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(a)Staff qualifications.
(1)An individualized skills and socialization provider
must:
(A)employ an administrator;
(B)ensure the administrator meets the requirements
outlined in paragraph (2) of this subsection; and
(C)have a policy regarding the delegation of responsibility
in the administrator'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 during
the provision of on-site individualized skills and socialization 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 administrator:
(A)manages the individualized skills and socialization
services and the on-site individualized skills and socialization location;
(B)ensures staff are trained;
(C)supervises staff; and
(D)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, unless the individualized skills and socialization
provider provides off-site individualized skills and socialization
only.
(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 prohibited setting for an
individual, as set forth in the rules governing the HCS Program.
(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 setting for an individual, as set
forth in the rules governing the HCS Program, unless:
(i)provided in an event open to the public; or
(ii)the activity is a volunteer activity performed
by an individual in such a setting; or
(C)the residence of an individual or another person,
unless the activity is a volunteer activity performed by an individual
in the residence.
(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)An individualized skills and socialization provider
must provide on-site and off-site individualized skills and socialization
in-person.
(k)Training.
(1)Initial training.
(A)An individualized skills and socialization provider
must:
(i)provide service providers with training on fire,
disaster, and their responsibilities under the emergency response
plan developed in accordance with §559.229 of this subchapter
(relating to Environment and 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)infection control;
(iv)overview of the population served by the individualized
skills and socialization provider; and
(v)identification and reporting of abuse, neglect,
or exploitation.
(2)Ongoing training.
(A)An individualized skills and socialization provider
must:
(i)ensure that service providers maintain current
certification in CPR;
(ii)train on responsibilities under the emergency
response plan developed in accordance with §559.229;
(iii)train on infection control policies and procedures
developed in accordance with subsection (n) of this section; and
(iv)train on the identification and reporting of abuse,
neglect, or exploitation.
(l)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 provide assistance with such medications and the performance
of related tasks if:
(i)a registered nurse has assessed the assistance
and related tasks and delegated such to the individualized skills
and socialization provider in accordance with state law and rules;
or
(ii)a physician has delegated the assistance and related
tasks as a medical act to the individualized skills and socialization
provider under Texas Occupations Code Chapter 157, as documented by
the physician.(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.
(m)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.
(2)An individualized skills and socialization provider
delivering off-site individualized skills and socialization must ensure
first aid supplies to treat burns, cuts, and poisoning are immediately
available at all times during service provision.
(3)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.
(n)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 adoption and found it to be a valid exercise of the agency's legal
authority.
Filed
with the Office of the Secretary of State on December 12, 2022
TRD-202204967 Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: January 1, 2023
Proposal publication date: August 12, 2022
For further information, please call: (512)
438-3161
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