(a) Accounting for personal funds. If a program provider
manages personal funds, the program provider must comply with this
section and ensure that:
(1) a complete accounting of personal funds entrusted
to the program provider is maintained;
(2) personal funds are not commingled with program
provider funds or the funds of any person other than another individual
for whom the program provider manages personal funds; and
(3) personal funds are only expended for the individual's
use and benefit and in a manner and for purposes determined to be
in the individual's best interest.
(b) Account requirements. A program provider must manage
personal funds in a trust fund account.
(1) The program provider may manage personal funds
in a pooled account or a separate account. If the program provider
chooses a pooled account, an individual may request and receive a
separate account. The program provider may also maintain some personal
funds in a petty cash fund.
(2) Trust fund accounts must be insured under federal
or state law.
(3) The program provider must retain all statements
from financial institutions regarding trust fund accounts.
(4) The program provider must reconcile such statement
with the account ledger as described in subsection (c)(1)(A) and (2)(A)
of this section and personal ledger as described in subsection (h)(1)(F)
of this section within 30 days after receiving such statement.
(c) Types of accounts.
(1) Pooled accounts. If a program provider manages
personal funds in a pooled account, the program provider must:
(A) maintain an account ledger that separately identifies
each financial transaction, including:
(i) the name of the individual for whom the transaction
was made;
(ii) the date and amount of the transaction, including
interest; and
(iii) the balance after the transaction;
(B) title the account "Name of facility), Resident
Trust Fund Account" or a similar title that shows a fiduciary relationship
exists between an individual and the program provider; and
(C) if the personal funds of Medicaid and private-pay
individuals are pooled, obtain a signed, dated statement from private
pay individuals allowing the program provider to release financial
information to DADS, Health and Human Services Commission, Texas Attorney
General's Medicaid Fraud Control Unit, and US Department of Health
and Human Services.
(2) Separate accounts. If a program provider manages
personal funds in a separate account, the program provider must:
(A) maintain an account ledger that identifies each
financial transaction, including:
(i) the date and amount of the transaction, including
interest; and
(ii) the balance after the transaction; and
(B) title the account "(Program Provider's Name), (Individual's
Name) Trust Fund Account" or a similar title that shows a fiduciary
relationship exists between an individual and the program provider.
(d) Petty cash fund. If a program provider maintains
some personal funds in a petty cash fund, the program provider must:
(1) set a limit on the amount maintained in the petty
cash fund;
(2) set a limit on the amount of a single expenditure
from the petty cash fund;
(3) maintain a petty cash fund ledger that includes:
(A) the date and amount of each transaction;
(B) the name of the individual for whom each transaction
was made; and
(C) the balance after each transaction.
(e) Interest. If personal funds accrue interest, a
program provider must prorate and distribute the interest earned to
each participating individual.
(f) Depositing personal funds. A program provider must
deposit in a trust fund account all funds that it receives on behalf
of the individual. If the deposit slip documents deposits for more
than one individual, the program provider must indicate on the deposit
slip the amount allocated to each individual.
(g) Access to personal funds.
(1) An individual's IDT must, based on the individual's
assessment described in §9.253 of this division (relating to
Determining Management of Personal Funds), determine:
(A) if there is a need for a budgeted amount and, if
so, set the amount; and
(B) if there is a need to restrict the individual's
use of personal funds and, if so, make a recommendation to the specially
constituted committee.
(2) If the individual's IDT makes a recommendation
to the specially constituted committee to restrict an individual's
use of to personal funds, the specially constituted committee's decision
is documented, signed by the specially constituted committee members,
and made a part of the individual's IPP.
(h) Personal funds record.
(1) A program provider must maintain a personal funds
record for each individual that includes:
(A) the name of the individual;
(B) the name of the individual's LAR and representative
payee, as applicable;
(C) the date of the individual's admission to the facility;
(D) the individual's budgeted amount;
(E) the account number and location of all accounts
in which the individual's personal funds are managed;
(F) a personal ledger that includes the date and amount
of each transaction and the balance after each transaction; and
(G) any contribution acknowledgment as described in §9.261
of this division (relating to Contributions).
(2) The personal ledger reconciled in accordance with
subsection (b)(4) of this section must not be less than zero. If reconciled
balance is less than zero, the program provider must deposit in and
credit to the individual's trust fund account the amount that increases
such balance to zero.
(3) At least quarterly, and within 72 hours after receiving
a request from the individual or LAR, the program provider must provide
to the individual or LAR a copy of the individual's personal ledger.
(i) Documenting expenditures and deposits.
(1) Expenditures.
(A) Except as provided in subparagraph (C) of this
paragraph, a program provider must retain a sales receipt for each
expenditure.
(i) If a sales receipt documents an expenditure for
more than one individual, the program provider must indicate on the
sales receipt the amount allocated to each individual.
(ii) If a sales receipt does not include the specific
item or service purchased or the name of the seller, the program provider
must attach such documentation.
(B) The program provider must explain each expenditure
to the individual and request that the individual sign the receipt.
If the program provider determines that the individual does not understand
the explanation, the individual does not sign the receipt, or the
individual's signature is illegible, a witness to the expenditure
must sign the receipt. The witness must not be responsible for managing
personal funds or responsible for supervising persons performing such
duties.
(C) A sales receipt is not required for an expenditure:
(i) if the program provider makes a purchase on behalf
of an individual from a vending machine;
(ii) if an expenditure is within the individual's budgeted
amount and the program provider obtains an acknowledgment signed by
the individual indicating that the funds were received;
(iii) if the program provider releases funds in response
to a written request in accordance with §9.257 of this division
(relating to Requests for Personal Funds from Trust Fund Accounts);
or
(iv) if the program provider obtains written approval
for alternative documentation from DADS before the expenditure is
made.
(2) Deposits. Except for deposits made electronically,
a program provider must retain a deposit slip issued by the financial
institution for each deposit.
|
Source Note: The provisions of this §261.256 adopted to be effective January 1, 2001, 25 TexReg 12790; amended 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; amended to be effective November 4, 2013, 38 TexReg 7724; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127 |