Header:
TEXAS ADMINISTRATIVE CODE
TITLE 40. SOCIAL SERVICES AND ASSISTANCE
PART 1. DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 90. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
SUBCHAPTER D. G
Date:
04/25/2014
Document:
§ 90.61. Introduction, Application, and General Requirements for Facilities for Persons with an Intellectual Disability or Related Conditions
(a) Scope. The requirements of this section are applicable to both new and existing facilities unless stated other-wise.
(b) Purpose.
(1) The concept of requirements for fire safety with regard to the residents is based on evacuation capability as published by National Fire Protection Association (NFPA) in NFPA 101 Life Safety Code. These standards are written with the premise that the residents will be capable of self-evacuation without continuous staff assistance. Residents that are not normally capable of self-evacuation nor capable of negotiating stairs unassisted shall not be housed above or below the floor of exit discharge unless the facility meets the construction requirements of NFPA 101, Chapter 18 titled "New Health Care Occupancies" or Chapter 19 titled "Existing Health Care Occupancies" for large facilities, or the "impractical" requirements for small facilities as found in NFPA 101, Chapter 32 titled "New Residential Board and Care Occupancies" or Chapter 33 titled "Existing Residential Board and Care Occupancies." Examples of residents who may not be capable of self-evacuation are as follows:
(A) a person with a physical disability of a nature that he/she is not capable of maneuvering in a wheelchair, walker, etc., unaided;
(B) a person with an intellectual disability who will not take or cannot understand instructions from a staff member; or
(C) a person that is taking medication before bedtime which will make it difficult for a staff member to arouse the person quickly.
(2) The method of determining the evacuation capability of residents under NFPA 101, Chapter 32 or 33, is by rating each resident and each staff member to determine an evacuation difficulty score (E-score). If the E-score is 1.5 or less, the evacuation capability of the facility is prompt, greater than 1.5 to five is slow, greater than five is impractical. The worksheets to be completed are located in NFPA 101A, Guide on Alternative Approaches to Life Safety, 2001 edition, Chapter 6. Intermediate care facilities for persons with an intellectual disability (ICF/ID) with 16 beds or less must meet the evacuation requirement for their designated Chapter 32 or 33 rating. The ratings and their require-ments follow:
(A) Impractical rating. (i) The facility must have one fire drill per shift each calendar quarter (minimum of 12 drills per year). (ii) The facility must actually evacuate clients once a year on each shift. (iii) All facility staff, including relief and substitute staff, must participate in drills as soon as possible after beginning employment on their shift. (iv) For initial certification, one client must be admitted. (v) E-scores are not required for certification under this rating.
(B) Slow rating. (i) The facility must have one fire drill per shift each calendar quarter (minimum of 12 drills per year). (ii) The facility must actually evacuate clients during all drills. (iii) Staff on each shift must participate in drills. (iv) New, relief, and substitute staff must participate in a drill within ten days of employment on their assigned shift. (v) For initial certification, two clients must be admitted. (vi) E-scores must be calculated as soon as possible, but within ten calendar days of admission. (vii) Initial E-scores are based on four drills, as follows:
(I) two conducted during the daytime, and
(II) two conducted during the nighttime, after the first 30 minutes and within the first three hours of sleep. (viii) After the initial E-scores are obtained, a worksheet for rating residents must be completed for all newly admitted cli-ents to obtain an E-score. The evacuation capability is calculated as described in clause (vii) of this subparagraph. (ix) E-scores must be updated annually or sooner if significant changes occur in any client's evacuation capability. These updated scores are based on the group's overall performance during fire drills as they are conducted throughout the year. Scores do not have to be calculated in accordance with the drills required for newly admitted clients based on the requirements stated in clause (vii) of this subparagraph.
(C) Prompt rating. (i) The facility must have one fire drill per shift each calendar quarter (minimum of 12 drills per year). (ii) The facility must actually evacuate clients during all drills. (iii) Staff on each shift must participate in drills. (iv) New, relief, and substitute staff must participate in a drill within ten days of employment on their assigned shift. (v) For initial certification, all six clients must be admitted. (vi) E-scores must be calculated as soon as possible, but within ten calendar days of admission. (vii) Initial E-scores are based on four drills, as follows:
(I) two conducted during the daytime, and
(II) two conducted during the nighttime, after the first 30 minutes and within the first three hours of sleep. (viii) After the initial E-scores are obtained, a worksheet for rating residents must be completed for all newly admitted cli-ents to obtain an E-score. The evacuation capability is calculated as described in clause (vii) of this subparagraph. (ix) E-scores must be updated annually or sooner if significant changes occur that would affect a client's evacuation capa-bility. These updated scores are based on the group's overall performance during fire drills as they are conducted throughout the year. Scores do not have to be calculated in accordance with the drills required for newly admitted clients based on the requirements stated in clause (vii) of this subparagraph.
(3) The "E" score will determine which NFPA 101 features are to be installed and maintained in the facility. These features include construction, fire alarm systems, smoke detector systems, interior finish, sprinkler systems, separation of bedrooms, and egress from the building.
(c) Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
(1) Addition-The addition of floor space.
(2) Large facilities-Facilities with 17 or more resident beds.
(3) Life safety features-Fire safety components required by NFPA 101 such as building construction, fire alarm systems, smoke detection systems, interior finishes, sizes and thicknesses of doors, exits, emergency electrical systems, sprinkler systems, etc.
(4) Remodeling-The altering of the structure, e.g., removal or addition of walls or partitions, floors, ceiling, roof.
(5) Renovation-The restoration to a former better state by cleaning, repairing, or rebuilding, e.g., routine mainte-nance, repairs, equipment replacement, painting.
(6) Small facilities-Facilities with 16 or fewer resident beds.
(d) Construction.
(1) New construction is any construction work that began on or after March 11, 2003. The provisions of NFPA 101, Chapter 18 are applicable for large facilities, and Chapter 32 for small facilities.
(2) An existing facility is one that was operating with a license as a facility for persons with an intellectual disability and related conditions before September 11, 2003, and has not subsequently become unlicensed. The provisions of NFPA 101, Chapter 19 are applicable for large facilities, and Chapter 33 for small facilities.
(3) Alterations or new installations of building services equipment, such as mechanical and electrical systems, generators, fire alarm, and detection systems, etc., must be accomplished in conformance with the requirements for new construction as required by NFPA 101.
(4) Site approval, as required by the local health officer, building department, and/or fire marshal having jurisdic-tion, must be obtained. Any conditions considered to be a fire, safety, or health hazard will be grounds for disapproval of the site by the department unless applied in an arbitrary or discriminating manner.
(5) Facilities that renovate must provide documentation for the flame spread rate of any new materials applied as an interior finish.
(6) Life safety features and equipment that have been installed in existing buildings and are now in excess of that required by NFPA 101 must continue to be maintained or must be removed at the direction of DADS.
(7) When an existing licensed facility plans building additions or remodeling, which includes construction of addi-tional resident beds, then the ratio of bathing units must be reevaluated to meet minimum standards and the square footage of dining and living areas must be reevaluated by DADS. Conversion of existing living, dining, or activity areas to resident bedrooms must not reduce these functions to an area less than required by minimum standards.
(8) Buildings must be of recognized permanent type construction. They must be structurally sound with regard to actual or expected dead, live, and wind loads according to applicable building codes.
(9) Each building must be classified as to the building construction type for fire resistance rating purposes in ac-cordance with NFPA 220 Standard on Types of Building Construction, and NFPA 101.
(e) Applicable codes and standards. Facilities must meet the requirements of NFPA 101, 2000 edition, and any other codes and standards of NFPA listed in this section, except as may be otherwise approved or required by DADS.
(1) If the municipality has a building code and a plumbing code, then those codes must govern in those areas of construction. Where local codes or ordinances are applicable, the most restrictive parts concerning the same subject item must apply unless otherwise determined by the authority having jurisdiction for local codes and DADS.
(2) In the absence of such governing municipal codes, nationally recognized codes must be used, such as the Standard Building Code and the Standard Plumbing Code, both of the Southern Building Code Congress International, Inc. Such nationally recognized codes, when used, must all be publications of the same group or organization to assure the intended continuity.
(3) Heating, ventilating, and air-conditioning systems must be designed and installed in accordance with NFPA 90A Standard for the Installation of Air Conditioning and Ventilating Systems, and NFPA 90B Standard for the Installation of Warm Air Heating and Air Conditioning Systems, as applicable, and the American Society of Heating, Ventilating, and Air- Conditioning Engineers (ASHRAE), except as may be modified in this subchapter.
(4) Electrical and illumination system must be designed and installed in accordance with NFPA 70 National Electrical Code, and the Lighting Handbook of the Illuminating Engineering Society of North America (IES) except as may be modified in this subchapter.
(5) The facility must meet all applicable provisions and requirements concerning accessibility for individuals with disabilities in the following laws and regulations: the Americans with Disabilities Act of 1990 (Public Law 101-336; Title 42, United States Code, Chapter 126); Title 28, Code of Federal Regulations, Part 35; Texas Civil Statutes, Article 9102; and Title 16, Texas Administrative Code, Chapter 68. Plans for new construction, substantial renovations, modifications, and alterations must be submitted to the Texas Department of Licensing and Regulation (Attention: Elimination of Architectural Barriers Program) for accessibility approval under Article 9102.
(6) All boilers not exempted by the Texas Health and Safety Code Annotated § 755.022 shall be inspected and cer-tified for operation by the Texas Department of Licensing and Regulation.
(f) General requirements.
(1) The facility must provide and maintain furnishings and decorations that meet the needs of the residents.
(2) The building, grounds, and equipment must be maintained in good repair, operational, sanitary, and free of hazards.
(3) There must be at least one telephone (other than a pay phone) in the facility, accessible to residents for use in making calls to summon help in case of emergency.
(4) The facility must have:
(A) floors that are free of irregularities and are substantially level (floor areas may be at different elevations with connecting stairs or ramps);
(B) floors that have a resilient, nonabrasive, and slip-resistant surface;
(C) nonabrasive carpeting, if the area used by residents is carpeted and serves residents who lie on the floor or ambulate with parts of their bodies, other than feet, touching the floor; and
(D) exposed floor surfaces and floor coverings that promote mobility in areas used by residents and promote maintenance of sanitary conditions.
(5) Walls and ceilings must be cleanable and in good repair.
(6) Walls and floors must be kept free of cracks. The joint between the walls and floors is to be maintained so as to be free of spaces which might harbor insects, rodents, or vermin.
(7) An adequate supply of hot water must be provided. The hot water system for resident use must be capable of being regulated to not exceed 110 degrees Fahrenheit at the fixtures.
(8) Draperies, curtains (including cubicle curtains), and other similar furnishings and decorations must be flame resistant in accordance with NFPA 701 Standard Methods of Fire Tests for Flame Resistant Textiles and Films. Docu-mentation must be kept on file in the facility.
(9) Wastebaskets must be of noncombustible material.
(10) An initial pressure test of facility gas lines from the meter must be provided. Additional pressure tests will be required when the facility has major renovations or additions where the gas service is interrupted. All gas heating sys-tems must be checked for proper operation and safety prior to the heating season. Any unsatisfactory conditions must be corrected promptly.
(11) The IES recommendations must be followed to achieve proper illumination characteristics and lighting levels throughout the facility. Minimum illumination must be 10 foot candles in resident rooms during the day and 20 foot candles in corridors, staff stations, dining rooms, lobbies, toilets, bathing facilities, laundries, stairways, and elevators during the day. Illumination requirements for these areas apply to lighting throughout the space and should be meas-ured at approximately 30 inches above the floor anywhere in the room. Minimum illumination for medication prepa-ration or storage areas, kitchens, and staff station desks must be 50 foot candles during the day. Illumination re-quirements for these areas apply to the task performed and should be measured on the tasks.
(12) In addition to the required illumination (normal and emergency), the facility must keep on hand and readily available to night staff, no less than one working flashlight.
(13) Combustible attic areas larger than 3,000 square feet must be divided into compartments not exceeding 3,000 square feet or the attic area must be sprinkled. The separating barrier must be at least one layer of 1/2-inch gypsum board on one side of support members.
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