| (a) A program provider must serve an eligible applicant
or individual who selects the program provider unless the program
provider's enrollment has reached its service capacity as identified
in the DADS data system.
(b) The program provider must maintain a separate record
for each individual enrolled with the provider. The individual's record
must include:
(1) a copy of the individual's current PDP and, if
CFC PAS/HAB is included on the PDP, a copy of the completed DADS HCS/TxHmL
CFC PAS/HAB Assessment form as provided by the LIDDA;
(2) a copy of the individual's current IPC as provided
by the LIDDA; and
(3) a copy of the individual's current ID/RC Assessment
as provided by the LIDDA.
(c) The program provider must:
(1) participate as a member of the service planning
team, if requested by the individual or LAR;
(2) develop:
(A) in conjunction with the individual, the individual's
family or LAR, an implementation plan for:
(i) TxHmL Program services, except for transportation
as a community support activity; and
(ii) CFC services, except for CFC support management;
and
(B) a transportation plan, if transportation as a community
support activity is included on the PDP.
(d) The program provider must provide:
(1) TxHmL Program services in accordance with an individual's
PDP, IPC, implementation plan, transportation plan, §9.555 of
this subchapter (relating to Description of TxHmL Program Services),
and Appendix C of the TxHmL Program waiver application approved by
CMS and found at www.dads.state.tx.us; and
(2) CFC services in accordance with an individual's
PDP, IPC, and implementation plan.
(e) The program provider must ensure that services
and supports provided to an individual assist the individual to achieve
the outcomes identified in the PDP.
(f) The program provider must ensure that an individual's
progress or lack of progress toward achieving the individual's identified
outcomes is documented in observable, measurable terms that directly
relate to the specific outcome addressed, and that such documentation
is available for review by the service coordinator.
(g) The program provider must communicate to the individual's
service coordinator changes needed to the individual's PDP or IPC
as such changes are identified by the program provider or communicated
to the program provider by the individual or LAR.
(h) The program provider must ensure that an individual
who performs work for the program provider is paid at a wage level
commensurate with that paid to a person without disabilities who would
otherwise perform that work. The program provider must comply with
local, state, and federal employment laws and regulations.
(i) The program provider must ensure that an individual
provides no training, supervision, or care to another individual unless
the individual is qualified and compensated in accordance with local,
state, and federal regulations.
(j) The program provider must ensure that an individual
who produces marketable goods and services during habilitation activities
is paid at a wage level commensurate with that paid to a person without
disabilities who would otherwise perform that work. Compensation must
be paid in accordance with local, state, and federal regulations.
(k) The program provider must offer an individual opportunity
for leisure time activities, vacation periods, religious observances,
holidays, and days off, consistent with the individual's choice and
the routines of other members of the community.
(l) The program provider must offer an individual of
retirement age opportunities to participate in activities appropriate
to individuals of the same age and provide supports necessary for
the individual to participate in such activities consistent with the
individual's or LAR's choice and the individual's PDP.
(m) The program provider must offer an individual choices
and opportunities for accessing and participating in community activities
including employment opportunities and experiences available to peers
without disabilities and provide supports necessary for the individual
to participate in such activities consistent with an individual's
or LAR's choice and the individual's PDP.
(n) A program provider must develop a written service
backup plan for a TxHmL Program service or a CFC service identified
on the PDP as critical to meeting an individual's health and safety.
(1) A service backup plan must:
(A) contain the name of the service;
(B) specify the period of time in which an interruption
to the service would result in an adverse effect to the individual's
health or safety; and
(C) in the event of a service interruption resulting
in an adverse effect as described in subparagraph (B) of this paragraph,
describe the actions the program provider will take to ensure the
individual's health and safety.
(2) A program provider must ensure that:
(A) if the action in the service backup plan required
by paragraph (1) of this subsection identifies a natural support,
that the natural support receives pertinent information about the
individual's needs and is able to protect the individual's health
and safety; and
(B) a person identified in the service backup plan,
if paid to provide the service, meets the qualifications described
in this subchapter.
(3) If a service backup plan is implemented, a program
provider must:
(A) discuss the implementation of the service backup
plan with the individual and the service providers or natural supports
identified in the service backup plan to determine whether or not
the plan was effective;
(B) document whether or not the plan was effective;
and
(C) revise the plan if the program provider determines
the plan was ineffective.
(o) If respite is provided in a location other than
an individual's family home, the location must be acceptable to the
individual or LAR and provide an accessible, safe, and comfortable
environment for the individual that promotes the health and welfare
of the individual.
(1) Respite may be provided in the residence of another
individual receiving TxHmL Program services or similar services if
the program provider has obtained written approval from the individuals
living in the residence or their LARs and:
(A) no more than three individuals receiving TxHmL
Program services or CFC services and other persons receiving similar
services are provided services at any one time; or
(B) no more than four individuals receiving TxHmL Program
services or CFC services and other persons receiving similar services
are provided services in the residence at any one time and the residence
is approved in accordance with §9.188 of this chapter (relating
to DADS Approval of Residences).
(2) Respite may be provided in a respite facility if
the program provider provides or intends to provide respite to more
than three individuals receiving TxHmL Program services or CFC services
or persons receiving similar services at the same time; and
(A) the program provider has obtained written approval
from the local fire authority having jurisdiction stating that the
facility and its operation meet the local fire ordinances; and
(B) the program provider obtains such written approval
from the local fire authority having jurisdiction on an annual basis.
(3) If respite is provided in a camp setting, the program
provider must ensure the camp is accredited by the American Camp Association.
(4) Respite must not be provided in an institution
such as an ICF/IID, nursing facility, or hospital.
(p) The program provider must ensure that nursing is
provided in accordance with:
(1) Texas Occupations Code, Chapter 301 (Nursing Practice
Act);
(2) 22 TAC Chapter 217 (relating to Licensure, Peer
Assistance, and Practice);
(3) 22 TAC Chapter 224 (relating to Delegation of Nursing
Tasks by Registered Professional Nurses to Unlicensed Personnel for
Clients with Acute Conditions or in Acute Care Environments); and
(4) 22 TAC Chapter 225 (relating to RN Delegation to
Unlicensed Personnel and Tasks Not Requiring Delegation in Independent
Living Environments for Clients with Stable and Predictable Conditions).
(q) A program provider may determine that an individual
does not require a nursing assessment if:
(1) nursing services are not on the individual's IPC
and the program provider has determined that no nursing task will
be performed by the program provider's unlicensed service provider
as documented on DADS form "Nursing Task Screening Tool"; or
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