reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter M - DISCIPLINE AND PUNISHMENT › Section 748.2307 - What other methods of punishment are prohibited?

Current through Reg. 49, No. 28; July 12, 2024
In addition to corporal punishment, prohibited discipline
					 techniques include:
(1) Any harsh,
				  cruel, unusual, unnecessary, demeaning, or humiliating discipline or
				  punishment;
(2) Denial of mail or
				  visits with their families as discipline or punishment;
(3) Threatening with the loss of placement as
				  discipline or punishment;
(4) Using
				  sarcastic or cruel humor;
(5)
				  Maintaining an uncomfortable physical position, such as kneeling, or holding
				  his arms out;
(6) Pinching, pulling
				  hair, biting, or shaking a child;
(7) Putting anything in or on a child's
				  mouth;
(8) Humiliating, shaming,
				  ridiculing, rejecting, or yelling at a child;
(9) Subjecting a child to abusive or profane
				  language;
(10) Placing a child in a
				  dark room, bathroom, or closet;
(11) Requiring a child to remain silent or
				  inactive for inappropriately long periods of time for the child's
				  age;
(12) Confining a child to a
				  highchair, box, or other similar furniture or equipment as discipline or
				  punishment;
(13) Denying basic
				  child rights as discipline or punishment;
(14) Withholding food that meets the child's
				  nutritional requirements; and
(15)
				  Using or threatening to use emergency behavior intervention as discipline or
				  punishment.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter M - DISCIPLINE AND PUNISHMENT › Section 748.2309 - To what extent may I restrict a child's activities as a behavior management tool?

Current through Reg. 49, No. 28; July 12, 2024
(a) Within limits, a
				  caregiver may restrict a child's activities as a behavior management
				  tool.
(b) Restrictions of
				  activities that will be imposed on a child for more than fourteen days, must
				  have prior approval by the treatment director, service planning team, or
				  professional level service provider.
(c) Restrictions to a particular room or
				  building that will be imposed on a child for more than 24 hours must have prior
				  approval by the treatment director, service planning team, or professional
				  level service provider.
(d) You
				  must inform the child and parent about any restrictions that you place on the
				  child.
(e) Documentation of all
				  approvals, justification for the restriction, and informing the child and
				  parents must be in the child's record.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter M - DISCIPLINE AND PUNISHMENT › Section 748.2311 - May a child or adult in care discipline or punish another person in care?

Current through Reg. 49, No. 28; July 12, 2024
No. A person in care must not discipline or punish another
					 person in care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 1 - DEFINITIONS › Section 748.2401 - What do certain words mean in this subchapter?

Current through Reg. 49, No. 28; July 12, 2024
These terms have the following meaning in this
						subchapter:
(1) Transitional hold--The
					 use of a temporary restraint technique that lasts no longer than one minute as
					 part of the continuation of a longer personal or mechanical
					 restraint.
(2) Triggered review--A
					 review of a specific child's placement, treatment plan, and orders or
					 recommendations for intervention, because a certain number of interventions
					 have been made within a specified period of time (e.g. three seclusions within
					 a seven-day period).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 2 - TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED › Section 748.2451 - What types of emergency behavior intervention may I administer?

Current through Reg. 49, No. 28; July 12, 2024
(a) If permitted in your policies and you
					 meet the requirements of this subchapter, you may administer the following
					 types of emergency behavior intervention to a child in your care:
(1) Short personal restraint;
(2) Personal restraint;
(3) Emergency medication;
(4) Seclusion:
(A) Only for a child with an emotional
					 disorder or an Autism Spectrum Disorder; and only if you provide treatment
					 services to 25 or more children with emotional disorders or Autism Spectrum
					 Disorder, or if more than 30% of the children in your care receive treatment
					 services for emotional disorders or Autism Spectrum Disorder. Seclusion is not
					 permitted for children receiving therapeutic camp services; or
(B) Only if you provide emergency care
					 services to the child and only while waiting for the arrival of law enforcement
					 or emergency medical services; and
(5) Mechanical restraint, only if you are a
					 Residential Treatment Center.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 2 - TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED › Section 748.2453 - Who may administer emergency behavior intervention?

Current through Reg. 49, No. 28; July 12, 2024
Only a caregiver qualified in emergency behavior
						intervention may administer any form of emergency behavior intervention, except
						for the short personal restraint of a child.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 2 - TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED › Section 748.2455 - What actions must a caregiver take before using a permitted type of emergency behavior intervention?

Current through Reg. 49, No. 28; July 12, 2024
(a) Before
					 using a permitted type of emergency behavior intervention, the caregiver must:
(1) Attempt less restrictive behavior
					 interventions that prove to be ineffective at defusing the situation;
					 and
(2) Determine that the basis
					 for the emergency behavior intervention is:
(A) An emergency situation; or
(B) A need for a personal restraint to
					 administer intra-muscular medication or other medical treatments prescribed by
					 a licensed physician, such as administering insulin to a child with
					 diabetes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 2 - TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED › Section 748.2459 - What is the appropriate use for a short personal restraint?

Current through Reg. 49, No. 28; July 12, 2024
Generally, a short personal restraint is used in urgent
						situations, such as:
(1) To protect
					 the child from external danger that causes imminent significant risk to the
					 child, such as preventing the child from running into the street or coming into
					 contact with a hot stove. The restraint must end immediately after the danger
					 is averted;
(2) To intervene when a
					 child under five years old (chronological or developmental age) demonstrates
					 disruptive behavior, if other efforts to de-escalate the child's behavior have
					 failed;
(3) When a child over five
					 years old demonstrates behavior disruptive to the environment or milieu, such
					 as disrobing in public, provoking others that creates a safety risk, or to
					 intervene to prevent a child from physically fighting; or
(4) When a child is significantly damaging
					 property, such as breaking car windows or putting holes into walls.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 2 - TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED › Section 748.2461 - What precautions must a caregiver take when implementing a short personal restraint?

Current through Reg. 49, No. 28; July 12, 2024
(a) When a
					 caregiver implements a short personal restraint, the caregiver must:
(1) Minimize the risk of physical discomfort,
					 harm, or pain to the child; and
(2)
					 Use the minimal amount of reasonable and necessary physical force.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 2 - TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED › Section 748.2463 - Are there any purposes for which emergency behavior intervention cannot be used?

Current through Reg. 49, No. 28; July 12, 2024
Emergency behavior intervention may never be used
						as:
(1) Punishment;
(2) Retribution or retaliation;
(3) A means to get a child to
					 comply;
(4) A convenience for
					 caregivers or other persons; or
(5)
					 A substitute for effective treatment or habilitation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 3 - ORDERS › Section 748.2501 - Are written orders required to administer emergency behavior intervention, and if so, who can write them?

Current through Reg. 49, No. 28; July 12, 2024
According to the following chart, written orders by
						certain professionals are required to administer certain emergency behavior
						intervention:
Attached
						Graphic
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 3 - ORDERS › Section 748.2503 - Must the written order be in a child's record before a caregiver can use an emergency behavior intervention on a child?

Current through Reg. 49, No. 28; July 12, 2024
Yes, any type of written order that is required, must be
						in the child's record before a caregiver can use emergency behavior
						intervention on that child, except for seclusion when it is necessary to
						prevent the child from endangering himself or others. In this seclusion
						situation, a licensed psychiatrist, psychologist, or physician must provide a
						verbal order within one hour after a caregiver initiates the seclusion. The
						caregiver must document this order, and the professional who provides the
						verbal order must provide a written version of the order within 72 hours after
						issuing the order. The written copy must include the time, date, and the
						professional's signature.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 3 - ORDERS › Section 748.2505 - What information must a written order include?

Current through Reg. 49, No. 28; July 12, 2024
(a) All written orders must include the
					 following:
(1) A statement that the
					 particular type of emergency behavior intervention may only be used in an
					 emergency situation;
(2)
					 Designation of the specific intervention and procedure or technique that is
					 authorized;
(3) Any specific
					 measures for ensuring the child's health, safety, and well being, and the
					 privacy of the setting that safeguards the child's personal dignity;
(4) A complete description of the behaviors
					 and circumstances under which the intervention may be used;
(5) Instructions for observation or
					 heightened observation of the child during the intervention;
(6) The behaviors that indicate the child is
					 ready to be released from the intervention;
(7) The maximum length of time the child may
					 be restrained or secluded regardless of behaviors exhibited;
(8) The prescribing professional's
					 consideration of any potential medical and/or psychiatric contraindications for
					 the specific child, such as a history of physical or sexual abuse or
					 victimization involving the type of intervention; and
(9) Clinical justification for the
					 intervention.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 3 - ORDERS › Section 748.2507 - Under what conditions are PRN orders permitted for a specific child?

Current through Reg. 49, No. 28; July 12, 2024
(a) PRN orders for certain emergency behavior
					 interventions are permitted under the following conditions:
Attached Graphic
(b) If you obtain a PRN order, you
					 must provide the parent with a copy of the PRN order within 72 hours.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 4 - RESPONSIBILITIES DURING ADMINISTRATION OF ANY TYPE OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2551 - What responsibilities does a caregiver have when implementing a type of emergency behavior intervention?

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The use of emergency behavior intervention must be an appropriate response to
					 the behavior demonstrated, and de-escalation must have failed.
(b) The caregiver must act to protect the
					 child's safety and consider:
(1) The
					 characteristics of the immediate physical environment;
(2) The permitted types of emergency behavior
					 intervention; and
(3) The potential
					 risk of harm in using emergency behavior intervention versus the risk of not
					 using emergency behavior intervention.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 4 - RESPONSIBILITIES DURING ADMINISTRATION OF ANY TYPE OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2553 - When must a caregiver release a child from an emergency behavior intervention?

Current through Reg. 49, No. 28; July 12, 2024
A child must be released as follows:
Attached
						Graphic
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 5 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A PERSONAL RESTRAINT › Section 748.2601 - Who must monitor a personal restraint?

Current through Reg. 49, No. 28; July 12, 2024
(a) During any personal restraint, a
					 caregiver qualified in emergency behavior intervention must:
(1) Monitor the:
(A) Personal restraint to make sure it is
					 being performed appropriately; and
(B) Child's breathing and other signs of
					 physical distress; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 5 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A PERSONAL RESTRAINT › Section 748.2603 - What is the appropriate action for a caregiver to take to ensure the child's adequate respiration, circulation, and overall well-being?

Current through Reg. 49, No. 28; July 12, 2024
Appropriate action includes responding prudently to a
						potentially life-threatening situation, for example, releasing a child when a
						child is unresponsive or indicates the child cannot breathe and immediately
						seeking medical assistance from a health-care professional.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 5 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A PERSONAL RESTRAINT › Section 748.2605 - What personal restraint techniques are prohibited?

Current through Reg. 49, No. 28; July 12, 2024
(a) The following personal restraint
					 techniques are prohibited:
(1) Restraints
					 that impair the child's breathing by putting pressure on the child's torso,
					 including restraints that obstruct the child's lungs from expanding such as
					 leaning a child forward during a seated restraint;
(2) Restraints that obstruct the child's
					 airway, including procedures that place anything in, on, or over the child's
					 mouth, nose, or neck;
(3)
					 Restraints that obstruct a caregiver's ability to view the child's
					 face;
(4) Restraints that interfere
					 with the child's ability to communicate or vocalize distress; or
(5) Restraints that twist or place the
					 child's limb(s) behind the child's back.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 6 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF SECLUSION › Section 748.2651 - What are the additional responsibilities for implementing seclusion?

Current through Reg. 49, No. 28; July 12, 2024
(a) Caregivers must continuously observe the
					 child placed in seclusion. This observation can take place by a caregiver in
					 the environment or room where the child is placed in seclusion, through a
					 window or a one-way mirror. The use of a video camera in lieu of direct
					 observation to continuously observe a child in seclusion is not
					 permitted.
(b) There must be a
					 protected, private, and observable environment or room that safeguards the
					 child's personal dignity and well-being that must:
(1) Have 40 square-feet of floor space and a
					 ceiling height of at least eight feet;
(2) Be free of safety hazards;
(3) Be adequately ventilated during warm
					 weather and adequately heated during cold weather;
(4) Be appropriately lighted; and
(5) Have a mat and bedding, unless the
					 prescribing professional writes orders to the contrary.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 6 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF SECLUSION › Section 748.2653 - What must occur for a caregiver to remove the mat or bedding without a written order?

Current through Reg. 49, No. 28; July 12, 2024
(a) If a caregiver
					 cannot obtain a written order to remove the mat or bedding, the caregiver must
					 obtain and document a licensed psychiatrist's, psychologist's, or physician's
					 verbal order with the rationale for the removal no later than one hour
					 following the intervention.
(b) The
					 verbal order must include an evaluation by the psychiatrist, psychologist, or
					 physician assessing whether seclusion is the most appropriate intervention for
					 the child given the situation.
(c)
					 The professional who provides the verbal order must provide a written version
					 of the order within 72 hours of issuing the order. The written copy must
					 include the time, date, and the professional's signature.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 7 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A MECHANICAL RESTRAINT › Section 748.2701 - What are the additional responsibilities for implementing a mechanical restraint?

Current through Reg. 49, No. 28; July 12, 2024
(a) Only
					 commercially available devices specifically designed for the safe and
					 comfortable restraint of humans may be used as mechanical restraints.
(b) Mechanical restraint devices must be
					 inspected after each use to ensure that they are in good repair and are free
					 from tears or protrusions that may cause injury. Damaged devices may not be
					 used to restrain a child.
(c) There
					 must be a protected, private, and observable environment or room that
					 safeguards the child's personal dignity and well-being.
(d) Caregivers must continuously observe the
					 child placed in mechanical restraint ensuring the child has adequate
					 respiration, circulation, and overall well-being. This observation can take
					 place through a window or a one-way mirror. The use of a video camera to
					 continuously observe a child in mechanical restraint is not permitted. In
					 addition to continual observation, a caregiver must check for circulation, skin
					 color, and respiration at least every 15 minutes.
(e) You must notify a child's parent that
					 mechanical restraint was used on the child within 72 hours after the restraint
					 is concluded.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 7 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A MECHANICAL RESTRAINT › Section 748.2703 - May my residential treatment center use altered mechanical restraint devices when restraining a child?

Current through Reg. 49, No. 28; July 12, 2024
Yes; however, any alteration of commercially available
						mechanical restraint devices must be reviewed and approved by a licensed
						psychiatrist who must:
(1) Base his
					 approval on the individual child's special physical needs; and
(2) Take into consideration any potential
					 medical contraindications, including psychiatric contraindications, such as the
					 child's history of sexual abuse or previous use of mechanical
					 restraints.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 7 - ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A MECHANICAL RESTRAINT › Section 748.2705 - What mechanical and other restraint devices are prohibited?

Current through Reg. 49, No. 28; July 12, 2024
The following must not be used as restraint
						devices:
(1) Devices with metal wrist
					 or ankle cuffs, such as handcuffs or shackles;
(2) Devices with rubber bands, rope, or
					 cord;
(3) Devices with padlocks,
					 key locks, or fastening devices;
(4) Long ties, such as leashes;
(5) Bed sheets or blankets; and
(6) Veil beds.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 8 - SUCCESSIVE USE AND COMBINATIONS OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2751 - May a caregiver successively use emergency behavior interventions on a child?

Current through Reg. 49, No. 28; July 12, 2024
(a) A caregiver may
					 successively use emergency behavior interventions on a child only if:
(1) Allowed by your policies;
(2) Permitted by rules of this subchapter for
					 both types of emergency behavior intervention; and
(3) The following written orders are met:
(A) If the successive intervention is
					 seclusion immediately following a personal restraint or mechanical restraint:
					 the written order for the seclusion meets the requirements in Division 3 of
					 this subchapter (relating to Orders) and provides clinical justification for
					 the use of the seclusion successive to a personal restraint or a mechanical
					 restraint;
(B) If the successive
					 intervention is a mechanical restraint immediately following a personal
					 restraint or seclusion: the written order for the mechanical restraint meets
					 the requirements in Division 3 of this subchapter and permits and provides
					 clinical justification for the use of the mechanical restraint successive to a
					 personal restraint or a seclusion; and
(C) If the successive intervention is a
					 personal restraint immediately following a seclusion or a mechanical restraint:
					 The professional ordering the seclusion or mechanical restraint must approve of
					 and provide clinical justification for the successive use of the personal
					 restraint in a written order.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 8 - SUCCESSIVE USE AND COMBINATIONS OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2753 - May a caregiver simultaneously use emergency medication in combination with another emergency behavior intervention?

Current through Reg. 49, No. 28; July 12, 2024
(a) A caregiver may simultaneously use
					 emergency medication in combination with personal restraint or seclusion only
					 if:
(1) Allowed by your policies;
(2) Permitted by the rules of this subchapter
					 for both types of emergency behavior intervention; and
(3) Written orders specifically allow the
					 combination.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 8 - SUCCESSIVE USE AND COMBINATIONS OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2755 - May a caregiver simultaneously implement mechanical restraint in combination with emergency medication?

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 caregiver may simultaneously implement mechanical restraint in combination with
					 emergency medication only if:
(1) Allowed by
					 your policies;
(2) Permitted by the
					 rules of this subchapter for both types of emergency behavior intervention;
					 and
(3) Written orders specifically
					 allow the combination.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 8 - SUCCESSIVE USE AND COMBINATIONS OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2757 - May a caregiver simultaneously implement mechanical restraint in combination with seclusion?

Current through Reg. 49, No. 28; July 12, 2024
No, mechanical restraint and seclusion may not be
						simultaneously implemented.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 9 - TIME RESTRICTIONS FOR EMERGENCY BEHAVIOR INTERVENTION › Section 748.2801 - What is the maximum length of time that an emergency behavior intervention can be administered to a child?

Current through Reg. 49, No. 28; July 12, 2024
The maximum length of time that certain emergency
						behavior interventions can be administered to a child is as follows:
Attached Graphic
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 9 - TIME RESTRICTIONS FOR EMERGENCY BEHAVIOR INTERVENTION › Section 748.2803 - How long may a caregiver seclude or mechanically restrain a child who has been released within the same 12-hour time period?

Current through Reg. 49, No. 28; July 12, 2024
If a child is released from seclusion or a mechanical
						restraint and then secluded or mechanically restrained again within the same
						12-hour period, the time spent in seclusion or mechanical restraint is
						cumulative and may not exceed the maximum length of time
						permitted.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 9 - TIME RESTRICTIONS FOR EMERGENCY BEHAVIOR INTERVENTION › Section 748.2805 - Can a caregiver exceed the maximum length of time that an emergency behavior intervention can be administered to a child?

Current through Reg. 49, No. 28; July 12, 2024
A caregiver may exceed the maximum length of time for
						certain emergency behavior interventions as follows:
Attached
						Graphic
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 9 - TIME RESTRICTIONS FOR EMERGENCY BEHAVIOR INTERVENTION › Section 748.2807 - May continuation orders be obtained verbally to exceed the maximum length of time that seclusion or mechanical restraint can be administered to a child?

Current through Reg. 49, No. 28; July 12, 2024
(a) Yes, if:
(1) The caregiver does a face-to-face
					 evaluation of the child;
(2) Verbal
					 authorization is obtained before the end of the maximum length of
					 time;
(3) The caregiver documents
					 the verbal continuation orders; and
(4) The professional who provides the verbal
					 order provides a written version of the order within 72 hours of issuing the
					 order. The written copy must include the time, date, and the professional's
					 signature.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 10 - GENERAL CAREGIVER RESPONSIBILITIES, INCLUDING DOCUMENTATION, AFTER THE ADMINISTRATION OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2851 - What follow-up actions must caregivers take after the child's behavior no longer constitutes an emergency situation?

Current through Reg. 49, No. 28; July 12, 2024
(a) The caregivers must take appropriate
					 actions to help the child return to routine activities. The follow-up actions
					 of the caregivers must include:
(1) Providing
					 the child with an appropriate transition and offering the child an opportunity
					 to return to regular activities;
(2) Observing the child for at least 15
					 minutes; and
(3) Providing the
					 child with an opportunity to discuss the situation that led to the need for
					 emergency behavior intervention and the caregiver's reaction to that situation.
					 The discussion must be held in private as soon as possible and no later than 48
					 hours after the child's use of an emergency medication or release from any
					 emergency behavior intervention.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 10 - GENERAL CAREGIVER RESPONSIBILITIES, INCLUDING DOCUMENTATION, AFTER THE ADMINISTRATION OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2853 - What must the caregiver document after discussing with the child the use of the emergency behavior intervention?

Current through Reg. 49, No. 28; July 12, 2024
The caregiver must document the following after
						discussing with the child the use of the emergency behavior
						intervention:
(1) The date and time the
					 caregiver offered the discussion;
(2) The child's reaction to the opportunity
					 for discussion;
(3) The date and
					 time the discussion took place, if applicable; and
(4) The content of the discussion, if
					 applicable.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 10 - GENERAL CAREGIVER RESPONSIBILITIES, INCLUDING DOCUMENTATION, AFTER THE ADMINISTRATION OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2855 - When must a caregiver document the use of an emergency behavior intervention, and what must the documentation include?

Current through Reg. 49, No. 28; July 12, 2024
(a) As soon as possible, but no later than 24
					 hours after the initiation of the emergency behavior intervention, the
					 caregiver involved in the intervention must document in the child's record the
					 following information:
(1) The child's
					 name;
(2) A description and
					 assessment of the circumstances and specific behaviors that caused the basis
					 for the emergency behavior intervention;
(3) The de-escalation attempted before and
					 during the use of the emergency behavior intervention and the child's reaction
					 to those strategies;
(4) The
					 specific emergency behavior intervention administered;
(5) The date and time the intervention was
					 administered;
(6) The length of
					 time the child was restrained or secluded;
(7) The name of the caregiver(s) that
					 participated in the incident that led to the intervention, and who administered
					 the intervention;
(8) The name of
					 the person(s) who observed the child;
(9) The names of any witnesses to the
					 emergency behavior intervention, including any child in care who witnessed the
					 intervention;
(10) All attempts to
					 explain to the child what behaviors were necessary for release from the
					 intervention;
(11) The child's
					 condition following the use of the medication or release from the intervention,
					 including any injury the child sustained as a result of the intervention or any
					 adverse effects caused by the use of the intervention. If the child received
					 medical assistance or treatment, the caregiver must document the name of the
					 person(s) who provided medical assistance or treatment; and
(12) The actions the caregiver(s) took to
					 facilitate the child's return to normal activities following the end of the
					 intervention.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 10 - GENERAL CAREGIVER RESPONSIBILITIES, INCLUDING DOCUMENTATION, AFTER THE ADMINISTRATION OF EMERGENCY BEHAVIOR INTERVENTION › Section 748.2857 - What notice must I provide to the parent when I use an emergency behavior intervention with a child in care?

Current through Reg. 49, No. 28; July 12, 2024
(a) As soon as possible, but no later than 72
					 hours after the initiation of the intervention, you must provide written notice
					 to the parent that includes:
(1) The child's
					 name;
(2) The specific emergency
					 behavior intervention administered;
(3) The length of time the child was
					 restrained;
(4) The child's
					 condition following the use of the medication or release from the intervention,
					 including:
(A) Any injury the child sustained
					 as a result of the intervention or any adverse effects caused by using the
					 intervention; and
(B) If the child
					 received medical assistance or treatment, the name of each person who provided
					 the medical assistance or treatment;
(5) If a personal restraint was used, the
					 specific restraint techniques used, including if a prone or supine restraint
					 used as a transitional hold; and
(6) If emergency medication was used, the
					 specific medication used, and the dosage administered to the child.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 11 - TRIGGERED REVIEWS › Section 748.2901 - What circumstances trigger a review of the use of emergency behavior intervention for a specific child?

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 following circumstances trigger a review for certain emergency behavior
					 interventions:
Attached
						Graphic
(b) You
					 may exceed the number of restraints otherwise allowed in (2) Personal restraint
					 of Figure: 40 TAC § 748.2901(a) for a child if a licensed psychiatrist or
					 psychologist issues a written order or if a service planning team makes a
					 recommendation allowing you to do so and you ensure the following:
(1) If applicable, the recommendation from
					 the service planning team includes the same written information as an order, as
					 specified in § 748.2505 of Title 40 (relating to What information must a
					 written order include?); and
(2) At
					 least one triggered review is conducted in accordance with § 748.2907 of
					 Title 40 (relating to What must the triggered review include and what must be
					 documented in the child's record?) every 30 days that personal restraints in
					 excess of the threshold are authorized.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 11 - TRIGGERED REVIEWS › Section 748.2903 - When must a triggered review occur?

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 triggered review must occur as soon as possible, but no later than 30 days
					 after the review is triggered.
(b)
					 The regularly scheduled review of the child's service plan can serve as the
					 triggered review if it meets the requirements in § 748.2907 of Title 40
					 (relating to What must the triggered review include and what must be documented
					 in the child's record?) and takes place no later than 30 days after the review
					 is triggered.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 11 - TRIGGERED REVIEWS › Section 748.2905 - Who must participate in the triggered review?

Current through Reg. 49, No. 28; July 12, 2024
(a) A full service planning team must
					 participate in the triggered review. You must invite the child, as appropriate,
					 and the parents to the review, so they may have the opportunity to participate
					 and provide input into the content of the review. However, you are not required
					 to delay a review because a parent or child is unable to participate in the
					 review at its scheduled time.
(b)
					 Even if the child is not receiving treatment services, the two additional
					 professions required in § 748.1339(b) of Title 40 (relating to Who must be
					 involved in developing an initial service plan?) must be involved in the
					 triggered review.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 11 - TRIGGERED REVIEWS › Section 748.2907 - What must the triggered review include and what must be documented in the child's record?

Current through Reg. 49, No. 28; July 12, 2024
(a) Except in cases in
					 which the regularly scheduled review of the child's service plan also addresses
					 the requirements of a triggered review in accordance with § 748.2903(b) of
					 Title 40 (relating to When must a triggered review occur?), a triggered review
					 is not a full review of the child's service plan and is focused on the
					 requirements identified in subsection (c) of this section.
(b) Other than the requirements in this
					 section and in § 748.2905 of Title 40 (relating to Who must participate in
					 the triggered review?), the notification, participation, implementation, and
					 documentation requirements in Division 4 of Subchapter I (relating to
					 Admission, Service Planning, And Discharge) do not otherwise apply to a
					 triggered review.
(c) The following
					 must be included in a triggered review and documented in the child's record:
(1) A review of the records and orders of the
					 emergency behavior interventions;
(2) A review and documentation of any
					 potential medical or psychiatric reason for not using emergency behavior
					 interventions on the child, including the prescribing professional's
					 consideration of any potential medical and/or psychiatric contraindications for
					 the specific child, such as a history of physical or sexual abuse or
					 victimization involving the type of intervention;
(3) An examination of identified behaviors
					 and patterns, any significant events leading up to the use of emergency
					 behavior intervention, and all attempted de-escalation methods, whether
					 successful or unsuccessful;
(4)
					 Identification of alternatives to manage the child's behavior and more
					 effectively prevent the use of emergency behavior intervention in the future;
					 and
(5) A written plan for reducing
					 the need for emergency behavior intervention.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 11 - TRIGGERED REVIEWS › Section 748.2909 - What if there are four triggered reviews within a 90-day period?

Current through Reg. 49, No. 28; July 12, 2024
If there are four triggered reviews within a 90-day
						period:
(1) A licensed psychiatrist,
					 psychologist, clinical social worker, professional counselor, or marriage and
					 family therapist must examine the child; and
(2) The licensed professional must make
					 service plan recommendations regarding the use of emergency behavior
					 interventions. You must document these recommendations in the child's
					 record.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 12 - OVERALL OPERATION EVALUATION › Section 748.2951 - What is an overall operation evaluation?

Current through Reg. 49, No. 28; July 12, 2024
(a) The overall operation evaluation is an
					 annual review regarding:
(1) The use and
					 effectiveness of emergency behavior interventions at your operation;
					 and
(2) Your emergency behavior
					 intervention policies and procedures, including the training policy and
					 curriculum.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter N - EMERGENCY BEHAVIOR INTERVENTION › Division 12 - OVERALL OPERATION EVALUATION › Section 748.2953 - What data must be collected?

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Quarterly, you must collect, document, and review aggregate numbers of
					 emergency behavior interventions by type of intervention, with the exception of
					 short personal restraints.
(b) This
					 information must be reported to us no later than 15 days after the end of each
					 quarter.
(c) You must maintain the
					 data for five years.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter O - SAFETY AND EMERGENCY PRACTICES › Division 1 - SANITATION AND HEALTH PRACTICES › Section 748.3001 - When must I have an annual sanitation inspection?

Current through Reg. 49, No. 28; July 12, 2024
(a) A local sanitation official must conduct
					 a sanitation inspection of your operation:
(1) Before we issue you an initial permit;
					 and
(2) At least once every 12
					 months from the date of the last sanitation inspection.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter O - SAFETY AND EMERGENCY PRACTICES › Division 1 - SANITATION AND HEALTH PRACTICES › Section 748.3003 - How must I document that a sanitation inspection has been completed?

Current through Reg. 49, No. 28; July 12, 2024
You must keep the most recent sanitation inspection
						report, letter, or checklist at your operation to verify the inspection date
						and findings. The report must include the name and telephone number of the
						inspector.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter O - SAFETY AND EMERGENCY PRACTICES › Division 1 - SANITATION AND HEALTH PRACTICES › Section 748.3005 - Must I make all corrections specified in the sanitation inspection report?

Current through Reg. 49, No. 28; July 12, 2024
You must correct deficiencies and comply with
						corrections, restrictions, or conditions that the inspector specifies in the
						sanitation report, letter, or checklist.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter O - SAFETY AND EMERGENCY PRACTICES › Division 1 - SANITATION AND HEALTH PRACTICES › Section 748.3007 - What must I sanitize?

Current through Reg. 49, No. 28; July 12, 2024
You must sanitize any item or surface that comes into
						contact with bodily fluids and has the possibility for cross
						contamination.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 748 - MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS › Subchapter O - SAFETY AND EMERGENCY PRACTICES › Division 1 - SANITATION AND HEALTH PRACTICES › Section 748.3009 - How should items be sanitized?

Current through Reg. 49, No. 28; July 12, 2024
Items may be sanitized by:
(1) Completing the four-step process outlined
					 in the definition in § 748.43(41) of Title 40 (relating to What do certain
					 words and terms mean in this chapter?);
(2) Washing the items for five or more
					 minutes in a dishwasher or washing machine that uses hot water of a temperature
					 of at least 160 degrees Fahrenheit;
(3) Washing in a three-compartment sink or
					 three containers. The sinks and/or containers must be large enough to
					 completely immerse the items for soaking, rinsing, and disinfecting;
					 or
(4) Following the requirements
					 of any alternative methods that have been approved by the Department of State
					 Health Services for your operation.