Document Citation: 40 TAC § 42.626
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:

§ 42.626. Habilitation

(a) General.

(1) A program provider may deliver habilitation as:

(A) day habilitation; or

(B) residential habilitation.

(2) A program provider may bill for time spent by a day habilitation or residential habilitation service provider:

(A) in direct contact with an individual;

(B) participating as a member of an individual's service planning team; or

(C) performing tasks delegated by a registered nurse.

(3) A program provider must not bill for time spent by a day habilitation or residential habilitation service provider:

(A) in administrative meetings;

(B) in inservice or general training;

(C) processing paperwork; or

(D) traveling to or from an individual's home, except when the service provider is transporting the individual.

(4) A program provider must document the following outcomes for day or residential habilitation in the individual's record:

(A) the individual effectively communicates wants and needs to a day or residential habilitation 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 the day habilitation or residential habilitation setting.

(5) If requested by DADS, a program provider must be able to demonstrate the outcomes in paragraph (4)(A) - (E) of this subsection.

(b) Day habilitation. A program provider must ensure:

(1) day habilitation:

(A) is provided in a non-residential setting separate from the individual's own or family home or the residence in which the individual receives licensed assisted living or licensed home health assisted living that: (i) is accessible to and usable by the individual; (ii) is maintained in good repair; (iii) has at least two means of egress; and (iv) is in continuous compliance with applicable local building codes and ordinances and applicable state and federal laws, rules, and regulations;

(B) reinforces: (i) therapeutic outcomes targeted by other DBMD Program services; and (ii) for an individual eligible for public education services, education goals in the Individualized Education Program (IEP) and services provided by the school district;

(C) includes transportation necessary for the individual's participation in day habilitation activities;

(D) is not provided to the individual at the same time that one of the following DBMD Program services is provided: (i) employment assistance; (ii) supported employment; (iii) residential habilitation; or (iv) respite;

(2) a day habilitation service provider works with one individual at a time unless the individual's service planning team documents on the IPP that the individual's needs can be met with a day habilitation service provider to individual ratio of one-to-two or one-to-three;

(3) a service planning team recommendation on the IPP for a day habilitation service provider to individual ratio higher than one-to-three is supported by documentation of the individual's ability to integrate and meaningfully participate in an environment with a higher ratio;

(4) a day habilitation service provider:

(A) develops and implements a written emergency response plan that describes the actions the day habilitation service provider will take in the event of an emergency such as a fire or other man-made or natural disaster at a day habilitation site including evacuation or sheltering-in-place of the individual, as appropriate;

(B) takes into account the needs and abilities of the individual in developing the emergency response plan;

(C) requires its staff members to demonstrate competency in implementation of the emergency response plan at the time job duties are assumed and annually thereafter;

(D) reviews the emergency response plan at least annually and, if necessary, revises the plan;

(E) maintains a copy of the current emergency response plan in a location that is easily accessible by all staff at the day habilitation site;

(F) conducts a fire drill at least once every 90 calendar days; and

(G) documents that requirements in subparagraphs (C) - (F) of this paragraph are met.

(c) Residential habilitation.

(1) A program provider must ensure:

(A) residential habilitation: (i) is provided:

(I) in the individual's own or family home; or

(II) in a setting outside the individual's own or family home appropriate for the type of residential habilitation activities described in the individual's IPP; (ii) for an individual under 18 years of age, is not provided by the individual's parent or managing conservator; (iii) may include:

(I) transportation necessary for the individual to participate in community activities or assistance in securing such transportation;

(II) assistance with ambulation and mobility;

(III) reinforcement of behavioral support or therapy activities;

(IV) assistance with medications and the performance of tasks delegated by an RN in accordance with state law;

(V) supervision of the individual's safety and security;

(VI) assistance with acquisition, retention, or improvement in skills related to activities of daily living, including:

(-a-) personal grooming and cleanliness;

(-b-) bed making and household chores; and

(-c-) preparation and consumption of food;

(VII) use of natural supports and typical community services; and

(VIII) social interaction and participation in leisure activities; (iv) is not provided to the individual at the same time that one of the following DBMD Program services is provided:

(I) employment assistance;

(II) supported employment;

(III) day habilitation;

(IV) respite; or

(V) licensed assisted living or licensed home health assisted living; and

(B) a residential habilitation service provider works with no more than one individual at a time.

(2) DADS does not reimburse a program provider for:

(A) the routine care and supervision that a family member is legally obligated to provide;

(B) activities or supervision for which a payment is made by a source other than Medicaid;

(C) room and board; or

(D) any service that is not provided in accordance with this chapter and DBMD Program Manual.