reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.309 - Financial Management Services, CFC Support Management, and Vendor Fiscal/Employer Agent Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(a) An FMSA
				  must provide FMS to an employer or DR. FMS consists of the following
				  activities:
(1) providing an initial
				  orientation as described in §
											41.307
				  of this chapter (relating to Initial Orientation of an Employer);
(2) after the initial orientation, doing the
				  following annually:
(A) providing to the
				  employer and DR a printed or an electronic document that contains an
				  explanation of how to report allegations of abuse, neglect, and exploitation of
				  the individual to DFPS as described in §
												41.701(a)(1)(A)
				  or (B) of this chapter (relating to Reporting
				  Allegations of Abuse, Neglect, or Exploitation of an Individual); and
(B) educating the employer and DR about
				  protecting the individual from abuse, neglect, and exploitation;
(3) providing ongoing training,
				  assistance, and support for employer-related responsibilities;
(4) assisting an employer to verify
				  qualifications of service providers before services are delivered, including
				  citizenship status;
(5) monitoring
				  continued eligibility of service providers;
(6) approving and monitoring budgets for
				  services delivered through the CDS option;
(7) collecting and processing service
				  provider timesheets or invoices approved by the employer;
(8) processing payroll, including calculating
				  employee withholdings and employer contributions and depositing these funds
				  with applicable federal, state, and local agencies;
(9) complying with applicable government
				  regulations concerning employee withholdings, garnishments, mandated
				  withholdings, and benefits;
(10)
				  preparing and filing required tax forms and reports;
(11) paying allowable expenses incurred by
				  the employer;
(12) providing status
				  reports concerning the individual's budget, expenditures, and compliance with
				  CDS option requirements; and
(13)
				  responding to the employer or DR as soon as possible, but at least within two
				  working days after receipt of information requiring a response from the FMSA,
				  unless indicated otherwise in this chapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.311 - Employer Support Services and Support Consultation Services

Current through Reg. 49, No. 28; July 12, 2024
If requested, a CDSA must assist an employer or DR to plan,
					 budget, and purchase allowable employer support services and goods for:
(1) employer-related activities;
(2) employment-related activities;
				  and
(3) support
				  consultation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.313 - Individual Service Planning Process

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  FMSA may participate as a member of an individual's service planning team when
				  requested by the individual or LAR and agreed to by the FMSA.
(b) Within three working days after receiving
				  a request from an employer, DR, case manager, service coordinator, or HHSC, the
				  FMSA must provide information related to an individual's participation in the
				  CDS option.
(c) The FMSA must
				  document and notify a case manager or service coordinator of issues or concerns
				  related to an individual's participation in the CDS option, including:
(1) allegations of fraud;
(2) concerns about the individual's health,
				  safety, or welfare;
(3)
				  non-delivery or extended breaks in services;
(4) noncompliance with employer
				  responsibilities;
(5) noncompliance
				  with service back-up plans; or
(6)
				  over or under utilization of services or funds allocated in the individual's
				  service plan for delivery of services to the individual through the CDS option
				  and in accordance with the requirements of the individual's program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.315 - Service Back-up Plan

Current through Reg. 49, No. 28; July 12, 2024
A CDSA must:
(1)
				  assist an employer as requested to revise budgets to meet service back-up plan
				  strategies approved by the individual's service planning team;
(2) review, validate, and approve revised
				  budgets in accordance with §
										41.511
				  of this chapter (relating to Budget Revisions and Approval);
(3) reimburse documented, budgeted, allowable
				  expenses incurred related to implementing service back-up plan strategies;
				  and
(4) retain a copy of service
				  back-up plans received from the employer.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.317 - CDSA Reports

Current through Reg. 49, No. 28; July 12, 2024
A CDSA must:
(1)
				  compile a report in accordance with the format provided by DADS addressing each
				  service delivered through the CDS option, including the actual number of hours
				  or units of service delivered;
(2)
				  provide the report no less than quarterly, and monthly if requested, to:
(A) the employer or DR; and
(B) the case manager or service coordinator;
				  and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.319 - Corrective Action Plans

Current through Reg. 49, No. 28; July 12, 2024
(a) A CDSA may
				  require that the employer or DR develop a written corrective action plan
				  related to employer responsibilities, such as:
(1) an ineligible service provider is hired
				  or retained for service delivery;
(2) documentation of service delivery is
				  incomplete, inaccurate, or late;
(3) the budget has not been
				  followed;
(4) the rules in this
				  chapter have not been followed; or
(5) other employer responsibilities are not
				  followed.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.321 - Liability Acknowledgment and Workers' Compensation

Current through Reg. 49, No. 28; July 12, 2024
(a) A CDSA must verify that an applicant for
				  employment has completed, signed, and dated Form 1728, Liability
				  Acknowledgment, before approving the applicant for hire by the
				  employer.
(b) A CDSA must assist an
				  employer if requested to obtain coverage for employee work-related injuries,
				  including:
(1) workers' compensation through
				  the Texas Department of Insurance, Division of Workers Compensation;
				  or
(2) other options listed on Form
				  1728.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.323 - Criminal History Check of an Applicant for Employment and to be an Employee

Current through Reg. 49, No. 28; July 12, 2024
(a) The FMSA must
				  ensure that the employer or DR signs the Criminal History and Registry Checks
				  form (Form 1725) acknowledging that criminal history reports are confidential
				  and must not be shared, released, or otherwise disclosed, under penalty of
				  law.
(b) The FMSA must, using the
				  applicant information provided by the employer on the Criminal History and
				  Registry Checks Form (Form 1725):
(1) obtain
				  the criminal history record information directly from the Texas Department of
				  Public Safety's (DPS) secure online criminal history website within two working
				  days after the CDS employer or DR requests the information; and
(2) if requested by the CDS employer or DR,
				  using a DPS-approved secure method, send the original printed document of the
				  criminal history record information to the employer within two working days
				  after receiving the request.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.325 - Required Registry Checks of an Applicant to be an Employee

Current through Reg. 49, No. 28; July 12, 2024
(a) For each applicant for delivery of
				  services through the CDS option as an employee, an FMSA must:
(1) check DADS' Nurse Aide Registry and
				  Employee Misconduct Registry not more than 30 calendar days prior to the hire
				  date;
(2) document and maintain the
				  results of each applicant registry check on Form 1725, Criminal Conviction
				  History and Registry Check; and
(3)
				  provide a copy of completed Form 1725 for each applicant to the
				  employer.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.327 - Verification of Applicants for Employees, Contractors, and Vendors

Current through Reg. 49, No. 28; July 12, 2024
(a) For each applicant for delivery of
				  services through the CDS option as an employee, contractor, or vendor, the FMSA
				  must:
(1) obtain and review documentation
				  from the employer, DR, or applicant that is required to verify each required
				  qualification of the applicant;
(2)
				  notify the employer or DR of required documentation not received;
(3) notify the employer or DR using the
				  Verification of Applicant Form (DADS Form 1729) within three working days after
				  receipt of all required documentation that the applicant is or is not qualified
				  to be hired or retained for delivery of the specific service or services;
				  and
(4) retain documentation on
				  file if the applicant is hired or retained by the employer or DR for service
				  delivery.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.329 - Continued Eligibility of an Employee, Contractor, or Vendor

Current through Reg. 49, No. 28; July 12, 2024
(a) For each employee, contractor, or vendor,
				  an FMSA must:
(1) obtain from the employer,
				  DR, or service provider a copy of a renewed license or certificate, if required
				  by the individual's program, within 30 calendar days after the expiration date
				  of the current document on file required to maintain qualifications;
(2) notify the employer or DR to send
				  required documentation to the FMSA, if not received within the 30
				  days;
(3) notify the employer or DR
				  in writing within three working days after receipt of all required
				  documentation if the service provider is not qualified to continue service
				  delivery; and
(4) retain the
				  documentation on file.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.331 - Evaluation of Job Performance and Satisfaction

Current through Reg. 49, No. 28; July 12, 2024
(a) If required by the individual's program,
				  and the CDSA has not received a copy of a completed program-required evaluation
				  from the employer or DR within 20 calendar days after the due date, the CDSA
				  must notify the employer or DR in writing that a copy must be provided to the
				  CDSA within 14 calendar days after receipt of the notice.
(b) The CDSA must provide the DADS
				  satisfaction survey of CDSA services to the employer or DR for each individual
				  enrolled with the CDSA:
(1)
				  annually;
(2) upon transfer to
				  another CDSA; and
(3) upon
				  termination from the CDS option.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.333 - Service Agreements

Current through Reg. 49, No. 28; July 12, 2024
(a) After initial
				  orientation of the employer by the CDSA and before additional FMS may be
				  provided by the CDSA, the CDSA must receive from the employer a completed copy
				  of Form 1735, Service Agreement between the Employer and the Consumer Directed
				  Services Agency, and required attachments.
(b) Before the CDSA pays an eligible service
				  provider, the CDSA must obtain a completed original of the DADS provided
				  Service Acknowledgment Between a Service Provider and the Consumer Directed
				  Services Agency, and required attachments, for:
(1) each employee of the employer;
(2) each contractor retained by the employer;
				  and
(3) each vendor retained by the
				  employer, if required in instructions for completion of the DADS Service
				  Acknowledgment Between a Service Provider and the Consumer Directed Services
				  Agency.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.335 - Documentation of Services Delivered

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  CDSA must verify that the service provider:
(1) documents each element required by the
				  individual's program;
(2) documents
				  service dates within the same calendar month; and
(3) unless using an EVV system as required by
				  Chapter 68 of this title (relating to Electronic Visit Verification (EVV)
				  System), has a dated signature of the employer or DR on all documentation of
				  services delivered.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.337 - Payment of Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A CDSA must
				  make payments in accordance with posted pay dates and required time frames
				  unless delay is documented by the CDSA as being caused by an employer, DR, or
				  service provider.
(b) A CDSA
				  approves and pays for purchases through the CDS option only if:
(1) documentation provided is in accordance
				  with §
											41.239
				  of this chapter (relating to Documentation of Services Delivered) and §
											41.335
				  of this chapter (relating to Documentation of Services Delivered);
				  and
(2) services, goods, or items
				  documented are included in the approved budget before purchase.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS) › Section 264.339 - Records

Current through Reg. 49, No. 28; July 12, 2024
(a) An FMSA must maintain records to support
				  claims submitted to HHSC and payments received from HHSC.
(b) An FMSA must, in accordance with
				  generally accepted accounting principles and HHSC requirements, document and
				  maintain financial records, including:
(1)
				  deposit slips, bank statements, cancelled checks, and receipts;
(2) purchase orders;
(3) invoices;
(4) journals and ledgers;
(5) time sheets, payroll, and tax
				  records;
(6) records, forms, and
				  reports required by the Internal Revenue Service, the Texas Workforce
				  Commission, and other applicable government agencies;
(7) insurance coverage related to staff
				  persons, including claims and payments;
(8) equipment inventory records;
(9) the FMSA's internal accounting
				  procedures; and
(10) chart of
				  accounts.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter D - ENROLLMENT, TRANSFER, SUSPENSION, AND TERMINATION › Section 264.401 - Enrollment Process

Current through Reg. 49, No. 28; July 12, 2024
The enrollment process is conducted in accordance with
					 §
										41.109
					 of this chapter (relating to Enrollment in the CDS Option). Within five working
					 days after receipt of a completed Form 1584, Consumer Participation Choice, by
					 an eligible individual or LAR, or upon receipt of Form 1584 and within five
					 working days after eligibility determination for an applicant applying for
					 program services, a case manager or service coordinator must provide the
					 following documentation to the CDSA:
(1) Form 1584;
(2) the individual's authorized service
				  plan;
(3) the individual's plan of
				  care; and
(4) if not provided in
				  paragraph (1) - (3) of this section:
(A) the
				  date the employer may begin incurring expenses to initiate start-up activities
				  and to incur recruitment and hiring expenses;
(B) the date the employer may begin delivery
				  of program services through the employer's service providers;
(C) the number of units, the approved rate,
				  or the amount authorized in the individual's service plan for each service to
				  be delivered through the CDS option;
(D) the total funds authorized for each
				  program service to be delivered through the CDS option; and
(E) the authorized schedule of service
				  delivery per day, week, month, or other time frame specific to the
				  service.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter D - ENROLLMENT, TRANSFER, SUSPENSION, AND TERMINATION › Section 264.403 - Transfer Process

Current through Reg. 49, No. 28; July 12, 2024
(a) An individual's
				  CDSA must process a request by the individual or LAR to transfer from one CDSA
				  to another CDSA in accordance with transfer procedures and requirements of the
				  individual's program.
(b) The
				  transferring CDSA must, within five working days after receipt of a request to
				  transfer:
(1) account in writing for the
				  funds allocated in the individual's service plan or plan of care and budgets
				  and:
(A) bill DADS for funds in the
				  individual's budget that the CDSA must pay on behalf of the employer;
(B) make payments within required time
				  frames;
(C) submit billing
				  adjustments for prior claims and payments from DADS that will not be paid, or
				  deposited by the CDSA for accrued funds, for:
(i) deposits, withholdings, and employee and
				  employer contributions; and
(ii) a
				  pending payment that will transfer to the receiving CDSA;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter D - ENROLLMENT, TRANSFER, SUSPENSION, AND TERMINATION › Section 264.404 - Ensuring Development, Approval, and Review of Service Backup Plans

Current through Reg. 49, No. 28; July 12, 2024
(a) A service planning team must determine if
				  a service the individual is receiving through the CDS option is critical to the
				  individual's health and safety.
(b)
				  The case manager or service coordinator must request and ensure that the
				  employer or DR develop a service backup plan, using DADS Form 1740, CDS Service
				  Backup Plan, if:
(1) a service backup plan is
				  required by the rules of the individual's program; or
(2) the service planning team determines that
				  a service is critical to the health and safety of the individual in accordance
				  with subsection (a) of this section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter D - ENROLLMENT, TRANSFER, SUSPENSION, AND TERMINATION › Section 264.405 - Suspension of Participation in the CDS Option

Current through Reg. 49, No. 28; July 12, 2024
(a) An employer may request voluntary
				  suspension of participation in the CDS option and request that all program
				  services be delivered through a program provider at any time.
(b) The suspension must last at least 90
				  calendar days.
(c) The employer
				  must notify the individual's case manager or service coordinator of intent to
				  reactivate participation in the CDS option.
(d) A CDSA must monitor an individual's
				  program eligibility and notify the individual's case manager or service
				  coordinator of a lapse of program eligibility.
(e) The case manager or service coordinator
				  must notify the individual's service planning team of the individual's loss of
				  eligibility to determine if suspension of participation in the CDS option is
				  recommended. If participation in the CDS option is suspended, the case manager
				  or service coordinator must give notice to the individual or LAR in accordance
				  with the requirements of the individual's program.
(f) If participation in the CDS option is
				  suspended, FMS and, if applicable, support consultation, are suspended in the
				  individual's service plan.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter D - ENROLLMENT, TRANSFER, SUSPENSION, AND TERMINATION › Section 264.407 - Termination of Participation in the CDS Option

Current through Reg. 49, No. 28; July 12, 2024
(a) An employer may request voluntary
				  termination of participation in the CDS option and receive services through a
				  program agency provider at any time. The termination must last at least 90
				  calendar days.
(b) An individual
				  may be involuntarily terminated from participation in the CDS option in
				  accordance with the requirements of the individual's program.
(c) FMS and, if applicable, support
				  consultation, are terminated in the individual's service plan when
				  participation in the CDS option is terminated.
(d) An individual's case manager or service
				  coordinator convenes the individual's service planning team concerning issues
				  that may warrant immediate termination of the individual's participation in the
				  CDS option. On review of the information, the service planning team may
				  recommend immediate termination of participation in the CDS option when:
(1) the individual's health or welfare is
				  immediately jeopardized by the individual's participation in the CDS
				  option;
(2) the DR has been
				  convicted of an offense under Chapter 32 of the Penal Code or an offense
				  barring employment as listed in the Texas Health and Safety Code, §
											250.006(a) and
				  (b); or
(3) DADS or another government agency with
				  applicable regulatory authority recommends that participation in the CDS option
				  be immediately terminated.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter D - ENROLLMENT, TRANSFER, SUSPENSION, AND TERMINATION › Section 264.409 - Re-enrollment for Participation in the CDS Option

Current through Reg. 49, No. 28; July 12, 2024
(a) Following suspension or termination of
				  participation in the CDS option, an individual or LAR must request
				  re-enrollment in the CDS option by notifying the individual's case manager or
				  service coordinator.
(b) If an
				  individual or LAR wishes to re-enroll in the CDS option, the case manager or
				  service coordinator must:
(1) review the
				  reason that the individual was suspended or terminated from the CDS
				  option;
(2) verify that the
				  individual has fulfilled the minimum 90-day period and any conditions specified
				  by the individual's service planning team or a hearing officer, if
				  applicable;
(3) verify how each
				  issue that contributed to the suspension or termination has been resolved;
				  and
(4) refer the request for
				  re-enrollment in the CDS option to the individual's service planning team and
				  follow requirements of the individual's program, including:
(A) revising the individual's service plan
				  and re-enrolling the individual in the CDS option upon approval; and
(B) issuing a denial and providing
				  information related to requesting a fair hearing if the request is not
				  approved.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter E - BUDGETS › Section 264.501 - Budget Development

Current through Reg. 49, No. 28; July 12, 2024
(a) The employer or
				  DR, with assistance obtained from the CDSA or others, must:
(1) develop a budget for each program service
				  to be delivered through the CDS option;
(2) project expenditures of funds allocated
				  in the individual's authorized service plan for the effective period of the
				  service plan;
(3) use applicable
				  budget workbooks available through DADS at
www.dads.state.tx.us/business/communitycare/cds/CDSforms.html
;
(4) request assistance from the CDSA as
				  needed;
(5) submit each budget to
				  the CDSA for review; and
(6) obtain
				  written approval for each budget from the CDSA before initiating services or
				  making purchases for payment.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter E - BUDGETS › Section 264.503 - Financial Management Services

Current through Reg. 49, No. 28; July 12, 2024
An employer or DR must budget the amount established by the
					 Health and Human Services Commission for payment of FMS delivered by the CDSA
					 for each program service to be delivered through the CDS
					 option.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter E - BUDGETS › Section 264.505 - Payroll Budgeting

Current through Reg. 49, No. 28; July 12, 2024
(a) An employer or
				  DR must, when developing a budget that includes payroll expenses for an
				  employee:
(1) budget to pay an employee who
				  is a "personal attendant," as defined in 1 TAC § 355.7051(a) (relating to
				  Base Wage for a Personal Attendant), at least the base wage specified in 1 TAC
				  § 355.7051(c), (d)(2), or (f).
(2) budget employee benefits, if chosen by
				  the employer or DR:
(A) as provided in:
(i) this chapter;
(ii) Section 1000, Wages and Benefits Plan,
				  of the
Consumer Directed Services Handbook
available at
http://www.dads.state.tx.us/handbooks/CDS/1000/index.htm
;
				  or
(iii) Appendix XI, Allowable and
				  Non-Allowable Expenditures, in the
Consumer Directed Services
				  Handbook
available at
http://www.dads.state.tx.us/handbooks/CDS/appendix/XI/index.htm
;
(B) that are in accordance with
				  requirements of the individual's program:
(i)
				  an allowable cost, as defined in §
													41.103 of
				  this chapter (relating to Definitions);
(ii) reasonable, with regard to the cost of
				  the service, good, or item; and
(iii) necessary to meet employer
				  responsibilities;
(C)
				  that are within the approved rate and spending limits established for the
				  service;
(D) that are accrued and
				  paid based on actual hours worked; and
(E) that may include any of the following:
(i) increased wages;
(ii) paid vacation;
(iii) paid holiday;
(iv) paid sick leave;
(v) medical insurance;
(vi) taxable work-related expenses;
(vii) coverage of work-related injuries or
				  illnesses for employees, including workers' compensation or options listed in
				  "Liability Notice to Applicants for Employment," Section II, of Form 1728,
				  Liability Acknowledgment;
(viii) a
				  hire-on bonus, paid when an employee is hired, and the amount budgeted for the
				  bonus must be accrued from hours worked by the person within the first three
				  months of employment;
(ix) a bonus,
				  based on the employee's job performance, that is budgeted and accrued from
				  hours worked as a portion of the budget unit rate from hours worked by the
				  employee, not to extend beyond the end date of the individual's service
				  plan;
(x) a bonus, based on the
				  employee's length of employment, with the employer, if budgeted and accrued as
				  a portion of the budget unit rate from hours worked by the employee, not to
				  extend beyond the end date of the individual's service plan; and
(xi) employer contributions for employee
				  benefits;
(3)
				  make budget revisions if necessary to compensate for payment of overtime pay
				  that must be calculated and paid in accordance with current state and federal
				  labor laws and regulations.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter E - BUDGETS › Section 264.507 - Employer Support Services Budgeting

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  An employer or DR may budget employer support services and start-up expenses,
				  through the services that are delivered by one or more employees in the CDS
				  option.
(1) Employer support services:
(A) include:
(i) employment-related expenses, as described
				  in subsection (d) of this section;
(ii) employer-related expenses, as described
				  in subsection (e) of this section; and
(iii) support consultation services, as
				  described in subsection (f) of this section when available in the individual's
				  program; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter E - BUDGETS › Section 264.509 - Budget Approval

Current through Reg. 49, No. 28; July 12, 2024
(a) An employer or
				  DR must, for each initial and annual budget:
(1) request assistance from the CDSA as
				  needed;
(2) complete and modify
				  budgets as directed by the CDSA; and
(3) receive written approval from the CDSA
				  before implementation of the budget and initiation of service delivery through
				  the CDS option.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter E - BUDGETS › Section 264.511 - Budget Revisions and Approval

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  employer or DR must make budget revisions if:
(1) a change to the individual's authorized
				  service plan affects funding for a program service delivered through the CDS
				  option;
(2) a budget has been or
				  will be exceeded before the end date of the service plan;
(3) authorized units, unit rate, or amount of
				  funds allocated have changed;
(4)
				  an amount paid for one or more services, goods, or items affects the approved
				  budget;
(5) strategies are added or
				  revisions are made to a service back-up plan;
(6) funds budgeted for a service back-up plan
				  are not used or needed; or
(7) the
				  CDSA, the case manager or service coordinator, the individual's service
				  planning team, or a DADS representative require a revision.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter F - SUPPORT CONSULTATION SERVICES AND SUPPORT ADVISORY RESPONSIBILITIES › Section 264.601 - Support Consultation Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Support consultation, if available through the individual's program, is an
				  optional service available to an individual participating in the CDS option.
				  Support consultation is delivered to:
(1) an
				  employer;
(2) an employer's DR;
				  or
(3) an individual receiving
				  services through the CDS option if that individual will be the employer within
				  six months of the initiation of support consultation services to the
				  individual.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter F - SUPPORT CONSULTATION SERVICES AND SUPPORT ADVISORY RESPONSIBILITIES › Section 264.603 - Support Advisor Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  person must meet the following qualifications to be eligible to deliver support
				  consultation as a support advisor:
(1) be:
(A) at least 18 years old;
(B) a high school graduate or posses
				  certification of equivalency; and
(C) a person who does not provide a program
				  service to the individual, other than support consultation and FMS through the
				  CDS option;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter F - SUPPORT CONSULTATION SERVICES AND SUPPORT ADVISORY RESPONSIBILITIES › Section 264.605 - Support Advisor Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  support advisor must provide practical skills training in accordance with the
				  individual's service plan, including:
(1)
				  principles of self-determination;
(2) compliance requirements of the
				  individual's program as related to services delivered through the CDS
				  option;
(3) completion of forms,
				  assessments, and other documents required for the individual's program that
				  require individual or LAR input or completion;
(4) recruiting, screening, and hiring
				  workers, preparing job descriptions, verifying employment eligibility and
				  qualifications, and training for employees;
(5) completion of documents required to
				  employ an individual, retain a contractor or vendor, and manage service
				  providers;
(6) recruitment and
				  procurement of employees, contractors, and vendors;
(7) negotiations of service agreements,
				  including pricing and scheduling of services, goods, and items;
(8) management of service providers for
				  authorized program services delivered through the CDS option;
(9) effective communication, decision making,
				  and problem-solving skills to meet employer responsibilities;
(10) development, revision, and
				  implementation of service back-up plans;
(11) compliance with the individual's program
				  and this chapter;
(12) tools for
				  accessing information, resources, and assistance timely through government
				  agencies, including DADS, as needed through means available to the individual,
				  employer, or DR;
(13) contacting
				  appropriate persons or entities based on their roles, responsibilities, and
				  eligibility related to the individual's program or the CDS option, including:
(A) a case manager or service
				  coordinator;
(B) potential and
				  current service providers, including:
(i) an
				  employee;
(ii) a
				  contractor;
(iii) a
				  vendor;
(iv) a CDSA; and
(v) a support advisor;
(C) traditional program provider
				  agencies;
(D) government agencies,
				  including DADS and the Department of Family and Protective (DFPS);
				  and
(E) the employer, the
				  individual, and the DR; and
(14) ongoing employer-related
				  skills.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter G - ALLEGATIONS OF ABUSE, NEGLECT, AND EXPLOITATION › Section 264.701 - Reporting Allegations of Abuse, Neglect, or Exploitation of an Individual

Current through Reg. 49, No. 28; July 12, 2024
(a) If an employer or DR knows or suspects
				  that an individual is being or has been abused, neglected, or exploited, the
				  employer or DR must:
(1) report the knowledge
				  or suspicion to DFPS:
(A) for an individual
				  who is in the HCS Program or TxHmL Program, immediately, but not later than one
				  hour, after having knowledge or suspicion by:
(i) calling the toll-free telephone number,
				  1-800-647-7418; or
(ii) using the
				  DFPS website; or
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter G - ALLEGATIONS OF ABUSE, NEGLECT, AND EXPLOITATION › Section 264.702 - Requirements Related to HHSC Investigations When an Alleged Perpetrator is a Service Provider

Current through Reg. 49, No. 28; July 12, 2024
(a) If a report
				  required by §
										41.701(a) or
				  (b) of this subchapter (relating to Reporting
				  Allegations of Abuse, Neglect, or Exploitation of an Individual) alleges abuse,
				  neglect, or exploitation by a service provider; or if an employer, DR, or FMSA
				  is notified by HHSC of an allegation of abuse, neglect, or exploitation by a
				  service provider:
(1) the employer or DR
				  must:
(A) obtain immediate and ongoing
				  medical or psychological services for the individual as necessary;
(B) take actions to secure the safety of the
				  individual, including if necessary, ensuring that the alleged perpetrator does
				  not have contact with the individual until HHSC completes the investigation;
				  and
(C) when taking the actions
				  described in paragraphs (A) and (B) of this subsection, avoid compromising the
				  investigation or further traumatizing the individual;
(D) preserve and protect evidence related to
				  the allegation, including timesheets and other employee-related
				  documentation;
(E) cooperate with
				  the HHSC investigation as requested by HHSC, including providing documentation
				  and participating in an interview; and
(F) ensure that service providers comply with
				  subparagraphs (C) and (D) of this paragraph; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter G - ALLEGATIONS OF ABUSE, NEGLECT, AND EXPLOITATION › Section 264.703 - Requirements Related to HHSC Investigations When an Alleged Perpetrator is a Staff Person or a Controlling Person of an FMSA

Current through Reg. 49, No. 28; July 12, 2024
(a) If a report required by §
										41.701(c)
				  of this subchapter (relating to Reporting Allegations of Abuse, Neglect, or
				  Exploitation of an Individual) alleges abuse, neglect, or exploitation of an
				  individual by a staff person or a controlling person; or if an FMSA is notified
				  by HHSC of an allegation of abuse, neglect, or exploitation by a staff person
				  or a controlling person, the FMSA must:
(1)
				  take actions to secure the safety of the individual, including if necessary,
				  ensuring that the alleged perpetrator does not have contact with the individual
				  or any other individual receiving services from the FMSA until HHSC completes
				  the investigation; and
(2) preserve
				  and protect evidence related to the allegation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 264 - CONSUMER DIRECTED SERVICES OPTION › Subchapter H - OVERSIGHT › Section 264.801 - Oversight

Current through Reg. 49, No. 28; July 12, 2024
DADS oversees roles and responsibilities of the
					 following:
(1) an individual or LAR
				  who elects to be the employer for services delivered through the CDS
				  option;
(2) a DR;
(3) a CDSA;
(4) a support advisor;
(5) a service provider;
(6) a case manager; and
(7) a service coordinator.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter A - INTRODUCTION › Section 265.1 - Introduction

Current through Reg. 49, No. 28; July 12, 2024
This chapter describes:
(1) the SRO available to an individual or the
				  individual's LAR;
(2) the process
				  for enrollment and participation of an individual in the SRO;
(3) the responsibilities and requirements of
				  an individual, LAR, or representative participating in the SRO;
(4) the responsibilities and requirements of
				  a person or entity providing services under the SRO; and
(5) the people and entities DADS oversees in
				  the SRO.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter A - INTRODUCTION › Section 265.2 - Application

Current through Reg. 49, No. 28; July 12, 2024
This chapter applies to the following:
(1) an individual or LAR who elects to manage
				  services delivered through the SRO;
(2) a representative;
(3) an SRO provider;
(4) a support advisor;
(5) a service provider; and
(6) a case manager or service
				  coordinator.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter A - INTRODUCTION › Section 265.3 - Overview of the SRO

Current through Reg. 49, No. 28; July 12, 2024
(a) SRO is a
				  service delivery option available to an individual or LAR who wants some
				  control over the individual's service providers but does not want to assume all
				  employer responsibilities, as required by the CDS option.
(b) In the SRO, the individual, LAR, or
				  representative selects, trains, and supervises a service provider, while
				  payroll and personnel functions remain with the SRO provider.
(c) DADS offers the SRO at the same time as
				  the CDS option.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter A - INTRODUCTION › Section 265.4 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 have the following meanings unless the context clearly indicates
					 otherwise:
(1) Adult--A person who is
				  18 years of age or older.
(2)
				  Applicant--Depending on the context, an applicant is:
(A) a person applying for employment with an
				  SRO provider;
(B) a person or legal
				  entity applying for a contract with an SRO provider to deliver services to an
				  individual; or
(C) a person
				  applying for services through a program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter B - RESPONSIBILITIES OF INDIVIDUALS CHOOSING TO PARTICIPATE IN THE SRO › Section 265.11 - Enrollment in the SRO

Current through Reg. 49, No. 28; July 12, 2024
(a) At the time an
				  individual chooses to participate in the SRO, and, at least annually
				  thereafter, a case manager, service coordinator, or other person designated by
				  the individual's program must:
(1) provide
				  the individual or LAR a copy of DADS' Service Responsibility Option Roles and
				  Responsibilities form, the
It's Your Choice
brochure, and
				  DADS' Acknowledgement of Information Regarding Support Consultation Services in
				  the Consumer Directed Services (CDS) Option form;
(2) provide an oral explanation of the
				  information contained in the Service Responsibility Option Roles and
				  Responsibilities and Acknowledgement of Information Regarding Support
				  Consultation Services in the Consumer Directed Services (CDS) Option forms to
				  the applicant or LAR;
(3) document
				  the individual's choice on DADS' Consumer Participation Choice form;
(4) present the SRO provider list and the
				  support advisor list to the individual;
(5) instruct the individual to contact the
				  selected support advisor within one day after the individual signs DADS'
				  Consumer Participation Choice form; and
(6) document the individual's SRO provider
				  and support advisor on DADS' Consumer Participation Choice form.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter B - RESPONSIBILITIES OF INDIVIDUALS CHOOSING TO PARTICIPATE IN THE SRO › Section 265.12 - Service Planning in the SRO

Current through Reg. 49, No. 28; July 12, 2024
(a) A case
				  manager, service coordinator, or other person designated by the individual's
				  program completes service planning in the SRO in the same manner as services
				  delivered through a program provider.
(b) A service plan must identify and
				  document:
(1) an individual's
				  services;
(2) an individual's
				  service needs;
(3) an individual's
				  service levels;
(4) changes to the
				  service plan, including an explanation of a change;
(5) that the service plan does not exceed the
				  individual's costs caps and cost limits; and
(6) the approval for planned
				  services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 265 - SERVICE RESPONSIBILITY OPTION › Subchapter B - RESPONSIBILITIES OF INDIVIDUALS CHOOSING TO PARTICIPATE IN THE SRO › Section 265.13 - SRO Orientation

Current through Reg. 49, No. 28; July 12, 2024
(a) Upon choosing
				  to participate in the SRO and before the first meeting with an SRO provider, an
				  individual or LAR must complete the SRO orientation.
(b) During the SRO orientation, the
				  individual or LAR must complete:
(1) DADS'
SRO Self-Assessment Checklist
to identify additional training
				  and other support needed to ensure the individual's success in daily management
				  of services;
(2) DADS' SRO
Roles and Responsibilities Agreement;
(3) DADS'
Planning For Success and
				  the Risk Planning Checklist
to identify informal supports to be
				  included in the individual's service back-up plan;
(4) a service back-up plan for critical
				  services containing specific strategies, the sequence of activities, and
				  service back-up plan contact information;
(5) a review of the resources available to an
				  individual participating in the SRO;
(6) a review of the responsibility for
				  potential liability if the individual or service provider is injured while
				  doing tasks under the individual's training and supervision;
(7) a review of the management agreement that
				  will be negotiated with the SRO provider;
(8) a checklist of the characteristics and
				  skills an SRO provider will seek in a potential service provider; and
(9) documentation that an individual is
				  choosing a representative and the specific management tasks the representative
				  will assume.