Current through Reg. 49, No. 38; September 20, 2024
(a) A LIDDA must
maintain an up-to-date interest list of applicants interested in receiving
TxHmL Program services for whom the LIDDA is the applicant's designated LIDDA
in the HHSC data system.
(b) A
person may request that an applicant's name be added to the TxHmL interest list
by contacting the LIDDA serving the Texas county in which the applicant or
person resides.
(c) If a request is
made in accordance with subsection (b) of this section for an applicant who
resides in Texas, a LIDDA must add the applicant's name to the TxHmL interest
list using the date the LIDDA receives the request as the TxHmL interest list
date.
(d) For an applicant
determined diagnostically or functionally ineligible during the enrollment
process for the Community Living Assistance and Support Services (CLASS)
Program, Deaf-Blind with Multiple Disabilities (DBMD) Program, or Medically
Dependent Children Program (MDCP):
(1) if the
applicant's name is not on the TxHmL interest list, at the request of the
applicant or LAR, HHSC adds the applicant's name to the TxHmL interest list
using the applicant's interest list date for the program for which the
applicant was determined ineligible as the TxHmL interest list date;
(2) if the applicant's name is on the TxHmL
interest list and the applicant's interest list date for the program for which
the applicant was determined ineligible is earlier than the applicant's TxHmL
interest list date, at the request of the applicant or LAR, HHSC changes the
applicant's TxHmL interest list date to the applicant's interest list date for
the program for which the applicant was determined ineligible as the TxHmL
interest list date; or
(3) if the
applicant's name is on the TxHmL interest list and the applicant's TxHmL
interest list date is earlier than the applicant's interest list date for the
program for which the applicant was determined ineligible, HHSC does not change
the applicant's TxHmL interest list date.
(e) This subsection applies to an applicant
who was enrolled in MDCP and, because the individual did not meet the LOC
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 applicant or LAR, HHSC adds the applicant's name to the TxHmL
interest list:
(A) using the MDCP interest
list date as the TxHmL interest list date, if the applicant's name is not on
the TxHmL interest list but it was previously on the TxHmL interest list;
or
(B) using the date HHSC receives
the request as the TxHmL interest list date, if the applicant's name is not on
the TxHmL interest list and it never has been on the TxHmL interest
list.
(2) At the request
of the applicant or LAR, HHSC changes the TxHmL interest list date to the MDCP
interest list date if the applicant's MDCP interest list date is earlier than
the applicant's TxHmL interest list date.
(f) HHSC or the LIDDA removes an applicant's
name from the TxHmL interest list if:
(1) the
applicant or LAR requests in writing that the applicant's name be removed from
the TxHmL interest list;
(2) the
applicant moves out of Texas, unless the applicant 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 applicant declines an offer of TxHmL
Program services or, as described in §
262.103(f) of
this subchapter (relating to Process for Enrollment of Applicants), an offer of
TxHmL Program services is withdrawn, unless the applicant 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;
(4) the applicant 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
applicant is deceased; or
(6) HHSC
has denied the applicant enrollment in the TxHmL Program and the applicant or
LAR has had an opportunity to exercise the applicant's right to appeal the
decision in accordance with §
262.601 of this chapter (relating
to Fair Hearing) and did not appeal the decision, or appealed and did not
prevail.
(g) If HHSC or
the LIDDA removes an applicant's name from the TxHmL interest list in
accordance with subsection (f)(1) - (4) of this section and, within 90 calendar
days after the name was removed, the LIDDA receives an oral or written request
from a person to add the applicant's name to the TxHmL interest list:
(1) the LIDDA must notify HHSC of the
request; and
(2) HHSC:
(A) adds the applicant's name to the TxHmL
interest list using the TxHmL interest list date that was in effect at the time
the applicant's name was removed from the TxHmL interest list; and
(B) notifies the applicant or LAR in writing
that the applicant's name has been added to the TxHmL interest list in
accordance with subparagraph (A) of this paragraph.
(h) If HHSC or the LIDDA
removes an applicant's name from the TxHmL interest list in accordance with
subsection (f)(1)-(4) of this section, the LIDDA receives an oral or written
request from a person to add the applicant's name to the TxHmL interest list
within 90 calendar days after the name was removed, and the request is the
applicant's first request:
(1) the LIDDA must
notify HHSC of the request; and
(2)
HHSC:
(A) adds the applicant's name to the
TxHmL interest list using the TxHmL interest list date that was in effect at
the time the applicant's name was removed from the TxHmL interest list;
and
(B) notifies the applicant or
LAR in writing that the applicant's name has been added to the TxHmL interest
list in accordance with subparagraph (A) of this
paragraph.
(i)
If HHSC or the LIDDA removes an applicant's name from the TxHmL interest list
in accordance with subsection (f)(1)-(4) of this section, the LIDDA receives an
oral or written request from a person to add the applicant's name to the TxHmL
interest list more than 90 calendar days after the name was removed, and the
request is the applicant's first request:
(1)
one of the following occurs:
(A) the LIDDA
adds the applicant's name to the TxHmL interest list using the date the LIDDA
receives the oral or written request as the TxHmL interest list date;
or
(B) if HHSC determines that
extenuating circumstances exist, HHSC adds the applicant's name to the TxHmL
interest list using the TxHmL interest list date that was in effect at the time
the applicant's name was removed from the TxHmL interest list as the TxHmL
interest list date; and
(2) HHSC notifies the applicant or LAR in
writing that the applicant's name has been added to the TxHmL interest list in
accordance with paragraph (1) of this subsection.
(j) If HHSC or the LIDDA removes an
applicant's name from the TxHmL interest list in accordance with subsection
(f)(1)-(4) of this section, the LIDDA receives an oral or written request from
a person to add the applicant's name to the TxHmL interest list, and the
request is not the applicant's first request:
(1) the LIDDA adds the applicant's name to
the TxHmL interest list using the date the LIDDA receives the oral or written
request as the TxHmL interest list date; and
(2) HHSC notifies the applicant or LAR in
writing that the applicant's name has been added to the TxHmL interest list in
accordance with paragraph (1) of this subsection.
(k) If HHSC or the LIDDA removes an
applicant's name from the TxHmL interest list in accordance with subsection
(f)(6) of this section and the LIDDA subsequently receives an oral or written
request from a person to add the applicant's name to the TxHmL interest list:
(1) the LIDDA must add the applicant's name
to the TxHmL interest list using the date the LIDDA receives the oral or
written request as the TxHmL interest list date; and
(2) HHSC notifies the applicant or LAR in
writing that the applicant's name has been added to the TxHmL interest list in
accordance with paragraph (1) of this subsection.
