| (a) HHSC may terminate an individual's CLASS Program
services and CFC services if the individual refuses to comply with
a mandatory participation requirement described in §259.103 of
this chapter (relating to Mandatory Participation Requirements of
an Individual).
(b) If a CMA becomes aware that an individual has not
complied with a mandatory participation requirement described in §259.103
of this chapter, the CMA must immediately attempt to resolve the situation,
including facilitating at least one in-person meeting between:
(1) the individual or LAR;
(2) a representative from the CMA; and
(3) a representative from the DSA.
(c) If, after making attempts to resolve the situation
as required by subsection (b) of this section, a CMA determines that
the situation cannot be resolved, the CMA must request, in writing,
that HHSC terminate CLASS Program services and CFC services for the
individual. The request must be sent to HHSC no later than two business
days after the CMA's determination that the situation cannot be resolved
and be supported by written documentation. The written documentation
must include a description of:
(1) the situation that resulted in the request to terminate
CLASS Program services and CFC services; and
(2) the attempts by the CMA and DSA to resolve the
situation, including in-person meetings with the individual or LAR.
(d) HHSC notifies the individual's CMA, in writing,
of whether it authorizes the proposed termination of CLASS Program
services and CFC services.
(e) After receiving a written notice from HHSC authorizing
the proposed termination of CLASS Program services and CFC services,
a CMA must, in accordance with the Community
Living Assistance and Support Services Provider Manual:
(1) send written notice of the proposed termination
of services to the individual or LAR within two business days, copying
the individual's DSA and, if selected, FMSA; and
(2) include in the written notice the individual's
right to request a fair hearing in accordance with §259.101 of
this chapter (relating to Individual's Right to a Fair Hearing).
(f) If an individual or LAR requests a fair hearing
before the effective date of the termination of CLASS Program services
and CFC services, as specified in the written notice, the DSA must
provide the services to the individual in the amounts authorized in
the IPC while the appeal is pending.
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