(a) To be eligible to receive services under the CMPAS
Program, an applicant must:
(1) be age 18 years of age or older;
(2) obtain and submit to the provider's assessor of
need a completed practitioner's statement;
(3) be assessed under §44.203 of this subchapter
(relating to Assessment and Eligibility Determination) as needing
assistance with at least one personal care task and needing an allowable
service for at least five hours per week;
(4) be able and willing to:
(A) self-direct the attendant; or
(B) designate a relative or friend who is willing and
able to direct the attendant without compensation;
(5) reside in an area in which CMPAS Program services
are available;
(6) have a service plan developed under §44.203(a)(6)(A)
of this subchapter that does not exceed 52 hours per week of CMPAS
Program services;
(7) choose one of the three service delivery options
described in Subchapter D of this chapter (relating to Service Delivery
Options);
(8) not be receiving services in:
(A) a hospital;
(B) a nursing facility;
(C) a state supported living center;
(D) a state mental health facility; or
(E) an intermediate care facility for individuals
with an intellectual disability or related conditions.
(b) An individual is not eligible to receive services
under the CMPAS Program if the individual is receiving:
(1) other community services and supports, either Medicaid
or non-Medicaid, under a service plan that exceeds the reimbursement
rate that would have been paid for the same individual to receive
services in a nursing facility;
(2) services under any of the following DADS programs:
(A) Primary Home Care, including Family Care (FC) and
Community Attendant Services (CAS);
(B) Residential Care; or
(C) Adult Foster Care;
(3) services under a §1915(c) Medicaid waiver
program;
(4) regular or ongoing attendant services under either
of the following DADS programs:
(A) Special Services to Persons with Disabilities;
or
(B) In-Home and Family Support.
(c) An individual may not receive services under the
CMPAS Program if the individual is Medicaid eligible and lives in
a managed care service area, unless the individual's spouse was employed
as the individual's attendant and the individual chose to remain in
CMPAS when the managed care service area was expanded to include the
individual's place of residence.
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Source Note: The provisions of this §275.25 adopted to be effective October 1, 2013, 38 TexReg 6606; transferred effective August 1, 2022, as published in the Texas Register July 8, 2022, 47 TexReg 3983 |