| (a) An individual or the individual's LAR may make
a written or oral request to the LIDDA serving the area in which the
individual resides for a review of an existing DID report or a diagnostic
assessment that reflects current functioning to determine eligibility.
An authorized provider may:
(1) endorse the DID report;
(2) endorse the diagnostic assessment report;
(3) conduct additional testing to determine eligibility;
or
(4) conduct a new DID.
(b) Except as provided in subsection (d) of this section,
if an individual has been determined to have an ID, ASD, or a related
condition on the current HHSC-approved list of related conditions,
by an authorized provider who is not employed by or contracting with
the LIDDA at which the individual or the individual's LAR is seeking
services, the LIDDA must ensure that:
(1) the diagnostic assessment report is reviewed by
an authorized provider employed by or contracting with the LIDDA;
and
(2) the authorized provider conducting the review interviews
and observes the individual in-person or in real time using audio-visual
technology.
(c) Except as provided in subsection (d) of this section,
if an individual has been determined to have an ID, ASD, or a related
condition on the current HHSC-approved list of related conditions,
by an authorized provider who is not employed by or contracting with
the SSLC at which the individual is receiving services, the SSLC must
ensure that:
(1) the diagnostic assessment report is reviewed by
an authorized provider employed by or contracting with the SSLC; and
(2) the authorized provider conducting the review interviews
and observes the individual in-person or in real time using audio-visual
technology.
(d) An authorized provider employed by or contracting
with a LIDDA or SSLC:
(1) may, but is not required to, endorse a DID conducted
by another authorized provider employed by or contracting with a LIDDA
or SSLC; and
(2) must not endorse a DID that they conducted without
adhering to endorsement requirements in subsections (b) - (c) of this
section.
(e) If a diagnostic assessment report reviewed in accordance
with subsection (b) or (c) of this section is endorsed by the authorized
provider employed by or contracting with the LIDDA or SSLC as a valid
reflection of the individual's current level of functioning, within
30 days after the review is completed:
(1) the authorized provider must:
(A) document the outcome of the review; and
(B) inform the individual or the individual's LAR orally
and in writing of the outcome of the review; and
(2) the LIDDA or SSLC must inform the individual or
the individual's LAR orally and in writing of the right to an administrative
hearing to contest the determination of ID, as described in 40 TAC
Chapter 4, Subchapter D (relating to Administrative Hearings under
Texas Health and Safety Code, Title 7, Subtitle D).
(f) If a DID or other diagnostic assessment report
reviewed in accordance with subsection (b) or (c) of this section
is not endorsed by the authorized provider as a valid reflection of
the individual's current level of functioning, the authorized provider
must, within 30 days after the review is completed:
(1) inform the individual or the individual's LAR orally
and in writing of:
(A) the outcome of the review; and
(B) the opportunity to have an authorized provider
employed by or contracting with the LIDDA or SSLC conduct a diagnostic
assessment at no expense to the individual or the individual's LAR;
and
(2) the LIDDA or SSLC must inform the individual or
the individual's LAR orally and in writing of the right to an administrative
hearing to contest the determination of ID, as described in 40 TAC
Chapter 4, Subchapter D.
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