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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 301IDD-BH CONTRACTOR ADMINISTRATOR FUNCTIONS
SUBCHAPTER FPROVIDER NETWORK DEVELOPMENT
RULE §301.265Content of the Plan

(a) Plan preparation. An LMHA must use the results of its network development evaluation described in §412.757 of this title (relating to Network Development Evaluation) to create its draft plan.

(b) Plan content applicable to all LMHAs. All plans must include the following components.

  (1) The LMHA's projected service capacity for each level of care based on service data from the previous fiscal year for services provided under the performance contract and any information about changes that will impact the service capacity.

  (2) Baseline data specified by the department showing the type and quantity of services provided by the LMHA and by external providers.

  (3) A description of the process the LMHA used to evaluate the potential for network development and the results of that evaluation, including any information relating to specific services or populations.

  (4) A list of the LMHA's external providers, including all current contractors and any other providers with whom the LMHA had a contract or agreement in effect during any part of the current or previous fiscal year. The list shall include the number of contracts and agreements with individual peer support providers, but not the names of individual peer support providers without their written consent.

(c) Plan content for LMHAs with potential for network development. If an LMHA identifies the potential for network development, the plan must also include the following elements.

  (1) A description of the LMHA's plans for procurement, including:

    (A) the adult and children's services to be procured;

    (B) the capacity to be procured for each service;

    (C) the geographic area(s) in which services would be procured;

    (D) the procurement method(s) to be used; and

    (E) the timeline(s) for conducting the procurement.

  (2) The rationale for any provision that would limit individual choice or prevent procurement of all available capacity offered by external provider organizations.

    (A) The rationale must address any proposed restrictions on:

      (i) the type of service to be procured;

      (ii) the volume of services to be procured;

      (iii) the geographic area in which services would be procured; or

      (iv) the number of providers to be accepted.

    (B) The rationale for limiting procurement must be based on one or more of the conditions identified in §412.755 of this title (relating to Conditions Permitting LMHA Service Delivery).

    (C) The rationale must provide a basis for the proposed level of restriction, including the volume of services to be provided by the LMHA. An LMHA may be required to submit additional data to support its rationale.

  (3) A description of the strategies the LMHA would use to maximize funds available to provide services, as required in §412.754(c) of this title (relating to Local Network Development).

  (4) A summary of procurement activities from past network and development planning cycles and the results of those efforts.

  (5) If an LMHA is not procuring all available capacity offered by external provider organizations, the timeframe and steps for achieving full procurement of the external provider capacity identified in its network development evaluation, not to exceed the LMHA's capacity.


Source Note: The provisions of this §301.265 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237

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