| (a) Rights. A client's parent(s), foster parent(s),
guardian, or managing conservator, or an adult client has the right
to:
(1) apply for eligibility determination;
(2) choose providers subject to program limitations;
(3) be notified of modification, suspension, or termination
of service;
(4) refuse entry into the home to any employee, agent,
or representative of the commission or the department;
(5) appeal program decisions and receive a response
within the deadline as described in §38.13 of this title (relating
to Right of Appeal); and
(6) have all client files and other information maintained
in a confidential manner to the extent authorized by law.
(b) Responsibilities. A client's parent(s), foster
parent(s), guardian, or managing conservator, or an adult client has
the responsibility to:
(1) provide accurate medical information to providers
and notify all providers of program coverage prior to delivery of
services;
(2) provide the program with accurate information regarding
any change of circumstance which might affect eligibility within 30
days of such change;
(3) receive and utilize services as close to the client's
home community as possible, unless program contracts, policies, or
a referral by a program provider requires the use of specific facilities
or specialty centers;
(4) reimburse the program if payments from health insurance
or other benefits are made directly to the client or parent, guardian,
or managing conservator for services or equipment purchased by the
program;
(5) consult with the provider regarding authorization
of service from the program prior to service delivery;
(6) utilize services provided by the program appropriately
including keeping appointments and using supplies and equipment judiciously;
(7) utilize health insurance (following all plan guidelines
and paying required co-payments), other benefits, and assets and to
inform service providers of same;
(8) notify the program of any other benefits, as defined
in §38.2 of this title (relating to Definitions), available to
the client at the time of application or thereafter and any lawsuit(s)
contemplated or filed concerning the cause of the medical condition
for which the program has paid for services; and
(9) bear a portion of the expense of medical or dental
care if deemed financially able by the program. Items of routine daily
living are not covered by the program.
(c) Nondiscrimination. The department operates in compliance
with Title VI, Civil Rights Act of 1964 (Public Law 88-352) and 45
Code of Federal Regulations, Part 80, so that no person will be excluded
from participation in or otherwise subjected to discrimination on
the grounds of race, color, or national origin.
|
| Source Note: The provisions of this §351.5 adopted to be effective July 1, 2001, 26 TexReg 2979; amended to be effective June 1, 2006, 31 TexReg 4200; amended to be effective October 3, 2010, 35 TexReg 8921; amended to be effective April 21, 2013, 38 TexReg 2362; transferred effective March 15, 2022, as published in the February 25, 2022 issue of the Texas Register, 47 TexReg 982 |
