§9.583: Txhml Program Principles for Mental Retardation Authorities

(a) An MRA must notify an applicant of a TxHmL Program vacancy in accordance with §9.566 of this subchapter (relating to Notification of Applicants).

(b) An MRA must process requests for enrollment in the TxHmL Program in accordance with §9.567 of this subchapter (relating to Process for Enrollment).

(c) An MRA must have a mechanism to ensure objectivity in the process to assist an individual or LAR in the selection of a program provider and a system for training all MRA staff who may assist an individual or LAR in such process.

(d) An MRA must ensure the development and completion of the initial IPC and all necessary assessments within 45 working days of the individual or LAR documenting the choice of TxHmL Program services over ICF/MR Program services in accordance with §9.566(d)(2) of this subchapter.

(e) An MRA must submit to DADS necessary documentation for an applicant's enrollment within 10 working days after the applicant's or LAR's selection of a program provider.

(f) An MRA must ensure that its employees and contractors possess legally necessary licenses, certifications, registrations, or other credentials and are in good standing with the appropriate professional agency before performing any function or delivering services.

(g) An MRA must ensure that an individual or LAR is informed orally and in writing of the following processes for filing complaints about service provision:

(1) processes for filing complaints with the MRA about the provision of service coordination; and

(2) processes for filing complaints about the provision of TxHmL Program services including:

(A) the telephone number of the MRA to file a complaint;

(B) the toll-free telephone number of DADS to file a complaint; and

(C) the toll-free telephone number of DFPS (1-800-647-7418) to file a complaint of abuse, neglect, or exploitation.

(h) An MRA must maintain for each individual:

(1) a current IPC;

(2) a current PDP;

(3) a current MR/RC Assessment; and

(4) current service information.

(i) For an individual receiving TxHmL Program services within the MRA's local service area, the MRA must provide the individual's program provider a copy of the individual's current PDP, IPC, and MR/RC Assessment.

(j) An MRA must employ service coordinators who:

(1) meet the minimum qualifications and staff training requirements specified in Chapter 2, Subchapter L of this title (relating to Service Coordination for Individuals with Mental Retardation); and

(2) have received training about the TxHmL Program, including the requirements of this subchapter and the TxHmL Program service components as specified in §9.555 of this subchapter (relating to Definitions of TxHmL Program Service Components).

(k) An MRA must ensure that a service coordinator:

(1) initiates, coordinates, and facilitates the person-directed planning process to meet the desires and needs as identified by an individual and LAR in the individual's PDP;

(2) coordinates the development and implementation of the individual's PDP;

(3) submits a correctly completed request for authorization of payment from non-TxHmL Program sources for which an individual may be eligible;

(4) coordinates and develops an individual's IPC based on the individual's PDP;

(5) coordinates and monitors the delivery of TxHmL Program and non-TxHmL Program services;

(6) integrates various aspects of services delivered under the TxHmL Program and through non-TxHmL Program sources;

(7) records each individual's progress;

(8) develops discharge and transfer plans, when necessary; and

(9) keeps records as they pertain to the implementation of an individual's PDP.

(l) An MRA must ensure that an individual or LAR is informed of the name of the individual's service coordinator and how to contact the service coordinator.

(m) A service coordinator must:

(1) assist the individual or LAR in exercising the legal rights of the individual as a citizen and as a person with a disability;

(2) assist the individual's LAR or family members to encourage the individual to exercise the individual's rights;

(3) inform the individual or LAR orally and in writing of:

(A) the eligibility criteria for participation in the TxHmL Program;

(B) the services and supports provided by the TxHmL Program and the limits of those services and supports; and

(C) the reasons an individual may be discharged from the TxHmL Program as described in §9.570 of this subchapter (relating to Permanent Discharge from the TxHmL Program);

(4) ensure that the individual and LAR participate in developing a personalized PDP and IPC that meet the individual's identified needs and service outcomes and that the individual's PDP is updated when the individual's needs or outcomes change but not less than annually;

(5) ensure that a restriction affecting the individual is approved by the individual's service planning team before the imposition of the restriction;

(6) ensure that the individual or LAR is informed of decisions regarding denial or termination of services and the individual's or LAR's right to request a fair hearing as described in §9.571 of this subchapter (relating to Fair Hearings);

(7) ensure that, if needed, the individual or LAR participates in developing a discharge plan that addresses assistance for the individual after the individual is discharged from the TxHmL Program; and

(8) inform the individual or LAR that the service coordinator will assist the individual or LAR to transfer the individual's TxHmL Program services from one program provider to another program provider as chosen by the individual or LAR.

(n) When a change to an individual's PDP or IPC occurs or is needed, the service coordinator must communicate the need for the change to the individual or LAR, the individual's program provider, and other appropriate persons as necessary.

(o) At least 30 calendar days before the expiration of an individual's IPC, the service coordinator must:

(1) update the individual's PDP in conjunction with the individual's service planning team; and

(2) submit the updated information to the program provider for completion of necessary support methodologies to be incorporated in the updated PDP.

(p) A service coordinator must:

(1) review the status of an individual who is temporarily discharged at least every 90 calendar days following the effective date of the temporary discharge and document in the individual's record the reasons for continuing the discharge; and

(2) if the temporary discharge continues 270 calendar days, submit written documentation of the 90, 180, and 270 calendar day reviews to DADS for review and approval to continue the temporary discharge status.

(q) A service coordinator must:

(1) inform the individual or LAR orally and in writing, of the requirements described in subsection (m) of this section:

(A) upon receipt of DADS approval of the enrollment of the individual;

(B) if the requirements described in subsection (m) of this section are revised;

(C) at the request of the individual or LAR; and

(D) if the legal status of the individual changes; and

(2) document that the information described in paragraph (1) of this subsection was provided to the individual or LAR.

(r) A service coordinator must, at least annually:

(1) inform the individual or LAR of the individual's right to participate in CDS and discontinue participation in CDS at any time, except as provided in §41.405(a) of this title (relating to Suspension of Participation in CDS);

(2) provide the individual or LAR a copy of Forms 1581, 1582, and 1583, which are available at http://www.dads.state.tx.us/handbooks/forms/default.asp?HB=CDS, and which contain information about CDS, including financial management services and support consultation;

(3) provide an oral explanation of the information contained in Forms 1581, 1582, and 1583 to the individual or LAR; and

(4) provide the individual or LAR the opportunity to choose to participate in CDS and document the individual's choice on Form 1584, which is available at http://www.dads.state.tx.us/handbooks/forms/default.asp?HB=CDS.

(s) If an individual or LAR chooses to participate in CDS, the service coordinator must:

(1) provide names and contact information to the individual or LAR regarding all CDSAs providing services in the MRA's local service area;

(2) document the individual's or LAR's choice of CDSA on Form 1584;

(3) document, in the individual's PDP, a description of the service components provided through CDS; and

(4) document, in the individual's PDP, a description of the individual's service back-up plan.

(t) The service coordinator must document in the individual's PDP that the information described in subsections (r) and (s)(1) of this section was provided to the individual or LAR.

(u) For an individual participating in CDS, the MRA must recommend to DADS that financial management services and support consultation, if applicable, be terminated if the service coordinator determines that:

(1) the individual's continued participation in CDS poses a significant risk to the individual's health, safety or welfare; or

(2) the individual or LAR has not complied with Chapter 41, Subchapter B of this title (relating to Responsibilities of Employers and Designated Representatives).

(v) If an MRA makes a recommendation under subsection (u) of this section, the MRA must:

(1) submit the individual's IPC to DADS electronically; and

(2) submit the following, in writing, to the Department of Aging and Disability Services, Access and Intake, Program Enrollment, P.O. Box 149030, Mail Code W-354, Austin, Texas 78714-9030:

(A) a description of the service recommended for termination;

(B) the reasons why termination is recommended;

(C) a description of the attempts to resolve the issues before recommending termination; and

(D) other supporting documentation, as appropriate.

Comments

Source Note: The provisions of this §9.583 adopted to be effective January 5, 2003, 27 TexReg 12254; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective March 1, 2007, 32 TexReg 544