Informal Comment on Draft Rule 18R047 Mental Health Services

Public Policy Input — 2020

 

Submitted via email: healthandspecialtycare@hhsc.state.tx.us

Jan. 28, 2020

Thank you for the opportunity to provide comments during the informal development phase of the subject rules.

The Texas Council for Developmental Disabilities (TCDD) is established by state and federal law and is governed by 27 board members, appointed by the Governor, 60% of whom are individuals with developmental disabilities or family members of individuals with disabilities. TCDD’s purpose in law is to encourage policy change so that people with disabilities have opportunities to be fully included in their communities and exercise control over their own lives.

We believe these are among the most fundamental rules that establish and maintain a therapeutic and supportive culture of care for people seeking mental health services. Please consider the following general observations:

  • Rights rules can and should provide easily understandable information about how existing legal protections will be practically applied.
  • Not all protections apply in all circumstances and differences in details are significant to intent.
  • Rules that are expressed in accessible language make it easier for everyone to understand and follow the laws on which they are based. It is important that key details are not lost in generalizations.
  • Most people, including staff expected to implement rules, do not have the ability or time to access the laws that underlie rules. Still, a recitation of laws verbatim (or a long list of legal and rule citations) is not helpful to any person seeking direction in what to do.
  • Flexibility in implementation of laws and rules has limits. Otherwise, the state governing agency will need to closely review the policies and procedures of every provider to ensure understanding and compliance with relevant laws. When a large number of providers are involved, it may conserve staff time to develop a baseline practical rule that is compliant with law and that everyone can understand and follow.

We have reviewed and concur in whole with the comments of Disability Rights Texas (DRTx). Several years ago, current TCDD staff were closely involved in the development of the rules proposed for repeal and which the proposed new rules would replace, including the development of related materials, e.g., age-appropriate bills of rights. We have discussed with DRTx staff our concerns with the current draft rules and those concerns are well reflected in their comments.

In addition to the DRTx comments, we request that given the numbers of individuals with intellectual and developmental disabilities who receive mental health services in the settings to which the draft rules apply, the proposed rules should include clear non-technical language that explains to individuals, legally authorized representatives, staff, and the public the extent to which these rules apply and differences in application, if any.

We would be happy to consult with HHS/HHSC staff in this activity and other preparations of the draft rules and related documents for proposal.

Respectfully submitted,

Linda Logan
Texas Council for Developmental Disabilities
linda.logan@tcdd.texas.gov