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(a)Staff qualifications.
(1)An individualized skills and socialization provider
must:
(A)employ a director;
(B)ensure the director meets the requirements outlined
in paragraph (2) of this subsection; and
(C)have a policy regarding the delegation of responsibility
in the director's absence.
(2)A service provider of individualized skills and
socialization must be at least 18 years of age and:
(A)have a high school diploma or a certificate recognized
by a state as the equivalent of a high school diploma; or
(B)have documentation of a proficiency evaluation
of experience and competence to perform the job tasks that includes:
(i)a written competency-based assessment of the ability
to document service delivery and observations of the individuals receiving
services; and
(ii)at least three written personal references from
persons not related by blood that indicate the ability to provide
a safe, healthy environment for the individuals receiving services.
(3)A service provider of individualized skills and
socialization who provides transportation must:
(A)have a valid driver's license; and
(B)transport individuals in a vehicle insured in accordance
with state law.
(b)Staffing. An individualized skills and socialization
provider must ensure that:
(1)an individual whose needs cannot be met by the
individualized skills and socialization provider is not admitted or
retained;
(2)the ratio of service providers to individuals is
maintained in accordance with §260.507 of this title (relating
to Staffing Ratios), §262.917 of this title (relating to Staffing
Ratios for Off-Site Individualized Skills and Socialization), and §263.2017
of this title (relating to Staffing Ratios for Off-Site Individualized
Skills and Socialization), during the provision of off-site individualized
skills and socialization, including during transportation; and
(3)sufficient staff are on duty at all times to ensure:
(A)the health and safety of the individuals;
(B)supervision is provided in accordance with the
needs of an individual; and
(C)individualized skills and socialization are provided
in accordance with an individual's individual plan of care (IPC),
individual program plan (IPP), person-directed plan (PDP), and implementation
plan, as applicable.
(c)Staff responsibilities.
(1)The director:
(A)manages the individualized skills and socialization
services and the on-site individualized skills and socialization location;
(B)trains and supervises staff; and
(C)maintains all records.
(2)A service provider:
(A)delivers individualized skills and socialization
services;
(B)assists with recreational activities; and
(C)provides protective supervision through observation
and monitoring.
(d)An individualized skills and socialization provider
must make both on-site and off-site individualized skills and socialization
available to an individual.
(e)An individualized skills and socialization provider
must ensure that on-site individualized skills and socialization:
(1)is provided in a building or a portion of a building
that is owned or leased by an individualized skills and socialization
provider; and
(2)is not provided in:
(A)a prohibited residential setting for an individual,
unless provided in an event open to the public; or
(B)the residence of an individual or another person.
(f)An individualized skills and socialization provider
must ensure that off-site individualized skills and socialization:
(1)are provided in a community setting chosen by the
individual from among available community setting options;
(2)includes transportation necessary for the individual's
participation in off-site individualized skills and socialization;
and
(3)is not provided in:
(A)a building in which on-site individualized skills
and socialization are provided;
(B)a prohibited residential setting for an individual,
unless provided in an event open to the public; or
(C)the residence of an individual or another person.
(g)An individualized skills and socialization provider
must provide individualized skills and socialization:
(1)in the Deaf Blind with Multiple Disabilities (DBMD)
program, in accordance with an individual's individual plan of care
(IPC) and individual program plan (IPP); and
(2)in the Texas Home Living (TxHmL) program and Home
and Community-based Services (HCS) program, in accordance with an
individual's person-directed plan (PDP), IPC, and implementation plan.
(h)An individualized skills and socialization provider
must not require an individual to take a skills test or meet other
requirements to receive off-site individualized skills and socialization.
(i)If an individual does not want to participate in
an activity the individual scheduled for on-site individualized skills
and socialization or off-site individualized skills and socialization,
or the legally authorized representative (LAR) does not want the individual
to participate in such activity, the individualized skills and socialization
provider must document the decision not to participate in the individual's
record.
(j)Training.
(1)Initial training.
(A)An individualized skills and socialization provider
must:
(i)provide service providers with training on their
responsibilities under the emergency response plan developed in accordance
with §559.229 of this subchapter (relating to Emergency Response
Plan) within three workdays after the start of employment and document
the training in the individualized skills and socialization provider's
records; and
(ii)provide service providers a minimum of eight hours
of training during the first three months after the start of employment
and document the training in the records of the individualized skills
and socialization provider.
(B)The training provided in accordance with subparagraph
(A)(ii) of this paragraph must include:
(i)any nationally or locally recognized adult CPR
course or certification;
(ii)first aid;
(iii)orientation to health care delivery, including
the following topics:
(I)safe body function and mechanics;
(II)personal care techniques and procedures; and
(III)overview of the population served by the individualized
skills and socialization provider; and
(iv)identification and reporting of abuse, neglect,
or exploitation.
(2)Ongoing training.
(A)An individualized skills and socialization provider
must:
(i)provide at least eight hours of ongoing training
to service providers annually;
(ii)ensure that service providers maintain current
certification in CPR.
(B)The training provided in accordance with subparagraph
(A)(i) of this paragraph must include:
(i)training on responsibilities under the emergency
response plan developed in accordance with §559.229;
(ii)training on infection control policies and procedures
developed in accordance with subsection (m) of this section; and
(iii)identification and reporting of abuse, neglect,
or exploitation.
(k)Medications.
(1)Administration.
(A)If an individual cannot or chooses not to self-administer
his or her medications, an individualized skills and socialization
provider must ensure the individual's medications are administered
by a person who holds a current license under state law authorizing
the licensee to do so.
(B)An individualized skills and socialization provider
must record an individual's medications, including over-the-counter
medications, on the individual's medication profile record. The recorded
information must be obtained from the prescription label and must
include the medication name, strength, dosage, doses received, directions
for use, route of administration, prescription number, pharmacy name,
and the date each medication was issued by the pharmacy.
(2)General.
(A)An individualized skills and socialization provider
must immediately report to an individual's program provider any unusual
reactions to a medication or treatment.
(B)When an individualized skills and socialization
provider supervises or administers medications, the individualized
skills and socialization provider must document in writing if an individual
does not receive or take the medication and treatment as prescribed.
The documentation must include the date and time the dose should have
been taken, and the name and strength of medication missed.
(3)Storage.
(A)An individualized skills and socialization provider
must provide a locked area for all medications, which may include:
(i)a central storage area; or
(ii)a medication cart.
(B)An individualized skills and socialization provider
must store an individual's medication separately from other individuals'
medications within the storage area.
(C)An individualized skills and socialization provider
must store medication requiring refrigeration in a locked refrigerator
that is used only for medication storage or in a separate, permanently
attached, locked medication storage box in a refrigerator.
(D)An individualized skills and socialization provider
must store poisonous substances and medications labeled for "external
use only" separately within the locked area.
(E)An individualized skills and socialization provider
must store drugs covered by Schedule II of the Controlled Substances
Act of 1970 in a locked, permanently attached cabinet, box, or drawer
that is separate from the locked storage area for other medications.
(l)Accident, injury, or acute illness.
(1)An individualized skills and socialization provider
must stock and maintain in a single location in the on-site individualized
skills and socialization location first aid supplies to treat burns,
cuts, and poisoning. An individualized skills and socialization provider
that only delivers off-site individualized skills and socialization
must ensure these first aid supplies are immediately available at
all times during service provision.
(2)In the event of accident or injury to an individual
requiring emergency care, or in the event of death of an individual,
an individualized skills and socialization provider must:
(A)arrange for emergency care or transfer to an appropriate
place for treatment, including:
(i)a physician's office;
(ii)a clinic; or
(iii)a hospital;
(B)immediately notify an individual's program provider
with which the individualized skills and socialization provider contracts
to provide services to the individual; and
(C)describe and document the accident, injury, or
illness on a separate report containing a statement of final disposition
and maintain the report on file.
(m)An individualized skills and socialization provider
must create and enforce written policies and procedures for infection
control, including spread of disease to ensure staff compliance with
state law, the Occupational Safety and Health Administration, and
the Centers for Disease Control and Prevention.
The agency certifies that legal counsel
has reviewed the proposal and found it to be within the state agency's
legal authority to adopt.
Filed
with the Office of the Secretary of State on July 28, 2022
TRD-202202837 Karen Ray
Chief Counsel
Health
and Human Services Commission
Earliest possible date of adoption: September 11, 2022
For further information, please call: (512) 438-3161
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