| (a) A parent who is required to complete a Family Service
Plan may obtain services from a qualified or licensed noncontracted
service provider, and this provider may be reimbursed by DFPS in an
amount equal to the average cost for the specific service from DFPS
contractors providing the service in the region where the parent resides.
Only services where the parent is the direct client of the service
provider are eligible for reimbursement. In addition, the rules relating
to the reimbursement of noncontracted service providers are intended
to further supplement and clarify Texas Family Code §263.1021.
This rule is operable to the extent that DFPS has existing resources
to implement Texas Family Code §263.1021.
(b) Definitions:
(1) Case Plan: a Case Plan, as defined by 42 U.S.C.
675, is a written document which meets the requirements 42 U.S.C.
675a. Texas has divided the federal requirement of a Case Plan into
two separate plans, the Family Service Plan as defined in Texas Family
Code §263.101 and the Child's Plan of Service as defined in Texas
Family Code §264.128. For the purpose of this Rule, a Child's
Plan (also referred to as a Child's Plan of Service) is not a Family
Service Plan.
(2) Family Service Plan (also referred to as a "Family
Plan of Service," "Family Plan" or "Individual Family Service Plan")
is a written plan in which DFPS and a child's parents identify the
actions, specific skills, knowledge, steps, and/or responsibilities
that are necessary for the parents to achieve the Family Service Plan's
goal during this Plan's service period and the assistance to be provided
to the parents by the DFPS or other agency toward meeting that goal.
(3) Single Source Continuum Contract/Contractor (SSCC)
is an entity, as described in Texas Family Code §264.154, with
whom DFPS enters into a contract for the provision of the full continuum
of substitute care, case management, and reunification services in
a Designated Community Area.
(4) Licensed Provider is an individual who is required
by the State of Texas to be licensed to provide the professional service
that the parent is receiving and DFPS is reimbursing.
(5) Qualified Provider is an individual who has completed
certification or other training programs and has two (2) years of
verified full-time experience in the professional service in which
they are providing to the parent and DFPS is reimbursing.
(6) Noncontracted Service Provider is one who is not
under a current contract with DFPS or SSCC for the service that they
are seeking reimbursement for. They also cannot be an employee of
DFPS or SSCC.
(c) SSCCs must adopt similar requirements relating
to the manner in which noncontracted service providers are reimbursed
that do not conflict with this Section.
(d) Only the noncontracted service provider may seek
reimbursement from DFPS for services and must not have already been
paid by the parent or a third party.
(e) To be reimbursed, services may be provided in-person
or through an electronic communication platform.
(f) DFPS cannot use state funds to reimburse a noncontracted
service provider for Medicaid services to a parent who is a Medicaid
beneficiary, as described in Texas Human Resources Code Chapter 32.
If the parent has Texas Medicaid, the noncontracted service provider
must bill Medicaid and not seek reimbursement through DFPS.
(g) All the following requirements/conditions must
be met in order for a noncontracted service provider to be reimbursed:
(1) Must be qualified or licensed provider and comply
with the DFPS's guidelines and requirements for reimbursement pursuant
to Texas Family Code §263.1021.
(2) If a license is required, the service provider
must maintain licensure and the license must remain in good standing
while providing services that they are seeking reimbursement for.
(3) Services obtained from a service provider selected
must be designed to achieve the stated goals of the Family Plan of
Service for a child in DFPS conservatorship and the noncontracted
service provider must certify whether the parent has satisfactorily
completed the required service that is being sought for reimbursement.
(4) DFPS cannot reimburse for services that occur after
DFPS is dismissed from the case, or the parental rights have been
terminated (earlier of two). If a Family Service Plan is reinstated,
then the service provider would have to seek reimbursement though
a new claim under the reinstated Family Service Plan.
(5) The noncontracted service provider must be able
to receive reimbursement from state or federal funds and not be debarred
from receiving these funds.
(6) The noncontracted service provider cannot have
had a prior DFPS contract to provide the specific service that they
are seeking reimbursement for which DFPS terminated for cause.
(7) The noncontracted service provider cannot be related
by consanguinity or affinity to the parent receiving services.
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