(a) Definitions of Domains. The following words or terms, when used in this section, shall have the following meanings unless the context clearly indicates otherwise.
  (1) Medical domain: The medical domain is related to a child's physical health. It includes, but is not limited to, medication management, medication monitoring, and management of acute and chronic medical conditions.
  (2) Safety and security domain: The safety and security domain is characterized by the absence of harm to self and others and safety to self, others, and community. This domain includes, but is not limited to, self-harm, aggression, and destructive acts.
  (3) Recreational domain: The recreational domain involves the child's ability to choose and participate in age-appropriate play and activities. This domain includes, but is not limited to, hobbies and sports.
  (4) Educational domain: The educational domain is related to a child's performance, progress, and conduct in the most appropriate and least restrictive academic or vocational setting.
  (5) Mental/behavioral health domain: The mental/behavioral health domain refers to the behavioral and emotional functioning of the child, as well as any psychiatric symptomatology that may be present.
  (6) Relationship domain: The relationship domain is characterized by, but is not limited to, a child's ability to trust, to form positive relationships, to function well as part of family unit, as well as by the development and maintenance of age-appropriate social relationships.
  (7) Socialization domain: The socialization domain is characterized by, but is not limited to, age-appropriate social behavior, problem-solving, and social skills in various social settings.
  (8) Permanence domain: The permanence domain is characterized by a child moving out of a substitute care system and remaining in the least restrictive environment in the community.
  (9) Parent and child participation domain: The parent and child participation domain involves, but is not limited to, both the parent's and child's general satisfaction with services, their relationship with service providers, their participation in the treatment or service plan, and improvement in the relationship between the child and the parents.
(b) Other Definitions.
  (1) Contracting entity--a health and human services agency (the Texas Juvenile Probation Commission and juvenile boards that contract with the Texas Juvenile Probation Commission, Texas Department of Mental Health and Mental Retardation and local mental health and/or mental retardation authorities, and/or Texas Department of Protective and Regulatory Services) that is responsible for implementing, coordinating, and monitoring outcome standards for substitute care services for children placed in a licensed foster families, foster group homes, or 24-hour residential care facilities. This rule is not applicable to contracts for persons residing in state-operated facilities as listed in §532.001, Health and Safety Code, or persons residing in HCS or ICF/MR facilities under contract with the Texas Department of Mental Health and Mental Retardation under the state's Medicaid program.
  (2) Substitute care provider--a person who provides residential care for children for 24 hours a day, including:
    (A) a child-care institution, as defined by §42.002, Human Resources Code;
    (B) a child-placing agency, as defined by §42.002, Human Resources Code;
    (C) a foster group home or foster family home, as defined by §42.002, Human Resources Code; and
    (D) an agency group home or agency home, as defined by §42.002, Human Resources Code, other than an agency group home, agency home, or a foster home verified or certified by the Texas Department of Protective and Regulatory Services.
  (3) Individualized Treatment Plan--this term has the same meaning as that set out in 25 TAC §402.53 (Definitions in Continuity of Services--Mental Health).
  (4) Service Plan--this term has the same meaning as that set out in 40 TAC §700.1331 (Child's Service Plan).
(c) Individualized Treatment Plan or Service Plan. A substitute care provider who receives funds from the state to provide substitute care services to children under the care of the State shall maintain an individualized treatment plan or service plan on each individual child. The plan shall contain specific behavioral goals that are appropriate to the child and the types of services to be provided under the appropriate levels of care. The provider should use the nine domains in subsection (a) of this section in setting the behavioral goals. A child is not required to have a goal in each domain; however, a child may have one or more different goals within the same domain.
(d) Development of Goals. The responsibility of developing goals in a child's individual treatment plan or service plan resides with contracting entity in conjunction with the substitute care provider. The child and family should be involved in the development of treatment goals whenever possible. Once a child has met goal(s) identified in the treatment or service plan, new goals should be developed for the child.
(e) Measurement of Progress toward Goals.
  (1) The staff, representative, or third party independent agent of the contracting entity shall monitor the progress of the child in achieving the goals. The frequency of monitoring shall be based upon the current review period appropriate for that specific child's level of care. A six-point scale measures the child's progress towards the achievement of each goal. The staff, representative, or third party independent agent also rates the child. Progress is rated at given intervals on the following six-point scale:
    (A) +3 Goal achieved and maintained;
    (B) +2 Substantial improvement in behavior identified in the goal;
    (C) +1 Some improvement in behavior identified in the goal;
    (D) 0 No decline or improvement in behavior identified in the goal;
    (E) -1 Some worsening in behavior identified in the goal; and
    (F) -2 Substantial worsening in behavior identified in the goal.
  (2) The child's progress will be assessed on each identified goal within the nine domains listed in subsection (a) of this section. If the child has shown improvement in 50% or more of the identified goal(s) as measured by a positive rating (+1, +2, or +3) during the monitoring period, the child will be considered to be progressing towards the goal(s).
  (3) The outcome of a substitute care provider's service delivery shall be measured by the percentage of children under its care that are considered to have made progress towards their goals, as defined in paragraph (2) of this subsection.
  (4) When a contracting entity has an option in placing a child in substitute care, the entity shall consider whether the children in a particular substitute care provider's care are progressing as defined in paragraph (2) of this subsection.

Source Note: The provisions of this §351.13 adopted to be effective August 23, 1998, 23 TexReg 8419