SECTION 904.105. Arrangements for the Move to an Alternative Living Arrangement of an Individual Residing in a State MR Facility

(a) Within 14 calendar days of the IDT meeting at which a provider is selected the state MR facility will forward the following to the designated MRA, any other involved MRA, the provider, and the individual with the ability to provide legally adequate consent or the LAR, as appropriate:

(1) a copy of the draft community living/discharge plan;

(2) the planned date for the individual's move, if available;

(3) the report from the last annual planning meeting of the IDT;

(4) the most recent psychological, social, medical, and vocational/educational assessments; and

(5) reports from any interim meetings of the IDT which addressed living options issues not addressed at the annual planning meeting.

(b) The MRA will review the material and visit the provider setting as needed, to determine whether the provider setting:

(1) complies with applicable Life Safety Code requirements;

(2) presents environmental concerns that impact the individual's needs;

(3) effectively addresses the outcomes important to the individual or LAR and the services and supports necessary assist the individual in achieving those outcomes; and

(4) ensures the individual's health, safety, and welfare.

(c) Within 14 calendar days of making its determination in subsection (b) of this section, the MRA must notify the IDT in writing that:

(1) the provider setting meets the criteria in subsection (b) of this section and that the MRA recommends that the IDT approve the provider setting; or

(2) the provider setting does not meet the criteria in subsection (b) of this section and that the MRA recommends that the IDT not approve the provider setting.

(d) If the MRA recommends that the IDT not approve the provider setting, the MRA must include in the notice described in subsection (c)(2) of this section:

(1) the criteria described in subsection (b) of this section that the provider setting did not meet; and

(2) the reasons why the MRA determined the criteria was not met.

(e) If the IDT accepts an MRA recommendation to approve the provider setting, the community living/discharge plan will be completed for distribution to all parties, and final arrangements will be initiated for the individual's move to the community.

(f) If the MRA has recommended that the provider setting not be approved, the IDT will make written recommendations for specific remedies to address the problems and send the recommendations to the provider and the individual or LAR.

(1) The individual with the ability to provide legally adequate consent or the LAR has the option of:

(A) continuing with the move after the IDT determines that the recommendations have been or are in the process of being implemented by the provider;

(B) continuing with the move without the IDT determining that the recommendations have been or are in the process of being implemented by the provider; or

(C) selecting another provider.

(2) If the individual does not have the ability to provide legally adequate consent and does not have an LAR, then the individual will remain in the state MR facility until:

(A) the IDT determines that the recommendations have been or are in the process of being implemented by the provider; or

(B) another provider is identified by the by the IDT.

(g) When the individual moves, the state MR facility shall ensure the following:

(1) a 30-day supply of prescribed medications has been provided;

(2) the individual's personal belongings accompany the individual;

(3) all necessary financial arrangements and agreements are addressed;

(4) appropriate special instructions for the individual or others are furnished in writing and orally prior to or at the time of departure;

(5) the records described in subsection (i) of this section accompany the individual; and

(6) the appropriate Social Security office has been notified of the individual's impending move.

(h) Responsibilities for transporting the individual to the alternative living arrangement will be detailed in the community living/discharge plan. If deemed necessary by the IDT, these responsibilities could include having state MR facility and/or MRA staff accompany the individual and remaining there for a period of time deemed necessary for satisfactory transition. The MRA must assign a service coordinator who will meet with the individual and LAR before or on the day of the move.

(i) The following records, as applicable, will be provided by the state MR facility to the provider before the move or will accompany the individual, with copies also offered to the individual or LAR, before or at the time of the move:

(1) a copy of the birth certificate;

(2) copies of any current legal documents;

(3) a copy of the individual's Social Security card;

(4) a current photograph;

(5) a copy of the immunization record;

(6) a copy of the height and weight record;

(7) a copy of the seizure record;

(8) a copy of the most recent physician's orders, to include treatment and diet orders;

(9) a copy of the most recent medical and dental examination;

(10) copies of the most recent laboratory test results to include any one of a kind laboratory test results;

(11) copies of any additional significant reports including the most recent chest X-ray, electrocardiogram (EKG), or electroencephalogram (EEG);

(12) a copy of the social history and the most recent psychological examination;

(13) Medicaid, Medicare, or third-party insurance cards, if available;

(14) a copy of current nursing care plan;

(15) a summary of the individual's medical history to include all major surgeries, significant acute illnesses, and injuries requiring hospitalization or a long recovery period;

(16) a summary of the individual's medication history to include start and stop dates, dose ranges and effectiveness of all long-term medications, and history of antibiotic use to include dates, effectiveness, sensitivities, and allergies;

(17) a summary of dental history including all oral surgeries, extractions, restorations, appliances, and types of anesthesia required for dental work; and

(18) any other data requested by the community program or by the individual or LAR.

(j) Prior to or at the time of movement, the state MR facility physician shall prepare a letter summarizing the highly relevant medical information to be given to the new physician or health care entity that will be providing services to the individual in the community. The letter will be copied to the designated MRA and other involved MRA and the provider. When appropriate, the state MR facility physician shall communicate directly with the new physician or health care entity.

(k) If a school eligible individual will be enrolled in public school, the state MR facility and MRA must provide the following to the school district prior to the move or within 14 working days after the move:

(1) the birth certificate or other document as proof of identity;

(2) the medical history and medical records, including current immunization records;

(3) the social history;

(4) the vision and hearing screening and/or evaluation;

(5) reports of psychological, educational, related services, and vocational assessments;

(6) the habilitation plan, including plan for reintegration;

(7) the Admission, Review and Dismissal (ARD) Committee report, Individual Education Plan (IEP), and Comprehensive Assessment, and, for school eligible individuals over the age of 13, the most recent Individual Transition Plan; and

(8) if the individual was committed to the state MR facility, a copy of the court order.

(l) A provider required to comply with §411.63 of this title (relating to Interagency Coordination of Special Education Services to Students with Disabilities in Residential Care Facilities) must notify, in writing, the school district where the provider is located of the admission of a school eligible individual. The notification will occur no later than three working days after the admission.

Source Note: The provisions of this §904.105 adopted to be effective January 1, 2001, 25 TexReg 12746; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective September 1, 2023, as published in the August 11, 2023, issue of the Texas Register, 48 TexReg 4397