| (a) The department will maintain a balanced and effective
service delivery system that affords a full range of services and
supports to individuals and their families.
(1) The continuum of care within the department's service
delivery system encompasses residential services in state mental retardation
(MR) facilities and community-based ICF/MR programs, waiver services,
and those services and supports provided or contracted by a mental
retardation authority (MRA).
(2) Residential services in a state MR facility are
intended to serve individuals with severe or profound mental retardation
and those individuals with mental retardation who are medically fragile
or who have behavioral problems.
(b) If an individual or LAR chooses services in a state
MR facility, the MRA serving the local service area where the individual
lives will assist the individual or LAR in accessing those services
if the individual is eligible, i.e., meets the criteria described
in this subchapter for admission or commitment to a state MR facility.
(c) It is the policy of the State of Texas to strive
to ensure that the basic needs for safety, security, and stability
are met for each individual under 22 years of age with a developmental
disability. A successful family is the most efficient and effective
way to meet those needs. The state and local communities must work
together to provide encouragement and support for well-functioning
families and ensure that each individual receives the benefits of
being a part of a successful permanent family as soon as possible.
(d) For an individual residing in a state MR facility,
the MRA designated in CARE for that individual is responsible for:
(1) maintaining a link between the individual and the
individual's home community;
(2) ensuring that the individual, LAR, and state MR
facility are provided with information concerning alternative living
arrangements that may be appropriate for the individual;
(3) assisting the individual or LAR who decides to
seek an alternative living arrangement in accessing the alternative
living arrangement, including working with other MRAs if the alternative
living arrangement being sought is outside the designated MRA's local
service area; and
(4) providing the state MR facility with current, provider-furnished
information about services and supports in the MRA's local service
area.
(e) The MRA and state MR facility will provide the
supports and encouragement necessary to ensure that each individual
or LAR is able to exercise choice and decision-making authority in
all issues related to services and supports.
(1) Whether an individual lives in the community or
is a resident of a state MR facility, if the individual does not have
an LAR and cannot communicate a preference concerning services and
supports, the MRA or state MR facility will involve those persons
who are actively involved with the individual in discussions regarding
services and supports.
(2) For the individual residing in a state MR facility,
the state MR facility must have procedures in place to ensure that
an individual residing in the state MR facility or the individual's
LAR is supported in making decisions concerning living options.
(3) The following principles support choice and decision-making
by the individual or LAR. Each MRA and state MR facility must follow
these principles when addressing issues of services and supports.
(A) The choices, preferences, expectations, likes,
and dislikes of the individual and LAR are the dominant force in discussions
about service planning.
(B) When considering Medicaid services, the individual
with the ability to provide legally adequate consent or LAR is entitled
to choose a provider from:
(i) a list of ICF/MR Program providers qualified and
willing to provide services and supports to that individual; or
(ii) a list of waiver program providers serving the
area in which the individual or LAR is interested.
(C) The individual will be provided with opportunities
for appropriate training, counseling, and other learning experiences
that may facilitate the exercise of choice and decision-making. If
the individual has an LAR, these opportunities will be provided only
with the consent of the LAR.
(D) Whenever possible, the individual and the LAR will
be encouraged to visit a residential setting prior to the individual's
admission. If the individual does not have an LAR, persons who are
actively involved with the individual will be encouraged to visit
a residential setting prior to the individual's admission, unless
the individual objects.
|
| Source Note: The provisions of this §904.7 adopted to be effective January 1, 2001, 25 TexReg 12746; amended to be effective March 31, 2002, 27 TexReg 2445; 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 |
