|(a) An agency must maintain a written policy regarding
implementation of advance directives. The policy must comply with
the Advance Directives Act, Texas Health and Safety Code Chapter 166.
The policy must include a clear and precise statement of any procedure
the agency is unwilling or unable to provide or withhold in accordance
with an advance directive.
(b) The agency must provide written notice to a client
of the written policy required by subsection (a) of this section.
The notice must be provided at the earlier of:
(1) the time the client is admitted to receive services
from the agency; or
(2) the time the agency begins providing care to the
(c) If, at the time notice must be provided under subsection
(b) of this section, the client is incompetent or otherwise incapacitated
and unable to receive the notice, the agency must provide the required
written notice, in the following order of preference, to:
(1) the client's legal guardian;
(2) a person responsible for the health care decisions
of the client;
(3) the client's spouse;
(4) the client's adult child;
(5) the client's parent; or
(6) the person admitting the client.
(d) If subsection (c) of this section applies, except
as provided by subsection (e) of this section, and an agency is unable,
after a diligent search, to locate an individual listed by subsection
(c) of this section, the agency is not required to provide the notice.
(e) If a client who was incompetent or otherwise incapacitated
and unable to receive the notice required by this section, at the
time notice was to be provided under subsection (b) of this section,
later becomes able to receive the notice, the agency must provide
the written notice at the time the client becomes able to receive
(f) HHSC assesses an administrative penalty of $500
without an opportunity to correct against an agency that violates
|Source Note: The provisions of this §558.283 adopted to be effective February 1, 2002, 26 TexReg 9159; amended to be effective June 1, 2006, 31 TexReg 1455; amended to be effective December 1, 2006, 31 TexReg 9620; amended to be effective January 15, 2009, 34 TexReg 254; transferred effective May 1, 2019, as published in the April 12, 2019, issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427