Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 262 - TEXAS HOME LIVING (TxHmL) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
Subchapter D - DEVELOPMENT AND REVIEW OF AN IPC
Section 262.301 - IPC Requirements

Universal Citation: 26 TX Admin Code ยง 262.301

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

(a) An IPC must be based on the PDP and specify:

(1) the type and amount of each TxHmL Program service and CFC service to be provided to the individual during an IPC year;

(2) the services and supports to be provided to the individual through resources other than TxHmL Program services or CFC services during an IPC year, including natural supports, medical services, day activity, and educational services;

(3) if an individual will receive CFC support management; and

(4) if there are any TxHmL Program services or CFC services identified on the PDP as critical, requiring a service backup plan.

(b) If an applicant's or individual's IPC includes only CFC PAS/HAB to be delivered through the CDS option, a service coordinator must include in the IPC:

(1) CFC FMS instead of FMS; and

(2) if the applicant or individual will receive support consultation, CFC support consultation instead of support consultation.

(c) The type and amount of each TxHmL Program service and CFC service in an IPC:

(1) must be necessary to protect the individual's health and welfare in the community;

(2) must not be available to the individual through any other source, including the Medicaid State Plan, other governmental programs, private insurance, or the individual's natural supports;

(3) must be the most appropriate type and amount to meet the individual's needs;

(4) must be cost effective;

(5) must be necessary to enable community integration and maximize independence;

(6) if an adaptive aid or minor home modification, must:
(A) be included on HHSC's approved list in the TxHmL Program Billing Requirements; and

(B) be within the service limit described in § 262.304 of this subchapter (relating to Service Limits);

(7) if an adaptive aid costing $500 or more, must be supported by a written assessment from a licensed professional specified by HHSC in the TxHmL Program Billing Requirements;

(8) if a minor home modification costing $1,000 or more, must be supported by a written assessment from a licensed professional specified by HHSC in the TxHmL Program Billing Requirements;

(9) if dental treatment, must be within the service limit described in § 262.304 of this subchapter; and

(10) if CFC PAS/HAB, must be supported by the HHSC HCS/TxHmL CFC PAS/HAB Assessment form.

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