Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 330 - LIDDA Role And Responsibilities
Section 330.9 - Access, Intake, and Enrollment Related Responsibilities
Universal Citation: 26 TX Admin Code ยง 330.9
Current through Reg. 49, No. 38; September 20, 2024
(a) Access. A LIDDA must have a place of business reasonably accessible to the residents of the local service area where an individual can request services and supports. The LIDDA must assist an individual for whom it is the designated LIDDA with accessing such services and supports.
(b) Screening.
(1) A LIDDA must develop and implement
policies and procedures related to screening an individual seeking services and
supports that address:
(A) providing an oral
and written explanation of services and supports to the individual and LAR or
actively involved person and family member using DADS-approved
documents;
(B) gathering and
documenting information to determine a need for services and
supports;
(C) triaging immediate
needs to be responsive to a crisis situation;
(D) determining whether a request can be met
with resources at the LIDDA or whether the individual will be directed to
alternate resources in the community;
(E) assisting the individual or LAR in
identifying services and supports preferences, documenting those preferences on
the DADS-approved form, and maintaining a copy of the documentation;
and
(F) if the services and
supports preferred by the individual or LAR are not available:
(i) assisting the individual or LAR in
gaining access to alternative services and supports and registering the
individual's name on the appropriate interest lists;
(ii) documenting efforts undertaken by the
LIDDA to obtain the requested services and supports, including the names and
addresses of programs and facilities to which the individual or LAR was
referred; and
(iii) documenting the
services and supports for which the individual is waiting.
(2) If the individual or LAR is
seeking residential services, the LIDDA must develop and implement policies and
procedures that address:
(A) providing to the
individual, LAR, and, unless the LAR is a family member, at least one family
member (if possible) both an oral and written explanation of the residential
services and supports for which the individual may be eligible, including:
(i) as required by THSC, §533.038(d):
(I) state supported living centers;
(II) community ICFs/IID;
(III) waiver services under §1915(c) of
the Social Security Act; and
(IV)
other community-based services and supports;
(ii) as required by THSC,
§533.038(g)(1), a copy of the DADS-approved publication relating to
residential options for individuals with an intellectual disability or related
condition; and
(iii) as required by
THSC, §533.038(g)(2), information relating to whether appropriate
residential services are available in each program for which the individual may
be eligible, including state supported living centers, community ICFs/IID,
waiver services, or other services located nearest to the residence of the
individual; and
(B) if an
individual is under 22 years of age, providing to the LAR an explanation of
permanency planning.
(c) Intake. A LIDDA must develop and implement policies and procedures related to intake that address:
(1) determining if an individual seeking
services and supports is a member of the LIDDA priority population in
accordance with Chapter 5, Subchapter D, of this title (relating to Diagnostic
Assessment), and eligible for general revenue services;
(2) determining an individual's eligibility
for service coordination in accordance with §2.554 of
this chapter (relating to Eligibility) contained in Subchapter L (relating to
Service Coordination for Individuals with an Intellectual Disability), and
documenting a description of the individual's preferences and needs using a
person-directed planning process that is consistent with DADS Person
Directed Planning Guidelines;
(3) conducting a financial assessment as
required by Subchapter C of this chapter (relating to Charges for Community
Services) and assisting an individual with applying for Medicaid benefits,
Supplemental Security Income, or Social Security Disability Income, if
appropriate;
(4) providing an
explanation of rights of individuals with an intellectual disability in
accordance with Chapter 4, Subchapter C of this title (relating to Rights of
Individuals with an Intellectual Disability); and
(5) providing information to the individual
and LAR about the LIDDA complaint, notification, and appeal processes in
accordance with Subchapter A of this chapter (relating to Local Authority
Notification and Appeal).
(d) Service coordination.
(1) A LIDDA must offer an individual service
coordination if the individual:
(A) is
eligible for Medicaid and service coordination; or
(B) is not eligible for Medicaid, but is
eligible for service coordination and will be enrolled in general revenue
services other than service coordination.
(2) A LIDDA must designate a staff member to
authorize and monitor an individual's service need in accordance with the
performance contract if the individual:
(A) is
not eligible for service coordination; and
(B) will be enrolled in a general revenue
service other than service coordination.
(e) Enrollment into general revenue services.
(1) A LIDDA must develop and implement
policies and procedures related to enrollment into general revenue services
that address:
(A) developing a written plan
of services and supports that uses a person-directed planning process and
includes:
(i) current services and supports,
including existing natural supports;
(ii) outcomes to be achieved by the
individual and the general revenue services to be provided to the
individual;
(iii) any assessment to
be conducted after enrollment;
(iv)
the reason for each general revenue service to be provided; and
(v) the amount and duration of each general
revenue service to be provided; and
(B) authorizing the provision of the general
revenue services identified in the plan.
(2) Except for the provision of respite in an
emergency, the LIDDA may not provide general revenue services unless authorized
in accordance with the policies and procedures required by paragraph (1) of
this subsection.
(f) Enrollment activities for the ICF/IID, HCS, and TxHmL programs.
(1) A LIDDA must enroll an individual in the
ICF/IID, HCS, or TxHmL program, in accordance with the performance contract and
DADS rules relating to those programs.
(2) A LIDDA must conduct permanency planning
for an individual under 22 years of age who is enrolling in an HCS Program
residential setting or an ICF/IID in accordance with the performance contract
and DADS rules relating to those programs.
(g) Enrollment activities for Community First Choice (CFC). A LIDDA must conduct enrollment activities for an individual who is referred to the LIDDA by a Medicaid managed care organization and who is enrolling in CFC in accordance with the performance contract and the LIDDA contract with the Medicaid managed care organization.
(h) Commitment or admission to a state supported living center (SSLC).
(1) A LIDDA
must perform its responsibilities related to an individual's commitment or
admission to an SSLC in accordance with Subchapter F of this chapter (relating
to Continuity of Services--State Facilities).
(2) A LIDDA must conduct permanency planning
for an individual under 22 years of age who resides in an SSLC in accordance
with §
2.283
of this chapter (relating to MRA and State MR Facility Responsibilities)
contained in Subchapter F (relating to Continuity of Services--State
Facilities), and the performance contract.
(i) Safety net functions. A LIDDA must develop policies and procedures related to safety net functions that reflect the priorities of its local planning efforts and are responsive to the needs of its local service area.
(j) PASRR Evaluations. A LIDDA must conduct Pre-admission Screening and Resident Review (PASRR) Evaluations as required by Chapter 17 of this title (relating to Pre-admission Screening and Resident Review (PASRR)) and the performance contract.
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