Current through Reg. 50, No. 13; March 28, 2025
(a) A LIDDA must
maintain an up-to-date interest list of applicants interested in receiving HCS
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 HCS 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 HCS interest list using
the date the LIDDA receives the request as the HCS interest list
date.
(d) For an applicant under 22
years of age who is residing in an ICF/IID or nursing facility located in
Texas, HHSC adds the applicant's name to the HCS interest list using the date
of admission to the ICF/IID or nursing facility as the HCS interest list
date.
(e) 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 HCS interest list, at the request of the
applicant or LAR, HHSC adds the applicant's name to the HCS interest list using
the applicant's interest list date for the program for which the applicant was
determined ineligible as the HCS interest list date;
(2) if the applicant's name is on the HCS
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 HCS
interest list date, at the request of the applicant or LAR, HHSC changes the
applicant's HCS interest list date to the applicant's interest list date for
the program for which the applicant was determined ineligible; or
(3) if the applicant's name is on the HCS
interest list and the applicant's HCS 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 HCS interest list
date.
(f) This
subsection applies to an applicant who was enrolled in MDCP and, because the
applicant 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 HCS interest list:
(A) using the MDCP interest list date as the
HCS interest list date, if the applicant's name is not on the HCS interest list
but it was previously on the HCS interest list; or
(B) using the date HHSC receives the request
as the HCS interest list date, if the applicant's name is not on the HCS
interest list and it never has been on the HCS interest
list.
(2) At the request
of the applicant or LAR, HHSC changes the HCS interest list date to the MDCP
interest list date if the applicant's MDCP interest list date is earlier than
the applicant's HCS interest list date.
(g) HHSC or the LIDDA removes an applicant's
name from the HCS interest list if:
(1) the
applicant or LAR requests in writing that the applicant's name be removed from
the HCS interest list, unless the applicant is under 22 years of age and
residing in an ICF/IID or nursing facility;
(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 HCS
Program services or, as described in §
263.104(f) of
this subchapter (relating to Process for Enrollment of Applicants), an offer of
HCS Program services is withdrawn, unless:
(A)
the applicant is a military family member living outside of Texas:
(i) while the military member is on active
duty, or
(ii) for less than one
year after the former military member's active duty ends;
or
(B) the applicant is
under 22 years of age and residing in an ICF/IID or nursing
facility;
(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 HCS Program and the applicant or LAR has had an opportunity to exercise
the applicant's right to appeal the decision in accordance with §
263.801 of this chapter (relating
to Fair Hearing) and did not appeal the decision or appealed and did not
prevail.
(h) If HHSC or
the LIDDA removes an applicant's name from the HCS interest list in accordance
with subsection (g)(1) - (4) of this section, the LIDDA receives an oral or
written request from a person to add the applicant's name to the HCS 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
HCS interest list using the HCS interest list date that was in effect at the
time the applicant's name was removed from the HCS interest list; and
(B) notifies the applicant or LAR in writing
that the applicant's name has been added to the HCS interest list in accordance
with subparagraph (A) of this paragraph.
(i) If HHSC or the LIDDA removes an
applicant's name from the HCS interest list in accordance with subsection
(g)(1) - (4) of this section, the LIDDA receives an oral or written request
from a person to add the applicant's name to the HCS 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 HCS interest list using the date the LIDDA receives the oral or
written request as the HCS interest list date; or
(B) if HHSC determines that extenuating
circumstances exist, HHSC adds the applicant's name to the HCS interest list
using the HCS interest list date that was in effect at the time the applicant's
name was removed from the HCS interest list as the HCS interest list date;
and
(2) HHSC notifies the
applicant or LAR in writing that the applicant's name has been added to the HCS
interest list in accordance with paragraph (1) of this subsection.
(j) If HHSC or the LIDDA removes
an applicant's name from the HCS interest list in accordance with subsection
(g)(1) - (4) of this section, the LIDDA receives an oral or written request
from a person to add the applicant's name to the HCS interest list, and the
request is not the applicant's first request:
(1) the LIDDA adds the applicant's name to
the HCS interest list using the date the LIDDA receives the oral or written
request as the HCS interest list date; and
(2) HHSC notifies the applicant or LAR in
writing that the applicant's name has been added to the HCS interest list in
accordance with paragraph (1) of this subsection.
(k) If HHSC or the LIDDA removes an
applicant's name from the HCS interest list in accordance with subsection
(g)(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 HCS interest list:
(1) the LIDDA must add the applicant's name
to the HCS interest list using the date the LIDDA receives the oral or written
request as the HCS interest list date; and
(2) HHSC notifies the applicant or LAR in
writing that the applicant's name has been added to the HCS interest list in
accordance with paragraph (1) of this subsection.