Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 259 - COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES (CLASS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
Subchapter G - ADDITIONAL CMA REQUIREMENTS
Section 259.305 - DSA Services Outside the Catchment Area
Universal Citation: 26 TX Admin Code ยง 259.305
Current through Reg. 49, No. 38; September 20, 2024
(a) If a CMA is notified by the DSA in accordance with § 259.359(g)(2) of this chapter (relating to DSA: Service Delivery) that an individual is receiving transportation as a habilitation activity, out-of-home respite in a camp, adaptive aids, nursing, or CFC PAS/HAB outside the catchment area in which the individual resides, the CMA must:
(1) provide an oral explanation to the
individual or LAR, on or before the 35th day of the period services have been
provided outside the catchment area, that:
(A) the individual must do one of the
following before the 61st day of the period services have been provided outside
the catchment area to ensure the continued provision of transportation as a
habilitation activity, out-of-home respite in a camp, adaptive aids, nursing,
or CFC PAS/HAB:
(i) transfer to a DSA
contract for the catchment area in which the individual is receiving
transportation as a habilitation activity, out-of-home respite in a camp,
adaptive aids, nursing, or CFC PAS/HAB; or
(ii) return to the catchment area in which
the individual resides; and
(B) if the individual receives transportation
as a habilitation activity, out-of-home respite in a camp, adaptive aids,
nursing, or CFC PAS/HAB outside the catchment area during a period of 60
consecutive days, the individual must return to the catchment area in which the
individual resides and receive services in that catchment area before the DSA
may accept another request from the individual or LAR that the DSA provide
transportation as a habilitation activity, out-of-home respite in a camp,
adaptive aids, nursing, or CFC PAS/HAB outside the catchment area;
(2) document that the CMA provided
the oral explanation required by paragraph (1) of this subsection; and
(3) if the individual or LAR
expresses a desire for the individual to transfer to a DSA contract for the
catchment area in which the individual is receiving transportation as a
habilitation activity, out-of-home respite in a camp, adaptive aids, nursing,
or CFC PAS/HAB:
(A) give the individual and
LAR or actively involved person a written list of CMAs and DSAs serving the
catchment area in which the individual is receiving transportation as a
habilitation activity, out-of-home respite in a camp, adaptive aids, nursing,
or CFC PAS/HAB;
(B) have the
individual or LAR select a CMA and DSA by completing an HHSC Selection
Determination form, as described in the Community Living Assistance and Support
Services Provider Manual; and
(C)
coordinate the individual's transfer in accordance with §
259.151 of this chapter (relating
to Coordination of Transfers).
(b) If an individual requests that the case manager convene a meeting of the service planning team to discuss the DSA's reasons for declining a request to allow services to be provided outside the catchment area, as described in § 259.359(h)(1)(B) of this chapter, the case manager must:
(1)
convene a meeting to review the reasons the DSA declined the request to allow
services outside the catchment area;
(2) facilitate a discussion between the
individual or LAR and the DSA during the meeting regarding the reasons the DSA
declined the request; and
(3)
document the results of the meeting.
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