The following supporting documentation, at a minimum, must be submitted to the department when requesting an LON:
  (1) if a request is made to increase an LON 1, LON 5, or LON 8 in accordance with §419.241(b) of this title (relating to Level of Need Criteria), due to a person's dangerous behavior:
    (A) the person's IPP;
    (B) the person's ICAP assessment booklet;
    (C) the person's person directed plan (PDP), if available;
    (D) the person's behavior intervention plan; and
    (E) written descriptions (e.g. incident reports or progress notes) of specific incidents of the dangerous behavior and the staff interventions;
  (2) if a request is made for an LON 9 in accordance with §419.241(c) of this title (relating to Level of Need Criteria), due to the person's extremely dangerous behavior:
    (A) the person's IPP;
    (B) the person's ICAP assessment booklet;
    (C) the person's PDP, if available;
    (D) the person's behavior intervention plan;
    (E) written descriptions (e.g. incident reports or progress notes) of specific incidents of the extremely dangerous behavior and the staff interventions; and
    (F) time sheets that verify the assignment of a staff member to exclusively and constantly supervise the person during the person's waking hours, which must be at least 16 hours per day;
  (3) if a request is made to increase an LON 1, LON 5, or LON 8 in accordance with §419.241(d) of this title (relating to Level of Need Criteria), due to a person's extraordinary medical needs:
    (A) the person's IPP;
    (B) the person's ICAP assessment booklet;
    (C) the person's PDP, if available; and
    (D) description, frequency, and duration of each type of nursing treatment; and
  (4) if a request is made to increase an individual's existing LON based on the results of an ICAP assessment:
    (A) the individual's previous ICAP assessment booklet;
    (B) the individual's latest ICAP reassessment;
    (C) the individual's IPP;
    (D) program progress notes; and
    (E) the individual's PDP, if available.

Source Note: The provisions of this §261.242 adopted to be effective September 1, 2001, 26 TexReg 5384; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127