| (a) The HCS Program is a Medicaid waiver program approved
by CMS pursuant to §1915(c) of the Social Security Act. It provides
community-based services and supports to eligible individuals as an
alternative to the ICF/IID Program. The HCS Program is operated by
HHSC.
(b) Enrollment in the HCS Program is limited to the
number of individuals in specified target groups and to the geographic
areas approved by CMS.
(c) HCS Program services described in §263.5 of
this subchapter (relating to Description of HCS Program Services)
and CFC services described in §263.6 of this subchapter (relating
to Description of CFC Services) are selected for inclusion in an individual's
IPC to ensure the individual's health, safety, welfare, and integration
in the community. HCS Program services and CFC Services supplement
rather than replace the individual's natural supports and other community
services for which the individual may be eligible and prevent the
individual's admission to an institutional setting.
(d) CFC is a state plan option governed by 42 CFR Chapter
441, Subpart K, regarding Home and Community-Based Attendant Services
and Supports State Plan Option (Community First Choice).
(e) HHSC has grouped Texas counties into geographical
areas, referred to as "local service areas," each of which is served
by a LIDDA. HHSC has further grouped the local service areas into
"waiver contract areas." A list of the counties included in each local
service area and waiver contract area is available on the HHSC website.
(1) A program provider may provide HCS Program services
and CFC services only to persons residing in the counties specified
for the program provider in the HHSC automated enrollment and billing
system.
(2) A program provider must have a separate contract
for each waiver contract area served by the program provider.
(3) A program provider may have a contract to serve
one or more local service areas within a waiver contract area, but
the program provider must serve all of the counties within each local
service area covered by the contract.
(4) A program provider may not have more than one contract
per waiver contract area.
(f) A program provider must comply with all applicable
state and federal laws, rules, and regulations.
(g) The CDS option is a service delivery option, described
in 40 TAC Chapter 41 (relating to Consumer Directed Services Option),
in which an individual or LAR employs and retains service providers
and directs the delivery of a service through the CDS option, as described
in 40 TAC §41.108 (relating to Services Available Through the
CDS Option).
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