reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.409 - Involuntary Administration of Medication to Patients Committed to Mental Health Facilities under the Texas Health and Safety Code or by Court Order

Current through Reg. 49, No. 28; July 12, 2024
(a) The physician will order medications
											  administered involuntarily under §
										414.407
											  of this title (relating to Patients Committed to Mental Health Facilities under Provisions of the Texas
											  Health and Safety Code) or §
										414.411
											  of this title (relating to Order Authorizing Administration of Psychoactive Medication) to be given by the
											  method most acceptable to the patient, if clinically appropriate.
(b) The authority to administer a medication involuntarily to a patient
											  under §
										414.407
											  or §
										414.411
											  of this title includes the authority to obtain evaluations and laboratory tests necessary to safely
											  administer the medication.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.410 - Psychiatric Emergencies

Current through Reg. 49, No. 28; July 12, 2024
(a) Nothing in this subchapter is intended to preclude the administration
											  of psychoactive medication to any patient in a psychiatric emergency.
(b) If a physician issues an order to administer psychoactive medication to
											  a patient without the patient's consent because of a psychiatric emergency, then the physician will document
											  in the patient's clinical record in specific medical or behavioral terms:
(1) why the order is necessary:
(2) other generally accepted, less intrusive forms of treatment, if any,
											  that the physician has evaluated but rejected; and
(3) the
											  reasons those treatments were rejected.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.411 - Order Authorizing Administration of Psychoactive Medication

Current through Reg. 49, No. 28; July 12, 2024
(a) Filing of Petition. A physician
											  who is treating a patient may petition a probate court or a court with probate jurisdiction for an order to
											  authorize the administration of a class or classes of psychoactive medication regardless of the patient's
											  refusal:
(1) if the physician believes that the patient lacks the capacity
											  to make a decision regarding the administration of the psychoactive medication;
(2) if the physician determines that the medication is the proper course of
											  treatment for the patient; and
(3) if the patient is under an
											  order for temporary or extended mental health services under THSC §574.034 or §574.035 and the
											  patient, verbally or by other indication, refuses to take the medication voluntarily.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.412 - Designation of Medication Classes

Current through Reg. 49, No. 28; July 12, 2024
(a) TDMHMR will maintain an updated list of
											  psychoactive medication classes to be used by the court. The list will be revised and distributed at least
											  annually or more frequently as needed and will include the most common psychoactive medications. The list
											  will be available from the Office of the Medical Director, TDMHMR, and on the TDMHMR website,
											  www.mhmr.state.tx.us (Office of the Medical Director).
(b) As
											  provided by §
										414.411(c)(1)
											  of this title (relating to Order Authorizing Administration of Psychoactive Medication), the court will only
											  approve classes of medications unless the specific medication appears in the other category on the list or is
											  not on the list and:
(1) the medication is being used for a non-FDA
											  approved indication; or
(2) the medication is a recently FDA
											  approved psychiatric medication.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.413 - Monitoring Compliance with Policies and Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) Each service setting will implement policies
											  and procedures in accordance with this subchapter.
(b)
											  Self-monitoring of compliance will include the following components:
(1)
											  procedures to audit records for compliance;
(2) procedures to
											  analyze and report audit results to staff responsible for the informed consent process; and
(3) procedures to improve the performance of individual employees,
											  contractors, and agents, and to improve overall facility performance.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.414 - References

Current through Reg. 49, No. 28; July 12, 2024
The following statutes are referenced in this subchapter:
(1) the Texas Health and Safety Code;
(2) the Texas Code of Criminal Procedure; and
(3) the Texas Family Code.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.415 - Distribution

Current through Reg. 49, No. 28; July 12, 2024
This subchapter is distributed to:
(1) members of the Texas Mental Health and Mental Retardation
											  Board;
(2) executive, management, and program staff of Central
											  Office;
(3) CEOs and medical directors of all facilities and
											  LAs;
(4) CEOs of psychiatric hospitals and crisis stabilization
											  units;
(5) advocacy organizations; and
(6) any person on request.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.501 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to protect consumers at a
													 facility, local authority, community center, or contract provider of residential services, and the property
													 of those consumers. To do so, this subchapter:
(1) describes the
											  process by which criminal history clearances are conducted for applicants for employment or volunteer status
											  with facilities, local authorities, community centers, and contract providers of residential
											  services;
(2) requires facilities, local authorities, community
											  centers, and contract providers of residential services to have an effective self-reporting procedure for
											  employees and volunteers; and
(3) describes the process by which
											  registry clearances are conducted for applicants for employment or volunteer status with facilities, local
											  authorities, community centers, and contract providers of residential services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.502 - Application

Current through Reg. 49, No. 28; July 12, 2024
(a) This subchapter applies to:
(1)
											  facilities (which include TDMHMR Central Office);
(2) local
											  authorities; and
(3) community centers.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.504 - Pre-Employment and Pre-Assignment Clearance

Current through Reg. 49, No. 28; July 12, 2024
(a) Each facility, local authority, community center, and provider must
											  conduct:
(1) a pre-employment criminal history and registry clearance of
											  all applicants (as defined) for employment; and
(2) a
											  pre-assignment criminal history and registry clearance of all applicants for volunteer status.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.505 - Obtaining or Requesting Criminal History Record Information and Checking Registry

Current through Reg. 49, No. 28; July 12, 2024
(a) Facilities must
											  obtain criminal history record information directly from the Texas Department of Public Safety (TDPS) by
											  contacting Crime Records Services, TDPS, P.O. Box 4143, Austin, TX 78765-4143.
(b) Local authorities and community centers may:
(1) pay a private agency to obtain criminal history record information
											  directly from TDPS; or
(2) obtain criminal history record
											  information directly from the Texas Department of Public Safety (TDPS) by contacting Crime Records Services,
											  TDPS, P.O. Box 4143, Austin, TX 78765-4143.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.506 - Criminal History Record Information and Registry Information

Current through Reg. 49, No. 28; July 12, 2024
(a) Facilities, local authorities,
											  community centers, and providers will have written policies and procedures consistent with this subchapter
											  that describe how information obtained through a criminal history and registry clearance will be processed
											  and later destroyed. The policies and procedures must include:
(1)
											  processes that protect the confidentiality of criminal history record information pursuant to the Texas
											  Health and Safety Code, §
											250.007;
(2) the process for notifying an applicant if:
(A) the applicant's criminal history record information identifies a
											  conviction barring, or a contraindication to, employment or volunteer status; or
(B) the applicant is listed as revoked in the Nurse Aide Registry or is
											  listed as unemployable in the Employee Misconduct Registry;
(3) information on how an applicant can address inaccuracies in criminal
											  history record information (i.e., the opportunity to be heard by Texas Department of Public Safety (TDPS),
											  pursuant to Texas Health and Safety Code, §
											250.005(b))
											  if the applicant believes he/she has been unjustly denied employment or volunteer status as a result of
											  inaccurate criminal history record information; and
(4)
											  procedures for destroying all criminal history record information obtained in accordance with this subchapter
											  after an employment/volunteer decision has been made or personal action has been taken, as required by the
											  Texas Government Code, §
											411.115(e).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.507 - Self-Reporting and Subsequent Criminal History and Registry Checks

Current through Reg. 49, No. 28; July 12, 2024
(a) Upon the effective date of this subchapter,
											  each facility, local authority, community center, and provider must initiate a registry check of all current
											  employees and volunteers. If an employee/volunteer is listed as revoked in the Nurse Aide Registry or listed
											  as unemployable in the Employee Misconduct Registry, then the employer must immediately discharge the
											  employee or volunteer.
(b) Following employment with or
											  assignment of volunteer status at a facility, local authority, community center, or provider, all employees
											  and volunteers must report to a person designated by that facility, local authority, community center, or
											  provider:
(1) any subsequent convictions or offenses for which they are
											  charged; and
(2) a subsequent listing as revoked in the Nurse
											  Aide Registry or listing as unemployable in the Employee Misconduct Registry.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.508 - References

Current through Reg. 49, No. 28; July 12, 2024
The following documents were referenced in this subchapter:
(1) 40 TAC §§ 76.101-76.106 and §94.11;
(2) Texas Health and Safety Code, Chapters 250, 253, and 534, and
											  §533.007 and §533.035;
(3) Texas Government Code,
											  §
										411.115;
											  and
(4) Penal Code, Chapters 19-22, 25, 28-29, and 31.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter K - CRIMINAL HISTORY AND REGISTRY CLEARANCES › Section 414.509 - Distribution

Current through Reg. 49, No. 28; July 12, 2024
(a) This subchapter will be distributed to:
(1) members of the Texas MHMR Board;
(2) executive, management, and program staff at TDMHMR Central
											  Office;
(3) chief executive officers of all facilities, local
											  authorities, and community centers; and
(4) advocacy
											  organizations.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.551 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to implement §
										48.255(c)
													 of the Human Resources Code, which requires TDMHMR to develop joint rules with the Texas Department of
													 Protective and Regulatory Services (TDPRS) to facilitate investigations in local authorities and community
													 centers and to describe the requirements for:
(1) reporting
											  allegations of abuse, neglect, and exploitation of persons served;
(2) ensuring the safety and protections of persons served involved in
											  allegations;
(3) facilitating investigations; and
(4) ensuring proper disciplinary or other action is taken when abuse,
											  neglect, or exploitation is confirmed.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.552 - Application

Current through Reg. 49, No. 28; July 12, 2024
(a) This subchapter applies to local authorities and community centers.
											  However, local authorities and community centers that are Medicaid providers of a home and community-based
											  services waiver program must comply with TDMHMR rules governing the home and community-based services waiver
											  program when addressing abuse, neglect, and exploitation in the home and community-based services waiver
											  program.
(b) Local authorities and community centers are
											  responsible for amending their contracts to ensure contractors' compliance with this subchapter.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.554 - Responsibilities of Local Authorities, Community Centers, and Contractors

Current through Reg. 49, No. 28; July 12, 2024
(a) Promulgate and implement policies and
											  procedures. Each local authority and community center shall promulgate and implement policies and procedures
											  that meet the requirements of this section.
(b) Prohibition of
											  abuse, neglect, and exploitation. Each local authority, community center, and contractor shall ensure that
											  its employees and agents are informed of the prohibition of abuse, neglect, and exploitation of persons
											  served.
(c) Identifying programs and investigatory agencies.
(1) Each local authority, community center, and contractor shall ensure
											  that the name and phone number of the investigatory agency are clearly identified and displayed for its
											  employees and agents at each of its program and service delivery sites.
(2) Each local authority and community center shall provide to each
											  investigatory agency a list of the names and addresses of its contracted and non-contracted program and
											  service delivery sites in the investigatory agency's purview, including the name of the staff who will serve
											  as contact for investigators, as required in subsection (g)(1) of this section.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.555 - Information To Be Provided to Victim or Alleged Victim and Others

Current through Reg. 49, No. 28; July 12, 2024
(a) Each local authority and
											  community center shall promulgate and implement policies and procedures that meet the requirements of this
											  section.
(b) As soon as possible, but no later than 24 hours
											  following notification of an allegation by the investigatory agency, the administrator or contractor CEO
											  shall notify the alleged victim and the alleged victim's guardian or parent (if the alleged victim is a
											  minor) of the allegation.
(c) The administrator or contractor CEO
											  shall ensure that the victim or alleged victim, guardian, or parent (if the victim or alleged victim is a
											  minor) is notified of:
(1) the finding and any decisions made after review
											  and/or appeal of the finding;
(2) the method to appeal the
											  finding, if any;
(3) how to receive a copy of the investigative
											  report; and
(4) if the allegation is confirmed, the disciplinary
											  or other action taken against the perpetrator.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.556 - Investigations Conducted by the Texas Department of Protective and Regulatory Services (TDPRS)

Current through Reg. 49, No. 28; July 12, 2024
(a) TDPRS submits a copy of the
											  investigative report to the administrator or contractor CEO or both in accordance with Chapter 711 of Title
											  40 (relating to Investigations in TDMHMR Facilities and Related Programs).
(b) The administrator or contractor CEO may not change a confirmed finding
											  made by a TDPRS investigator. The administrator or contractor CEO may request a review of the finding or the
											  methodology used to conduct the investigation in accordance with Chapter 711 of Title 40 (relating to
											  Investigations in TDMHMR Facilities and Related Programs).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.557 - Disciplinary and Other Action

Current through Reg. 49, No. 28; July 12, 2024
(a) Each local authority and community center shall promulgate and
											  implement policies and procedures that meet the requirements of this section.
(b) Administrators and contractor CEOs must take appropriate disciplinary
											  or other action in confirmed cases of abuse, neglect, and exploitation involving employees and agents.
(1) If the investigatory agency has a process by which the administrator or
											  contractor CEO can request a review of the finding and a review is requested, then the outcome of the review
											  is final and forms the basis for disciplinary action.
(2) If the
											  investigatory agency does not have a process by which the administrator or contractor CEO can request a
											  review of the finding, the investigatory agency's finding is final and forms the basis for disciplinary
											  action.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.558 - Data Reporting Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
If the perpetrator or alleged perpetrator is an employee or agent of
													 a local authority, community center, or contractor, or the perpetrator is unknown, then the administrator
													 shall ensure that a Client Abuse and Neglect Reporting form (AN-1-A) is completed within 14 calendar days of
													 the receipt of the investigative report or decision made after review or appeal using the CANRS Definitions
													 and the CANRS Classifications. (The Client Abuse and Neglect Reporting form (AN-1-A), the CANRS Definitions,
													 and the CANRS Classifications are referenced as Exhibits E, A, and D, respectively, in §
										414.562 of this title (relating to Exhibits).) Within
													 one working day after completion of the AN-1-A form, the administrator shall ensure that:
(1) the information contained in the completed AN-1-A is entered into the
											  Client Abuse and Neglect Reporting System (CANRS); or
(2) if
											  access to CANRS is unavailable, a copy of the completed AN-1-A is forwarded for data entry to the Office of
											  Consumer Services and Rights Protection - Ombudsman, TDMHMR, P.O. Box 12668, Austin, TX 78711-2668.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.559 - Confidentiality of Investigative Process and Report

Current through Reg. 49, No. 28; July 12, 2024
(a) The reports, records, and working papers used by or developed in the
											  investigative process by an investigatory agency, and the investigatory agency's resulting investigative
											  report, are confidential and may be disclosed only as allowed by law or rule.
(b) Upon request, the administrator or contractor CEO will provide a copy
											  of the investigative report to the victim or alleged victim or guardian with the identities of other persons
											  served and any information determined confidential by law concealed. The administrator or contractor CEO may
											  charge a reasonable fee for providing a copy of the investigative report.
(c) Advocacy, Inc. is entitled to access the records of persons served in
											  accordance with 42 USC
											  §10805 and §
										10806 or §
										6042(a)(2)(I) (Protection and Advocacy of
											  Individuals with Mental Illness and Protection and Advocacy of Individuals with Developmental Disabilities).
											  A copy of 42 USC
											  §10805, §
										10806, and §
										6042(a)(2)(I) are referenced as Exhibit F in
											  §
										414.562 of this title (relating to
											  Exhibits).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.560 - Competency of Employees and Agents

Current through Reg. 49, No. 28; July 12, 2024
(a) Each local authority, community center, and
											  contractor shall ensure that all employees and agents demonstrate a thorough understanding of the relevant
											  elements of reporting, investigating, and preventing abuse, neglect, and exploitation, before contact with
											  persons served and annually thereafter. The relevant elements of reporting, investigating, and preventing
											  abuse, neglect, and exploitation include:
(1) the acts and signs of
											  possible abuse, neglect, and exploitation;
(2) the prohibition of
											  abuse, neglect, and exploitation of persons served;
(3) the
											  disciplinary consequences for:
(A) committing abuse, neglect, and
											  exploitation;
(B) failing to report abuse, neglect, or
											  exploitation; and
(C) failing to cooperate with an
											  investigation;
(4) the procedures for reporting
											  allegations of abuse, neglect, and exploitation;
(5) the
											  prohibition of retaliatory action and the consequences for engaging in retaliatory action;
(6) the methods for preventing abuse, neglect, and exploitation;
											  and
(7) memoranda of understanding and rules of investigatory
											  agencies.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.561 - TDMHMR Oversight Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
The Office of Consumer Services and Rights Protection - Ombudsman in
													 TDMHMR's Central Office is responsible for the maintenance of systems that provide statistical trends in
													 abuse, neglect, and exploitation in local authorities and community centers.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.562 - Exhibits

Current through Reg. 49, No. 28; July 12, 2024
The following exhibits are referenced in this subchapter:
(1) Exhibit A--CANRS Definitions;
(2) Exhibit B--"Guidelines for Securing Evidence";
(3) Exhibit C--a copy of the Texas Civil Practice and Remedies Code, §
										81.001 and
											  §
										81.006;
(4) Exhibit D--CANRS Classifications;
(5) Exhibit E--Client Abuse and Neglect Report form (AN-1-A); and
(6) Exhibit F--a copy of
											  42 USC
											  §10805, §
										10806, and §
										6042(a)(2)(I).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.563 - References

Current through Reg. 49, No. 28; July 12, 2024
Reference is made to the following statutes and rules:
(1) Texas Health and Safety Code, Chapter 534, Subchapter A, and
											  §533.035(a);
(2) Texas Civil Practices and Remedies Code,
											  Chapter 81;
(3) Human Resources Code, §
										48.255(c);
(4)
										42 USC
											  §10805, §
										10806, and §
										6042(a)(2)(I); and
(5) Texas Administrative Code, Title 40, Chapter 711 (relating to
											  Investigations in TDMHMR Facilities and Related Programs).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter L - ABUSE, NEGLECT, AND EXPLOITATION IN LOCAL AUTHORITIES AND COMMUNITY CENTERS › Section 414.564 - Distribution

Current through Reg. 49, No. 28; July 12, 2024
(a) This subchapter shall be distributed to:
(1) members of the Texas MHMR Board;
(2) investigatory agencies;
(3)
											  executive, management, and program staff of Central Office;
(4)
											  administrators of all local authorities and community centers; and
(5) advocacy organizations.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
(a) The purpose
											  of this subchapter is to establish standards for prescribing psychoactive medication to patients served by
											  the state mental health and mental retardation system in Texas.
(b) This subchapter is not a clinical guide to prescribing psychoactive
											  medication and is not the only source of information concerning related issues of appropriate
											  practice.
(c) Accepted guidelines, as defined in §
										415.3 of this title (relating to Definitions)
											  supplement the use of this subchapter.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.2 - Application

Current through Reg. 49, No. 28; July 12, 2024
(a) The
											  provisions of this subchapter apply to the employees and contractors of:
(1) the facilities of the Texas Department of Mental Health and Mental
											  Retardation (TDMHMR); and
(2) TDMHMR local authorities.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.4 - Philosophy

Current through Reg. 49, No. 28; July 12, 2024
The standard of care for psychoactive medication use in patients
													 should not vary according to service setting. The variations in treatment should be individualized according
													 to patient needs.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.5 - General Principles

Current through Reg. 49, No. 28; July 12, 2024
(a) All state facilities and LAs will establish and implement written
											  policies and procedures as approved by their medical staff in accordance with this subchapter.
(b) The prescribing professional will practice within the scope of his or
											  her license with supervision as appropriate to that license.
(c)
											  The prescribing of psychoactive medication will be in accordance with accepted guidelines. Use of
											  psychoactive medication that falls outside accepted guidelines may be permissible if the clinical rationale
											  is documented in the patient record.
(d) In no case will
											  psychoactive medication be used for punishment, for convenience of staff, as a substitute for appropriate
											  psychosocial treatments, or in amounts that interfere with a patient's quality of life or plan of
											  care.
(e) The patient's plan of care will reflect any use of
											  psychoactive medication as part of an integrated treatment approach aimed at increasing the patient's
											  functioning and quality of life.
(f) The prescribing professional
											  will document the rationale for initiating, continuing, or discontinuing psychoactive medication in the
											  clinical record.
(g) Medications traditionally considered
											  psychoactive may be prescribed for nonpsychiatric indications if such use is supported by accepted guidelines
											  and the provisions of this subchapter would not apply.
(h) If a
											  service setting must meet other standards (external or otherwise), the more stringent standards will
											  prevail.
(i) The service setting will have policies and
											  procedures governing the scope of practice regarding prescription of psychoactive medications when the
											  prescribing professional is not a psychiatrist. These policies and procedures must require involvement of a
											  psychiatrist and describe the nature, extent, and time frame of this involvement regarding the following:
(1) initiation of any psychoactive medication;
(2) significant changes in the medication regimen other than simple
											  titration or substitution of equivalent medications;
(3)
											  institution of polypharmacy under §
											415.7(e)(4) of this
											  title (relating to Prescribing Parameters); and
(4) prescription
											  of any regimen that falls outside accepted guidelines, including dosing guidelines.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.6 - Evaluation and Diagnosis

Current through Reg. 49, No. 28; July 12, 2024
(a) Prior to initiating psychoactive medication according to accepted
											  guidelines, the prescribing professional will:
(1) assess and document the
											  medical history including the chief complaint, psychiatric history, substance use history, and medication
											  history along with medication allergies of the patient;
(2)
											  conduct and document a mental status examination of the patient according to accepted guidelines;
(3) assess and document the current physical status and general health of
											  the patient in detail sufficient for safe prescription of the medication contemplated and may include a
											  reference to a physical examination conducted within the past 12 months, a physical examination by the
											  physician, or a referral of the patient for a more thorough examination as appropriate to health status and
											  service setting;
(4) assess and document the need for laboratory
											  screening and other procedures to gather relevant clinical information; and
(5) make and document the psychiatric diagnosis in accordance with the DSM
											  and within the scope of the professional's license.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.7 - Prescribing Parameters

Current through Reg. 49, No. 28; July 12, 2024
(a) Target signs and symptoms. The prescribing professional will identify
											  and document the target signs and symptoms along with their initial frequency and severity for each
											  medication prescribed prior to its initial use.
(b) Choice of
											  psychoactive medication. The prescribing professional will choose the psychoactive medication in accordance
											  with accepted guidelines.
(c) Laboratory and screenings. The
											  prescribing professional will identify, order, and follow up any laboratory tests, screenings, or other
											  procedures indicated by the proposed psychoactive medication and the physical condition of the patient in
											  accordance with accepted guidelines.
(d) Dose and route of
											  administration. The prescribing professional will choose doses at or below the maximum doses indicated in the
											  TDMHMR Formulary. Higher doses or unusual routes of administration may be used with documentation in the
											  patient record of appropriate supporting clinical rationale. The use of nasogastric intubation requires
											  consultation with a second physician with documentation of the consultation in the supporting clinical
											  rationale.
(e) Polypharmacy. The prescribing professional will
											  not prescribe polypharmacy as a mechanism to avoid single drug dosage recommendations, adequate monotherapy
											  drug trials, or adequate psychosocial treatment or programming. Polypharmacy is acceptable practice when:
(1) overlapping medications are used as part of a change from one
											  medication to another;
(2) currently prescribed medication is not
											  available in the route most appropriate to a psychiatric emergency situation;
(3) documentation exists of inadequate patient response after simpler and
											  safer regimens have been attempted following accepted guidelines; or
(4) accepted guidelines provide no guidance and appropriate single drug
											  trials have failed, provided the rationale for determining the choice to prescribe polypharmacy is documented
											  to support the situation, and:
(A) the prescribing professional is
											  privileged through the medical staff privileging process to prescribe psychoactive medication; and
(B) the prescribing professional is a psychiatrist, or in the case of a
											  child patient, a child psychiatrist, or consults with a psychiatrist or a child psychiatrist as appropriate
											  prior to initiating polypharmacy.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.8 - Emergency Use of Psychoactive Medication

Current through Reg. 49, No. 28; July 12, 2024
(a) Emergency psychoactive medications are used
											  to treat the signs and symptoms of mental illness in a psychiatric emergency when other interventions are
											  ineffective or inappropriate.
(b) The selection of the medication
											  should take into account the patient's current medication regimen. Using a medication that the patient is
											  currently prescribed is preferable, if clinically indicated.
(c)
											  All required documentation will be entered into the patient's record as soon as the emergency
											  abates.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.9 - Consent and Patient Education

Current through Reg. 49, No. 28; July 12, 2024
(a) Informed consent for treatment with a
											  psychoactive medication will be obtained in accordance with the provisions of Chapter 414, Subchapter I of
											  this title (relating to Consent to Treatment with Psychoactive Medication - Mental Health Facilities) or
											  Chapter 405, Subchapter I of this title (relating to Consent to Treatment with Psychotropic Medication -
											  Mental Retardation Facilities), as appropriate.
(b) The use of
											  PRN medication requires an appropriate consent process in accordance with the provisions referred to in
											  subsection (a) of this section.
(c) The service setting will
											  provide individual and group medication education when appropriate to patients, their families, and LARs
											  according to accepted guidelines (e.g., TIMA patient and family education guidelines). If accepted guidelines
											  do not exist, the education will discuss characteristics of the medication, including expected benefits,
											  potential adverse or side effects, dosage, standard alternative treatments, legal rights, and any questions
											  the patient, family, or LAR may have. Education is also provided to address significant changes in the
											  patient's medication regimen.
(d) The service setting will have
											  policies and procedures to address medication education and documentation standards.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.10 - Medication Monitoring

Current through Reg. 49, No. 28; July 12, 2024
(a) All patients receiving psychoactive medication will receive timely
											  ongoing face-to-face evaluation and documentation by the prescribing professional of:
(1) data collected since the last follow-up, including data about the
											  frequency, severity, and timing of target signs and symptoms;
(2)
											  effectiveness of the medication in treating target signs and symptoms; and
(3) assessment for side effects and adverse effects.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.11 - Special Populations

Current through Reg. 49, No. 28; July 12, 2024
Special populations will be managed according to accepted guidelines
													 as appropriate to their special needs.
(1) Patients with
											  dyskinesias, including tardive dyskinesia.
(A) A diagnosis of a dyskinesia
											  will be verified by a psychiatrist or neurologist and documented in the patient record along with suspected
											  or known duration and severity.
(B) The patient and, as
											  appropriate, family and LAR will receive relevant education about the diagnosis and its implications for
											  psychoactive medication use.
(C) Risks and benefits of continued
											  psychoactive medication use will be assessed and communicated to the patient and, as appropriate, family or
											  LAR. If continued use is recommended, a new consent for medication will be obtained.
(D) If continued use of psychoactive medication is contemplated, then the
											  prescribing professional, if not a psychiatrist or neurologist, must obtain and document consultation from a
											  psychiatrist or neurologist.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.12 - Quality Improvement

Current through Reg. 49, No. 28; July 12, 2024
(a) Each service setting will have in place policies and procedures that
											  address standards monitoring and related procedures for quality management of provision of psychoactive
											  medication related services.
(b) At a minimum, psychoactive
											  medication utilization in each service setting must be reviewed and evaluated at least semiannually and
											  strategies for improvement identified using accepted guidelines.
(c) Required areas of review include:
(1)
											  appropriateness of prescribing (including choice of medication, dose, and route);
(2) documentation;
(3)
											  polypharmacy;
(4) emergency use of psychoactive
											  medication;
(5) PRN use;
(6) medication errors;
(7)
											  adverse drug reactions; and
(8) frequency of medication
											  monitoring.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.13 - References

Current through Reg. 49, No. 28; July 12, 2024
The following statutes and TDMHMR rules are referenced in this
													 subchapter:
(1) Texas Administrative Code, Title 25, Part II,
											  Chapter 414, Subchapter I, relating to Consent to Treatment with Psychoactive Medications - Mental Health
											  Services; and
(2) Texas Administrative Code Title 25, Part II,
											  Chapter 405, Subchapter I, relating to Consent to Treatment with Psychotropic Medication.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter A - PRESCRIBING OF PSYCHOACTIVE MEDICATION › Section 415.14 - Distribution

Current through Reg. 49, No. 28; July 12, 2024
This subchapter is distributed to:
(1) all members of the Texas Mental Health and Mental Retardation
											  Board;
(2) executive, management, and program staff of Central
											  Office;
(3) CEOs and medical directors of all facilities and
											  LAs;
(4) advocacy organizations; and
(5) any person on request.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES › Subchapter F - INTERVENTIONS IN MENTAL HEALTH SERVICES › Section 415.251 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to reduce the use of restraint and
													 seclusion as much as possible and to ensure that:
(1) the least
											  restrictive methods of intervention are used and that, wherever possible, alternatives are first attempted
											  and determined ineffective; and
(2) the rights and well-being of
											  individuals are protected during the use of restraint or seclusion.