Current through Reg. 49, No. 38; September 20, 2024
(a)
Within 30 days after the provider receives a referral from DADS regional
office, the provider must:
(1) ensure that
the assessor of need conducts an initial on-site assessment with the
applicant;
(2) determine CMPAS
Program eligibility in accordance with §44.201 of this subchapter
(relating to Eligibility Criteria);
(3) inform the applicant, both orally and in
writing, of all applicable publicly funded programs that offer attendant
services and allow the applicant to choose whether to participate in
CMPAS;
(4) keep in the applicant's
record a written record of the notification given in accordance with paragraph
(3) of this subsection and the applicant's signed and dated acknowledgement and
choice document;
(5) assess the
applicant's service needs by using the DADS Needs Assessment Questionnaire and
Task/Hour Guide form available at
www.dads.state.tx.us; and
(6) for an eligible applicant:
(A) develop a service plan based on the
results of the assessment questionnaire that:
(i) includes the number of hours and tasks
negotiated between the applicant and the assessor of need; and
(ii) is agreed to and signed by the applicant
and assessor of need;
(B)
determine with the applicant the amount of the applicant's co-payment under
§44.501 of this chapter (relating
to Determining an Individual's Co-payment) and explain to the applicant that
making co-payments is required to remain eligible for CMPAS;
(C) explain orally and give written
information to the applicant on the available service delivery options
described in Subchapter D of this chapter (relating to Service Delivery
Options);
(D) have the applicant
sign and date a service delivery option choice document; and
(E) keep the signed and dated service
delivery choice document in the applicant's file.
(b) If the applicant's service plan includes
a health-related task, the provider must:
(1)
before an attendant performs a health-related task, verify that the task:
(A) may be performed under Texas Government
Code, §
531.051(e);
(B) does not require nurse or physician
delegation; or
(C) is properly
delegated under:
(i) 22 TAC Part 11, Chapter
225; or
(ii) Texas Occupations
Code, Chapter 157; and
(2) if a health-related task is delegated,
maintain records in the applicant's file that:
(A) identify and are signed and dated by the
delegating physician or registered nurse;
(B) include the name of the individual, the
names of the attendants performing the delegated health-related tasks for the
individual, and a description of the specific health-related tasks to be
performed; and
(C) comply with the
Texas Nurse Practice Act, the Medical Practice Act, and any other applicable
state or federal law.
(c) The provider must notify an applicant who
is not eligible for services in writing by mailing the DADS Notification of
Community Care Services form within three days after the date of the decision.
This form notifies the applicant of the right to a fair hearing and explains
how to request a fair hearing.
(d)
The provider must send DADS written notice of the disposition of the referral.
The provider must ensure that DADS receives the notice within 30 days after the
provider receives the referral from DADS. If the provider does not notify DADS
within the 30-day period, DADS may impose contract sanctions on the
provider.
(e) The provider must
document any failure to complete the assessment activities within the 30-day
period, including the reasons for the delay, the provider's ongoing efforts to
complete the assessment, and the anticipated date of completion. The reasons
for delay must be beyond the provider's control. The provider must send the
documentation of delays to the DADS regional designee by the due date in
subsection (d) of this section.
(f)
Upon receiving notice from the provider of an applicant's eligibility to
receive services in the CMPAS Program, the DADS regional designee will enter
the CMPAS authorization in DADS Service Authorization System.
