| (a) In addition to the requirements described in Chapter
2, Subchapter L of this title (relating to Service Coordination for
Individuals with an Intellectual Disability), a LIDDA must ensure:
(1) compliance with:
(A) this subchapter;
(B) Chapter 41 of this title (relating to Consumer
Directed Services Option); and
(C) Chapter 4, Subchapter L, of this title (relating
to Abuse, Neglect, and Exploitation in Local Authorities and Community
Centers); and
(2) a rights protection officer, as required by §4.113
of this title (relating to Rights Protection Officer at a State MR
Facility or MRA), who receives a copy of an HHSC initial intake report
or a final investigative report from an FMSA, in accordance with §41.702
of this title (relating to Requirements Related to HHSC Investigations
When an Alleged Perpetrator is a Service Provider) or §41.703
of this title (relating to Requirements Related to HHSC Investigations
When an Alleged Perpetrator is a Staff Person or a Controlling Person
of an FMSA), gives a copy of the report to the individual's service
coordinator.
(b) A LIDDA must employ service coordinators who:
(1) meet the minimum qualifications and LIDDA staff
training requirements specified in Chapter 2, Subchapter L of this
title; and
(2) have received training about:
(A) the HCS Program and CFC, including the requirements
of this subchapter and the HCS Program services and CFC services described
in §9.154 of this subchapter (relating to Description of the
HCS Program and CFC); and
(B) Chapter 41 of this title.
(c) A LIDDA must have a process for receiving and resolving
complaints from a program provider related to the LIDDA's provision
of service coordination or the LIDDA's process to enroll an applicant
in the HCS Program.
(d) If, as a result of monitoring, the service coordinator
identifies a concern with the implementation of the PDP, the LIDDA
must ensure that the concern is communicated to the program provider
and attempts are made to resolve the concern. The LIDDA may refer
an unresolved concern to HHSC by calling the HHSC Complaint and Incident
Intake toll-free telephone number at 1-800-458-9858.
(e) A service coordinator must:
(1) assist an individual or LAR in exercising the legal
rights of the individual as a citizen and as a person with a disability;
(2) provide an individual, LAR, or family member with
a written copy of the rights of the individual as described in §9.173(b)
of this subchapter (relating to Certification Principles: Rights of
Individuals) and the booklet Your Rights In the Home and Community-based
Services (HCS) Program, available on the HHSC website,) and an oral
explanation of such rights:
(A) upon the individual's enrollment in the HCS Program;
(B) upon revision of the booklet;
(C) upon request; and
(D) upon change in the individual's legal status (that
is when the individual turns 18 years of age, is appointed a guardian,
or loses a guardian);
(3) document the provision of the rights described
in §9.173(b) of this subchapter, and the booklet and oral explanation
required by paragraph (2) of this subsection, and ensure that the
documentation is signed by:
(A) the individual or LAR; and
(B) the service coordinator;
(4) ensure that, upon enrollment of an individual and
annually thereafter, the individual or LAR is informed orally and
in writing of the following:
(A) the telephone number of the LIDDA to file a complaint;
(B) the toll-free telephone number of the HHSC Complaint
and Incident Intake, 1-800-458-9858, to file a complaint; and
(C) the toll-free telephone number of DFPS, 1-800-647-7418,
to report an allegation of abuse, neglect, or exploitation;
(5) maintain for an individual for an IPC year:
(A) a copy of the IPC;
(B) the PDP and, if CFC PAS/HAB is included on the
PDP, the completed HHSC HCS/TxHmL CFC PAS/HAB Assessment form;
(C) a copy of the ID/RC Assessment;
(D) documentation of the activities performed by the
service coordinator in providing service coordination; and
(E) any other pertinent information related to the
individual;
(6) initiate, coordinate, and facilitate person-directed
planning, including scheduling service planning team meetings;
(7) to meet the needs of an individual as those needs
are identified, develop for the individual a full range of services
and resources using:
(A) providers for services other than HCS Program services
and CFC services; and
(B) advocates or other actively involved persons;
(8) ensure that the PDP for an applicant or individual:
(A) is developed, reviewed, and updated in accordance
with:
(i) §9.158(j)(4)(A) of this subchapter (relating
to Process for Enrollment of Applicants);
(ii) §9.166 of this subchapter (relating to Renewal
and Revision of an IPC); and
(iii) §2.556 of this title (relating to LIDDA's
Responsibilities);
(B) states, for each HCS Program service, other than
supervised living and residential support, and for each CFC service,
whether the service is critical to the individual's health and safety
as determined by the service planning team;
(9) participate in the development, renewal, and revision
of an individual's IPC in accordance with §9.158 and §9.166
of this subchapter;
(10) ensure that the service planning team participates
in the renewal and revision of the IPC for an individual in accordance
with §9.166 of this subchapter and ensure that the service planning
team completes other responsibilities and activities as described
in this subchapter;
(11) notify the service planning team of the information
conveyed to the service coordinator pursuant to §9.178(q)(3)(C)
and (4)(B) of this subchapter (relating to Certification Principle:
Quality Assurance);
(12) if a change to an individual's PDP is needed,
other than as required by §9.166 of this subchapter:
(A) communicate the need for the change to the individual
or LAR, the program provider, and other appropriate persons; and
(B) revise the PDP as necessary;
(13) provide an individual's program provider a copy
of the individual's current PDP;
(14) monitor the delivery of HCS Program services,
CFC services, and non-HCS Program and non-CFC services to an individual;
(15) document whether an individual progresses toward
desired outcomes identified on the individual's PDP;
(16) together with the program provider, ensure the
coordination and compatibility of HCS Program services and CFC services
with non-HCS Program and non-CFC services, including, in coordination
with the program provider, assisting an individual in obtaining a
neurobehavioral or neuropsychological assessment and plan of care
from a qualified professional as described in §9.174(a)(27)(B)
of this subchapter (relating to Certification Principles: Service
Delivery);
(17) for an individual who has had a guardian appointed,
determine, at least annually, if the letters of guardianship are current;
(18) for an individual who has not had a guardian appointed,
make a referral of guardianship to a court, if appropriate;
(19) immediately notify the program provider if the
service coordinator becomes aware that an emergency necessitates the
provision of an HCS Program service or a CFC service to ensure the
individual's health or safety and the service is not on the IPC or
exceeds the amount on the IPC;
(20) if informed by the program provider that an individual's
HCS Program services or CFC services have been suspended:
(A) request the program provider enter necessary information
in the HHSC data system to inform HHSC of the suspension;
(B) review the individual's status and document in
the individual's record the reasons for continuing the suspension,
at least every 90 calendar days after the effective date of the suspension;
and
(C) to continue suspension of the services for more
than 270 calendar days, submit to HHSC written documentation of each
review made in accordance with subparagraph (B) of this paragraph
and a request for approval by HHSC to continue the suspension;
(21) if notified by the program provider that an individual
or LAR has refused a nursing assessment and that the program provider
has determined it cannot ensure the individual's health, safety, and
welfare in the provision of a service as described in §9.174(e)
of this of this subchapter:
(A) inform the individual or LAR of the consequences
and risks of refusing the assessment, including that the refusal will
result in the individual not receiving:
(i) nursing services; or
(ii) host home/companion care, residential support,
supervised living, supported home living, respite, employment assistance,
supported employment, day habilitation, or CFC PAS/HAB, if the individual
needs one of those services and the program provider has determined
that it cannot ensure the health and safety of the individual in the
provision of the service; and
(B) notify the program provider if the individual or
LAR continues to refuse the assessment after the discussion with the
service coordinator;
(22) notify the program provider if the service coordinator
becomes aware that an individual has been admitted to a setting described
in §9.155(e) of this subchapter (relating to Eligibility Criteria
and Suspension of HCS Program Services and of CFC Services);
(23) if the service coordinator determines that HCS
Program services or CFC services provided to an individual should
be terminated, including for a reason described in §9.158(k)(15)(A)
or (B) of this subchapter:
(A) document a description of:
(i) the situation that resulted in the service coordinator's
determination that services should be terminated;
(ii) the attempts by the service coordinator to resolve
the situation; and
(B) send a written recommendation to terminate the
individual's HCS Program services or CFC services to HHSC and include
the documentation required by subparagraph (A) of this paragraph;
(C) provide a copy of the written recommendation and
the documentation required by subparagraph (A) of this paragraph to
the program provider;
(24) if an individual requests termination of all HCS
Program services or all CFC services, the service coordinator must,
within ten calendar days after the individual's request:
(A) inform the individual or LAR of:
(i) the individual's option to transfer to another
program provider;
(ii) the consequences of terminating HCS Program services
and CFC services; and
(iii) possible service resources upon termination,
including CFC services through a managed care organization; and
(B) submit documentation to HHSC that:
(i) states the reason the individual is making the
request; and
(ii) demonstrates that the individual or LAR was provided
the information required by subparagraph (A)(ii) and (iii) of this
paragraph;
(25) in accordance with HHSC's instructions, manage
the process to transfer an individual's HCS Program services and CFC
services from one program provider to another or transfer from one
FMSA to another, including:
(A) informing the individual or LAR who requests a
transfer to another program provider or FMSA that the service coordinator
will manage the transfer process;
(B) informing the individual or LAR that the individual
or LAR may choose:
(i) to receive HCS Program services and CFC services
from any program provider that is in the geographic location preferred
by the individual or LAR and whose enrollment has not reached its
service capacity in the HHSC data system; or
(ii) to transfer to any FMSA in the geographic location
preferred by the individual or LAR; and
(C) if the individual or LAR has not selected another
program provider or FMSA, providing the individual or LAR with a list
of and contact information for HCS Program providers and FMSAs in
the geographic location preferred by the individual or LAR;
(26) be objective in assisting an individual or LAR
in selecting a program provider or FMSA;
(27) at the time of assignment and as changes occur,
ensure that an individual and LAR and program provider are informed
of the name of the individual's service coordinator and how to contact
the service coordinator;
(28) unless contraindications are documented with justification
by the service planning team, ensure that a school-age individual
receives educational services in a six-hour-per-day program, five
days per week, provided by the local school district and that no individual
receives educational services at a state supported living center or
at a state center;
Cont'd... |
