Current through Reg. 50, No. 13; March 28, 2025
(a) If a service
coordinator receives information that an individual wants to transfer to a
different program provider or FMSA, or that an LAR wants the individual to
transfer to a different program provider or FMSA, the service coordinator must:
(1) if the information was received from the
individual or LAR, document the date the information was received in the
individual's record;
(2) if the
information was received from a person other than the individual or LAR, within
three business days after the information was received:
(A) contact the individual or LAR to confirm
whether the individual wants to transfer or the LAR wants the individual to
transfer to a different program provider or FMSA; and
(B) if the service coordinator makes the
confirmation described in subparagraph (A) of this paragraph, document such
confirmation in the individual's record; and
(3) within three business days after
receiving information from the individual or LAR that the individual wants to
transfer or the LAR wants the individual to transfer to a different program
provider or FMSA or making the confirmation described in paragraph (2)(A) of
this subsection:
(A) explain to the
individual or LAR that the individual may transfer to a program provider whose
enrollment has not reached its service capacity in the HHSC data system or FMSA
of the individual's or LAR's choice; and
(B) provide the individual or LAR the names
and contact information of all program providers or FMSAs in the geographic
location preferred by the individual or LAR.
(b) After the individual or LAR selects a
different program provider or FMSA, the service coordinator must coordinate
with the individual, LAR, the transferring program provider or FMSA, and the
receiving program provider or FMSA to determine a transfer effective date that
is:
(1) not earlier than the date of the
meeting described in subsection (c)(2) of this section; and
(2) agreed to by the service coordinator, the
individual or LAR, and the receiving program provider.
(c) On or before the transfer effective date,
the service coordinator must:
(1) take action
to complete the HHSC Request for Transfer of Waiver Program Services form in
accordance with the HCS Handbook;
(2) convene a meeting with the individual or
LAR and the receiving program provider or receiving FMSA to develop a transfer
IPC;
(3) send the individual's IPC,
ID/RC, and PDP to the receiving program provider or the receiving
FMSA;
(4) if the individual is
transferring to a different program provider, request the following records of
the individual from the transferring program provider;
(A) pertinent medication records and medical
information;
(C) Medicare information, if
applicable;
(D) the ICAP booklet
and summary sheet;
(E) trust
fund/financial records and any money due the individual;
(F) behavior support plan, if
applicable;
(G) guardianship
information, if applicable; and
(H)
any other pertinent information to ensure health and safety or continuity of
services;
(5) within two
business days after receipt of the records requested in accordance with
paragraph (4) of this subsection, send the records to the receiving program
provider; and
(6) if, within three
business days after requesting that the program provider provide records as
described in paragraph (4) of this subsection, the service coordinator does not
receive all of the records requested, notify HHSC that the records were not
received.
(d) If an
individual was evicted by a program provider or service provider of host
home/companion care and the individual or LAR has not paid the delinquent room
or board, but wants to include residential support, supervised living, or host
home/companion care on the individual's IPC, the service coordinator must
inform the individual or LAR at the meeting described in subsection (c)(2) of
this section that HHSC will deny residential support, supervised living, or
host home/companion care, if included on the individual's IPC, until the
individual pays the delinquent room or board.
(e) Within 10 business days after the
transfer effective date, the service coordinator must:
(1) complete data entry into the HHSC data
system in accordance with the HCS Handbook after the activities described in
subsection (c) of this section are completed; and
(2) send the transfer IPC and HHSC Request
for Transfer of Waiver Program Services form to HHSC.
