| (a) An applicant or client may request an appeal of
any decision that denies, reduces, or terminates his benefits. The
effective date of the action depends on the situation, as shown in
the following table.
Attached Graphic
(b) A client is entitled to be notified 10 days before
any reduction or termination of his services, or to have the notification
mailed 12 days before the date of reduction or termination. If a client
threatened his own health or safety or that of others, purchased services
may be terminated without advance notice.
(c) A client is not eligible for CCAD services when:
(1) he dies;
(2) he is admitted to an institution;
(3) his physician requests service termination (Medicaid
services only); or
(4) he requests service termination or repeatedly refuses
to accept help, except in an involuntary protective services case,
or he refuses to comply with his service plan.
(d) The client is not eligible for emergency response
services if:
(1) he abuses the service by activating:
(A) four false alarms which result in a response by
fire department, police/sheriff, or ambulance personnel within a six-month
period; or
(B) 20 false alarms of any kind within a six-month
period;
(2) he is admitted to a skilled institution, personal
care home, foster care setting, or any other setting where 24-hour
supervision is available;
(3) in the caseworker's judgment, he is no longer mentally
alert enough to operate the equipment properly. Situations include,
but are not limited to:
(A) he damages the equipment;
(B) he disconnects the equipment and has received two
warnings that are documented in the case record;
(C) he refuses to participate in the monthly system
checks; or
(4) he is away from the home or is unable to participate
in the service delivery for three consecutive months or more.
(e) The client is not eligible for residential care
if he is required to contribute to the cost of his care, but refuses
to do so.
(f) If the client repeatedly and directly or knowingly
and passively condones the behavior of someone in his home and thus,
refuses (more than three times) to comply with service delivery provisions,
the caseworker may terminate services. Refusal to comply with service
delivery provisions includes actions by the client or someone in the
client's home that prevent determining eligibility, carrying out the
service plan, and monitoring the services. Before services are terminated,
the client is entitled to receive written notification that his services
will be terminated if he does not comply with service delivery provisions
or if he continues to condone someone's behavior that results in
non-compliance with service delivery provisions. Also before services
are terminated, a referral to APS is made if the client is abused,
neglected, or exploited by the person who prevents delivery provisions.
Services continue pending the outcome of the APS investigation. If
an applicant's services were terminated in the past due to his failure
to comply with his service plan, the applicant must agree to cooperate
with DHS staff to facilitate service delivery.
|
| Source Note: The provisions of this §271.155 adopted to be effective February 1, 1989, 13 TexReg 5751; amended to be effective April 15, 1990, 15 TexReg 205; amended to be effective June 1, 1991, 16 TexReg 2053; amended to be effective October 1, 1992, 17 TexReg 6374; amended to be effective November 15, 1992, 17 TexReg 7241; amended to be effective March 15, 1993, 18 TexReg 1170; amended to be effective March 1, 1994, 19 TexReg 272; amended to be effective January 1, 1996, 20 TexReg 9748; transferred effective September 15, 2023, as published in the August 18, 2023, issue of the Texas Register, 48 TexReg 4523 |
