<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 9INTELLECTUAL DISABILITY SERVICES--MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER DHOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM
RULE §9.178Certification Principles: Quality Assurance

(a) In the provision of HCS Program services to an individual, the program provider must promote the active and maximum cooperation with generic service agencies, non-HCS Program service providers, and advocates or other actively involved persons.

(b) The program provider must ensure personalized service delivery based upon the choices made by each individual or LAR and those choices that are available to persons without an intellectual disability or other disability.

(c) Before providing services to an individual in a residence in which foster/companion care, supervised living, or residential support is provided, and annually thereafter, the program provider must:

  (1) conduct an on-site inspection to ensure that, based on the individual's needs, the environment is healthy, comfortable, safe, appropriate, and typical of other residences in the community, suited for the individual's abilities, and is in compliance with applicable federal, state, and local regulations for the community in which the individual lives;

  (2) ensure that the service coordinator is provided with a copy of the results of the on-site inspection within five calendar days after completing the inspection;

  (3) complete any action identified in the on-site inspection for a residence in which supervised living or residential support will be provided to ensure that the residence meets the needs of the individual; and

  (4) ensure completion of any action identified in the on-site inspection for a residence in which foster/companion care will be provided to ensure that the residence meets the needs of the individual.

(d) The program provider must ensure that:

  (1) emergency plans are maintained in each residence in which foster/companion care, supervised living or residential support is provided;

  (2) the emergency plans address relevant emergencies appropriate for the type of service, geographic location, and the individuals living in the residence;

  (3) the individuals and service providers follow the plans during drills and actual emergencies; and

  (4) documentation of drills and responses to actual emergencies are maintained in each residence.

(e) A program provider must comply with the requirements in this subsection regarding a four-person residence.

  (1) Before providing residential support in a four-person residence, the program provider must:

    (A) ensure that the four-person residence meets one of the following:

      (i) is certified by:

        (I) the local fire safety authority having jurisdiction in the location of the residence as being in compliance with the applicable portions of the National Fire Protection Association 101: Life Safety Code (Life Safety Code) as determined by the local fire safety authority;

        (II) the local fire safety authority having jurisdiction in the location of the residence as being in compliance with the applicable portions of the International Fire Code (IFC) as determined by the local fire safety authority; or

        (III) the Texas State Fire Marshal's Office as being in compliance with the applicable portions of the Life Safety Code as determined by the Texas State Fire Marshal's Office; or

      (ii) as described in paragraph (2) of this subsection, is certified by DADS as being in compliance with the portions of the Life Safety Code applicable to small residential board and care facilities and most recently adopted by the Texas State Fire Marshal's Office; and

    (B) obtain DADS approval of the residence in accordance with §9.188 of this subchapter (relating to DADS Approval of Residences).

  (2) DADS inspects for certification as described in paragraph (1)(A)(ii) of this subsection only if the program provider submits to DADS Architectural Unit:

    (A) one of the following:

      (i) if the four-person residence is located in a jurisdiction with a local fire safety authority:

        (I) a completed DADS Form 5606 available at http://www.dads.state.tx.us documenting that the local fire safety authority having jurisdiction refused to inspect for certification using the code (i.e. the Life Safety Code or IFC) for that jurisdiction; and

        (II) written documentation from the Texas State Fire Marshal's Office that it refused to inspect for certification using the Life Safety Code; or

      (ii) if the four-person residence is located in a jurisdiction without a local fire safety authority, written documentation from the Texas State Fire Marshal's Office that it refused to inspect for certification using the Life Safety Code; and

    (B) a completed DADS form "Request for Life Safety Inspection-HCS Four-Person Home" available at http://www.dads.state.tx.us.

  (3) The program provider must:

    (A) obtain the certification required by paragraph (1)(A) of this subsection annually; and

    (B) ensure that a four-person residence:

      (i) contains a copy of the most recent inspection of the residence by the local fire safety authority, Texas State Fire Marshal's Office, or DADS; and

      (ii) is in continuous compliance with all applicable local building codes and ordinances and state and federal laws, rules, and regulations.

(f) The program provider must establish an ongoing consumer/advocate advisory committee composed of individuals, LARs, community representatives, and family members that meets at least quarterly. The committee, at least annually:

  (1) reviews information provided by the program provider regarding satisfaction of individuals and LARs with the program provider's services as described in subsection (p)(1) of this section;

  (2) reviews information provided by the program provider regarding complaints about the operations of the program provider as described in subsection (p)(2) of this section;

  (3) reviews information provided by the program provider regarding incidents of confirmed abuse, neglect, and exploitation and unusual incidents as described in subsection (p)(3) of this section;

  (4) reviews information provided by the program provider regarding termination of HCS Program services as described in subsection (p)(4) of this section;

  (5) based on the information reviewed as required by this subsection, makes recommendations to the program provider for improvements to the processes and operations of the program provider; and

  (6) reviews information provided by the program provider regarding the data about restraints described in subsection (p)(5) of this section.

(g) The program provider must make available all records, reports, and other information related to the delivery of HCS Program services as requested by DADS, other authorized agencies, or the Centers for Medicare and Medicaid Services and deliver such items, as requested, to a specified location.

(h) The program provider must conduct, at least annually, a satisfaction survey of individuals and LARs and take action regarding any areas of dissatisfaction.

(i) The program provider must publicize and make available a process for eliciting complaints and maintain a record of verifiable resolutions of complaints received from:

  (1) individuals, their families, and LARs;

  (2) staff members, service providers, and CDS service providers;

  (3) the general public; and

  (4) the local authority.

(j) The program provider must ensure that:

  (1) the individual and LAR are informed of how to report allegations of abuse, neglect, or exploitation to DFPS and are provided with the DFPS toll-free telephone number (1-800-647-7418) in writing; and

  (2) all staff members and service providers:

    (A) are instructed to report to DFPS immediately, but not later than one hour after having knowledge or suspicion, that an individual has been or is being abused, neglected, or exploited; and

    (B) are provided with the DFPS toll-free telephone number (1-800-647-7418) in writing; and

  (3) all staff members and service providers report suspected abuse, neglect, or exploitation as instructed.

(k) If the program provider suspects an individual has been or is being abused, neglected, or exploited or is notified of an allegation of abuse, neglect, or exploitation, the program provider must take necessary actions to secure the safety of the alleged victim, including:

  (1) obtaining immediate and ongoing medical or psychological services for the alleged victim as necessary;

  (2) if necessary, restricting access by the alleged perpetrator of the abuse, neglect, or exploitation to the alleged victim or other individuals pending investigation of the allegation; and

  (3) notifying, as soon as possible but no later than 24 hours after the program provider reports or is notified of an allegation, the alleged victim, the alleged victim's LAR, and the service coordinator of the allegation report and the actions that have been or will be taken.

(l) Staff members and service providers must cooperate with the DFPS investigation of an allegation of abuse, neglect, or exploitation, including:

  (1) providing complete access to all HCS Program service sites owned, operated, or controlled by the program provider;

  (2) providing complete access to individuals and program provider personnel;

  (3) providing access to all records pertinent to the investigation of the allegation; and

  (4) preserving and protecting any evidence related to the allegation in accordance with DFPS instructions.

(m) In all respite facilities and all residences in which a service provider of residential assistance or the program provider hold a property interest, the program provider must post in a conspicuous location:

  (1) the name, address, and telephone number of the program provider;

  (2) the effective date of the Waiver Program Provider Agreement; and

  (3) the name of the legal entity named on the Waiver Program Provider Agreement.

(n) The program provider must:

  (1) promptly, but not later than five calendar days after the program provider's receipt of a DFPS investigation report:

    (A) notify the alleged victim or LAR and the service coordinator of:

      (i) the investigation finding; and

      (ii) the corrective action taken by the program provider in response to the DFPS investigation; and

    (B) notify the alleged victim or LAR of:

      (i) the process to appeal the investigation finding as described in Chapter 711, Subchapter M, of this title (relating to Requesting an Appeal if You are the Reporter, Alleged Victim, Legal Guardian, or with Advocacy, Incorporated); and

      (ii) the process for requesting a copy of the investigative report from the program provider;

  (2) report to DADS in accordance with DADS instructions the program provider's response to the DFPS investigation that involves a staff member or service provider within 14 calendar days after the program provider's receipt of the investigation report; and

  (3) upon request of the alleged victim or LAR, provide to the alleged victim or LAR a copy of the DFPS investigative report after concealing any information that would reveal the identity of the reporter or of any individual who is not the alleged victim.

(o) If abuse, neglect, or exploitation is confirmed by the DFPS investigation, the program provider must take appropriate action to prevent the reoccurrence of abuse, neglect or exploitation, including, when warranted, disciplinary action against or termination of the employment of a staff member confirmed by the DFPS investigation to have committed abuse, neglect, and exploitation.

(p) At least annually, the program provider must:

  (1) evaluate information about the satisfaction of individuals and LARs with the program provider's services and identify program process improvements to increase the satisfaction;

  (2) review records of complaints, as described in subsection (i) of this section about the operations of the program provider and identify program process improvements to reduce the filing of complaints;

  (3) review incidents of confirmed abuse, neglect, or exploitation; complaints; and unusual incidents; and identify program process improvements that will prevent the reoccurrence of such incidents and improve service delivery;

  (4) review the reasons for terminating HCS Program services to individuals and identify any related need for program process improvements;

  (5) evaluate its use of restraint and, at a minimum, compare aggregate data provided by DADS at www.dads.state.tx.us with critical incident data concerning use of restraint and identify program process improvements that will prevent the reoccurrence of restraints and improve service delivery;

Cont'd...

Next Page Previous Page



Home TxReg TAC OM NewTac Public Footer Bar