26 TAC Ch. 301

Local Authority Responsibilities

This subchapter establishes procurement and contracting requirements for Texas local authorities (community mental health and mental retardation authorities) when acquiring goods and services, including community mental health and mental retardation services. It sets standards for conflict-of-interest, standards of conduct, competitive procurement procedures, best-value determinations, contract award, and contract management. Facility operators contracting with a local authority must comply with all contract provisions, ensure quality service delivery to consumers, and adhere to applicable state and federal grant management standards.

§301.1 Purpose
The purpose of this subchapter is to comply with the Texas Health and Safety Code, §534.052, §534.055, and §534.065.
Source Note: The provisions of this §301.1 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.3 Application
This subchapter applies to all contracts for goods and services awarded by a local authority.
Source Note: The provisions of this §301.3 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.5 Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

(1) Application--Documents prepared by a respondent in response to a request for applications.

(2) Best value--The optimum combination of economy and quality that is the result of fair, efficient, and practical procurement decision-making and which achieves the following objectives:

(A) promote fairness and competition for local authority contracts;

(B) support the delivery of services and benefits that best meets the needs of clients of programs administered by the local authority;

(C) promote timely, high quality, and responsive performance by contractors; and

(D) encourage and reward the continuing participation of quality contractors.

(3) Business entity--A sole proprietorship, partnership, firm, corporation, holding company, joint-stock company, receivership, trust, or any other entity recognized by law.

(4) Consumer--A person in the priority population or otherwise designated in the performance contract as eligible for community services.

(5) Contract--A written agreement, including a purchase order, between a local authority and a business entity that obligates the entity to provide goods or services in exchange for money or other valuable consideration.

(6) Contract management--Initiating, procuring, awarding, monitoring, and enforcing a contract.

(7) Contract term--The period of time during which a contract is in effect, identified by a starting and ending date.

(8) Contractor--A business entity that has a contract for goods or services with a local authority.

(9) Goods--Tangible personal property and intellectual property.

(10) Intellectual property--Any intangible asset that consists of human knowledge and ideas (e.g., software).

(11) Local authority--An entity designated by the TDMHMR commissioner in accordance with the Texas Health and Safety Code, §533.035(a).

(12) Local service area--A geographic area composed of one or more Texas counties delimiting the population which may receive community services from a local authority.

(13) Participated--To have taken action as an officer or employee through decision, approval, disapproval, recommendation, giving advice, investigation, or similar action.

(14) Particular matter--A specific investigation, application, request for a ruling or determination, proceeding related to the development of policy, contract, claim, charge, accusation, arrest, or judicial or other proceeding.

(15) Performance contract--The contract between TDMHMR and a local authority in which TDMHMR agrees to pay the local authority a specified sum and in which the local authority agrees to provide local match, for, at a minimum, ensuring and/or monitoring the provision of specified mental health and mental retardation services in a local service area.

(16) Priority population--Those groups of persons with mental illness and mental retardation identified in TDMHMR's current strategic plan as being most in need of mental health and mental retardation services.

(17) Proposal--Documents prepared by a respondent in response to a request for proposals.

(18) Respondent--A business entity that submits an oral, written, or electronic response to a solicitation. The term is intended to include "applicant," "offeror," "proposer," and other similar terminology to describe a business entity that responds to a solicitation.

(19) Response--An oral, written, or electronic "offer," "proposal," "quote," "application," or other applicable expression of interest to a solicitation.

(20) Services--

(A) Community services--Mental health and mental retardation services required to be available in each local service area pursuant to the Texas Health and Safety Code, §534.053(a), for which TDMHMR contracts through the performance contract as well as all other services specified in the performance contract.

(B) Non-community services--All services other than community services.

(21) Solicitation--A notification of the local authority's intent to purchase community services (e.g., request for proposals and request for applications).

(22) TDMHMR--The Texas Department of Mental Health and Mental Retardation.
Source Note: The provisions of this §301.5 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.7 Accountability
(a) All purchases of goods and services must be made pursuant to a contract.

(b) Conflicts of interests and standards of conduct for local authority employees and officers.

(1) Conflicts of interest. Local authority employees and officers may not have a conflict of interest in contracts management. An employee or officer has a conflict of interest when the employee, officer, a partner of the employee or officer, or a person related within the second degree of consanguinity or affinity to the employee or officer, has or intends to have:

(A) employment with a respondent or contractor;

(B) paid consultation with a respondent or contractor;

(C) membership on a respondent's or contractor's board of directors;

(D) ownership of 10% or more of the voting stock of shares of a respondent or contractor;

(E) ownership of 10% or more or $5,000 or more of the fair market value of a respondent or contractor; or

(F) income from a respondent or contractor in excess of 10% of the employee's, officer's, or related person's gross income for the previous year.

(2) Standards of conduct. The local authority must develop and enforce standards of conduct governing its employees' and officers' who participate in contracts management, which prohibits such employees and officers from:

(A) accepting or soliciting any gift, favor, service, or benefit from a business entity, respondent, or contractor that might reasonably tend to influence the employee or officer in the discharge of official duties relating to contract management, or that the employee or officer knows or should know is being offered with the intent to influence the employee's or officer's official duties; or

(B) intentionally or knowingly soliciting, accepting, or agreeing to accept any benefit for having exercised official powers or for having performed official duties in favor of another business entity, respondent, or contractor.

(c) Conflicts of interests and standards of conduct for a respondent and its officers and employees.

(1) Conflict of interest. A respondent and its officers and employees responsible for development of a response or performance of a contract for which the respondent is submitting a response may not be related within the second degree of consanguinity or affinity to a local authority employee or officer participating in the contract management for the contract for which the respondent is submitting a response.

(2) Standards of conduct.

(A) A respondent and its officers and employees may not attempt to induce any business entity to submit or not to submit a response.

(B) A respondent and its officers and employees must arrive at its response independently and without consultation, communication, or agreement for the purposes of restricting competition.

(C) A respondent and its officers and employees may not have a relationship with any person, at the time of submitting the response or during the contract term, that may interfere with fair competition.

(D) A respondent and its officers and employees may not participate in the development of specific criteria for award of the contract, nor participate in the selection of the response to be awarded the contract.

(d) The local authority may not contract with a former officer or employee of the local authority if the contract relates to a particular matter (as defined) in which the former officer or employee participated (as defined) during the period of employment, either through personal involvement or because the case or proceeding was a matter within the officer's or employee's official responsibility, unless:

(1) the former employee was compensated on the last day of service or employment below the amount prescribed by the General Appropriations Act for salary group 17, Schedule A, or salary group 9, Schedule B, of the position classification salary schedule; or

(2) the former officer or employee is employed by a state agency or another local authority.

(e) The local authority must ensure that its contractors comply with all contract provisions regardless of whether a contractor subcontracts some or all of the contract.

(f) A local authority may make advance payments to a contractor provided the payments meet a public purpose, ensure adequate consideration, and sufficient controls are in place to ensure accomplishment of the public purpose. With the exception of contracts paid on a capitated basis, at the end of each contract term the contractor must return to the local authority any state or federal funds received from or through TDMHMR which have not been encumbered.

(g) The local authority is prohibited from contracting with a business entity that is currently:

(1) held in abeyance or barred from the award of a federal or state contract; or

(2) is not in good standing for state tax, pursuant to the Texas Business Corporation Act, Texas Civil Statutes, Article 2.45.

(h) The local authority must ensure each contractor is provided information relating to the local authority's policies and procedures that are relevant to the contractor.

(i) The local authority shall ensure quality community services are provided to consumers, including during the transition from one contractor to another.

(j) When purchasing goods and services, the local authority shall comply with the Uniform Grant and Contracts Management Standards (UGMS) promulgated by the Governor's Office of Budget and Planning (pursuant to the Texas Government Code, Chapter 783, and 1 TAC, Part 1, Chapter 5, Subchapter A, Division 4), except to the extent that any provision in §412.55(a)(2) of this title (relating to Contract Procurement) conflicts with UGMS, Part III (State Uniform Administrative Requirements for Grants and Cooperative Agreements), Subpart C (Post-Award Requirements; Changes Property, and Subawards), Section __.36(d) (Procurement), then §412.55(a)(2) of this title (relating to Contract Procurement) shall control. In UGMS:

(1) the terms "recipient" and "grantee" apply to TDMHMR;

(2) the terms "subrecipient" and "subgrantee" apply to the local authority; and

(3) the terms "vendor" and "subcontractor" apply to a contractor (as defined in this subchapter), unless the contractor operates as a "subgrantee" as defined under UGMS, Part III (State Uniform Administrative Requirements for Grants and Cooperative Agreements), Subpart A (General), Section __.3 (Definitions).
Source Note: The provisions of this §301.7 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.9 Procurement
(a) Procurement method. The local authority must develop and enforce procurement procedures that comply with this subchapter.

(1) Goods and non-community services. The local authority must acquire goods and non-community services by any procurement method described in the Uniform Grant and Contracts Management Standards (UGMS), Section __.36(d), that provides the best value to the local authority.

(2) Community services. The local authority must acquire community services by a procurement method described in this subchapter that provides the best value to the local authority. All community services must be procured competitively in accordance with §412.58 of this title (relating to Competitive Procurement of Community Services Contracts) unless the local authority determines that the community service(s):

(A) can be procured non-competitively in accordance with §412.59 of this title (relating to Non-competitive Procurement of Community Services Contracts); or

(B) should be procured through open enrollment in accordance with §412.60 of this title (relating to Open Enrollment).

(b) Relevant factors. The local authority must consider all relevant factors in determining best value, which may include:

(1) any installation cost;

(2) the delivery terms;

(3) the quality and reliability of the respondent's goods or services;

(4) the extent to which the goods or services meet the local authority's needs;

(5) indicators of probable respondent performance under the contract, such as past offeror performance, the respondent's financial resources and ability to perform, the respondent's experience and responsibility, and the respondent's ability to provide reliable maintenance agreements;

(6) the impact on the ability of the local authority to comply with laws and rules relating to historically underutilized businesses or relating to the procurement of goods and services from persons with disabilities;

(7) the total long term cost to the local authority of acquiring the respondent's goods or services;

(8) the cost of any employee training associated with the acquisition;

(9) the effect of an acquisition on the local authority's productivity;

(10) the acquisition price;

(11) whether the respondent can perform the contract or provide the service(s) within the contract term, without delay or interference;

(12) the respondent's history of compliance with the laws relating to its business operations and the affected service(s) and whether it is currently in compliance;

(13) whether the respondent's financial resources are sufficient to perform the contract and to provide the service(s);

(14) whether necessary or desirable support and ancillary services are available to the respondent;

(15) the character, responsibility, integrity, reputation, and experience of the respondent;

(16) the quality of the facilities and equipment available to or proposed by the respondent;

(17) the ability of the respondent to provide continuity of services;

(18) the ability of the respondent to meet all applicable written policies, principles, and regulations; and

(19) any other factor relevant to determining the best value for the local authority in the context of a particular acquisition.

(c) Award. All contracts must be awarded based on best value, as determined by considering all relevant factors.

(d) Renewal of community services contracts. The local authority may renew a community services contract only if the contract meets best value as determined by considering all relevant factors.
Source Note: The provisions of this §301.9 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.11 Community Services Contracting Requirements
(a) The local authority is prohibited from amending a community services contract:

(1) to increase the contract amount by more than 25%; or

(2) to add a new community service unless the contract was procured through open enrollment.

(b) Upon written request by an unsuccessful respondent, the local authority must provide information concerning why the respondent's response was not selected for award.

(c) The local authority must develop written procedures that provide respondents an opportunity to protest a contract award.

(1) The procedures must allow respondents to protest matters relating to:

(A) alleged conflict of interests;

(B) alleged failure of the local authority to comply with statute or rule; and

(C) alleged failure of the local authority to comply with its procurement procedures.

(2) The procedures must describe the local authority's process for reviewing and resolving protests.

(d) The local authority must maintain for five years or until the end of any litigation concerning the contract the following contract management documentation:

(1) justification for non-competitive procurement as permitted in §412.59(a) of this title (relating to Non-competitive Procurement of Community Services Contracts), if applicable;

(2) the solicitation and any modifications or revisions made to the solicitation;

(3) all responses to the solicitation and any modifications or revisions made to such responses;

(4) the evaluations of all responses and evidence that the local authority considered all relevant factors;

(5) written correspondence between the local authority and respondents prior to contract award;

(6) optional or required credentials (certifications, licenses, accreditations), if any;

(7) written protests, if any, and their disposition;

(8) the executed contract;

(9) written correspondence between the local authority and the contractor concerning the contractor's performance; and

(10) copies of any audits performed or required by the local authority.
Source Note: The provisions of this §301.11 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.13 Provisions for Community Services Contracts
(a) The local authority must ensure that all its community services contracts are consistent with the local authority's performance contract and with the model contracts designed by TDMHMR as required by the Texas Health and Safety Code, §534.055(c).

(b) The local authority must include in all of its community services contracts that are funded by TDMHMR provisions stating:

(1) the contract term;

(2) the community service(s) to be purchased;

(3) the identification of all parties;

(4) the total allowable payment or, if the community service is procured through open enrollment or is on a capitated basis, the rate of payment;

(5) the method of payment;

(6) that the contractor must comply with all applicable federal and state laws, rules, and regulations, including:

(A) Title VI of the Civil Rights Act of 1964;

(B) Section 504 of the Rehabilitation Act of 1973;

(C) the Americans with Disabilities Act of 1990 (ADA); and

(D) the Age Discrimination in Employment Act of 1967;

(7) that if, as a result of a change to a TDMHMR rule or state or federal law, the contractual obligations of the contractor are materially changed or a significant financial burden is placed on the contractor, then the parties may renegotiate in good faith to amend the contract;

(8) that no consumer will be excluded from participation in, denied the benefits of, or unlawfully discriminated against, in any program or activity funded by the contract on the grounds of race, color, ethnicity, national origin, religion, sex, age, disability, or political affiliation in accordance with applicable laws;

(9) that all documents pertinent to the contract, including consumer records, will be retained by the contractor for a period of five years;

(10) that all consumer-identifying information will be maintained by the contractor as confidential in accordance with applicable law and Chapter 414, Subchapter A of this title (relating to Client-Identifying Information);

(11) that the contractor, its licensed staff, and other appropriate staff (such as QMHP-CS) will be credentialed before services are delivered to consumers by such contractor and staff;

(12) a dispute resolution process;

(13) the clearly defined performance expectations which directly relate to the community service's objectives, including goals, outputs, and measurable outcomes, and that the contractor must provide services in accordance with such expectations;

(14) that any allegation of abuse, neglect, or exploitation of a consumer under the contract will be reported in accordance with applicable law, TDMHMR rules, and Texas Department of Protective and Regulatory Services rules;

(15) that AIDS/HIV workplace guidelines, similar to those adopted by TDMHMR and AIDS/HIV confidentiality guidelines and consistent with state and federal law, will be adopted and implemented by the contractor;

(16) that the contractor will comply with the relevant TDMHMR rules, certifications, accreditations, and licenses, that are specified in the contract;

(17) that services will be provided in accordance with consumers' treatment plans;

(18) that pursuant to Texas Health and Safety Code, §534.061, TDMHMR, the local authority, and their designees, including independent financial auditors, shall have, with reasonable notice, unrestricted access to all facilities, records, data, and other information under the control of the contractor as necessary to enable the local authority to audit, monitor, and review all financial and programmatic activities and services associated with the contract;

(19) any sanctions and remedies the local authority may take in response to the contractor's failure to comply with the contract provisions; and

(20) that the contractor will immediately notify the local authority of any change, or potential change, in its status that could affect its inclusion in the provider network.

(c) The local authority must include in all of its community services contracts for residential services that are funded by TDMHMR provisions stating:

(1) that the contractor shall provide evidence of criminal history record information on the contractor's applicants, employees, and volunteers, pursuant to the Texas Health and Safety Code, §533.007 and Chapter 250; the Texas Government Code, §411.115; and Chapter 414, Subchapter K of this title (relating to Criminal History Clearances); and

(2) that if an applicant, employee, or volunteer of the contractor has a criminal history relevant to his or her employment as described in Chapter 414, Subchapter K of this title (relating to Criminal History Clearances), then the contractor will take appropriate action with respect to the applicant, employee, or volunteer, including terminating or removing the employee or volunteer from direct contact with consumers served by the contractor.

(d) Community services contracts that require the contractor to assume responsibility for the funds of a consumer must contain provisions requiring the contractor to have and abide by a written policy, which is subject to approval by the local authority, for protecting and accounting for such funds in accordance with generally accepted accounting principles.
Source Note: The provisions of this §301.13 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.15 Competitive Procurement Methods for Community Services
Competitive procurement methods for community services are as follows.

(1) Informal solicitation.

(A) Determination. The local authority may competitively procure community services through informal solicitation if the contract amount does not exceed $25,000.

(B) Solicitation.

(i) The local authority must solicit business entities that provide the type of community service(s) being procured and attempt to obtain at least three responses for the service's specifications. Solicitation and responses may be oral, written, or electronic.

(ii) Documentation for informal solicitation must include:

(I) the names and telephone numbers of the business entities contacted and the date of contact;

(II) the specifications for the community service(s); and

(III) all responses.

(C) Award. The award of a contract procured through informal solicitation is made in accordance with §412.55(c) of this title (relating to Contract Procurement).

(2) Request for proposals (RFP).

(A) Determination. The local authority may competitively procure community services through an RFP.

(B) Solicitation.

(i) The local authority must make a reasonable effort to give notice of its intent to contract for community services to providers of the community service(s) in the authority's local service area. The local authority must publish an RFP Notice in a local newspaper or professional association newsletter or announce by direct mail to all known providers of those community service(s) at least 10 calendar days, but not more than 90 calendar days, prior to the due date for the submission of proposals. An RFP Notice must include:

(I) the contract term;

(II) a general description of the community service(s) to be purchased;

(III) the geographic area to be served;

(IV) any limitations on who may submit a proposal;

(V) the procedures for obtaining an RFP; and

(VI) the date and time by which proposals must be received by the local authority.

(ii) The local authority must provide an RFP to each business entity that requests one. The local authority may not restrict competition by unreasonably eliminating or limiting participation in the procurement process. An RFP must include:

(I) a detailed description of the community service(s) to be purchased, the consumer eligibility criteria, and all other information included in the RFP Notice;

(II) the approximate number of consumers to be served pursuant to the contract;

(III) method of payment;

(IV) a detailed description of information to be included in a proposal;

(V) instructions for the submission of questions concerning the procurement;

(VI) instructions for the submission of proposals;

(VII) respondent eligibility requirements for contract award (e.g., credentials for providing the community service(s), such as applicable certifications, licenses; evidence of compliance or ability to comply with relevant TDMHMR rules; evidence of accessibility; evidence of financial solvency; and evidence of liability insurance);

(VIII) assurances that:

(-a-) the respondent has no conflict of interest and meets the standards of conduct requirements pursuant to §412.54(c) of this title (relating to Accountability);

(-b-) the respondent is not currently held in abeyance or barred from the award of a federal or state contract; and

(-c-) the respondent is not delinquent in a tax owed the state under Chapter 171, Tax Code, pursuant to the Texas Business Corporation Act, Texas Civil Statutes, Article 2.45;

(IX) the criteria for evaluation of proposals and contract award; and

(X) all relevant factors the local authority will use to determine best value.

(iii) A proposal must include:

(I) the respondent's name, address, telephone number, and type of business entity; and

(II) all information required in paragraphs (2)(B)(ii)(IV), (VII), and (VIII) of this subsection.

(iv) Changes to an RFP may be made by the local authority prior to the date designated for submission of proposals if everyone who has obtained an RFP is notified of the changes and is provided equal opportunity to respond.

(v) The local authority must keep all information contained in proposals confidential until a contract has been awarded.

(vi) Any changes to a proposal must be made by the respondent in writing and must be received by the local authority prior to the submission date and time.

(vii) The local authority may validate any information in a proposal by using outside sources or materials.

(C) Award.

(i) For a proposal to be considered for award, the respondent must follow the instructions and meet the requirements specified in the RFP.

(ii) After the proposal submission date, the local authority may obtain clarification or confirmation of information submitted in a proposal if such information is necessary to complete the award process; however, no respondent may be given information which would give that respondent a competitive advantage over any other respondent.

(iii) Negotiations may be conducted with a respondent to complete the procurement process or to complete an evaluation of a proposal.

(I) If only one proposal is received that may be considered for award, the local authority and the respondent may negotiate the contract requirements as necessary to complete the procurement process.

(II) If more than one proposal is received that may be considered for award, the local authority may negotiate to further evaluate proposals and to select one or more respondents for award; however, no respondent may be given information which will give that respondent a competitive advantage over any other respondent.

(iv) The award of a contract procured through an RFP must be made in accordance with §412.55(c) of this title (relating to Contract Procurement).

(v) The local authority may cancel an RFP without award.
Source Note: The provisions of this §301.15 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.17 Non-competitive Procurement of Community Services
(a) Determination. The local authority may procure community services non-competitively only if:

(1) the procurement is pursuant to the Texas Health and Safety Code, §533.017;

(2) the services are proprietary to a single source or only one source can or will provide the service;

(3) the services will be provided by a governmental entity;

(4) there exists an emergency situation in which a delay may result in harm to a consumer who is to receive the community service;

(5) the services are for less than $5000 and the total amount was not divided to qualify for a non-competitive procurement; or

(6) a competitive procurement was attempted and either no qualified response or only one qualified response was received.

(b) Award. The award of a contract procured non-competitively must be made in accordance with §412.55(c) of this title (relating to Contract Procurement).
Source Note: The provisions of this §301.17 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.19 Open Enrollment
(a) Determination. The local authority may issue a Request for Applications (RFA) to procure community services through open enrollment in accordance with this section.

(b) Solicitation.

(1) The local authority must publish in a local newspaper or professional association newsletter an RFA Notice to providers of all community services the local authority intends to procure through open enrollment. In addition, the local authority must continuously and prominently display such RFA Notice at the local authority's administrative office(s). At least once every two years the local authority must publish in a local newspaper or professional association newsletter an RFA Notice to providers of all community services currently procured through open enrollment. The RFA Notice must include:

(A) a brief description of the types of community services the local authority intends to procure through open enrollment;

(B) the geographic area to be served;

(C) the procedure for obtaining an application; and

(D) the date and time by which applications must be submitted, if any.

(2) A local authority must provide an application to each business entity that requests one. An RFA must include:

(A) a detailed description of each type of community service the local authority intends to procure through open enrollment, the consumer eligibility criteria, and all other information included in the RFA Notice;

(B) the rate of payment for each type of community service and the method used to determine that rate;

(C) a detailed description of the information to be included in an application;

(D) instructions for the submission of applications;

(E) respondents eligibility requirements for contract award (e.g., credentials for providing the community service(s), such as applicable certifications, licenses; evidence of compliance or ability to comply with relevant TDMHMR rules; evidence of accessibility; evidence of providing quality services; evidence of financial solvency; and evidence of liability insurance); and

(F) assurances that:

(i) the respondent is not currently held in abeyance or barred from the award of a federal or state contract; and

(ii) the respondent is currently in good standing for state tax, pursuant to the Texas Business Corporation Act, Texas Civil Statutes, Article 2.45.

(3) An application must include the following information:

(A) the respondent's name, address, telephone number, and type of business entity;

(B) all information required in paragraph (2)(C), (E), and (F) of this subsection; and

(C) a statement that the respondent agrees to provide the specified community service(s) at the rate of payment described in the RFA.

(c) Award.

(1) The local authority may obtain clarification or confirmation of information submitted in an application.

(2) The local authority must award a contract to all respondents whose applications are complete and who meet all requirements specified in the RFA.

(3) All contracts for each type of community service provided through open enrollment must contain the same contract term, conditions, provisions, and requirements, including a statement that the contractor is prohibited from:

(A) offering any gift with a value in excess of $10 to potential consumers; and

(B) soliciting potential consumers through direct-mail or by telephone.
Source Note: The provisions of this §301.19 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.21 Consumer Access to Participating Community Services Contractors in Provider Network
(a) The local authority must maintain, and make available to consumers, current information about each community services contractor participating in its provider network. The information must represent all participating contractors fairly and must be organized and relevant to consumers.

(b) The local authority must allow consumers to choose freely, without influence by any local authority staff or representative, any contractor participating in the provider network that provides the type of community service which the local authority has authorized for the consumer.
Source Note: The provisions of this §301.21 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.23 Monitoring and Enforcing Community Services Contracts
(a) Monitoring. The local authority must maintain a contracts management system that ensures each community services contractor performs in accordance with the provisions of the contract. The local authority shall monitor each community services contractor's compliance with the contract and evaluate the contractor's provision of services, including:

(1) competency of the contractor to provide care;

(2) consumers' access to services;

(3) safety of the environment in which services are provided;

(4) continuity of care;

(5) compliance with the performance expectations (referenced in §412.57(b)(13) of this title (relating to Provisions for Community Services Contracts));

(6) satisfaction of consumers and family members with services provided; and

(7) utilization of resources.

(b) Enforcing. The local authority shall enforce each community services contract. The local authority shall develop policies and procedures regarding contract enforcement that address the use of at least the following enforcement actions:

(1) training;

(2) technical assistance for contractors;

(3) a plan of correction; and

(4) sanctions, which may include:

(A) withholding or recouping funds;

(B) imposing financial penalties;

(C) requiring service delivery at no additional cost to the local authority;

(D) suspending participation in the provider network;

(E) contract amendment; and

(F) contract termination.
Source Note: The provisions of this §301.23 adopted to be effective April 22, 2001, 26 TexReg 2845; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.51 Purpose
The purpose of this subchapter is to protect consumers at a facility, local authority, community center, or contract provider of residential services, and the property of those consumers. To do so, this subchapter:

(1) describes the process by which criminal history clearances are conducted for applicants for employment or volunteer status with facilities, local authorities, community centers, and contract providers of residential services;

(2) requires facilities, local authorities, community centers, and contract providers of residential services to have an effective self-reporting procedure for employees and volunteers; and

(3) describes the process by which registry clearances are conducted for applicants for employment or volunteer status with facilities, local authorities, community centers, and contract providers of residential services.
Source Note: The provisions of this §301.51 adopted to be effective February 6, 2002, 27 TexReg 749; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.53 Application
(a) This subchapter applies to:

(1) facilities (which include TDMHMR Central Office);

(2) local authorities; and

(3) community centers.

(b) Facilities, local authorities, and community centers must require their contract providers of residential services, including residences certified by the intermediate care facilities for the mentally retarded or persons with a related condition (ICF/MR or ICF/MR/RC) program that are owned and operated by a local authority or community center, to comply with the applicable provisions of this subchapter.

(c) This subchapter does not apply to residences certified by the ICF/MR or ICF/MR/RC program that are owned by a local authority or community center but operated under contract by a private provider, or that are privately owned and operated. Criminal history and registry clearances are conducted for such residences in accordance with rules of the Texas Department of Human Services (TDHS) in 40 TAC §§76.101- 76.106.
Source Note: The provisions of this §301.53 adopted to be effective February 6, 2002, 27 TexReg 749; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.55 Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

(1) Applicant--At the employer's discretion, either a person who is one of a select number of final candidates for a position as an employee or volunteer or a person to whom the employer intends to offer a position as an employee or volunteer. The term "applicant" does not include a member of the Texas MHMR Board, a member of a local authority's or community center's board of trustees, or a member of a facility's, local authority's, or community center's advisory committee that is not a public responsibility committee (PRC).

(2) Community center--A community mental health and mental retardation center established under the Texas Health and Safety Code, Title 7, Chapter 534, Subchapter A.

(3) Consumer--An individual receiving services from a facility, local authority, community center, or contract provider of residential services.

(4) Conviction--The adjudication of guilt, plea of guilty or nolo contendere, or the assessment of probation or community supervision for a violation of the Penal Code.

(5) Facility--Any state hospital, state school, or state center operated by TDMHMR, or TDMHMR Central Office.

(6) Local authority--An entity designated by the TDMHMR commissioner in accordance with the Texas Health and Safety Code, §533.035(a).

(7) Provider--Any entity or person who contracts with a facility, local authority, or community center to deliver residential services to individuals with mental illness or mental retardation who have been furloughed or discharged from a facility or community center as described in the Texas Government Code, §411.115(b). This does not include private ICF/MR or ICF/MR/RC providers.

(8) Professional clinical intern--A person who is enrolled in a formal clinical rotation at a university/college in a professional training program accredited by the appropriate licensing authority or board of examiners, or is engaged in a recognized graduate level, clinical professional degree program. Professional degree programs include, but are not limited to, clinical psychology, dentistry, medicine, nursing, occupational therapy, pharmacy, physical therapy, psychiatry, and social work.

(9) Registry--

(A) The Nurse Aide Registry maintained by the Texas Department of Human Services in accordance with §94.11 of Title 40 (relating to Registry, Findings, Inquiries); and

(B) the Employee Misconduct Registry maintained by the Texas Department of Human Services in accordance with the Texas Health and Safety Code, Chapter 253.

(10) Visiting group--A group of varying individuals associated with an organization (e.g., civic, fraternal, corporate, religious, social, service, or education), which is not affiliated with a facility, local authority, community center, or provider, that visits a facility, local authority, community center, or provider (e.g., tours) or participates in a special event and has constant and adequate staff supervision.

(11) Volunteer--An individual who is not part of a visiting group and who provides time or services to consumers, a facility, local authority, community center, volunteer services council, or provider without compensation from the facility, local authority, community center, volunteer services council, or provider other than reimbursement for actual expenses. The term does not include a professional clinical intern.

(12) Volunteer services council--A 501(c)(3) organization that is formed for the purpose of generating resources on behalf of a facility, local authority, or community center.
Source Note: The provisions of this §301.55 adopted to be effective February 6, 2002, 27 TexReg 749; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.57 Pre-employment and Pre-assignment Clearance
(a) Each facility, local authority, community center, and provider must conduct:

(1) a pre-employment criminal history and registry clearance of all applicants (as defined) for employment; and

(2) a pre-assignment criminal history and registry clearance of all applicants for volunteer status.

(b) A provider that is required to conduct criminal history and registry clearances in accordance with the Texas Health and Safety Code, Chapter 250, must provide evidence of compliance with that law to the facility, local authority, or community center with which it contracts.

(c) For professional clinical interns, a written agreement must exist between the facility, local authority, or community center and the university/college. The written agreement must include:

(1) a statement that responsibility for the care of consumers is retained by the facility, local authority, or community center;

(2) a statement that background checks of professional clinical interns must ensure compliance with subsection (d) of this section; and

(3) a description of how background checks of professional clinical interns will be conducted and funded.

(d) The following individuals may not be employed by, assigned volunteer status at, or serve as a professional clinical intern at, a facility, local authority, community center, or provider:

(1) an individual who has been convicted of any of the criminal offenses listed in subsection (g) of this section;

(2) an individual who has been convicted of a criminal offense that the facility, local authority, community center, or provider has determined to be a contraindication to employment or volunteer status at that entity;

(3) an individual who is listed as revoked in the Nurse Aide Registry; or

(4) an individual who is listed as unemployable in the Employee Misconduct Registry.

(e) The facility, local authority, community center, or provider must inform applicants in writing at the time that application is made of the following:

(1) that a pre-employment/pre-assignment criminal history and registry clearance will be conducted;

(2) the types of criminal offenses for which a conviction would bar employment or volunteer status as required by law;

(3) that conviction of other types of criminal offenses may be considered a contraindication to employment or volunteer status at that entity; and

(4) that being listed as revoked in the Nurse Aide Registry or being listed as unemployable in the Employee Misconduct Registry would bar employment or volunteer status.

(f) An applicant who is not listed as revoked in the Nurse Aide Registry and who is not listed as unemployable in the Employee Misconduct Registry may be employed on a temporary or interim basis pending a criminal history clearance if an emergency exists in which there is a risk to the health and safety of consumers as a result of unfilled positions or in which the operations of the organization are severely impaired as determined by the chief executive officer of the facility, local authority, community center, or provider.

(1) The applicant must furnish the employer with an affidavit stating that the applicant has not been convicted of any of the criminal offenses listed in subsection (g) of this section or any criminal offense that the employer has determined is a contraindication to employment. The affidavit will be kept in the applicant's file. A sample affidavit may be obtained by contacting Human Resource Services, TDMHMR, P.O. Box 12668, Austin, Texas 78711-2668.

(2) Within 72 hours of the time the person is employed on a temporary or interim basis, the facility, local authority, community center, or provider must initiate a criminal history clearance of that person as described in §414.505 of this title (relating to Obtaining or Requesting Criminal History Record Information and Checking Registry).

(3) If the criminal history record information reveals a conviction for any of the criminal offenses listed in subsection (g) of this section or for any criminal offense that the employer has determined is a contraindication to employment, then the facility, local authority, community center, or provider must immediately discharge the person as unemployable.

(4) An applicant may not receive volunteer assignment on a temporary or interim basis pending a criminal history clearance.

(g) Consistent with the Texas Health and Safety Code, §250.006, convictions of criminal offenses which constitute an absolute bar to employment are:

(1) criminal homicide (Penal Code, Chapter 19);

(2) kidnapping and unlawful restraint (Penal Code, Chapter 20);

(3) indecency with a child (Penal Code, §21.11);

(4) sexual assault (Penal Code, §22.011);

(5) aggravated assault (Penal Code, §22.02);

(6) injury to a child, elderly individual, or disabled individual (Penal Code, §22.04);

(7) abandoning or endangering a child (Penal Code, §22.041);

(8) aiding suicide (Penal Code, §22.08);

(9) agreement to abduct from custody (Penal Code, §25.031);

(10) sale or purchase of a child (Penal Code, §25.08);

(11) arson (Penal Code, §28.02);

(12) robbery (Penal Code, §29.02);

(13) aggravated robbery (Penal Code, §29.03);

(14) a conviction under the laws of another state, federal law, or the Uniform Code of Military Justice for an offense containing elements that are substantially similar to the elements of an offense listed under paragraphs (1) - (13) of this subsection; and

(15) a conviction which occurred within the previous five years for:

(A) assault that is punishable as a Class A misdemeanor or as a felony (Penal Code, §22.01);

(B) burglary (Penal Code, §30.02);

(C) theft that is punishable as a felony (Penal Code, Chapter 31);

(D) misapplicateion of fiduciary property or property of a financial institution that is punishable as a Class A misdemeanor or felony (Penal Code, §32.45); or

(E) securing execution of a document by deception that is punishable as a Class A misdemeanor or a felony (Penal Code, §32.46).
Source Note: The provisions of this §301.57 adopted to be effective February 6, 2002, 27 TexReg 749; amended to be effective September 1, 2003, 28 TexReg 6885; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.59 Obtaining or Requesting Criminal History Record Information and Checking Registry
(a) Facilities must obtain criminal history record information directly from the Texas Department of Public Safety (TDPS) by contacting Crime Records Services, TDPS, P.O. Box 4143, Austin, TX 78765-4143.

(b) Local authorities and community centers may:

(1) pay a private agency to obtain criminal history record information directly from TDPS; or

(2) obtain criminal history record information directly from the Texas Department of Public Safety (TDPS) by contacting Crime Records Services, TDPS, P.O. Box 4143, Austin, TX 78765-4143.

(c) In addition to obtaining criminal history record information from TDPS, facilities, local authorities, community centers, and providers must obtain criminal history information for applicants who have lived outside the State of Texas at any time during the two years preceding the application for employment/volunteer status through the FBI using a complete set of fingerprints on the official FBI card. The FBI charges for this information. The official FBI card may be obtained from Human Resource Services, TDMHMR, P.O. Box 12668, Austin, TX 78711-2668.

(d) A provider that is not required to conduct criminal history clearances in accordance with the Texas Health and Safety Code, Chapter 250, must obtain criminal history record information through the facility, local authority, or community center with which it contracts.

(e) Facilities, local authorities, community centers, and providers must check the Employee Misconduct Registry and the Nurse Aide Registry by calling 1-800-452-3934.
Source Note: The provisions of this §301.59 adopted to be effective February 6, 2002, 27 TexReg 749; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.61 Criminal History Record Information and Registry Information
(a) Facilities, local authorities, community centers, and providers will have written policies and procedures consistent with this subchapter that describe how information obtained through a criminal history and registry clearance will be processed and later destroyed. The policies and procedures must include:

(1) processes that protect the confidentiality of criminal history record information pursuant to the Texas Health and Safety Code, §250.007;

(2) the process for notifying an applicant if:

(A) the applicant's criminal history record information identifies a conviction barring, or a contraindication to, employment or volunteer status; or

(B) the applicant is listed as revoked in the Nurse Aide Registry or is listed as unemployable in the Employee Misconduct Registry;

(3) information on how an applicant can address inaccuracies in criminal history record information (i.e., the opportunity to be heard by Texas Department of Public Safety (TDPS), pursuant to Texas Health and Safety Code, §250.005(b)) if the applicant believes he/she has been unjustly denied employment or volunteer status as a result of inaccurate criminal history record information; and

(4) procedures for destroying all criminal history record information obtained in accordance with this subchapter after an employment/volunteer decision has been made or personal action has been taken, as required by the Texas Government Code, §411.115(e).

(b) If an applicant's criminal history record information identifies a conviction barring employment or volunteer status or if the applicant is listed as revoked in the Nurse Aide Registry or is listed as unemployable in the Employee Misconduct Registry, then the applicant must be notified in writing of the following:

(1) the existence of the TDPS or FBI record of the conviction or the registry listing;

(2) the applicant's ineligibility for employment or volunteer status because of the conviction or registry listing; and

(3) how to address possible inaccuracies in criminal history record information (i.e., the opportunity to be heard by Texas Department of Public Safety (TDPS), pursuant to Texas Health and Safety Code, §250.005(b)) or how to address a possibly inaccurate registry listing (i.e., by calling TDHS registry administrators at 1-800-458-9858).
Source Note: The provisions of this §301.61 adopted to be effective February 6, 2002, 27 TexReg 749; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.63 Self-Reporting and Subsequent Criminal History and Registry Checks
(a) Upon the effective date of this subchapter, each facility, local authority, community center, and provider must initiate a registry check of all current employees and volunteers. If an employee/volunteer is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry, then the employer must immediately discharge the employee or volunteer.

(b) Following employment with or assignment of volunteer status at a facility, local authority, community center, or provider, all employees and volunteers must report to a person designated by that facility, local authority, community center, or provider:

(1) any subsequent convictions or offenses for which they are charged; and

(2) a subsequent listing as revoked in the Nurse Aide Registry or listing as unemployable in the Employee Misconduct Registry.

(c) A facility, local authority, community center, or provider may conduct subsequent criminal history and registry checks on any employee or volunteer at any time it deems appropriate.

(d) Each facility, local authority, community center, and provider must develop written policies and procedures consistent with this subchapter describing how it will respond to information obtained through self-reporting and subsequent criminal history and registry checks.

(1) Pursuant to the Texas Health and Safety Code, §533.007(b), adverse personnel action may not be taken if the information received pertains to arrest warrants or wanted persons' notices. However, the employer may reassign the employee/volunteer to a non-direct care area until resolution of the matters relating to the arrest warrant or wanted persons' notice.

(2) If the information reflects a conviction for an offense listed in §414.504(g) of this title (relating to Pre-employment and Pre-assignment Clearance), then consideration may be given to any contention by the employee/volunteer concerning errors of fact or identity in the criminal history record information. While the employee/volunteer is attempting to rectify the accuracy of the information, the employer must remove the employee/volunteer from direct contact with consumers. If the employee or volunteer fails to rectify the accuracy of the information, as provided by Texas Health and Safety Code, §250.005(b), then the employer must immediately discharge the employee or volunteer.

(3) If the information reflects a conviction for an offense determined to be a contraindication to employment or volunteer status, then consideration may be given to any contention by the employee/volunteer concerning errors of fact or identity in the criminal history record information. While the employee/ volunteer is attempting to rectify the accuracy of the information, the employer may remove the employee/volunteer from direct contact with consumers. If the employee or volunteer fails to rectify the accuracy of the information, as provided by Texas Health and Safety Code, §250.005(b), then the employer must immediately discharge the employee or volunteer.

(4) If the information indicates the employee/volunteer is listed as revoked in the Nurse Aide Registry or listed as unemployable in the Employee Misconduct Registry, then the employer must immediately discharge the employee or volunteer.
Source Note: The provisions of this §301.63 adopted to be effective February 6, 2002, 27 TexReg 749; transferred effective October 30, 2024, as published in the October 18, 2024, issue of the Texas Register, 49 TexReg 8475.

§301.101 Purpose
The purpose of this subchapter is to comply with the Texas Health and Safety Code, §534.067, by establishing a uniform fee collection policy for local mental health authorities that:

(1) is equitable;

(2) provides for collections; and

(3) maximizes contributions to local revenue.
Source Note: The provisions of this §301.101 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.103 Application
(a) This subchapter applies to all local mental health authorities for community services contracted for through the performance contract that the authority provides directly or through subcontractors to members of the priority population. This subchapter also applies to persons in the priority population, and parents of persons under age 18 years in the priority population, who are seeking or receiving services.

(b) This subchapter does not apply to:

(1) programs and services that are prohibited by statute or regulation from charging fees to persons served (e.g., Early Childhood Intervention Program);

(2) the department's In-Home and Family Support Program;

(3) inpatient services in a state mental health facility and non-crisis residential services as described in the performance contract; and

(4) specialized services mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987, as amended by OBRA 90, for preadmission screening and annual resident reviews (PASARR) provided to non-Medicaid eligible persons.

(c) In this subchapter all references to a parent means the requirement is applicable to the parent of a person under age 18 years who is in the priority population and who is seeking or receiving services.
Source Note: The provisions of this §301.103 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.105 Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

(1) Ability to pay--The person has third-party coverage that will pay for needed services, the person's maximum monthly fee is greater than zero, or the person has identified payment for a needed service or services in an approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense ).

(2) Community services or services--Except for inpatient services in a state mental health facility and non-crisis residential services, the required and optional mental health services described in the performance contract, including:

(A) 24-hour emergency screening and rapid crisis stabilization services;

(B) community-based crisis residential services or inpatient services in a mental health facility that is not a state mental health facility;

(C) community-based assessments, including the development of interdisciplinary treatment plans, and diagnosis and evaluation services;

(D) family support services, including respite care;

(E) case management services;

(F) medication-related services, including medication clinics, laboratory monitoring, medication education, mental health maintenance education, and the provision of medication; and

(G) psychosocial rehabilitation programs, including social support activities, independent living skills, and vocational training.

(3) Department--The Department of State Health Services.

(4) Extraordinary expenses--Major medical or health related expenses, major casualty losses, and child care expenses for the previous year or projections for the next year.

(5) Family members--

(A) For an unmarried person under the age of 18 years--The person, the person's parents, and the dependents of the parents, if residing in the same household;

(B) For an unmarried person age 18 years or older--The person and his/her dependents;

(C) For a married person of any age--The person, his/her spouse, and their dependents.

(6) Full subsidy eligible individual-An individual who has income below 135 percent of the federal poverty level applicable to the individual's family size and has resources that do not exceed the limits specified in 42 CFR §423.773(b). A full subsidy individual is eligible to receive premium and cost-sharing subsidies for Medicare Part D prescription drug plans. All individuals who are dually eligible for Medicaid and Medicare are full subsidy eligible individuals.

(7) Gross income--Revenue from all sources before taxes and other payroll deductions. The term does not include child support received.

(8) Inability to pay--The person's maximum monthly fee is zero and the person:

(A) does not have third-party coverage;

(B) has third-party coverage, but has exceeded the maximum benefit of the covered service(s) or the third-party coverage will not pay because the services needed by the person are not covered services; or

(C) has not identified payment for a needed service or services in an approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense ).

(9) Income-based public insurance--Government funded third-party coverage that bases eligibility on income e.g., CHIP and Medicaid.

(10) LMHA or local mental health authority--An entity designated as the local mental health authority by the department in accordance with the Texas Health and Safety Code, §533.035(a).

(11) Performance contract--A written agreement between the department and a LMHA for the provision of one or more functions as described in the Texas Health and Safety Code, §533.035(a).

(12) Person--A person in the priority population who is seeking or receiving services through a LMHA.

(13) Priority population--Those groups of persons with mental illness identified in the department's current strategic plan as being most in need of mental health services.

(14) Significant financial change--Any change in the person's (or parent's) financial documentation, as described in §412.105(d) of this title (relating to Accountability), that affects the person's (or parent's) ability to pay. Examples of a significant financial change are:

(A) a reduction in income due to the loss of a job or due to a reduction in hours worked on a job;

(B) an increase in income because of an inheritance or a salary increase;

(C) an increase or decrease in the number of family members;

(D) the gain or loss of third-party coverage; and

(E) an increase or decrease in extraordinary expenses.

(15) Standard charge--A fixed price for a community service or unit of service.

(16) State mental health facility--A state hospital or a state center with an inpatient component.

(17) Team--The interdisciplinary team, multidisciplinary team, or treatment team.

(18) Third-party coverage--A public or private payer of community services for a specific person that is not the person (e.g., Medicaid, Medicare, private insurance, CHIP, TRICARE).
Source Note: The provisions of this §301.105 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.107 Principles
The department supports the following principles:

(1) Persons are charged for services based on their ability to pay.

(2) Procedures for determining ability to pay are fair, equitable, and consistently implemented.

(3) Paying for services in accordance with his/her ability to pay reinforces the role of the person as a customer.

(4) Earned revenues are optimized.

(5) The department is the payer of last resort.
Source Note: The provisions of this §301.107 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.109 Accountability
(a) Prohibition from denying services. Local mental health authorities are prohibited from denying services to a person:

(1) because of the person's inability to pay for the services;

(2) in crisis because:

(A) a financial assessment has not been completed;

(B) financial responsibility has not been determined;

(C) the person has a past-due account; or

(D) the person had his/her services involuntarily reduced or terminated for non-payment under §412.109(d) of this title (relating to Payments, Collections, and Non-payment); or

(3) pending resolution of an issue relating solely to payment for services, including failure of the person (or parent) to comply with any requirement in subsections (c), (d), (e), and (g) of this section.

(b) Identifying funding sources. Local authorities are responsible for identifying and accessing available funding sources other than the department, and for assisting persons (and parents) in identifying and accessing available funding sources other than the department, to pay for services. Available funding sources may include third-party coverage, state and/or local governmental agency funds (e.g., crime victims fund), Qualified Medicare Beneficiary (QMB) Program, indigent pharmaceutical programs, or a trust that provides for the person's healthcare and rehabilitative needs.

(c) Requirement for parents to enroll their children in income-based public insurance. Parents of children who may be eligible for Medicaid or the Children's Health Insurance Program (CHIP) must enroll their children in Medicaid or CHIP or provide documentation that they have been denied Medicaid or CHIP benefits or that their Medicaid or CHIP enrollment is pending. The LMHA shall provide assistance as needed to facilitate the enrollment process.

(d) Financial documentation. If requested by the LMHA, persons (or parents) must provide the following financial documentation:

(1) annual or monthly gross income/earnings, if any;

(2) extraordinary expenses (as defined) paid during the past 12 months or projected for the next 12 months;

(3) number of family members (as defined); and

(4) proof of any third-party coverage.

(e) Authorizing third-party coverage payment to the LMHA. Persons (and parents) with third-party coverage must execute an assignment of benefits authorizing third-party coverage payment to the LMHA.

(f) Failure to comply.

(1) Except as provided by paragraph (2) of this subsection, if the person (or parent) fails to comply with any requirement in subsections (c) - (e) or (h) of this section, then the LMHA will charge the person (or parent) the standard charge(s) for services. If, within 30 days after the person (or parent) initially failed to comply, the person (or parent) complies with the requirements, then the LMHA will adjust the person's account to retroactively reflect compliance.

(2) The LMHA will not charge the person the standard charge(s) for services if the LMHA makes a decision, based on a clinical determination that is documented and includes input from the person's team, that the person's failure to comply is related to the person's mental illness. The clinical determination must be reassessed at least every three months. If the LMHA decides that a person's failure to comply is related to the person's mental illness, then the LMHA must develop and implement a plan to reduce or eliminate the barriers related to the person's failure to comply.

(g) Requirement for adult persons to apply for SSI to become eligible for Medicaid. Adult persons who may be eligible for Medicaid must apply for Supplemental Security Income (SSI) or provide documentation that they have been denied SSI or that their SSI application is pending. The LMHA shall provide assistance as needed to facilitate all aspects of the application process. If the adult person is unable to act in accordance with the requirement because of the person's mental illness, then the LMHA must develop and implement a plan to reduce or eliminate the barriers related to the person's inability to act in accordance with the requirement.

(h) Requirement for persons to enroll in Medicare Part D prescription drug plan.

(1) A person who is a full subsidy eligible individual under Medicare Part D must choose and enroll in a Medicare Part D prescription drug plan.

(2) The LMHA shall educate persons who are not full subsidy eligible individuals about the benefits of enrollment in a Medicare Part D prescription drug plan. The LMHA shall assess whether enrollment in a Medicare Part D prescription drug plan will be cost effective to the person and to the LMHA and shall provide the results of this assessment to the person to assist him or her determine whether to enroll in a Medicare Part D prescription drug plan. If the person decides to enroll in a Medicare Part D prescription drug plan, The LMHA may pay the person's incurred costs under the Medicare Part D prescription drug plan.

(3) The LMHA shall provide assistance as needed to facilitate all aspects of the Medicare Part D enrollment process. If the person is unable to act in accordance with the requirements set forth in paragraph (1) or (2) of this subsection because of the person's mental illness, lack of adequate notification, or other circumstances beyond the individual's control, the LMHA shall continue to provide medications and must develop and implement a plan to reduce or eliminate the barriers related to the person's inability to act in accordance with the requirement.
Source Note: The provisions of this §301.109 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.111 Determination of Ability to Pay
(a) Financial assessment. The LMHA must conduct and document a financial assessment for each person within the first 30 days of services. The LMHA must update each person's financial assessment at least annually and whenever a significant financial change (as defined) occurs as long as the person continues to receive services. The financial assessment is accomplished using the financial documentation listed in §412.105(d) of this title (relating to Accountability), which represents the finances of the:

(1) person who is age 18 years or older and the person's spouse; or

(2) parents of the person who is under age 18 years.

(b) Maximum monthly fee. A person's maximum monthly fee is based on the financial assessment and calculated using the Monthly Ability-To-Pay Fee Schedule, referenced as Exhibit A in §412.113 of this title (relating to Exhibit). The calculation is based on the number of family members and annual gross income, reduced by extraordinary expenses paid during the past 12 months or projected for the next 12 months. No other sliding scale is used.

(1) A maximum monthly fee that is greater than zero is established for persons who are determined as having an ability to pay. If two or more members of the same family are receiving services, then the maximum monthly fee is for the family.

(2) A maximum monthly fee of zero is established for persons who are determined as having an inability to pay.

(c) Third-party coverage.

(1) Third-party coverage that will pay. A person with third-party coverage that will pay for needed services is determined as having an ability to pay for those services.

(2) Third-party coverage that will not pay.

(A) If the person's third-party coverage will not pay for needed services because the LMHA does not have an approved provider on its network, then the LMHA will propose to refer the person to his/her third-party coverage to identify a provider for which the third-party coverage will pay unless:

(i) the LMHA is identified as being responsible for providing court-ordered outpatient services to the person;

(ii) the LMHA is able to negotiate adequate payment for services with the person's third-party coverage; or

(iii) the person (or parent) voluntarily agrees to pay the standard charge(s) for the needed service(s).

(B) If the LMHA proposes to refer the person to his/her third-party coverage as described in paragraph (2)(A) of this subsection, then the LMHA will provide written notification to the person (or parent) in accordance with §412.109(e)(1) of this title (relating to Payments, Collections, and Non-payment), which provides an opportunity to appeal. The LMHA must also comply with §412.109(e)(2) - (3) as initiated by the person (or parent).

(C) If the LMHA refers the person to his/her third-party coverage, then the LMHA will assist the person (or parent) in identifying a provider for which the third-party coverage will pay.

(D) If a person who has been referred to his/her third-party coverage is unable to identify or access needed services from an approved provider or if access will be unduly delayed, then the LMHA will:

(i) assist the person (or parent) in resolving the matter with the third-party coverage (e.g., contacting customer service at the third-party coverage, filing a complaint with the third-party coverage or the Texas Department of Insurance); and

(ii) if clinically indicated, ensure the provision of the needed services to the person pending resolution.

(E) The LMHA will maintain documentation of:

(i) all referrals as described in paragraph (2)(C) of this subsection;

(ii) all assistance as described in paragraph (2)(D)(i) of this subsection; and

(iii) whether the person received services pending resolution as described in paragraph (2)(D)(ii) of this subsection.

(d) Social Security work incentive provisions. A person who identified payment for specific needed services in his/her approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense ) is determined as having an ability to pay for the specific services. Persons are not required to identify payment for any service for which they may be eligible as part of their approved plan for utilizing the Social Security work incentive provisions.

(e) Notification. After a financial assessment is conducted, the LMHA must provide written notification to the person (or parents) that includes:

(1) the determination of whether the person (or parent) has an ability or an inability to pay;

(2) a copy of the financial assessment form that is signed by the person (or parent) and a copy of the Monthly Ability-to-Pay Fee Schedule, with the applicable areas indicated (i.e., annual gross income, number of family members);

(3) the amount of the maximum monthly fee;

(4) the name and phone number of at least one LMHA staff who the person (or parent) may contact during office hours to discuss the information contained in the written notification; and

(5) a statement that the person (or parent) may voluntarily pay more than the maximum monthly fee.
Source Note: The provisions of this §301.111 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.113 Standard Charges
Each LMHA must establish, at least annually, a reasonable standard charge for each community service as indicated in the performance contract. The standard charge must cover, at a minimum, the LMHA's cost of ensuring the provision of the service.
Source Note: The provisions of this §301.113 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.115 Billing Procedures
(a) Monthly account.

(1) The LMHA will maintain a monthly account for each person that lists all services provided to the person during the month and the standard charges for the services. Each service listed will indicate whether the service is:

(A) covered by Medicare third-party coverage;

(B) covered by non-Medicare third-party coverage;

(C) not covered by third-party coverage; or

(D) identified for payment in the person's approved plan utilizing Social Security work incentive provisions.

(2) If a person has exceeded the maximum third-party coverage benefit of a particular covered service, then that service is indicated as not covered by third-party coverage.

(b) Accessing funding sources. The LMHA must access all available funding sources before using the department's funds to pay for a person's services. Funding sources may include third-party coverage, state and/or local governmental agency funds (e.g., crime victims fund), Qualified Medicare Beneficiary (QMB) Program, indigent pharmaceutical programs, or a trust that provides for the person's healthcare and rehabilitative needs.

(c) Billing third-party coverage. The LMHA will bill the person's third-party coverage the monthly account amount for covered services. If the LMHA has negotiated a reimbursement amount with the third-party coverage that is different from the monthly account amount, then the LMHA may bill the third-party coverage the negotiated reimbursement amount for covered services.

(d) Billing the person (or parents).

(1) No third-party coverage. If the monthly account amount for services not covered by third-party coverage:

(A) exceeds the person's maximum monthly fee (MMF), then the amount is reduced to equal the MMF and the LMHA bills person (or parent) the MMF; or

(B) is less than the person's MMF, then the LMHA bills the person (or parent) the monthly account amount for services not covered by third-party coverage.

(2) Medicare third-party coverage. Nothing in this paragraph is intended to conflict with any applicable law, rule, or regulation with which a LMHA must comply.

(A) The following amounts are added to equal the total amount applied toward the person's MMF:

(i) the amount of all applicable co-payments and co-insurance for services listed in the monthly account as covered by Medicare third-party coverage;

(ii) the amount Medicare third-party coverage was billed but did not pay because the deductible hasn't been met; and

(iii) the monthly account amount for services not covered by third-party coverage.

(B) If the total amount applied toward the person's MMF as described in paragraph (2)(A) of this subsection:

(i) exceeds the person's MMF, then the amount is reduced to equal the MMF and the LMHA bills person (or parent) the MMF; or

(ii) is less than the person's MMF, then the LMHA bills the person (or parent) the total amount applied toward the MMF.

(3) Non-Medicare third-party coverage.

(A) Cost-sharing exceeds MMF. If the amount of all applicable co-payments, co-insurance, and deductibles for services listed in the monthly account as covered by non-Medicare third-party coverage exceeds the person's MMF, then the LMHA bills the person (or parent) all applicable co-payments, co-insurance, and deductibles.

(B) Cost-sharing does not exceed MMF.

(i) If the amount of all applicable co-payments, co-insurance, and deductibles for services listed in the monthly account as covered by non-Medicare third-party coverage does not exceed the person's MMF, then the following amounts are added to equal the total amount applied toward the person's MMF:

(I) the amount of all applicable co-payments, co-insurance, and deductibles; and

(II) the monthly account amount for services not covered by third-party coverage.

(ii) If the total amount applied toward the person's MMF as described in paragraph (3)(B) of this subsection:

(I) exceeds the person's MMF, then the amount is reduced to equal the MMF and the LMHA bills person (or parent) the MMF; or

(II) is less than the person's MMF, then the LMHA bills the person (or parent) the total amount applied toward the MMF.

(C) Annual cost-sharing limit. If the person (or parent) has reached his/her annual cost-sharing limit (i.e., maximum out-of-pocket expense) as verified by the non-Medicare third-party coverage, then the LMHA will not bill the person (or parent) any co-payments, co-insurance, or deductibles, as applicable to the annual cost-sharing limit, for services covered by the non-Medicare third-party coverage for the remainder of the policy-year.

(4) Social Security work incentive provisions.

(A) If the person identified a payment amount for specific services in his/her approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense), then the LMHA bills the person the monthly account amount for the specific services up to the identified payment amount. If the monthly account amount for the specific services is greater than the identified payment amount, then the remaining balance is applied toward the person's MMF.

(B) The following amounts are added to equal the total amount applied toward the person's MMF:

(i) any remaining balance as described in paragraph (4)(A) of this subsection; and

(ii) the monthly account amount for services not covered by third-party coverage.

(C) If the total amount applied toward the person's MMF as described in paragraph (4)(B) of this subsection:

(i) exceeds the person's MMF, then the amount is reduced to equal the MMF and the LMHA bills person (or parent) the MMF; or

(ii) is less than the person's MMF, then the LMHA bills the person (or parent) the total amount applied toward the MMF.

(e) Statements.

(1) The LMHA will send to persons (and parents) who have been determined as having the ability to pay monthly or quarterly statements that include:

(A) an itemized list, at least by date and by type, of all services provided during the period;

(B) the standard charge for each service;

(C) the total charge for the period;

(D) the amount paid (or to be paid) by each funding source; and

(E) the amount to be paid by the person (or parent).

(2) Unless requested otherwise, the LMHA does not send statements to persons (or parents) who have an ability to pay if they maintain a zero balance (i.e., the person (or parent) does not currently owe any money).

(3) Unless requested otherwise, the LMHA does not send statements to persons (or parents) who have an inability to pay.
Source Note: The provisions of this §301.115 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; amended to be effective February 19, 2017, 42 TexReg 561; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.117 Payments, Collections, and Non-payment
(a) Payment and collection.

(1) Persons (and parents) are responsible for promptly paying all charges owed to the LMHA.

(2) The LMHAs are responsible for making reasonable efforts to collect payments from all available funding sources before accessing the department's funds to pay for persons' services.

(b) Financial hardship. If a person (or parent) claims financial hardship as provided in this subsection, then the LMHA must determine whether a significant financial change (as defined) has occurred. If a significant financial change has occurred, then the LMHA must immediately update the person's (or parent's) financial assessment as required in §412.106(a) of this title (relating to Determination of Ability to Pay).

(1) If a person (or parent) claims, and provides documentation, that financial hardship prevents prompt payment of all charges owed, then the LMHA may arrange for the person (or parent) to pay a lesser amount each month.

(2) If a person (or parent) claims that financial hardship prevents prompt payment of all charges owed, then the LMHA must arrange for the person (or parent) to pay a lesser amount each month only if the person has third-party coverage that is neither income-based public insurance nor Medicare and the person's cost-sharing exceeds his/her MMF. The lesser amount:

(A) will be no more than the person's MMF, if the person's MMF is greater than zero; or

(B) will be no more than $5.00, if the person's MMF is zero.

(3) Although the person (or parent) may pay a lesser amount each month because a portion of the charges will be deferred, the person (or parent) is still responsible for paying all charges owed.

(c) Discontinuing charges to persons (or parents) for services. If the LMHA makes a decision, based on a clinical determination that is documented and includes input from the person's team, that being charged for services and receiving statements will result in a reduction in the functioning level of the person or the person's (or parent's) refusal or rejection of the needed services, then the LMHA will discontinue charging the person (or parent) for services and stop sending statements. The clinical determination must be reassessed at least every three months. If the LMHA decides to discontinue charging the person (or parent) for services, then the LMHA must develop and implement a plan to address the issues related to the person's functioning level or the person's (or parent's) refusal or rejection of the needed services.

(d) Involuntary reduction or termination of services for non-payment by person (or parent).

(1) The LMHA will address the past-due account of a person (or parent) who is not making payments to ensure reasonable efforts to secure payments are initiated with the person (or parent). For example, if the LMHA determines that non-payment is related to financial hardship, then the LMHA may assist the person (or parent) in making arrangements to pay a lesser amount each month in accordance with subsection (a)(2) of this section or if the LMHA makes a decision, based on a clinical determination that is documented and includes input from the person's team, that non-payment is related to the person's mental illness, then the person's treatment/service plan may be modified to address the non-payment.

(2) If the LMHA makes a decision, based on a clinical determination that is documented and includes input from the person's team, that non-payment is not related to the person's mental illness and, despite reasonable efforts to secure payment, the person (or parent) does not pay, then the LMHA may propose to involuntarily reduce or terminate the person's services. The LMHA may not propose to involuntarily reduce or terminate the person's services if the proposed action would cause the person's mental or physical health to be at imminent risk of serious deterioration or the LMHA is identified as being responsible for providing court-ordered outpatient services to the person.

(3) If the LMHA proposes to involuntarily reduce or terminate the person's services, then the LMHA must:

(A) maintain clinical documentation that the proposed action would not cause the person's mental or physical health to be at imminent risk of serious deterioration;

(B) provide written notification to the person (or parent) in accordance with subsection (e)(1) of this section and comply with subsection (e)(2) - (3) as initiated by the person (or parent).

(e) Notification, Appeal, and Review.

(1) Notification. The LMHA will notify the person (or parent) in writing of the proposed action (i.e., to involuntarily reduce or terminate the person's services or refer the person to his/her third-party coverage) and the right to appeal the proposed action in accordance with §401.464 of this title (relating to Notification and Appeals Process). The notification will describe the time frames and process for requesting an appeal and include a copy of this subchapter. If the person (or parent) requests an appeal within the prescribed time frame, then the LMHA may not take the proposed action while the appeal is pending. The LMHA may take the proposed action if the person (or parent) does not request a review within the prescribed time frame.

(2) Appeal and appeal decision. The appeal is conducted in accordance with §401.464(g) of this title. The local mental health authority will notify the person (or parent) in writing of the appeal decision in accordance with §401.464(h) of this title and the right to have the appeal decision reviewed by the department's Mental Health and Substance Abuse Client's Rights Office (1-800-252-8154) if the person (or parent) is dissatisfied with the appeal decision. The notification must describe the time frames and process for requesting a review.

(3) Review of appeal decision. If the person (or parent) is dissatisfied with the appeal decision, then the person (or parent) may request a review by the department's Mental Health and Substance Abuse Client's Rights Office. A request for review must be submitted to the department's Mental Health and Substance Abuse Client's Rights Office, Mail Code 2019, P.O. Box 12668, Austin, TX 78751, within 10 working days of receipt of the appeal decision. If the person (or parent) requests a review within the prescribed time frame, then the LMHA may not take the proposed action while the review is pending. The LMHA may take the proposed action if the person (or parent) does not request a review within the prescribed time frame and the appeal decision upholds the decision to take the proposed action.

(A) A person (or parent) who requests a review may choose to have the reviewer conduct the review:

(i) by telephone conference with the person (or parent) and a representative from the LMHA and make a decision based upon verbal testimony made during the telephone conference and any documents provided by the person (or parent) and the LMHA; or

(ii) by making a decision based solely upon documents provided by the person (or parent) and the LMHA without the presence of any of the parties involved.

(B) The review:

(i) will be conducted no sooner than 10 working days and no later than 30 working days of receipt of the request for review unless an extension is granted by the director of the department's Mental Health and Substance Abuse Client's Rights Office;

(ii) will include an examination of the pertinent information concerning the proposed action and may include consultation with the department's Mental Health and Substance Abuse Client's Rights Office clinical staff and staff who are responsible for the policy contained in this subchapter;

(iii) will result in a final decision which will uphold, reverse, or modify the original decision to take the proposed action; and

(iv) is the final step of the appeal process for involuntarily reducing or terminating the person's services for non-payment and for referring the person to his/her third-party coverage.

(C) Within five working days after the review, the reviewer will send written notification of the final decision to the person (or parent) and the LMHA .

(D) The LMHA will take appropriate action consistent with the final decision.

(f) Prohibition of financial penalties. The LMHA may not impose financial penalties on a person (or parent).

(g) Debt collection. Local authorities must make reasonable efforts to collect debts before an account is referred to a debt collection agency. Local authorities must document their efforts at debt collection.

(1) Local authorities must incorporate into a written agreement or contract for debt collection provisions that state that both parties shall:

(A) maintain the confidentiality of the information and not disclose the identity of the person or any other identifying information; and

(B) not harass, threaten, or intimidate persons and their families.

(2) Local authorities will enforce the provisions contained in paragraph (1) of this subsection.
Source Note: The provisions of this §301.117 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.119 Monthly Ability-to-Pay Fee Schedule
The Monthly Ability-To-Pay Fee Schedule, referenced as Exhibit A in §412.113 of this title (relating to Exhibit), is based on 150% of the Federal Poverty Guidelines. The department may revise the Monthly Ability-To-Pay Fee Schedule, based on any changes in the Federal Poverty Guidelines.
Source Note: The provisions of this §301.119 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.121 Training
In accordance with a prescribed training program developed by the department, all local mental health authority staff who are involved in implementing or explaining the content of this subchapter must demonstrate competency prior to performing tasks related to charging for community services and annually thereafter.
Source Note: The provisions of this §301.121 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.123 Brochure for Persons (and Parents)
(a) The department will develop a brochure that contains the policies for charging for community services that are contained in this subchapter, including:

(1) a general reference to the statutory trust exemption; and

(2) information related to claiming financial hardship.

(b) The LMHA must provide persons (and parents) a copy of the brochure prior to their entry into services, except in a crisis.
Source Note: The provisions of this §301.123 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.125 Exhibit
This subchapter references Exhibit A--The Monthly Ability-To-Pay Fee Schedule, copies of which are available by contacting Mental Health and Substance Abuse Program Services, Department of State Health Services, Mail Code 2018, P.O. Box 13247, Austin, TX 78711-2668.
Source Note: The provisions of this §301.125 adopted to be effective September 1, 2002, 27 TexReg 2041; amended to be effective September 15, 2005, 30 TexReg 5806; transferred effective August 15, 2024, as published in the July 19, 2024, issue of the Texas Register, 49 TexReg 5361.

§301.155 Notification and Appeals Process
(a) The TXMHMR service system is dedicated to providing mental health and mental retardation services/supports which are viewed as satisfactory by persons receiving those services/supports and their legally authorized representatives. Therefore, local authorities and their contractors shall take steps to assure that these persons:

(1) have a method to express their concerns or dissatisfaction;

(2) are assisted to do so in a constructive way; and

(3) have their concerns or dissatisfaction addressed through a review process.

(b) A request to review decisions described in this section may be made by the person requesting or receiving services/supports, the person's legal representative, or any other individual with the person's consent.

(c) At the time of admission into services and on an annual basis thereafter, the local authority and its contractors shall provide to persons who receive services/supports and their legally authorized representatives written notification in a language and/or method understood by the individual of the local authority or its contractor's policy for addressing concerns or dissatisfaction with services/supports. The notification shall explain:

(1) an easily understood process for persons and legally authorized representatives to request a review of their concerns or dissatisfaction by the local authority or its contractor, whichever is appropriate;

(2) how the person may receive assistance in requesting the review;

(3) the timeframes for the review; and

(4) the method by which the person is informed of the outcome of that review.

(d) Local authorities and their contractors shall notify persons and legally authorized representatives in writing in a language and/or method understood by the individual of the following decisions and of the process to appeal by requesting a review of those decisions:

(1) a decision to deny the person services/supports at the conclusion of a local authority's procedure which determines whether the person meets the criteria for the priority population; and

(2) a decision to terminate services/supports and follow-along from the local authority or its contractor, if appropriate.

(e) The written notification referred to in subsection (d) of this section must:

(1) be given or mailed to the person and the legally authorized representative within ten working days of the date the decision was made;

(2) state the reason for the decision;

(3) explain that the person and legally authorized representative may contact either the local authority or its contractor, whichever is appropriate, within 30 days of receipt of notification if dissatisfied with the decision and request that the decision be reviewed in accordance with subsection (g) of this section; and

(4) include name(s), phone number(s) and address(es) of one or more accessible staff to contact during office hours.

(f) If a person or legally authorized representative believes that the local authority or its contractor has made a decision to involuntarily reduce services by changing the amount, duration, or scope of services/supports provided and is dissatisfied with that decision, then the person may request in writing that the decision be reviewed in accordance with subsection (g) of this section.

(g) The review by the local authority or its contractor shall:

(1) begin within ten working days of receipt of the request for a review and be completed within ten working days of the time it begins unless an extension is granted by the CEO of the local authority or its contractor, whichever is appropriate;

(2) begin immediately upon receipt of the request and be completed within five working days if the decision is related to a crisis service;

(3) be conducted by an individual(s) who was not involved in the initial decision;

(4) include a review of the original decision which led to the person's dissatisfaction;

(5) result in a decision to uphold, reverse, or modify the original decision; and

(6) provide the person an opportunity to express his or her concerns in person or by telephone to the individual reviewing the decision. The review shall also allow the person to:

(A) have a representative talk with the reviewer; or

(B) submit his or her concerns in writing, on tape, or in some other fashion.

(h) Following a review, either the local authority or its contractor, whichever is appropriate, shall explain to the person and legally authorized representative in writing and also in person or by telephone, if requested, the action it will take or, if no action will be taken, why it will not change the decision or believes such action would not be in the person's best interest. This is the final step in the review process.

(i) The notification and review process described in this section:

(1) is applicable only to services/supports funded by TXMHMR and provided or contracted for by its local authorities;

(2) does not preclude a person or legally authorized representative's right to reviews, appeals, or other actions that accompany other funds administered through a local authority or its contractors, or to other appeals processes provided for by other state and federal laws, e.g., Texas Health and Safety Code, Title 7, Chapter 593 (Persons with Mental Retardation Act); 42 USC §1396 (Medicaid statute); and Texas Human Resources Code, Chapter 73 (Chapter 621 of this title (relating to Early Childhood Intervention)), Early Childhood Intervention programs as funded by the Texas Interagency Council for Early Childhood Intervention.
Source Note: The provisions of this §301.155 adopted to be effective February 11, 1994, 19 TexReg 591; amended to be effective January 3, 1997, 21 TexReg 12402; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective January 1, 2024, as published in the Texas Register December 1, 2023, 48 TexReg 7081.

§301.251 Purpose
The purpose of this subchapter is to establish the process for a local mental health authority (LMHA) to assemble and maintain a network of service providers as required by the Health and Safety Code, §533.035(b) - (f).
Source Note: The provisions of this §301.251 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.253 Application
This subchapter applies to local mental health authorities (LMHAs) and their use of funds disbursed by the Department of State Health Services (department) pursuant to the Health and Safety Code, §533.035(b), which authorizes the department to distribute funds to LMHAs for mental health services.
Source Note: The provisions of this §301.253 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.255 Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

(1) Critical infrastructure--The resources necessary to ensure services are available without significant disruption to the individuals served by the LMHA and to allow the LMHA to fulfill its obligations under the performance contract.

(2) Department--The Texas Department of State Health Services.

(3) Discrete services--Individual services provided as part of a defined level of care.

(4) External provider--An organization that provides mental health services that is not an LMHA, or an individual who provides mental health services who is not an employee of an LMHA.

(5) Individual--An individual seeking or receiving mental health services through an LMHA, or the individual's legally authorized representative.

(6) Legally authorized representative (LAR)--A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, including, but not limited to, a parent, guardian, or managing conservator.

(7) Licensed psychiatric hospital--A hospital that is:

(A) A private psychiatric hospital licensed under Texas Health and Safety Code, Chapter 577, and Chapter 134 of this title (relating to Private Psychiatric Hospitals and Crisis Stabilization Units) rules; or

(B) an identifiable inpatient mental health services unit in a hospital licensed under Health and Safety Code, Chapter 241, and Chapter 133 of this title (relating to Hospital) rules.

(8) LOC or level of care--A designation given to the department's standardized packages of mental health services which specify the amount, and duration of mental health services to be provided to an individual, based on the uniform assessment and utilization management guidelines referenced in §416.17 of this title (relating to Guidelines).

(9) Local Authority Network Advisory Committee (LANAC)--The committee established under Health and Safety Code, §533.0351 to advise the department on technical and administrative issues that directly affect LMHA responsibilities. The committee has equal numbers of representatives from eight stakeholder groups.

(10) Local mental health authority (LMHA)--An entity designated as a local mental health authority according to the Health and Safety Code, §533.035(a).

(11) Local service area--A geographic area composed of one or more Texas counties defining the population that may receive mental health services through an LMHA.

(12) Network development--The addition of new provider organizations, services, or capacity to an LMHA's external provider network.

(13) Performance contract--The contract between the department and an LMHA that is in effect at the time of an action required under this subchapter.

(14) Planning and Network Advisory Committee (PNAC)--The advisory committee of local stakeholders established by an LMHA as required by the performance contract.

(15) Provider or service provider--An organization or person who delivers mental health services.

(16) Qualified provider--A provider that is:

(A) a practitioner with the minimum qualifications required by the performance contract; or

(B) an organization that demonstrates the ability to provide services described in the performance contract, as specified in the department's approved procurement template.

(17) Routine outpatient services--Services available in a level of care, excluding inpatient, residential and most crisis services. Routine outpatient services include office-based crisis intervention provided as part of rehabilitation services during normal business hours but exclude all other crisis services.

(18) Service capacity--The estimated number of individuals that can be served in each level of care with available resources.

(19) Specialized services--Services that are not generally provided by the individual's treatment team, including stand-alone crisis and residential services.
Source Note: The provisions of this §301.255 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.257 Local Network Development
(a) Use of resources. An LMHA must maximize funds available to provide services by minimizing overhead and administrative costs and achieving purchasing efficiencies. Strategies that an LMHA must consider in achieving this objective include joint efforts with other local authorities related to authority functions, administrative activities, and service delivery.

(b) Establishing a network. Each LMHA must demonstrate a reasonable effort to establish and maintain a network of qualified providers. In developing the network, the LMHA must consider public input, ultimate cost-benefit, and client care issues to ensure individual choice and best use of public funds.

(c) Developing a plan. Each LMHA must develop a biennial (2-year) local network development plan (plan) to guide the development of the LMHA's provider network. The plan must reflect local needs and priorities and must be designed to maximize individual choice and individual access to services provided by qualified providers. The plan is a framework for network development based on a biennial assessment of provider availability and is not intended to limit procurement and contracting. LMHAs are expected to consider opportunities for network development that develop between planning periods. Such opportunities include new funding and/or services and inquiries from interested providers.

(d) Involving the PNAC. The local PNAC must be actively involved in developing the plan. The local PNAC must receive information and training related to Provider Network Development, including the provisions of this subchapter and Health and Safety Code §533.035, §533.03521, and §533.0358.
Source Note: The provisions of this §301.257 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.259 Conditions Permitting LMHA Service Delivery
An LMHA may only provide services if one or more of the following conditions is present.

(1) The LMHA determines that interested, qualified providers are not available to provide services in the LMHA's service area or that no providers meet procurement specifications.

(2) The network of external providers does not provide the minimum level of individual choice. A minimal level of individual choice is present if individuals and their legally authorized representatives can choose from two or more qualified providers.

(3) The network of external providers does not provide individuals with access to services that is equal to or better than the level of access in the local network, including services provided by the LMHA, as of a date determined by the department. An LMHA relying on this condition must submit the information necessary for the department to verify the level of access.

(4) The combined volume of services delivered by external providers is not sufficient to meet 100 percent of the LMHA's service capacity for each level of care identified in the LMHA's plan.

(5) Existing agreements restrict the LMHA's ability to contract with external providers for specific services during the two-year period covered by the LMHA's plan. If the LMHA relies on this condition, the department shall require the LMHA to submit copies of relevant agreements.

(6) The LMHA documents that it is necessary for the LMHA to provide specified services during the two-year period covered by the LMHA's plan to preserve critical infrastructure needed to ensure continuous provision of services. An LMHA relying on this condition must:

(A) document that it has evaluated a range of other measures to ensure continuous delivery of services, including but not limited to those identified by the LANAC and the department at the beginning of each planning cycle;

(B) document implementation of appropriate other measures;

(C) identify a timeframe for transitioning to an external provider network, during which the LMHA shall procure an increasing proportion of the service capacity from external provider in successive procurement cycles; and

(D) give up its role as a service provider at the end of the transition period if the network has multiple external providers and the LMHA determines that external providers are willing and able to provide sufficient added service volume within a reasonable period of time to compensate for service volume lost should any one of the external provider contracts be terminated.
Source Note: The provisions of this §301.259 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.261 Department Website
(a) Website maintenance. The department shall maintain a website with information about network development.

(b) Planning schedule and templates. Using input from the Local Authority Network Advisory Committee, the department will develop a biennial schedule and templates for the local network development plan and provider profile. In addition, the department will work with the LANAC to develop a list of measures that may be helpful in stabilizing the provider network and ensuring continuous delivery of services.

(c) LMHA information. The department shall post minimum service requirements and service capacity information for each local service area on its website. Service capacity information includes:

(1) the performance contract targets for the number of adults and children to be served by the LMHA;

(2) the current state funding allocation for the LMHA;

(3) the number of individuals served in each level of care in the previous fiscal year; and

(4) the demographic breakout of individuals services in the previous fiscal year.

(d) List of interested provider organizations. The department shall create and maintain a list showing the provider organizations interested in contracting with each LMHA.

(1) The department's website must allow provider organizations to submit a description of their qualifications and indicate their interest in providing services in each local service area.

(2) The website also must provide a mechanism for providers to send their information directly to LMHAs.

(3) The department shall post information submitted by interested provider organizations on the department's website. The purpose of the list of interested provider organizations is to inform procurement decisions made by LMHAs, but the list may not be interpreted as conclusive evidence of the existence of interested, qualified provider organizations for purposes of determining that procurement is required.

(e) Public access to plans. The department's website must provide public access to approved plans.
Source Note: The provisions of this §301.261 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.263 Network Development Evaluation
An LMHA shall evaluate the potential for network development.

(1) The LMHA must seek and use available information to identify and contact potential provider organizations, including the list of interested provider organizations posted on the department's website.

(2) The LMHA must also consider current contractors, providers who have contacted the LMHA within the past two years, and other service providers in the local service area.

(3) If a provider has submitted printed or electronic documentation of interest, the LMHA may not eliminate the provider from consideration during the planning process without evidence that the provider:

(A) is no longer interested; or

(B) is clearly not qualified or capable of providing services in accordance with applicable state and local laws and regulations.

(4) The potential for network development exists if an LMHA has one or more provider organizations interested in providing routine outpatient or specialized services.

(5) If an LMHA identifies the potential for network development, it must develop a procurement plan. The plan shall include all opportunities for network development, except as limited by the conditions listed in §412.755 of this title (relating to Conditions Permitting LMHA Service Delivery). This includes opportunities to add new services, new provider organizations, and/or additional capacity. An LMHA may choose to procure discrete services if it can ensure the integrity of levels of care and effective service coordination.
Source Note: The provisions of this §301.263 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.265 Content of the Plan
(a) Plan preparation. An LMHA must use the results of its network development evaluation described in §412.757 of this title (relating to Network Development Evaluation) to create its draft plan.

(b) Plan content applicable to all LMHAs. All plans must include the following components.

(1) The LMHA's projected service capacity for each level of care based on service data from the previous fiscal year for services provided under the performance contract and any information about changes that will impact the service capacity.

(2) Baseline data specified by the department showing the type and quantity of services provided by the LMHA and by external providers.

(3) A description of the process the LMHA used to evaluate the potential for network development and the results of that evaluation, including any information relating to specific services or populations.

(4) A list of the LMHA's external providers, including all current contractors and any other providers with whom the LMHA had a contract or agreement in effect during any part of the current or previous fiscal year. The list shall include the number of contracts and agreements with individual peer support providers, but not the names of individual peer support providers without their written consent.

(c) Plan content for LMHAs with potential for network development. If an LMHA identifies the potential for network development, the plan must also include the following elements.

(1) A description of the LMHA's plans for procurement, including:

(A) the adult and children's services to be procured;

(B) the capacity to be procured for each service;

(C) the geographic area(s) in which services would be procured;

(D) the procurement method(s) to be used; and

(E) the timeline(s) for conducting the procurement.

(2) The rationale for any provision that would limit individual choice or prevent procurement of all available capacity offered by external provider organizations.

(A) The rationale must address any proposed restrictions on:

(i) the type of service to be procured;

(ii) the volume of services to be procured;

(iii) the geographic area in which services would be procured; or

(iv) the number of providers to be accepted.

(B) The rationale for limiting procurement must be based on one or more of the conditions identified in §412.755 of this title (relating to Conditions Permitting LMHA Service Delivery).

(C) The rationale must provide a basis for the proposed level of restriction, including the volume of services to be provided by the LMHA. An LMHA may be required to submit additional data to support its rationale.

(3) A description of the strategies the LMHA would use to maximize funds available to provide services, as required in §412.754(c) of this title (relating to Local Network Development).

(4) A summary of procurement activities from past network and development planning cycles and the results of those efforts.

(5) If an LMHA is not procuring all available capacity offered by external provider organizations, the timeframe and steps for achieving full procurement of the external provider capacity identified in its network development evaluation, not to exceed the LMHA's capacity.
Source Note: The provisions of this §301.265 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.267 Public Comment
(a) Distributing the draft plan. An LMHA shall post the draft plan on its website and invite public comment for at least 30 days. The LMHA shall send notice of the opportunity for comment to key stakeholders, including local consumer and advocacy groups, all licensed psychiatric hospitals in the LMHA's service area, and all providers identified in its network development evaluation.

(b) Responding to public comment. The LMHA shall acknowledge and consider all comments received and make any revisions it deems appropriate.

(c) Plan submission. The LMHA shall submit its proposed plan to the department with:

(1) a summary of the public comments received; and

(2) the LMHA's response to the comments.
Source Note: The provisions of this §301.267 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.269 Plan Approval and Implementation
(a) Department review. The department shall review each plan to ensure compliance with the requirements of this subchapter and to determine whether the LMHA is making reasonable attempts to develop its provider network.

(1) The department shall establish a mechanism for stakeholder involvement in the review process.

(2) In reviewing an LMHA's plan, the department shall evaluate the level of effort made by the LMHA to achieve compliance and the rationale and any supporting documentation for its decisions and plans. This evaluation must include:

(A) the LMHA's response to public comment;

(B) the LMHA's past efforts and progress made in developing a network of external providers;

(C) the specific context of the local service area, including population density and distribution, existing service organizations, and local priorities;

(D) the potential impact on individual choice and access; and

(E) input from the LMHA's PNAC.

(3) The department may require an LMHA to submit additional information or documentation.

(b) Department approval. The department shall notify an LMHA of its decision within the timeframe established at the beginning of the planning cycle.

(1) The department shall approve the plan if it determines that the LMHA:

(A) is in compliance with the requirements of this subchapter; and

(B) is making reasonable attempts to develop an available and appropriate external provider base that is sufficient to meet the needs of individuals in its local service area.

(2) The department may require the LMHA to make revisions before approving the plan. If revisions are required, the department will determine a timeframe for resubmission.

(c) Posting the approved plan. After the department approves the plan, the LMHA shall post the approved version on its website. The posting must include the summary of public comments and the LMHA's response.

(d) Implementation. An LMHA shall conduct procurement as described in its approved plan.

(e) Amendment. If an LMHA determines it is unable to conduct the procurement as originally approved by the department, it shall submit a request for plan amendment to the department within 30 days of making the determination. An amendment is not required to expand the scope of a planned procurement or to conduct additional procurements outside of what is approved by the department. The department will evaluate the amendment request using the same process used for the original plan. Any proposed amendment must be approved in writing by the department and posted on the LMHA's website before it is implemented.

(f) List of external providers. The LMHA must maintain a current list of external providers on its website, including the name of each organization or private practitioner and the services provided. The list shall include the number of contracts and agreements with individual peer support providers, but not the names of individual peer support providers.
Source Note: The provisions of this §301.269 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.271 Procurement
(a) Procurement procedures. An LMHA shall develop and implement procurement procedures that comply with applicable state laws and rules. The LMHA may procure mental health services by any procurement method allowed by applicable statutes and rules that provides the best value to the LMHA.

(b) Content of the procurement document. A procurement document shall include:

(1) the actual or maximum rate of payment for providing the services, as applicable;

(2) the criteria for determining whether an applicant is a qualified provider; and

(3) a detailed description of information to be included in a proposal, including:

(A) how the provider would meet the cultural and linguistic needs of the individuals in the LMHA's local service area; and

(B) how the provider would involve individuals, legally authorized representatives, and families at the policy and practice levels within the respondent's organization.

(c) Publication. An LMHA shall publicize the procurement document by:

(1) posting on the Electronic State Business Daily;

(2) posting on the LMHA's website;

(3) posting a link on the department website;

(4) sending to providers known to be interested in providing services in the LMHA's local service area; and

(5) sending to local consumer and advocacy organizations and local private psychiatric hospitals.

(d) Provider follow-up. If a provider submits printed or electronic documentation of interest but does not submit an application, the LMHA shall attempt to contact the provider to determine why the provider withdrew from the process.

(e) Provider standards. An LMHA shall not apply more rigorous standards and requirements to external providers than it applies to its own programs and staff. This does not preclude the LMHA from requiring documentation and reporting necessary to verify compliance with the terms of the contract.

(f) Provider compensation. An LMHA shall pay external providers a fair and reasonable rate in relation to the local prevailing market.

(g) Monitoring and enforcement. An LMHA shall implement effective procedures for contract monitoring and enforce the requirements set out in applicable rules and contract provisions. Examples include standards for service delivery, cultural and linguistic competency, and consumer protections.
Source Note: The provisions of this §301.271 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.273 Post Procurement Report
Report content. An LMHA shall submit a post procurement report to the department within 30 days of completing a procurement described in the LMHA's approved plan. If procurement is conducted through open enrollment, the LMHA shall submit a procurement report at intervals specified in the timeline established by the department at the beginning of the planning cycle. The report must include:

(1) a list of the applications received in response to the procurement;

(2) the results of the procurement;

(3) an updated list of the LMHA's external providers; and

(4) the responses from providers who did not complete the procurement process regarding their reasons for withdrawing from consideration, if applicable.
Source Note: The provisions of this §301.273 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.275 Appeals
(a) Local appeal process. An LMHA shall establish an appeal process for providers that:

(1) is available to any provider who submitted a written statement of interest or participated in any phase of the procurement process; and

(2) includes an opportunity for informal review and resolution as well as a formal appeal procedure.

(b) Department review. If an issue cannot be resolved at the local level and involves an alleged violation by the LMHA of a state rule or contract provision, either the LMHA or the provider may submit the issue to the department in writing for review. Potential actions that may be taken by the department shall be defined in the performance contract. The decision of the Commissioner or his designee will be final.
Source Note: The provisions of this §301.275 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.277 Individual Selection of Providers
(a) Individual choice. An LMHA shall give consumers the opportunity to choose from any available provider in the LMHA's provider network offering services for which the individual is authorized at the time of admission and at least annually thereafter.

(b) Changing providers. Individuals may request and change providers at any time.

(c) Provider information. An LMHA shall maintain a current list of providers and a provider profile for each provider in the network, including the LMHA, on its website. The LMHA's website must also provide instructions for requesting a change in providers as described in §401.464 of this title (relating to Notification and Appeals Processes).

(1) The provider list must include the following information about each provider:

(A) name;

(B) service locations and the services provided at each location; and

(C) contact information, including the provider's website address.

(2) The provider profile is a standardized form completed by the provider, may include information such as staffing patterns, special features of service delivery, and cultural and linguistic specialization. An LMHA shall use the provider profile template established by the department at the beginning of the planning cycle. The LMHA may add additional items to the provider profile based on input from the local PNAC.

(d) Provider selection process. The LMHA shall inform individuals, verbally and in writing, that they may choose to receive services from any available provider in the LMHA's network that offers the authorized services. The LMHA shall also provide individuals with a neutral presentation of available providers consistent with the plan to support consumer transition to the external network described in subsection (f) of this section. When an individual is given the opportunity to choose a provider, the LMHA shall:

(1) state that the individual may change providers at any time;

(2) give the individual the provider list, provider profiles, and a written copy of the procedures for requesting a change in providers;

(3) allow a reasonable period of time and make an area available for the individual to review the materials and make a decision; and

(4) maintain documentation of the individual's choice of provider.

(e) An LMHA shall not offer or schedule services before the individual selects a provider. If an individual is unable to select a provider or does not select a provider before leaving the first appointment, the LMHA shall provide the consumer with an appointment for ongoing services at an assigned provider. Except as provided in subsection (f) of this section, assignments shall rotate equally among all available external providers. In this situation, the LMHA shall also provide the individual with information about how to have the appointment rescheduled with a different provider.

(f) External network transition plan. The LMHA shall develop and implement a plan to promote consumer transition to the external network when a new provider joins the network.

(1) The plan shall be developed with input from the LMHA's PNAC, any local consumer-operated organization, and its external providers.

(2) LMHAs may emphasize benefits of receiving services from an external provider, but shall not favor one provider over another except to identify service sites that may be more convenient for a client.

(3) The plan may include reassigning consumers to external providers based on geographic proximity, but must give them the option of choosing a different provider instead.

(4) The plan may include directing new individuals to choose an external provider, but must give them the option of choosing an LMHA service site instead.
Source Note: The provisions of this §301.277 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237.

§301.401 Purpose
The purpose of this subchapter is to provide clinical peer review procedures and, separately, administrative review procedures to be followed upon the death of an individual receiving services directly operated or contracted for by a community mental health center, and their respective contract providers, in order to improve the quality of care.
Source Note: The provisions of this §301.401 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.403 Application
The provisions of this subchapter apply to community mental health centers and to their respective contract providers.
Source Note: The provisions of this §301.403 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.405 Definitions
The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.

(1) Administrative death review--An administrative/quality assurance review activity to identify non-clinically related problems requiring correction and opportunities to improve the quality of care.

(2) Attending physician--A physician licensed to practice medicine in the State of Texas who is responsible for the general medical care and/or psychiatric care of the individual served.

(3) Chief executive officer or CEO--The executive director of a community center.

(4) Clinical death review--A clinical quality assurance/peer review activity conducted to identify clinically related problems requiring correction and opportunities to improve the quality of care pursuant to the statutes that authorize peer review activities in the State of Texas.

(5) Community center--A community mental health center organized pursuant to the Texas Health and Safety Code, Title 7, Chapter 534, §534.053 (formerly the Texas Mental Health and Mental Retardation Act, §3, as amended, Texas Civil Statutes, Article 5547-201 et seq.).

(6) Contract provider--An entity which, through written agreement or contract, is providing services to an individual served by a community center, including entities regulated by other governmental agencies.

(7) Deceased--An individual who, at death, is receiving services directly operated or contracted for by a community center.

(8) HHSC--The Texas Health and Human Services Commission.

(9) Investigating officer--A physician or registered nurse who is neither the attending physician nor anyone significantly involved as the primary provider of treatment to the deceased immediately preceding the death.

(10) Registered nurse--A nurse licensed by the Texas Board of Nurse Examiners to practice professional nursing in the State of Texas.

(11) Unusual circumstances--A death which occurs under circumstances including, but not limited to, the following: unnatural death; death by unlawful means or suspicion of death by unlawful means; absence of witnesses; suicide or suspicion of suicide; or death within 24 hours of admission to the community center.
Source Note: The provisions of this §301.405 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.407 Community Centers: Actions Taken upon the Death of an Individual Served
(a) Each community center shall develop separate clinical peer review and administrative review procedures consistent with this subchapter to be implemented at the time that a determination has been made to conduct a death review.

(b) When appropriate, the community center CEO or designee shall notify the deceased's personal representative (primary or emergency correspondent(s)) of the death; provide an explanation of the relevant facts related to the death; and inform them of their right to examine the deceased's medical information relevant to the death, death certificate, and autopsy findings, if any. A physician shall request consent to conduct an autopsy when appropriate.

(c) Immediately after determination of the need to conduct an administrative death review, the community center CEO shall be responsible for ensuring that the completed HHSC reporting form is submitted to HHSC.
Source Note: The provisions of this §301.407 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.409 Community Centers: General Guidelines upon Death of an Individual Served
(a) When a death has been determined to require an administrative death review, a copy of the certificate of death shall be made a part of the deceased's record, when possible.

(b) When appropriate, the property of the deceased will be disposed of under the provisions of the Texas Probate Code.
Source Note: The provisions of this §301.409 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.411 Community Centers: Administrative Death Review Determination
(a) Within one working day of the knowledge of death of an individual receiving services in an HHSC-funded or HHSC-contracted program, the community center CEO is responsible for conducting a preliminary review to determine whether:

(1) the death occurred on the premises of an HHSC-funded or HHSC-contracted program (e.g., the individual dies in his/her sleep at an MHA/MRA funded group home);

(2) the death occurred while the individual was participating in HHSC-funded or HHSC-contracted program activities (e.g., the individual dies in a community hospital after being transferred from the community center; the individual drowns while on a psychosocial program outing);

(3) other conditions indicate that the death may reasonably have been related to the individual's care or activities as part of the community center program (e.g., the individual overdoses on a psychoactive drug; the individual dies by suicide); or

(4) other conditions indicate that although the death is not reasonably related to the individual's care or activities as part of the community center program, an evaluation of policy is warranted (e.g., the individual dies of a chronic illness in a community hospital).

(b) If none of the conditions described in subsection (a) of this section is met, then the community center CEO may elect not to conduct an administrative death review. Documentation that this preliminary review was conducted must be included in the deceased's record.

(c) If any of the conditions described in subsection (a) of this section are met, an administrative death review must be conducted in compliance with this section. In addition, the need for a clinical death review must be determined as described in §405.272 of this subchapter (relating to Community Centers: Clinical Death Review Determination).
Source Note: The provisions of this §301.411 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.413 Community Centers: Clinical Death Review Determination
(a) Upon notification of a death requiring an administrative death review, the community center CEO or designee shall appoint a physician or registered nurse as the investigating officer, as defined in this subchapter, who shall begin a preliminary investigation based upon the deceased's medical record, particularly the circumstances leading to the transfer to a facility or outpatient status where death occurred, and other information he/she deems appropriate.

(b) Within seven working days of the knowledge of death, the CEO, and investigating officer shall use the preliminary investigation information to determine whether the death should be reviewed clinically, in compliance with §405.274 of this subchapter (relating to Community Centers: Clinical Death Review).

(1) The determination shall be based upon the possible need for review of clinical policies and procedures, the opportunity for professional education, and/or the opportunity to improve patient care through medical practice.

(2) It shall also be determined whether a preliminary administrative death review should proceed before the completion of the clinical death review, addressing the issue described in §405.275(c)(2) of this subchapter (relating to Community Centers: Administrative Death Review) or should be deferred until the submission of the recommendations of the clinical death review committee.

(3) The deliberations and findings of a preliminary administrative death review will be considered at the final administrative death review after receipt of the recommendations of the clinical death review committee.

(c) If it has been determined that a clinical death review is unnecessary, then the CEO shall be responsible for forwarding to the administrative death review committee the following:

(1) a summary of the preliminary investigation information;

(2) a copy of the death/discharge summary, if available;

(3) a copy of the death certificate, bearing a valid diagnosis, if available;

(4) a copy of the preliminary or full autopsy report, if available; and

(5) the probable final diagnosis, including contributory causes, and reasons for variance from the death certificate, if any.
Source Note: The provisions of this §301.413 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.415 Community Centers: Clinical Death Review
(a) Each community center shall develop and implement procedures consistent with this subchapter for the timely reporting and review of deaths.

(b) Deaths subject to a clinical death review will be reviewed by a medical review committee pursuant to the statutes that authorize peer review activities in the State of Texas, consisting of the previously appointed investigating officer and at least two other medical/nursing professionals (M.D., D.O., or R.N.), one of which should be a medical professional whom is neither an employee of the community center nor was the deceased's attending physician (if such medical professional is not available, then the effort to obtain external membership must be documented in the information sent to the administrative death review committee). Of these three committee members, all must be either medical doctors or registered nurses. The community center CEO shall appoint one of the three medical/nursing professionals as chair of the clinical death review committee. For the purposes of this subchapter the term employee does not refer to consultants or contractors. Additionally, the membership of the clinical death review committee may include the community center CEO and/or the director of clinical quality assurance, designee, or the person who is responsible for clinical quality assurance functions.

(1) Upon determination of the need for a clinical death review, the investigating officer shall provide to the clinical death review committee:

(A) the individual's medical record;

(B) a copy of the death certificate, bearing a valid diagnosis, if available;

(C) a copy of the preliminary or full autopsy report, if available;

(D) the probable final diagnosis, including contributory causes, and reasons for variance from the death certificate, if any; and

(E) a briefing of possible issues involving clinically related community center operational policies and procedures and quality of medical care.

(2) Within 14 calendar days (or 45 days in which an autopsy is performed, or for deaths occurring at medical facilities to which the individual was transferred before death) of the determination of the need for a clinical death review, the clinical death review committee shall meet to review the information the investigating officer has provided as described in subsection (b)(1) of this subsection. On the basis of the review, the committee shall evaluate the quality of medical and nursing care given before death and shall formulate written recommendations, if appropriate, for changes in policy and procedures, professional education, operations, or patient care. Suspected abuse or neglect must be reported in accordance with the rules of the Texas Department of Family and Protective Services.

(c) Within 21 calendar days of the determination of the need for a clinical death review (or 52 days in cases in which an autopsy is performed, or for deaths occurring at medical facilities to which the individual was transferred before death), the clinical death review committee shall submit to the administrative death review committee the following:

(1) the clinical death review committee's recommendations;

(2) a copy of the death/discharge summary, if available;

(3) a copy of the death certificate, bearing a valid diagnosis, if available;

(4) the probable final diagnosis, including contributory causes, and reasons for variance from the death certificate, if any; and

(5) documentation of the effort to obtain an external medical professional, if no such person was available.

(d) To maintain the effectiveness of the death review process, HHSC may conduct reviews of the community center's clinical death review process.

(e) The community center CEO is authorized to grant variances from the timelines by this section on a case-by-case basis. Reasons for timeline variances must be justified and documented.
Source Note: The provisions of this §301.415 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.417 Community Centers: Administrative Death Review
(a) The community center CEO shall convene an administrative death review committee:

(1) immediately after the determination of the need for an administrative death review, if a clinical death review was not conducted;

(2) when a preliminary administrative death review is to take place as determined in §405.272(b) of this subchapter (relating to Community Centers: Clinical Death Review Determinations); or

(3) immediately after the receipt of the information from the clinical death review committee as described in §405.274(c) of this subchapter (relating to Community Centers: Clinical Death Review).

(b) The membership of the administrative death review committee shall consist of:

(1) three senior administrative and medical personnel (e.g., CEO, medical director, director of nursing, director of quality assurance, etc.) one of whom shall be designated as the chair by the CEO;

(2) a representative of the public, external to HHSC and not related to or associated with the deceased (e.g., a member of the public responsibility committee, a member of the community hospital's ethics committee, a family member, an advocate, a consumer, etc.). If such representative of the public is not available, then the effort to obtain external membership must be documented in the information sent to HHSC; and

(3) other individuals appropriate to the death being reviewed (e.g., the investigating officer).

(c) The purpose of the administrative death review committee is to:

(1) review the information and recommendations provided by the clinical death review committee and/or from the preliminary investigation;

(2) review operational policies and procedures and continuity of care issues which may have affected the care of the individual and formulate written recommendations for changes in policies and procedures, if appropriate; and

(3) act upon the recommendations described in paragraphs (1) and (2) of this subsection.

(d) If information presented during the administrative review indicates the need for a clinical death review or a re-review, then the administrative death review committee has the authority to request such review.

(e) Suspected abuse or neglect must be reported in accordance with the rules of the Texas Department of Family and Protective Services.

(f) Within 14 calendar days of the determination of the need for an administrative death review (or 45 days in cases in which an autopsy is performed, or for deaths occurring at medical facilities to which the individual was transferred before death) or within 14 calendar days after the receipt of the information from the clinical death review committee, the administrative death review committee shall submit the following elements to HHSC:

(1) a copy of the death/discharge summary, if available;

(2) a copy of the death certificate, bearing a valid diagnosis, if available;

(3) a copy of the preliminary or full autopsy report, if available;

(4) the probable final diagnosis, including contributory causes, and reasons for variance from the death certificate, if any;

(5) a copy of the clinical death review committee's recommendations, if such review was conducted;

(6) a copy of the administrative death review committee's recommendations; and

(7) if applicable, documentation of the effort to obtain external membership for the clinical death review committee and/or the administrative death review committee, if no such medical professional and/or representative of the public was available.

(g) A summary of the resulting actions taken in response to the recommendations of the administrative and clinical death review committees shall be forwarded by the CEO or designee to HHSC within 28 calendar days following the submission of the elements contained in subsection (f)(1) - (7) of this section.
Source Note: The provisions of this §301.417 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.419 Reporting of Systemic Issues Emerging from Death Reviews
Utilizing information gathered from the elements submitted in §405.275(f)(6) and (g) of this subchapter (relating to Community Centers: Administrative Death Review), the community center CEO shall report to the community center's board of trustees any systemic issues emerging from death reviews and the corrective actions taken, on a routine basis or when necessary.
Source Note: The provisions of this §301.419 adopted to be effective June 1, 1993, 18 TexReg 2133; amended to be effective May 26, 2022, 47 TexReg 3056; transferred effective October 18, 2024, as published in the September 20, 2024, issue of the Texas Register, 49 TexReg 7639.

§301.501 Purpose
The purpose of this subchapter is to comply with Texas Health and Safety Code, §534.067, by establishing a uniform fee collection policy for an MRA that:

(1) is equitable;

(2) provides for collections; and

(3) maximizes contributions to local revenue.
Source Note: The provisions of this §301.501 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.503 Application
(a) This subchapter applies to an MRA for community services contracted for through the performance contract that the MRA provides directly or through a subcontractor to a member of the MR priority population. This subchapter also applies to an adult person in the MR priority population and a parent of a person under age 18 years in the MR priority population.

(b) This subchapter does not apply to:

(1) a program or service that is prohibited by statute or regulation from charging a fee to a person served;

(2) the DADS In-Home and Family Support Program--Mental Retardation;

(3) residential services as described in the performance contract; and

(4) specialized services mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987, as amended by OBRA 90, for a preadmission screening and resident review (PASARR) provided to a non-Medicaid eligible person.
Source Note: The provisions of this §301.503 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.505 Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

(1) Ability to pay--The person has third-party coverage that will pay for needed services, the person's maximum monthly fee is greater than zero, or the person has identified payment for a needed service or services in an approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense).

(2) Community services or services--Except for residential services, eligibility determination, and screening, the required and optional mental retardation services described in the performance contract.

(3) DADS--The Department of Aging and Disability Services.

(4) Extraordinary expenses--Major medical or health related expenses, major casualty losses, and child care expenses for the previous year or projections for the next year.

(5) Family members--

(A) For an unmarried person under age 18 years--The person, the person's parents, and the dependents of the parents, if residing in the same household;

(B) For an unmarried person age 18 years or older--The person and the person's dependents; or

(C) For a married person of any age--The person, the person's spouse, and their dependents.

(6) Gross income--Revenue from all sources before taxes and other payroll deductions. The term does not include child support received.

(7) Inability to pay--The person's maximum monthly fee is zero and the person:

(A) does not have third-party coverage;

(B) has third-party coverage, but has exceeded the maximum benefit of the covered service(s) or the third-party coverage will not pay because the services needed by the person are not covered services; or

(C) has not identified payment for a needed service or services in an approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense).

(8) Income-based public insurance--Government funded third-party coverage that bases eligibility on income (i.e., CHIP and Medicaid).

(9) MMF--Maximum monthly fee. A fee that is calculated in accordance with §2.106(b) of this chapter (relating to Determination of Ability to Pay).

(10) MRA--Mental retardation authority. An entity to which the Health and Human Services Commission's authority and responsibility described in Texas Health and Safety Code, §531.002(11) have been delegated.

(11) MR priority population--Groups of persons identified in the Health and Human Services Commission's current strategic plan as being most in need of mental retardation services.

(12) Parent--A biological or adoptive parent of a person under age 18 years.

(13) Performance contract--A written agreement between DADS and an MRA for the provision of one or more functions as described in Texas Health and Safety Code, §533.035(a).

(14) Person--A person in the MR priority population who is seeking or receiving services through an MRA.

(15) Significant financial change--Any change in the person's (or parent's) financial status as shown in the financial documentation, as described in §2.105(d) of this subchapter (relating to Accountability), that affects the person's (or parent's) ability to pay. Examples of a significant financial change are:

(A) a reduction in income due to the loss of a job or due to a reduction in hours worked on a job;

(B) an increase in income because of an inheritance or a salary increase;

(C) an increase or decrease in the number of family members;

(D) the gain or loss of third-party coverage; and

(E) an increase or decrease in extraordinary expenses.

(16) Standard charge--A fixed price for a community service or unit of service.

(17) Team--A person's service planning team.

(18) Third-party coverage--A public or private payer of community services (e.g., Medicaid, Medicare, private insurance, CHIP, TRICARE).
Source Note: The provisions of this §301.505 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.507 Accountability
(a) Prohibition from denying services. An MRA is prohibited from denying services:

(1) to a person because of the person's inability to pay for the services;

(2) to a person in crisis, and the denial is because:

(A) a financial assessment has not been completed;

(B) financial responsibility has not been determined;

(C) the person has a past-due account; or

(D) the person had services involuntarily reduced or terminated for non-payment under §2.109(d) of this subchapter (relating to Payments, Collections, and Non-payment); or

(3) to a person pending resolution of an issue relating solely to payment for services, including failure of the person (or parent) to comply with any requirement in subsection (c), (d), (e), or (g) of this section.

(b) Identifying funding sources. An MRA must identify and access available funding sources other than DADS, and assist a person (or parent) in identifying and accessing available funding sources other than DADS, to pay for services. Available funding sources may include third-party coverage, state and/or local governmental agency funds (e.g., crime victims fund), Qualified Medicare Beneficiary (QMB) Program, or a trust that provides for the person's need for community services.

(c) Requirement for a parent to enroll a child in income-based public insurance. A parent of a child who may be eligible for Medicaid or the Children's Health Insurance Program (CHIP) must enroll the child in Medicaid or CHIP or provide documentation that the child has been denied Medicaid or CHIP benefits or that the child's Medicaid or CHIP enrollment is pending. An MRA must provide assistance as needed to facilitate the enrollment process.

(d) Financial documentation. A person (or parent) must provide the following financial documentation:

(1) annual or monthly gross income/earnings, if any;

(2) extraordinary expenses (as defined) paid during the past 12 months or projected for the next 12 months;

(3) number of family members (as defined); and

(4) proof of any third-party coverage.

(e) Authorizing third-party coverage payment to the MRA. A person (or parent) with third-party coverage must execute an assignment of benefits authorizing third-party coverage payment to the MRA.

(f) Failure to comply.

(1) Except as provided by paragraph (2) of this subsection, if the person (or parent) fails to comply with any requirement in subsection (c), (d), (e), or (g) of this section, then the MRA must charge the person (or parent) the standard charge(s) for services. If, within 30 days after the person (or parent) initially failed to comply, the person (or parent) complies with the requirements, then the MRA must adjust the person's account to retroactively reflect compliance.

(2) The MRA may not charge the person the standard charge(s) for services if the MRA makes a decision, which is documented and includes input from the person's team, that the person's failure to comply is related to the person's functioning limitations. The decision must be reassessed at least annually. If the MRA decides that a person's failure to comply is related to the person's functioning limitations, then the MRA must develop and implement a plan to reduce or eliminate the barriers related to the person's failure to comply.

(g) Requirement for an adult person to apply for Supplemental Security Income (SSI) to become eligible for Medicaid. An adult person who may be eligible for Medicaid must apply for SSI or provide documentation that the person has been denied SSI or that the person's SSI application is pending. The MRA must provide assistance as needed to facilitate all aspects of the application process.
Source Note: The provisions of this §301.507 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.509 Determination of Ability to Pay
(a) Financial assessment.

(1) An MRA must conduct and document a financial assessment for a person within 30 days after the person begins to receive services.

(2) Except for a Medicaid recipient who is receiving Supplemental Security Income (SSI) benefits but not receiving employment income, the MRA must update a person's financial assessment at least annually while the person is receiving services. The MRA must monitor the continuing availability of benefits for a person with income-based public insurance.

(3) The MRA must update a person's financial assessment if the person experiences a significant financial change.

(4) The financial assessment must be conducted using the financial documentation listed in §2.105(d) of this subchapter (relating to Accountability) that represents the finances of:

(A) the person who is age 18 years or older and the person's spouse; or

(B) the parents of the person who is under age 18 years.

(b) MMF. A person's MMF is based on the financial assessment and calculated using the Monthly Ability-To-Pay Fee Schedule, as referenced in §2.110 of this subchapter (relating to Monthly Ability-To-Pay Fee Schedule). The calculation is based on the number of family members and annual gross income, reduced by extraordinary expenses paid during the past 12 months or projected for the next 12 months. No other sliding scale is used.

(1) An MMF that is greater than zero is established for a person who is determined as having an ability to pay. If two or more members of the same family are receiving services, then the MMF is for the family.

(2) An MMF of zero is established for a person who is determined as having an inability to pay.

(c) Third-party coverage.

(1) Third-party coverage that will pay. A person with third-party coverage that will pay for needed services is determined as having an ability to pay for those services.

(2) Third-party coverage that will not pay.

(A) If the person's third-party coverage will not pay for needed services because the MRA does not have an approved provider on its network, then the MRA must propose to refer the person to the person's third-party coverage to identify a provider for which the third-party coverage will pay unless:

(i) the MRA is identified as being responsible for providing court-ordered services to the person;

(ii) the MRA is able to negotiate adequate payment for services with the person's third-party coverage; or

(iii) the person (or parent) voluntarily agrees to pay the standard charge(s) for the needed service(s).

(B) If the MRA proposes to refer the person to the person's third-party coverage as described in paragraph (2)(A) of this subsection, then the MRA must provide written notification to the person (or parent) in accordance with §2.109(e)(1) of this subchapter (relating to Payments, Collections, and Non-payment), which provides an opportunity to appeal. The MRA must also comply with §2.109(e)(2) - (3) of this subchapter as initiated by the person (or parent).

(C) If the MRA refers the person to third-party coverage, then the MRA must assist the person (or parent) in identifying a provider for which the third-party coverage will pay.

(D) If a person who has been referred to third-party coverage is unable to identify or access needed services from an approved provider or if access will be unduly delayed, then the MRA must:

(i) assist the person (or parent) in resolving the matter with the third-party coverage (e.g., contacting customer service at the third-party coverage, filing a complaint with the third-party coverage or the Texas Department of Insurance); and

(ii) if indicated, ensure the provision of the needed services to the person pending resolution.

(E) The MRA must maintain documentation of:

(i) all referrals as described in paragraph (2)(C) of this subsection;

(ii) all assistance as described in paragraph (2)(D)(i) of this subsection; and

(iii) whether the person received services pending resolution as described in paragraph (2)(D)(ii) of this subsection.

(d) Social Security work incentive provisions. A person who identified payment for specific needed services in the person's approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense) is determined as having an ability to pay for the specific services. A person is not required to identify payment for any service for which the person may be eligible as part of the person's approved plan for utilizing the Social Security work incentive provisions.

(e) Notification. After a financial assessment is conducted, the MRA must provide written notification to the person (or parent) that includes:

(1) the determination of whether the person (or parent) has an ability or an inability to pay;

(2) a copy of the financial assessment form and a copy of the Monthly Ability-to-Pay Fee Schedule, with the applicable areas indicated (i.e., annual gross income, number of family members);

(3) the amount of the MMF;

(4) the name and phone number of at least one MRA staff who the person (or parent) may contact during office hours to discuss the information contained in the written notification; and

(5) a statement that the person (or parent) may voluntarily pay more than the maximum monthly fee.
Source Note: The provisions of this §301.509 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.511 Standard Charges
An MRA must establish, at least annually, a reasonable standard charge for a community service as indicated in the performance contract. The standard charge must cover, at a minimum, the MRA's cost of ensuring the provision of the service.
Source Note: The provisions of this §301.511 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.513 Billing Procedures
(a) Monthly account.

(1) The MRA must maintain a monthly account for a person that lists all services provided to the person during the month and the standard charges for the services. Each service listed must indicate whether the service is:

(A) covered by Medicare third-party coverage;

(B) covered by non-Medicare third-party coverage;

(C) not covered by third-party coverage; or

(D) identified for payment in the person's approved plan utilizing Social Security work incentive provisions.

(2) If a person has exceeded the maximum third-party coverage benefit of a particular covered service, then that service is indicated as not covered by third-party coverage.

(b) Accessing funding sources. The MRA must access all available funding sources before using DADS funds to pay for a person's services. Funding sources may include third-party coverage, state and/or local governmental agency funds (e.g., crime victims fund), Qualified Medicare Beneficiary (QMB) Program, or a trust that provides for the person's need for community services.

(c) Billing third-party coverage. The MRA bills the person's third-party coverage the monthly account amount for covered services. If the MRA has negotiated a reimbursement amount with the third-party coverage that is different from the monthly account amount, then the MRA may bill the third-party coverage the negotiated reimbursement amount for covered services.

(d) Billing the person (or parent).

(1) No third-party coverage. If the monthly account amount for services not covered by third-party coverage:

(A) exceeds the person's MMF, then the amount is reduced to equal the MMF and the MRA bills the person (or parent) the MMF; or

(B) is less than the person's MMF, then the MRA bills the person (or parent) the monthly account amount for services not covered by third-party coverage.

(2) Medicare third-party coverage. Nothing in this paragraph is intended to conflict with any applicable law, rule, or regulation with which an MRA must comply.

(A) The following amounts are added to equal the total amount applied toward the person's MMF:

(i) the amount of all applicable co-payments and co-insurance for services listed in the monthly account as covered by Medicare third-party coverage;

(ii) the amount Medicare third-party coverage was billed but did not pay because the deductible hasn't been met; and

(B) If the total amount applied toward the person's MMF as described in paragraph (2)(A) of this subsection:

(i) exceeds the person's MMF, then the amount is reduced to equal the MMF and the MRA bills the person (or parent) the MMF; or

(ii) is less than the person's MMF, then the MRA bills the person (or parent) the total amount applied toward the MMF.

(3) Non-Medicare third-party coverage.

(A) Cost-sharing exceeds MMF. If the amount of all applicable co-payments, co-insurance, and deductibles for services listed in the monthly account as covered by non-Medicare third-party coverage exceeds the person's MMF, then the MRA bills the person (or parent) all applicable co-payments, co-insurance, and deductibles.

(B) Cost-sharing does not exceed MMF.

(i) If the amount of all applicable co-payments, co-insurance, and deductibles for services listed in the monthly account as covered by non-Medicare third-party coverage does not exceed the person's MMF, then the following amounts are added to equal the total amount applied toward the person's MMF:

(I) the amount of all applicable co-payments, co-insurance, and deductibles; and

(II) the monthly account amount for services not covered by third-party coverage.

(ii) If the total amount applied toward the person's MMF as described in paragraph (3)(B)(i) of this subsection:

(I) exceeds the person's MMF, then the amount is reduced to equal the MMF and the MRA bills person (or parent) the MMF; or

(II) is less than the person's MMF, then the MRA bills the person (or parent) the total amount applied toward the MMF.

(C) Annual cost-sharing limit. If the person (or parent) has reached the person's annual cost-sharing limit (i.e., maximum out-of-pocket expense) as verified by the non-Medicare third-party coverage, then the MRA must not bill the person (or parent) any co-payments, co-insurance, or deductibles, as applicable to the annual cost-sharing limit, for services covered by the non-Medicare third-party coverage for the remainder of the policy-year.

(4) Social Security work incentive provisions.

(A) If the person identified a payment amount for specific services in the person's approved plan utilizing Social Security work incentive provisions (i.e., Plan to Achieve Self-Sufficiency; Impairment Related Work Expense), then the MRA bills the person the monthly account amount for the specific services up to the identified payment amount. If the monthly account amount for the specific services is greater than the identified payment amount, then the remaining balance is applied toward the person's MMF.

(B) The following amounts are added to equal the total amount applied toward the person's MMF:

(i) any remaining balance as described in paragraph (4)(A) of this subsection; and

(ii) the monthly account amount for services not covered by third-party coverage.

(C) If the total amount applied toward the person's MMF as described in paragraph (4)(B) of this subsection:

(i) exceeds the person's MMF, then the amount is reduced to equal the MMF and the MRA bills person (or parent) the MMF; or

(ii) is less than the person's MMF, then the MRA bills the person (or parent) the total amount applied toward the MMF.

(e) Statements.

(1) The MRA must send to a person (or parent) who has been determined as having the ability to pay monthly or quarterly statements that include:

(A) an itemized list, at least by date and by type, of all services provided during the period;

(B) the standard charge for each service;

(C) the total charge for the period;

(D) the amount paid (or to be paid) by each funding source; and

(E) the amount to be paid by the person (or parent).

(2) Unless requested otherwise, the MRA may not send a statement to a person (or parent) who has an ability to pay if the person (or parent) maintains a zero balance (i.e., the person (or parent) does not currently owe any money).

(3) Unless requested otherwise, the MRA may not send a statement to a person (or parent) who has an inability to pay.
Source Note: The provisions of this §301.513 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.515 Payments, Collections, and Non-payment
(a) Payment and collection.

(1) A person (or parent) must promptly pay all charges owed to the MRA.

(2) An MRA must make reasonable efforts to collect payments from all available funding sources before accessing DADS funds to pay for a person's services.

(b) Financial hardship. If a person (or parent) claims financial hardship as provided in this subsection, then the MRA must determine whether a significant financial change (as defined) has occurred. If a significant financial change has occurred, then the MRA must immediately update the person's (or parent's) financial assessment as required in §2.106(a) of this subchapter (relating to Determination of Ability to Pay).

(1) If a person (or parent) claims, and provides documentation, that financial hardship prevents prompt payment of all charges owed, then the MRA may arrange for the person (or parent) to pay a lesser amount each month.

(2) If a person (or parent) claims that financial hardship prevents prompt payment of all charges owed, then the MRA must arrange for the person (or parent) to pay a lesser amount each month only if the person has third-party coverage that is neither income-based public insurance nor Medicare and the person's cost-sharing exceeds the person's MMF. The lesser amount:

(A) will be no more than the person's MMF, if the person's MMF is greater than zero; or

(B) will be no more than $5.00, if the person's MMF is zero.

(3) Although the person (or parent) may pay a lesser amount each month because a portion of the charges will be deferred, the person (or parent) is still responsible for paying all charges owed.

(c) Discontinuing charges to a person (or parent) for services. If the MRA makes a decision, which is documented and includes input from the person's team, that being charged for services and receiving statements will result in a significant reduction in the functioning of the person or the person's (or parent's) refusal or rejection of the needed services, then the MRA must stop charging the person (or parent) for services and stop sending statements. The decision must be reassessed at least annually. If the MRA decides to discontinue charging the person (or parent) for services, then the MRA must develop and implement a plan to address the issues related to the person's functioning limitations or the person's (or parent's) refusal or rejection of the needed services.

(d) Involuntary reduction or termination of services for non-payment by person (or parent).

(1) The MRA must address the past-due account of a person (or parent) who is not making payments to ensure reasonable efforts to secure payments are initiated with the person (or parent). For example, if the MRA determines that non-payment is related to financial hardship, then the MRA may assist the person (or parent) in making arrangements to pay a lesser amount each month in accordance with subsection (a)(2) of this section or if the MRA makes a decision, which is documented and includes input from the person's team, that non-payment is related to the person's functioning limitations, then the person's service plan may be modified to address the non-payment.

(2) If the MRA makes a decision, which is documented and includes input from the person's team, that non-payment is not related to the person's functioning limitations and, despite reasonable efforts to secure payment, the person (or parent) does not pay, then the MRA may propose to involuntarily reduce or terminate the person's services. The MRA may not propose to involuntarily reduce or terminate the person's services if:

(A) the proposed action would result in a significant reduction in the person's functioning;

(B) the proposed action would put at risk the person's health, safety, or support system; or

(C) the MRA is identified as being responsible for providing court-ordered services to the person.

(3) If the MRA proposes to involuntarily reduce or terminate the person's services, then the MRA must:

(A) maintain documentation that the proposed action would not result in a significant reduction in the person's functioning or put at risk the person's health, safety, or support system; and

(B) provide written notification to the person (or parent) in accordance with subsection (e)(1) of this section and comply with subsection (e)(2) - (3) as initiated by the person (or parent).

(e) Notification, Appeal, and Review.

(1) Notification. The MRA must notify the person (or parent) in writing of the proposed action (i.e., to involuntarily reduce or terminate the person's services or refer the person to third-party coverage) and the right to appeal the proposed action in accordance with §2.46 of this chapter (relating to Notification and Appeals Process). The notification must describe the time frames and process for requesting an appeal and include a copy of this subchapter. If the person (or parent) requests an appeal within the prescribed time frame, then the MRA must not take the proposed action while the appeal is pending. The MRA may take the proposed action if the person (or parent) does not request a review within the prescribed time frame.

(2) Appeal and appeal decision. The MRA must conduct the appeal in accordance with §2.46(g) of this chapter. The MRA must notify the person (or parent) in writing of the appeal decision in accordance with §2.46(h) of this chapter and the right to have the appeal decision reviewed by the Office of Consumer Rights and Services at DADS if the person (or parent) is dissatisfied with the appeal decision. The notification must describe the time frames and process for requesting a review.

(3) Review of appeal decision. If the person (or parent) is dissatisfied with the appeal decision, then the person (or parent) may request a review by the Office of Consumer Rights and Services at DADS. A request for review must be submitted to the Office of Consumer Rights and Services, Department of Aging and Disability Services, P.O. Box 149030, MC E-249, Austin, TX 78714-9030, within 10 working days after receipt of the appeal decision. If the person (or parent) requests a review within the prescribed time frame, then the MRA must not take the proposed action while the review is pending. The MRA may take the proposed action if the person (or parent) does not request a review within the prescribed time frame and the appeal decision upholds the decision to take the proposed action.

(A) A person (or parent) who requests a review may choose to have the reviewer conduct the review:

(i) by telephone conference with the person (or parent) and a representative from the MRA and make a decision based upon verbal testimony made during the telephone conference and any documents provided by the person (or parent) and the MRA; or

(ii) by making a decision based solely upon documents provided by the person (or parent) and the MRA without the presence of any of the parties involved.

(B) The review:

(i) is conducted no sooner than 10 working days and no later than 30 working days after receipt of the request for review unless an extension is granted by the director of the Office of Consumer Rights and Services;

(ii) includes an examination of the pertinent information concerning the proposed action and may include consultation with DADS staff who are responsible for the policy contained in this subchapter;

(iii) results in a final decision which will uphold, reverse, or modify the original decision to take the proposed action; and

(iv) is the final step of the appeal process for involuntarily reducing or terminating the person's services for non-payment and for referring the person to third-party coverage.

(C) Within five working days after the review, the reviewer sends written notification of the final decision to the person (or parent) and the MRA.

(D) The MRA must take appropriate action consistent with the final decision.

(f) Prohibition of financial penalties. The MRA must not impose financial penalties on a person (or parent).

(g) Debt collection. The MRA must make reasonable efforts to collect debts before an account is referred to a debt collection agency. The MRA must document its efforts at debt collection.

(1) The MRA must incorporate into a written agreement or contract for debt collection provisions that state that both parties must:

(A) maintain the confidentiality of the information and not disclose the identity of the person or any other identifying information; and

(B) not harass, threaten, or intimidate a person or the person's family.

(2) The MRA must enforce the provisions contained in paragraph (1) of this subsection.
Source Note: The provisions of this §301.515 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.517 Monthly Ability-to-Pay Fee Schedule
The Monthly Ability-To-Pay Fee Schedule, which can be found at www.dads.state.tx.us, is based on 150% of the Federal Poverty Guidelines. DADS may revise the Monthly Ability-To-Pay Fee Schedule, based on any changes in the Federal Poverty Guidelines.
Source Note: The provisions of this §301.517 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.519 Training
MRA staff who are involved in implementing or explaining the content of this subchapter must receive initial training and demonstrate competency prior to performing tasks related to charging for community services. Such staff must demonstrate competency annually thereafter.
Source Note: The provisions of this §301.519 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.521 Brochure for a Person (or Parent)
(a) DADS makes available on its website a brochure that contains the policies for charging for community services that are contained in this subchapter, including:

(1) a general reference to the statutory trust exemption; and

(2) information related to claiming financial hardship.

(b) An MRA must provide a person (or parent) a copy of the brochure prior to the person's entry into services, except in a crisis.
Source Note: The provisions of this §301.521 adopted to be effective September 1, 2002, 27 TexReg 2041; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 1, 2007, 32 TexReg 7494; transferred effective July 15, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4433.

§301.601 Purpose
The purpose of this subchapter is to require a mental retardation authority (MRA) or a community center to:

(1) have an effective procedure for conducting criminal history and registry checks on an applicant, employee, contractor, or volunteer of the MRA or community center;

(2) have an effective procedure for requiring an employee, contractor, or volunteer of the MRA or community center to self-report a conviction or charge of a criminal offense or a registry listing; and

(3) require a contract agency to conduct criminal history and registry checks on an applicant, employee, contractor, or volunteer of the contractor agency in accordance with this subchapter.
Source Note: The provisions of this §301.601 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.603 Application
This subchapter applies to:

(1) an MRA; and

(2) a community center.
Source Note: The provisions of this §301.603 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.605 Definitions
The following words and terms, when used in this subchapter (relating to Criminal History and Registry Checks for MRAs and Community Centers), have the following meanings, unless the context clearly indicates otherwise:

(1) Applicant--A person to whom an MRA, community center, or contract agency intends to offer employment, a contract, or volunteer status.

(2) Community center--A community mental health and mental retardation center established under the Texas Health and Safety Code, Title 7, Chapter 534, Subchapter A.

(3) Contract--An agreement between an MRA, community center, or contract agency and a contractor whose contractual duties may put the contractor in direct contact with an individual.

(4) Contract agency--A person that contracts with an MRA or community center to provide an employee or contractor whose duties may put the employee or contractor in direct contact with an individual.

(5) Contractor--A person who contracts with an MRA, community center, or contract agency and whose contractual duties may put the person in direct contact with an individual.

(6) Conviction--The adjudication of guilt for a criminal offense. The term does not include deferred adjudication community supervision as described in Texas Health and Safety Code, §250.006(d).

(7) DADS--The Department of Aging and Disability Services.

(8) Employee--A person who is employed by an MRA, community center, or contract agency and whose duties may put the person in direct contact with an individual.

(9) Individual--A person receiving services that are funded by or through DADS and provided by an MRA or community center or provided by a contract agency through a contract with an MRA or community center.

(10) MRA--Mental retardation authority. An entity designated in accordance with Texas Health and Safety Code, §533.035(a).

(11) Registry--

(A) The employee misconduct registry maintained by DADS in accordance with Texas Health and Safety Code, Chapter 253, and Chapter 93 of this title (relating to Employee Misconduct Registry (EMR)); or

(B) The nurse aide registry maintained by DADS in accordance with §94.10 of this title (relating to Registry, Findings, and Inquiries).

(12) Volunteer--A person who provides services to an MRA, community center, or contract agency without compensation from the MRA, community center, or contract agency, other than reimbursement for actual expenses, and whose duties may put the person in direct contact with an individual.
Source Note: The provisions of this §301.605 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.607 Prohibition to Employment or Contractual or Volunteer Status
(a) An MRA or community center may not hire, enter into a contract with, or assign volunteer status to an applicant with the MRA or community center who:

(1) has a conviction of an offense listed in Texas Health and Safety Code §250.006(a);

(2) has a conviction of an offense listed in Texas Health and Safety Code §250.006(b), during the five years before the proposed employment or contractual or volunteer status;

(3) has a conviction of an offense that the MRA or community center determines is a contraindication to employment or contractual or volunteer status; or

(4) is listed as unemployable in a registry.

(b) An MRA or community center may not continue to employ, contract with, or give volunteer status to a person who:

(1) has a conviction of an offense listed in Texas Health and Safety Code §250.006(a);

(2) has a conviction of an offense listed in Texas Health and Safety Code §250.006(b), during the five years before the MRA or community has knowledge of the conviction;

(3) has a conviction of an offense that the MRA or community center determines is a contraindication to employment or contractual or volunteer status; or

(4) is listed as unemployable in a registry.

(c) An MRA or community center must give an applicant with the MRA or community center the following information, in writing, when the applicant makes an application for employment or contractual or volunteer status:

(1) that criminal history and registry checks will be conducted on the applicant;

(2) the types of criminal offenses for which a conviction prohibits employment by law;

(3) that a conviction of other types of criminal offenses may be considered a contraindication to employment or contractual or volunteer status;

(4) that a registry check will be conducted to determine if an applicant is listed as unemployable; and

(5) that a registry check will be conducted annually to determine if an employee, contractor, or volunteer is listed as unemployable.
Source Note: The provisions of this §301.607 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.609 Conducting Criminal History and Registry Checks
(a) Criminal history check.

(1) Before making an offer of employment or contractual or volunteer status to an applicant, an MRA or community center must conduct a criminal history check by:

(A) obtaining criminal history record information from the Texas Department of Public Safety (TDPS); and

(B) if the applicant has lived outside the State of Texas at any time during the two years before making the application for employment or contractual or volunteer status with an MRA or community center, obtaining criminal history information from the Federal Bureau of Investigation.

(2) An MRA or community center may conduct a criminal history check on an employee, contractor, or volunteer of the MRA or community center at any time the MRA or community center determines it is necessary.

(b) Registry check.

(1) Before making an offer of employment or contractual or volunteer status to an applicant, an MRA or community center must conduct a registry check by searching both registries listed in §4.503(11) of this subchapter (relating to Definitions) to determine if the applicant is listed as unemployable.

(2) An MRA or community center must conduct a registry check annually to ensure that an employee, contractor, or volunteer of the MRA or community center is not listed as unemployable. The MRA and community center must retain a copy of the results of an annual registry check.

(3) An MRA or community center may conduct a registry check to determine if an employee, contractor, or volunteer of the MRA or community center is listed as unemployable at any time the MRA or community center determines it is necessary.
Source Note: The provisions of this §301.609 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.611 Self-Reporting a Criminal Offense Charge or Conviction
An MRA or community center must require an employee, contractor, or volunteer of the MRA or community center to report to a staff person designated by the MRA or community center:

(1) a criminal offense that the employee, contractor, or volunteer is charged with or convicted of after starting employment or volunteer status or after the execution of the contractor's contract; or

(2) a listing of the employee, contractor, or volunteer as unemployable in a registry after starting employment or volunteer status or after the execution of the contractor's contract.
Source Note: The provisions of this §301.611 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.613 LIDDA and Community Center Policies Related to Criminal History and Registry Checks
(a) An MRA or community center must have written procedures consistent with this subchapter (relating to Criminal History and Registry Checks for MRAs and Community Centers) that describes how information obtained through criminal history and registry checks is processed, including:

(1) procedures that protect the confidentiality of criminal history record information pursuant to Texas Health and Safety Code §250.007 and Texas Government Code §411.115;

(2) procedures for notifying an applicant, employee, volunteer, or contractor if:

(A) the criminal history record information of the applicant, employee, volunteer, or contractor identifies a conviction that prohibits or contraindicates employment or contractual or volunteer status; or

(B) the applicant, employee, or volunteer is listed as unemployable in a registry;

(3) procedures for notifying an applicant, employee, volunteer, or contractor how to address inaccuracies in criminal history record information (i.e., the opportunity to be heard by Texas Department of Public Safety) if the person believes he or she has been unjustly denied employment or contractual or volunteer status as a result of criminal history record information that is incorrect or relates to another person;

(4) procedures for documenting the results of criminal history and registry checks of an applicant, employee, volunteer, or contractor;

(5) procedures for maintaining a copy of the results of the annual registry checks in the file of an employee, contractor, or volunteer of the MRA or community center;

(6) procedures for destroying all criminal history record information obtained in accordance with this subchapter immediately after an employment or volunteer decision has been made or personnel action has been taken, as required by Texas Government Code §411.115(e); and

(7) procedures for destroying all criminal history record information related to a contractor of the MRA or community center obtained in accordance with this subchapter immediately after execution of the contract.

(b) An MRA or community center must develop written procedures consistent with this subchapter describing how it will respond to information obtained through self-reporting and subsequent criminal history and registry checks.

(1) Pursuant to the Texas Health and Safety Code, §533.007(b), an MRA or community center may not take adverse personnel action against an employee of the MRA or community center if the information received pertains to an arrest warrant or wanted persons information. However, the MRA or community center may reassign the employee until resolution of the matter relating to the arrest warrant or wanted persons information.

(2) If the information obtained by self-reporting or from a criminal history check states that the employee, contractor, or volunteer of an MRA or community center has a conviction for an offense described in §4.505(b)(1) - (3) of this subchapter (relating to Prohibition to Employment or Contractual or Volunteer Status), the MRA or community center may consider a contention by the employee, contractor, or volunteer that the information is incorrect or that it relates to another person. The MRA or community center may give the employee, contractor, or volunteer a reasonable period of time to have the information corrected, but the MRA or community center must reassign the employee, contractor, or volunteer to duties that are not contraindicated by the conviction. If the employee, contractor, or volunteer fails to get the information corrected as provided by Texas Health and Safety Code §250.005(b), the MRA or community center must immediately discharge the employee or volunteer or terminate the contractor's contract.

(3) If the information obtained by self-reporting or a registry check states that an employee, contractor, or volunteer of the MRA or community center is listed as unemployable in a registry, the MRA or community center must immediately discharge the employee or volunteer or terminate the contractor's contract.
Source Note: The provisions of this §301.613 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.615 Contract Agency
(a) An MRA or community center must require a contract agency to conduct criminal history and registry checks on an applicant with the contract agency.

(b) An MRA or community center must require a contract agency to annually conduct a registry check on an employee, contractor, or volunteer with the contract agency.

(c) An MRA or community center must require a contract agency to require an employee, contractor, or volunteer of the contract agency to report to the contract agency:

(1) a criminal offense that the employee, contractor, or volunteer is convicted of or charged with after starting employment or volunteer status or after the execution of the contractor's contract; and

(2) a listing of the employee, contractor, or volunteer as unemployable in a registry after starting employment or volunteer status or after the execution of the contractor's contract.

(d) An MRA or community center must require a contract agency to conduct criminal history and registry checks on an employee, contractor, or volunteer of the contract agency if the contract agency has reason to believe the employee, contractor, or volunteer may have a criminal history that makes the employee, contractor, or volunteer unqualified or unsuitable for employment or contractual or volunteer status or may be listed as unemployable on a registry.

(e) An MRA or community center must prohibit a contract agency from allowing an employee, contractor, or volunteer of the contract agency to have direct contact with an individual if the contract agency becomes aware that:

(1) a criminal history check indicates that the employee, contractor, or volunteer is not qualified or suitable; or

(2) the employee, contractor, or volunteer is listed as unemployable in a registry.
Source Note: The provisions of this §301.615 adopted to be effective October 6, 2011, 36 TexReg 6513; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.651 Purpose
The purpose of this subchapter is to implement §48.255(c) of the Human Resources Code, which requires TDMHMR to develop joint rules with the Texas Department of Protective and Regulatory Services (TDPRS) to facilitate investigations in local authorities and community centers and to describe the requirements for:

(1) reporting allegations of abuse, neglect, and exploitation of persons served;

(2) ensuring the safety and protections of persons served involved in allegations;

(3) facilitating investigations; and

(4) ensuring proper disciplinary or other action is taken when abuse, neglect, or exploitation is confirmed.
Source Note: The provisions of this §301.651 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.653 Application
(a) This subchapter applies to local authorities and community centers. However, local authorities and community centers that are Medicaid providers of a home and community-based services waiver program must comply with TDMHMR rules governing the home and community-based services waiver program when addressing abuse, neglect, and exploitation in the home and community-based services waiver program.

(b) Local authorities and community centers are responsible for amending their contracts to ensure contractors' compliance with this subchapter.
Source Note: The provisions of this §301.653 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.655 Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

(1) Abuse--For purposes of reporting allegations, the term is defined by the investigatory agency. For purposes of classifying allegations as part of the TDMHMR Client Abuse and Neglect Reporting System (CANRS), the term is defined in CANRS Definitions, which is referenced as Exhibit A of §414.562 of this title (relating to Exhibits).

(2) Administrator--The individual in charge of a local authority or community center, or designee.

(3) Agent--Any individual not employed by a local authority, community center, or contractor, but working under the auspices of the local authority, community center, or contractor (e.g., student, volunteer).

(4) Allegation--A report by an individual suspecting or having knowledge that a person served has been or is in a state of abuse, neglect, or exploitation as defined by the investigatory agency or in CANRS Definitions, which is referenced as Exhibit A in §414.562 of this title.

(5) Clinical practice--Relates to the demonstration of professional competence by a licensed professional.

(6) Community center--A community mental health center, community mental retardation center, or community mental health and mental retardation center, established under the Texas Health and Safety Code, Title 7, Chapter 534, Subchapter A.

(7) Confirmed--The finding of an investigation if there is a preponderance of credible evidence to support that abuse, neglect, or exploitation occurred.

(8) Contractor--Any organization, entity, or individual who contracts with a local authority or community center to provide mental health or mental retardation services to a person served. The term includes a local independent school district with which a local authority or community centers has a memorandum of understanding (MOU) for educational services.

(9) Contractor CEO--The individual in charge of a contractor that has one or more employees excluding the CEO.

(10) Exploitation--For purposes of reporting allegations, the term is defined by the investigatory agency. For purposes of classifying allegations as part of the TDMHMR CANRS, the term is defined in CANRS Definitions, which is referenced as Exhibit A in §414.562 of this title.

(11) Investigatory agency--An agency with statutory authority to investigate abuse, neglect, and exploitation of a person served by a local authority, community center, or contractor. For example, the Texas Department of Protective and Regulatory Services investigates allegations in local authorities and community centers (including intermediate care facilities for the mentally retarded or persons with a related condition (ICF/MR or ICF/MR/RC) operated by a local authority or community center) and all contractors of local authorities and community centers except psychiatric hospitals; the Texas Department of Health (TDH) investigates allegations in psychiatric hospitals; and the Texas Commission on Alcohol and Drug Abuse (TCADA) investigates allegations in TCADA-funded programs operated by a local authority or community center pursuant to a contract with TCADA.

(12) Local authority--An entity designated by the TDMHMR commissioner in accordance with the Texas Health and Safety Code, §533.035(a).

(13) Neglect--For purposes of reporting allegations, the term is defined by the investigatory agency. For purposes of classifying allegations as part of the TDMHMR CANRS, the term is defined in CANRS Definitions, which is referenced as Exhibit A in §414.562 of this title.

(14) Perpetrator--An individual who has committed an act of abuse, neglect, or exploitation.

(15) Person served--

(A) Any person with mental illness or mental retardation receiving services from a local authority or community center or through a contract with a local authority or community center who is registered or assigned in the Client Assignment and Registration (CARE) system; or

(B) any child or disabled person as defined in the Human Resources Code, Chapter 48, who is otherwise receiving services from a local authority or community center or through a contract with a local authority or community center.

(16) Professional review--A review of clinical and/or professional practice(s) by peer professionals.

(17) Retaliatory action--Any action intended to inflict emotional or physical harm or inconvenience on an employee, agent, or person served that is taken because he or she has reported abuse, neglect, or exploitation. Retaliatory action includes, but is not limited to, harassment, disciplinary measures, discrimination, reprimand, threat, and criticism.
Source Note: The provisions of this §301.655 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.657 Responsibilities of Local Authorities, Community Centers, and Contractors
(a) Promulgate and implement policies and procedures. Each local authority and community center shall promulgate and implement policies and procedures that meet the requirements of this section.

(b) Prohibition of abuse, neglect, and exploitation. Each local authority, community center, and contractor shall ensure that its employees and agents are informed of the prohibition of abuse, neglect, and exploitation of persons served.

(c) Identifying programs and investigatory agencies.

(1) Each local authority, community center, and contractor shall ensure that the name and phone number of the investigatory agency are clearly identified and displayed for its employees and agents at each of its program and service delivery sites.

(2) Each local authority and community center shall provide to each investigatory agency a list of the names and addresses of its contracted and non-contracted program and service delivery sites in the investigatory agency's purview, including the name of the staff who will serve as contact for investigators, as required in subsection (g)(1) of this section.

(d) Reporting abuse, neglect, and exploitation and securing evidence.

(1) Each local authority, community center, and contractor shall require its employees and agents who suspect or have knowledge of abuse, neglect, or exploitation of a person served to:

(A) make a verbal report to the investigatory agency immediately, but in no case more than one hour after suspicion or knowledge of the abuse, neglect, or exploitation, in compliance with existing state laws, rules, memorandums of understanding, and this subchapter;

(B) as needed, assist any individual in making a report when the individual alleging abuse, neglect, or exploitation is not an employee or agent, (e.g., a person served, a guest); and

(C) secure evidence related to the allegation in accordance with "Guidelines for Securing Evidence" referenced as Exhibit B in §414.562 of this title (relating to Exhibits).

(2) Failure to make reports of abuse, neglect, or exploitation immediately without sufficient justification is considered a violation of this section and makes the employee or agent subject to disciplinary or other appropriate action and possible criminal prosecution.

(3) In addition to the reporting requirement described in paragraph (1)(A) of this subsection, reports regarding alleged sexual exploitation committed by a mental health services provider are made to the prosecuting attorney in the county in which the alleged sexual exploitation occurred and any state licensing board that has responsibility for the mental health services provider's licensing in accordance with the Texas Civil Practice and Remedies Code, §81.006. A copy of the Texas Civil Practice and Remedies Code, §81.006, and §81.001, which includes the definitions of "sexual exploitation" and "mental health services provider," is referenced as Exhibit C in §414.562 of this title (relating to Exhibits).

(e) Notifying contractor CEO. If the administrator is notified of an allegation involving a contractor, then the administrator must immediately notify the contractor CEO of the allegation unless the contractor CEO is the alleged perpetrator. If the contractor CEO is the alleged perpetrator, then the administrator shall ensure the activities described in subsections (f), (h), and (i) are accomplished.

(f) Safeguarding the alleged victim. Immediately upon notification of an allegation by the investigatory agency the administrator or contractor CEO shall ensure necessary measures are taken to secure the safety of the alleged victim(s) involved in the allegation, including:

(1) ensuring immediate and on-going medical and psychological attention is provided to the alleged victim(s), as necessary; and

(2) separating the alleged victim(s) from the alleged perpetrator(s) until an investigation has been completed.

(g) Prohibiting retaliatory action. Any employee or agent, or any individual affiliated with an employee or agent is prohibited from engaging in retaliatory action against an employee, agent, or person served who in good faith reports an allegation. Any employee or agent found to have engaged in retaliatory action is subject to disciplinary or other appropriate action.

(1) Any employee or agent who believes he or she is being subjected to retaliatory action upon making a report of abuse, neglect, or exploitation, or who believes an allegation has been ignored without cause, should immediately contact the administrator or contractor CEO and may also contact the Office of Consumer Services and Rights Protection - Ombudsman at TDMHMR's Central Office, at the toll free number 1-800-252-8154.

(2) Retaliatory action against a person served which might be considered abuse, neglect, or exploitation must be reported in accordance with this section.

(h) Facilitating investigations.

(1) Administrators and contractor CEOs shall ensure the designation of a contact staff at each program and service delivery site who will be responsible for coordinating with the investigator to ensure the availability of and access to private interview space, private telephones, and employees, agents, and persons served.

(2) Administrators and contractor CEOs shall require employees and agents to cooperate with investigators so that investigators are afforded immediate access to persons served, employees, agents, records of persons served, and other documents requested by the investigator.

(3) Falsification of fact during an investigation is considered a violation of this section and makes the employee or agent subject to disciplinary or other appropriate action and possible criminal prosecution.

(i) Referring allegations involving clinical practice. If the investigator refers to the administrator or contractor CEO an allegation involving the clinical practice of a licensed professional, then the administrator or contractor CEO shall refer the allegation for professional review or, if the local authority, community center, or contractor does not have a professional review process, the administrator or contractor CEO shall refer the allegation to the appropriate licensing authority. The administrator or contractor CEO shall ensure relevant conclusions of a professional review are submitted to the appropriate licensing authority.

(j) Facilitating resolution of other issues.

(1) Administrators and contractor CEOs shall ensure that general complaints and administrative issues that are referred to them by an investigator are reviewed and resolved in a timely manner.

(2) Local authorities, community centers, and contractors shall afford TDMHMR immediate access to persons served, employees, agents, records of persons served, and other documents when TDMHMR responds to a complaint that the health, welfare, or safety of a person served may be jeopardized.
Source Note: The provisions of this §301.657 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.659 Information To Be Provided to Victim or Alleged Victim and Others
(a) Each local authority and community center shall promulgate and implement policies and procedures that meet the requirements of this section.

(b) As soon as possible, but no later than 24 hours following notification of an allegation by the investigatory agency, the administrator or contractor CEO shall notify the alleged victim and the alleged victim's guardian or parent (if the alleged victim is a minor) of the allegation.

(c) The administrator or contractor CEO shall ensure that the victim or alleged victim, guardian, or parent (if the victim or alleged victim is a minor) is notified of:

(1) the finding and any decisions made after review and/or appeal of the finding;

(2) the method to appeal the finding, if any;

(3) how to receive a copy of the investigative report; and

(4) if the allegation is confirmed, the disciplinary or other action taken against the perpetrator.
Source Note: The provisions of this §301.659 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.661 Investigations Conducted by the Texas Department of Family and Protective Services (DFPS)
(a) TDPRS submits a copy of the investigative report to the administrator or contractor CEO or both in accordance with Chapter 711 of Title 40 (relating to Investigations in TDMHMR Facilities and Related Programs).

(b) The administrator or contractor CEO may not change a confirmed finding made by a TDPRS investigator. The administrator or contractor CEO may request a review of the finding or the methodology used to conduct the investigation in accordance with Chapter 711 of Title 40 (relating to Investigations in TDMHMR Facilities and Related Programs).
Source Note: The provisions of this §301.661 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.663 Disciplinary and Other Action
(a) Each local authority and community center shall promulgate and implement policies and procedures that meet the requirements of this section.

(b) Administrators and contractor CEOs must take appropriate disciplinary or other action in confirmed cases of abuse, neglect, and exploitation involving employees and agents.

(1) If the investigatory agency has a process by which the administrator or contractor CEO can request a review of the finding and a review is requested, then the outcome of the review is final and forms the basis for disciplinary action.

(2) If the investigatory agency does not have a process by which the administrator or contractor CEO can request a review of the finding, the investigatory agency's finding is final and forms the basis for disciplinary action.

(c) Nothing in this subchapter precludes an administrator or contractor CEO from taking disciplinary or other appropriate action pending investigation, including termination of employment. If disciplinary or other action is taken before the investigation is complete, then the executive director or CEO shall notify the investigator of such action and the investigation continues.

(d) Administrators and contractor CEOs shall ensure that disciplinary or other appropriate action, including seeking criminal prosecution as appropriate, is taken when an employee or agent fails to make reports immediately without sufficient justification or an employee or agent is found to have made a false statement of fact during an investigation.
Source Note: The provisions of this §301.663 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.665 Data Reporting Responsibilities
If the perpetrator or alleged perpetrator is an employee or agent of a local authority, community center, or contractor, or the perpetrator is unknown, then the administrator shall ensure that a Client Abuse and Neglect Reporting form (AN-1-A) is completed within 14 calendar days of the receipt of the investigative report or decision made after review or appeal using the CANRS Definitions and the CANRS Classifications. (The Client Abuse and Neglect Reporting form (AN-1-A), the CANRS Definitions, and the CANRS Classifications are referenced as Exhibits E, A, and D, respectively, in §414.562 of this title (relating to Exhibits).) Within one working day after completion of the AN-1-A form, the administrator shall ensure that:

(1) the information contained in the completed AN-1-A is entered into the Client Abuse and Neglect Reporting System (CANRS); or

(2) if access to CANRS is unavailable, a copy of the completed AN-1-A is forwarded for data entry to the Office of Consumer Services and Rights Protection - Ombudsman, TDMHMR, P.O. Box 12668, Austin, TX 78711-2668.
Source Note: The provisions of this §301.665 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.667 Confidentiality of Investigative Process and Report
(a) The reports, records, and working papers used by or developed in the investigative process by an investigatory agency, and the investigatory agency's resulting investigative report, are confidential and may be disclosed only as allowed by law or rule.

(b) Upon request, the administrator or contractor CEO will provide a copy of the investigative report to the victim or alleged victim or guardian with the identities of other persons served and any information determined confidential by law concealed. The administrator or contractor CEO may charge a reasonable fee for providing a copy of the investigative report.

(c) Advocacy, Inc. is entitled to access the records of persons served in accordance with 42 USC §10805 and §10806 or §6042(a)(2)(I) (Protection and Advocacy of Individuals with Mental Illness and Protection and Advocacy of Individuals with Developmental Disabilities). A copy of 42 USC §10805, §10806, and §6042(a)(2)(I) are referenced as Exhibit F in §414.562 of this title (relating to Exhibits).
Source Note: The provisions of this §301.667 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.669 Competency of Employees and Agents
(a) Each local authority, community center, and contractor shall ensure that all employees and agents demonstrate a thorough understanding of the relevant elements of reporting, investigating, and preventing abuse, neglect, and exploitation, before contact with persons served and annually thereafter. The relevant elements of reporting, investigating, and preventing abuse, neglect, and exploitation include:

(1) the acts and signs of possible abuse, neglect, and exploitation;

(2) the prohibition of abuse, neglect, and exploitation of persons served;

(3) the disciplinary consequences for:

(A) committing abuse, neglect, and exploitation;

(B) failing to report abuse, neglect, or exploitation; and

(C) failing to cooperate with an investigation;

(4) the procedures for reporting allegations of abuse, neglect, and exploitation;

(5) the prohibition of retaliatory action and the consequences for engaging in retaliatory action;

(6) the methods for preventing abuse, neglect, and exploitation; and

(7) memoranda of understanding and rules of investigatory agencies.

(b) Each local authority, community center, and contractor shall ensure that employees and agents who will routinely perform any job duty in proximity to persons served demonstrate competency in the safe management of verbally and physically aggressive behavior before contact with persons served and annually thereafter.

(c) Each local authority, community center, and contractor shall ensure that documentation of the competencies of its employees and agents is maintained.
Source Note: The provisions of this §301.669 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.671 HHSC Oversight Responsibilities
The Office of Consumer Services and Rights Protection - Ombudsman in TDMHMR's Central Office is responsible for the maintenance of systems that provide statistical trends in abuse, neglect, and exploitation in local authorities and community centers.
Source Note: The provisions of this §301.671 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.673 Exhibits
The following exhibits are referenced in this subchapter:

(1) Exhibit A--CANRS Definitions;

(2) Exhibit B--"Guidelines for Securing Evidence";

(3) Exhibit C--a copy of the Texas Civil Practice and Remedies Code, §81.001 and §81.006;

(4) Exhibit D--CANRS Classifications;

(5) Exhibit E--Client Abuse and Neglect Report form (AN-1-A); and

(6) Exhibit F--a copy of 42 USC §10805, §10806, and §6042(a)(2)(I).
Source Note: The provisions of this §301.673 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.675 References
Reference is made to the following statutes and rules:

(1) Texas Health and Safety Code, Chapter 534, Subchapter A, and §533.035(a);

(2) Texas Civil Practices and Remedies Code, Chapter 81;

(3) Human Resources Code, §48.255(c);

(4) 42 USC §10805, §10806, and §6042(a)(2)(I); and

(5) Texas Administrative Code, Title 40, Chapter 711 (relating to Investigations in TDMHMR Facilities and Related Programs).
Source Note: The provisions of this §301.675 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.

§301.677 Distribution
(a) This subchapter shall be distributed to:

(1) members of the Texas MHMR Board;

(2) investigatory agencies;

(3) executive, management, and program staff of Central Office;

(4) administrators of all local authorities and community centers; and

(5) advocacy organizations.

(b) Each administrator is responsible for disseminating copies of this subchapter to:

(1) employees and agents;

(2) contractors; and

(3) any person served or other individual desiring a copy.

(c) Each contractor CEO is responsible for disseminating copies of this subchapter to all employees and agents.
Source Note: The provisions of this §301.677 adopted to be effective July 1, 2001, 26 TexReg 4708; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective May 31, 2024, as published in the May 3, 2024, issue of the Texas Register, 49 TexReg 3019.