Current through Reg. 49, No. 38; September 20, 2024
(a) The Texas Department of Protective and
Regulatory Services (PRS) must give clients timely and/or adequate notice if a
review of the client's situation shows that the grant is to be lowered or
denied or services reduced or terminated; PRS decides to make or continue a
protective, vendor, or two-party payment; or PRS decides to continue a
protective payment in AFDC mismanagement cases.
(1) PRS mails a timely notice at least 10
days before the date of action. The 10-day period begins the day the notice is
mailed and ends 10 calendar days later, unless the 10th day is a nonworkday. In
this case, the period ends on the next workday.
(2) PRS continues assistance if a request for
a fair hearing is postmarked on or before the 10th day. Payment may not be
changed to a protective, vendor, or two-party payment pending the appeal. PRS
allows two full calendar days mailing time for receiving the appeal notice
before taking action to terminate or reduce assistance or services.
(3) An adequate notice includes a statement
of the proposed action; the reasons for the action; the specific regulations
supporting the action; an explanation of the client's right to a hearing, if
any; and the circumstances under which assistance or services are continued if
the client requests a hearing.
(4)
PRS must give adequate notice to every client for across-the-board reductions
necessarily made in good faith, such as denials or reductions made because of
raises in Social Security; reductions required because of changes in PRS
policies of general applicability; termination of the grant when a client
reaches the maximum eligibility age, such as an AFDC child reaching 18 years
old or 19 years old if attending school; or reduction because a member of the
dependent group received a new grant, and the total of the two grants is equal
to or larger than the original grant.
(b) PRS may withhold assistance or services
without the timely 10-day notice and continued benefits pending appeal, but it
must send adequate notice not later than the effective date of the action if:
(1) PRS has facts confirming the death of a
client or of an AFDC payee when no relative is available to serve as the new
payee;
(2) the client sends a clear
written and signed statement that he no longer wishes assistance or services.
The statement gives information that requires PRS to terminate or reduce
assistance or services. The client must indicate that he understands the
consequence of supplying this information;
(3) the client has been admitted or committed
to an institution, and further payments to the client do not qualify for
federal financial participation under the state plan;
(4) the client has been placed in skilled
nursing care, intermediate care, or long-term hospitalization;
(5) the client's whereabouts are unknown, and
the postal service returns mail PRS sent indicating no known forwarding
address. If the client is located during the payment period covered by the
returned check, PRS must make the check available to him;
(6) a client is accepted for assistance in a
new jurisdiction (either certified in another state or for SSI), and this has
been established by the new jurisdiction;
(7) an AFDC child is removed from the home as
a result of a judicial determination or voluntarily placed in foster care by
the legal guardian;
(8) the client
fails to submit a correctly completed status report, and the household admits
it did not submit the form;
(9) the
client's attending physician prescribes a lower level of care or concurs with
the Texas Department of Health's long-term care unit's change in level-of-care
determination; and
(10) a
protective or family self-support service is provided for a specific,
time-limited period, and the recipient was informed in writing when it was
initiated that the allowance or service terminates at the end of the specified
period.
(c) PRS may
terminate services without advance notice to a person receiving nonprotective
purchased community care for aged and disabled services who threatens his own
health or safety or that of others in the facility.