Current through Reg. 49, No. 38; September 20, 2024
(a) The program
provider must:
(1) assist the individual or
LAR in understanding the requirements for participation in the TxHmL Program
and include the individual or LAR in planning service provision and any changes
to the plan for service provision if changes become necessary;
(2) assist and cooperate with the
individual's or LAR's request to transfer to another program
provider;
(3) assist the individual
to access public accommodations or services available to all
citizens;
(4) assist the individual
to manage the individual's financial affairs upon documentation of the
individual's or LAR's written request for such assistance;
(5) ensure that any restriction affecting the
individual is approved by the individual's service planning team before the
imposition of the restriction;
(6)
inform the individual or LAR about the individual's health, mental condition,
and related progress;
(7) inform
the individual or LAR of the name and qualifications of any person serving the
individual and the option to choose among various available service
providers;
(8) provide the
individual or LAR access to TxHmL Program and CFC records, including, if
applicable, financial records maintained on the individual's behalf, about the
individual and the delivery of services by the program provider to the
individual;
(9) assist the
individual to communicate by phone or by mail during the provision of TxHmL
Program services or CFC services unless the service planning team has agreed to
limit the individual's access to communicating by phone or by mail;
(10) assist the individual, as specified in
the individual's PDP, to attend religious activities as chosen by the
individual or LAR;
(11) ensure the
individual is free from unnecessary restraints during the provision of TxHmL
Program services or CFC services;
(12) regularly inform the individual or LAR
about the individual's or program provider's progress or lack of progress made
in the implementation of the PDP;
(13) receive and act on complaints about the
TxHmL Program services or CFC services provided by the program
provider;
(14) ensure that the
individual is free from abuse, neglect, or exploitation by program provider
staff members, service providers, and volunteers;
(15) provide active, individualized
assistance to the individual or LAR in exercising the individual's rights and
exercising self-advocacy, including:
(A)
making complaints;
(B) registering
to vote;
(C) obtaining citizenship
information and education;
(D)
obtaining advocacy services; and
(E) obtaining information regarding legal
guardianship;
(16)
provide the individual privacy during treatment and care of personal
needs;
(17) include the
individual's LAR in decisions involving the planning and provision of TxHmL
Program services and CFC services;
(18) inform the individual or LAR of the
process for reporting a complaint to HHSC or the LIDDA when the program
provider's resolution of a complaint is unsatisfactory to the individual or
LAR, including the HHSC Complaint and Incident Intake toll-free telephone
number, 1-800-458-9858, to initiate complaints and the LIDDA telephone number
to initiate complaints;
(19) ensure
the individual is free from seclusion;
(20) inform the individual or LAR, orally and
in writing, of the requirements described in paragraphs (1) - (19) of this
subsection:
(A) when the individual is
enrolled in the program provider's program;
(B) if the requirements described in
paragraphs (1) - (19) of this subsection are revised;
(C) at the request of the individual or LAR;
and
(D) if the legal status of the
individual changes;
(21)
obtain an acknowledgement stating that the information described in paragraph
(20) of this subsection was provided to the individual or LAR and that is
signed by:
(A) the individual or
LAR;
(B) the program provider staff
person providing such information; and
(C) a third-party witness; and
(22) notify the individual's
service coordinator of an individual's or LAR's expressed interest in the CDS
option and document such notification.
(b) The program provider must make available
all records, reports, and other information related to the delivery of TxHmL
Program services and CFC services as requested by HHSC, other authorized
agencies, or CMS and deliver such items, as requested, to a specified
location.
(c) At least annually,
the program provider must conduct a satisfaction survey of individuals, their
families, and LARs, and take action regarding any areas of
dissatisfaction.
(d) The program
provider must comply with §
49.309 of this
title (relating to Complaint Process).
(e) In all respite facilities, 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 contract; and
(3) the name of the legal entity named on the
contract.
(f) At least
annually, the program provider must review:
(1) all final investigative reports from HHSC
and, based on the review, identify program process improvements that help
prevent the occurrence of abuse, neglect, and exploitation and improve the
delivery of services;
(2)
complaints, as described in §
49.309 of this
title, and identify program process improvements to reduce the filing of
complaints;
(3) the reasons for
suspensions, terminations, and transfers and identify any related need for
program process improvements; and
(4) critical incident data reported in
accordance with subsection (n) of this section and identify program process
improvements that help prevent the reoccurrence of critical incidents and
improve the delivery of services.
(g) A program provider must ensure that all
personal information maintained by the program provider or its contractors
concerning an individual, such as lists of names, addresses, and records
created or obtained by the program provider or its contractor, is kept
confidential, that the use or disclosure of such information and records is
limited to purposes directly connected with the administration of the TxHmL
Program or provision of CFC services, and is otherwise neither directly nor
indirectly used or disclosed unless the written permission of the individual to
whom the information applies or the individual's LAR is obtained before the use
or disclosure.
(h) The program
provider must ensure that:
(1) the individual
or LAR has agreed in writing to all charges assessed by the program provider
against the individual's personal funds before the charges are assessed;
and
(2) charges for items or
services are reasonable and comparable to the costs of similar items and
services generally available in the community.
(i) The program provider must not charge an
individual or LAR for costs for items or services reimbursed through the TxHmL
Program or through CFC.
(j) At the
written request of an individual or LAR, the program provider:
(1) must manage the individual's personal
funds entrusted to the program provider;
(2) must not commingle the individual's
personal funds with the program provider's funds; and
(3) must maintain a separate, detailed record
of all deposits and expenditures for the individual.
(k) When a behavioral support plan includes
techniques that involve restriction of individual rights or intrusive
techniques, the program provider must ensure that the implementation of such
techniques includes:
(1) approval by the
individual's service planning team;
(2) written consent of the individual or
LAR;
(3) verbal and written
notification to the individual or LAR of the right to discontinue participation
in the behavioral support plan at any time;
(4) assessment of the individual's needs and
current level/severity of the behavior targeted by the plan;
(5) use of techniques appropriate to the
level/severity of the behavior targeted by the plan;
(6) a written behavioral support plan
developed by a service provider of behavioral support with input from the
individual, LAR, the individual's service planning team, and other professional
personnel;
(7) collection and
monitoring of behavioral data concerning the targeted behavior;
(8) allowance for the decrease in the use of
intervention techniques based on behavioral data;
(9) allowance for revision of the behavioral
support plan when the desired behavior is not displayed or techniques are not
effective;
(10) consideration of
the effects of the techniques in relation to the individual's physical and
psychological well-being; and
(11)
at least annual review by the individual's service planning team to determine
the effectiveness of the program and the need to continue the
techniques.
(l) A program
provider must report the death of an individual:
(1) to HHSC and the LIDDA by the end of the
next business day after the program provider becomes aware of the death;
and
(2) if the program provider
reasonably believes that the LAR does not know of the individual's death, to
the LAR as soon as possible, but not later than 24 hours after the program
provider becomes aware of the death.
(m) A program provider must not retaliate
against:
(1) a staff member, service
provider, individual, or other person who files a complaint, presents a
grievance, or otherwise provides good faith information relating to the
possible abuse, neglect, or exploitation of an individual, including:
(A) the use of seclusion; and
(B) the use of a restraint not in compliance
with federal and state laws, rules, and regulations; and
(2) an individual because a person on behalf
of the individual files a complaint, presents a grievance, or otherwise
provides good faith information relating to the possible abuse, neglect, or
exploitation of an individual, including:
(A)
the use of seclusion; and
(B) the
use of a restraint not in compliance with federal and state laws, rules, and
regulations.
(n) A program provider must enter critical
incident data in the HHSC data system no later than the last calendar day of
the month that follows the month being reported in accordance with the TxHmL
Provider User Guide.
(o) A program
provider must ensure that:
(1) the name and
phone number of an alternate to the Chief Executive Officer (CEO) of the
program provider is entered in the HHSC data system; and
(2) the alternate to the CEO:
(A) performs the duties of the CEO during the
CEO's absence; and
(B) if the CEO
is named as an alleged perpetrator of abuse, neglect, or exploitation of an
individual, acts as the contact person in an HHSC investigation and complies
with §9.585(d) - (f) of this subchapter (relating to Certification
Principles: Requirements Related to the Abuse, Neglect, and Exploitation of an
Individual).
