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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 263HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
SUBCHAPTER JLIDDA REQUIREMENTS
RULE §263.901LIDDA Requirements for Providing Service Coordination in the HCS Program
Texas Register

(a) In addition to the requirements described in Chapter 331 of this title (relating to LIDDA Service Coordination), a LIDDA must:

  (1) comply with:

    (A) this chapter;

    (B) 40 TAC Chapter 41 (relating to Consumer Directed Services Option); and

    (C) 40 TAC Chapter 4, Subchapter L (relating to Abuse, Neglect, and Exploitation in Local Authorities and Community Centers); and

  (2) ensure that a rights protection officer required by 40 TAC §4.113 (relating to Rights Protection Officer at a State MR Facility or MRA), who receives a copy of an HHSC initial intake report or a final investigative report from an FMSA in accordance with 40 TAC §41.702 (relating to Requirements Related to HHSC Investigations When an Alleged Perpetrator is a Service Provider) or 40 TAC §41.703 (relating to Requirements Related to HHSC Investigations When an Alleged Perpetrator is a Staff Person or a Controlling Person of an FMSA), gives a copy of the report to the individual's service coordinator.

(b) A LIDDA must ensure that a service coordinator is an employee of the LIDDA and meets the requirements of this subsection.

  (1) A service coordinator must meet the minimum qualifications and LIDDA staff training requirements described in Chapter 331 of this title except as described in paragraph (2) of this subsection.

  (2) Notwithstanding §331.19(b)(2)(B) of this title (relating to Staff Person Training), a service coordinator must complete a comprehensive non-introductory person-centered service planning training developed or approved by HHSC within six months after the service coordinator's date of hire, unless an extension of the six month timeframe is granted by HHSC.

  (3) A service coordinator must receive training about the following within the first 90 calendar days after beginning service coordination duties:

    (A) rules governing the HCS Program and CFC; and

    (B) 40 TAC Chapter 41.

(c) A LIDDA must have a process for receiving and resolving complaints from a program provider related to the LIDDA's provision of service coordination or the LIDDA's process to enroll an applicant in the HCS Program.

(d) If, as a result of monitoring, the service coordinator identifies a concern with the implementation of the PDP, the LIDDA must ensure that the concern is communicated to the program provider and attempts are made to resolve the concern. The LIDDA may refer an unresolved concern to HHSC by calling the HHSC IDD Ombudsman toll-free telephone number at 1-800-252-8154.

(e) A service coordinator must:

  (1) assist an individual, LAR, or actively involved person in exercising the legal rights of the individual;

  (2) provide an individual, LAR, or family member with the booklet, Your Rights In the Home and Community-based Services (HCS) Program, available on the HHSC website, and the HHSC HCS Rights Addendum form, and an oral explanation of the rights in the booklet and the form:

    (A) upon the individual's enrollment in the HCS Program;

    (B) upon revision of the booklet or the form;

    (C) upon request; and

    (D) if one of the following occurs:

      (i) the individual becomes 18 years of age;

      (ii) a guardian is appointed for the individual; or

      (iii) a guardianship for the individual ends;

  (3) document the provision of the information required by paragraph (2) of this subsection, and ensure that the documentation is signed by:

    (A) the individual or LAR; and

    (B) the service coordinator;

  (4) ensure that, upon enrollment of an individual and annually thereafter, the individual or LAR is informed orally and in writing of the following:

    (A) the telephone number of the LIDDA to file a complaint;

    (B) the toll-free telephone number of the HHSC IDD Ombudsman, 1-800-252-8154, to file a complaint; and

    (C) the toll-free telephone number of DFPS, 1-800-647-7418, to report an allegation of abuse, neglect, or exploitation;

  (5) maintain for an individual for an IPC year:

    (A) a copy of the IPC;

    (B) the PDP and, if CFC PAS/HAB is included on the PDP, the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment form;

    (C) a copy of the ID/RC Assessment;

    (D) documentation of the activities performed by the service coordinator in providing service coordination; and

    (E) any other pertinent information related to the individual;

  (6) initiate, coordinate, and facilitate the person-centered planning process to meet the goals and outcomes identified by an individual and LAR in the individual's PDP, including scheduling service planning team meetings;

  (7) to meet the needs of an individual as those needs are identified, develop for the individual a full range of services and resources using:

    (A) providers for services other than HCS Program services and CFC services; and

    (B) advocates or other actively involved persons;

  (8) ensure that the PDP for an applicant or individual:

    (A) is developed, reviewed, and updated in accordance with:

      (i) §263.104(j)(4)(A) of this chapter (relating to Process for Enrollment of Applicants);

      (ii) §263.302 of this chapter (relating to Renewal and Revision of an IPC); and

      (iii) §331.11 of this title (relating to LIDDA's Responsibilities); and

    (B) document, for each HCS Program service, other than supervised living and residential support, and for each CFC service, whether the service is critical to the individual's health and safety as determined by the service planning team;

  (9) ensure that the updated finalized PDP is signed by the individual or LAR;

  (10) participate in the development, renewal, and revision of an individual's IPC in accordance with §263.104 and §263.302 of this chapter;

  (11) ensure the service planning team participates in the renewal and revision of the IPC for an individual in accordance with §263.302 of this chapter and ensure the service planning team completes other responsibilities and activities as described in this chapter;

  (12) notify the service planning team if the service coordinator receives notification from the program provider that:

    (A) an individual's behavior requires the implementation of a behavior support plan; or

    (B) based on an annual review by the program provider, an individual's behavior support plan needs to continue;

  (13) if a change to an individual's PDP is needed, other than as required by §263.302 of this chapter:

    (A) communicate the need for the change to the individual or LAR, the program provider, and other appropriate persons;

    (B) update the PDP as necessary; and

    (C) within 10 calendar days after the PDP is updated, send a copy of the updated PDP to the program provider, the individual or LAR and, if applicable, the FMSA;

  (14) provide an individual's program provider a copy of the individual's current PDP;

  (15) monitor the provision of HCS Program services, CFC services, and non-HCS Program and non-CFC services to an individual;

  (16) document whether an individual or LAR perceives that the individual is progressing toward desired outcomes identified on the individual's PDP;

  (17) together with the program provider, ensure the coordination and compatibility of HCS Program services and CFC services with non-HCS Program and non-CFC services, including, in coordination with the program provider, assisting an individual in obtaining a neurobehavioral or neuropsychological assessment and plan of care from one of the following professionals:

    (A) a psychologist licensed in accordance with Texas Occupations Code Chapter 501;

    (B) a speech-language pathologist licensed in accordance with Texas Occupations Code Chapter 401; or

    (C) an occupational therapist licensed in accordance with Texas Occupations Code Chapter 454;

  (18) for an individual who has had a guardian appointed, determine, at least annually, if the letters of guardianship are current;

  (19) if individual does not have a guardian:

    (A) ensure that the service planning team determines whether the individual would benefit from having a guardian or a less restrictive alternative to a guardian;

    (B) if the service planning team determines that the individual would benefit from having a less restrictive alternative to a guardian such as a supported decision making agreement, take appropriate actions to implement such an alternative; and

    (C) if the service planning team determines that the individual would benefit from having a guardian, make a referral to the appropriate court if:

      (i) the individual would not benefit from a less restrictive alternative to a guardian; or

      (ii) the individual would benefit from having a less restrictive alternative to a guardian but implementing such an alternative is not feasible;

  (20) immediately notify the program provider if the service coordinator becomes aware that an emergency necessitates the provision of an HCS Program service or a CFC service to ensure the individual's health or safety and the service is not on the IPC or exceeds the amount on the IPC;

  (21) if notified by the program provider that a requirement described in §263.503(c)(15) of this chapter (relating to Residential Agreements) or §263.502(b)(1) - (7) of this chapter (relating to Requirements for Program Provider Owned or Controlled Residential Settings) needs to be modified, update the individual's PDP to include the following:

    (A) a description of the specific and individualized assessed need that justifies the modification;

    (B) a description of the positive interventions and supports that were tried but did not work;

    (C) a description of the less intrusive methods of meeting the need that were tried but did not work;

    (D) a description of the condition that is directly proportionate to the specific assessed need;

    (E) a description of how data will be routinely collected and reviewed to measure the ongoing effectiveness of the modification;

    (F) the established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;

    (G) the individual's or LAR's signature evidencing informed consent to the modification; and

    (H) the program provider's assurance that the modification will cause no harm to the individual;

  (22) if notified by the program provider that an individual or LAR has refused a comprehensive nursing assessment and that the program provider has determined it cannot ensure the individual's health, safety, and welfare in the provision of host home/companion care, residential support, supervised living, supported home living, respite, employment assistance, supported employment, in-home day habilitation, day habilitation, or CFC PAS/HAB:

    (A) inform the individual or LAR of the consequences and risks of refusing the assessment, including that the refusal will result in the individual's not receiving:

      (i) nursing services; or

      (ii) host home/companion care, residential support, supervised living, supported home living, respite, employment assistance, supported employment, in-home day habilitation, day habilitation, or CFC PAS/HAB, if the individual needs one of those services and the program provider has determined that it cannot ensure the health and safety of the individual in the provision of the service; and

    (B) notify the program provider if the individual or LAR continues to refuse the assessment after the discussion with the service coordinator;

  (23) if the service coordinator determines that HCS Program services or CFC services provided for an individual should be terminated, including for a reason described in §263.104(k)(14)(C) or (D) of this chapter:

    (A) document a description of:

      (i) the situation that resulted in the service coordinator's determination that services should be terminated; and

      (ii) the attempts by the service coordinator to resolve the situation;

    (B) send a written recommendation to terminate the individual's HCS Program services or CFC services to HHSC and include the documentation required by subparagraph (A) of this paragraph; and

    (C) provide a copy of the written recommendation and the documentation required by subparagraph (A) of this paragraph to the program provider;

  (24) if an individual requests termination of all HCS Program services or all CFC services, within ten calendar days after the individual's request:

    (A) inform the individual or LAR of:

      (i) the individual's option to transfer to another program provider;

Cont'd...

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