| (a) Personal care services (PCS) may be provided in
an individual or group setting.
(b) PCS may be authorized for the following place(s)
of service:
(1) The recipient's home;
(2) The home of the primary or alternate care giver;
(3) The recipient's school;
(4) The recipient's day care facility; or
(5) Any community setting in which the recipient is
located.
(c) PCS may not be authorized in hospitals, nursing
facilities, or intermediate care facilities for individuals with intellectual
or developmental disabilities.
(d) Texas Medicaid does not reimburse providers for
PCS that duplicate services that are the legal responsibility of school
districts. The school district, through the Individuals with Disabilities
Education Act (IDEA), is required to meet the recipient's personal
care needs while the recipient is at school. If those needs cannot
be met by the school district, the school district must submit documentation
to the Department of State Health Services case manager indicating
the school district is unable to provide necessary services.
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