| (a) Renewal of an IPC. At least annually and before
the expiration of an individual's IPC, an individual's IPC must be
renewed in accordance with this subsection and HHSC's instructions.
(1) At least 60 but no more than 90 calendar days before
the expiration of an individual's IPC, the service coordinator must:
(A) notify the service planning team that the individual's
PDP must be reviewed and updated;
(B) convene a meeting of the service planning team
to:
(i) review and update the individual's PDP; and
(ii) if CFC PAS/HAB is included on the PDP, complete
the HHSC HCS/TxHmL CFC PAS/HAB Assessment form to determine the number
of CFC PAS/HAB hours the individual needs; and
(C) use the HHSC Understanding Program Eligibility
and Services form to provide the individual or LAR both an oral and
written explanation of:
(i) the eligibility requirements for the HCS Program
as described in §263.101(a) of this chapter (relating to Eligibility
Criteria for HCS Program Services and CFC Services);
(ii) if the individual's PDP includes CFC services:
(I) the eligibility requirements for CFC services as
described in §263.101(c) of this chapter to individuals who do
not receive MAO Medicaid; and
(II) the eligibility requirements for CFC services
as described in §263.101(d) of this chapter to individuals who
receive MAO Medicaid;
(iii) all HCS Program services and CFC services as
described in §263.4 of this chapter (relating to Description
of the HCS Program and CFC);
(iv) the reason HCS Program services and CFC services
may be suspended as described in §263.705(a) of this chapter
(relating to Suspension of HCS Program Services and CFC Services);
and
(v) the reason HCS Program services and CFC services
may be terminated as described in §263.707 of this chapter (relating
to Termination of HCS Program Services and CFC Services with Advance
Notice) and §263.708 of this chapter (relating to Termination
of HCS Program Services and CFC Services Without Advance Notice).
(2) The HHSC HCS/TxHmL CFC PAS/HAB Assessment form
required by paragraph (1)(B)(ii) of this subsection must be completed
in person with the individual unless the following conditions are
met, in which case the form may be completed by videoconferencing
or telephone:
(A) the service coordinator gives the individual the
opportunity to complete the form in person in lieu of completing it
by videoconferencing or telephone and the individual agrees to the
form being completed by videoconferencing or telephone; and
(B) the individual receives appropriate in-person support
during the completion of the form by videoconferencing or telephone.
(3) The service coordinator, within 10 calendar days
after the PDP is updated, must send a copy of the following to the
program provider, the individual or LAR and, if applicable, the FMSA:
(A) the updated PDP; and
(B) if CFC PAS/HAB is included on the PDP, a copy of
the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment form.
(4) The program provider must ensure that a meeting
between the service planning team and the program provider occurs
at least 30 but no more than 60 calendar days before the expiration
of the individual's IPC to:
(A) review the PDP and, if CFC PAS/HAB is included
on the PDP, the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment form;
and
(B) develop the renewal IPC that meets the requirements
described in §263.301(c) of this subchapter (relating to IPC
Requirements), including completion of the CDS option portion of the
renewal IPC, if applicable, and the non-HCS Program services and non-CFC
services.
(5) The program provider must convene a meeting with
the individual or LAR to develop, before the effective date of the
renewal IPC:
(A) an implementation plan for:
(i) HCS Program services, except for supported home
living, that is based on the individual's PDP and renewal IPC; and
(ii) CFC services, except for CFC support management,
that is based on the individual's PDP, and renewal IPC, and if CFC
PAS/HAB is included on the PDP, the completed HHSC HCS/TxHmL CFC PAS/HAB
Assessment form; and
(B) a transportation plan, if supported home living
is included on the PDP.
(6) Within seven calendar days after development of
the renewal IPC as required by paragraph (4) of this subsection, the
program provider must comply with the requirements in subsection (e)(1)
of this section.
(7) Within seven calendar days after the program provider
enters the information from the renewal IPC in the HHSC data system
and electronically submits the information to HHSC as required by
subsection (e)(1)(C) of this section, the service coordinator must
comply with the requirements in subsection (e)(2) of this section.
(8) The program provider must provide HCS Program services
and CFC services in accordance with:
(A) an implementation plan that is based on:
(i) the individual's PDP;
(ii) the renewal IPC; and
(iii) if CFC PAS/HAB is included on the PDP, the completed
HHSC HCS/TxHmL CFC PAS/HAB Assessment form; and
(B) a transportation plan, if supported home living
is included on the PDP.
(b) Revisions to an IPC. Except as provided in subsection
(f) of this section, a service coordinator or a program provider may
determine whether an individual's IPC needs to be revised to add a
new HCS Program service or CFC service or change the amount of an
existing service.
(1) The service coordinator must notify the program
provider if the service coordinator determines that the IPC needs
to be revised.
(2) The program provider must notify the service coordinator
if the program provider determines that the IPC needs to be revised.
(3) Within 14 calendar days after the notification
required by paragraph (1) or (2) of this subsection:
(A) if the IPC needs to be revised to add CFC PAS/HAB,
the service planning team must complete the HHSC HCS/TxHmL CFC PAS/HAB
Assessment form in order to determine the number of CFC PAS/HAB hours
the individual needs;
(B) if the IPC needs to be revised to change the amount
of CFC PAS/HAB, the service planning team must update the HHSC HCS/TxHmL
CFC PAS/HAB Assessment form to reflect the amount of CFC PAS/HAB needed
to meet the individual needs;
(C) the service coordinator must send a copy of the
completed or updated HHSC HCS/TxHmL CFC PAS/HAB Assessment form to
the program provider for review;
(D) if a new service is being added or a current service
is being removed from the IPC or the amount of a service is being
increased or decreased and requires the addition of, removal of, or
a change to an outcome in the PDP:
(i) the service coordinator must convene a meeting
with the service planning team to update the PDP; and
(ii) the service planning team and the program provider
must convene a meeting to develop a revised IPC;
(E) if the amount of an existing service is being increased
or decreased or a requisition fee is added or removed and does not
require the addition of, removal of, or a change to an outcome in
the PDP:
(i) the program provider must develop a revised IPC;
and
(ii) the service coordinator must document the reasons
for the IPC revision;
(F) the program provider must convene a meeting with
the individual or LAR to revise:
(i) the implementation plan for:
(I) HCS Program services, except for supported home
living, that is based on the individual's PDP and revised IPC; and
(II) CFC services, except for CFC support management,
that is based on the individual's PDP, revised IPC, and if CFC PAS/HAB
is included on the PDP, the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment
form; and
(ii) the transportation plan, if supported home living
is modified on the PDP or IPC; and
(G) the program provider must comply with the requirements
in subsection (e)(1) of this section.
(4) The CFC PAS/HAB Assessment form required by paragraph
(3)(A) of this subsection must be completed in person with the individual
unless the following conditions are met, in which case the form may
be completed by videoconferencing or telephone:
(A) the service coordinator gives the individual the
opportunity to complete the form in person in lieu of completing it
by videoconferencing or telephone and the individual agrees to the
form being completed by videoconferencing or telephone; and
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