| (a) An individual is eligible for DBMD Program services
if:
(1) the individual meets the financial eligibility
criteria as described in Appendix B of the DBMD Program waiver application
approved by CMS and available on the HHSC website;
(2) the individual is determined by HHSC to meet the
LOC VIII criteria described in §261.239 of this title (relating
to ICF/MR Level of Care VIII Criteria);
(3) the individual, as documented on the ID/RC Assessment:
(A) has one or more diagnosed related conditions and,
as a result:
(i) has deafblindness;
(ii) has been determined to have a progressive medical
condition that will result in deafblindness; or
(iii) functions as a person with deafblindness; and
(B) has one or more additional disabilities that result
in impairment to independent functioning;
(4) the individual has an IPC with a cost for DBMD
Program services at or below $114,736.07;
(5) the individual is not enrolled in another waiver
program or receiving a service that may not be received if the individual
is enrolled in the DBMD Program, as identified in the Mutually Exclusive
Services table in Appendix V of the Deaf
Blind with Multiple Disabilities Program Manual;
(6) the individual does not reside in:
(A) an ICF/IID;
(B) a nursing facility;
(C) an ALF, unless it provides licensed assisted living
in the DBMD Program;
(D) a residential child-care facility unless it is
an agency foster home;
(E) a hospital;
(F) a mental health facility;
(G) an inpatient chemical dependency treatment facility;
(H) a residential facility operated by the Texas Workforce
Commission;
(I) a residential facility operated by the Texas Juvenile
Justice Department;
(J) a jail; or
(K) a prison;
(7) at least one program provider is willing to provide
DBMD Program services to the individual;
(8) the individual resides or moves to reside in a
county served by a program provider; and
(9) the individual requires the provision of:
(A) at least one DBMD Program Service per month or
a monthly monitoring by a case manager; and
(B) at least one DBMD Program Service during an IPC
period.
(b) Except as provided in subsection (c) of this section,
an individual is eligible for a CFC service under this chapter if
the individual:
(1) meets the criteria described in subsection (a)
of this section;
(2) requires the provision of the CFC service; and
(3) is not receiving licensed assisted living or licensed
home health assisted living.
(c) To be eligible for a CFC service under this chapter,
an individual receiving MAO Medicaid must, in addition to meeting
the eligibility criteria described in subsection (b) of this section,
receive a DBMD Program service at least monthly, as required by 42
CFR §441.510(d).
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