(a) Except as provided in subsection (b) of this section,
only an MRA may request enrollment of an applicant by DADS.
(b) A program provider may request enrollment of an
applicant by DADS in accordance with subsection (k) of this section
if the applicant:
(1) has received ICF/MR services from a non-state operated
facility during the 180 days before the enrollment request; and
(2) is not moving from or seeking admission to a state
school or state center.
(c) An MRA must request an applicant's enrollment if:
(1) the program provider selected by the applicant
or LAR notifies the MRA in writing that admission to the program provider's
facility has been offered to the applicant; and
(2) the applicant or LAR notifies the MRA that the
applicant or LAR chooses to accept the admission offered by the program
provider.
(d) If an MRA receives the notifications described
in subsection (c) of this section, the MRA must comply with §5.159(c)
of this title (relating to Assessment of Individual's Need for Services
and Supports) including providing an explanation to the applicant
or LAR of the services and supports for which the applicant may be
eligible. For an applicant under 22 years of age, an MRA must also
comply with the following requirements:
(1) Except as provided in paragraphs (2) and (3) of
this subsection, before placement of an applicant in a facility, the
MRA must inform the LAR:
(A) of the benefits of living in a family or community
setting;
(B) that the placement of the applicant is considered
temporary; and
(C) that an ongoing permanency planning process is
required.
(2) If an MRA is notified of a request for enrollment
after the applicant is admitted to the facility, the MRA must provide
the information described in paragraph (1) of this subsection to the
LAR not later than the 14th working day after the date the MRA is
notified of the request for the enrollment, unless this time period
is extended by the LAR.
(3) An MRA does not have to comply with paragraph (1)
or (2) of this subsection if the applicant has been committed to
a facility under Chapter 46B, Code of Criminal Procedure, or Chapter
55, Family Code.
(e) To request an applicant's enrollment, an MRA must,
within 15 working days after the MRA receives both notifications described
in subsection (c) of this section:
(1) initiate, monitor, and support the processes necessary
to obtain a financial eligibility determination for the applicant
if Medicaid financial eligibility has not been established;
(2) obtain an ICAP score for the applicant by:
(A) reviewing and endorsing an existing ICAP for the
applicant; or
(B) administering the ICAP if an ICAP score for the
applicant does not exist, is not available, or is not endorsed by
the MRA; and
(3) request or review an LOC determination and LON
for the applicant by:
(A) completing and electronically submitting an MR/RC
Assessment, if the applicant does not have a current LOC determination;
or
(B) reviewing the existing MR/RC Assessment for the
applicant if the applicant has a current LOC determination and:
(i) if the MRA does not endorse the existing MR/RC
Assessment, completing and electronically submitting a new MR/RC Assessment
recommending a revised LOC or LON; or
(ii) if the MRA endorses the existing MR/RC Assessment,
notifying the selected program provider in writing that no changes
to the current LOC or LON are recommended.
(f) Upon notification of a request for enrollment of
an applicant under 22 years of age, an MRA must take or ensure that
the following actions are taken to conduct permanency planning:
(1) The MRA must convene a permanency planning meeting
with the LAR and, if possible, the applicant before admission or,
if notified of a request for enrollment after the applicant's admission,
not later than the 14th working day after the date the MRA is notified
of the request.
(2) Before the permanency planning meeting, the MRA
staff must review the applicant's records and, if possible, meet the
applicant.
(3) During the permanency planning meeting, the meeting
participants must discuss and choose one of the following goals:
(A) for an applicant under 18 years of age:
(i) to live in the applicant's family home where the
natural supports and strengths of the applicant's family are supplemented,
as needed, by activities and supports provided or facilitated by the
MRA or program provider; or
(ii) to live in a family-based alternative in which
a family other than the applicant's family:
(I) has received specialized training in the provision
of support and in-home care for an individual under 18 years of age
with mental retardation;
(II) will provide a consistent and nurturing environment
in a family home that supports a continued relationship with the applicant's
family to the extent possible; and
(III) if necessary, will provide an enduring, positive
relationship with a specific adult who will be an advocate for the
applicant; or
(B) for an applicant 18-22 years of age, to live in
a setting chosen by the applicant or LAR in which the applicant's
natural supports and strengths are supplemented by activities and
supports provided or facilitated by the MRA or program provider, and
to achieve a consistent and nurturing environment in the least restrictive
setting, as defined by the applicant and LAR.
(4) To accomplish the goal chosen in accordance with
paragraph (3) of this subsection, the meeting participants must discuss
and identify:
(A) the problems or issues that led the applicant
or LAR to request admission to a facility;
(B) the applicant's daily support needs;
(C) for an applicant under 18 years of age:
(i) barriers to having the applicant reside in the
family home;
(ii) supports that would be necessary for the applicant
to remain in the family home; and
(iii) actions that must be taken to overcome the barriers
and provide the necessary supports;
(D) for an applicant 18-22 years of age, the barriers
to the applicant moving to a consistent and nurturing environment
as defined by the applicant and LAR;
(E) the importance for the applicant to live in a
long-term nurturing relationship with a family;
(F) alternatives to the applicant living in an institutional
setting;
(G) the applicant's and LAR's need for information
and preferences regarding those alternatives;
(H) how, after admission to the facility, to facilitate
regular contact between the applicant and the applicant's family,
and, if desired by the applicant and family, between the applicant
and advocates and friends in the community to continue supportive
and nurturing relationships;
(I) natural supports and family strengths that will
assist in accomplishing the identified permanency planning goal;
(J) activities and supports that can be provided by
the family, MRA, or program provider to achieve the permanency planning
goal;
(K) assistance needed by the applicant's family:
(i) in maintaining a nurturing relationship with the
applicant; and
(ii) preparing the family for the applicant's eventual
return to the family home or move to a family-based alternative; and
(L) action steps, both immediate and long term, for
achieving the permanency plan goal.
(5) The MRA must make reasonable accommodations to
promote the participation of the LAR in a permanency planning meeting,
including:
(A) conducting a meeting in person or by telephone,
as mutually agreed upon by the MRA and LAR;
(B) conducting a meeting at a time and, if the meeting
is in person, at a location that is mutually agreed upon by the MRA
and LAR;
(C) if the LAR has a disability, providing reasonable
accommodations in accordance with the Americans with Disabilities
Act, including providing an accessible meeting location or a sign
language interpreter, if appropriate; and
(D) providing a language interpreter, if appropriate.
(6) The MRA must develop a permanency plan using, as
appropriate:
(A) the Permanency Planning Instrument for Children
Under 18 Years of Age; or
(B) the Permanency Planning Instrument for Individuals
18-22 Years of Age.
(7) The MRA must:
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