Texas Administrative Code

Texas Administrative Code

TITLE 26	HEALTH AND HUMAN SERVICES
PART 1	HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 261	INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM--CONTRACTING
SUBCHAPTER E	ELIGIBILITY, ENROLLMENT AND REVIEW
RULE §261.236	Eligibility Criteria

(a) To be eligible for the ICF/MR Program, a person must:

(1) meet the LOC I or LOC VIII criteria described in §419.238 of this title (relating to Level of Care I Criteria) and §419.239 of this title (relating to Level of Care VIII Criteria);

(2) be in need of and able to benefit from the active treatment provided in the 24-hour supervised residential setting of an ICF/MR; and

(3) be eligible for Supplemental Security Income (SSI) or be determined by TDHS to be financially eligible for Medicaid.

(b) Circumstances under which a person is not in need of and able to benefit from active treatment include when the person:

(1) has been diagnosed by a licensed physician as having "brain death";

(2) does not respond in any way to the living environment;

(3) has a health condition that prevents participation in active treatment; or

(4) is generally able to function with little supervision or without a program of continuous active treatment.

Source Note: The provisions of this §261.236 adopted 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; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127