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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 550LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER CGENERAL PROVISIONS
DIVISION 1OPERATIONS AND SAFETY PROVISIONS
RULE §550.209Emergency Preparedness Planning and Implementation

(a) A center must have a written emergency preparedness and response plan that comprehensively describes its approach to an emergency situation, including a public health disaster that could affect the need for its services or its ability to provide those services.

(b) Administration. A center must:

  (1) develop and implement a written plan as described in subsection (c) of this section;

  (2) maintain a current written copy of the plan in a central location that is accessible to all staff at all times and at a work station of each staff who has responsibilities under the plan;

  (3) evaluate the plan to determine if information in the plan must change:

    (A) no later than 30 days after an emergency situation;

    (B) as soon as possible after the remodeling or construction of an addition to the center; and

    (C) at least annually;

  (4) revise the plan no later than 30 days after information in the plan changes; and

  (5) maintain documentation of compliance with this section.

(c) Emergency Preparedness and Response Plan. A center's plan must:

  (1) include a risk assessment of all potential external and internal emergency situations that pose a risk for harm to minors or property and are relevant to the provision of services at a center and the center's geographical area, such as fire, earthquake, hurricane, tornado, flood, extreme snow and ice conditions for the area, wildfire, terrorism, hazardous materials accident, thunderstorm, wind storm, wave action, oil spill or other water contamination, epidemic, air contamination, infestation, explosion, riot, hostile military or paramilitary action, energy emergency, water outage, failure of heating and cooling systems, power outage, bomb threat, and explosion;

  (2) include a description of minors served at the center;

  (3) include a description of the services and assistance needed by minors served at the center in an emergency situation;

  (4) include a section for each core function of emergency management, as described in subsection (d) of this section, that is based on the center's decision to either temporarily shelter-in-place or evacuate during an emergency situation; and

  (5) include a section for a fire safety plan that complies with §15.205 of this division (relating to Safety Provisions).

(d) Plan Requirements Regarding Eight Core Functions of Emergency Management.

  (1) Direction and control. A center's plan must contain a section for direction and control that:

    (A) designates by name or title the emergency preparedness coordinator (EPC) who is the staff person with the authority to manage the center's response to an emergency situation in accordance with the plan, and includes the EPC's current phone number;

    (B) designates by name or title the alternate EPC who is the staff person with the authority to act as the EPC if the EPC is unable to serve in that capacity, and includes the alternate EPC's current phone number;

    (C) documents the name and contact information for the local emergency management coordinator (EMC) for the area where the center is located, as identified by the office of the local mayor or county judge;

    (D) includes procedures for notifying the local EMC of the execution of the plan;

    (E) includes a plan for coordinating a staffing response to an emergency situation; and

    (F) includes a plan for relocating minors to a safe location that is based on the type of emergency situation occurring and a center's decision to either temporarily shelter-in-place or evacuate during an emergency situation.

  (2) Warning. A center's plan must contain a section for warning that:

    (A) describes how the EPC will be notified of an emergency situation;

    (B) identifies who the EPC will notify of an emergency situation and when the notification will occur, including during off hours, weekends, and holidays; and

    (C) addresses monitoring local news and weather reports regarding a disaster or potential disaster, taking into consideration factors such as geographic-specific natural disasters, whether a disaster is likely to be addressed or forecast in the reports, and the conditions, natural or otherwise, that would cause staff to monitor news and weather reports for a disaster.

  (3) Communication. A center's plan must contain a section for communication that:

    (A) identifies the center's primary mode of communication to be used during an emergency situation and the center's alternate mode of communication to be used in the event of power failure or the loss of the center's primary mode of communication in an emergency situation;

    (B) requires posting of the emergency contact number for the local fire department, ambulance, and police at or near each telephone at the center in communities where a 911 emergency management system is unavailable;

    (C) includes procedures for maintaining a current list of telephone numbers for:

      (i) minors' parents;

      (ii) safe locations; and

      (iii) center staff;

    (D) identifies the location of the lists described in subparagraph (C) of this paragraph;

    (E) includes procedures to notify:

      (i) center staff about an emergency situation;

      (ii) a contact person at a safe location about an impending or actual evacuation of minors; and

      (iii) a minor's parent about an impending or actual evacuation;

    (F) provides a method for staff to obtain a minor's emergency information during an emergency situation;

    (G) includes procedures for the center to maintain communication with:

      (i) center staff during an emergency situation;

      (ii) a contact person at a safe location; and

      (iii) the authorized driver of a vehicle transporting minors, medication, medical records, food, water, equipment, or supplies during an evacuation; and

    (H) includes procedures for reporting to DADS an emergency situation that caused the death or serious injury of a minor as follows:

      (i) by telephone at 1-800-458-9858 or by using the DADS website, no later than 24 hours after the death or serious injury of a minor; and

      (ii) in writing on the DADS Provider Investigation Report Form no later than five days after the center makes the report.

  (4) Shelter-in-place. A center's plan must contain a section that includes procedures to temporarily shelter minors in place during an emergency situation.

  (5) Evacuation. A center's plan must contain a section for evacuation that:

    (A) requires posting center evacuation routes conspicuously throughout the center;

    (B) identifies evacuation destinations and routes for an authorized driver, and includes a map that shows the destinations and routes;

    (C) includes procedures for implementing a decision to evacuate minors to a safe location;

    (D) includes a current copy of an agreement with a pre-arranged safe location, outlining arrangements for receiving minors in the event of an evacuation, if the evacuation destination identified in accordance with subparagraph (B) of this paragraph is a prearranged safe location that is not owned by the same entity as the evacuating center;

    (E) includes procedures for:

      (i) ensuring that staff accompany evacuating minors;

      (ii) ensuring that minors and staff present at the center have been evacuated;

      (iii) ensuring that visitors, including parents and service providers, evacuate the center;

      (iv) accounting for minors and staff after they have been evacuated;

      (v) accounting for minors absent from the center at the time of the evacuation;

      (vi) releasing minor information in an emergency situation to promote continuity of a minor's care, in accordance with state law;

      (vii) includes procedures for notifying the local EMC regarding an evacuation of the center, if required by the local EMC guidelines;

      (viii) contacting the local EMC, if required by the local EMC guidelines, to find out if it is safe to return to the geographical area after an evacuation; and

      (ix) determining if it is safe to re-enter and occupy the center after an evacuation;

      (x) includes procedures for notifying DADS by telephone, at 1-800-458-9858, no later than 24 hours after an evacuation that minors have been evacuated; and

      (xi) includes procedures for notifying DADS Regulatory Services by telephone immediately after the EPC makes a decision to evacuate all minors from the center.

  (6) Transportation. A center's plan must contain a section for transportation that:

    (A) arranges for a sufficient number of vehicles to safely evacuate all minors;

    (B) identifies staff or contractors designated to drive a center owned, leased, or rented vehicle during an evacuation;

    (C) includes procedures for safely transporting minors and staff involved in an evacuation; and

    (D) includes procedures for safely transporting and having timely access to oxygen, medications, medical records, food, water, equipment, and supplies needed during an evacuation.

  (7) Health and Medical Needs. A center's plan must contain a section for health and special needs that:

    (A) identifies the types of services and medical equipment used by minors, including oxygen, respirator care, or hospice services; and

    (B) ensures that a minor's needs identified in subparagraph (A) of this paragraph are met during an emergency situation.

  (8) Resource Management. A center's plan must contain a section for resource management that:

    (A) includes a plan for identifying medications, medical records, food, water, equipment, and supplies needed during an emergency situation;

    (B) identifies staff who are assigned to locate the items in subparagraph (A) of this paragraph and who must ensure the transportation of the items during an emergency situation; and

    (C) includes procedures to ensure that medications are secure and maintained at the proper temperature during an emergency situation.

(e) Training. A center must:

  (1) train staff on their responsibilities under the plan no later than 30 days from their hire date;

  (2) train staff on the staff responsibilities under the plan at least annually and when the staff member's responsibilities under the plan change; and

  (3) conduct one unannounced annual drill with staff for severe weather and other emergency situations identified by a center as likely to occur, based on the results of the risk assessment required by subsection (c) of this section.

(f) Fire Emergency Response Plan.

  (1) The center must have a comprehensive written fire emergency response plan. Copies of the plan must be available to all staff. The center must periodically instruct and inform staff about the duties of their positions under the plan. The written fire emergency response plan must provide for the following:

    (A) use of alarms;

    (B) transmission of an alarm to a fire department;

    (C) response to alarms;

    (D) isolation of fire;

    (E) evacuation of the immediate area;

    (F) preparation of floors and building for evacuation; and

    (G) fire extinguishment;

  (2) The fire emergency response plan must include procedures to contact DADS by telephone, at 1-800-458-9858, no later than 24 hours after activation of its Fire Emergency Response Plan.

  (3) The staff must conduct emergency egress and relocation drills as follows:

    (A) perform a monthly fire drill with all occupants of the building at expected and unexpected times and under varying conditions;

    (B) relocate, during the monthly drill, all occupants of the building to a predetermined location where occupants must remain until a recall or dismissal is given; and

    (C) complete the DADS Fire Drill Report Form for each required drill.

  (4) The EPC or a designee must conduct fire prevention inspections on a monthly basis and prepare a report of the inspection results. The center must maintain copies of the fire prevention inspection report prepared by the center within the last 12 months. The center must post a copy of the most recent fire prevention inspection report in a conspicuous place at the center.


Source Note: The provisions of this §550.209 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875

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