Source: http://www.dfps.state.tx.us/handbooks/cps/files/CPS_pg_1600.asp
Timestamp: 2020-01-27 07:41:29
Document Index: 299938719

Matched Legal Cases: ['§700', '§264', '§700', '§700', '§700', '§700', '§700', '§700', '§700', '§700']

1600 Permanency Care Assistance; 1610 Definitions Related to Permanency Care Assistance; 1611 Overview of Permanency Care Assistance; 1612 Eligibility Requirements for Permanency Care Assistance; 1613 Requesting an Extension of Permanency Care Assistance; 1614 Informing Families About Permanency Care Assistance; 1615 Applying for Permanency Care Assistance; 1616 The Regional Role in Determining Eligibility for Permanency Care Assistance; 1618 Negotiating Permanency Care and Deferred Agreements; 1619 Providing Medical Assistance to Recipients of Permanency Care Assistance
For the definitions of terms related to permanency care assistance, see:
DFPS Rules, 40 TAC §700.1027
Services to Kinship Caregivers Resource Guide, under Definitions
Texas Family Code §264.851
Permanency care assistance is provided to persons who assume managing conservatorship of a child who was previously in the temporary or permanent managing conservatorship of DFPS. Assistance is provided as long as all of the eligibility criteria for assistance are met.
The assistance may take the form of:
• Financial assistance – Negotiated monthly payments paid to an eligible caregiver to assist with a child’s needs
• Medical assistance – Provided through Medicaid
• Reimbursement of nonrecurring expenses – Provided for expenses related to obtaining the permanent managing conservatorship of an eligible child.
Permanency care assistance is intended to provide benefits to relatives and fictive kin when the relatives and fictive kin might otherwise be unable to care permanently for children in DFPS’ managing conservatorship. (A fictive kin is someone considered to be a relative, even though he or she may not be related to the child.)
Permanency care assistance is not intended to replace the permanent managing conservator’s legal responsibility to support the child. Families are responsible for using their own resources to help provide for the child’s needs. The family’s resources are considered when determining how much permanency care assistance a family may receive.
To receive permanency care assistance for a child, a prospective permanent managing conservator must meet all of the following eligibility criteria:
1. Become verified as a foster parent
2. Serve as the child’s foster parent for at least six consecutive months before becoming the child’s permanent managing conservator
For a relative or fictive kin to qualify as having served as a verified foster parent to a child for six consecutive months, all of the following conditions must be met. (It is acceptable for the six months to have occurred in the past, and for the relative or fictive kin to have stopped serving as the child’s foster parent after that time, as long as all of the following were met throughout the six months):
• DFPS placed the child with the relative or fictive kin
• DFPS recognized the relative or fictive kin as the child’s verified foster parent
• The relative or fictive kin served as the child’s verified foster parent for six consecutive months
• The relative’s or fictive kin’s signed authorization agreement to serve as the child’s verified foster parent remained in effect throughout the six months
• The child remained in DFPS conservatorship throughout the six months
• The child’s placement in the home was continuous throughout the six months. (Placement is considered continuous when the child lives in the home the entire time, with the exception of short absences that do not to exceed 14 days. If a temporary absence exceeds 14 days, the count of the child’s total time in the placement must start over.)
Also see the Services to Kinship Caregivers Resource Guide, under Definitions.
3. Enter into an agreement for permanency care assistance before the court grants permanent managing conservatorship of the child.
Essential Step: Unlike in adoption assistance, there is no possibility of receiving permanency care assistance if the agreement for assistance is not in place before the child is transferred to permanent managing conservatorship. It is therefore extremely important that any court order that could delay the transfer of conservatorship be brought to the attention of management, if necessary, and possibly appealed.
4. Become the permanent managing conservator of an eligible child after the agreement for permanency care assistance is signed.
The following persons are not eligible to become permanent managing conservators and receive permanency care assistance:
• A person who shares joint managing conservatorship of a child with one or both of the child’s parents.
• The child’s parent or other person from whom the child was removed.
In addition, the prospective permanent managing conservator must apply for permanency care assistance and provide all necessary supporting documentation. See 6685 Applying for Permanency Care Assistance.
A child is eligible to receive permanency care assistance if all of the following eligibility criteria apply to that child:
• The child is in the Temporary or Permanent Managing Conservatorship of DFPS.
• The prospective permanent managing conservator is related to the child by consanguinity or affinity, or has had a longstanding and significant relationship to the child before DFPS placed the child in the home of the prospective conservator.
• At the time the agreement for permanency care assistance is signed, DFPS has determined that reunification and adoption are not appropriate permanency options for the child, in accordance with 6683 Ruling Out Family Reunification and Adoption Before Pursuing Permanency Care Assistance.
• The child has demonstrated a strong attachment to the prospective managing conservator, and the prospective permanent managing conservator has a strong commitment to caring permanently for the child.
• DFPS has consulted with the child about the arrangement for transfer of permanent managing conservatorship to the prospective managing conservator, if the child will be at least 14 years old when the permanency care agreement is signed.
If the prospective permanent managing conservator has previously entered into an agreement for permanency care assistance on behalf of one child, the same caregiver is eligible to receive permanency care assistance on behalf of a sibling of the child, if the following eligibility requirements are met:
• The sibling is placed in the home of the same kinship caregiver;
• The caregiver and DFPS agree on the appropriateness of the arrangement; and
• DFPS has temporary or permanent managing conservatorship of the joining sibling at the time the agreement is signed.
Federal Assistance for Siblings
When siblings are placed together at the same time and one sibling is eligible for Title IV-E assistance, the worker must apply for permanency care assistance on behalf of the Title IV-E eligible child. If neither child is eligible for Title IV-E funding, then the child and his or her joining sibling are eligible for state paid funding.
To determine which sibling is the primary child eligible for Title IV-E funding, the caseworker contacts the eligibility specialist for adoption assistance.
If a child and caregiver are not eligible for permanency care assistance (PCA), a court may not order PCA.
However, a relative or other caregiver for a child in DFPS conservatorship who does not qualify for permanency care assistance may be eligible for benefits under the Relative or Other Designated Caregiver Programs.
DFPS Rules 40 TAC §700.1001
Extended permanency care assistance benefits are available to eligible youth to permit them to remain eligible for permanency care assistance through the month in which they turn 21.
Eligibility Criteria for Extended Benefits
Youth are eligible for extended benefits, if they meet the following criteria:
• The youth’s permanent managing conservator initially enters into a permanency care agreement with DFPS following the youth’s 16th birthday and before to the youth’s 18th birthday: and
• The youth or permanent managing conservator submits documentation sufficient to establish that the youth:
• regularly attends high school (or a program leading toward a high school diploma or high school equivalency certificate); or
• regularly attends an institution of higher education (or a postsecondary vocational or technical program); or
• works at least 80 hours a month; or
• participates in a program or activity that promotes employment or removes barriers to it; or
• is incapable of performing the activities described above because of a documented medical condition. (There is a presumption that a youth is capable of performing the activities. The burden of proof to demonstrate that the youth is incapable is the responsibility of the prospective managing conservator.)
Extended permanency care assistance is not available before October 1, 2010. Youth who turn 18 before that date are categorically excluded from receiving benefits or a fair hearing to appeal the denial of benefits.
Each year, the adoption assistance eligibility specialist verifies that the youth works or attends school. The prospective managing conservator submits documents directly to the adoption assistance eligibility specialist verifying the student’s attendance.
DFPS Rules 40 TAC §§700.1053; 700.1057
When a caregiver is considering becoming the permanent managing conservator of a child, the caseworker:
• makes the caregiver aware of the programs DFPS offers kinship caregivers (including permanency care assistance);
• makes the caregiver aware of the requirements of those programs;
• ensures that the caregiver receives Form 2115 Request for Permanency Care Assistance; and
• informs the caregiver that:
• the caregiver may name a person or multiple persons who may potentially serve as the child’s permanent successor caregiver in the event the caregiver is no longer able to care for the child due to death or incapacity, and
• the named person(s) may continue to receive PCA benefits on behalf of the child if certain criteria are met (see 1624 Permanency Care Assistance Successor).
To apply for permanency care assistance, the caregiver takes the following steps.
Step 1: Caregiver Completes the Required Forms
The child’s primary caseworker helps the caregiver complete:
• Form 2115 Permanency Care Assistance Request (the application for assistance)
• Form 2116 Permanency Care Assistance Worksheet
• Form 2118 Kinship Family Resources
Step 2: Child’s Primary Caseworker Submits the Packet Within Five Days
The child’s primary caseworker:
• completes the electronic PCA application in the IMPACT system; and
• submits the complete packet for permanency care assistance (Form 2115, 2116, and 2117) to the appropriate eligibility specialist no more than five days after completing the application in the IMPACT system.
Step 3: Child’s Primary Caseworker Obtains All Documentation
The child’s primary caseworker ensures that all documentation in the packet is complete and includes the following:
• Proof of the child’s age
For acceptable proof of age, see subsection B of Appendix 1530-F: Categorical Requirements for AFDC Eligibility;
• Proof of the child’s citizenship (or verification of alien status when the child is not a citizen)
For acceptable proof of citizenship or qualified alien status, see 1530 Foster Care Assistance Eligibility Requirements for Children in DFPS Conservatorship.
If the child is not a U.S. citizen, the caseworker must record how the worker arrived at that conclusion (that is, describes the steps taken to determine whether the child is a citizen);
• Form 2115 Permanency Care Assistance Request, Form 2116 Permanency Care Assistance Worksheet, and Form 2118 Kinship Family Resources;
• A copy of the FBI fingerprint-based criminal records checks from the National Crime Information Database, the name-based criminal records checks submitted to DPS through IMPACT, any records checks provided by another state or by local law enforcement, and checks from the Child Abuse and Neglect Registry.
Copies may be requested from the foster and adoption home development (FAD) worker or from the case manager of the private child-placing agency for the caregiver’s home and must reflect that the checks were conducted before the home was verified. If the checks were not conducted before verification, eligibility for the foster care assistance and permanency care assistance must be state-paid, rather than being paid for by Title IV-E funding;
• A copy of the initial court order appointing DFPS as temporary managing conservator of the child
For children who are eligible for assistance under Title IV-E, the court order must contain documentation that the child was removed by court order because continuing to live in the home would be contrary to the child’s welfare;
• The results of a home screening (an approved FAD home screening or a foster home screening conducted by the private child placing agency).
Step 4: Child’s Primary Caseworker Obtains Supervisory Approval of the Packet
The supervisor approves the packet after ensuring that the required documentation is included.
For homes verified by a private child-placing agency, the supervisor must also ensure that Form 2189 Referral to FAD for Non-DFPS Home, is sent to the regional FAD unit at the time the packet is approved. The referral form notifies the FAD unit to create a FAD home in IMPACT for the purpose of applying for permanency care assistance.
Step 5: Primary Caseworker Sends Packet to Eligibility Specialist 30 Days Before Transfer to Managing Conservatorship
In a routine case, the caseworker ensures that the packet is sent to the eligibility specialist for adoption assistance in the appropriate unit a minimum of 30 days before conservatorship of the child is transferred to the caregiver.
Cases That Are Not Routine
When a court order or other circumstance beyond the control of DFPS staff, the caregiver, and other involved the parties necessitates that eligibility for permanency care assistance must be determined in fewer than 30 days, all staff involved in the determination process must expedite the processing of the application and other documentation.
If it is impossible to comply with a court order, conservatorship staff must consult in a staffing with CPS management and the attorney representing DFPS, as appropriate, before transferring managing conservatorship.
Step 6: If the Child Is Preliminarily Eligible, the Primary Caseworker Sends Documentation of the Transfer of Managing Conservatorship to the Eligibility Specialist
See 6685.41 Submitting the Permanent Managing Conservatorship Order.
Eligibility for permanency care assistance is determined in the DFPS regions by designated Eligibility Assistance units that handle eligibility for adoption assistance.
This determination is based on:
• information provided to the eligibility worker by DFPS staff, including the placing worker and the child’s caseworker; and
• data in the DFPS automated systems, such as IMPACT.
The child’s caseworker:
• completes a copy of the appropriate checklist for permanency care assistance;
• includes it in the case record for permanency care assistance; and
• forwards it to the eligibility specialist who will then conduct a review.
To determine a child’s eligibility for permanency care assistance, the worker takes the following steps. See:
1616.23 Step 3: Negotiate a PCA Agreement With a Prospective Managing Conservator
As soon as the eligibility specialist receives the application packet for permanency care assistance from the child’s primary caseworker, the specialist: logs receipt of the packet into the regional share drive for permanency care assistance.
No more than three workdays from the date the packet is received, the specialist reviews the packet to ensure:
• that the packet is complete; and
• that a foster and adoption (FAD) home entry has been made in the IMPACT system for any homes verified by a private child-placing agency.
The specialist then requests any missing or insufficient documentation from the child’s primary caseworker.
A preliminary determination of eligibility is one in which all of the eligibility requirements are met except that:
• the agreement for permanency care assistance has not yet been negotiated and signed; and
• managing conservatorship has not been granted by the courts.
The preliminary determination of eligibility must be made within five working days of receipt of a completed packet, whether the packet is complete initially or the packet is completed after an additional documentation request from the specialist.
To determine whether all of the eligibility requirements are met, the specialist follows 1600 Permanency Care Assistance and the relevant sub-items.
Within two working days of the determination, the specialist notifies the appropriate parties in accordance with Step 2a If the Child Is Determined Preliminarily Eligible or Step 2b If the Child Is Determined Ineligible, in this item, as applicable.
Step 2a: If the Child Is Determined Preliminarily Eligible
Evaluate Eligibility for Title IV-E or State-Paid Permanency Care Assistance
If a family is determined to be preliminarily eligible, the eligibility specialist must determine whether permanency care assistance will paid for with:
• federal Title IV-E funding; or
A child’s eligibility for Title IV-E or state-paid permanency care assistance is based his or her eligibility for funding while in foster care. The eligibility specialist verifies this in the IMPACT system, based on the child’s initial application for foster care assistance and any change in the determination. A copy of this documentation must be included as part of the eligibility file.
A child is eligible for permanency care assistance paid for with Title IV-E funding, if the child was eligible for Title IV-E foster care maintenance payments while living for at least six-consecutive months in the home of the prospective permanent managing conservator who was a verified foster parent during that time.
If the child does not meet the requirements for Title IV-E eligibility, but otherwise satisfies the requirements for PCA eligibility that are explained in 1612 Eligibility Requirements for Permanency Care Assistance, the child’s permanency care assistance is paid for by the state.
Notify Appropriate Parties About the Determination
After determining whether a child who is preliminarily eligible for permanency care assistance is eligible to receive that assistance through federal Title IV-E funding or state funding, the eligibility specialist for adoption assistance completes and sends Form 2117 Notice of Preliminary Eligibility Determination to all of the following:
• The child’s primary caseworker and the supervisors that signed the permanency care assistance packet
• The permanent managing conservator
• The PCA negotiator responsible for negotiating the child’s permanency care assistance benefits
Step 2b: If the Child Is Determined Ineligible
If the child is determined ineligible for permanency care assistance, the eligibility specialist for adoption assistance sends the prospective managing conservator a written and dated notification of denial, Form 2119 Permanency Care Assistance Denial:
• citing each reason for the decision; and
• informing the family of their right to appeal.
Any appeal must be concluded before the child is transferred to managing conservatorship, if the family is to be eligible for any benefits.
DFPS Rules, 40 TAC §700.1057
A copy of the notification is also sent to the child’s worker. The case file must contain documentation showing the date that the denial notice was mailed to the permanent managing conservator.
See 1612.4 When a Child Is Not Eligible for Permanency Care Assistance (State-Paid or Title IV-E Funded).
For children who are ineligible following the preliminary determination, Step 2a is the final step in the Permanency Care Assistance Application process, unless a subsequent fair hearing and appeal result in an order establishing the prospective managing conservator’s eligibility for Permanency Care Assistance benefits. If such an order is issued, benefits are negotiated and activated in accordance with the order.
The PCA negotiator negotiates the amount of permanency care assistance the family will receive, in accordance with 1618 Negotiating Permanency Care and Deferred Agreements.
When negotiation is complete, the PCA negotiator and family complete Form 2121 Permanency Care Agreement. The negotiator then sends the original to the adoption assistance eligibility specialist and provides the family with a copy.
Upon receipt of the notice described in 6685.41 Submitting the Permanent Managing Conservatorship Order, the eligibility specialist records and authorizes all permanency care assistance payments in IMPACT. Once benefits are activated, the specialist also completes and sends Form 2120 Activation of Permanency Care Assistance Notice to the managing conservator and the child’s primary caseworker.
The effective date of the PCA agreement is the date upon which managing conservatorship is awarded to the prospective managing conservator. Benefits should begin in the first month following the effective date of the agreement.
DFPS Rule, 40 TAC §700.1041
The adoption assistance eligibility specialists have the following ongoing responsibilities related to permanency care assistance (PCA):
• Distributing Form 2115 Permanency Care Assistance Request, when requested by the child-placing worker or prospective permanent managing conservator.
• Maintaining information in the IMPACT system when there is a change in the family’s circumstances, as described in 1612 Eligibility Requirements for Permanency Care Assistance.
• Processing the reimbursement of qualified nonrecurring expenses related to obtaining permanent managing conservatorship, as described in 1616.5 Reimbursing Nonrecurring Expenses Covered by Permanency Care Assistance.
• Obtaining certification of continued eligibility, as follows:
• Children under 18 – Every five years (or more often, as needed)
• Youth 18 and older – Annually
See 1621.1 Recertification of Eligibility for Permanency Care Assistance.
• Notifying and requesting that other states or U.S. territories provide Medicaid coverage to Texas recipients of permanency care assistance who live out-of-state.
• Authorizing Medicaid coverage for children from other states who live in Texas but receive permanency care assistance paid for with Title IV-E funding from another state’s public child welfare agency.
• Initiating reimbursement when assistance has been overpaid.
• Authorizing supplemental payments when assistance has been underpaid.
• Maintaining the case in the appropriate eligibility unit, as described in 1616.6 Determining Which Region Maintains a Case Involving Permanency Care Assistance.
• Activating benefits in accordance with any orders issued following a fair hearing.
CPS July 2015
A permanent managing conservator may seek reimbursement of up to $1,200 for nonrecurring expenses for each child covered by a permanency care agreement.
The nonrecurring expenses for which a permanent managing conservator may be reimbursed include only those expenses incurred directly by the conservator, or for which the conservator was required to reimburse a third party, that were reasonable and necessary to complete the legal process of becoming the child’s managing conservator.
The expenses must not be not reimbursable or payable from other sources.
Examples of Expenses That May Be Reimbursed
Costs Associated With Becoming Verified as a Foster Home
• obtaining a home study;
• fire and health inspections;
• costs of CPR/First Aid training;
• fingerprint-based criminal history background checks;
• transportation for training to become a foster home;
• requested furniture and locks;
• pet vaccinations; and
• health/psychological examinations.
Costs Associated With Assuming Managing Conservatorship of the Child
• reasonable costs for transportation; and
• lodging and food for the child or person becoming the permanent managing conservator.
Examples of Expenses That May Not Be Reimbursed
Reimbursement cannot be made for:
• home modifications (adjustments to the physical structure of the home);
• items previously purchased with kinship integration payment or reimbursed with the annually allowed $500 for unverified kinship placements prior to verification; or
• costs of the child’s daily care and supervision that are covered by the foster care maintenance payment made following verification.
To apply for reimbursement, the permanent managing conservator submits receipts (or other proof of payment, such as cancelled checks) to DFPS no more than 18 months after obtaining managing conservatorship of the child.
DFPS Rule, 40 TAC §700.1043
Determine Which Region Is Responsible
The following guidelines are used to determine which region is responsible for maintaining a case that involves permanency care assistance:
the child’s eligibility is confirmed, the permanency care agreement is entered into, and payment has been made to the recipient for nonrecurring adoption expenses …
the region in which the permanent managing conservator lives maintains the case
the child is placed for permanent managing conservatorship out-of-state ...
the region that determined eligibility and entered into the permanency care agreement maintains the case.
the family moves out-of-state ...
the region that last managed the case maintains the case.
DFPS is authorizing only Medicaid to permanency care recipients from another state who live in Texas ...
the region where the family lives maintains the case.
Upon receiving notice of a preliminary determination of eligibility, the benefits negotiator must complete the following steps:
1. Determine the child’s needs by reviewing the records of the child and family, as well as reviewing information on the personal circumstances of both, the results of the home study, and the content of Form 2116 Permanency Care Assistance Worksheet and Form 2118 Kinship Family Resources.
2. Contact the family within two days of receiving the preliminary determination of eligibility to make an appointment to discuss permanency care benefits and to negotiate the permanency care agreement.
3. Discuss permanency care assistance with the family, particularly how to obtain Medicaid benefits in Texas and other states, and discuss potential issues, as explained in 1619 Providing Medical Assistance to Recipients of Permanency Care Assistance.
4. Provide the family with information about the educational requirements described in 1618.4 Explaining Education Requirements When Negotiating for Permanency Care Assistance.
5. Determine the ceiling for monthly payments in accordance with the policy explained in 1618.2 Determining the Payment Ceiling When Negotiating for Permanency Care Assistance and communicate the payment ceiling to the family.
6. Negotiate and execute a permanency care agreement with the family, in accordance with 1618 Negotiating Permanency Care and Deferred Agreements. Negotiators meet face-to-face with the family when possible. Contact may be made in the family’s home or in a DFPS office, whichever is suitable to both parties, or contact may be made by telephone. The Permanency Care Agreement must be negotiated before the child is transferred to managing conservatorship, or eligibility will be permanently lost.
The ceiling for monthly payments is based on the child’s authorized service level at the time that the agreement for permanency care assistance is negotiated.
• $400 per month for the Basic level of care; and
• $545 per month for the Moderate, Specialized, or Intense levels of care.
DFPS Rule, 40 TAC §700.1039
The negotiator for permanency care assistance and the permanent managing conservator must consider the following when discussing and negotiating the amount of permanency care assistance:
• The child’s present and future need for services, assessed in relation to the family’s income, other resources, expenses, and plans for the future.
• The child’s income and benefits, such as Retirement, Survivors, Disability Insurance (RSDI) or benefits provided through the U.S. Department of Veterans Affairs (VA), that are specifically designated for the child and that the child will retain in the permanent conservatorship and that must be applied toward meeting the child’s needs.
• The costs associated with meeting the child’s needs through private sources, only when those needs cannot be met through other publicly funded sources.
• The policies explained in Appendix 1618.3: Permanency Care Assistance Discussion Guide and the Permanency Care Worksheet.
The negotiator for permanency care assistance explains to the prospective managing conservator that DFPS may periodically require proof that a child who has attained the minimum age for compulsory school attendance is a full-time elementary or secondary student.
The term full-time elementary or secondary student means a child who:
• is enrolled in, or is in the process of enrolling in, an institution that provides elementary or secondary education, in accordance with Texas law or the law of the state in which the child lives;
• is instructed in elementary or secondary education at home, in accordance with Texas law or the law of the state in which the child lives;
• is enrolled in, or is in the process of enrolling in, a program of independent study at the elementary or secondary school level, administered by a school or school district, in accordance with Texas law or the law of the state in which the child lives; or
• is incapable of attending school on a full-time basis due to a medical condition, and the incapability is supported by regularly updated information.
DFPS Rule, 40 TAC §700.1049(d)
A deferred agreement for permanency care assistance (PCA) is a written agreement between the prospective permanent managing conservator and DFPS to negotiate permanency care assistance at a future date, if the need arises.
Deferred agreements are used when:
• the child and the prospective managing conservator meet the eligibility requirements for permanency care assistance at the time that the court awards permanent managing conservatorship, including meeting the requirement of signing the PCA agreement before transferring the child to managing conservatorship;
• the prospective managing conservator is able to meet the child’s current needs; and
• the negotiator anticipates that the prospective managing conservator will need assistance meeting the child’s needs in the future.
Under the terms of a deferred agreement
• the family and child’s eligibility for permanency care assistance is already established; and
• if the family and child require assistance in the future, the family and DFPS negotiate at that time for specific benefits, including Medicaid, monthly financial assistance, or both.
The existence of a deferred agreement eliminates the need for a fair hearing in the event that a need arises for permanency care assistance.
DFPS Rule, 40 TAC §700.1045
The medical care for a child who receives permanency care assistance in Texas is covered under the Texas Medicaid program.
Texas Medicaid assists with the child’s:
• eye care;
• durable medical equipment and supplies;
• psychiatric and behavioral health care; and
• medical transportation.
When a child is eligible for permanency care assistance that is paid for with Title IV-E funding and the child lives outside of Texas, his or her state of residence is responsible for providing medical assistance.
It may be more difficult to obtain medical coverage outside of Texas for a child in DFPS conservatorship who lives outside of Texas, if the child is eligible only for state-paid permanency care assistance. The child will continue to be covered through the Texas Medicaid program, but unless the child independently qualifies for the other state’s Medicaid program, the managing conservator will generally be able to access benefits only if he or she can find a Texas Medicaid provider.