SECTION 551.61. Introduction, Application, and General Requirements for Facilities for Persons with an Intellectual Disability or Related Conditions

(a) Scope. The requirements of this section are applicable to both new and existing facilities unless stated otherwise.

(b) Purpose.

(1) The concept of requirements for fire safety with regard to the residents is based on evacuation capability as published in NFPA 101. These standards are written with the premise that the residents will be capable of self-evacuation without continuous staff assistance. Residents that are not normally capable of self-evacuation nor capable of negotiating stairs unassisted must not be housed above or below the floor of exit discharge unless the facility meets the construction requirements of NFPA 101, Chapter 18, New Health Care Occupancies, or Chapter 19, Existing Health Care Occupancies, for large facilities, or the "impractical" requirements for small facilities as found in NFPA 101, Chapter 32, New Residential Board and Care Occupancies, or Chapter 33, Existing Residential Board and Care Occupancies. Examples of residents who may not be capable of self-evacuation are as follows:

(A) a person with a physical disability of a nature that he or she is not capable of maneuvering in a wheelchair, walker, or other assistive device unaided;

(B) a person with an intellectual disability who will not take or cannot understand instructions from a staff member; or

(C) a person that is taking medication before bedtime which will make it difficult for a staff member to arouse the person quickly.

(2) The method of determining the evacuation capability of residents under NFPA 101, Chapter 32, New Residential Board and Care Occupancies or Chapter 33, Existing Residential Board and Care Occupancies, is by rating each resident and each staff member to determine an evacuation difficulty score (E-score). If the E-score is 1.5 or less, the evacuation capability of the facility is prompt, greater than 1.5 to five is slow, greater than five is impractical. The worksheets to be completed are located in NFPA 101A, Chapter 6, Evacuation Capability Determination for Board and Care Occupancies. Facilities with capacity for 16 residents or less must meet the evacuation requirement for their designated Chapter 32, New Residential Board and Care Occupancies or Chapter 33, Existing Residential Board and Care Occupancies rating. The ratings and their requirements are:

(A) Impractical rating.

(i) The facility must have one fire drill per shift each calendar quarter (minimum of 12 drills per year).

(ii) The facility must actually evacuate residents once a year on each shift.

(iii) All facility staff, including relief and substitute staff, must participate in drills as soon as possible after beginning employment on their shift.

(iv) E-scores are not required for certification under this rating.

(B) Slow rating.

(i) The facility must have one fire drill per shift each calendar quarter (minimum of 12 drills per year).

(ii) The facility must actually evacuate residents during all drills.

(iii) Staff on each shift must participate in drills.

(iv) New, relief, and substitute staff must participate in a drill within ten days of employment on their assigned shift.

(v) E-scores must be calculated as soon as possible, but within ten calendar days of admission.

(vi) Initial E-scores are based on four drills, as follows:

(I) two conducted during the daytime; and

(II) two conducted during the nighttime, after the first 30 minutes and within the first three hours of sleep.

(vii) After the initial E-scores are obtained, a worksheet for rating residents must be completed for all newly admitted residents to obtain an E-score. The evacuation capability is calculated as described in clause (vi) of this subparagraph.

(viii) E-scores must be updated annually or sooner if significant changes occur in any resident's evacuation capability. These updated scores are based on the group's overall performance during fire drills as they are conducted throughout the year. Scores do not have to be calculated in accordance with the drills required for newly admitted residents based on the requirements stated in clause (vi) of this subparagraph.

(C) Prompt rating.

(i) The facility must have one fire drill per shift each calendar quarter (minimum of 12 drills per year).

(ii) The facility must actually evacuate residents during all drills.

(iii) Staff on each shift must participate in drills.

(iv) New, relief, and substitute staff must participate in a drill within ten days of employment on their assigned shift.

(v) E-scores must be calculated as soon as possible, but within ten calendar days of admission.

(vi) Initial E-scores are based on four drills, as follows:

(I) two conducted during the daytime; and

(II) two conducted during the nighttime, after the first 30 minutes and within the first three hours of sleep.

(vii) After the initial E-scores are obtained, a worksheet for rating residents must be completed for all newly admitted residents to obtain an E-score. The evacuation capability is calculated as described in clause (vi) of this subparagraph.

(viii) E-scores must be updated annually or sooner if significant changes occur that would affect a resident's evacuation capability. These updated scores are based on the group's overall performance during fire drills as they are conducted throughout the year. Scores do not have to be calculated in accordance with the drills required for newly admitted residents based on the requirements stated in clause (vi) of this subparagraph.

(3) The "E" score will determine which NFPA 101 features are to be installed and maintained in the facility. These features include construction, fire alarm systems, smoke detector systems, interior finish, sprinkler systems, separation of bedrooms, and egress from the building.

(c) Construction.

(1) New construction is any construction work that began on or after July 5, 2016. The provisions of NFPA 101, Chapter 18, New Health Care Occupancies are applicable for large facilities, and Chapter 32, New Residential Board and Care Occupancies for small facilities.

(2) An existing facility is one that was operating with a license as a facility for persons with an intellectual disability or related conditions before November 1, 2016, and has not subsequently become unlicensed. The provisions of NFPA 101, Chapter 19, Existing Health Care Occupancies are applicable for large facilities, and Chapter 33, Existing Residential Board and Care Occupancies for small facilities.

(3) Alterations or new installations of building services equipment, such as mechanical and electrical systems, generators, fire alarm, and detection systems must be accomplished in conformance with the requirements for new construction as required by NFPA 101.

(4) Site approval, as required by the local health officer, building department, or fire marshal having jurisdiction, must be obtained. Any conditions considered to be a fire, safety, or health hazard will be grounds for disapproval of the site by the Texas Health and Human Services Commission (HHSC) unless applied in an arbitrary or discriminating manner.

(5) Facilities that renovate must provide documentation for the flame spread rate of any new materials applied as an interior finish.

(6) Life safety features and equipment that have been installed in existing buildings and are now in excess of that required by NFPA 101 must continue to be maintained or must be removed at the direction of HHSC.

(7) When an existing licensed facility plans building additions or remodeling, which includes construction of additional resident beds, then the ratio of bathing units must be reevaluated to meet minimum standards and the square footage of dining and living areas must be reevaluated by HHSC. Conversion of existing living, dining, or activity areas to resident bedrooms must not reduce these functions to an area less than required by minimum standards.

(8) Buildings must be of recognized permanent type construction. They must be structurally sound with regard to actual or expected dead, live, and wind loads according to applicable building codes.

(9) Each building must be classified as to the building construction type for fire resistance rating purposes in accordance with NFPA 220 and NFPA 101.

(d) Applicable codes and standards. Except as provided in paragraph (9) of this subsection, a facility must comply with NFPA 101, NFPA 99, and a Tentative Interim Amendment (TIA) issued by the NFPA for NFPA 99 or NFPA 101, including the TIAs listed in paragraphs (1) and (2) of this subsection. A facility must also comply with other NFPA publications referenced in this chapter and a TIA issued for a publication referenced in this chapter, unless otherwise approved or required by HHSC.

(1) The following TIAs have been issued for NFPA 101:

(A) TIA 12-1 to NFPA 101, issued August 11, 2011;

(B) TIA 12-2 to NFPA 101, issued October 30, 2012;

(C) TIA 12-3 to NFPA 101, issued October 22, 2013; and

(D) TIA 12-4 to NFPA 101, issued October 22, 2013.

(2) The following TIAs have been issued for NFPA 99:

(A) TIA 12-2 to NFPA 99, issued August 11, 2011;

(B) TIA 12-3 to NFPA 99, issued August 9, 2012;

(C) TIA 12-4 to NFPA 99, issued March 7, 2013;

(D) TIA 12-5 to NFPA 99, issued August 1, 2013; and

(E) TIA 12-6 to NFPA 99, issued March 3, 2014.

(3) If the municipality has a building code and a plumbing code, then those codes must govern in those areas of construction. Where local codes or ordinances are applicable, the most restrictive parts concerning the same subject item must apply unless otherwise determined by the authority having jurisdiction for local codes and HHSC.

(4) In the absence of such governing municipal codes, nationally recognized codes must be used, such as the Standard Building Code and the Standard Plumbing Code, both of the Southern Building Code Congress International, Inc. Such nationally recognized codes, when used, must all be publications of the same group or organization to assure the intended continuity.

(5) Heating, ventilating, and air-conditioning systems must be designed and installed in accordance with NFPA 90A and NFPA 90B, as applicable, and the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), except as may be modified in this subchapter.

(6) Electrical and illumination system must be designed and installed in accordance with NFPA 70 and the Lighting Handbook of the Illuminating Engineering Society of North America (IES) except as may be modified in this subchapter.

(7) The facility must meet all applicable provisions and requirements concerning accessibility for individuals with disabilities in the following laws and regulations: the Americans with Disabilities Act of 1990 (Title 42, United States Code, Chapter 126); 28 CFR Part 35, Nondiscrimination on the Basis of Disability in State and Local Government Services; Texas Government Code, Chapter 469, Elimination of Architectural Barriers; and 16 TAC , Chapter 68, Elimination of Architectural Barriers. Plans for new construction, substantial renovations, modifications, and alterations must be submitted to the Texas Department of Licensing and Regulation (Attention: Elimination of Architectural Barriers Program) for accessibility approval under Chapter 469.

(8) A facility with a boiler must meet all applicable provisions and requirements of Texas Health and Safety Code, Chapter 755, Boilers.

(9) A facility that is required to comply with NFPA 101, Chapter 33, Existing Residential Board and Care Occupancies, must be in compliance with Chapter 33.2.3.5.7.1 or 33.2.3.5.7.2 by July 5, 2019.

(e) General requirements.

(1) The facility must provide and maintain furnishings and decorations that meet the needs of the residents.

(2) The building, grounds, and equipment must be maintained in good repair, operational, sanitary, and free of hazards.

(3) There must be at least one telephone (other than a pay phone) in the facility, accessible to residents for use in making calls to summon help in case of emergency.

(4) The facility must have:

(A) floors that are free of irregularities and are substantially level (floor areas may be at different elevations with connecting stairs or ramps);

(B) floors that have a resilient, nonabrasive, and slip-resistant surface;

(C) nonabrasive carpeting, if the area used by residents is carpeted and serves residents who lie on the floor or ambulate with parts of their bodies, other than feet, touching the floor; and

(D) exposed floor surfaces and floor coverings that promote mobility in areas used by residents and promote maintenance of sanitary conditions.

(5) Walls and ceilings must be cleanable and in good repair.

(6) Walls and floors must be kept free of cracks. The joint between the walls and floors is to be maintained so as to be free of spaces which might harbor insects, rodents, or vermin.

(7) An adequate supply of hot water must be provided. The hot water system for resident use must be capable of being regulated to not exceed 110 degrees Fahrenheit at the fixtures.

(8) Draperies, curtains (including cubicle curtains), and other similar furnishings and decorations must be flame resistant in accordance with NFPA 701. Documentation must be kept on file in the facility.

(9) Wastebaskets must be of noncombustible material.

(10) An initial pressure test of facility gas lines from the meter must be provided. Additional pressure tests will be required when the facility has major renovations or additions where the gas service is interrupted. All gas heating systems must be checked for proper operation and safety prior to the heating season. Any unsatisfactory conditions must be corrected promptly.

(11) The IES recommendations must be followed to achieve proper illumination characteristics and lighting levels throughout the facility. Minimum illumination must be 10 footcandles in resident rooms during the day and 20 footcandles in corridors, staff stations, dining rooms, lobbies, toilets, bathing facilities, laundries, stairways, and elevators during the day. Illumination requirements for these areas apply to lighting throughout the space and must be measured at approximately 30 inches above the floor anywhere in the room. Minimum illumination for medication preparation or storage areas, kitchens, and staff station desks must be 50 footcandles during the day. Illumination requirements for these areas apply to the task performed and must be measured on the tasks.

(12) In addition to the required illumination (normal and emergency), the facility must keep on hand and readily available to night staff, no less than one working flashlight.

(13) Combustible attic areas larger than 3,000 square feet must be divided into compartments not exceeding 3,000 square feet or the attic area must be sprinkled. The separating barrier must be at least one layer of 1/2-inch gypsum board on one side of support members.

Source Note: The provisions of this §551.61 adopted to be effective July 1, 1996, 21 TexReg 5328; amended to be effective May 1, 1998, 23 TexReg 4060; amended to be effective May 1, 2000, 25 TexReg 3557; amended to be effective May 1, 2004, 29 TexReg 3237; amended to be effective July 30, 2012, 37 TexReg 5629; amended to be effective October 12, 2017, 42 TexReg 5508; transferred effective May 1, 2019, as published in the Texas Register April12,2019, 44 TexReg 1883; amended to be effective February 24, 2022, 47 TexReg 787