|(a) The TxHmL Program is a Medicaid waiver program
approved by CMS pursuant to §1915(c) of the Social Security Act.
It provides community-based services and supports to eligible individuals
who live in their own homes or in their family homes. The TxHmL Program
is operated by DADS under the authority of HHSC.
(b) DADS has grouped the counties of the state of Texas
into geographical areas, referred to as "local service areas," each
of which is served by a LIDDA. DADS has further grouped the local
service areas into "waiver contract areas." A list of the counties
included in each local service area and waiver contract area is available
(1) A program provider may provide TxHmL Program services
and CFC services only to persons residing in the counties specified
in its contract.
(2) A program provider must have a separate contract
for each waiver contract area served by the program provider.
(3) A program provider may have a contract to serve
one or more local service areas within a waiver contract area, but
the program provider must serve all of the counties within each local
service area covered by the contract.
(4) A program provider may not have more than one contract
per waiver contract area.
(c) A LIDDA must provide service coordination to an
individual who is enrolled in the TxHmL Program in accordance with
(d) TxHmL Program services, as described in §9.555
of this subchapter (relating to Description of TxHmL Program Services),
are selected by the service planning team for inclusion in an applicant's
or individual's IPC to:
(1) ensure the applicant's or individual's health and
welfare in the community;
(2) supplement rather than replace the applicant's
or individual's natural supports and other non-TxHmL Program sources
for which the applicant or individual may be eligible; and
(3) prevent the applicant's or individual's admission
to institutional services.
(e) A program provider may only provide and bill for
community support if the activity provided is transportation as described
in §9.555(a)(1)(B) of this subchapter (relating to Description
of TxHmL Program Services).
(f) CFC is a state plan option governed by Code of
Federal Regulations, Title 42, Chapter 441, Subchapter K, regarding
Home and Community-Based Attendant Services and Supports State Plan
Option (Community First Choice) that provides the following services
(1) CFC PAS/HAB;
(2) CFC ERS; and
(3) CFC support management for an individual receiving
(g) The CDS option is a service delivery option, as
described in Chapter 41 of this title (relating to Consumer Directed
Services Option), in which an individual or LAR employs and retains
service providers and directs the delivery of a service through the
CDS option, as described in §41.108 of this title (relating to
Services Available Through the CDS Option).
(h) A program provider must comply with all applicable
state and federal laws, rules, and regulations, including Chapter
49 of this title (relating to Contracting for Community Services).
|Source Note: The provisions of this §9.554 adopted to be effective January 5, 2003, 27 TexReg 12254; amended to be effective March 11, 2004, 29 TexReg 2317; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective March 1, 2007, 32 TexReg 544; amended to be effective June 1, 2008, 33 TexReg 4340; amended to be effective September 1, 2014, 39 TexReg 6549; amended to be effective November 15, 2015, 40 TexReg 7827; amended to be effective March 20, 2016, 41 TexReg 1867