Header:
TEXAS ADMINISTRATIVE CODE
TITLE 40. SOCIAL SERVICES AND ASSISTANCE
PART 1. DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 42. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM
SUBCHAPTER F. SERVICE DESCRIPTIONS AND REQUIREMENTS
DIVISI
Date:
08/31/2009
Document:
§ 42.630. Residential Services
(a) General.
(1) A program provider may provide residential services as:
(A) licensed assisted living, either 18 hour or 24 hour; or
(B) licensed home health assisted living, either 18 hour or 24 hour.
(2) A program provider must:
(A) provide personal assistance with activities of daily living;
(B) provide assistance with housekeeping;
(C) provide therapeutic social and recreational activities;
(D) provide on-site response staff to meet scheduled or unpredictable needs;
(E) provide supervision of an individual's safety and security; and
(F) provide, or make arrangements for, transportation other than medical transportation.
(3) A program provider must not provide either licensed assisted living or licensed home health assisted living to the individual at the same time that one of the following DBMD Program services is provided:
(A) respite;
(B) residential habilitation; or
(C) chore services.
(4) A program provider must ensure that an individual transitioning from institutional services to either licensed assisted living or licensed home health assisted living is not receiving TAS.
(5) DADS does not reimburse a program provider for 24-hour skilled nursing care provided to an individual receiving residential services.
(6) A program provider must bill for 18-hour licensed assisted living or 18-hour licensed home health assisted living for those days an individual is absent from the residence for six or more hours participating in school, work, or volunteer activities.
(7) If an individual's IPC includes day habilitation, the program provider must bill for 18-hour licensed assisted living or 18-hour licensed home health assisted living for those days on which the individual participates in day habilitation.
(8) A program provider must maintain documentation of the daily census using the Daily Census Documentation form described in the DBMD Program Manual or a form developed by the program provider which captures the information addressed on the Daily Census Documentation form.
(9) A program provider must notify DADS in writing of an individual's death within 24 hours after learning of the death.
(10) The program provider must have and implement written polices and procedures concerning room and board payment, to include:
(A) how the program provider determines the amount of room and board based on the costs of maintaining the residence;
(B) due date;
(C) credit balances;
(D) written notice of late payment to include late fees;
(E) return check charges;
(F) provision of receipt at time payment is made; and
(G) proportional refund when individual moves from the residence.
(11) The program provider must maintain a room and board ledger in accordance with generally accepted accounting principles.
(12) If a program provider provides an item or service at the request of the individual or LAR that is not a reimbursable item, the program provider may charge the individual or LAR for the items or service but must not bill DADS.
(13) A program provider must not charge a pet deposit to an individual or LAR for a service animal, including a guide dog, signal dog, or other animal individually trained to provide assistance to the individual.
(14) A program provider must document the following outcomes for residential services in the individual's record:
(A) the individual effectively communicates wants and needs to a residential services service provider;
(B) the individual actively participates in activities of daily living to the extent of the individual's ability;
(C) the individual's choices are implemented;
(D) the individual is able to access and participate in community activities; and
(E) the individual is able to move safely and efficiently within home and community settings.
(15) If requested by DADS, a program provider must be able to demonstrate the outcomes described in paragraph (14)(A) - (E) of this section.
(b) Licensed assisted living. A program provider:
(1) must comply with applicable provisions of Chapter 92 of this title (relating to Licensing Standards for Assisted Living Facilities);
(2) must serve no more than six individuals in a single residence;
(3) must not bill DADS for the cost of a minor home modification; and
(4) must notify the DBMD program specialist in writing of a fire, accident, or natural disaster within 24 hours after becoming aware of the occurrence.
(c) Licensed home health assisted living.
(1) A program provider:
(A) must comply with applicable provisions of Chapter 97 of this title (relating to Licensing Standards for Home and Community Support Services Agencies);
(B) must serve no more than three individuals in a single residence (e.g., an apartment, house, or duplex); and
(C) must ensure the residence of an individual: (i) is accessible to and usable by the individual; (ii) is maintained in good repair; and (iii) has two means of egress from:
(I) the living areas; and
(II) the individual's bedroom; (iv) has working smoke alarms installed to detect smoke in the kitchen, living areas, and the individual's bedroom; and (v) has a universal, fully-charged, and unexpired fire extinguisher easily accessible:
(I) from the kitchen;
(II) from the laundry area;
(III) from the vicinity of a hot water heater or furnace;
(IV) from each bedroom area; and
(V) on each floor of a multi-level residence; and (vi) has a first aid kit that complies with American Red Cross recommendations and is checked at least annually to ensure contents are not out-of-date; and (vii) the temperature of water from faucets used by an individual who cannot regulate water temperature does not exceed 110 degrees Fahrenheit.
(2) The program provider must ensure:
(A) an individual's prescribed medication is stored in a locked container and in the original container labeled with: (i) individual's name; (ii) date dispensed; (iii) instructions; (iv) name of medication with dosage; and (v) physician's name;
(B) a medication requiring refrigeration is kept separate from food in a clearly labeled, designated locked container;
(C) a medication that is no longer needed by the individual or that is past its expiration date is disposed of according to federal and state laws and regulations;
(D) a medication prescribed for one individual is not given to another individual; and
(E) an individual takes prescribed medications according to the physician's instructions and over-the-counter medications according to the package directions.
(3) A program provider must:
(A) develop and implement a written emergency response plan for the residence that describes the actions the program provider will take in the event of an emergency, such as a fire or other man-made or natural disaster, including evacuation or sheltering-in-place of the individual, as appropriate;
(B) ensure that: (i) the emergency response plan takes into account the abilities of the individual to follow the plan; (ii) the individual receives instruction concerning the emergency response plan:
(I) within 48 hours after the individual moves into the residence and annually thereafter; and
(II) if the individual's ability to follow the emergency response plan changes; (iii) the individual's service providers demonstrate competency in implementation of the emergency response plan at the time job duties are assumed and annually thereafter; (iv) the emergency response plan is reviewed and revised by the program provider when necessary and at least annually; and (v) a copy of the current emergency response plan is:
(I) maintained in the residence; and
(II) accessible to service providers.
(4) The program provider must ensure an individual participates in a fire drill:
(A) within 48 hours after the individual moves into the residence;
(B) at least every 90 calendar days thereafter, with at least two drills per year conducted during the individual's normal sleep hours; and
(C) if the individual's ability to participate in a fire drill changes.
(5) The program provider must ensure:
(A) the residence has furnishings that are safe for the individual in all common areas;
(B) a bedroom in the residence: (i) has at least:
(I) 80 square feet of floor space for a single occupancy room; and
(II) 60 square feet of floor space per individual in a double occupancy room; (ii) was built as a bedroom when the residence was built, or was remodeled under a permit that meets local building codes; (iii) is finished with walls or partitions of standard construction that go from floor to ceiling; (iv) is adequately ventilated and lighted; (v) has at least one window that will open freely and remain open from the inside without special tools; (vi) has no more than two beds in any room; (vii) has adequate drawer and closet space; and (viii) provides comfortable sleeping arrangements for the individual;
(C) the residence has a common telephone or other communication system usable by the individual and for which: (i) an individual has an opportunity to have input on residence procedures concerning:
(I) time limits on calls; and
(II) privacy during an individual's use of the phone; and (ii) the program provider does not charge an individual for local calls;
(D) bathrooms have adequate supplies of towels, washcloths, soap, and toilet tissue at all times; and
(E) flammable or poisonous substances are stored in a manner to make them inaccessible to an individual.
|