Section 550.206 - Person-Centered Direction and Guidance(a) A center must adopt and enforce written policies and procedures for the use of person-centered direction and guidance by individuals providing services to minors at the center. The policy must include: (1) the implementation of a system-wide, person-centered direction and guidance program for minors that includes: (A) the teaching of successful behavior and coping skills;(B) proactive strategies to identify and manage a minor's behaviors before they escalate; and(C) the monitoring and evaluation of the effectiveness of direction and guidance used with a minor by a committee as described in this section;(2) procedures for ensuring consistent language, practices, and application of direction and guidance by individuals providing services at a center; and(3) procedures for documenting and providing to a minor's parent a daily report of the minor's behavior.(b) A center must ensure that only person-centered strategies and techniques that encourage self-esteem, self-control, and self-direction are used for the purposes of direction and guidance of a minor at a center. A center must not use a restraint as part of person-centered direction and guidance.(c) Person-centered direction and guidance must be:(1) individualized and consistent for each minor;(2) differentiated in both nature and intensity based on a minor's level of behavior;(3) appropriate to the minor's level of understanding and functional or educational development; and(4) directed toward teaching the minor successful behavior, awareness of behavior triggers and self-control, including:(A) encouraging a minor to develop positive behavior in accordance with a minor's individualized psychosocial program;(B) redirecting behavior using positive statements; and(C) teaching the minor to use effective behavior management techniques.(d) A center must ensure that quiet time, if used, is:(1) in accordance with the minor's psychosocial program and plan of care;(2) brief and under continuous face-to-face observation by center staff;(3) appropriate for the minor's age and development;(4) limited to no more than one minute per year of the minor's developmental age; and(5) does not place a minor alone in a room.(e) A center must ensure the protection of minors at the center from harsh, cruel, or unusual treatment. Negative discipline is considered punishment and abuse and is prohibited at a center, including:(1) corporal punishment or threats of corporal punishment;(2) punishment associated with food, naps, or toilet training;(3) pinching, shaking, or biting a minor;(4) hitting a minor with a hand or object;(5) putting anything in or on a minor's mouth;(6) humiliating, ridiculing, rejecting, or yelling at a minor;(7) subjecting a minor to harsh, abusive, or profane language;(8) placing a minor alone in a locked or darkened room, bathroom, or closet without windows; and(9) requiring a minor to remain silent or inactive for inappropriately long periods of time for the minor's developmental age.(f) The center must establish a person-centered direction and guidance committee to review the techniques and strategies used at a center to: (1) determine whether the individualized direction and guidance used as established in a plan of care is consistently applied for each minor in accordance with center policy; and(2) evaluate the frequency and outcomes of strategies and techniques used with a minor to: (A) determine the impact of the direction and guidance on a minor's ability to achieve progress in goals;(B) determine effectiveness of the minor's program; and(C) recommend the use of new strategies and techniques when current strategies and techniques are determined to be ineffective.(g) The committee must include: (1) the center's administrator;(2) the center's nursing director or designee;(3) an individual providing psychosocial treatment and services on behalf of a center; and(4) a parent or an individual from a parent council or support group for minors receiving services at the center.(h) The center is not required to include a parent or individual from a parent council or support group if, after a good faith effort, the center is unable to include a parent or individual in a committee meeting. The center must document, for review by HHSC, a good faith effort to include a parent or individual from a parent council or support group at each meeting.(i) The center must adopt and enforce written policies and procedures for the frequency, format, and documentation of committee meetings.(j) A center must provide its written person-centered direction and guidance policy to all parents, employees, volunteers, and contractors. The center must maintain documentation of acknowledgment of the written policy from all employees, volunteers, and contractors.26 Tex. Admin. Code § 550.206
The provisions of this §550.206 adopted to be effective September 1, 2014, 39 TexReg 6569; Transferred from Title 40, Chapter 15 by Texas Register, Volume 44, Number 15, April 12, 2019, TexReg 1875, eff. 5/1/2019; Amended by Texas Register, Volume 49, Number 39, September 27, 2024, TexReg 7930, eff. 10/16/2024