| (a) Safe environment. The LMHA, MCO, and provider must:
(1) ensure service delivery sites (including, but not
limited to, facilities and vehicles) are safe, sanitary, and free
from hazards, including but not limited to:
(A) hand washing facilities and supplies in restrooms
and in areas where staff have routine physical contact with individuals
(e.g., exam rooms, medication areas, laboratories);
(B) a utility area with necessary equipment for the
safe and required cleaning or disposal of instruments, equipment,
and sharps;
(C) locked areas for storing drugs, needles, syringes,
hazardous materials, other potentially dangerous equipment, and toxic
chemical products; and
(D) adequate prevention of exposure to tobacco smoke
and other environmental pollutants.
(2) ensure delivery sites are prepared to manage onsite
life threatening emergencies, and that each site will have:
(A) a written plan for the management of onsite medical
emergencies requiring ambulance services, hospitalization, or hospital
treatment;
(B) emergency resuscitative drugs, supplies, and equipment
appropriate to the needs of individuals and staff qualifications;
(C) written protocols and instructions for disasters
and other emergencies; and
(D) documented disaster drills appropriate for local
conditions.
(3) comply with the most current edition of the National
Fire Protection Association's Life Safety Code, and related codes,
standards, and other applicable requirements;
(4) implement an infection control plan and procedures
for group residential services, clinics, and other areas where a high
volume of people congregate, that address the prevention, education,
management, and monitoring of significant infections. Components addressed
in the plan must include:
(A) prevention and management of infection in the service
delivery site(s);
(B) reporting of reportable diseases as required by
Chapter 97, Subchapter A of this title (relating to Control of Communicable
Diseases);
(C) compliance with the Human Immunodeficiency Virus
Services Act (Texas Health and Safety Code, §85.001 et seq.),
the Communicable Disease Prevention and Control Act (Texas Health
and Safety Code, §81.001 et seq.), and other applicable laws
(e.g., the Americans with Disabilities Act of 1990, 42 U.S.C. §12101
et seq.; and the Rehabilitation Act of 1973, 29 U.S.C. §701 et
seq.);
(D) identification of illnesses and conditions for
which an individual's participation in mental health community services
is safely allowed;
(E) identification of illnesses and conditions for
which an individual's participation in mental health community services
is restricted and the procedures for minimizing exposure and facilitating
an individual's transfer to a more appropriate setting;
(5) implement safeguards regarding hazardous equipment
and weather; and
(6) implement procedures for the disposal of biohazardous
wastes that minimize the risks of contamination, injury, and disease
transmission.
(b) Sufficient staff. The provider must have sufficient
number of qualified and competent staff members on duty to ensure
the safety of individuals and adequacy of mental health community
services, including responding to crises during the provision of mental
health community services.
(c) Compliance with state and federal law. The provider
must comply with all applicable state and federal law and regulations,
including those relating to:
(1) blood borne pathogens;
(2) food borne pathogen exposure controls; and
(3) tuberculosis exposure controls.
(d) Limited use of restraint or seclusion.
(1) Restraint. In outpatient settings, a provider may
only use restraint if the intervention is:
(A) necessary to address a behavioral health emergency,
as defined in Chapter 415, Subchapter F of this title (relating to
Interventions in Mental Health Programs); and
(B) performed according to the department's rules described
in Chapter 415, Subchapter F of this title.
(2) Seclusion. Seclusion is prohibited in outpatient
settings with the exception of partial hospitalization programs for
children or adolescents. A provider may only use seclusion in those
programs if the conditions in paragraph (1)(A) - (B) of this subsection
are met.
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