1200, Extenuating Circumstances and Need for Consent

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Revision 25-1; Effective Nov. 12, 2025

In the PASRR program, LIDDAs, LMHAs or LBHAs are allowed to use audio-visual communication options for extenuating circumstances if consent is obtained.

1210 Extenuating Circumstances                          

Revision 25-1; Effective Nov. 12, 2025

Extenuating circumstances are situations beyond the LIDDA's, LMHA's or LBHA's control that prevent an in-person meeting. A disaster declared by the governor is excluded from this definition.

The following scenarios may be extenuating circumstances, however, this is not an exhaustive list:

  • the nursing facility (NF) denies entry because of an outbreak of the flu or other highly contagious virus;
  • the person is in isolation at the NF because of temporary illness;
  • the roadways to the NF are impassable because of inclement weather.

Extenuating circumstances should be reviewed on a case-by-case basis. Habilitation coordinators should discuss questionable circumstances with a supervisor. Contact PASRR.Support@hhs.texas.govif more assistance from HHSC is required.

1220 Consent

Revision 25-1; Effective Nov. 12, 2025

LIDDA, LMHA or LBHA staff may use Form 1035, PASRR Consent for Use of Audio-Only and Audio-Visual Communication to indicate the person’s or their LAR’s agreement to receive certain PASRR activities via audio-visual communication.

Note: This is an optional HHSC form. The LIDDA, LMHA or LBHA may choose to use their own consent form.

1220.1 Consent for PE or Resident Review

Revision 25-1; Effective Nov. 12, 2025

Before the LIDDA, LMHA or LBHA staff conducts the PASRR level II evaluation (PE) via audio-visual communication because of extenuating circumstances, one of the following must be completed:

  • obtain the written consent of the person or their LAR; or
  • obtain the person's or their LAR's oral consent and document the oral consent in the person's record; and
  • document a description of the extenuating circumstances that prevented meeting in person in the person's record.

If the person or their LAR refuses to give written or oral consent, the LIDDA, LMHA or LBHA must:

  • conduct the PE by meeting with the LAR and NF staff most familiar with the person to review and gather all necessary information to complete the PE; and
  • enter the PE in the LTC online portal.

1220.2 Consent for Quarterly SPT Meetings

Revision 25-1; Effective Nov. 12, 2025

A habilitation coordinator must facilitate a quarterly SPT meeting in person, or in extenuating circumstances via audio-visual communication.

Before the habilitation coordinator conducts quarterly meetings via audio-visual communication, the habilitation coordinator must:

  • record a description of the extenuating circumstances that required the use of audio-visual communication in the person’s record, and
  • obtain the written consent of the person or their LAR; or
  • obtain the person’s or their LAR’s oral consent and document the oral consent in the person’s record.

If the person or their LAR refuses to give written or oral consent, the habilitation coordinator must:

  • document the person’s or their LAR's refusal in the person's record; and
  • convene an SPT meeting in person as soon as possible after the extenuating circumstances no longer exist.

1220.3 Consent for Transition Planning

Revision 25-1; Effective Nov. 12, 2025

The ECC coordinator facilitates an in-person SPT meeting during transition planning. The meeting is conducted via audio-visual communication in extenuating circumstances.

Before the ECC coordinator conducts the transition planning meetings via audio-visual communication, the ECC coordinator must:

  • obtain the written consent of the person or their LAR; or
  • obtain and document the person's or their LAR's oral consent in the person's record; and
  • document a description of the extenuating circumstances that prevented meeting with the person in person in the person's record.

If the person or their LAR refuses to give written or oral consent for audio-visual meetings, the ECC coordinator must:

  • document the person’s or LAR’s refusal in the person’s record; and
  • convene an SPT meeting in person as soon as possible after the extenuating circumstances no longer exist.

1220.4 Consent for Habilitation Coordination

Revision 25-1; Effective Nov. 12, 2025

Habilitation coordinators may meet via audio-visual communication in a month when an in-person meeting is not required. Specific information about the frequency of in-person habilitation coordination visits is in 5100, Required In-Person Visits.

Habilitation coordinators must obtain consent before conducting visits via audio-visual communication.

If the person or their LAR refuses the written or oral consent required, the habilitation coordinator must:

  • document the person's or their LAR's refusal in the person's record; and
  • conduct habilitation coordination contacts in person.

Note: Habilitation coordinators may not use audio-only communication for visits.