Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 261 - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM-CONTRACTING
Subchapter E - ELIGIBILITY, ENROLLMENT AND REVIEW
Section 261.236 - Eligibility Criteria

Universal Citation: 26 TX Admin Code § 261.236

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

(a) To be eligible for the ICF/MR Program, a person must:

(1) meet the LOC I or LOC VIII criteria described in § 261.238 of this chapter (relating to Level of Care I Criteria) and § 261.239 of this chapter (relating to Level of Care VIII Criteria);

(2) be in need of and able to benefit from the active treatment provided in the 24-hour supervised residential setting of an ICF/MR; and

(3) be eligible for Supplemental Security Income (SSI) or be determined by TDHS to be financially eligible for Medicaid.

(b) Circumstances under which a person is not in need of and able to benefit from active treatment include when the person:

(1) has been diagnosed by a licensed physician as having "brain death";

(2) does not respond in any way to the living environment;

(3) has a health condition that prevents participation in active treatment; or

(4) is generally able to function with little supervision or without a program of continuous active treatment.

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