Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
Subchapter I - RESIDENT ASSESSMENT
Section 554.805 - Permanency Planning for a Resident Under 22 Years of Age
Universal Citation: 26 TX Admin Code ยง 554.805
Current through Reg. 49, No. 38; September 20, 2024
(a) Definitions. The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.
(1)
Permanency planning--A philosophy and planning process that focuses on the
outcome of family support by facilitating a permanent living arrangement, with
the primary feature of an enduring and nurturing parental relationship.
Family-directed planning empowers the family of a child under the age of 18 to
direct the development of supports and services that meet the child and
family's personal outcomes as related to that child. Person-directed planning
empowers the child who is between 18 and 22 years of age to direct the
development of a plan of supports and services that meets the needs for
self-determination.
(2) Child--A
person with a developmental disability who is under 22 years of age.
(3) CRCG (Community resource coordination
group)--A local interagency group composed of public and private agencies that
develops service plans for individuals whose needs can be met only through
interagency coordination and cooperation. The group's role and responsibilities
are described in the Memorandum of Understanding on Coordinated Services to
Persons Needing Services from More Than One Agency, available on the Health and
Human Services Commission website at
www.hhsc.state.tx.us/crcg/crcg.htm.
(4) Emergency situation--An unexpected
situation involving a child's health, safety, or welfare, of which a person of
ordinary prudence would determine that the LAR should be informed, such as:
(A) a child needing emergency medical
care;
(B) a child being removed
from his residence by law enforcement;
(C) a child leaving his residence without
notifying staff and not being located; and
(D) a child being moved from his residence to
protect the child (for example, because of a hurricane, fire, or
flood).
(5) LAR (legally
authorized representative)--A person authorized by law to act on behalf of a
resident with regard to a matter described in this subchapter, which may
include a parent, guardian, managing conservator of a minor individual, a
guardian of an adult individual, or legal representative of a deceased
individual.
(6) Permanency
planner--A person assigned by DADS to conduct permanency planning activities
for a child who resides in a facility.
(b) Facility responsibilities regarding permanency planning.
(1) A facility must
request a Preadmission Screening and Resident Review (PASARR) on every child
who is a potential admission to a facility, as well as on all children
currently residing in a facility who have not had a previous PASARR completed.
Documentation regarding the request for or completion of a PASARR must be kept
in the chart.
(2) A facility must
notify the following entities of the child's admission not later than the third
day after a child is initially placed in a facility:
(A) DADS via fax, using DADS Form 2437,
Notification of Nursing Facility Admission of Individual Under Age
22;
(B) the CRCG in the county
where the LAR resides (see www.hhsc.state.tx.us/crcg/crcg.htm for a listing of
CRCG chairpersons by county);
(C)
the local office of the Early Childhood Intervention (ECI) Program of the Texas
Department of Assistive and Rehabilitative Services, if a child is less than
three years of age (see www.dars.state.tx.us/ecis/index.shtml or call
1-800-628-5115 for a listing of ECI programs by county); and
(D) the local school district, if a child is
3 to 22 years of age, with which the facility must coordinate educational
opportunities (See § 554.1934 of Title 40 (relating to Educational
Requirements for Persons under Age 22)).
(3) A facility must keep in a separate
section at the front of each child's records:
(A) documentation regarding the notifications
required in paragraph (2) of this subsection;
(B) a copy of all PASARR documents;
and
(C) a copy of the current
permanency plan.
(4) A
facility must:
(A) cooperate with the
permanency planner by:
(i) allowing access to
a child's records or providing other information in a timely manner as
requested by the permanency planner or the Health and Human Services
Commission;
(ii) participating in
meetings to review the child's permanency plan; and
(iii) identifying, in coordination with the
permanency planner, activities, supports, and services that can be provided by
the family, LAR, facility, or the permanency planner to prepare the child for
an alternative living arrangement;
(B) encourage regular contact between the
child and LAR and, if desired by the child and LAR, between the child and
advocates and friends in the community to continue supportive and nurturing
relationships;
(C) encourage
participation in the comprehensive care plan meetings by the LAR, and, if
desired by the child or LAR, by family members, advocates, and friends in the
community;
(D) make reasonable
accommodations to promote the participation of the LAR in all planning and
decision-making regarding the child's care, including participating in:
(i) the initial development and annual review
of the child's comprehensive care plan;
(ii) decision-making regarding the child's
medical care;
(iii) routine
interdisciplinary team meetings; and
(iv) decision-making and other activities
involving the child's health and safety;
(E) ensure that reasonable accommodations
include:
(i) conducting a meeting in person
or by telephone, as mutually agreed upon by the facility and the LAR;
(ii) conducting a meeting at a time and, if
the meeting is in person, at a location that is mutually agreed upon by the
facility and the LAR;
(iii) if the
LAR has a disability, providing reasonable accommodations in accordance with
the Americans with Disabilities Act, including providing an accessible meeting
location or a sign language interpreter, if appropriate; and
(iv) providing a language interpreter, if
appropriate;
(F) upon
admission and annually thereafter:
(i)
request from and encourage an LAR to provide the following information for a
child during the annual comprehensive care plan meeting and, for an applicant,
upon admission:
(I) the LAR's:
(-a-) name;
(-b-) address;
(-c-) telephone number;
(-d-) driver license number and state of
issuance or personal identification card number issued by the Department of
Public Safety; and
(-e-) place of
employment and the employer's address and telephone number;
(II) the name, address, and
telephone number of a relative of the child or other person whom DADS or the
facility may contact in an emergency situation, a statement indicating the
relation between that person and the child, and at the LAR's option:
(-a-) that person's driver license number and
state of issuance or personal identification card number issued by the
Department of Public Safety; and
(-b-) the name, address, and telephone number
of that person's employer; and
(III) a signed acknowledgement of
responsibility stating that the LAR agrees to:
(-a-) notify the facility of any changes to
the contact information submitted; and
(-b-) make reasonable efforts to participate
in the child's life and in planning activities for the child; and
(ii) inform the LAR
that if the information described in clause (i) of this subparagraph is not
provided or is not accurate and the facility and DADS are unable to locate the
LAR as described in subparagraph (J) of this paragraph, DADS refers the case to
the Department of Family and Protective Services, in accordance with subsection
(c) of this section;
(G)
refrain from providing the LAR with inaccurate or misleading information
regarding the risks of moving the child to another facility or community
setting;
(H) if an emergency
situation occurs, attempt to notify the LAR as soon as the emergency situation
allows and request a response from the LAR;
(I) if an LAR does not respond to a notice of
the child's annual comprehensive care plan meeting, a request for the LAR's
consent, or an emergency situation, attempt to locate the LAR by contacting a
person identified by the LAR in the contact information described in
subparagraph (F) if this paragraph;
(J) no later than 30 days after the date the
facility determines that it is unable to locate the LAR, notify DADS at
1-800-458-9858 of that determination and request that DADS initiate a search
for the LAR;
(K) before a child who
is under 18 years of age, or who is 18-22 years of age and for whom an LAR has
been appointed, is Transferred to another facility operated by the transferring
facility, attempt to obtain consent for the transfer from the LAR, unless the
transfer is made because of a serious risk to the health and safety of the
child or another person; and
(L)
document compliance with the requirements of this paragraph in the child's
records.
(5) The
facility administrator must ensure that the social worker or other appropriate
staff, as needed, will contribute to the development of the permanency
plan.
(6) Paragraphs (3) - (5) of
this subsection do not apply to short-stay care of less than 14 days; however,
the facility must notify DADS, the CRCG, ECI, and the local school district as
required in paragraph (2)(A) - (D) of this subsection.
(c) If, within one year of the date DADS receives the notification described in subsection (b)(4)(J) of this section, DADS is unable to locate the LAR, DADS refers the case to:
(1) the Child Protective Services Division of
the Department of Family and Protective Services if the child is under 18 years
of age; or
(2) the Adult Protective
Services Division of the Department of Family and Protective Services if the
child is 18-22 years of age.
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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