reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 4 - MOVING FROM A STATE FACILITY TO AN ALTERNATIVE LIVING ARRANGEMENT › Section 2.276 - Accessing Alternative Living Arrangements for an Individual Residing in a State MR Facility Who Does Not Have the Ability to Give Legally Adequate Consent and Who Does Not Have a Legally Authorized Representative (LAR)

Current through Reg. 49, No. 28; July 12, 2024
(a) If the IDT recommends an alternative
					 living arrangement for an individual who does not have the ability to give
					 legally adequate consent and who does not have an LAR, the IDT will:
(1) notify the individual's designated MRA
					 and persons actively involved with the individual of the
					 recommendation;
(2) identify issues
					 which could prevent the individual from successfully adapting to an alternative
					 living arrangement including:
(A) the
					 individual's inability to provide legally adequate consent; and
(B) the lack of effective community services
					 and supports to address behavioral or medical concerns;
(3) recommend possible solutions to address
					 the issues; and
(4) document the
					 identified issues and recommended solutions in the IDT report.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 4 - MOVING FROM A STATE FACILITY TO AN ALTERNATIVE LIVING ARRANGEMENT › Section 2.277 - Arrangements for the Move to an Alternative Living Arrangement of an Individual Residing in a State MR Facility

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Within 14 calendar days of the IDT meeting at which a provider is selected the
					 state MR facility will forward the following to the designated MRA, any other
					 involved MRA, the provider, and the individual with the ability to provide
					 legally adequate consent or the LAR, as appropriate:
(1) a copy of the draft community
					 living/discharge plan;
(2) the
					 planned date for the individual's move, if available;
(3) the report from the last annual planning
					 meeting of the IDT;
(4) the most
					 recent psychological, social, medical, and vocational/educational assessments;
					 and
(5) reports from any interim
					 meetings of the IDT which addressed living options issues not addressed at the
					 annual planning meeting.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 4 - MOVING FROM A STATE FACILITY TO AN ALTERNATIVE LIVING ARRANGEMENT › Section 2.278 - Community Living/Discharge Plan for Alternative Living Arrangements

Current through Reg. 49, No. 28; July 12, 2024
(a) Designated state MR facility staff will
					 prepare the community living/discharge plan as described in § 412.277 of
					 this title (relating to Arrangements for the Move to an Alternative Living
					 Arrangement of an Individual Residing in a State MR Facility) and this section.
					 The plan incorporates information provided by the individual, LAR, MRA, other
					 state MR facility staff, and the provider. The plan:
(1) is customized based on the abilities and
					 needs of the individual to specify the:
(A)
					 timelines and intervals for monitoring activities;
(B) form those monitoring activities will
					 take (e.g. on-site visitations, phone contacts, record reviews, and written
					 reports);
(C) responsibilities of
					 the designated MRA and other MRAs if the proposed move is outside the
					 designated MRA's local services area;
(D) responsibilities of the provider;
					 and
(E) criteria for a
					 recommendation for discharge from the state MR facility;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 5 - DISCHARGE › Section 2.279 - Discharge from a State MR Facility of an Individual Who Moves to an Alternative Living Arrangement

Current through Reg. 49, No. 28; July 12, 2024
(a) An individual
					 who moves from a state MR facility into an alternative living arrangement may
					 be discharged from the state MR facility of record pursuant to THSC, Chapter
					 594, if the state MR facility determines and documents in the individual's
					 Community Living/Discharge plan or other record that:
(1) the individual's needs are better served
					 in a setting other than a state MR facility; and
(2) the individual is being successfully
					 treated and habilitated in the current community living arrangement.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 5 - DISCHARGE › Section 2.280 - Administrative Discharges Initiated by a State MR Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) A state MR facility may discharge an
					 individual who has been admitted or committed to a state MR facility if:
(1) the individual is determined as a result
					 of a DMR conducted in accordance with § 415.155 of this title (relating to
					 Determination of Mental Retardation (DMR)) to not have mental
					 retardation;
(2) the individual has
					 been listed as an unauthorized departure for at least 30 calendar days and
					 attempts to locate the individual have been unsuccessful; or
(3) the individual with the ability to
					 provide legally adequate consent or with an LAR moves from the state MR
					 facility against staff advice.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 5 - DISCHARGE › Section 2.281 - Administrative Discharges from a Voluntary Admission Initiated by an Individual or LAR

Current through Reg. 49, No. 28; July 12, 2024
A state MR facility must discharge an individual who has
						been voluntarily admitted to a state MR facility no later than 96 hours after
						the time the individual or LAR requests discharge of the individual
						unless:
(1) the head of the MR
					 facility determines that the individual's condition or other circumstances are
					 such that the individual cannot be discharged without endangering the safety of
					 the individual or the general public;
(2) the head of the facility files an
					 application for judicial commitment under THSC, §593.041; and
(3) a court issues an order of protective
					 custody under THSC, §593.044 pending a final determination on the
					 application for judicial commitment.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 6 - SPECIAL CONSIDERATIONS FOR INDIVIDUALS WHO MOVED FROM A STATE FACILITY TO AN ALTERNATIVE LIVING ARRANGEMENT PRIOR TO SPETEMBER 1, 1997 › Section 2.282 - Review by Local MRA of Individual in a Community Living Arrangement

Current through Reg. 49, No. 28; July 12, 2024
(a) Upon written notification to MRAs from
					 the department identifying individuals who moved from a state MR facility into
					 an alternative living arrangement prior to September 1, 1997, a planning team
					 organized by the designated MRA must review each identified individual's:
(1) treatment and habilitation in the
					 alternative living arrangement; and
(2) need, if any, for monitoring.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 2 - LOCAL AUTHORITY RESPONSIBILITIES › Subchapter F - CONTINUITY OF SERVICES-STATE FACILITIES › Division 7 - PERMANENCY PLANNING AND LAR NOTIFICATION REQUIREMENTS FOR AN INDIVIDUAL UNDER 22 YEARS OF AGE › Section 2.283 - MRA and State MR Facility Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(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;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter A - DEFINITIONS › Section 3.101 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 have the following meanings, unless the context clearly indicates
					 otherwise:
(1) Abuse--An act or
				  failure to act that, with regard to an individual, meets the definition of
				  "physical abuse," "sexual abuse," or "verbal/emotional abuse" in Chapter 711,
				  Subchapter A of this title (relating to Introduction), or the definition of
				  "abuse," "physical abuse," "sexual abuse," "verbal abuse," "psychological
				  abuse," or "threat" in the Centers for Medicare & Medicaid Services (CMS)
				  State Operations Manual, Appendix J, Guidance to Surveyors: Intermediate Care
				  Facilities for Individuals with Intellectual Disabilities, available at
				  www.cms.gov.
(2) Administrative
				  death review--An administrative, quality-assurance activity related to the
				  death of an individual to identify non-clinical problems requiring correction
				  and opportunities to improve the quality of care at a facility.
(3) Allegation--A report by a person
				  suspecting or having knowledge that an individual has been or is in a state of
				  abuse, neglect, or exploitation as defined in this chapter.
(4) Alleged offender--An individual who was
				  committed or Transferred to a facility:
(A)
				  under Texas Code of Criminal Procedure, Chapters 46B or 46C, as a result of
				  being charged with or convicted of a criminal offense; or
(B) under Texas Family Code, Chapter 55, as a
				  result of being alleged by petition or having been found to have engaged in
				  delinquent conduct constituting a criminal offense.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.201 - Pre-employment or Pre-assignment Checks and Clearances

Current through Reg. 49, No. 28; July 12, 2024
(a) Before employment or assignment, a
				  facility must conduct a criminal history check and registry clearance of an
				  applicant for employment or volunteer status consisting of:
(1) a criminal history check obtained
				  directly from the Texas Department of Public Safety;
(2) a criminal history check obtained through
				  the Federal Bureau of Investigation using a complete set of fingerprints;
				  and
(3) searches of the registries
				  and CANRS.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.201 - Pre-employment or Pre-assignment Checks and Clearances

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.202 - Emergency Employment Pending Criminal History Check

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility may employ an applicant on a
				  temporary basis pending the results of a criminal history check if:
(1) the facility has searched the registries
				  and CANRS and determined that the applicant:
(A) is not listed as revoked in the Nurse
				  Aide Registry;
(B) is not listed as
				  unemployable in the Employee Misconduct Registry; and
(C) does not have a finding of abuse or
				  neglect in CANRS; and
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.203 - Notification to Applicants

Current through Reg. 49, No. 28; July 12, 2024
A facility must provide the following information to
					 applicants in writing at the time an application is made:
(1) that the facility will conduct a criminal
				  history check and registry clearance;
(2) that conviction of or deferred
				  adjudication for certain criminal offenses may constitute a bar to employment
				  or volunteer status;
(3) that being
				  listed as revoked in the Nurse Aide Registry or being listed as unemployable in
				  the Employee Misconduct Registry is a bar to employment or volunteer status;
				  and
(4) that a confirmation of
				  abuse or neglect in CANRS is a bar to employment or volunteer status.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.204 - Self-Reporting and Subsequent Criminal History Checks and Registry Clearances

Current through Reg. 49, No. 28; July 12, 2024
(a) At any time
				  while employed by or assigned to a facility, an employee, volunteer, or unpaid
				  professional intern must report to the designated person within five calendar
				  days any of the following events:
(1) the
				  employee's, volunteer's, or intern's conviction, arrest, indictment,
				  adjudication of guilt, plea of guilty or nolo contendre, assessment of
				  probation, pretrial diversion, or deferred adjudication for any criminal
				  offense; or a dismissal, acquittal, or similar final outcome for any criminal
				  offense that does not involve a plea of guilty or nolo contendre; and
(2) any listing of the employee, volunteer,
				  or intern as revoked in the Nurse Aide Registry or as unemployable in the
				  Employee Misconduct Registry.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.204 - Self-Reporting and Subsequent Criminal History Checks and Registry Clearances

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter B - CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES › Section 3.205 - Unpaid Professional Interns

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility may not allow an unpaid
				  professional intern to have direct contact with an individual if that intern:
(1) has been convicted of or received
				  deferred adjudication for any of the criminal offenses listed in HSC
				  §250.006(a);
(2) has been
				  convicted of or received deferred adjudication for any of the criminal offenses
				  listed in HSC §250.006(b) within five years preceding the date of
				  assignment;
(3) has been convicted
				  of or received deferred adjudication for a criminal offense that DADS has
				  determined to be a contraindication to assignment pursuant to HSC
				  §533.007;
(4) is listed as
				  revoked in the Nurse Aide Registry;
(5) is listed as unemployable in the Employee
				  Misconduct Registry; or
(6) has a
				  confirmation of abuse or neglect in CANRS.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.301 - Prohibition of Abuse, Neglect, and Exploitation

Current through Reg. 49, No. 28; July 12, 2024
(a) Abuse, neglect, and exploitation of an
				  individual are prohibited.
(b) If
				  an aggressive action by an individual, including non-consensual sexual activity
				  between individuals, occurs as a result of possible neglect, the facility must
				  report the action as neglect.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.301 - Prohibition of Abuse, Neglect, and Exploitation

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.302 - Reporting Abuse, Neglect, and Exploitation to DFPS

Current through Reg. 49, No. 28; July 12, 2024
(a) A person who knows or suspects an
				  individual has been abused, neglected, or exploited must immediately report the
				  alleged abuse, neglect, or exploitation to DFPS within one hour of learning of
				  or suspecting the incident by calling 1-800-647-7418. Abuse, neglect, or
				  exploitation may occur before an individual is admitted to a facility, during
				  an absence from a facility, or while in residence at the facility.
(b) A facility must report incidents
				  identified as abuse, neglect, or exploitation during the course of a facility
				  investigation or peer review.
(c)
				  If the person with knowledge or suspicion of abuse, neglect, or exploitation is
				  not an employee or contractor, an employee must assist the person in making a
				  report, if necessary.
(d) DADS may
				  take disciplinary action, including termination, against an employee who is
				  found to have:
(1) failed to report as
				  required by this section within the allotted time period without sufficient
				  justification; or
(2) made a false
				  statement of fact, refused to cooperate, or destroyed evidence during an
				  investigation.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.302 - Reporting Abuse, Neglect, and Exploitation to DFPS

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.303 - Prohibition Against Retaliation

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility may not retaliate against a
				  person who in good faith reports an allegation.
(b) A person who believes he or she has been
				  subjected to retaliation as a result of reporting an allegation, or who
				  believes an allegation has been ignored, may contact the director of the
				  facility where the alleged abuse, neglect, or exploitation occurred or DADS
				  state office. An employee may also contact:
(1) The Office of the Attorney General at
				  (512) 463-2185 (Consumer Protection Division), if the employee believes adverse
				  personnel action was taken against him or her in violation of Texas Government
				  Code, Chapter 554; or
(2) The
				  Office of Inspector General at 1-800-436-6184.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.304 - During an Investigation

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Immediately after receiving notification of an allegation from a DFPS
				  investigator, the director receiving the notification must take measures to
				  protect the alleged victim of abuse, neglect, or exploitation in accordance
				  with DADS operational procedures.
(b) The director must arrange for immediate
				  and on-going medical and psychological attention for an alleged victim and any
				  other individual involved in the incident, as necessary.
(c) The director must:
(1) ensure that required reports are made to
				  DFPS, DADS Regulatory Services Division, and law enforcement;
(2) in accordance with the Civil Practice and
				  Remedies Code, Chapter 81, report allegations of sexual exploitation committed
				  by a mental health services provider to the prosecuting attorney in the county
				  where the alleged sexual exploitation occurred and any state licensing board
				  with responsibility for the mental health services provider's licensing;
				  and
(3) notify the following
				  persons of the allegation immediately, but in no case more than 24 hours, after
				  being notified of an allegation:
(A) the
				  alleged victim, unless contraindicated based on clinical evaluation;
				  and
(B) the alleged victim's
				  guardian or primary contact, or parent if the alleged victim is a
				  child.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.305 - Completion of an Investigation

Current through Reg. 49, No. 28; July 12, 2024
(a) A director may not change a confirmed
				  finding of abuse, neglect, or exploitation made by DFPS. A director may change
				  an unconfirmed, inconclusive, or unfounded finding of abuse, neglect, or
				  exploitation made by DFPS to a confirmed finding. If the director changes a
				  finding to confirmed, the confirmed finding may not be appealed to
				  DFPS.
(b) A facility has the appeal
				  opportunities described in Chapter 711, Subchapter J , of this title (relating
				  to Appealing the Investigative Finding ). If a director disagrees with the
				  secondary appeal decision made by DFPS in accordance with §
										711.911(b)
				  of this title (relating to How and When is the Appeal Conducted?), the director
				  must notify the DADS Commissioner of the disagreement. If the DADS Commissioner
				  also disagrees with the secondary appeal decision, the DADS Commissioner may
				  request that the DFPS Commissioner reconsider the decision. The DADS
				  Commissioner must submit a reconsideration request to the DFPS Commissioner
				  within 60 days after the date of the secondary appeal decision. DADS may not
				  contest the decision of the DFPS Commissioner.
(c) A director must ensure that a victim, a
				  victim's LAR, and the protection and advocacy organization, if the protection
				  and advocacy organization is the victim's designated representative, are
				  promptly notified of:
(1) a final finding
				  made by DFPS;
(2) the process for
				  appealing the final finding as described in Chapter 711, Subchapter J, of this
				  title; and
(3) the right to receive
				  a copy of the DFPS investigative report, if requested from the
				  director.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter C - ABUSE, NEGLECT, AND EXPLOITATION › Section 3.306 - Contractors

Current through Reg. 49, No. 28; July 12, 2024
(a) A director is
				  responsible for requiring the facility's contractors to comply with this
				  subchapter (relating to Abuse, Neglect, and Exploitation).
(b) A director must ensure that a contractor
				  is provided a copy of DFPS rules in 40 TAC Chapter 711 (relating to
				  Investigations in DADS Mental Retardation and DSHS Mental Health Facilities and
				  Related Programs).
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.602 - Mechanical Devices

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Safety and maintenance.
(1) Only commercially
				  available mechanical restraint devices designed specifically for the safe and
				  relatively comfortable use of restraint may be used. The director must approve
				  any modifications to a mechanical restraint to accommodate an individual's
				  specific physical needs.
(2) Staff
				  must inspect a mechanical device before and after each use to ensure that the
				  device is in good repair and without tears or protrusions that may cause
				  injury. Staff must have a damaged mechanical device repaired before it can be
				  used to restrain an individual.
(3)
				  Staff must ensure that a mechanical device is applied correctly.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.603 - Evaluation and Assessment

Current through Reg. 49, No. 28; July 12, 2024
(a) The IDT must develop and implement
				  person-centered proactive supports, training, and treatment with the goal of
				  making the use of restraints unnecessary.
(b) When evidence indicates that the
				  individual's behaviors result in a behavioral crisis or sustained self-injury
				  or make it difficult to provide needed medical or dental care, the IDT,
				  including the individual and LAR, with the involvement of a PCP and other
				  relevant professional staff, must assess and identify any issues or
				  contraindications for the use of restraint, including:
(1) any physical, behavioral, psychiatric, or
				  medical conditions that constitute a risk; and
(2) any considerations in the use of
				  restraint due to the individual's communication level, cognitive functioning
				  level, height, weight, emotional condition (including whether the individual
				  has a history of having been physically or sexually abused), and age.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.604 - Imminent Harm Resulting from a Behavioral Crisis

Current through Reg. 49, No. 28; July 12, 2024
(a) Only staff who have successfully
				  completed competency-based training on the use of restraints may implement
				  restraint procedures. Staff who implement restraint procedures must also
				  complete training on person-specific instructions and other measures regarding
				  restraints contained in an individual's crisis intervention plan or other
				  plan.
(b) The following conditions
				  must be met before a PCP may order a restraint in response to a behavioral
				  crisis:
(1) the individual's behavior
				  constitutes a behavioral crisis;
(2) if no PBSP, desensitization plan, or
				  other preventive measures are in place, staff have considered the level of
				  imminent risk of violence or injury and have applied a graduated range of
				  less-restrictive approved procedures as safety permits and the measures have
				  not reduced the risk of imminent physical harm to the individual or
				  others;
(3) if a PBSP,
				  desensitization plan, or other preventive measures are in place, the
				  individualized procedures for prevention, de-escalation and a graduated range
				  of less restrictive measures have been followed, as safety permits, but have
				  not reduced the risk of imminent physical harm to the individual or others;
				  and
(4) if a helmet, mittens with
				  ties, wristlets, or other mechanical restraints will be used to prevent
				  self-injury in a behavioral crisis:
(A) an
				  approved crisis intervention plan allowing the use of the mechanical restraint
				  must be in place; or
(B) the use of
				  the mechanical restraint must be approved by the individual's psychologist or
				  board certified behavior analyst (BCBA) or the psychologist or BCBA on call,
				  the administrator on duty, and the director of psychology or behavioral
				  services.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.605 - Imminent Harm Resulting from a Medical or Dental Procedure

Current through Reg. 49, No. 28; July 12, 2024
(a) Only a PCP, dentist, or psychiatrist may
				  order a medical restraint. Medical restraint orders must include a specific
				  start and stop date or time. If the time limit on the original order is
				  exceeded, the PCP must write a new order.
(b) Only staff who have successfully
				  completed competency-based training on the use of restraints may implement
				  restraint procedures. Staff who implement restraint procedures must also
				  complete training on person-specific instructions and other measures regarding
				  restraints contained in an individual's medical restraint plan or other
				  plan.
(c) If restraint is used
				  before or during intervention for routine medical or dental care, a medical
				  restraint plan must be developed to describe the rationale for use of the
				  restraint and to provide specific individualized instructions on how to safely
				  implement the restraint.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.606 - Imminent Harm Resulting from Documented Self-Injurious Behavior

Current through Reg. 49, No. 28; July 12, 2024
(a) Only staff who have successfully
				  completed competency-based training on the use of restraints may implement
				  restraint procedures. Staff who implement restraint procedures must also
				  complete training on person-specific instructions and other measures regarding
				  restraints contained in an individual's protective mechanical restraint plan
				  for self-injurious behavior or other plan.
(b) Staff may implement restraint to protect
				  an individual from imminent harm resulting from documented self-injurious
				  behavior if the following conditions have been met:
(1) the IDT has developed an ISP action plan
				  for the individual that describes the need for protective mechanical restraint
				  for self-injurious behavior; includes the procedures that will be employed to
				  reduce the need for restraint, including a PBSP; and provides specific
				  individualized instructions for staff on how to apply the restraints safely and
				  the periods of time and the conditions under which the restraints can be safely
				  removed;
(2) a structural and
				  functional assessment has been completed or revised that identifies possible
				  functions of the self-injurious behavior;
(3) the IDT has developed other clinical
				  plans, as applicable, such as habilitation plans supported by an assessment or
				  evaluation, to reduce the need for protective mechanical restraint;
(4) a PBSP has been completed or revised,
				  based on a structural and functional assessment, that includes procedures, as
				  appropriate, for teaching and strengthening alternative behaviors to
				  self-injurious behaviors and teaching procedures that will help prevent
				  self-injurious behavior as the time without the use of protective mechanical
				  restraints increases;
(5) the
				  instructions for applying the protective mechanical restraint for
				  self-injurious behavior have been developed, including a schedule for removing
				  and replacing the mechanical restraint that safely increases the time out of
				  protective mechanical restraint;
(6) a PCP has assessed the individual and
				  determined that the self-injurious behavior is at an intensity and frequency
				  that causes imminent risk of serious physical injury and there is a need for
				  protective mechanical restraints for self-injurious behavior; and
(7) a system for monthly reviews of data by
				  the IDT has been established, including the PCP's continued reevaluation as to
				  whether the intensity and frequency of the self-injurious behavior warrants
				  continuing the restraint plan.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.606 - Imminent Harm Resulting from Documented Self-Injurious Behavior

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.607 - Release

Current through Reg. 49, No. 28; July 12, 2024
(a) An individual
				  who is restrained as a result of a behavioral crisis must be released from
				  restraint as soon as he or she no longer poses an imminent risk of physical
				  harm to self or others.
(b) The PCP
				  or appropriate provider must determine the release criteria for an individual
				  restrained in response to imminent harm resulting from a medical or dental
				  procedure.
(c) For mechanical
				  restraints used for protection from self-injurious behavior, removal of
				  restraints must follow the individual's protective mechanical restraint plan
				  for self-injurious behavior. A fading schedule, designed to phase out the use
				  of a restraint device, must be reviewed by the IDT, including the PCP and
				  appropriate therapists, each month and adjusted to permit the maximum safe time
				  out of restraints.
(d) If an
				  individual experiences a medical emergency while in restraint, staff must
				  release the individual from the restraint immediately and ensure that the
				  medical emergency is promptly addressed according to statewide and facility
				  policies and procedures.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter F - RESTRAINTS › Section 3.608 - Reporting, Tracking, and Documentation

Current through Reg. 49, No. 28; July 12, 2024
(a) Staff must report and investigate a
				  serious injury or death occurring during restraint or within 24 hours after the
				  release from a restraint in accordance with statewide policy on incident
				  management.
(b) The facility must
				  review the use of each restraint in a timely manner to determine whether the
				  application of restraint was justified, the restraint was applied correctly,
				  injuries occurred, or factors exist that, if modified, may prevent the future
				  use of restraint.
(c) A pharmacist
				  and psychiatrist must conduct a clinical review of each chemical restraint in a
				  timely manner to determine whether the restraint was clinically justified, to
				  identify any potential medication-related risks, and to make any applicable
				  recommendations to the IDT.
(d) The
				  IDT, with a determination of risk of physical harm made by the PCP, must review
				  the continued application of restraint in response to risk from documented
				  self-injurious behavior monthly to determine whether current risk warrants
				  continuing the restraint, to analyze the effectiveness of the fading plan, and
				  to adjust the time without restraint, if possible to safely do so.
(e) The IDT must review an individual
				  restrained in response to a behavioral crisis or medical or dental intervention
				  at least quarterly to assess progress in changing the circumstances that lead
				  to the use of restraint.
(f) A
				  facility must track, trend, and analyze data regarding the application of
				  restraints in accordance with statewide policy on the use of restraints to
				  identify issues or emerging trends and to develop appropriate
				  responses.
(g) DADS must report the
				  restraint of an individual to the executive commissioner.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.801 - Legally Adequate Consent or Authorization for Non-Emergency Administration of Psychotropic Medication

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  facility must obtain legally adequate consent or authorization for
				  non-emergency administration of psychotropic medication in accordance with
				  subsection (b) or (c) of this section, unless the administration of the
				  medication is authorized by an order issued under THSC §592.156:
(1) before the initial administration of each
				  class of psychotropic medication and annually thereafter; and
(2) before the administration of a dosage of
				  psychotropic medication that is not within the dosage range for which consent
				  or authorization has been given.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.801 - Legally Adequate Consent or Authorization for Non-Emergency Administration of Psychotropic Medication

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.802 - Administration of Psychotropic Medication during a Medication-Related Emergency

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility may
				  administer psychotropic medication to an individual who is having a
				  medication-related emergency without consent, authorization, or a court
				  order.
(b) If psychotropic
				  medication is administered in accordance with subsection (a) of this section, a
				  physician must:
(1) issue an order to
				  administer the psychotropic medication in a manner that is consistent with
				  clinically appropriate medical care and that is the least restrictive of the
				  individual's personal liberty; and
(2) document in the individual's active
				  record, in specific medical or behavioral terms, the necessity of the order and
				  that the physician has evaluated but rejected other generally accepted, less
				  intrusive forms of treatment, if any.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.802 - Administration of Psychotropic Medication during a Medication-Related Emergency

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.803 - Refusal of Psychotropic Medication

Current through Reg. 49, No. 28; July 12, 2024
(a) An individual has the right to refuse to
				  take psychotropic medication.
(b)
				  An individual's refusal to take psychotropic medication may be demonstrated
				  through written or oral communication or behavior that indicates an objection
				  to the medication, including refusing or pretending to swallow medication, or
				  refusing to submit to hypodermic injection of medication.
(c) An individual's LAR may refuse to consent
				  to the administration of psychotropic medication on the individual's
				  behalf.
(d) The director may refuse
				  to authorize the administration of psychotropic medication for an
				  individual.
(e) A facility must
				  document in the active record of an individual who refuses to take psychotropic
				  medication, whose LAR refuses to consent to the administration of psychotropic
				  medication, or for whom the director refuses to authorize the administration of
				  psychotropic medication:
(1) the individual's
				  refusal to take psychotropic medication and the manner in which the individual
				  demonstrated his refusal to take the psychotropic medication;
(2) the LAR's refusal to consent to the
				  administration of psychotropic medication on the individual's behalf;
				  or
(3) the director's refusal to
				  authorize the administration of psychotropic medication to the
				  individual.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.803 - Refusal of Psychotropic Medication

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.804 - Order Authorizing Administration of Psychotropic Medication

Current through Reg. 49, No. 28; July 12, 2024
In accordance with THSC §592.154, a treating physician
					 may file an application in a probate court or a court with probate jurisdiction
					 on behalf of the State of Texas for an order authorizing the administration of
					 a psychotropic medication to an individual if:
(1) the individual refuses to take the
				  psychotropic medication;
(2) the
				  treating physician believes that the individual lacks the capacity to make a
				  decision regarding the administration of the psychotropic medication;
(3) the treating physician determines that
				  the psychotropic medication is the proper course of treatment for the
				  individual;
(4) the individual does
				  not have an LAR; and
(5) the
				  individual:
(A) has been committed to a
				  facility involuntarily under:
(i) THSC,
				  Chapter 593, Subchapter C;
(ii)
				  Texas Code of Criminal Procedure, Chapter 46B or 46C; or
(iii) Texas Family Code, Chapter
				  55;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.804 - Order Authorizing Administration of Psychotropic Medication

Current through Reg. 49, No. 28; July 12, 2024
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 3 - RESPONSIBILITIES OF STATE FACILITIES › Subchapter H - CONSENT OR AUTHORIZATION FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION › Section 3.805 - Effect of Order

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  individual's consent to take a psychotropic medication is not valid and may not
				  be relied on if the individual is subject to an order issued under THSC
				  §592.156.
(b) The issuance of
				  an order under THSC §592.156 is not a determination or an adjudication of
				  mental incompetency and does not limit in any other respect the individual's
				  rights as a citizen or the individual's property rights or legal
				  capacity.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 4 - RIGHTS AND PROTECTION OF INDIVIDUALS RECEIVING INTELLECTUAL DISABILITY SERVICES › Subchapter A - PROTECTED HEALTH INFORMATION › Section 4.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to require facilities,
					 local authorities, community centers, their respective contract providers, and
					 TDMHMR Central Office to comply with all applicable privacy laws, rules, and
					 regulations.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 4 - RIGHTS AND PROTECTION OF INDIVIDUALS RECEIVING INTELLECTUAL DISABILITY SERVICES › Subchapter A - PROTECTED HEALTH INFORMATION › Section 4.2 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to:
(1) all facilities of the Texas Department of
				  Mental Health and Mental Retardation (TDMHMR);
(2) TDMHMR Central Office;
(3) all local authorities; and
(4) all community centers.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 4 - RIGHTS AND PROTECTION OF INDIVIDUALS RECEIVING INTELLECTUAL DISABILITY SERVICES › Subchapter A - PROTECTED HEALTH INFORMATION › Section 4.3 - 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) Community center--A
				  center established under the Texas Health and Safety Code, Title 7, Chapter
				  534, Subchapter A.
(2) Contract
				  provider--A person, entity, or organization that contracts with a facility,
				  local authority, or community center to provide mental health or mental
				  retardation services, or alcohol or drug abuse treatment.
(3) Facility--A state mental health facility
				  or a state mental retardation facility.
(4) Individual--A person who, voluntarily or
				  involuntarily, is seeking or receiving, or has sought or received mental health
				  or mental retardation services, or alcohol or drug abuse treatment from or
				  through a facility, a local authority, a community center, or its respective
				  contract providers, or TDMHMR Central Office.
(5) Local authority--An entity designated by
				  the TDMHMR commissioner in accordance with the Texas Health and Safety Code,
				  §
										533.035(a).
(6) More stringent--In accordance with
				  45
				  CFR 160.202, a state law that meets one or
				  more of the following criteria:
(A) with
				  respect to a use or disclosure, the law prohibits or restricts a use or
				  disclosure where the use or disclosure would be permitted under the federal
				  regulation, except if the disclosure is to the U.S. Department of Health and
				  Human Services or to the individual;
(B) with respect to the rights of an
				  individual regarding access to or amendment of protected health information,
				  the law permits greater rights of access or amendment;
(C) with respect to information to be
				  provided to an individual about a use, a disclosure, rights, and remedies, the
				  law provides a greater amount of information;
(D) with respect to consent or authorization
				  for use or disclosure of protected health information, the law narrows the
				  scope or duration of the consent or authorization, increases privacy
				  protections, or reduces the coercive effect of obtaining the consent or
				  authorization; or
(E) with respect
				  to recordkeeping or accounting of disclosures, the law provides for the
				  retention or reporting of more detailed information or for a longer
				  duration.