| (a) An IPC must be based on the PDP and specify:
(1) the type and amount of each TxHmL Program service
and CFC service to be provided to the individual during an IPC year;
(2) the services and supports to be provided to the
individual through resources other than TxHmL Program services or
CFC services during an IPC year, including natural supports, medical
services, day activity, and educational services;
(3) if an individual will receive CFC support management;
and
(4) if there are any TxHmL Program services or CFC
services identified on the PDP as critical, requiring a service backup
plan.
(b) If an applicant's or individual's IPC includes
only CFC PAS/HAB to be delivered through the CDS option, a service
coordinator must include in the IPC:
(1) CFC FMS instead of FMS; and
(2) if the applicant or individual will receive support
consultation, CFC support consultation instead of support consultation.
(c) The type and amount of each TxHmL Program service
and CFC service in an IPC:
(1) must be necessary to protect the individual's health
and welfare in the community;
(2) must not be available to the individual through
any other source, including the Medicaid State Plan, other governmental
programs, private insurance, or the individual's natural supports;
(3) must be the most appropriate type and amount to
meet the individual's needs;
(4) must be cost effective;
(5) must be necessary to enable community integration
and maximize independence;
(6) if an adaptive aid or minor home modification,
must:
(A) be included on HHSC's approved list in the TxHmL
Program Billing Requirements; and
(B) be within the service limit described in §262.304
of this subchapter (relating to Service Limits);
(7) if an adaptive aid costing $500 or more, must be
supported by a written assessment from a licensed professional specified
by HHSC in the TxHmL Program Billing Requirements;
(8) if a minor home modification costing $1,000 or
more, must be supported by a written assessment from a licensed professional
specified by HHSC in the TxHmL Program Billing Requirements;
(9) if dental treatment, must be within the service
limit described in §262.304 of this subchapter; and
(10) if CFC PAS/HAB, must be supported by the HHSC
HCS/TxHmL CFC PAS/HAB Assessment form.
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