| (a) To be eligible for family care, the applicant/client
must:
(1) meet the income and resource guidelines established
by the department in §§48.2902, 48.2903, 48.2922, and 48.2923
of this title (relating to Income and Income Eligibles; Determination
of Countable Income; Resource Limits; and Countable Resources);
(2) meet the minimum functional need criteria as set
by the department. The department uses a standardized assessment instrument
to measure the client's ability to perform activities of daily living.
This yields a score, which is a measure of the client's level of functional
need. The department sets the minimum required score for a client
to be eligible, which the department may periodically adjust commensurate
with available funding. The department will seek stakeholder input
before making any change in the minimum required score for functional
eligibility; and
(3) be ineligible to receive attendant care services
funded through Medicaid.
(b) If eligible, an applicant/client may receive one
or more of the following services:
(1) personal care;
(2) household tasks;
(3) meal preparation; and
(4) escort.
(c) Family care services are provided in a client's
residence. A client is not eligible to receive family care services
while living in:
(1) a hospital;
(2) a skilled nursing facility;
(3) an intermediate care facility;
(4) an assisted living facility;
(5) a foster care setting;
(6) a jail or prison;
(7) a state school;
(8) a state hospital; or
(9) any other setting where sources outside the family
care program are available to provide care.
(d) The applicant/client must require at least six
hours of family care per week to be eligible, unless the applicant/client:
(1) requires family care to provide respite to the
caregiver;
(2) lives in the same household as another individual
receiving family care, community based alternatives personal assistance
services, community attendant services, or primary home care;
(3) receives one or more of the following services
(through the department or other resources):
(A) congregate or home-delivered meals;
(B) assistance with activities of daily living from
a home health aide;
(C) day activity and health services; or
(D) special services to persons with disabilities in
adult day care;
(4) receives aid-and-attendance benefits from the Veterans
Administration;
(5) receives services through the department's In-home
and Family Support Program; or
(6) is determined, based upon the functional assessment,
to be at high risk of institutionalization without family care.
(e) The community care case manager establishes a priority
status for each client based on the functional assessment. An individual
is considered to have priority status if the following criteria are
met:
(1) The individual is completely unable to perform
one or more of the following activities without hands-on assistance
from another person:
(A) transferring himself into or out of bed or a chair
or on or off a toilet;
(B) feeding himself;
(C) getting to or using the toilet;
(D) preparing a meal; or
(E) taking self-administered prescribed medications.
(2) During a normally scheduled service shift, no one
is readily available who is capable and who is willing to provide
the needed assistance other than the family care attendant.
(3) The community care case manager determines that
there is a high likelihood the individual's health, safety, or well-being
would be jeopardized if family care services were not provided on
a single given shift.
(f) A client with priority status may receive no more
than 42 hours of service per week.
(g) A client without priority status may receive no
more than 50 hours of service per week.
|
| Source Note: The provisions of this §271.69 adopted to be effective March 29, 1982, 7 TexReg 1190; amended to be effective March 1, 1983, 8 TexReg 525; amended to be effective August 1, 1984, 9 TexReg 3876; amended to be effective January 11, 1985, 9 TexReg 6188; amended to be effective January 1, 1986, 10 TexReg 4696; amended to be effective July 1, 1986, 11 TexReg 2827; amended to be effective December 1, 1986, 11 TexReg 4581; amended to be effective May 15, 1989, 14 TexReg 1935; amended to be effective September 1, 1990, 15 TexReg 4579; amended to be effective May 15, 1992, 17 TexReg 3162; amended to be effective August 5, 1992, 17 TexReg 5121; amended to beeffective October 1, 1992, 17 TexReg 6374; amended to be effective November 15, 1992, 17 TexReg 7464; amended to be effective September 1, 1993, 18 TexReg 4754; amended to be effective September 1, 1993, 18 TexReg 4881; amended to be effective August 31, 2004, 29 TexReg 8376; transferred effective September 15, 2023, as published in the August 18, 2023, issue of the Texas Register, 48 TexReg 4523 |
