reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 281 - CONTRACTING TO PROVIDE HOME-DELIVERED MEALS › Section 281.39 - Recordkeeping

Current through Reg. 49, No. 28; July 12, 2024
A provider agency must maintain a record of names of
				  employees and volunteers who deliver meals.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 281 - CONTRACTING TO PROVIDE HOME-DELIVERED MEALS › Section 281.41 - Billing and Claims Payment

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				provider agency must accept the contracted reimbursement rates as payment in
				full for the meals provided and seek no other reimbursements from any source,
				except as allowed by DADS.
(b) For
				Title XX services, a provider agency:
(1)
				must provide an individual with an opportunity to donate toward the cost of a
				meal;
(2) must not require the
				individual to donate toward the cost of a meal;
(3) may provide the individual with a
				donation schedule that only suggests an amount based on income range of the
				program population being served, but may not determine an individual's donation
				amount using an individual's income;
(4) must protect the individual's privacy
				with respect to the individual's donations;
(5) must establish appropriate procedures to
				secure and account for all donations made; and
(6) must use all of an individual's donations
				to support or expand services for which the individual donated, in accordance
				with state and federal laws.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 281 - CONTRACTING TO PROVIDE HOME-DELIVERED MEALS › Section 281.43 - Complaints

Current through Reg. 49, No. 28; July 12, 2024
A provider agency must:
(1) comply with the complaint procedures
				outlined under Chapter 49 of this title (relating to Contracting for Community
				Care Services); and
(2) promptly
				contact the local health authorities to report complaints involving two or more
				persons with symptoms of food-borne illnesses that have occurred within a
				similar timeframe after consuming food from the provider agency, and request
				the local health authorities initiate an investigation of these complaints. The
				provider agency must report such complaints as detailed in Chapter 49 of this
				title.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 284 - COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS › Section 284.101 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
(a) The purpose of
				this chapter is to implement Texas Government Code §
									531.02448.
(b) The rules in this chapter must be read in
				conjunction with the rules and policies related to the Medicaid programs listed
				in §
									284.103 of this chapter (relating
				to Applicability) in which an individual is enrolled.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 284 - COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS › Section 284.103 - Applicability

Current through Reg. 49, No. 28; July 12, 2024
This chapter applies to an individual receiving services
				  under the following Medicaid programs authorized by Section 1915(c) or Section
				  1115 of the Social Security Act:
(1)
				the Home and Community-based Services (HCS) Program;
(2) the Texas Home Living (TxHmL)
				Program;
(3) the Deaf Blind with
				Multiple Disabilities (DBMD) Program;
(4) the Community Living Assistance and
				Support Services (CLASS) Program; and
(5) the STAR+PLUS Home and Community-Based
				Services program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 284 - COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS › Section 284.105 - Uniform Process

Current through Reg. 49, No. 28; July 12, 2024
(a) An individual's
				service planning team must determine during the person-centered planning
				process whether an individual desires to work and if so, the individual's case
				manager or service coordinator must:
(1)
				document the individual's desire to work on the individual's person-centered
				service plan; and
(2) complete the
				HHSC Employment First Discovery Tool available on the HHSC website to
				determine:
(A) the individual's employment
				goals; and
(B) the employment
				opportunities and employment services available to the individual through the
				program in which the individual is enrolled.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 284 - COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS › Section 284.107 - Strategies to Increase Number of Individuals Receiving Employment Services

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission (HHSC)
				  utilizes the following strategies to increase the number of individuals
				  receiving employment services from the Texas Workforce Commission (TWC) or
				  through the waiver program in which an individual is enrolled:
(1) use of the HHSC Employment First
				Discovery Tool identified in §
									284.105(a)(2) of
				this chapter (relating to Uniform Process);
(2) maintain a memorandum of understanding
				between HHSC and TWC to enable data sharing between those agencies in order to
				measure the number of individuals utilizing employment services;
(3) implement an employment-first policy
				jointly adopted by HHSC, the Texas Education Agency (TEA), and the TWC in
				accordance with Texas Government Code §
									531.02447(b);
				and
(4) implement additional
				strategies as outlined in the Promoting Independence Plan, which is HHSC's plan
				for implementing its obligation to provide people with disabilities
				opportunities to live, work, and be served in integrated settings.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 284 - COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS › Section 284.109 - Referrals to the Texas Workforce Commission

Current through Reg. 49, No. 28; July 12, 2024
After completing the HHSC Employment First Discovery Tool, as
				  described in §
									284.105(a)(2) of
				  this chapter (relating to Uniform Process), if an individual's person-centered
				  service plan does not include employment services through the waiver program in
				  which the individual is enrolled, the individual's case manager or service
				  coordinator must refer the individual to the Texas Workforce Commission (TWC)
				  for employment services available through the TWC.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 284 - COMPETITIVE AND INTEGRATED EMPLOYMENT INITIATIVE FOR CERTAIN MEDICAID RECIPIENTS › Section 284.111 - Increasing the Number of Individuals Receiving Employment Services

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission will ensure
				  that the number of individuals receiving employment services from the Texas
				  Workforce Commission or through the waiver programs in which the individuals
				  are enrolled on December 31, 2023, is at least 5% greater than the number of
				  individuals receiving employment services on December 31,
				  2022.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 285 - USE OF GENERAL REVENUE FOR SERVICES EXCEEDING THE INDIVIDUAL COST LIMIT OF A WAIVER PROGRAM › Section 285.1 - Use of General Revenue for Services Exceeding the Individual Cost Limit of a Waiver Program

Current through Reg. 49, No. 28; July 12, 2024
(a) The following
				words and terms, when used in this chapter, have the following meanings, unless
				the context clearly indicates otherwise:
(1)
				Waiver program--A program administered by the Department of Aging and
				Disability Services (DADS), other than the Texas Home Living Program, that
				provides services under a waiver granted by the Centers for Medicare and
				Medicaid Services in accordance with §1915(c) of the Social Security
				Act.
(2) General revenue--State
				funds appropriated by the Texas Legislature for use by DADS.
(3) Individual--A person applying for or
				enrolled in a waiver program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
(a) Health and Safety Code, Title 7, Chapter
				  534, Subchapter A, and this subchapter govern the establishment and operation
				  of a community center.
(b) The
				  purpose of this subchapter is to describe requirements by which a community
				  center is established and operated by a local agency with a plan approved by
				  DADS and DSHS in accordance with Health and Safety Code, §
										534.001(e).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.3 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to local agencies desiring to
					 establish a new community center or affiliate with an existing community center
					 and to all existing community centers established under Health and Safety Code,
					 Title 7, Chapter 534.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.7 - Process to Establish a New Community Center

Current through Reg. 49, No. 28; July 12, 2024
(a) Letter of intent. If a local agency
				  decides to establish a new community center, then the local agency submits a
				  letter of intent to DADS and DSHS outlining the proposed new center's region,
				  governing structure, and other information pertinent to the formation of the
				  proposed new center.
(1) If the local agency
				  submitting the letter of intent is not a county or counties, the letter must be
				  accompanied by a letter of endorsement from the appropriate county judge or
				  judges.
(2) DADS and DSHS review
				  the letter of intent using the following criteria:
(A) the benefits of establishing a new center
				  over affiliation with an existing center and the establishment of a new center
				  is consistent with DADS's and DSHS's mission for the development of community
				  services in Texas;
(B) the
				  population of the region of the proposed new center is at least 200,000 or
				  large enough to support a center;
(C) a comprehensive array of mental health
				  and mental retardation services will be provided;
(D) the extent of the local contribution
				  supports the intent; and
(E) the
				  efficient provision of services is financially viable.
(3) DADS and DSHS determine whether the
				  letter of intent meets the criteria described in paragraph (2) of this
				  section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.9 - Modifying a Community Center's Current Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) Submission. The board of trustees of a
				  community center shall submit a modification of its current plan in accordance
				  with this section as frequently as necessary to reflect changes in the
				  community center's local agencies, functions, or region as described in
				  paragraphs (1) - (3) of this subsection prior to implementing the changes. The
				  modified plan shall be in the format required by DADS and DSHS available at
www.dads.state.tx.us
.
(1) If a local agency wants to affiliate with
				  an existing community center and the existing center agrees, then the board of
				  trustees of the existing center submits to DADS and DSHS for approval a
				  modification of the center's current plan to reflect such affiliation,
				  including:
(A) any proposed expansion of the
				  center's region;
(B) a copy of the
				  new contract of interlocal agreement; and
(C) official documentation (e.g., a
				  resolution) confirming an intent to affiliate from each local agency and the
				  proposed local agency.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.11 - Dissolution and Merger of Community Centers

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Dissolution. If a community center proposes to cease operations and dissolve,
				  the center's board of trustees and each local agency shall inform DADS and DSHS
				  in writing of such a decision before dissolution. DADS, DSHS, the board of
				  trustees, and each local agency shall agree to a plan of dissolution that
				  addresses at least the following factors:
(1)
				  the center's assets and liabilities (including personnel);
(2) necessary audits to be
				  conducted;
(3) closure activities,
				  including arrangements for uninterrupted delivery of services;
(4) the transfer, archival, and security of
				  records and information; and
(5)
				  future plans for the region's service delivery system (e.g., affiliation with
				  an existing center or establishment of a new center).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.13 - Appointment of Manager or Management Team

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The DADS commissioner and the DSHS commissioner may appoint a manager or
				  management team to manage and operate a community center in accordance with
				  Health and Safety Code, §§
										534.038,
				  534.039,
				  and
				  534.040.
				  The DSHS commissioner may delegate responsibility for appointing a manager or
				  management team to the DADS commissioner.
(b) A community center may request a hearing
				  to appeal the commissioners' decision to appoint a manager or management team
				  in accordance with 1 Texas Administrative Code (TAC), Chapter 357, Subchapter I
				  (relating to Hearings Under the Administrative Procedure Act). Requesting a
				  hearing stays the appointment unless the commissioners based the appointment on
				  a finding under Health and Safety Code, §§
										534.038(a)(2)
				  or (4), which means the commissioners found
				  that the community center or an officer or employee of the center misused state
				  or federal money or endangers or may endanger the life, health, or safety of a
				  person served by the center.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.15 - Standards of Administration for Boards of Trustees

Current through Reg. 49, No. 28; July 12, 2024
(a) Each board of trustees shall:
(1) retain all financial records, supporting
				  documents, statistical records, and any other documents pertinent to its
				  community center budgets, contracts, performance/workload measure, and persons
				  served for a period of five years. If audit discrepancies have not been
				  resolved at the end of five years, the records must be retained until
				  resolution;
(2) deposit community
				  center funds through the Federal Deposit Insurance Corporation or the Federal
				  Savings and Loan Insurance Corporation, or secure deposits using collateral in
				  a manner that protects the deposited funds; and
(3) ensure DADS and DSHS have unrestricted
				  access to all facilities, records, data, and other information under control of
				  the community center or its contractors as necessary to enable DADS and DSHS to
				  audit, monitor, and review all financial and programmatic activities and
				  services associated with the center as provided by Health and Safety Code,
				  §
											534.033(a).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.17 - Civil Rights

Current through Reg. 49, No. 28; July 12, 2024
Each community center shall provide services in compliance
					 with the Civil Rights Act of 1964, as amended, and the Americans With
					 Disabilities Act (ADA) of 1990, and require the same of entities with which it
					 contracts.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 300 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter A - COMMUNITY CENTERS › Section 300.19 - Fiscal Controls

Current through Reg. 49, No. 28; July 12, 2024
Pursuant to Health and Safety Code, §
										534.035,
					 each community center must comply with the following review and audit
					 procedures to provide reasonable assurance that the community center has
					 adequate and appropriate fiscal controls.
(1) Audit procedures.
(A) Each board of trustees must ensure an
				  annual financial and compliance audit of its accounts is conducted by a
				  certified public accountant or public accountant licensed by the Texas State
				  Board of Public Accountancy. At a minimum, the audit must be conducted in
				  accordance with Government Auditing Standards.
(B) DADS and DSHS may conduct on-site audits
				  of a community center as determined by DADS's and DSHS's financial risk
				  analysis of the center.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter D - LIDDA, LMHA, and LBHA Notification and Appeal Process › Section 301.155 - Notification and Appeals Process

Current through Reg. 49, No. 28; July 12, 2024
(a) The TXMHMR
				  service system is dedicated to providing mental health and mental retardation
				  services/supports which are viewed as satisfactory by persons receiving those
				  services/supports and their legally authorized representatives. Therefore,
				  local authorities and their contractors shall take steps to assure that these
				  persons:
(1) have a method to express their
				  concerns or dissatisfaction;
(2)
				  are assisted to do so in a constructive way; and
(3) have their concerns or dissatisfaction
				  addressed through a review process.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.251 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to establish the process
					 for a local mental health authority (LMHA) to assemble and maintain a network
					 of service providers as required by the Health and Safety Code, §
										533.035(b) -
					 (f).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.253 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to local mental health authorities
					 (LMHAs) and their use of funds disbursed by the Department of State Health
					 Services (department) pursuant to the Health and Safety Code, §
										533.035(b),
					 which authorizes the department to distribute funds to LMHAs for mental health
					 services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.255 - 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) Critical
				  infrastructure--The resources necessary to ensure services are available
				  without significant disruption to the individuals served by the LMHA and to
				  allow the LMHA to fulfill its obligations under the performance contract.
(2) Department--The Texas
				  Department of State Health Services.
(3) Discrete services--Individual services
				  provided as part of a defined level of care.
(4) External provider--An organization that
				  provides mental health services that is not an LMHA, or an individual who
				  provides mental health services who is not an employee of an LMHA.
(5) Individual--An individual seeking or
				  receiving mental health services through an LMHA, or the individual's legally
				  authorized representative.
(6)
				  Legally authorized representative (LAR)--A person authorized by law to act on
				  behalf of an individual with regard to a matter described in this subchapter,
				  including, but not limited to, a parent, guardian, or managing conservator.
(7) Licensed psychiatric
				  hospital--A hospital that is:
(A) A private
				  psychiatric hospital licensed under Texas Health and Safety Code, Chapter 577,
				  and Chapter 134 of Title 25 (relating to Private Psychiatric Hospitals and
				  Crisis Stabilization Units) rules; or
(B) an identifiable inpatient mental health
				  services unit in a hospital licensed under Health and Safety Code, Chapter 241,
				  and Chapter 133 of Title 25 (relating to Hospital Licensing) rules.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.257 - Local Network Development

Current through Reg. 49, No. 28; July 12, 2024
(a) Use of
				  resources. An LMHA must maximize funds available to provide services by
				  minimizing overhead and administrative costs and achieving purchasing
				  efficiencies. Strategies that an LMHA must consider in achieving this objective
				  include joint efforts with other local authorities related to authority
				  functions, administrative activities, and service delivery.
(b) Establishing a network. Each LMHA must
				  demonstrate a reasonable effort to establish and maintain a network of
				  qualified providers. In developing the network, the LMHA must consider public
				  input, ultimate cost-benefit, and client care issues to ensure individual
				  choice and best use of public funds.
(c) Developing a plan. Each LMHA must develop
				  a biennial (2-year) local network development plan (plan) to guide the
				  development of the LMHA's provider network. The plan must reflect local needs
				  and priorities and must be designed to maximize individual choice and
				  individual access to services provided by qualified providers. The plan is a
				  framework for network development based on a biennial assessment of provider
				  availability and is not intended to limit procurement and contracting. LMHAs
				  are expected to consider opportunities for network development that develop
				  between planning periods. Such opportunities include new funding and/or
				  services and inquiries from interested providers.
(d) Involving the PNAC. The local PNAC must
				  be actively involved in developing the plan. The local PNAC must receive
				  information and training related to Provider Network Development, including the
				  provisions of this subchapter and Health and Safety Code §§
										533.035,
				  533.03521,
				  and
				  533.0358.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.259 - Conditions Permitting LMHA Service Delivery

Current through Reg. 49, No. 28; July 12, 2024
An LMHA may only provide services if one or more of the
					 following conditions is present.
(1)
				  The LMHA determines that interested, qualified providers are not available to
				  provide services in the LMHA's service area or that no providers meet
				  procurement specifications.
(2)
				  The network of external providers does not provide the minimum level of
				  individual choice. A minimal level of individual choice is present if
				  individuals and their legally authorized representatives can choose from two or
				  more qualified providers.
(3) The
				  network of external providers does not provide individuals with access to
				  services that is equal to or better than the level of access in the local
				  network, including services provided by the LMHA, as of a date determined by
				  the department. An LMHA relying on this condition must submit the information
				  necessary for the department to verify the level of access.
(4) The combined volume of services delivered
				  by external providers is not sufficient to meet 100 percent of the LMHA's
				  service capacity for each level of care identified in the LMHA's plan.
(5) Existing agreements restrict
				  the LMHA's ability to contract with external providers for specific services
				  during the two-year period covered by the LMHA's plan. If the LMHA relies on
				  this condition, the department shall require the LMHA to submit copies of
				  relevant agreements.
(6) The LMHA
				  documents that it is necessary for the LMHA to provide specified services
				  during the two-year period covered by the LMHA's plan to preserve critical
				  infrastructure needed to ensure continuous provision of services. An LMHA
				  relying on this condition must:
(A) document
				  that it has evaluated a range of other measures to ensure continuous delivery
				  of services, including but not limited to those identified by the LANAC and the
				  department at the beginning of each planning cycle;
(B) document implementation of appropriate
				  other measures;
(C) identify a
				  timeframe for transitioning to an external provider network, during which the
				  LMHA shall procure an increasing proportion of the service capacity from
				  external provider in successive procurement cycles; and
(D) give up its role as a service provider at
				  the end of the transition period if the network has multiple external providers
				  and the LMHA determines that external providers are willing and able to provide
				  sufficient added service volume within a reasonable period of time to
				  compensate for service volume lost should any one of the external provider
				  contracts be terminated.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.261 - Department Website

Current through Reg. 49, No. 28; July 12, 2024
(a) Website
				  maintenance. The department shall maintain a website with information about
				  network development.
(b) Planning
				  schedule and templates. Using input from the Local Authority Network Advisory
				  Committee, the department will develop a biennial schedule and templates for
				  the local network development plan and provider profile. In addition, the
				  department will work with the LANAC to develop a list of measures that may be
				  helpful in stabilizing the provider network and ensuring continuous delivery of
				  services.
(c) LMHA information.
				  The department shall post minimum service requirements and service capacity
				  information for each local service area on its website. Service capacity
				  information includes:
(1) the performance
				  contract targets for the number of adults and children to be served by the
				  LMHA;
(2) the current state
				  funding allocation for the LMHA;
(3) the number of individuals served in each
				  level of care in the previous fiscal year; and
(4) the demographic breakout of individuals
				  services in the previous fiscal year.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.263 - Network Development Evaluation

Current through Reg. 49, No. 28; July 12, 2024
An LMHA shall evaluate the potential for network
					 development.
(1) The LMHA must seek
				  and use available information to identify and contact potential provider
				  organizations, including the list of interested provider organizations posted
				  on the department's website.
(2)
				  The LMHA must also consider current contractors, providers who have contacted
				  the LMHA within the past two years, and other service providers in the local
				  service area.
(3) If a provider
				  has submitted printed or electronic documentation of interest, the LMHA may not
				  eliminate the provider from consideration during the planning process without
				  evidence that the provider:
(A) is no longer
				  interested; or
(B) is clearly not
				  qualified or capable of providing services in accordance with applicable state
				  and local laws and regulations.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.265 - Content of the Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) Plan
				  preparation. An LMHA must use the results of its network development evaluation
				  described in §
										301.263 of this title (relating to
				  Network Development Evaluation) to create its draft plan.
(b) Plan content applicable to all LMHAs. All
				  plans must include the following components.
(1) The LMHA's projected service capacity for
				  each level of care based on service data from the previous fiscal year for
				  services provided under the performance contract and any information about
				  changes that will impact the service capacity.
(2) Baseline data specified by the department
				  showing the type and quantity of services provided by the LMHA and by external
				  providers.
(3) A description of
				  the process the LMHA used to evaluate the potential for network development and
				  the results of that evaluation, including any information relating to specific
				  services or populations.
(4) A
				  list of the LMHA's external providers, including all current contractors and
				  any other providers with whom the LMHA had a contract or agreement in effect
				  during any part of the current or previous fiscal year. The list shall include
				  the number of contracts and agreements with individual peer support providers,
				  but not the names of individual peer support providers without their written
				  consent.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.267 - Public Comment

Current through Reg. 49, No. 28; July 12, 2024
(a) Distributing
				  the draft plan. An LMHA shall post the draft plan on its website and invite
				  public comment for at least 30 days. The LMHA shall send notice of the
				  opportunity for comment to key stakeholders, including local consumer and
				  advocacy groups, all licensed psychiatric hospitals in the LMHA's service area,
				  and all providers identified in its network development evaluation.
(b)Responding to public comment. The LMHA
				  shall acknowledge and consider all comments received and make any revisions it
				  deems appropriate.
(c) Plan
				  submission. The LMHA shall submit its proposed plan to the department with:
(1) a summary of the public comments
				  received; and
(2) he LMHA's
				  response to the comments.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.269 - Plan Approval and Implementation

Current through Reg. 49, No. 28; July 12, 2024
(a) Department
				  review. The department shall review each plan to ensure compliance with the
				  requirements of this subchapter and to determine whether the LMHA is making
				  reasonable attempts to develop its provider network.
(1) The department shall establish a
				  mechanism for stakeholder involvement in the review process.
(2) In reviewing an LMHA's plan, the
				  department shall evaluate the level of effort made by the LMHA to achieve
				  compliance and the rationale and any supporting documentation for its decisions
				  and plans. This evaluation must include:
(A)
				  the LMHA's response to public comment;
(B) the LMHA's past efforts and progress made
				  in developing a network of external providers;
(C) the specific context of the local service
				  area, including population density and distribution, existing service
				  organizations, and local priorities;
(D) the potential impact on individual choice
				  and access; and
(E) input from the
				  LMHA's PNAC.
(3) The
				  department may require an LMHA to submit additional information or
				  documentation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.271 - Procurement

Current through Reg. 49, No. 28; July 12, 2024
(a) Procurement procedures. An LMHA shall
				  develop and implement procurement procedures that comply with applicable state
				  laws and rules. The LMHA may procure mental health services by any procurement
				  method allowed by applicable statutes and rules that provides the best value to
				  the LMHA.
(b) Content of the
				  procurement document. A procurement document shall include:
(1) the actual or maximum rate of payment for
				  providing the services, as applicable;
(2) the criteria for determining whether an
				  applicant is a qualified provider; and
(3) a detailed description of information to
				  be included in a proposal, including:
(A) how
				  the provider would meet the cultural and linguistic needs of the individuals in
				  the LMHA's local service area; and
(B) how the provider would involve
				  individuals, legally authorized representatives, and families at the policy and
				  practice levels within the respondent's organization.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.273 - Post Procurement Report

Current through Reg. 49, No. 28; July 12, 2024
Report content. An LMHA shall submit a post procurement
					 report to the department within 30 days of completing a procurement described
					 in the LMHA's approved plan. If procurement is conducted through open
					 enrollment, the LMHA shall submit a procurement report at intervals specified
					 in the timeline established by the department at the beginning of the planning
					 cycle. The report must include:
(1) a
				  list of the applications received in response to the procurement;
(2) the results of the procurement;
(3) an updated list of the LMHA's
				  external providers; and
(4) the
				  responses from providers who did not complete the procurement process regarding
				  their reasons for withdrawing from consideration, if applicable.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.275 - Appeals

Current through Reg. 49, No. 28; July 12, 2024
(a) Local appeal process. An LMHA shall
				  establish an appeal process for providers that:
(1) is available to any provider who
				  submitted a written statement of interest or participated in any phase of the
				  procurement process; and
(2)
				  includes an opportunity for informal review and resolution as well as a formal
				  appeal procedure.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter F - PROVIDER NETWORK DEVELOPMENT › Section 301.277 - Individual Selection of Providers

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Individual choice. An LMHA shall give consumers the opportunity to choose from
				  any available provider in the LMHA's provider network offering services for
				  which the individual is authorized at the time of admission and at least
				  annually thereafter.
(b) Changing
				  providers. Individuals may request and change providers at any time.
(c) Provider information. An LMHA shall
				  maintain a current list of providers and a provider profile for each provider
				  in the network, including the LMHA, on its website. The LMHA's website must
				  also provide instructions for requesting a change in providers as described in
				  §
										401.464
				  of Title 25 (relating to Notification and Appeals Processes).
(1) The provider list must include the
				  following information about each provider:
(A) name;
(B) service locations and the services
				  provided at each location; and
(C)
				  contact information, including the provider's website address.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 1 - GENERAL PROVISIONS › Section 301.301 - Purpose and Application

Current through Reg. 49, No. 28; July 12, 2024
(a) The purpose of
					 this subchapter is to establish performance requirements and standards for the
					 provision of mental health community services, as authorized by the Texas
					 Health and Safety Code, §
											534.052.
(b) This subchapter applies to persons and
					 entities with which the department contracts, including local mental health
					 authorities (LMHA), managed care organizations (MCO), providers of mental
					 health rehabilitative services, as defined in § 419.453 of Title 25
					 (relating to Definitions), and providers of mental health case management
					 services, as defined in §
											412.403 of
					 Title 25 (relating to Definitions), and requires that they ensure the
					 performance requirements and standards in this subchapter are met in the
					 provision of mental health community services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 1 - GENERAL PROVISIONS › Section 301.303 - 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) Access--The ability to
					 obtain mental health community services based upon components such as
					 availability and acceptability of services to the individual, or the
					 individual's Legally Authorized Representative (LAR) on the individual's
					 behalf, transportation, distance, hours of operation, language, and the
					 cultural competency of staff members. Barriers to access may be structural,
					 financial, or specific to the individual.
(2) Adolescent--An individual who is at least
					 13 years of age, but younger than 18 years of age.
(3) Adult--An individual who is 18 years of
					 age or older.
(4) Advanced practice
					 nurse--A staff member who is a registered nurse approved by the Texas Board of
					 Nursing as a clinical nurse specialist in psychiatric/mental health or nurse
					 practitioner in psychiatric/mental health, in accordance with Texas Occupations
					 Code, Chapter 301.
(5)
					 Advocacy--Support for an individual or family member in expressing and
					 resolving issues or concerns regarding access to or quality and appropriateness
					 of services.
(6) Appeal--A
					 mechanism for an independent review of an adverse determination.
(7) Assessment--A systematic process for
					 measuring an individual's service needs.
(8) Child--An individual who is at least
					 three years of age, but younger than 13 years of age.
(9) Competency--Demonstrated knowledge and
					 skilled performance of a particular activity.
(10) Continuity of services--Services that
					 ensure uninterrupted services are provided to an individual during a transition
					 between service types (e.g., inpatient services, outpatient services) or
					 providers, in accordance with applicable rules (e.g., Chapter 412, Subchapter D
					 of Title 25 (relating to Mental Health Services - Admission, Continuity, and
					 Discharge)). These activities include:
(A)
					 assisting with admissions and discharges;
(B) facilitating access to appropriate
					 services and supports in the community, including identifying and connecting
					 the individual with community resources;
(C) participating in the individual's
					 treatment plan development and reviews;
(D) promoting implementation of the
					 individual's treatment plan or continuing care plan; and
(E) facilitating coordination and follow-up
					 between the individual and the individual's family, as well as with available
					 community resources.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 1 - GENERAL PROVISIONS › Section 301.305 - Responsibility for Compliance

Current through Reg. 49, No. 28; July 12, 2024
(a) Compliance
					 with Divisions 2 - 3 of this subchapter requires:
(1) the LMHA and MCO to comply with the
					 applicable sections and subsections contained in Divisions 2 - 3 of this
					 subchapter;
(2) the LMHA and MCO to
					 obligate by contract the providers in their networks to comply with the
					 applicable sections and subsections contained in Divisions 2 - 3 of this
					 subchapter;
(3) the LMHA and MCO to
					 monitor their providers for compliance with the applicable sections and
					 subsections contained in Divisions 2 - 3 of this subchapter; and
(4) providers of mental health case
					 management or mental health rehabilitative services to comply with §
												301.321(e) of this title (relating
					 to Leadership), §
												301.323 of this title
					 (relating to Environment of Care and Safety), §
												301.325 of this title (relating to
					 Rights and Protection), §
												301.327(e) of this title (relating
					 to Access to Mental Health Community Services), §
												301.329 of this title (relating to
					 Medical Records System), and §
												301.331 of this title (relating to
					 Competency and Credentialing), contained in Division 2 of this subchapter, and
					 with all the sections in Division 3 of this subchapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 2 - ORGANIZATIONAL STANDARDS › Section 301.321 - Leadership

Current through Reg. 49, No. 28; July 12, 2024
(a) Organizational planning and
					 communication. The LMHA and MCO must define and implement organizational plans
					 and systems as described in this subchapter (e.g., quality management plan,
					 utilization management plan) and ensure that there are mechanisms in place that
					 facilitate effective communication throughout the organization to promote the
					 provision of quality mental health community services.
(b) Management of key processes and
					 functions. The LMHA and MCO must define organizational and clinical processes
					 and functions, including performance activities, as well as:
(1) allocate adequate, appropriate resources;
					 and
(2) provide oversight for such
					 processes and functions.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 2 - ORGANIZATIONAL STANDARDS › Section 301.323 - Environment of Care and Safety

Current through Reg. 49, No. 28; July 12, 2024
(a) Safe
					 environment. The LMHA, MCO, and provider must:
(1) ensure service delivery sites (including,
					 but not limited to, facilities and vehicles) are safe, sanitary, and free from
					 hazards, including but not limited to:
(A)
					 hand washing facilities and supplies in restrooms and in areas where staff have
					 routine physical contact with individuals (e.g., exam rooms, medication areas,
					 laboratories);
(B) a utility area
					 with necessary equipment for the safe and required cleaning or disposal of
					 instruments, equipment, and sharps;
(C) locked areas for storing drugs, needles,
					 syringes, hazardous materials, other potentially dangerous equipment, and toxic
					 chemical products; and
(D) adequate
					 prevention of exposure to tobacco smoke and other environmental
					 pollutants.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 2 - ORGANIZATIONAL STANDARDS › Section 301.325 - Rights and Protection

Current through Reg. 49, No. 28; July 12, 2024
(a) Non-coercive
					 policy. The LMHA, MCO, and provider must ensure that an individual's refusal of
					 a particular mental health community service (e.g., psychoactive medication)
					 does not preclude the individual from accessing other medically necessary
					 mental health community services.
(b) Non-discrimination. The LMHA, MCO, and
					 provider may not unlawfully discriminate against any individual based on race,
					 color, national origin, religion, sex, age, or disability. The LMHA and MCO and
					 provider may not deny medically necessary mental health community services
					 based on an individual's sexual orientation or political affiliation.
(c) Initial and ongoing eligibility. In
					 determining an individual's initial and ongoing eligibility for any service, an
					 LMHA, MCO, and provider may not exclude an individual based on the following
					 factors:
(1) the individual's past or present
					 mental illness or substance use diagnosis or services;
(2) the individual's past or present
					 involvement in the criminal or juvenile justice system;
(3) medications prescribed to the individual
					 in the past or present;
(4) the
					 presumption of the individual's inability to benefit from treatment;
(5) the individual's use or continued use of
					 alcohol, tobacco, or other drugs; or
(6) the individual's level of success in
					 prior treatment episodes.