| (B) the individual receives appropriate in-person support
during the completion of the form by videoconferencing or telephone.
(l) A service coordinator must:
(1) in accordance with 40 TAC Chapter 41, Subchapter
D (relating to Enrollment, Transfer, Suspension, and Termination):
(A) inform the applicant or LAR of the applicant's
right to participate in the CDS option; and
(B) inform the applicant or LAR that the applicant
or LAR may choose to have one or more services provided through the
CDS option, as described in 40 TAC §41.108 (relating to Services
Available Through the CDS Option); and
(2) if the applicant or LAR chooses to participate
in the CDS option, comply with §262.701(r) of this chapter (relating
to LIDDA Requirements for Providing Service Coordination in the TxHmL
Program).
(m) The service coordinator must develop an initial
IPC with the applicant or LAR based on the PDP and in accordance with §262.301
of this chapter (relating to IPC Requirements).
(n) If an applicant or LAR chooses to receive a TxHmL
Program service or CFC service provided by a program provider, the
service coordinator must review the initial IPC with potential program
providers as requested by the applicant or the LAR.
(o) A service coordinator must:
(1) ensure that the initial IPC includes a sufficient
number of RN nursing units for the program provider's RN to perform
a comprehensive nursing assessment, unless:
(A) nursing services are not on the initial IPC and
the applicant or LAR and selected program provider have determined
that no nursing tasks will be performed by an unlicensed service provider
as documented on the HHSC Nursing Task Screening Tool form; or
(B) an unlicensed service provider will perform a nursing
task and a physician has delegated the task as a medical act under
Texas Occupations Code Chapter 157, as documented by the physician;
(2) if an applicant or LAR refuses to include a sufficient
number of RN nursing units on the initial IPC for the program provider's
RN to perform a comprehensive nursing assessment as required by paragraph
(1) of this subsection:
(A) inform the applicant or LAR that the refusal:
(i) will result in the applicant not receiving nursing
services from the program provider; and
(ii) if the applicant needs community support, day
habilitation, employment assistance, supported employment, respite,
or CFC PAS/HAB from the program provider, will result in the applicant
not receiving the service unless:
(I) the program provider's unlicensed service provider
does not perform nursing tasks in the provision of the service; and
(II) the program provider determines that it can ensure
the applicant's health, safety, and welfare in the provision of the
service; and
(B) document the refusal of the RN nursing units on
the initial IPC for a comprehensive nursing assessment by the program
provider's RN in the applicant's record;
(3) negotiate and finalize the initial IPC and the
date services will begin with the selected program provider, consulting
with HHSC if necessary to reach agreement with the selected program
provider on the content of the initial IPC and the date services will
begin;
(4) ensure that the applicant or LAR signs and dates
the initial IPC and provides the signed and dated IPC to the service
coordinator in person, electronically, by fax, or by United States
mail;
(5) ensure that the selected program provider signs
and dates the initial IPC, demonstrating agreement that the services
will be provided to the applicant; and
(6) sign and date the initial IPC to demonstrate that
the service coordinator agrees that the requirements described in §262.301(c)
of this chapter have been met.
(p) A service coordinator must:
(1) provide an oral and written explanation to the
applicant or LAR of the following information using the HHSC Understanding
Program Eligibility and Services form, which is available on the HHSC
website:
(A) the eligibility requirements for TxHmL Program
services as described in §262.101(a) of this subchapter (relating
to Eligibility Criteria for TxHmL Program Services and CFC Services);
and
(B) if the applicant's PDP includes CFC services:
(i) the eligibility requirements for CFC services as
described in §262.101(b) of this subchapter to applicants who
do not receive MAO Medicaid; and
(ii) the eligibility requirements for CFC services
as described in §262.101(c) of this subchapter to applicants
who receive MAO Medicaid; and
(2) provide an oral and written explanation to the
applicant or LAR of:
(A) the reasons TxHmL Program services may be terminated
as described in §262.507 of this chapter (relating to Termination
of TxHmL Program Services and CFC Services with Advance Notice) and §262.508
of this chapter (relating to Termination of TxHmL Program Services
and CFC Services without Advance Notice); and
(B) if the applicant's PDP includes CFC services, the
reasons CFC services may be terminated as described in §262.507
and §262.508 of this chapter.
(q) After an initial IPC is finalized and signed in
accordance with subsection (o) of this section, the LIDDA must:
(1) enter the information from the initial IPC in the
HHSC data system and electronically submit the information to HHSC;
(2) keep the original initial IPC in the individual's
record;
(3) ensure the information from the initial IPC entered
in the HHSC data system and electronically submitted to HHSC contains
information identical to the information on the initial IPC; and
(4) submit other required enrollment information to
HHSC;
(r) HHSC notifies the applicant or LAR, the selected
program provider, the FMSA, if applicable, and the LIDDA of its approval
or denial of the applicant's enrollment. If the enrollment is approved,
HHSC authorizes the applicant's enrollment in the TxHmL Program through
the HHSC data system and issues an enrollment letter to the applicant
that includes the effective date of the applicant's enrollment in
the TxHmL Program.
(s) The selected program provider and the individual
or LAR must develop:
(1) an implementation plan for:
(A) TxHmL Program services, except for community support,
that is based on the individual's PDP and initial IPC; and
(B) CFC services, except for CFC support management,
that is based on the individual's PDP, IPC, and if CFC PAS/HAB is
included on the PDP, the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment
form; and
(2) a transportation plan, if community support is
included on the PDP.
(t) Before the applicant's service begin date, a LIDDA
must provide to the selected program provider and FMSA, if applicable:
(1) copies of all enrollment documentation and associated
supporting documentation, including relevant assessment results and
recommendations;
(2) the completed ID/RC Assessment;
(3) the IPC;
(4) the applicant's PDP; and
(5) if CFC PAS/HAB is included on the PDP, a copy of
the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment form.
(u) In accordance with §262.401(a)(5)(N) of this
chapter (relating to Program Provider Reimbursement), if a selected
program provider provides services before the date of an applicant's
enrollment into the TxHmL Program, HHSC does not pay the program provider
for the services.
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