| (a) Within 14 calendar days of the IDT meeting at which
a provider is selected the state MR facility will forward the following
to the designated MRA, any other involved MRA, the provider, and the
individual with the ability to provide legally adequate consent or
the LAR, as appropriate:
(1) a copy of the draft community living/discharge
plan;
(2) the planned date for the individual's move, if
available;
(3) the report from the last annual planning meeting
of the IDT;
(4) the most recent psychological, social, medical,
and vocational/educational assessments; and
(5) reports from any interim meetings of the IDT which
addressed living options issues not addressed at the annual planning
meeting.
(b) The MRA will review the material and visit the
provider setting as needed, to determine whether the provider setting:
(1) complies with applicable Life Safety Code requirements;
(2) presents environmental concerns that impact the
individual's needs;
(3) effectively addresses the outcomes important to
the individual or LAR and the services and supports necessary assist
the individual in achieving those outcomes; and
(4) ensures the individual's health, safety, and welfare.
(c) Within 14 calendar days of making its determination
in subsection (b) of this section, the MRA must notify the IDT in
writing that:
(1) the provider setting meets the criteria in subsection
(b) of this section and that the MRA recommends that the IDT approve
the provider setting; or
(2) the provider setting does not meet the criteria
in subsection (b) of this section and that the MRA recommends that
the IDT not approve the provider setting.
(d) If the MRA recommends that the IDT not approve
the provider setting, the MRA must include in the notice described
in subsection (c)(2) of this section:
(1) the criteria described in subsection (b) of this
section that the provider setting did not meet; and
(2) the reasons why the MRA determined the criteria
was not met.
(e) If the IDT accepts an MRA recommendation to approve
the provider setting, the community living/discharge plan will be
completed for distribution to all parties, and final arrangements
will be initiated for the individual's move to the community.
(f) If the MRA has recommended that the provider setting
not be approved, the IDT will make written recommendations for specific
remedies to address the problems and send the recommendations to the
provider and the individual or LAR.
(1) The individual with the ability to provide legally
adequate consent or the LAR has the option of:
(A) continuing with the move after the IDT determines
that the recommendations have been or are in the process of being
implemented by the provider;
(B) continuing with the move without the IDT determining
that the recommendations have been or are in the process of being
implemented by the provider; or
(C) selecting another provider.
(2) If the individual does not have the ability to
provide legally adequate consent and does not have an LAR, then the
individual will remain in the state MR facility until:
(A) the IDT determines that the recommendations have
been or are in the process of being implemented by the provider; or
(B) another provider is identified by the by the IDT.
(g) When the individual moves, the state MR facility
shall ensure the following:
(1) a 30-day supply of prescribed medications has been
provided;
(2) the individual's personal belongings accompany
the individual;
(3) all necessary financial arrangements and agreements
are addressed;
(4) appropriate special instructions for the individual
or others are furnished in writing and orally prior to or at the time
of departure;
(5) the records described in subsection (i) of this
section accompany the individual; and
(6) the appropriate Social Security office has been
notified of the individual's impending move.
(h) Responsibilities for transporting the individual
to the alternative living arrangement will be detailed in the community
living/discharge plan. If deemed necessary by the IDT, these responsibilities
could include having state MR facility and/or MRA staff accompany
the individual and remaining there for a period of time deemed necessary
for satisfactory transition. The MRA must assign a service coordinator
who will meet with the individual and LAR before or on the day of
the move.
(i) The following records, as applicable, will be provided
by the state MR facility to the provider before the move or will accompany
the individual, with copies also offered to the individual or LAR,
before or at the time of the move:
(1) a copy of the birth certificate;
(2) copies of any current legal documents;
(3) a copy of the individual's Social Security card;
(4) a current photograph;
(5) a copy of the immunization record;
(6) a copy of the height and weight record;
(7) a copy of the seizure record;
(8) a copy of the most recent physician's orders, to
include treatment and diet orders;
(9) a copy of the most recent medical and dental examination;
(10) copies of the most recent laboratory test results
to include any one of a kind laboratory test results;
(11) copies of any additional significant reports including
the most recent chest X-ray, electrocardiogram (EKG), or electroencephalogram
(EEG);
(12) a copy of the social history and the most recent
psychological examination;
(13) Medicaid, Medicare, or third-party insurance cards,
if available;
(14) a copy of current nursing care plan;
(15) a summary of the individual's medical history
to include all major surgeries, significant acute illnesses, and injuries
requiring hospitalization or a long recovery period;
(16) a summary of the individual's medication history
to include start and stop dates, dose ranges and effectiveness of
all long-term medications, and history of antibiotic use to include
dates, effectiveness, sensitivities, and allergies;
(17) a summary of dental history including all oral
surgeries, extractions, restorations, appliances, and types of anesthesia
required for dental work; and
(18) any other data requested by the community program
or by the individual or LAR.
(j) Prior to or at the time of movement, the state
MR facility physician shall prepare a letter summarizing the highly
relevant medical information to be given to the new physician or health
care entity that will be providing services to the individual in the
community. The letter will be copied to the designated MRA and other
involved MRA and the provider. When appropriate, the state MR facility
physician shall communicate directly with the new physician or health
care entity.
(k) If a school eligible individual will be enrolled
in public school, the state MR facility and MRA must provide the following
to the school district prior to the move or within 14 working days
after the move:
(1) the birth certificate or other document as proof
of identity;
(2) the medical history and medical records, including
current immunization records;
(3) the social history;
(4) the vision and hearing screening and/or evaluation;
(5) reports of psychological, educational, related
services, and vocational assessments;
(6) the habilitation plan, including plan for reintegration;
(7) the Admission, Review and Dismissal (ARD) Committee
report, Individual Education Plan (IEP), and Comprehensive Assessment,
and, for school eligible individuals over the age of 13, the most
recent Individual Transition Plan; and
(8) if the individual was committed to the state MR
facility, a copy of the court order.
(l) A provider required to comply with §411.63
of this title (relating to Interagency Coordination of Special Education
Services to Students with Disabilities in Residential Care Facilities)
must notify, in writing, the school district where the provider is
located of the admission of a school eligible individual. The notification
will occur no later than three working days after the admission.
|
| Source Note: The provisions of this §904.105 adopted to be effective January 1, 2001, 25 TexReg 12746; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective September 1, 2023, as published in the August 11, 2023, issue of the Texas Register, 48 TexReg 4397 |
