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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 554NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER IRESIDENT ASSESSMENT
RULE §554.805Permanency Planning for a Resident Under 22 Years of Age

(a) Definitions. The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

  (1) Permanency planning--A philosophy and planning process that focuses on the outcome of family support by facilitating a permanent living arrangement, with the primary feature of an enduring and nurturing parental relationship. Family-directed planning empowers the family of a child under the age of 18 to direct the development of supports and services that meet the child and family's personal outcomes as related to that child. Person-directed planning empowers the child who is between 18 and 22 years of age to direct the development of a plan of supports and services that meets the needs for self-determination.

  (2) Child--A person with a developmental disability who is under 22 years of age.

  (3) CRCG (Community resource coordination group)--A local interagency group composed of public and private agencies that develops service plans for individuals whose needs can be met only through interagency coordination and cooperation. The group's role and responsibilities are described in the Memorandum of Understanding on Coordinated Services to Persons Needing Services from More Than One Agency, available on the Health and Human Services Commission website at www.hhsc.state.tx.us/crcg/crcg.htm.

  (4) Emergency situation--An unexpected situation involving a child's health, safety, or welfare, of which a person of ordinary prudence would determine that the LAR should be informed, such as:

    (A) a child needing emergency medical care;

    (B) a child being removed from his residence by law enforcement;

    (C) a child leaving his residence without notifying staff and not being located; and

    (D) a child being moved from his residence to protect the child (for example, because of a hurricane, fire, or flood).

  (5) LAR (legally authorized representative)--A person authorized by law to act on behalf of a resident with regard to a matter described in this subchapter, which may include a parent, guardian, managing conservator of a minor individual, a guardian of an adult individual, or legal representative of a deceased individual.

  (6) Permanency planner--A person assigned by DADS to conduct permanency planning activities for a child who resides in a facility.

(b) Facility responsibilities regarding permanency planning.

  (1) A facility must request a Preadmission Screening and Resident Review (PASARR) on every child who is a potential admission to a facility, as well as on all children currently residing in a facility who have not had a previous PASARR completed. Documentation regarding the request for or completion of a PASARR must be kept in the chart.

  (2) A facility must notify the following entities of the child's admission not later than the third day after a child is initially placed in a facility:

    (A) DADS via fax, using DADS Form 2437, Notification of Nursing Facility Admission of Individual Under Age 22;

    (B) the CRCG in the county where the LAR resides (see www.hhsc.state.tx.us/crcg/crcg.htm for a listing of CRCG chairpersons by county);

    (C) the local office of the Early Childhood Intervention (ECI) Program of the Texas Department of Assistive and Rehabilitative Services, if a child is less than three years of age (see www.dars.state.tx.us/ecis/index.shtml or call 1-800-628-5115 for a listing of ECI programs by county); and

    (D) the local school district, if a child is 3 to 22 years of age, with which the facility must coordinate educational opportunities (See §19.1934 of this title (relating to Educational Requirements for Persons under Age 22)).

  (3) A facility must keep in a separate section at the front of each child's records:

    (A) documentation regarding the notifications required in paragraph (2) of this subsection;

    (B) a copy of all PASARR documents; and

    (C) a copy of the current permanency plan.

  (4) A facility must:

    (A) cooperate with the permanency planner by:

      (i) allowing access to a child's records or providing other information in a timely manner as requested by the permanency planner or the Health and Human Services Commission;

      (ii) participating in meetings to review the child's permanency plan; and

      (iii) identifying, in coordination with the permanency planner, activities, supports, and services that can be provided by the family, LAR, facility, or the permanency planner to prepare the child for an alternative living arrangement;

    (B) encourage regular contact between the child and LAR and, if desired by the child and LAR, between the child and advocates and friends in the community to continue supportive and nurturing relationships;

    (C) encourage participation in the comprehensive care plan meetings by the LAR, and, if desired by the child or LAR, by family members, advocates, and friends in the community;

    (D) make reasonable accommodations to promote the participation of the LAR in all planning and decision-making regarding the child's care, including participating in:

      (i) the initial development and annual review of the child's comprehensive care plan;

      (ii) decision-making regarding the child's medical care;

      (iii) routine interdisciplinary team meetings; and

      (iv) decision-making and other activities involving the child's health and safety;

    (E) ensure that reasonable accommodations include:

      (i) conducting a meeting in person or by telephone, as mutually agreed upon by the facility and the LAR;

      (ii) conducting a meeting at a time and, if the meeting is in person, at a location that is mutually agreed upon by the facility and the LAR;

      (iii) if the LAR has a disability, providing reasonable accommodations in accordance with the Americans with Disabilities Act, including providing an accessible meeting location or a sign language interpreter, if appropriate; and

      (iv) providing a language interpreter, if appropriate;

    (F) upon admission and annually thereafter:

      (i) request from and encourage an LAR to provide the following information for a child during the annual comprehensive care plan meeting and, for an applicant, upon admission:

        (I) the LAR's:

          (-a-) name;

          (-b-) address;

          (-c-) telephone number;

          (-d-) driver license number and state of issuance or personal identification card number issued by the Department of Public Safety; and

          (-e-) place of employment and the employer's address and telephone number;

        (II) the name, address, and telephone number of a relative of the child or other person whom DADS or the facility may contact in an emergency situation, a statement indicating the relation between that person and the child, and at the LAR's option:

          (-a-) that person's driver license number and state of issuance or personal identification card number issued by the Department of Public Safety; and

          (-b-) the name, address, and telephone number of that person's employer; and

        (III) a signed acknowledgement of responsibility stating that the LAR agrees to:

          (-a-) notify the facility of any changes to the contact information submitted; and

          (-b-) make reasonable efforts to participate in the child's life and in planning activities for the child; and

      (ii) inform the LAR that if the information described in clause (i) of this subparagraph is not provided or is not accurate and the facility and DADS are unable to locate the LAR as described in subparagraph (J) of this paragraph, DADS refers the case to the Department of Family and Protective Services, in accordance with subsection (c) of this section;

    (G) refrain from providing the LAR with inaccurate or misleading information regarding the risks of moving the child to another facility or community setting;

    (H) if an emergency situation occurs, attempt to notify the LAR as soon as the emergency situation allows and request a response from the LAR;

    (I) if an LAR does not respond to a notice of the child's annual comprehensive care plan meeting, a request for the LAR's consent, or an emergency situation, attempt to locate the LAR by contacting a person identified by the LAR in the contact information described in subparagraph (F) if this paragraph;

    (J) no later than 30 days after the date the facility determines that it is unable to locate the LAR, notify DADS at 1-800-458-9858 of that determination and request that DADS initiate a search for the LAR;

Cont'd...

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