Minimum Standards for Child-Placing Agencies

1 Minimum Standards for Child Placing Agencies Child Care Regulation Texas Health and Human Services Commission June 2021 Revised: 11/10/20212 Table of Contents Table of Contents .. 2 INTRODUCTION .. 6 Minimum Standards .. 6 Deficiencies .. 6 Weights .. 6 Maintaining Compliance .. 7 The Inspection .. 7 Technical Assistance .. 7 Investigations .. 8 Your Rights and Entitlements .. 8 For Further Information .. 8 Subchapter A, Purpose and Scope .. 9 Subchapter B, Definitions and Services .. 10 Division 1, Definitions .. 10 Division 2, Services .. 23 Subchapter C, Organization and Administration .. 29 Division 1, Plans and Policies Required For the Application Process .. 29 Division 2, Operational Responsibilities and Notifications .. 47 Division 3, General Fiscal Requirements .. 52 Division 4, Fiscal Requirements for Adoption Agencies .. 53 Division 5, Financial Assistance to Birth Mothers .. 55 Division 6, Fiscal Accountability/Pass-Through Expenses .. 59 Division 7, Branch Offices.

2 61 Division 9, Clients and Appeals .. 64 Subchapter D, Reports and Record Keeping .. 67 Division 1, Reporting Serious Incidents and Other Occurrences .. 67 Division 2, Operation Records .. 83 Division 3, Personnel Records .. 86 Division 4, Client Records .. 88 Division 5, Unauthorized Absences .. 92 Subchapter E, Agency Staff and Caregivers .. 97 Division 1, General Requirements .. 97 Division 2, Child-Placing Agency Administrator .. 99 Division 3, Child Placement Staff and Child Placement Management Staff 101 Division 4, Treatment Director .. 110 Division 5, Treatment Services Provided by Nursing Professionals .. 112 Division 6, Contract Staff and Volunteers .. 113 Revised: 11/10/2021 3 Subchapter F, Training and Professional Development .. 115 Division 1, Definitions .. 115 Division 2, Overview of Training and Experience Requirements .. 116 Division 3, Orientation .. 118 Division 4, Pre-Service Experience and Training .. 119 Division 5, Curriculum Components for Pre-Service Training.

3 128 Division 6, Pediatric First Aid and Pediatric CPR Certification .. 133 Division 7, Annual Training .. 135 Division 8, Topics and Curriculum Components for Annual Training .. 144 Subchapter G, Children s Rights .. 149 Subchapter H, Foster Care Services: Admission and Placement .. 159 Division 1, Admissions .. 159 Division 2, Admission 166 Division 3, Required Admission Information .. 172 Division 4, Emergency 174 Division 5, Foster Care Placement .. 177 Division 6, Subsequent Placement .. 179 Division 7, Post-Placement Contact .. 180 Subchapter I, Foster Care Services: Service Planning, Discharge .. 182 Division 1, Service Plans .. 182 Division 2, Service Plan Review and Updates .. 192 Division 3, Discharge and Transfer Planning .. 197 Subchapter J, Foster Care Services: Medical and Dental .. 202 Division 1, Medical and Dental Care .. 202 Division 2, Administration of Medication .. 214 Division 3, Self-Administration of Medication .. 217 Division 4, Medication Storage and Destruction.

4 218 Division 5, Medication Records .. 219 Division 6, Medication and Label Errors .. 222 Division 7, Side Effects and Adverse Reactions to Medication .. 224 Division 8, Use of Psychotropic Medication .. 226 Division 9, Protective Devices .. 230 Division 10, Supportive 232 Subchapter K, Foster Care Services: Daily Care, Problem Management .. 234 Division 1, Additional Requirements for Infant Care .. 234 Division 2, Additional Requirements for Toddler Care .. 241 Division 3, Additional Requirements for Pregnant Children .. 242 Division 4, Educational Services .. 244 Division 5, Recreational Services .. 247 Division 6, Discipline and Punishment .. 250 Revised: 11/10/2021 4 Subchapter L, Foster Care Services: Emergency Behavior Intervention .. 255 Division 1, Definitions .. 255 Division 2, Types of Emergency Behavior Intervention That May Be Administered .. 255 Division 3, Orders .. 259 Division 4, Responsibilities During Administration of Any Type of Emergency Behavior Intervention.

5 262 Division 5, Additional Responsibilities During Administration of a Personal Restraint .. 264 Division 6, Combinations of Emergency Behavior Intervention .. 266 Division 7, Time Restrictions for Emergency Behavior Intervention .. 268 Division 8, General Caregiver Responsibilities, Including Documentation, After the Administration of Emergency Behavior Intervention .. 270 Division 9, Triggered Reviews .. 273 Division 10, Overall Agency Evaluation .. 276 Subchapter M, Foster Homes: Screenings and Verifications .. 278 Division 1, General Requirements .. 278 Division 2, Foster Home Screenings .. 280 Division 3, Verification of Foster Homes .. 292 Division 4, Temporary, Time-Limited, and Provisional Verifications .. 306 Division 5, Capacity and Child/Caregiver Ratio .. 311 Division 6, 319 Division 7, 323 Division 8, Respite Child-Care Services .. 326 Division 9, Agency Foster Family Relationships .. 330 Subchapter N, Foster Homes: Management and Evaluation .. 332 Subchapter O, Foster Homes: Health and Safety Requirements, Environment, Space and Equipment.

6 340 Division 1, Health and Safety .. 340 Division 2, Tobacco and E-Cigarette Use .. 347 Division 3, Weapons, Firearms, Explosive Materials, and Projectiles .. 347 Division 4, Space and Equipment .. 350 Division 5, Nutrition and Food Preparation .. 357 Division 6, Transportation .. 364 Division 7, Swimming Pools, Bodies of Water, Safety .. 368 Subchapter P, Foster-Adoptive Homes and Legal Risk Placements .. 375 Division 1, Verification of Foster-Adoptive Homes .. 375 Division 2, Legal Risk Placements .. 376 Revised: 11/10/2021 5 Subchapter Q, Adoption Services: Children .. 377 Division 1, Consent .. 377 Division 2, Adoption Service Plan .. 377 Division 3, Preparation for Adoption .. 379 Division 4, Placement Requirements .. 383 Division 5, Required Information .. 384 Division 6, Post-Placement Supervision .. 389 Division 7, Post-Adoption Services .. 393 Subchapter R, Adoption Services: Birth Parents .. 395 Division 1, Birth Parent Preparation .. 395 Division 2, Termination of Parental Rights.

7 397 Division 3, Post Adoption Services .. 398 Subchapter S, Adoption Services: Adoptive Parents .. 400 Division 1, Adoptive Applicant 400 Division 2, Adoptive Home Screening .. 401 Division 3, Basic Care and Safety Requirements .. 412 Division 4, Pre-Placement Requirements .. 413 Division 5, Pre-Adoption Consummation Activities .. 414 Division 6, Post-Placement Adoptive Report .. 416 Division 7, Counseling Services .. 420 Division 8, Subsequent Adoptions .. 421 Subchapter T, Additional Requirements for Child-Placing Agencies That Provide an Assessment Services Program .. 422 Division 1, Regulation .. 422 Division 2, Admission .. 422 Division 3, Plan for the Assessment .. 423 Division 4, Assessment Report .. 425 Subchapter V, Additional Requirements for Child-Placing Agencies That Provide Trafficking Victim Services .. 428 Division 1, Definition and Scope .. 428 Division 2, Policies and Procedures .. 430 Division 3, Personnel .. 432 Division 4, Training .. 433 Division 5, Admission and Service Planning.

8 440 Appendix A: Definitions .. 446 Appendix B, Vaccine-Preventable Diseases .. 451 Revised: 11/10/2021 6 INTRODUCTION Minimum Standards These Minimum Standards tell you (the child care operation permit holder) what requirements you, your employees, and your caregivers must follow. These Minimum Standards : were developed by the Texas Health and Human Services Commission (HHSC) with the assistance of child-care operations, parents, stakeholders, and other experts in a variety of fields; reflect what the citizens of Texas consider to be reasonable and Minimum ; and meet the guidelines set forth in Chapter 42 of the Texas Human Resources Code (law) for what must be included in the Minimum Standards . The Administrative Procedure and Texas Register Act requires that proposed Standards be published for public comment before they are adopted as rules. All members of the public, including providers, are encouraged to provide input when proposed Minimum Standards are published for comment.

9 The commission considers recommendations from interested persons or groups in formulating the final draft, which is filed as rules with the Secretary of State. Deficiencies A deficiency is any failure to comply with a Minimum standard, rule in Texas Administrative Code Chapter 745, law, specific term of the permit , or specific condition of probation or suspension. Weights The Minimum Standards are weighted based on a common understanding of the risk to children presented if the standard or rule is violated. The weights are: high, medium-high, medium, medium-low, and low. The assigned weights do not change based on the scope or severity of an actual deficiency. Scope and severity are assessed by Child Care Regulation (CCR) staff, documented, and considered in conjunction with the weight when making CCR decisions. You will see the weight is noted at the end of each standard or subsection in green. Only those Minimum Standards which can be cited as a deficiency are weighted.

10 For example, the Minimum standard prohibiting physical discipline is weighted but Minimum Standards that are definitions are not weighted. Revised: 11/10/2021 7 Maintaining Compliance It is essential that you, your employees, and your caregivers recognize four critical aspects of CCR s efforts to protect the children in care and to help operation employees and caregivers comply with the law, rules, and Standards . The four aspects are: Inspection Technical assistance Investigations Caregiver s rights and entitlements The Inspection Various aspects of regulated operations are evaluated for compliance with the Minimum Standards , rules, and laws during regular inspections. The emphasis on these inspections is to prevent risk to children in care. The frequency of inspections will fluctuate depending on the type of permit and the operation s history of compliance with the Minimum Standards , rules, and law. During any inspection, if we find that your operation does not meet Minimum standard, rule, or law, the deficiencies are discussed with the person in charge at the time of the inspection.