26 Tex. Admin. Code § 260.7

Current through Reg. 49, No. 45; November 8, 2024

Section 260.7 - Description of the DBMD Program and CFC

(a) The DBMD Program is a Medicaid waiver program approved by CMS and operated by HHSC pursuant to §1915(c) of the Social Security Act. It provides community-based services and supports to an eligible individual as an alternative to the ICF/IID Program. DBMD Program services are intended to:

(1) enhance the individual's integration into the community;

(2) maintain or improve the individual's independent functioning, and

(3) prevent the individual's admission to an institution.

(b) HHSC limits the enrollment in the DBMD Program to the number of individuals approved by CMS and funded by the State of Texas.

(c) The DBMD Program offers the following services approved by CMS:

(1) adaptive aids;

(2) residential assistance, provided as:

(A) licensed assisted living; or

(B) licensed home health assisted living;

(3) behavioral support;

(4) case management;

(5) chore services;

(6) day habilitation;

(7) dental treatment;

(8) dietary services;

(9) employment assistance;

(10) intervener services;

(11) minor home modifications;

(12) nursing;

(13) occupational therapy;

(14) orientation and mobility;

(15) physical therapy;

(16) residential habilitation;

(17) respite, provided as:

(A) in-home respite; or

(B) out-of-home respite;

(18) speech-language pathology;

(19) audiology;

(20) supported employment;

(21) TAS; and

(22) if the individual's IPC includes at least one DBMD Program service to be delivered through the CDS option:

(A) FMS; and

(B) support consultation.

(d) A program provider may only provide and bill for residential habilitation if the activity provided is transportation, as described in § 260.343(b)(1)(A)(ii)(I) of this chapter (relating to Day Habilitation, Residential Habilitation, and CFC PAS/HAB).

(e) CFC is a state plan option governed by CFR, Title 42, Part 441, Subpart K, regarding Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice) that provides the following services to an individual:

(1) CFC PAS/HAB;

(2) CFC ERS; and

(3) CFC support management for an individual receiving CFC PAS/HAB.

(f) A program provider with a contract enrollment date on or after September 1, 2009, must serve all counties within an HHSC region.

(g) A program provider with a contract enrollment date before September 1, 2009, may continue to serve only the counties specified in its contract. If such a program provider chooses to provide services in additional counties, the program provider does not have to serve all the counties within the HHSC region.

26 Tex. Admin. Code § 260.7

Adopted by Texas Register, Volume 48, Number 07, February 17, 2023, TexReg 0900, eff. 2/26/2023