Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC maintains
an interest list that contains the names of individuals interested in receiving
CLASS Program services.
(b) A
person may request an individual's name be added to the CLASS interest list by:
(1) calling HHSC's toll-free number; or
(2) submitting a written request
to HHSC.
(c) If a request
is made in accordance with subsection (b) of this section for an individual who
resides in Texas, HHSC adds the individual's name to the CLASS interest list
using the date HHSC receives the request as the CLASS interest list
date.
(d) For an individual under
22 years of age who is residing in a nursing facility located in Texas, HHSC
adds the individual's name to the CLASS interest list using the date of
admission to the nursing facility as the CLASS interest list date.
(e) For an individual determined
diagnostically or functionally ineligible during the enrollment process for the
Deaf-Blind with Multiple Disabilities (DBMD) Program, Home and Community-based
Services (HCS) Program, Texas Home Living (TxHmL) Program, or Medically
Dependent Children Program (MDCP):
(1) if the
individual's name is not on the CLASS interest list, at the request of the
individual or LAR, HHSC adds the individual's name to the CLASS interest list
using the individual's interest list date for the program for which the
individual was determined ineligible as the CLASS interest list date;
(2) if the individual's name is on
the CLASS interest list and the individual's interest list date for the program
for which the individual was determined ineligible is earlier than the
individual's CLASS interest list date, at the request of the individual or LAR,
HHSC changes the individual's CLASS interest list date to the individual's
interest list date for the program for which the individual was determined
ineligible; or
(3) if the
individual's name is on the CLASS interest list and the individual's CLASS
interest list date is earlier than the individual's interest list date for the
program for which the individual was determined ineligible, HHSC does not
change the individual's CLASS interest list date.
(f) This subsection applies to an individual
who was enrolled in MDCP and, because the individual did not meet the level of
care criteria for medical necessity for nursing facility care or did not meet
the age requirement of being under 21 years of age, was determined ineligible
for MDCP after November 30, 2019.
(1) At the
request of the individual or LAR, HHSC adds the individual's name to the CLASS
interest list:
(A) using the MDCP interest
list date as the CLASS interest list date, if the individual's name is not on
the CLASS interest list but it was previously on the CLASS interest list; or
(B) using the date HHSC receives
the request as the CLASS interest list date, if the individual's name is not on
the CLASS interest list and it never has been on the CLASS interest list.
(2) At the request of
the individual or LAR, HHSC changes the CLASS interest list date to the MDCP
interest list date if the individual's MDCP interest list date is earlier than
the individual's CLASS interest list date.
(g) HHSC removes an individual's name from
the CLASS interest list if:
(1) the
individual or LAR requests in writing that the individual's name be removed
from the CLASS interest list, unless the individual is under 22 years of age
and residing in a nursing facility;
(2) the individual moves out of Texas, unless
the individual is a military family member living outside of Texas:
(A) while the military member is on active
duty; or
(B) for less than one year
after the former military member's active duty ends;
(3) the individual declines an offer of CLASS
Program services or, as described in §
259.55(d) of this
subchapter (relating to Written Offer of CLASS Program Services), HHSC
withdraws an offer of enrollment in the CLASS Program, unless:
(A) the individual is a military family
member living outside of Texas:
(i) while the
military member is on active duty; or
(ii) for less than one year after the former
military member's active duty ends; or
(B) the individual is under 22 years of age
and residing in a nursing facility;
(4) the individual is a military family
member living outside of Texas for more than one year after the former military
member's active duty ends;
(5) the
individual is deceased; or
(6) HHSC
has denied the individual enrollment in the CLASS Program and the individual or
LAR:
(A) has had an opportunity to exercise
the individual's right to appeal the decision in accordance with §
259.101 of this chapter (relating
to Individual's Right to a Fair Hearing), and:
(B) either:
(i) did not appeal the decision; or
(ii) appealed and did not prevail.
(h)
If HHSC removes an individual's name from the CLASS interest list in accordance
with subsection (g)(1) - (4) of this section, HHSC receives an oral or written
request from a person to add the individual's name to the CLASS interest list
within 90 calendar days after the name was removed, and the request is the
individual's first request, HHSC:
(1) adds
the individual's name to the CLASS interest list using the CLASS interest list
date that was in effect at the time the individual's name was removed from the
CLASS interest list; and
(2)
notifies the individual or LAR in writing that the individual's name has been
added to the CLASS interest list in accordance with paragraph (1) of this
subsection.
(i) If HHSC
removes an individual's name from the CLASS interest list in accordance with
subsection (g)(1) - (4) of this section, HHSC receives an oral or written
request from a person to add the individual's name to the CLASS interest list
more than 90 calendar days after the name was removed, and the request is the
individual's first request, HHSC:
(1) adds
the individual's name to the CLASS interest list using as the CLASS interest
list date:
(A) the date HHSC receives the
oral or written request; or
(B) if
HHSC determines extenuating circumstances exist, the CLASS interest list date
that was in effect at the time the individual's name was removed from the CLASS
interest list; and
(2)
notifies the individual or LAR in writing that the individual's name has been
added to the CLASS interest list in accordance with paragraph (1) of this
subsection.
(j) If HHSC
removes an individual's name from the CLASS interest list in accordance with
subsection (g)(1) - (4) of this section, HHSC receives an oral or written
request from a person to add the individual's name to the CLASS interest list,
and the request is not the individual's first request:
(1) HHSC adds the individual's name to the
CLASS interest list using the date HHSC receives the oral or written request as
the CLASS interest list date; and
(2) HHSC notifies the individual or LAR in
writing that the individual's name has been added to the CLASS interest list in
accordance with paragraph (1) of this subsection.
(k) If HHSC removes an individual's name from
the CLASS interest list in accordance with subsection (g)(6) of this section
and HHSC subsequently receives an oral or written request from a person to add
the individual's name to the CLASS interest list, HHSC:
(1) adds the individual's name to the CLASS
interest list using the date HHSC receives the oral or written request as the
CLASS interest list date; and
(2)
notifies the individual or LAR in writing that the individual's name has been
added to the CLASS interest list in accordance with paragraph (1) of this
subsection.
