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 259.65 - Development of an Enrollment IPC

Current through Reg. 49, No. 28; July 12, 2024
(a) No later than
					 30 calendar days after the date a DSA notifies an individual's CMA of HHSC's
					 determination that the individual meets the LOC VIII criteria, as described in
					 §259.61(k) of this division (relating to Process for Enrollment of an
					 Individual), the CMA must ensure that the individual's case manager:
(1) convenes a service planning team meeting
					 in person or by videoconferencing in which the service planning team:
(A) reviews the HHSC CLASS/DBMD Nursing
					 Assessment form completed by an RN as described in §259.61(h)(3) of this
					 division;
(B) addresses any
					 information included in Addendum E of the HHSC CLASS/DBMD Nursing Assessment
					 form, Recommendations/Coordination of Care, to ensure the individual's needs
					 are met;
(C) documents on the HHSC
					 CLASS/DBMD Coordination of Care form how the information in Addendum E of the
					 HHSC CLASS/DBMD Nursing Assessment form was addressed;
(D) develops a PAS/HAB plan based on review
					 of the information obtained from assessments conducted and observations made by
					 a DSA as required by §259.61(h)(2) and (3) of this division;
(E) develops a proposed enrollment IPC that:
(i) documents each CLASS Program service and
					 CFC service, other than CFC support management, to be provided to an
					 individual;
(ii) specifies the
					 number of units of each CLASS Program service and CFC service, other than CFC
					 support management, to be provided to an individual;
(iii) for each CLASS Program service:
(I) is within the service limit described in
					 §259.73 of this division (relating to Service Limits);
(II) if an adaptive aid, meets the
					 requirements in Subchapter F, Division 1, of this chapter (relating to Adaptive
					 Aids); and
(III) if a minor home
					 modification, meets the requirements in Subchapter F, Division 2, of this
					 chapter (relating to Minor Home Modifications);
(iv) for CFC ERS, meets the requirements in
					 Subchapter F, Division 3, of this chapter (relating to CFC ERS);
(v) identifies if an individual will receive
					 CFC support management;
(vi)
					 describes any other service or support to be provided to the individual through
					 sources other than CLASS Program services or CFC services;
(vii) if the proposed enrollment IPC includes
					 nursing or CFC PAS/HAB, identifies whether the service is critical to the
					 individual's health and safety, as required by §
														259.89(a)(2) of
					 this subchapter (relating to Service Backup Plans);
(viii) if the individual will receive TAS,
					 the TAS and the monetary amount authorized by HHSC; and
(ix) if the individual chooses to receive
					 services through the CDS option, identifies:
(I) the name of the individual's FMSA; and
(II) the type and estimated units
					 of each CLASS Program service and CFC service provided through the CDS option;
(F) develops
					 an IPP for each CLASS Program service and CFC service listed on the proposed
					 enrollment IPC, other than CFC support management, as required by §259.67
					 of this division (relating to Development of IPPs);
(G) develops an HHSC IPP Addendum form;
(H) if the proposed enrollment IPC
					 identifies nursing or CFC PAS/HAB as critical, develops a service backup plan
					 for the service in accordance with §
													259.89 of this subchapter; and
(I) if transportation as a
					 habilitation activity or as an adaptive aid is included on the proposed
					 enrollment IPC, develops an individual transportation plan; and