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RULE §9.554Description of the TxHmL Program and CFC

(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 at www.dads.state.tx.us.

  (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 this subchapter.

(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 to individuals:

  (1) CFC PAS/HAB;

  (2) CFC ERS; and

  (3) CFC support management for an individual receiving CFC PAS/HAB.

(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

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