Current through Reg. 50, No. 13; March 28, 2025
(a) The department will maintain a balanced
and effective service delivery system that affords a full range of services and
supports to individuals and their families.
(1) The continuum of care within the
department's service delivery system encompasses residential services in state
mental retardation (MR) facilities and community-based ICF/MR programs, waiver
services, and those services and supports provided or contracted by a mental
retardation authority (MRA).
(2)
Residential services in a state MR facility are intended to serve individuals
with severe or profound mental retardation and those individuals with mental
retardation who are medically fragile or who have behavioral
problems.
(b) If an
individual or LAR chooses services in a state MR facility, the MRA serving the
local service area where the individual lives will assist the individual or LAR
in accessing those services if the individual is eligible, i.e., meets the
criteria described in this subchapter for admission or commitment to a state MR
facility.
(c) It is the policy of
the State of Texas to strive to ensure that the basic needs for safety,
security, and stability are met for each individual under 22 years of age with
a developmental disability. A successful family is the most efficient and
effective way to meet those needs. The state and local communities must work
together to provide encouragement and support for well-functioning families and
ensure that each individual receives the benefits of being a part of a
successful permanent family as soon as possible.
(d) For an individual residing in a state MR
facility, the MRA designated in CARE for that individual is responsible for:
(1) maintaining a link between the individual
and the individual's home community;
(2) ensuring that the individual, LAR, and
state MR facility are provided with information concerning alternative living
arrangements that may be appropriate for the individual;
(3) assisting the individual or LAR who
decides to seek an alternative living arrangement in accessing the alternative
living arrangement, including working with other MRAs if the alternative living
arrangement being sought is outside the designated MRA's local service area;
and
(4) providing the state MR
facility with current, provider-furnished information about services and
supports in the MRA's local service area.
(e) The MRA and state MR facility will
provide the supports and encouragement necessary to ensure that each individual
or LAR is able to exercise choice and decision-making authority in all issues
related to services and supports.
(1) Whether
an individual lives in the community or is a resident of a state MR facility,
if the individual does not have an LAR and cannot communicate a preference
concerning services and supports, the MRA or state MR facility will involve
those persons who are actively involved with the individual in discussions
regarding services and supports.
(2) For the individual residing in a state MR
facility, the state MR facility must have procedures in place to ensure that an
individual residing in the state MR facility or the individual's LAR is
supported in making decisions concerning living options.
(3) The following principles support choice
and decision-making by the individual or LAR. Each MRA and state MR facility
must follow these principles when addressing issues of services and supports.
(A) The choices, preferences, expectations,
likes, and dislikes of the individual and LAR are the dominant force in
discussions about service planning.
(B) When considering Medicaid services, the
individual with the ability to provide legally adequate consent or LAR is
entitled to choose a provider from:
(i) a
list of ICF/MR Program providers qualified and willing to provide services and
supports to that individual; or
(ii) a list of waiver program providers
serving the area in which the individual or LAR is interested.
(C) The individual will be
provided with opportunities for appropriate training, counseling, and other
learning experiences that may facilitate the exercise of choice and
decision-making. If the individual has an LAR, these opportunities will be
provided only with the consent of the LAR.
(D) Whenever possible, the individual and the
LAR will be encouraged to visit a residential setting prior to the individual's
admission. If the individual does not have an LAR, persons who are actively
involved with the individual will be encouraged to visit a residential setting
prior to the individual's admission, unless the individual objects.
