter B - PROVIDER ENROLLMENT › Section 261.208 - Provider Agreement

Current through Reg. 49, No. 28; July 12, 2024
(a) DADS enters
				  into a provider agreement only with a provider applicant that has received
				  licensure under THSC, Chapter 252, if applicable, and certification by DADS in
				  accordance with §
										261.207 of this chapter (relating
				  to Certification and Licensure).
(b) The effective date of a provider
				  agreement is the effective date of certification by DADS.
(c) A provider agreement remains in effect
				  until it is terminated.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter C - PROVIDER ADMINISTRATIVE REQUIREMENTS › Section 261.211 - Compliance with State and Federal Laws

Current through Reg. 49, No. 28; July 12, 2024
A program provider must comply with:
(1) applicable state laws and rules,
				  including but not limited to:
(A) this
				  subchapter;
(B) Chapter 409,
				  Subchapter A Title 40 (relating to General Reimbursement Methodology for all
				  Medical Assistance Programs) [does not exist];
(C) Chapter 9, Subchapter B of Title 40
				  (relating to Adverse Actions);
(D)
				  Chapter 409, Subchapter C of Title 40 (relating to Fraud and Abuse and Recovery
				  of Benefits) [does not exist];
(E)
				  Chapter 419, Subchapter G of Title 40 (relating to Medicaid Fair Hearings) [now
				  repealed];
(F) 1 TAC Chapter 355,
				  Subchapter D (relating to Reimbursement Methodology); and
(G) 1 TAC §§ 355.701-355.709; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter C - PROVIDER ADMINISTRATIVE REQUIREMENTS › Section 261.212 - Non-Licensed Providers Meeting Licensure Standards

Current through Reg. 49, No. 28; July 12, 2024
Program providers that, in accordance with the THSC, §
					 252.003, are exempt from the license required by THSC, § 252.031, must
					 comply with the following subchapters of 40 TAC Chapter 90 (relating to
					 Intermediate Care Facilities for Persons with Mental Retardation or Related
					 Conditions):
(1) Subchapter C
				  (relating to Standards for Licensure);
(2) Subchapter D (relating to General
				  Requirements for Facility Construction); and
(3) Subchapter F (relating to Inspections,
				  Surveys, and Visits).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter C - PROVIDER ADMINISTRATIVE REQUIREMENTS › Section 261.213 - Records

Current through Reg. 49, No. 28; July 12, 2024
(a) A program provider must maintain a copy
				  of the following records for each individual:
(1) the birth certificate;
(2) relevant legal documents including
				  documents relating to guardianship, marital status, custody of a minor, or
				  immigration status, if any;
(3) the
				  Social Security card;
(4) a current
				  photograph;
(5) immunization
				  records;
(6) height and weight
				  records;
(7) seizure records, if
				  any;
(8) the most recent
				  physician's orders, including treatment and diet orders;
(9) the most recent nursing care plan, if
				  any;
(10) the most recent
				  laboratory test results, if any;
(11) any significant medical reports,
				  including reports regarding the most recent chest X-ray, electrocardiogram
				  (EKG), and electroencephalogram (EEG), if any;
(12) the most recent medical examination
				  results and a summary of the medical history, including all major surgeries,
				  significant acute illnesses, and injuries requiring hospitalization or a long
				  recovery period;
(13) a summary of
				  the medication history for the last five years or from the time services were
				  initiated, whichever is most recent, including start and stop dates, dose
				  ranges, effectiveness and reactions of all long-term medications and
				  antibiotics;
(14) the most recent
				  dental examination results and a summary of the dental history, including all
				  oral surgeries, extractions, restorations, appliances, and types of anesthesia
				  required for dental work;
(15) the
				  social history and the most recent psychological examination results;
(16) Medicaid and, if applicable, Medicare or
				  third-party insurance cards;
(17)
				  records necessary to disclose the nature and extent of services provided to the
				  individual; and
(18) any other
				  records required by this subchapter or the provider agreement.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter C - PROVIDER ADMINISTRATIVE REQUIREMENTS › Section 261.214 - Certified Capacity of a Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  certified capacity of a facility will be established by the
				  department.
(b) A program provider
				  may request that the department decrease the certified capacity of its
				  facility.
(1) The class of a non-state
				  operated facility that has its certified capacity decreased will be determined
				  according to 1 TAC §
											355.456(b)
				  (relating to Rate Setting Methodology) for reimbursement purposes.
(2) The department will amend the
Long Term Care Plan for People with Mental Retardation and Related
				  Conditions
to reflect the decrease in certified capacity of a facility
				  or will determine that beds authorized by the
Long Term Care Plan for
				  People with Mental Retardation and Related Conditions
are available
				  for allocation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter C - PROVIDER ADMINISTRATIVE REQUIREMENTS › Section 261.215 - Relocation of Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) Prior to
				  relocating its facility, a program provider must receive department approval of
				  a facility relocation application obtained from the department, if
				  certification of the facility at a new physical address will be
				  sought.
(b) To request the approval
				  required by subsection (a) of this section, a program provider must, prior to
				  the facility relocation, complete and submit to the department's Office of
				  Medicaid Administration, a facility relocation application.
(c) After reviewing an application, the
				  department will provide written notice to the program provider of its approval
				  or denial. An incomplete application will not be approved.
(d) If the department approves the
				  application for facility relocation, the department will notify the state
				  survey agency of the facility relocation and request that the state survey
				  agency initiate licensure and certification action of the relocated
				  facility.
(e) Prior to the
				  relocation, the program provider must notify each individual residing in the
				  facility and LAR in writing of the date of facility relocation and the address
				  of the relocated facility or explain to the individual or LAR why shorter
				  notification was necessary.
(f) At
				  the time of relocation, the program provider must notify the MRA in whose local
				  service area the facility has relocated of the name and address of the
				  relocated facility in writing.
(g)
				  If the relocated facility is licensed in accordance with state law and
				  determined by the state survey agency to meet certification requirements, the
				  department will initiate an amendment to the provider agreement to reflect the
				  address of the relocated facility. The program provider must execute and submit
				  the amendment to the department.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING › Subchapter C - PROVIDER ADMINISTRATIVE REQUIREMENTS › Section 261.217 - Assignment of Provider Agreement

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  program provider must notify the department's Office of Medicaid Administration
				  in writing at least 30 days prior to the date of a proposed assignment. The
				  notice must include:
(1) the legal name and
				  federal tax identification number of the proposed assignee;
(2) the proposed date of the assignment,
				  which must be on the first day of a month;
(3) the provider vendor number of the
				  assignor;
(4) an application for
				  enrollment obtained from the department and completed by the assignee as
				  required for provider applicants by § 261.206(d) of this chapter (relating
				  to Application Process); and
(5) a
				  copy of the assignment agreement, which must include a statement that the
				  assignee:
(A) must keep, perform, and fulfill
				  all of the terms, conditions, and obligations that must be performed by the
				  assignor under the provider agreement;
(B) is subject to all pending conditions that
				  exist against the assignor including, but not limited to, any plan of
				  correction, audit exception, vendor hold, or proposed contract termination;
				  and
(C) is liable to the department
				  for any liabilities or obligations that arise from any act, event, or condition
				  that occurred or existed prior to the effective date of the assignment and that
				  is identified in any survey, review, or audit conducted by the
				  department.