Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 351 - COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
Subchapter A - GENERAL PROVISIONS
Section 351.13 - Substitute Care Provider Outcome Standards
Universal Citation: 1 TX Admin Code ยง 351.13
Current through Reg. 49, No. 38; September 20, 2024
(a) Definitions of Domains. The following words or terms, when used in this section, shall have the following meanings unless the context clearly indicates otherwise.
(1) Medical domain: The medical domain is
related to a child's physical health. It includes, but is not limited to,
medication management, medication monitoring, and management of acute and
chronic medical conditions.
(2)
Safety and security domain: The safety and security domain is characterized by
the absence of harm to self and others and safety to self, others, and
community. This domain includes, but is not limited to, self-harm, aggression,
and destructive acts.
(3)
Recreational domain: The recreational domain involves the child's ability to
choose and participate in age-appropriate play and activities. This domain
includes, but is not limited to, hobbies and sports.
(4) Educational domain: The educational
domain is related to a child's performance, progress, and conduct in the most
appropriate and least restrictive academic or vocational setting.
(5) Mental/behavioral health domain: The
mental/behavioral health domain refers to the behavioral and emotional
functioning of the child, as well as any psychiatric symptomatology that may be
present.
(6) Relationship domain:
The relationship domain is characterized by, but is not limited to, a child's
ability to trust, to form positive relationships, to function well as part of
family unit, as well as by the development and maintenance of age-appropriate
social relationships.
(7)
Socialization domain: The socialization domain is characterized by, but is not
limited to, age-appropriate social behavior, problem-solving, and social skills
in various social settings.
(8)
Permanence domain: The permanence domain is characterized by a child moving out
of a substitute care system and remaining in the least restrictive environment
in the community.
(9) Parent and
child participation domain: The parent and child participation domain involves,
but is not limited to, both the parent's and child's general satisfaction with
services, their relationship with service providers, their participation in the
treatment or service plan, and improvement in the relationship between the
child and the parents.
(b) Other Definitions.
(1) Contracting entity--a health and human
services agency (the Texas Juvenile Probation Commission and juvenile boards
that contract with the Texas Juvenile Probation Commission, Texas Department of
Mental Health and Mental Retardation and local mental health and/or mental
retardation authorities, and/or Texas Department of Protective and Regulatory
Services) that is responsible for implementing, coordinating, and monitoring
outcome standards for substitute care services for children placed in a
licensed foster families, foster group homes, or 24-hour residential care
facilities. This rule is not applicable to contracts for persons residing in
state-operated facilities as listed in §
RSA
532.001, Health and Safety Code, or persons
residing in HCS or ICF/MR facilities under contract with the Texas Department
of Mental Health and Mental Retardation under the state's Medicaid
program.
(2) Substitute care
provider--a person who provides residential care for children for 24 hours a
day, including:
(A) a child-care institution,
as defined by §
RSA
42.002, Human Resources Code;
(B) a child-placing agency, as defined by
§
RSA
42.002, Human Resources Code;
(C) a foster group home or foster family
home, as defined by §
RSA
42.002, Human Resources Code; and
(D) an agency group home or agency home, as
defined by §
RSA
42.002, Human Resources Code, other than an
agency group home, agency home, or a foster home verified or certified by the
Texas Department of Protective and Regulatory Services.
(3) Individualized Treatment Plan--this term
has the same meaning as that set out in 25 TAC § 402.53(Definitions in
Continuity of Services--Mental Health).
(4) Service Plan--this term has the same
meaning as that set out in 40 TAC §
RSA
700.1331(Child's Service Plan).
(c) Individualized Treatment Plan or Service Plan. A substitute care provider who receives funds from the state to provide substitute care services to children under the care of the State shall maintain an individualized treatment plan or service plan on each individual child. The plan shall contain specific behavioral goals that are appropriate to the child and the types of services to be provided under the appropriate levels of care. The provider should use the nine domains in subsection (a) of this section in setting the behavioral goals. A child is not required to have a goal in each domain; however, a child may have one or more different goals within the same domain.
(d) Development of Goals. The responsibility of developing goals in a child's individual treatment plan or service plan resides with contracting entity in conjunction with the substitute care provider. The child and family should be involved in the development of treatment goals whenever possible. Once a child has met goal(s) identified in the treatment or service plan, new goals should be developed for the child.
(e) Measurement of Progress toward Goals.
(1) The staff, representative,
or third party independent agent of the contracting entity shall monitor the
progress of the child in achieving the goals. The frequency of monitoring shall
be based upon the current review period appropriate for that specific child's
level of care. A six-point scale measures the child's progress towards the
achievement of each goal. The staff, representative, or third party independent
agent also rates the child. Progress is rated at given intervals on the
following six-point scale:
(A) +3 Goal
achieved and maintained;
(B) +2
Substantial improvement in behavior identified in the goal;
(C) +1 Some improvement in behavior
identified in the goal;
(D) 0 No
decline or improvement in behavior identified in the goal;
(E) -1 Some worsening in behavior identified
in the goal; and
(F) -2 Substantial
worsening in behavior identified in the goal.
(2) The child's progress will be assessed on
each identified goal within the nine domains listed in subsection (a) of this
section. If the child has shown improvement in 50% or more of the identified
goal(s) as measured by a positive rating (+1, +2, or +3) during the monitoring
period, the child will be considered to be progressing towards the
goal(s).
(3) The outcome of a
substitute care provider's service delivery shall be measured by the percentage
of children under its care that are considered to have made progress towards
their goals, as defined in paragraph (2) of this subsection.
(4) When a contracting entity has an option
in placing a child in substitute care, the entity shall consider whether the
children in a particular substitute care provider's care are progressing as
defined in paragraph (2) of this subsection.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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