SECTION 301.333. Quality Management

(a) Quality management plan. The LMHA and MCO must develop a written quality management plan that includes:

(1) the quality management program description and work plan;

(2) measurable objective indicators to detect the need for improvement;

(3) procedures and timelines for taking appropriate action when problems are identified; and

(4) approval by the LMHA or MCO governing body.

(b) Quality management program. The LMHA and MCO must implement a quality management program that includes:

(1) a structure that ensures the program is implemented system-wide;

(2) allocation of adequate resources for implementation;

(3) oversight by professionals with adequate and appropriate experience in quality management;

(4) activities and processes that address identified clinical and organizational problems including fidelity and data integrity;

(5) periodic reporting of quality management program activities to its governing body, providers and other appropriate staff members and community stakeholders such as peer and family organizations;

(6) processes to systematically monitor, analyze, and improve performance of provider services and outcomes for individuals;

(7) review of the provider's treatment to determine:

(A) whether it is consistent with the department's approved evidenced-based practices and the fidelity manual; and

(B) the accuracy of assessments and treatment planning;

(8) ongoing monitoring of the quality of crisis services, access to services, service delivery, and continuity of services;

(9) provision of technical assistance to providers related to quality oversight necessary to improve the quality and accountability of provider services;

(10) use of reports and data from the department to inform performance improvement activities and assessment of unmet needs of individuals, service delivery problems, and effectiveness of authority functions for the local service area;

(11) mechanisms to measure, assess, and reduce incidents of abuse, neglect, and exploitation;

(12) mechanisms to improve individuals' rights protection processes;

(13) risk management processes such as competency determinations, and the management and reporting of incidents and deaths; and

(14) coordination of activities and information management with the utilization management (UM) program, including participation in UM oversight activities.

(c) The LMHA and MCO must establish an integrated system to sufficiently monitor the quality management program for effectiveness on a regular basis and update the quality management plan as needed.

Source Note: The provisions of this §301.333 adopted to be effective April 29, 2009, 34 TexReg 2603; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237