Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 259 - COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES (CLASS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES › Subchapter B - ELIGIBILITY, ENROLLMENT, AND REVIEW › Division 2 - ENROLLMENT PROCESS, PERSON-CENTERED SERVICE PLANNING, AND REQUIREMENTS FOR HOME AND COMMUNITY-BASED SETTINGS › Section 259.61 - Process for Enrollment of an Individual

Current through Reg. 49, No. 28; July 12, 2024
(a) After HHSC
					 notifies a CMA, as described in §259.55(c) of this division (relating to
					 Written Offer of CLASS Program Services), that an individual selected the CMA,
					 the CMA must assign a case manager to perform the following functions as soon
					 as possible, but no later than 14 calendar days after HHSC's notification:
(1) verify that the individual resides in the
					 catchment area for which the individual's selected CMA and DSA have a
					 contract;
(2) conduct an initial
					 in-person visit in the individual's residence with the individual and LAR or
					 actively involved person at a time convenient to the individual and LAR to:
(A) provide an oral and written explanation
					 of the following to the individual and LAR or actively involved person:
(i) CLASS Program services, including TAS if
					 the individual is receiving institutional services;
(ii) CFC services;
(iii) the mandatory participation
					 requirements of an individual described in §
														259.103 of this chapter (relating
					 to Mandatory Participation Requirements of an Individual);
(iv) the CDS option described in §259.71
					 of this division (relating to CDS Option);
(v) the right to request a fair hearing in
					 accordance with §
														259.101 of this chapter (relating
					 to Individual's Right to a Fair Hearing);
(vi) that the individual, LAR, or actively
					 involved person may report an allegation of abuse, neglect, or exploitation to
					 DFPS by calling the toll-free telephone number at 1-800-252-5400;
(vii) the process by which the individual,
					 LAR, or actively involved person may file a complaint regarding case management
					 as required by 40 TAC §
														49.309(relating to Complaint
					 Process);
(viii) that the HHSC
					 Office of the Ombudsman toll-free telephone number at 1-877-787-8999 may be
					 used to file a complaint regarding the CMA;
(ix) voter registration, if the individual is
					 18 years of age or older;
(x) that,
					 while the individual is staying at a location outside the catchment area in
					 which the individual resides but within the state of Texas for a period of no
					 more than 60 consecutive days, the individual and LAR or actively involved
					 person may request that the DSA provide:
(I)
					 transportation as a habilitation activity, as described in §
															259.5(56)(B)(i)(IX)
					 of this subchapter (relating to Definitions);
(II) out-of-home respite in a camp described
					 in §
															259.361(b)(2)(D)
					 of this chapter (relating to Respite and Dental Treatment);
(III) adaptive aids;
(IV) nursing; and
(V) CFC PAS/HAB;
(xi) the use of electronic visit
					 verification, as required by 1 TAC Chapter 354, Subchapter O; and
(xii) how to contact the individual's case
					 manager; and
(B) use the
					 HHSC Understanding Program Eligibility - CLASS/DBMD form to provide an oral and
					 written explanation to the individual or LAR, and obtain the individual's or
					 LAR's signature and date on the form, to acknowledge understanding of:
(i) the eligibility requirements for:
(I) CLASS Program services, as described in
					 §
															259.51(a) of this
					 subchapter (relating to Eligibility Criteria for CLASS Program Services and CFC
					 Services);
(II) CFC services for
					 individuals who do not receive MAO Medicaid, as described in §
															259.51(b) of this
					 subchapter; and
(III) CFC services
					 for individuals who receive MAO Medicaid, as described in §
															259.51(c) of this
					 subchapter;
(ii) the
					 reasons CLASS Program services and CFC services may be suspended, as described
					 in §
														259.157 of this chapter (relating
					 to Suspension of CLASS Program Services or CFC Services); and
(iii) that CLASS Program services and CFC
					 services may be terminated as described in §§
														259.161,
					 259.163,
					 259.165, and
					 259.167 of this chapter (relating
					 to Termination of CLASS Program Services and CFC Services With Advance Notice
					 for Reasons Other Than Non-compliance with Mandatory Participation
					 Requirements; Termination of CLASS Program Services and CFC Services With
					 Advance Notice Because of Non-compliance With Mandatory Participation
					 Requirements; Termination of CLASS Program Services and CFC Services Without
					 Advance Notice for Reasons Other Than Behavior Causing Immediate Jeopardy; and
					 Termination of CLASS Program Services and CFC Services Without Advance Notice
					 Because of Behavior Causing Immediate Jeopardy); and
(C) educate the individual, LAR, and actively
					 involved person about protecting the individual from abuse, neglect, and
					 exploitation; and
(3)
					 give the individual or LAR the HHSC Waiver Program Verification of Freedom of
					 Choice form to document the individual's or LAR's choice regarding the CLASS
					 Program or the ICF/IID Program.