| (a) A program provider may charge an individual or
allow an individual to expend personal funds for the following items
and services:
(1) an item or service that the program provider is
responsible for providing, if the individual requests a specific type
or brand of item or service that the program provider does not provide,
and the program provider documents in the individual's record:
(A) the individual's written, signed request for a
specific type or brand and the reason a specific type or brand has
been requested or if the individual is determined not to have the
ability to make such a request, the IDT's approval for a specific
type or brand;
(B) the type or brand that is provided at the program
provider's expense; and
(C) the reason the program provider does not provide
the type or brand requested;
(2) the difference between the Medicaid payment and
the actual cost of the eyeglasses, if the individual chooses a style
or feature not paid for by Medicaid;
(3) clothing;
(4) cosmetic dental procedures;
(5) transportation costs, other than those described
in §419.254(17) of this title (relating to Items and Services
Provided by the Program Provider):
(A) if reimbursement to a third party for private transportation
does not exceed the current state mileage reimbursement rate; and
(B) if adequate documentation is provided by a third
party to the program provider to support the expenditure;
(6) repair or replacement of personal property that
is damaged, lost, or stolen by the individual, if the expenditure
is approved by the committee;
(7) snacks and meals, if the individual chooses items
not listed on the program provider's menu;
(8) the individual's budgeted amount;
(9) activities that are not part of the program provider's
recreational program and are independently chosen by the individual;
(10) dry cleaning;
(11) hair setting, permanent waves, hair color treatments,
and beauty supplies, such as hair rollers and hair spray;
(12) cosmetics and perfume;
(13) cosmetic manicures, pedicures, and facials;
(14) charges to hold the individual's residential placement
in the facility as described in §419.227(j) of this title (relating
to Discharge From a Facility)
(15) school supplies, school fees, and other educational
expenses;
(16) fees charged by a financial institution, if the
individual manages his or her personal funds or the individual requests
that the program provider manage his or her personal funds in a separate
account; and
(17) applied income.
(b) Items purchased with an individual's personal
funds must not be available for general use by program provider staff
or other individuals.
|
| Source Note: The provisions of this §261.255 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; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127 |
