Texas Register, Volume 23, Number 15, Pages 3631-3764, April 10, 1998 Page: 3,689
3631-3764 p. ; 28 cm.View a full description of this periodical.
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and supports" followed by a renumbering of the subsequent
two paragraphs.
Two commenters recommended adding "and/or LARs" in
412.359(b)(2)(B). The department modifies the subparagraph
to reflect that the responses of all persons interviewed as part
of the external validation activities will be reviewed, including
those of the consumer, the LAR, if any, and other persons who
are actively involved with a consumer.
A commenter suggested that the number of outcomes listed
in 412.359(f) reflects The Council's 1993 Outcome Based
Performance Measures and should be changed to be consistent
with the newly revised edition. The department deletes the
numbers and explains that the subchapter adopts by reference
the 1993 Outcome Based Performance Measures because the
revised edition had not yet been released when the subchapter
was proposed in January. The 1998 version will be proposed for
adoption by reference upon the adoption of the new subchapter
in April.
A commenter stated that local MRAs are not funded to provide
health care services as is implied by the wording of 412.362(b)
and (c). The department agrees that the provisions as proposed
are misleading and has revised the section as described earlier
in this preamble.
A commenter stated that local MRAs can only "ensure" the
requirements imposed in 412.367 concerning environmental
requirements for those programs they operate or fund. The
department agrees with the commenter's concern and responds
that the application section of the subchapter, both as proposed
and as strengthened by revisions, clearly states that the local
MRA is responsible only for those programs it operates or
contracts for.
A commenter recommended that the requirement in
412.367(3) for all service sites to meet the appropriate
chapter of the most recent edition of the Life Safety Code be
revised to require compliance with the edition used by the
regional fire marshal and building code offices. The depart-
ment agrees that the provision is inadequate as proposed
and revises the paragraph to require that "all sites meet the
appropriate chapter of the most recent edition of the Life
Safety Code (LSC) published by the National Fire Protection
Association (NFPA) or the edition used by the authority having
jurisdiction over that site."
The sections are adopted under the THSC, 532.015, which
provides the Texas Mental Health and Mental Retardation Board
with broad rulemaking authority; 534.052, which requires the
board to adopt rules to ensure the adequate provision of
community-based mental retardation services by local MRAs;
534.058, which requires the department to develop standards
of care for services provided by local MRAs and their subcon-
tractors to ensure that the quality of those services is consistent
with the quality of care available in department facilities; and
534.057 which requires the department to adopt rules con-
cerning respite services.
9412.351. Purpose.
This subchapter describes the:
(1) quality assurance and improvement system (QAIS)
for community-based mental retardation services and supports which
is intended in part to ensure that the quality of those services and
supports is consistent with services provided by facilities of the TexasDepartment of Mental Health and Mental Retardation, as required by
the Texas Health and Safety Code (THSC), 534.058;
(2) minimum standards, as required by the THSC,
534.052, for ensuring the health, safety, rights, and freedom from
abuse and neglect of consumers receiving community-based mental
retardation services and supports; and
(3) minimum standards for respite services, as required
by THSC, 534.057.
412.352. Application.
The provisions of this subchapter apply to community-based mental
retardation services and supports delivered by:
(1) local MRAs and the providers with which they
contract; and
(2) designated providers.
412.353. Definitions.
The following words and terms, when used in this subchapter,
have the following meanings, unless the context clearly indicates
otherwise:
(1) Actively involved - Involvement with the consumer
which the planning team deems to be of a quality nature based on
the following:
(A) observed interactions of the person with the
consumer;
(B) advocacy for the best interests of the consumer;
(C) knowledge of and sensitivity to the consumer's
preferences, values, and beliefs;
(D) ability to communicate with the consumer; and
(E) availability to the consumer for assistance or
support when needed.
(2) Behavior management - All efforts to increase
socially adaptive behavior and to modify maladaptive or problem
behaviors and replace them with behaviors and skills that are adaptive
and socially productive. This broad category includes behavior
interventions, emergency interventions, and both formal and informal
planned interactions intended to increase socially adaptive behavior
and/or to modify maladaptive or problem behaviors.
(3) CARE - The department's Client Assignment and
Registration System, an on-line data entry system developed to
provide demographic and other data about consumers served by the
department.
(4) Department - The Texas Department of Mental
Health and Mental Retardation.
(5) Designated provider - As described in the Texas
Health and Safety Code, 534.054, a service provider with whom
the department contracts for the delivery of a specific community-
based mental retardation service in a specified local service area of
the state if the MRA for that local service area is unable or unwilling
to provide that service. The term does not include a local MRA.
(6) Emergency care- Procedures and interventions
designed to respond to medical emergencies.
(7) Emergency interventions - Procedures deemed neces-
sary to control severely aggressive or destructive behaviors that place
the consumer or others in imminent danger of harm. This may in-
clude restraint. These procedures are used on an emergency basis in
response to behaviors which could not reasonably be anticipated, andADOPTED RULES April 10, 1998 23 TexReg 3689
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Texas. Secretary of State. Texas Register, Volume 23, Number 15, Pages 3631-3764, April 10, 1998, periodical, April 10, 1998; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth113834/m1/59/: accessed April 28, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.