| (a) A center must adopt and enforce written policies
and procedures for the use of person-centered direction and guidance
by individuals providing services to minors at the center. The policy
must include:
(1) the implementation of a system-wide, person-centered
direction and guidance program for minors that includes:
(A) the teaching of successful behavior and coping
skills;
(B) proactive strategies to identify and manage a minor's
behaviors before they escalate; and
(C) the monitoring and evaluation of the effectiveness
of direction and guidance used with a minor by a committee as described
in this section;
(2) procedures for ensuring consistent language, practices,
and application of direction and guidance by individuals providing
services at a center; and
(3) procedures for documenting and providing to a minor's
parent a daily report of the minor's behavior.
(b) A center must ensure that only person-centered
strategies and techniques that encourage self-esteem, self-control,
and self-direction are used for the purposes of direction and guidance
of a minor at a center. A center must not use a restraint as part
of person-centered direction and guidance.
(c) Person-centered direction and guidance must be:
(1) individualized and consistent for each minor;
(2) differentiated in both nature and intensity based
on a minor's level of behavior;
(3) appropriate to the minor's level of understanding
and functional or educational development; and
(4) directed toward teaching the minor successful behavior,
awareness of behavior triggers and self-control, including:
(A) encouraging a minor to develop positive behavior
in accordance with a minor's individualized psychosocial program;
(B) redirecting behavior using positive statements;
and
(C) teaching the minor to use effective behavior management
techniques.
(d) A center must ensure that quiet time, if used,
is:
(1) in accordance with the minor's psychosocial program
and plan of care;
(2) brief and under continuous face-to-face observation
by center staff;
(3) appropriate for the minor's age and development;
(4) limited to no more than one minute per year of
the minor's developmental age; and
(5) does not place a minor alone in a room.
(e) A center must ensure the protection of minors at
the center from harsh, cruel, or unusual treatment. Negative discipline
is considered punishment and abuse and is prohibited at a center,
including:
(1) corporal punishment or threats of corporal punishment;
(2) punishment associated with food, naps, or toilet
training;
(3) pinching, shaking, or biting a minor;
(4) hitting a minor with a hand or object;
(5) putting anything in or on a minor's mouth;
(6) humiliating, ridiculing, rejecting, or yelling
at a minor;
(7) subjecting a minor to harsh, abusive, or profane
language;
(8) placing a minor alone in a locked or darkened room,
bathroom, or closet without windows; and
(9) requiring a minor to remain silent or inactive
for inappropriately long periods of time for the minor's developmental
age.
(f) The center must establish a person-centered direction
and guidance committee to review the techniques and strategies used
at a center to:
(1) determine whether the individualized direction
and guidance used as established in a plan of care is consistently
applied for each minor in accordance with center policy;
(2) evaluate the frequency and outcomes of strategies
and techniques used with a minor to:
(A) determine the impact of the direction and guidance
on a minor's ability to achieve progress in goals;
(B) determine effectiveness of the minor's program;
and
(C) recommend the use of new strategies and techniques
when current strategies and techniques are determined to be ineffective.
(g) The committee must include:
(1) the center's administrator;
(2) the center's nursing director or designee;
(3) an individual providing psychosocial treatment
and services on behalf of a center; and
(4) a parent or an individual from a parent council
or support group for minors receiving services at the center.
(h) The center is not required to include a parent
or individual from a parent council or support group if, after a good
faith effort, the center is unable to include a parent or individual
in a committee meeting. The center must document, for DADS review,
a good faith effort to include a parent or individual from a parent
council or support group at each meeting.
(i) The center must adopt and enforce written policies
and procedures for the frequency, format and documentation of committee
meetings.
(j) A center must provide its written person-centered
direction and guidance policy to all parents, employees, volunteers
and contractors. The center must maintain documentation of acknowledgment
of the written policy from all employees, volunteers and contractors.
|
| Source Note: The provisions of this §550.206 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875 |
