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 H - ADDITIONAL DSA REQUIREMENTS
Section 259.361 - Respite and Dental Treatment

Universal Citation: 26 TX Admin Code § 259.361

Current through Reg. 49, No. 38; September 20, 2024

(a) An individual may receive a maximum of 30 days of in-home and out-of-home respite combined, during an IPC period.

(b) A DSA must ensure that:

(1) in-home respite is provided in the individual's residence or the residence of a relative or friend that is not one of the settings listed in paragraph (2) of this subsection;

(2) out-of-home respite is provided in one of the following settings:

(A) an agency foster home;

(B) a nursing facility;

(D) an approved outdoor camp accredited by the American Camping Association;

(E) the residence of another person receiving a Medicaid waiver service; or

(F) an ALF; and

(3) the setting in which out-of-home respite is provided is:

(A) acceptable to the individual or LAR; and

(B) an accessible, safe, and comfortable environment for the individual and promotes the individual's health and welfare.

(c) If a DSA provides out-of-home respite in a residence described in subsection (b)(2)(E) of this section, the DSA must:

(1) obtain written approval from each person residing in the residence who is receiving a Medicaid waiver service, or LAR, for the provision of respite in the residence; and

(2) ensure that no more than four persons receiving a Medicaid waiver service are residing in the residence.

(d) The maximum amount HHSC approves as payment to a DSA for all dental treatment and adaptive aids combined for an individual is $10,000 per IPC period.

(e) A DSA must follow the process for requesting authorization to purchase dental treatment described in the Community Living Assistance and Support Services Provider Manual.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

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