| (a) Staff qualifications.
(1) An individualized skills and socialization provider
must:
(A) employ an administrator;
(B) ensure the administrator meets the requirements
outlined in paragraph (2) of this subsection; and
(C) have a policy regarding the delegation of responsibility
in the administrator's absence.
(2) A service provider of individualized skills and
socialization must be at least 18 years of age and:
(A) have a high school diploma or a certificate recognized
by a state as the equivalent of a high school diploma; or
(B) have documentation of a proficiency evaluation
of experience and competence to perform the job tasks that includes:
(i) a written competency-based assessment of the ability
to document service delivery and observations of the individuals receiving
services; and
(ii) at least three written personal references from
persons not related by blood that indicate the ability to provide
a safe, healthy environment for the individuals receiving services.
(3) A service provider of individualized skills and
socialization who provides transportation must:
(A) have a valid driver's license; and
(B) transport individuals in a vehicle insured in accordance
with state law.
(b) Staffing. An individualized skills and socialization
provider must ensure that:
(1) an individual whose needs cannot be met by the
individualized skills and socialization provider is not admitted or
retained;
(2) the ratio of service providers to individuals is
maintained in accordance with §260.507 of this title (relating
to Staffing Ratios), §262.917 of this title (relating to Staffing
Ratios for Off-Site Individualized Skills and Socialization), and §263.2017
of this title (relating to Staffing Ratios for Off-Site Individualized
Skills and Socialization), during the provision of off-site individualized
skills and socialization, including during transportation; and
(3) sufficient staff are on duty at all times during
the provision of on-site individualized skills and socialization to
ensure:
(A) the health and safety of the individuals;
(B) supervision is provided in accordance with the
needs of an individual; and
(C) individualized skills and socialization are provided
in accordance with an individual's individual plan of care (IPC),
individual program plan (IPP), person-directed plan (PDP), and implementation
plan, as applicable.
(c) Staff responsibilities.
(1) The administrator:
(A) manages the individualized skills and socialization
services and the on-site individualized skills and socialization location;
(B) ensures staff are trained;
(C) supervises staff; and
(D) maintains all records.
(2) A service provider:
(A) delivers individualized skills and socialization
services;
(B) assists with recreational activities; and
(C) provides protective supervision through observation
and monitoring.
(d) An individualized skills and socialization provider
must make both on-site and off-site individualized skills and socialization
available to an individual, unless the individualized skills and socialization
provider provides off-site individualized skills and socialization
only.
(e) An individualized skills and socialization provider
must ensure that on-site individualized skills and socialization:
(1) is provided in a building or a portion of a building
that is owned or leased by an individualized skills and socialization
provider; and
(2) is not provided in a prohibited setting for an
individual, as set forth in the rules governing the HCS Program.
(f) An individualized skills and socialization provider
must ensure that off-site individualized skills and socialization:
(1) are provided in a community setting chosen by the
individual from among available community setting options;
(2) includes transportation necessary for the individual's
participation in off-site individualized skills and socialization;
and
(3) is not provided in:
(A) a building in which on-site individualized skills
and socialization are provided;
(B) a prohibited setting for an individual, as set
forth in the rules governing the HCS Program, unless:
(i) provided in an event open to the public; or
(ii) the activity is a volunteer activity performed
by an individual in such a setting; or
(C) the residence of an individual or another person,
unless the activity is a volunteer activity performed by an individual
in the residence.
(g) An individualized skills and socialization provider
must provide individualized skills and socialization:
(1) in the Deaf Blind with Multiple Disabilities (DBMD)
program, in accordance with an individual's individual plan of care
(IPC) and individual program plan (IPP); and
(2) in the Texas Home Living (TxHmL) program and Home
and Community-based Services (HCS) program, in accordance with an
individual's person-directed plan (PDP), IPC, and implementation plan.
(h) An individualized skills and socialization provider
must not require an individual to take a skills test or meet other
requirements to receive off-site individualized skills and socialization.
(i) If an individual does not want to participate
in an activity the individual scheduled for on-site individualized
skills and socialization or off-site individualized skills and socialization,
or the legally authorized representative (LAR) does not want the individual
to participate in such activity, the individualized skills and socialization
provider must document the decision not to participate in the individual's
record.
(j) An individualized skills and socialization provider
must provide on-site and off-site individualized skills and socialization
in-person.
(k) Training.
(1) Initial training.
(A) An individualized skills and socialization provider
must:
(i) provide service providers with training on fire,
disaster, and their responsibilities under the emergency response
plan developed in accordance with §559.229 of this subchapter
(relating to Environment and Emergency Response Plan) within three
workdays after the start of employment and document the training in
the individualized skills and socialization provider's records; and
(ii) provide service providers a minimum of eight hours
of training during the first three months after the start of employment
and document the training in the records of the individualized skills
and socialization provider.
(B) The training provided in accordance with subparagraph
(A)(ii) of this paragraph must include:
(i) any nationally or locally recognized adult CPR
course or certification;
(ii) first aid;
(iii) infection control;
(iv) overview of the population served by the individualized
skills and socialization provider; and
(v) identification and reporting of abuse, neglect,
or exploitation.
(2) Ongoing training.
(A) An individualized skills and socialization provider
must:
(i) ensure that service providers maintain current
certification in CPR;
(ii) train on responsibilities under the emergency
response plan developed in accordance with §559.229;
(iii) train on infection control policies and procedures
developed in accordance with subsection (n) of this section; and
(iv) train on the identification and reporting of abuse,
neglect, or exploitation.
(l) Medications.
(1) Administration.
(A) If an individual cannot or chooses not to self-administer
his or her medications, an individualized skills and socialization
provider must provide assistance with such medications and the performance
of related tasks if:
(i) a registered nurse has assessed the assistance
and related tasks and delegated such to the individualized skills
and socialization provider in accordance with state law and rules;
or
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