| (a) Case management means services provided to assist
an eligible child and their family in gaining access to the rights
and procedural safeguards under IDEA Part C, and to needed medical,
social, educational, developmental, and other appropriate services.
Case management includes:
(1) coordinating the performance of evaluations and
assessments;
(2) facilitating and participating in the development,
review, and evaluation of the individualized family service plan in
accordance with Subchapter J of this chapter (relating to Individualized
Family Service Plan (IFSP)) which is based upon:
(A) the child's applicable history;
(B) the parent's input;
(C) input from others providing services and supports
to the child and family; and
(D) the results of all evaluations and assessments;
(3) assisting families in:
(A) identifying unmet needs;
(B) identifying available providers of services and
supports;
(C) making appropriate referrals and facilitating application;
and
(D) assisting with initial and ongoing contact to obtain
services from medical, social, and educational providers to address
identified needs and achieve goals specified in the IFSP;
(4) following up with families and providers of services
and supports to assist the child with timely access to services,
and discuss the status of referrals to determine if the services have
met the child's identified needs, and if ongoing assistance to ensure
continued access will be necessary;
(5) monitoring and assessment of the delivery of and
effectiveness of services that:
(A) occurs at least once every six months, or more
frequently as needed;
(B) is individualized and clearly related to the needs
of the child and family;
(C) collects information from family members, service
providers, and other entities and individuals who provide service
or supports to the child and family to assess if:
(i) services are being provided in accordance with
the child's IFSP;
(ii) services are adequate to meet the child's and
family's needs;
(iii) all service providers are effectively collaborating
to address the child's and family's needs; and
(iv) parents and routine caregivers are able to use
the interventions being presented;
(6) adjusting the IFSP and service arrangements if
new needs, ineffectiveness, or barriers to services are identified;
(7) assisting the parent or routine caregiver in advocating
for the child;
(8) coordinating with medical and other health providers
to ensure services are effective in meeting the child's and family's
needs; and
(9) facilitating the child's transition to preschool
or other appropriate services and supports.
(b) Medicaid reimbursement is available for the provision
of targeted case management if the following criteria are met:
(1) the contact occurs with the parent or routine caregiver;
(2) the contact occurs face to face or by telephone;
(3) the contact is of at least eight minutes in duration;
(4) the desired outcome of the contact is of direct
benefit to a child who is eligible for ECI services; and
(5) during the contact the service coordinator performs
a case management activity as described in subsection (a) of this
section.
(c) Non-billable case management contacts must be documented
in a child's record. These contacts occur when:
(1) the contact is with individuals other than a parent
or routine caregiver;
(2) the desired outcome of the contact is of direct
benefit to a child who is eligible for ECI services; and
(3) during the contact the service coordinator performs
a case management activity as defined in subsection (a) of this section.
|
| Source Note: The provisions of this §350.405 adopted to be effective September 1, 2009, 34 TexReg 5575; amended to be effective September 1, 2011, 36 TexReg 5403; amended to be effective June 30, 2019, 44 TexReg 3280; transferred effective March 1, 2021, as published in the Texas Register February 5, 2021, 46 TexReg 941 |
