(a) A program provider must provide or ensure the provision
of the following therapies:
(1) occupational therapy;
(2) physical therapy;
(3) speech-language pathology;
(4) audiology; and
(5) dietary services.
(b) A program provider must ensure a therapy:
(1) is delivered by an appropriately licensed service
provider, as follows:
(A) for occupational therapy, an occupational therapist
licensed in accordance with Texas Occupations Code Chapter 454;
(B) for physical therapy, a physical therapist licensed
in accordance with Texas Occupations Code Chapter 453;
(C) for speech-language pathology, a speech-language
pathologist licensed in accordance with Texas Occupations Code Chapter
401;
(D) for audiology, an audiologist licensed in accordance
with Texas Occupations Code Chapter 401; or
(E) for dietary services, a dietitian licensed in accordance
with Texas Occupations Code Chapter 701.
(2) includes, as appropriate, the following activities:
(A) screening and assessment;
(B) developing and implementing a treatment plan that,
as appropriate, includes a plan to:
(i) transfer a therapy task to an unlicensed service
provider; and
(ii) change the role of the therapist to a supervisory
role;
(C) directing therapeutic intervention in accordance
with the appropriate chapter of the Texas Occupations Code;
(D) consulting with or training of family members and
other service providers;
(E) participating on an individual's service planning
team, when appropriate;
(F) informing the physician and other appropriate professionals
of changes in the individual's health status that may require a change
in the IPC;
(G) preparing a report to the case manager as described
in subsection (g) of this section;
(H) supervising and training an unlicensed service
provider within the scope of applicable state statutes and rules;
and
(I) conducting assessments and preparing specifications
for the procurement of an adaptive aid or minor home modification;
and
(3) is provided to an individual at a location agreeable
to the individual or LAR.
(c) A program provider must:
(1) obtain a physician's order for therapy before the
delivery of the therapy;
(2) ensure that the physician's order includes the
following:
(A) individual's name;
(B) type of therapy;
(C) frequency and duration of therapy;
(D) other instructions, if applicable;
(E) physician's name and medical specialty; and
(F) effective date of the order; and
(3) retain the physician's order in the individual's
record.
(d) A program provider may accept faxed physician's
orders for therapy services.
(1) The program provider does not have to obtain a
countersignature of the faxed orders by the prescribing physician.
(2) The program provider must ensure the faxed orders
are legible.
(e) If requested by an individual's service planning
team, a service provider of a therapy may screen an individual for
therapy services without obtaining a physician's order.
(f) A program provider may bill HHSC only for the following
therapy activities:
(1) screening, assessing, and evaluating the need for
services;
(2) developing and implementing a treatment plan;
(3) periodically evaluating the individual's progress
toward achieving the goals and outcomes described in the IPP for the
therapy service and providing updates to the program provider;
(4) providing direct therapeutic intervention;
(5) interacting with the individual or LAR regarding
the individual's condition and progress toward or achievement of goals;
(6) training the individual to use an adaptive aid;
(7) delegating therapy tasks to an unlicensed person
in accordance with rules of the appropriate licensing board;
(8) consulting with family members and other service
providers regarding the individual's DBMD Program and CFC services;
(9) informing the physician and the program provider
of changes in the individual's health status requiring a service plan
change;
(10) participating in service planning team meetings,
if requested;
(11) supervising and training an unlicensed service
provider within the scope of the therapy examining board rules;
(12) participating in a fair hearing at the request
of a member of the service planning team to provide information within
the scope of the service provider's license;
(13) assisting with writing specifications for adaptive
aids; and
(14) providing consultation or justification for the
procurement of an adaptive aid or minor home modification.
(g) A program provider must ensure an appropriately
licensed therapist provides a report to the individual's case manager
at least 10 calendar days before the review described in §260.77(a)
of this chapter (relating to Renewal and Revision of an IPP and IPC)
that:
(1) reviews the individual's progress toward achieving
the goals and outcomes described in the IPP for that therapy;
(2) reviews whether the services are meeting the individual's
needs;
(3) documents whether the individual's needs have changed;
and
(4) documents attempts to teach maintenance services
and techniques to other service providers.
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