| (a) An IDT must include:
(1) the individual;
(2) a provider representative; and
(3) other persons as requested by the individual.
(b) A provider must convene an IDT meeting:
(1) within five working days after:
(A) an individual accepts the provider's offer for
an informal dispute resolution process due to a service plan or co-payment
disagreement, as described in §44.206 of this chapter (relating
to Service Plan and Co-payment Disagreements);
(B) the provider determines it cannot provide services
to an individual for any of the health and safety reasons described
in §44.301(c)(2) - (4) of this chapter (relating to Initiation
of Services); or
(C) the provider identifies the need to discuss with
the individual a service delivery issue that prevents the provider
from carrying out a provider responsibility described in this chapter;
(2) as described in §44.308(e) of this chapter
(relating to Suspension of Services); or
(3) as described in §44.443 of this chapter (relating
to Provider and Individual Responsibilities in the CDS Option Related
to HHSC Investigations When an Alleged Perpetrator is an Attendant
or Substitute Attendant) and §44.444 of this chapter (relating
to Provider and Individual Responsibilities in the CDS Option Related
to HHSC Investigations When an Alleged Perpetrator is a Staff Person
or a Controlling Person of a Provider).
(c) If a provider is unable to convene an IDT meeting
with all the members described in subsection (a) of this section,
the provider must:
(1) convene the IDT meeting with the available members;
(2) send documentation of the IDT meeting to the individual;
and
(3) document in the individual's record the provider's
efforts to convene an IDT meeting with all the members described in
subsection (a) of this section.
(d) The IDT must:
(1) meet by telephone conference call or in person;
(2) discuss the specific reason for conducting the
IDT meeting;
(3) identify any possible solutions to resolve the
specific reason for the meeting; and
(4) make recommendations to the provider and the individual.
(e) Within two working days after an IDT meeting, a
provider must:
(1) document:
(A) the specific reason for calling the IDT meeting;
(B) the names of the IDT members attending the meeting;
(C) the recommendations of the IDT to the provider
and the individual; and
(D) the actions to be taken or that have been taken
by the provider or the individual;
(2) provide a written copy of the documentation to
the individual; and
(3) notify the individual of the right to request a
fair hearing, as provided by §44.503 of this subchapter (relating
to Fair Hearing), if an action to be taken or that has been taken
by the provider denies, reduces, or terminates the individual's services.
|
| Source Note: The provisions of this §275.203 adopted to be effective October 1, 2013, 38 TexReg 6606; amended to be effective October 1, 2019, 44 TexReg 5106; transferred effective August 1, 2022, as published in the Texas Register July 8, 2022, 47 TexReg 3983 |
