(a) HHSC maintains an interest list that contains the
names of individuals interested in receiving DBMD Program services.
(b) A person may request an applicant's name be added
to the DBMD interest list by:
(1) calling HHSC's toll-free number; or
(2) submitting a written request to HHSC.
(c) If a request is made in accordance with subsection
(b) of this section for an individual who resides in Texas, HHSC adds
the individual's name to the DBMD interest list:
(1) if the individual resides in Texas; and
(2) using the date HHSC receives the request as the
DBMD interest list date.
(d) For an individual determined diagnostically or
functionally ineligible during the enrollment process for the Community
Living Assistance and Support Services (CLASS) Program, Home and Community-based
Services (HCS) Program, Texas Home Living (TxHmL) Program, or Medically
Dependent Children Program (MDCP):
(1) if the individual's name is not on the DBMD interest
list, at the request of the individual or LAR, HHSC adds the individual's
name to the DBMD interest list using the individual's interest list
date for the program for which the individual was determined ineligible
as the DBMD interest list date;
(2) if the individual's name is on the DBMD interest
list and the individual's interest list date for the program for which
the individual was determined ineligible is earlier than the individual's
DBMD interest list date, at the request of the individual or LAR,
HHSC changes the individual's DBMD interest list date to the individual's
interest list date for the program for which the individual was determined
ineligible; or
(3) if the individual's name is on the DBMD interest
list and the individual's DBMD interest list date is earlier than
the individual's interest list date for the program for which the
individual was determined ineligible, HHSC does not change the individual's
DBMD interest list date.
(e) This subsection applies to an individual who was
enrolled in MDCP and, because the individual did not meet the level
of care criteria for medical necessity for nursing facility care or
did not meet the age requirement of being under 21 years of age, was
determined ineligible for MDCP after November 30, 2019.
(1) At the request of the individual or LAR, HHSC adds
the individual's name to the DBMD interest list:
(A) using the MDCP interest list date as the DBMD interest
list date, if the individual's name is not on the DBMD interest list
but it was previously on the DBMD interest list; or
(B) using the date HHSC receives the request as the
DBMD interest list date, if the individual's name is not on the DBMD
interest list and it never has been on the DBMD interest list.
(2) At the request of the individual or LAR, HHSC changes
the DBMD interest list date to the MDCP interest list date if the
individual's MDCP interest list date is earlier than the individual's
DBMD interest list date.
(f) HHSC removes an individual's name from the DBMD
interest list if:
(1) the individual or LAR requests, in writing, that
the individual's name be removed from the DBMD interest list;
(2) the individual moves out of Texas, unless the individual
is a military family member living outside of Texas:
(A) while the military member is on active duty; or
(B) for less than one year after the former military
member's active duty ends;
(3) the individual or LAR declines an offer of enrollment
in the DBMD Program or, as described in §260.55(e) of this subchapter
(relating to Written Offer of Enrollment in the DBMD Program), HHSC
withdraws an offer of enrollment in the DBMD Program, unless the individual
is a military family member living outside of Texas:
(A) while the military member is on active duty; or
(B) for less than one year after the former military
member's active duty ends;
(4) the individual is a military family member living
outside of Texas for more than one year after the former military
member's active duty ends;
(5) the individual is deceased; or
(6) HHSC has denied the individual enrollment in the
DBMD Program and the individual or LAR:
(A) has had an opportunity to exercise the individual's
right to appeal the decision in accordance with §260.111 of this
subchapter (relating to Individual's Right to a Fair Hearing), and
(B) either:
(i) did not appeal the decision; or
(ii) appealed and did not prevail.
(g) If HHSC removes an individual's name from the DBMD
interest list in accordance with subsection (f)(1) - (4) of this section,
HHSC receives an oral or written request from a person to add the
individual's name to the DBMD interest list within 90 calendar days
after the name was removed, and the request is the individual's first
request, HHSC:
(1) adds the individual's name to the DBMD interest
list using the DBMD interest list date that was in effect at the time
the individual's name was removed from the DBMD interest list; and
(2) notifies the individual or LAR, in writing, that
the individual's name has been added to the DBMD interest list in
accordance with paragraph (1) of this subsection.
(h) If HHSC removes an individual's name from the DBMD
interest list in accordance with subsection (f)(1) - (4) of this section,
HHSC receives an oral or written request from a person to add the
individual's name to the DBMD interest list more than 90 calendar
days after the name was removed, and the request is the individual's
first request, HHSC:
(1) adds the individual's name to the DBMD interest
list using as the DBMD interest list date:
(A) the date HHSC receives the oral or written request;
or
(B) because of extenuating circumstances as determined
by HHSC the DBMD interest list date that was in effect at the time
the individual's name was removed from the DBMD interest list; and
(2) notifies the individual or LAR, in writing, that
the individual's name has been added to the DBMD interest list in
accordance with paragraph (1) of this subsection.
(i) If HHSC removes an individual's name from the DBMD
interest list in accordance with subsection (f)(6) of this section,
HHSC receives an oral or written request from a person to add the
individual's name to the DBMD interest list, and the request is not
the individual's first request:
(1) HHSC adds the individual's name to the DBMD interest
list using the date HHSC receives the oral or written request as the
DBMD interest list date; and
(2) HHSC notifies the individual or LAR, in writing,
that the individual's name has been added to the DBMD interest list
in accordance with paragraph (1) of this subsection.
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