reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.304 - Allowable and Unallowable Tasks

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Allowable tasks. Except as otherwise provided in subsection (b) of this
				  section, an attendant may perform one or more of the following tasks for an
				  individual enrolled in the CMPAS Program:
(1)
				  personal care tasks required to maintain the individual's physical health,
				  including:
(A) bathing;
(B) dressing and undressing;
(C) preparing meals;
(D) assisting with eating, including:
(i) assisting with eating and drinking
				  utensils and adaptive devices; and
(ii) providing standby assistance or
				  encouragement;
(E)
				  exercising;
(F) toileting,
				  including:
(i) changing an incontinence
				  brief;
(ii) assisting with the use
				  of a bedpan or urinal;
(iii)
				  assisting with feminine hygiene needs, including menstruation
				  supplies;
(iv) assisting with
				  clothing during toileting, including raising, lowering, removal or replacement
				  of garments for hygiene needs;
(v)
				  assisting with toilet hygiene, including the use of toilet paper and washing
				  hands;
(vi) changing an external
				  catheter;
(vii) preparing toileting
				  supplies and equipment but not preparing catheter equipment unless it is a
				  delegated task as described in paragraph (4) of this subsection; and
(viii) providing standby
				  assistance;
(G)
				  positioning;
(H) assisting with
				  self-administered medication, including administration through a permanently
				  placed feeding tube;
(I)
				  grooming;
(J) routine hair and skin
				  care; and
(K) transfer or
				  ambulation, including lifting;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.305 - Location of Tasks

Current through Reg. 49, No. 28; July 12, 2024
An attendant may perform an allowable task for an
					 individual in the individual's home, at a work site, or in another appropriate
					 location, including a shopping mall, a movie theater, or a community
					 event.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.306 - Individual Training by a Provider

Current through Reg. 49, No. 28; July 12, 2024
Before providing services to an individual, a provider must
					 educate and train the individual in:
(1) rights and responsibilities of the
				  individual;
(2) skills for
				  recruiting, selecting, instructing, supervising, and dismissing attendants, if
				  desired by the individual;
(3)
				  procedures for preparing attendant time sheets, as described in §
										44.504(b)(1)
				  of this chapter (relating to Records);
(4) procedures for the CMPAS Program service
				  delivery option that the individual chooses; and
(5) rights and responsibilities of the
				  attendant and the substitute attendant.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.307 - Individual Responsibilities in All CMPAS Service Delivery Options

Current through Reg. 49, No. 28; July 12, 2024
An applicant, individual, or the LAR or representative of
					 an applicant or individual must:
(1)
				  obtain and submit a practitioner's statement to the assessor of need;
(2) negotiate with the assessor of need at an
				  assessment or reassessment to determine which allowable tasks in §
										44.304
				  of this subchapter (relating to Allowable and Unallowable Tasks) are included
				  in the individual's service plan;
(3) select, supervise, and release from
				  service an attendant;
(4) train and
				  supervise a personal attendant in the specifics of the delivery of
				  services;
(5) certify the
				  attendant's time worked on or after the last day of each recording period by:
(A) verifying, signing, dating, and
				  submitting to the provider the attendant's time sheet; or
(B) if applicable, submitting appropriate
				  certification of the attendant's time worked through a provider's electronic
				  service delivery documentation system;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.308 - Suspension of Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A provider
				  must suspend services to an individual if:
(1) the individual changes residence to
				  outside the state of Texas;
(2) the
				  individual moves to a location where the provider does not provide CMPAS
				  Program services to the individual except as provided for in §
											44.403
				  of this chapter (relating to Attendant Services Provided Outside the Provider
				  Contracted Service Delivery Area in the Traditional Services Option);
(3) the individual dies;
(4) the individual is admitted to:
(A) a hospital;
(B) a nursing facility;
(C) a state supported living
				  center;
(D) a state mental health
				  facility; or
(E) an intermediate
				  care facility for individuals with an intellectual disability or related
				  conditions;
(5) the
				  individual requests that services end;
(6) the individual, representative, or
				  someone in the individual's home, as applicable, refuses to:
(A) supervise the attendant;
(B) adhere to the service plan; or
(C) otherwise comply with a requirement of
				  the CMPAS Program;
(7)
				  the individual or representative, as applicable, does not have the ability to:
(A) supervise the attendant;
(B) adhere to the service plan; or
(C) otherwise comply with a requirement of
				  the CMPAS Program;
(8)
				  the individual does not submit a co-payment as required by §
											44.501
				  of this chapter (relating to Determining an Individual's Co-payment);
(9) the individual does not provide a
				  practitioner's statement as required by §
											44.307
				  of this subchapter (relating to Individual Responsibilities in All CMPAS
				  Service Delivery Options); or
(10)
				  the provider becomes aware that the individual no longer meets eligibility
				  requirements for the CMPAS Program.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.309 - Termination of Services

Current through Reg. 49, No. 28; July 12, 2024
A provider may terminate services for the same reasons for
					 suspending services, listed in §
										44.308 of
					 this subchapter (relating to Suspension of Services). If a provider intends to
					 terminate services the provider must:
(1) send written notice of the termination to
				  the individual;
(2) inform the
				  individual in the written notice of:
(A) the
				  termination date;
(B) the reason
				  for termination;
(C) the right to
				  appeal the termination decision in accordance with §
											44.503 of
				  this chapter (relating to Fair Hearing); and
(D) the individual's right to continue to
				  receive services pending a fair hearing; and
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.310 - Prohibition of Restraint and Seclusion

Current through Reg. 49, No. 28; July 12, 2024
A provider must not use restraint or
					 seclusion.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter C - SERVICE DELIVERY IN ALL CMPAS OPTIONS › Section 44.311 - Provider Responsibilities Related to the Abuse, Neglect, and Exploitation of an Individual in All CMPAS Service Delivery Options

Current through Reg. 49, No. 28; July 12, 2024
(a) A provider, before providing services to
				  an individual and on an annual basis, must:
(1) inform the individual and representative
				  of how to report allegations of abuse, neglect, or exploitation to DFPS and
				  provide the individual with the DFPS Abuse Hotline toll-free telephone number,
				  1-800-252-5400, in writing; and
(2)
				  educate the individual and representative about how to protect the individual
				  from abuse, neglect, and exploitation.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 1 - TRADITIONAL SERVICE OPTION › Section 44.401 - Description of the Traditional Service Option

Current through Reg. 49, No. 28; July 12, 2024
In the traditional service option, the individual retains
						control over certain personnel decisions, including selecting, supervising, and
						dismissing the attendant, but the provider is the employer of record for the
						attendant and substitute attendant.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 1 - TRADITIONAL SERVICE OPTION › Section 44.402 - Provider Responsibilities in the Traditional Service Option

Current through Reg. 49, No. 28; July 12, 2024
In the traditional service option, a provider
						must:
(1) comply with the requirements
					 of §
											44.302
					 of this chapter (relating to Provider Qualifications and Responsibilities in
					 All CMPAS Service Delivery Options);
(2) maintain and supervise a pool of
					 substitute attendants to provide attendant services upon the individual's
					 request;
(3) refer prospective
					 attendants to the individual until the individual selects an
					 attendant;
(4) hire an attendant
					 who meets the qualifications of §
											44.303
					 of this chapter (relating to Attendant Qualifications) and whom the individual
					 agrees to supervise;
(5) if an
					 individual has not selected a prospective attendant within seven days after the
					 date the assessor of need determined the individual to be eligible for
					 services:
(A) confer with the
					 individual;
(B) identify the
					 reasons the individual has not selected an attendant; and
(C) provide training when necessary to enable
					 the individual to select an attendant;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 1 - TRADITIONAL SERVICE OPTION › Section 44.403 - Attendant Services Provided Outside the Provider Contracted Service Delivery Area in the Traditional Services Option

Current through Reg. 49, No. 28; July 12, 2024
(a) A provider may develop a service plan
					 that includes, at the request of the individual, services provided while the
					 individual is temporarily staying at a location outside the provider's
					 contracted service delivery area but within the State of Texas.
(b) The service plan must not exceed the
					 weekly authorized hours.
(c) The
					 provider may accept or decline the request of an individual for the provision
					 of services while the individual is temporarily staying at a location outside
					 the contracted service delivery area but within the State of Texas.
(1) If the provider accepts the individual's
					 request, the provider:
(A) may provide
					 services to the individual during a period of no more than 60 consecutive
					 days;
(B) must, within three days
					 after the provider begins providing services to the individual, notify the DADS
					 regional designee in writing of the following:
(i) that the individual is receiving services
					 outside the provider's contracted service delivery area;
(ii) the location where the individual is
					 receiving services;
(iii) the
					 estimated length of time the individual is expected to be outside the
					 contracted service delivery area; and
(iv) contact information for the
					 individual;
(C) must
					 notify the DADS regional designee in writing that the individual has returned
					 to the provider's contracted service delivery area within three working days
					 after becoming aware of the individual's return; and
(D) is not required to pay for expenses
					 incurred by attendants delivering services outside the contracted service
					 delivery area.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 1 - TRADITIONAL SERVICE OPTION › Section 44.404 - Individual Responsibilities in the Traditional Service Option

Current through Reg. 49, No. 28; July 12, 2024
Individuals who choose the traditional service option
						must comply with the responsibilities listed in §
											44.307
						of this chapter (relating to Individual Responsibilities in All CMPAS Service
						Delivery Options) and must:
(1)
					 actively assist the provider in recruiting attendants and substitute attendants
					 by seeking out and referring potential attendants to the provider;
(2) select an attendant from among the
					 potential attendants whom the provider refers to the individual;
(3) actively assist in delegating, directing,
					 and training for tasks being performed;
(4) not discriminate against any potential
					 attendant, attendant, or substitute attendant in violation of law;
					 and
(5) interview any prospective
					 attendant whom the provider refers to the individual and inform the provider
					 within seven days after the referral of whether the individual selects the
					 attendant.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 2 - BLOCK GRANT OPTION › Section 44.420 - Description of the Block Grant Option

Current through Reg. 49, No. 28; July 12, 2024
Effective September 1, 2013, an individual may not choose
						the block grant option. An individual receiving CMPAS services through the
						block grant option on that date may continue to receive services under this
						option but, if the individual chooses another service delivery option, the
						individual may not return to the block grant option. In the block grant option,
						the individual is the employer of record for an attendant and is responsible
						for payroll, filing tax-related reports, and developing a monthly budget. The
						provider is the employer of record for a substitute
						attendant.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 2 - BLOCK GRANT OPTION › Section 44.421 - Provider Responsibilities in the Block Grant Option

Current through Reg. 49, No. 28; July 12, 2024
In the block grant option, a provider must:
(1) comply with the requirements of §
											44.302
					 of this chapter (relating to Provider Qualifications and Responsibilities in
					 All CMPAS Service Delivery Options);
(2) reimburse the individual for attendant
					 wages and employment taxes paid by the individual;
(3) negotiate with the individual and agree
					 on an amount that the provider will retain from reimbursements made under
					 §
											44.505
					 of this chapter (relating to Reimbursement) to compensate the provider for its
					 services to the individual, based on the provider's actual cost of providing
					 services to the individual, which may include:
(A) the cost of providing substitute
					 attendants;
(B) the cost of
					 providing administrative services;
(C) the history of the individual's use of
					 substitute attendants; and
(D) the
					 need for provider intervention;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 2 - BLOCK GRANT OPTION › Section 44.422 - Individual Responsibilities in the Block Grant Option

Current through Reg. 49, No. 28; July 12, 2024
In the block grant option, an individual must:
(1) comply with the requirements of §
											44.307
					 of this chapter (relating to Individual Responsibilities in All CMPAS Service
					 Delivery Options);
(2) select,
					 hire, and pay the individual's attendants as the employer of record;
(3) before the individual's attendant
					 provides a service and on an annual basis:
(A) train an attendant regarding abuse,
					 neglect, and exploitation, as described in HHSC Form 1732, Management and
					 Training of Service Provider;
(B)
					 sign and date Form 1732 and have the attendant sign and date the form to
					 document completion of the training; and
(C) send a copy of the signed form to the
					 provider within 30 days after the date the form is signed by the individual and
					 the attendant;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 3 - CONSUMER DIRECTED OPTION › Section 44.440 - Description of the Consumer Directed Services Option

Current through Reg. 49, No. 28; July 12, 2024
In the consumer directed services option, an individual
						is the employer of record for an attendant and substitute attendant but the
						provider is responsible for payroll for attendants and substitute attendants
						and filing tax-related reports for attendants and substitute
						attendants.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 3 - CONSUMER DIRECTED OPTION › Section 44.441 - Provider Responsibilities in the CDS Option

Current through Reg. 49, No. 28; July 12, 2024
In the CDS option, a provider must:
(1) comply with the requirements of §
											44.302
					 of this chapter (relating to Provider Qualifications and Responsibilities in
					 All CMPAS Service Delivery Options);
(2) function as an FMSA to provide financial
					 management services to an individual;
(3) approve and monitor a budget for services
					 delivered through the CDS option;
(4) manage payroll, including calculating
					 employee withholdings and employer contributions and depositing the funds with
					 the appropriate agencies;
(5)
					 comply with applicable government regulations concerning employee withholding,
					 garnishments, mandated withholding, and benefits;
(6) prepare and file required tax forms and
					 reports;
(7) pay allowable expenses
					 incurred by the individual;
(8)
					 obtain employer-agent status with the Internal Revenue Service, the Texas
					 Workforce Commission, and any other appropriate government agencies within the
					 time frame established by each agency;
(9) perform all employer-agent
					 responsibilities required by government agencies that regulate the relationship
					 between the employer-agent and the individual acting as the employer of record,
					 and maintain an original or a copy of each form required to document
					 compliance; and
(10) attend, at
					 least annually, HHSC's training for FMSAs.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 3 - CONSUMER DIRECTED OPTION › Section 44.442 - Individual Responsibilities in the CDS Option

Current through Reg. 49, No. 28; July 12, 2024
(a) In the CDS option, an individual must:
(1) comply with the requirements in §
												44.307
					 of this chapter (relating to Individual Responsibilities in All CMPAS Service
					 Delivery Options);
(2) perform the
					 employer responsibilities described in Chapter 41 of this title (relating to
					 Consumer Directed Services Option), with the exception of the responsibilities
					 described in Chapter 41, Subchapter G of this title (relating to Allegations of
					 Abuse, Neglect and Exploitation);
(3) train each attendant and substitute
					 attendant, during the initial orientation and on an annual basis, regarding
					 abuse, neglect, and exploitation, as described in HHSC Form 1732, Management
					 and Training of Service Provider;
(4) sign and date Form 1732 and have the
					 attendant or substitute attendant sign and date the form to document completion
					 of the training; and
(5) send a
					 copy of the signed form to the provider within 30 days after the date the form
					 is signed by the individual and the attendant or substitute
					 attendant.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 3 - CONSUMER DIRECTED OPTION › Section 44.443 - Provider and Individual Responsibilities in the CDS Option Related to HHSC Investigations When an Alleged Perpetrator is an Attendant or Substitute Attendant

Current through Reg. 49, No. 28; July 12, 2024
(a) This section
					 applies in the CDS option to alleged abuse, neglect, or exploitation by an
					 attendant or substitute attendant:
(1) when
					 an allegation is reported as required by § 44.311(c) of this chapter
					 (relating to Provider Responsibilities Related to the Abuse, Neglect, and
					 Exploitation of an Individual in All CMPAS Service Delivery Options);
(2) when an allegation is reported as
					 required by §44.442 of this division (relating to Individual
					 Responsibilities in the CDS Option); or
(3) if a provider or individual is notified
					 by HHSC of an allegation.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter D - SERVICE DELIVERY OPTIONS › Division 3 - CONSUMER DIRECTED OPTION › Section 44.444 - Provider and Individual Responsibilities in the CDS Option Related to HHSC Investigations When an Alleged Perpetrator is a Staff Person or a Controlling Person of a Provider

Current through Reg. 49, No. 28; July 12, 2024
(a) This
					 section applies in the CDS option to an allegation of abuse, neglect, or
					 exploitation by a staff person or a controlling person:
(1) when the allegation is reported as
					 required by § 44.311(c) of this chapter (relating to Provider
					 Responsibilities Related to the Abuse, Neglect, and Exploitation of an
					 Individual in All CMPAS Service Delivery Options);
(2) when the allegation is reported as
					 required by §44.442 of this division (relating to Individual
					 Responsibilities in the CDS Option); or
(3) if a provider or individual is notified
					 by HHSC of an allegation.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter E - ADDITIONAL PROGRAM REQUIREMENTS › Section 44.501 - Determining an Individual's Co-payment

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  An individual's co-payment is a percentage of the monthly cost of services
				  provided to the individual. To calculate an individual's co-payment, a provider
				  must:
(1) determine the individual's total
				  net monthly income in accordance with subsections (f) -
(i) of this section;
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter E - ADDITIONAL PROGRAM REQUIREMENTS › Section 44.502 - Convening an IDT

Current through Reg. 49, No. 28; July 12, 2024
(a) An IDT must
				  include:
(1) the individual;
(2) a provider representative; and
(3) other persons as requested by the
				  individual.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter E - ADDITIONAL PROGRAM REQUIREMENTS › Section 44.503 - Fair Hearing

Current through Reg. 49, No. 28; July 12, 2024
(a) An individual
				  may request a fair hearing for any action that affects the co-payment of the
				  individual or that denies, reduces, or terminates benefits in accordance with 1
				  TAC Part 15, Chapter 357, Subchapter A. DADS does not continue services pending
				  a hearing if a suspension or termination is based on §
										44.308(b)(3)
				  of this chapter (relating to Suspension of Services). The individual's provider
				  must attend a hearing to explain any decision or action that led to the
				  hearing.
(b) The provider must
				  notify the DADS regional designee of a request for a fair hearing within 24
				  hours after the provider receives the request. DADS notifies the provider
				  whether to continue services pending the fair hearing officer's
				  decision.
(c) The provider must
				  notify the DADS regional designee of the fair hearing officer's decision and of
				  any action the provider takes as a result of that decision within 24 hours
				  after the provider receives the hearing decision.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter E - ADDITIONAL PROGRAM REQUIREMENTS › Section 44.504 - Records

Current through Reg. 49, No. 28; July 12, 2024
(a) General requirements. A provider must
				  develop and maintain records in accordance with:
(1) this chapter; and
(2) Chapter 49, Subchapter C, of this title
				  (relating to Requirements of a Contractor).
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 44 - CONSUMER MANAGED PERSONAL ATTENDANT SERVICES › Subchapter E - ADDITIONAL PROGRAM REQUIREMENTS › Section 44.505 - Reimbursement

Current through Reg. 49, No. 28; July 12, 2024
(a) General billing requirements. A provider
				  must submit to HHSC a claim for services provided to an individual in
				  accordance with §
										49.311
				  of this title (relating to Claims Payment).
(b) Billing requirements relating to
				  attendant tasks. A provider must bill HHSC:
(1) only for the allowable tasks described in
				  §
											44.304
				  of this chapter (relating to Allowable and Unallowable Tasks) that comprise
				  services actually delivered to an individual in accordance with the
				  individual's service plan authorized by HHSC;
(2) in accordance with the hourly rate
				  negotiated by HHSC; and
(3) for
				  attendant tasks in quarter-hour increments, meaning that:
(A) time worked that is not an exact
				  quarter-hour must be rounded up to a quarter-hour if it is eight minutes or
				  more; and
(B) time worked that is
				  less than eight minutes must not be billed.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter A - INTRODUCTION › Section 46.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
This chapter establishes the requirements for facilities
					 contracting to provide assisted living and residential care services to
					 eligible clients through the Texas Department of Human Services Community Based
					 Alternatives (CBA) Assisted Living/Residential Care (AL/RC) Program and the
					 Community Care for the Aged and Disabled (CCAD) Residential Care (RC) Program.
					 The requirements described in this chapter apply to both CBA AL/RC and CCAD RC,
					 unless otherwise specified in the text.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter B - PROVIDER CONTRACTS › Section 46.11 - Contracting Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) General
				  contracting requirements. A facility must meet all provisions described in this
				  chapter and Chapter 49 of this title (relating to Contracting for Community
				  Services).
(b) Number of beds. The
				  facility must specify in its contract the number of beds for clients of the
				  Department of Aging and Disability Services (DADS), as follows:
(1) The facility must ensure that the number
				  of contracted DADS beds are in rooms that meet the requirements in §
											46.13
				  of this chapter (relating to Housing Options).
(2) The facility must ensure the number of
				  DADS clients served by the facility does not exceed the number of contracted
				  DADS beds.
(3) The facility may
				  adjust the number of beds for DADS clients by contract amendment.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter B - PROVIDER CONTRACTS › Section 46.13 - Housing Options

Current through Reg. 49, No. 28; July 12, 2024
(a) Setting. A
				  facility must specify in the contract the type(s) of setting(s) it uses to
				  provide assisted living services according to the following guidelines:
(1) Assisted living apartment. An assisted
				  living apartment setting is a living unit that is a private space with living
				  and sleeping areas, a kitchen, a bathroom, and adequate storage space. The
				  bedroom must be single occupancy, except when the participant requests double
				  occupancy in writing. The living unit must have private kitchen and bath
				  facilities.
(A) Size. Assisted living
				  apartments must have a minimum of 220 square feet, not including the bathroom.
				  Current contracted assisted living apartments that do not meet the square
				  footage requirement may remain at their current size unless the apartment is
				  remodeled. Remodeling includes:
(i) the
				  construction, removal, or relocation of walls and partitions;
(ii) the construction of foundations, floors,
				  or ceiling-roof assemblies;
(iii)
				  the expansion or alteration of safety systems, including:
(I) sprinkler;
(II) fire alarm; and
(III) emergency systems; or
(iv) the conversion of space in a
				  facility to a different use.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter B - PROVIDER CONTRACTS › Section 46.15 - Additional Services and Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility may charge the client or the client's representative for additional
				  items or services that the Texas Department of Human Services (DHS) does not
				  require the facility to provide. The client or the client's representative must
				  request and approve the additional items or services in writing.
(b) The facility must not charge the client
				  or the client's representative for any service provided to the client as
				  required by its contract with DHS.
(c) The facility must inform the client or
				  the client's representative of the additional items or services and the charges
				  for those items or services at the following times:
(1) at admission;
(2) before a change in the additional items,
				  services, or charges; and
(3) when
				  the client requests the additional items or services.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter B - PROVIDER CONTRACTS › Section 46.19 - Recordkeeping

Current through Reg. 49, No. 28; July 12, 2024
(a) Daily service delivery documentation. The
				  facility must document the client's daily service delivery.
(1) The daily service delivery documentation
				  must contain the:
(A) client name;
(B) facility contract number issued by the
				  Department of Aging and Disability Services (DADS);
(C) coverage period of the daily service
				  delivery documentation;
(D) tasks
				  assigned;
(E) tasks performed
				  during the coverage period;
(F)
				  signature of the facility manager or supervisor; and
(G) date of signature of the facility manager
				  or supervisor.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter B - PROVIDER CONTRACTS › Section 46.21 - Reimbursement

Current through Reg. 49, No. 28; July 12, 2024
(a) A unit of service is one billable day of
				  authorized service delivered to a client.
(b) The unit rate reimbursed by the
				  Department of Aging and Disability Services (DADS) includes any copayment. The
				  combined reimbursement from DADS and the client or the client's representative
				  for the required services described in §
										46.41 of this
				  chapter (relating to Required Services) must not exceed the unit rate plus room
				  and board specified for each type of setting. The unit rate does not include
				  charges for services described in §
										46.15
				  of this chapter (relating to Additional Services and Fees).
(c) The facility must deduct the copayment
				  amount from reimbursement claims submitted to DADS.
(d) The facility must not bill DADS for the
				  day of discharge, unless the discharge is due to the death of the
				  client.
(e) The facility must bill
				  the double occupancy (Residential Care Apartment) rate for clients in the
				  single occupancy (Assisted Living Apartment) setting who request double
				  occupancy.
(f) The facility must
				  bill DADS for the balance of the bedhold charge for any clients whose daily
				  copayment is less than the maximum bedhold charge allowed by DADS.
(1) The facility must determine the client's
				  daily copayment amount by dividing the client's monthly copayment charge by the
				  number of days in the month.
(2)
				  The facility must deduct the client's daily copayment amount from the bedhold
				  rate and submit the claim to DADS.
(3) This subsection does not apply to the
				  Assisted Living (AL) services allowed in the Community Based Alternatives (CBA)
				  Program.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter B - PROVIDER CONTRACTS › Section 46.23 - Financial Errors

Current through Reg. 49, No. 28; July 12, 2024
Financial errors include the errors described in this
					 section.
(1) The facility is
				  reimbursed for services, but the daily census documentation and the daily
				  service delivery documentation are missing for the period for which services
				  are reimbursed. The Department of Aging and Disability Services (DADS) applies
				  the error to the total number of units reimbursed for the billing period for
				  which forms are missing.
(2) The
				  facility is reimbursed for units that exceed the units recorded on daily census
				  documentation and daily service delivery documentation. DADS applies the error
				  to the total number of units reimbursed in excess of units recorded.
(3) The facility is reimbursed for units of
				  service and the client did not receive services. DADS applies the error to the
				  total number of units reimbursed for the days the client did not receive
				  services.
(4) The facility is
				  reimbursed for units of service and the client was Medicaid ineligible. DADS
				  applies the error to the total number of units reimbursed for the days the
				  client was Medicaid ineligible. This does not apply to the Community Care for
				  Aged and Disabled (CCAD) Residential Care (RC) program.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.31 - Staff Requirements

Current through Reg. 49, No. 28; July 12, 2024
The facility must have staff as described in §
										92.41
					 of this title (relating to Standards for Type A, Type B, and Type E Assisted
					 Living Facilities).
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.33 - Staff Training

Current through Reg. 49, No. 28; July 12, 2024
(a) General
				  training requirements. The facility must provide all staff with training as
				  described in §
										92.41
				  of this title (relating to Standards for Type A and Type B Assisted Living
				  Facilities).
(b) Facility manager.
				  In addition to the requirements described in subsection (a) of this section,
				  the facility must train the facility manager on the following topics:
(1) facility requirements for the Community
				  Care for Aged and Disabled (CCAD) Residential Care (RC) or Assisted Living (AL)
				  Services allowed in the Community Based Alternatives (CBA) programs or both, as
				  applicable; and
(2) client
				  characteristics and needs.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.35 - Interdisciplinary Team

Current through Reg. 49, No. 28; July 12, 2024
(a) Interdisciplinary
				  Team (IDT). The IDT is a designated group that includes the following
				  individuals who meet when the need arises to discuss service delivery issues:
(1) the client or the client's
				  representative, or both;
(2) a
				  facility representative; and
(3) a
				  Texas Department of Human Services (DHS) representative. A DHS representative
				  may be:
(A) the case manager (or
				  designee);
(B) the contract manager
				  (or designee); or
(C) the regional
				  nurse (or designee).
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.37 - Copayment and Room and Board

Current through Reg. 49, No. 28; July 12, 2024
(a) Amount.
				  The facility must collect the copayment and room and board amounts indicated on
				  the Texas Department of Human Services' (DHS's) Notification of Community Care
				  Services form or DHS's Notification of Community Based Alternatives (CBA)
				  Services form. This subsection does not apply to clients who receive Community
				  Care for Aged and Disabled emergency care service.
(b) Due date.
(1) The facility must designate a due date
				  for copayment and room and board in writing. The due date must be during the
				  same month the copayment and room and board is applied.
(2) The facility must collect the entire
				  copayment and room and board on or before the due date. If the due date falls
				  on a weekend or a holiday, the facility must collect the entire copayment and
				  room and board on or before the first working day thereafter.
(3) If the client or the client's
				  representative fails to pay the entire copayment and room and board by the due
				  date, the facility must notify the client or the client's representative and
				  the case manager in writing no later than the first working day after the due
				  date.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.39 - Service Initiation

Current through Reg. 49, No. 28; July 12, 2024
(a) Negotiated
				  move-in date. The facility must negotiate a move-in date with the Texas
				  Department of Human Services (DHS) case manager and the client or the client's
				  representative.
(b) Reserved space.
				  The facility must reserve a living unit for three days from the agreed upon
				  move-in date for each referred client. The facility may request another
				  referral after three days if the move-in date is not re-negotiated.
(c) Client and facility agreement. The
				  facility must have a written agreement with the client or the client's
				  representative. Both parties must sign the written agreement before or at the
				  time of admission. The written agreement must include the following:
(1) bedhold policies for hospital and nursing
				  facility stays;
(2) personal leave
				  policies and charges;
(3) eviction
				  procedures;
(4) all available
				  services in the facility; and
(5)
				  charges for services not paid by DHS and charges not included in the facility's
				  basic daily rate, as described in §
											46.15
				  of this chapter (relating to Additional Services and Fees).
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.41 - Required Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Service
				  delivery. The facility must provide services according to the service plan
				  completed for the client.
(b)
				  Required services. Services include:
(1)
				  Personal care. The facility must provide or assist with personal care services
				  identified on the service plan completed for the client. Personal care services
				  are activities related to the care of the client's physical health that include
				  at a minimum:
(A) bathing;
(B) dressing;
(C) grooming;
(D) routine hair and skin care;
(E) exercising;
(F) toileting;
(G) medication administration, including
				  injections, except in the Community Care for Aged and Disabled (CCAD)
				  Residential Care (RC) Program;
(H)
				  transferring/ambulating, except in a Type A assisted living facility;
(I) twenty-four-hour supervision, which means
				  the facility must:
(i) conduct checks or
				  visits to each client as identified in the client's service plan, to ensure
				  that each client is safe and well; and
(ii) document the checks and visits in the
				  client's file;
(J) meal
				  services, which means the facility must:
(i)
				  provide meal services as described in §
													92.41(m)
				  of this title (relating to Standards for Type A, Type B, and Type E Assisted
				  Living Facilities);
(ii) offer
				  dietary counseling and nutrition education to the client;
(iii) modify food texture, including:
(I) chopping, grinding, and mashing foods for
				  clients who have trouble chewing; and
(II) cutting up food into bite size pieces
				  for clients who have trouble cutting food; and
(iv) assist with eating, including:
(I) assistance with spoon-feeding in
				  instances when the client is temporarily ill;
(II) bread buttering; and
(III) opening containers or pouring liquids
				  for clients with hand deformities, paralysis, or hand tremors.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.43 - Service Plan Changes

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must complete a new service plan anytime there is a need for a change in the
				  client's service plan.
(b) The
				  facility must implement service plan changes within seven days from the
				  assessment date.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.45 - Required Notifications

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility must notify the Department of Aging and Disability Services (DADS)
				  when one of the following happens:
(1)
				  significant changes in the client's health and/or condition;
(2) the client temporarily enters an
				  institution;
(3) serious
				  occurrences or emergencies involving the client or facility staff;
(4) the client or the client's representative
				  requests that services end;
(5) the
				  client refuses to comply with the service plan;
(6) the client engages in discrimination in
				  violation of applicable law;
(7)
				  the client or the client's representative fails to pay copayment;
(8) the client uses ten personal leave days
				  in the current calendar year;
(9)
				  the client or the client's representative requests to move to another facility;
				  or
(10) the facility believes that
				  a client's functional needs have changed such that it will impact the client's
				  level of care, if the facility provides assisted living services under the
				  Community Based Alternatives (CBA) Assisted Living/Residential Care (AL/RC)
				  Program and participates in the attendant compensation rate option.
Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 46 - CONTRACTING TO PROVIDE ASSISTED LIVING AND RESIDENTIAL CARE SERVICES › Subchapter C - PROVIDER REQUIREMENTS › Section 46.47 - Suspension of Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must suspend services when one of the following happens:
(1) the client dies;
(2) the client moves from the
				  facility;
(3) the client is
				  discharged because he threatens the health or safety of himself or other
				  clients in the facility;
(4) the
				  client is permanently admitted to an institution;
(5) the Texas Department of Human Services
				  (DHS) enforces sanctions against the facility by terminating the
				  contract;
(6) the client's
				  eligibility is denied; or
(7) the
				  case manager requests that services be suspended or terminated.