Texas Administrative Code
Title 40 - SOCIAL SERVICES AND ASSISTANCE
Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES
Chapter 48 - COMMUNITY CARE FOR AGED AND DISABLED
Subchapter I - CASE MANAGEMENT
Section 48.3901 - Application for Services

Universal Citation: 40 TX Admin Code ยง 48.3901

Current through Reg. 49, No. 38; September 20, 2024

(a) Information collected to determine eligibility for services, whether collected by DHS staff or provider agencies, is confidential.

(b) The applicant is entitled to a face-to-face interview during the department's determination of his eligibility for CCAD services. A person who is already receiving services from the Texas Department of Human Services (DHS) or for whom the Social Security Administration has already verified that income/resources are below the CCAD income/resource limit is not required to submit an application.

(c) Applicants or their representatives applying for services provided with regard to income must sign an application for assistance form. Non-Medicaid applicants or their representatives applying for retroactive reimbursement for Medicaid-covered attendant services must also sign an application for assistance form. The date of application is the date the department receives the signed application. Applicants must provide accurate information about income and resources.

(d) Eligibility for CCAD services for income-eligible applicants is determined within 30 calendar days after a signed application is received. For categorically-eligible applicants, eligibility must be determined within 30 calendar days after either the client's assessment or face-to-face contact with the worker, whichever comes first. If the applicant withdraws from the program before an assessment is completed or a face-to-face interview is conducted, no further action is necessary.

(e) Non-Medicaid applicants or their representatives applying for Medicaid-covered attendant services may be reimbursed for services provided up to three months prior to the month of receipt of a completed, signed, and dated application.

(f) The client must report promptly any changes in income, resources, or family size; loss of assistance grant or Medicaid benefits; or other changes in functional ability or circumstances that affect eligibility. The client is subject to fraud prosecution if he willfully fails to report changes and continues to receive services for which he is not eligible.

(g) A Medicaid-certified applicant for CCAD-purchased services who requires a verbal referral is eligible to receive CCAD-purchased services when his eligibility for Medicaid is verified. A non-Medicaid certified applicant who meets the requirements for a verbal referral is eligible to receive CCAD-purchased services while income and resources are verified.

(1) To be eligible, this applicant must:
(A) be a new applicant for CCAD services;

(B) appear to be eligible based on the declaration of income and resources on his application for services or have possession of a current medical care identification card; and

(C) meet the age and need criteria for the CCAD service he requires.

(2) The eligibility period for non-Medicaid applicants begins on the date of application.

(3) To continue receiving services, a non-Medicaid applicant must provide within 30 days of the application date the information needed to verify the applicant's income and resource amounts.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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