Revision 20-2; Effective October 15, 2020 Show
3100 Administrative PoliciesRevision 20-2; Effective October 15, 2020 This section assists the contractor in conducting administrative activities, such as assuring client access to services and managing client records. 3110 Client AccessRevision 20-2; Effective October 15, 2020 The contractor must ensure that clients are provided services in a timely and non- discriminatory manner. The contractor must:
3120 Important Information for Former Military Service MembersRevision 20-2; Effective October 15, 2020 Women and men who served in any branch of the United States Armed Forces, including Army, Navy, Marines, Air Forces, Coast Guard, Reserves or National Guard, may be eligible for additional benefits and services. For more information, visit the Texas Veterans Portal at https://veterans.portal.texas.gov. 3200 Abuse and Neglect ReportingRevision 20-2; Effective October 15, 2020 Texas Health and Human Services agencies may only provide funds to contractors/providers who show good faith efforts to comply with all child abuse reporting guidelines and requirements set forth in Chapter 261 of the Texas Family Code. To report abuse or neglect, call the Texas Abuse Hotline at 800-252-5400 or use the secure Texas Abuse Hotline website. For cases that pose an imminent threat or danger to an individual, call 9-1-1 or any local or state law enforcement agency. 3210 Child Abuse Reporting, Compliance and MonitoringRevision 20-2; Effective October 15, 2020 Contractors are required to develop policies and procedures that comply with the child abuse reporting guidelines and requirements set forth in Chapter 261 of the Texas Family Code. Contractors must develop an internal policy specific to:
During Quality Assurance (QA) monitoring, the following procedures will be used to evaluate compliance:
Additional information for abuse reporting is available at Texas Department of Family and Protective Services. 3220 Human TraffickingRevision 20-2; Effective October 15, 2020 HHSC mandates that contractors comply with state laws governing the reporting of abuse and neglect. Additionally, as part of the requirement that contractors comply with all applicable federal laws, contractors must comply with the federal anti-trafficking laws, including the Trafficking Victims Protection Act of 2000 (22 USC §7101, et seq.). Contractors must have a written policy on human trafficking which includes the provision of annual staff training. References for human trafficking policy development:
3230 Domestic and Intimate Partner ViolenceRevision 20-2; Effective October 15, 2020 Intimate partner violence (IPV) describes physical, sexual or psychological harm by a current or former partner or spouse. This type of violence can occur among heterosexual or same-sex couples and does not require sexual intimacy. Contractors must have a written policy related to assessment and prevention of domestic and intimate partner violence, including the provision of annual staff training. Additional information on intimate partner violence can be found on the CDC website. 3300 ConfidentialityRevision 20-2; Effective October 15, 2020 All contracting agencies must comply with the U.S. Health Insurance Portability and Accountability Act of 1996 (HIPPA) established standards for protection of client privacy. Contractors must ensure that all employees and volunteers receive training about client confidentiality during orientation and be made aware that violation of the law regarding confidentiality may result in civil damages and criminal penalties. All employees, volunteers, sub-contractors, board members and/or advisory board members must sign a confidentiality statement during orientation. The client’s preferred method of follow-up to clinic services (cell phone, email, work phone and/or text) and preferred language must be documented in the client’s record. Each client must receive verbal assurance of confidentiality and an explanation of what confidentiality means (kept private and not shared without permission) and any applicable exceptions such as abuse reporting. 3310 Minors and ConfidentialityRevision 20-2; Effective October 15, 2020 Except as permitted by law, a provider is legally required to maintain the confidentiality of care provided to a minor. Confidential care does not apply when the law requires parental notification or consent, or when the law requires the provider to report health information such as in the cases of contagious disease or abuse. The definition of privacy is the ability of the individual to maintain information in a protected way. Confidentiality in health care is the obligation of the health care provider not to disclose protected information. While confidentiality is implicit in maintaining a patient's privacy, confidentiality between provider and patient is not an absolute right. The HIPAA privacy rule requires a covered entity to treat a “personal representative” the same as the individual with respect to uses and disclosures of the individual’s protected health information. In most cases, parents are the personal representatives for their minor children, and they can exercise individual rights, such as access to medical records, on behalf of their minor children (45 Code of Federal Regulations §164.502(g)). For more information, see Adolescent Health – A Guide for Providers. 3320 Nondiscrimination and Limited English Proficiency (LEP)Revision 20-2; Effective October 15, 2020 As outlined in the HHSC Uniform Terms and Conditions – Grant Version 2.16, HHSC contractors must comply with state and federal anti-discrimination laws, including but not limited to:
More information about nondiscrimination laws and regulations can be found on the HHSC Civil Rights Office page. 3330 Termination of ServicesRevision 22-2; Effective April 8, 2022 A qualifying individual must never be denied services due to an inability to pay. Contractors have the right to terminate services to a client if the client is disruptive, unruly, threatening or uncooperative to the extent that the client seriously impairs the contractor’s ability to effectively and safely provide services or if the client’s behavior jeopardizes his or her own safety, clinic staff or others. An individual has the right to appeal the denial, modification, suspension or termination of services. (See Appeals, in the PHC rules Title 26, Part 1, Chapter 364, Subchapter A). Any policy related to termination of services must be included in the contractor’s policy manual. 3340 Resolution of ComplaintsRevision 20-2; Effective October 15, 2020 Contractors must ensure that clients can express concerns about care received and to further ensure that those complaints are handled in a consistent manner. Contractors’ policy and procedure manuals must explain the process clients may follow if they are not satisfied with the care received. If an aggrieved client requests a hearing, a contractor shall not terminate services to the client until a final decision is rendered by HHSC. Any client complaint must be documented in the client’s record. 3350 Research (Human Subject Clearance)Revision 20-2; Effective October 15, 2020 Contractors considering clinical or sociological research using PHC Services Program funded clients as subjects must obtain prior approval from their own internal Institutional Review Board (IRB) and HHSC. The contractor must have a policy in place that indicates that prior approval will be obtained from the HHSC PHC Program, as well as the IRB, prior to instituting any research activities. The contractor must also ensure that all staff is made aware of this policy through staff training. Documentation of training on this topic must be maintained. 3400 Client Records ManagementRevision 20-2; Effective October 15, 2020 HHSC contractors must have an organized and secure client record system. The contractor must ensure that the record is organized, readily accessible and available to the client upon request with a signed release of information. The records must be kept confidential and secure, as follows:
The written consent of the client is required for the release of personally identifiable information, except as may be necessary to provide services to the client or as required by law, with appropriate safeguards for confidentiality. If the client is 17 years of age or younger, the client’s parent, managing conservator or guardian, as authorized by Chapter 32 of the Texas Family Code or by federal law or regulations, must authorize the release. HIV information should be handled according to law. When information is requested, contractors should release only the specific information requested. Information collected for reporting purposes may be disclosed only in summary, statistically or in a form that does not identify individuals. Upon request, clients transferring to other providers must be provided with a copy or summary of their record to expedite continuity of care. Electronic records are acceptable as medical records. Contractors, providers, subrecipients and subcontractors must maintain for the time specified by HHSC all records pertaining to client services, contracts and payments. Contractors must follow contract provisions, maintain medical records for at least seven years after the close of the contract and follow the retention standards of the appropriate licensing entity. All records relating to services must be accessible for examination at any reasonable time to representatives of HHSC and as required by law. 3500 Personnel Policy and ProceduresRevision 20-2; Effective October 15, 2020 Contractors must develop and maintain personnel policies and procedures to ensure that clinical staff are hired, trained and evaluated appropriately to their job position. Contracted staff must also be trained and evaluated according to their responsibilities. Job descriptions, including those for contracted personnel, must specify required qualifications and licensure. All staff must be appropriately identified with a name badge. Personnel policies and procedures must include:
Contractors must show evidence that employees meet all required qualifications and are provided annual training. Job evaluations should include observation of staff/client interactions during clinical, counseling and educational services. Contractors shall establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. All employees and board members must complete a conflict of interest statement during orientation. All medical care must be provided under the supervision, direction and responsibility of a qualified medical director. All dental services must be provided under the supervision, direction and responsibility of a qualified licensed dentist. The PHC medical director for the clinic must be a licensed Texas physician and the PHC dental director for the clinic must be a U.S. licensed dentist. Contractors must have a documented plan for organized staff development. There must be an assessment of:
Staff development must include orientation and in-service training for all personnel and volunteers. Nonprofit entities must provide orientation for board members and government entities must provide orientation for their advisory committees. Employee orientation and continuing education must be documented in agency personnel files. 3600 Facilities and EquipmentRevision 20-2; Effective October 15, 2020 HHSC contractors are required to always maintain a safe environment. Contractors must have written policies and procedures that address hazardous waste, fire safety and medical equipment. 3610 Hazardous MaterialsRevision 20-2; Effective October 15, 2020 Contractors must have written policies and procedures that address:
3620 Fire SafetyRevision 20-2; Effective October 15, 2020 Contractors must have a written fire safety policy that includes a schedule for testing and maintenance of fire safety equipment. Evacuation plans for the premises must be clearly posted and visible to all staff and clients. 3630 Medical EquipmentRevision 20-2; Effective October 15, 2020 Contractors must have a written policy and maintain documentation of the maintenance, testing and inspection of medical equipment, including an Automated External Defibrillator (AED). Documentation must include:
3640 Radiology Equipment and StandardsRevision 20-2; Effective October 15, 2020 All facilities providing radiology services, including dental x-rays, must:
For information on x-ray machine registration, see the Texas Department of State Health Services, Radiation Control Program. 3650 Smoking BanRevision 20-2; Effective October 15, 2020 Contractors must have written policies that prohibit smoking in any portion of their indoor facilities. If a contractor subcontracts with another entity for the provision of health services, the subcontractor must also comply with this policy. 3660 Disaster Response PlanRevision 20-2; Effective October 15, 2020 Written and oral plans address how staff must respond to emergency situations (i.e., fires, flooding, power outage, bomb threats, etc.). The disaster plan must identify the procedures and processes that will be initiated during a disaster and the staff (position/s) responsible for each activity. A disaster response plan must be in writing, formally communicated to staff and kept in the workplace available to employees for review. For an employer with 10 or fewer employees, the plan may be communicated orally to employees. For additional resources on facilities and equipment, see the Occupational Safety and Health Administration website. 3700 Emergency ResponsivenessRevision 20-2; Effective October 15, 2020 3710 Clinical EmergenciesRevision 20-2; Effective October 15, 2020 Contractors must be adequately prepared to handle clinical emergency situations, as follows:
3720 Emergency PreparednessRevision 20-2; Effective October 15, 2020 There must be a written safety plan that includes maintenance of fire safety equipment, an emergency evacuation plan and a disaster response plan. 3800 Quality ManagementRevision 20-2; Effective October 15, 2020 Contractors must use internal Quality Assurance/Quality Improvement (QA/QI) systems and processes to monitor PHC services. Contractors must have a Quality Management (QM) program individualized to their organizational structure and based on the services provided. The goals of the quality program should ensure availability and accessibility of services, quality and continuity of care. Contractors should integrate QM concepts and methodologies into the structure of the organization and day-to-day operations. Contractors are expected to develop quality processes based on four core QM principles that focus on:
The QM program must be developed and implemented in such a way that provides for ongoing evaluation of services. Contractors should have a comprehensive plan for the internal review, measurement and evaluation of services, the analysis of monitoring data, and the development of strategies for improvement and sustainability. Contractors who subcontract for the provision of services must also address how quality will be evaluated and how compliance with HHSC policies and basic standards will be assessed with the subcontracting entities. The QM Committee, whose membership consists of key leadership of the organization, including the executive director/CEO, medical director, dental director and other appropriate staff, where applicable, annually reviews and approves the quality work plan for the organization. The QM Committee must meet at least quarterly to:
Minutes of the discussion and actions taken by the committee and a list of the attendees must be maintained. The comprehensive quality work plan, at a minimum, must:
Although each organization’s quality assurance program is unique, the following activities must be undertaken by all agencies providing client services:
HHSC contractors who subcontract for the provision of services must also address how quality will be evaluated and how compliance with policies and basic standards will be assessed with the subcontracting entities, including:
Data from these activities must be presented to the QM Committee. Plans to improve quality should result from the data analysis and reports considered by the committee and should be documented. Which of the following teaching strategies would benefit a patient with an output disability?Which of the following teaching strategies would benefit a patient with an output disability? Teaching strategies for a patient with an output learning disability would benefit from the use of hand gestures and motions. Those with input disabilities may have success using audiotapes, computers, and modeling.
What strategies should a nurse employ when providing health teaching to a client?What strategies should a nurse employ when providing teaching to a client?. develop evaluation questions.. identify where you will find data.. plan how you will analyze data.. Which of the following factors most influences a client's ability to learn from a health education?7. Which of the following factors most influences a client's ability to learn from a health education program? Learning depends primarily on emotional readiness, which is reinforced primarily by internal motivation. The learner must be willing to put forth the effort needed to learn.
Which action would be incorporated in a teaching strategy for a hearing impaired client quizlet?When teaching clients with a hearing impairment, the nurse should use slow, directed, and deliberate speech. Use of large-print materials and arrangement of materials in a clockwise position would be used for clients with a visual impairment.
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The nurse establishes a learning contract with an overweight client. the contract is best if it
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