| (a) Quality management plan. The LMHA and MCO must
develop a written quality management plan that includes:
(1) the quality management program description and
work plan;
(2) measurable objective indicators to detect the need
for improvement;
(3) procedures and timelines for taking appropriate
action when problems are identified; and
(4) approval by the LMHA or MCO governing body.
(b) Quality management program. The LMHA and MCO must
implement a quality management program that includes:
(1) a structure that ensures the program is implemented
system-wide;
(2) allocation of adequate resources for implementation;
(3) oversight by professionals with adequate and appropriate
experience in quality management;
(4) activities and processes that address identified
clinical and organizational problems including fidelity and data integrity;
(5) periodic reporting of quality management program
activities to its governing body, providers and other appropriate
staff members and community stakeholders such as peer and family organizations;
(6) processes to systematically monitor, analyze, and
improve performance of provider services and outcomes for individuals;
(7) review of the provider's treatment to determine:
(A) whether it is consistent with the department's
approved evidenced-based practices and the fidelity manual; and
(B) the accuracy of assessments and treatment planning;
(8) ongoing monitoring of the quality of crisis services,
access to services, service delivery, and continuity of services;
(9) provision of technical assistance to providers
related to quality oversight necessary to improve the quality and
accountability of provider services;
(10) use of reports and data from the department to
inform performance improvement activities and assessment of unmet
needs of individuals, service delivery problems, and effectiveness
of authority functions for the local service area;
(11) mechanisms to measure, assess, and reduce incidents
of abuse, neglect, and exploitation;
(12) mechanisms to improve individuals' rights protection
processes;
(13) risk management processes such as competency determinations,
and the management and reporting of incidents and deaths; and
(14) coordination of activities and information management
with the utilization management (UM) program, including participation
in UM oversight activities.
(c) The LMHA and MCO must establish an integrated system
to sufficiently monitor the quality management program for effectiveness
on a regular basis and update the quality management plan as needed.
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| Source Note: The provisions of this §301.333 adopted to be effective April 29, 2009, 34 TexReg 2603; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237 |
