SECTION 559.229. Environment and Emergency Response Plan

(a) Definitions. In this section:

(1) "emergency situation" means an impending or actual situation that:

(A) interferes with normal activities of an individualized skills and socialization provider or the individuals receiving services from the individualized skills and socialization provider;

(B) may:

(i) cause injury or death to an individual or staff member of the individualized skills and socialization provider; or

(ii) cause damage to property of the individualized skills and socialization provider;

(C) requires the individualized skills and socialization provider to respond immediately to mitigate or avoid the injury, death, damage, or interference; and

(D) does not include a situation that arises from the medical condition of an individual such as cardiac arrest, obstructed airway, cerebrovascular accident; and

(2) "plan" refers to an individualized skills and socialization provider's emergency response plan.

(b) Administration. An individualized skills and socialization provider must:

(1) develop and implement a written plan as described in subsection (c) of this section;

(2) maintain a written copy of the plan that is accessible to all staff at all times;

(3) evaluate and revise the plan as necessary:

(A) within 30 days after an emergency situation;

(B) at least annually; and

(4) revise the plan within 30 days after information included in the plan changes.

(c) Emergency response plan. An individualized skills and socialization provider's plan must:

(1) include a risk assessment of all potential internal and external emergency situations relevant to the individualized skills and socialization provider's operations and geographical area, such as a fire, failure of heating and cooling systems, a power outage, an explosion, a hurricane, a tornado, a flood, extreme snow and ice for the area, a wildfire, terrorism, or a hazardous materials accident;

(2) include a description of the services and assistance needed by the individuals in an emergency situation;

(3) include a section for each core function of emergency management, as described in subsection (d) of this section, that is based on an individualized skills and socialization provider's decision to either shelter-in-place or evacuate during an emergency; and

(4) for the on-site individualized skills and socialization location, include a fire safety plan that complies with subsection (e) of this section.

(d) Plan requirements regarding eight core functions of emergency management.

(1) Direction and control. An individualized skills and socialization provider's plan must contain a section for direction and control that:

(A) designates by name or title the emergency preparedness coordinator (EPC) who is the staff person with the authority to manage the individualized skills and socialization provider's response to an emergency situation in accordance with the plan;

(B) designates by name or title the alternate EPC who is the staff person with the authority to act as the EPC if the EPC is unable to serve in that capacity;

(C) documents the name and contact information for the local emergency management coordinator (EMC) for the area where the individualized skills and socialization provider is located, as identified by the office of the local mayor or county judge; and

(D) documents coordination with the local EMC as required by the local EMC's guidelines relating to emergency situations.

(2) Warnings, emergency alerts, or notifications. An individualized skills and socialization provider's plan must contain a section for warnings, emergency alerts, or notifications that:

(A) describes how the EPC will be notified of an emergency situation;

(B) identifies how the EPC will receive notification of relevant local news and weather reports; and

(C) ensures monitoring of local news and weather reports.

(3) Communication. An individualized skills and socialization provider's plan must contain a section for communication that:

(A) identifies the individualized skills and socialization provider's primary mode of communication and alternate mode of communication to be used in the event of power failure or the loss of the individualized skills and socialization provider's primary mode of communication in an emergency situation;

(B) includes procedures for maintaining a current list of telephone numbers for individuals, their program providers, and other relevant emergency contacts as appropriate;

(C) includes procedures for maintaining a current list of telephone numbers for the individualized skills and socialization provider's staff that also identifies the EPC;

(D) identifies the location of the lists described in subparagraphs (B) and (C) of this paragraph where individualized skills and socialization provider staff can obtain the list quickly;

(E) includes procedures to notify:

(i) staff about an emergency situation;

(ii) a receiving facility, if applicable, about an impending or actual evacuation of individuals; and

(iii) individuals, LARs, and other persons about an emergency situation;

(F) describes how the individualized skills and socialization provider will provide, during an emergency situation, general information to the public, such as the change in location and hours, or that the individualized skills and socialization provider is closed due to the emergency situation;

(G) includes procedures for the individualized skills and socialization provider to maintain communication with:

(i) staff during an emergency situation;

(ii) a receiving facility, if applicable; and

(iii) staff or other responsible parties who will transport individuals to a secure location during an evacuation in a vehicle;

(H) includes procedures for reporting to the Texas Health and Human Services Commission (HHSC) an emergency situation that caused the death or serious injury of an individual while receiving individualized skills and socialization services as follows:

(i) by telephone, at 1-800-458-9858, within 24 hours after the death or serious injury; and

(ii) within five working days after making a report described by clause (i) of this subparagraph, the individualized skills and socialization provider must ensure an investigation of the incident is conducted and send a written investigation report on Form 3613-A, Provider Investigation Report, or a form containing, at a minimum, the information required by Form 3613-A, to HHSC's Complaint and Incident Intake.

(4) Sheltering-in-place. An individualized skills and socialization provider that provides on-site services must include in the plan a section that includes procedures to shelter individuals in place during an emergency situation.

(5) Evacuation. An individualized skills and socialization provider that provides on-site services must include in the plan a section for evacuation that:

(A) requires posting building evacuation routes prominently throughout the on-site individualized skills and socialization location;

(B) includes procedures for evacuating individuals to a pre-arranged location in an emergency situation, if applicable;

(C) includes procedures for:

(i) ensuring staff accompany evacuating individuals, as appropriate;

(ii) ensuring that all persons present in the building have been evacuated;

(iii) accounting for individuals and staff after they have been evacuated;

(iv) accounting for individuals who are absent from the individualized skills and socialization provider at the time of the evacuation;

(v) contacting the local EMC, if required by the local EMC guidelines, to find out if it is safe to return to the geographical area; and

(vi) determining if it is safe to re-enter and occupy the building after an evacuation;

(D) includes procedures for notifying the local EMC regarding an evacuation of the building, if required by the local EMC guidelines;

(E) includes procedures for notifying HHSC by telephone, at 1-800-458-9858, within 24 hours after an evacuation that individuals have been evacuated;

(F) includes procedures for notifying the HHSC Regulatory Services regional office for the area in which the individualized skills and socialization provider is located, by telephone, as soon as safely possible after a decision to evacuate is made; and

(G) includes procedures for notifying the HHSC regional office for the area in which the individualized skills and socialization provider is located, by telephone, that individuals have returned to the building after an evacuation, within 48 hours after their return.

(6) Transportation. An individualized skills and socialization provider must include in the plan a section with procedures for transportation.

(7) Health and Medical Needs. An individualized skills and socialization provider's plan must contain a section ensuring that the health and medical needs of individuals are met during an emergency.

(8) Resource Management. An individualized skills and socialization provider's plan must contain a section for resource management that ensures individuals have appropriate access to resources during an emergency.

(e) Training. An individualized skills and socialization provider must:

(1) train all staff when hired on fire, disaster, and their responsibilities under the plan in accordance with §559.227(k) of this subchapter (relating to Program Requirements); and

(2) retrain staff at least annually on fire, disaster, and the staff member's responsibilities under the plan and when the staff member's responsibilities under the plan change.

(f) An individualized skills and socialization provider offering on-site services must:

(1) conduct unannounced drills with staff for fire, severe weather, and other emergency situations identified by the individualized skills and socialization provider as likely to occur, based on the results of the risk assessment required by subsection (c)(1) of this section; and

(2) establish procedures to:

(A) perform a fire drill at least once every 90 days with all occupants of the building at the time of the fire drill at expected and unexpected times and under varying conditions;

(B) relocate, during the fire drill, all occupants of the building to a predetermined location where participants must remain until a recall or dismissal signal is given; and

(C) complete the HHSC Fire Drill Report Form for each required fire drill.

(g) An individualized skills and socialization services provider or designee must enroll in an emergency communication system in accordance with instructions from HHSC.

(h) An individualized skills and socialization services provider or designee must respond to requests for information received through the emergency communication system in the format established by HHSC.

(i) An individualized skills and socialization services provider must ensure that each facility has:

(1) exterior doors that are unobstructed and accessible to all individuals;

(2) two means of escape from the facility;

(3) fire extinguishers that are:

(A) accessible and unobstructed to the service provider;

(B) on each level of the facility;

(C) serviced or replaced after each use; and

(D) if unused, serviced according to the manufacturer's instructions, or as required by the state or local fire marshal.

(j) The facility must conform to all applicable state laws and local ordinances pertaining to occupancy. When these laws, codes, and ordinances are more stringent than the standards in this section, the more stringent requirements govern. If state laws or local codes or ordinances conflict with the requirements of these standards, the provider must submit an application to alter the licensed capacity so that these conflicts may be legally resolved.

(k) The facility must meet the provisions and requirements concerning accessibility for individuals with disabilities in the following laws and regulations: the Americans with Disabilities Act (ADA) of 1990 (Title 42, United States Code, Chapter 126); Title 28, Code of Federal Regulations, Part 35; 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 (Attn: Elimination of Architectural Barriers Program) for accessibility approval under Texas Government Code, Chapter 469. At least 50 percent of the client restrooms must be in accordance with ADA. Exception: facilities licensed for 45 or fewer persons may provide one unisex restroom in accordance with accessibility requirements.

Source Note: The provisions of this §559.229 adopted to be effective January 1, 2023, 47 TexReg 8709