Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 301 - LOCAL AUTHORITY RESPONSIBILITIES
Subchapter F - PROVIDER NETWORK DEVELOPMENT
Section 301.269 - Plan Approval and Implementation

Universal Citation: 26 TX Admin Code § 301.269

Current through Reg. 50, No. 13; March 28, 2025

(a) Department review. The department shall review each plan to ensure compliance with the requirements of this subchapter and to determine whether the LMHA is making reasonable attempts to develop its provider network.

(1) The department shall establish a mechanism for stakeholder involvement in the review process.

(2) In reviewing an LMHA's plan, the department shall evaluate the level of effort made by the LMHA to achieve compliance and the rationale and any supporting documentation for its decisions and plans. This evaluation must include:
(A) the LMHA's response to public comment;

(B) the LMHA's past efforts and progress made in developing a network of external providers;

(C) the specific context of the local service area, including population density and distribution, existing service organizations, and local priorities;

(D) the potential impact on individual choice and access; and

(E) input from the LMHA's PNAC.

(3) The department may require an LMHA to submit additional information or documentation.

(b) Department approval. The department shall notify an LMHA of its decision within the timeframe established at the beginning of the planning cycle.

(1) The department shall approve the plan if it determines that the LMHA:
(A) is in compliance with the requirements of this subchapter; and

(B) is making reasonable attempts to develop an available and appropriate external provider base that is sufficient to meet the needs of individuals in its local service area.

(2) The department may require the LMHA to make revisions before approving the plan. If revisions are required, the department will determine a timeframe for resubmission.

(c) Posting the approved plan. After the department approves the plan, the LMHA shall post the approved version on its website. The posting must include the summary of public comments and the LMHA's response.

(d) Implementation. An LMHA shall conduct procurement as described in its approved plan.

(e) Amendment. If an LMHA determines it is unable to conduct the procurement as originally approved by the department, it shall submit a request for plan amendment to the department within 30 days of making the determination. An amendment is not required to expand the scope of a planned procurement or to conduct additional procurements outside of what is approved by the department. The department will evaluate the amendment request using the same process used for the original plan. Any proposed amendment must be approved in writing by the department and posted on the LMHA's website before it is implemented.

(f) List of external providers. The LMHA must maintain a current list of external providers on its website, including the name of each organization or private practitioner and the services provided. The list shall include the number of contracts and agreements with individual peer support providers, but not the names of individual peer support providers.

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