Current through Reg. 49, No. 49; December 6, 2024
Section 261.256 - Program Provider-Managed Personal Funds(a) Accounting for personal funds. If a program provider manages personal funds, the program provider must comply with this section and ensure that: (1) a complete accounting of personal funds entrusted to the program provider is maintained;(2) personal funds are not commingled with program provider funds or the funds of any person other than another individual for whom the program provider manages personal funds; and(3) personal funds are only expended for the individual's use and benefit and in a manner and for purposes determined to be in the individual's best interest.(b) Account requirements. A program provider must manage personal funds in a trust fund account. (1) The program provider may manage personal funds in a pooled account or a separate account. If the program provider chooses a pooled account, an individual may request and receive a separate account. The program provider may also maintain some personal funds in a petty cash fund.(2) Trust fund accounts must be insured under federal or state law.(3) The program provider must retain all statements from financial institutions regarding trust fund accounts.(4) The program provider must reconcile such statement with the account ledger as described in subsection (c)(1)(A) and (2)(A) of this section and personal ledger as described in subsection (h)(1)(F) of this section within 30 days after receiving such statement.(c) Types of accounts. (1) Pooled accounts. If a program provider manages personal funds in a pooled account, the program provider must: (A) maintain an account ledger that separately identifies each financial transaction, including: (i) the name of the individual for whom the transaction was made;(ii) the date and amount of the transaction, including interest; and(iii) the balance after the transaction;(B) title the account "Name of facility), Resident Trust Fund Account" or a similar title that shows a fiduciary relationship exists between an individual and the program provider; and(C) if the personal funds of Medicaid and private-pay individuals are pooled, obtain a signed, dated statement from private pay individuals allowing the program provider to release financial information to DADS, Health and Human Services Commission, Texas Attorney General's Medicaid Fraud Control Unit, and US Department of Health and Human Services.(2) Separate accounts. If a program provider manages personal funds in a separate account, the program provider must: (A) maintain an account ledger that identifies each financial transaction, including: (i) the date and amount of the transaction, including interest; and(ii) the balance after the transaction; and(B) title the account "(Program Provider's Name), (Individual's Name) Trust Fund Account" or a similar title that shows a fiduciary relationship exists between an individual and the program provider.(d) Petty cash fund. If a program provider maintains some personal funds in a petty cash fund, the program provider must: (1) set a limit on the amount maintained in the petty cash fund;(2) set a limit on the amount of a single expenditure from the petty cash fund;(3) maintain a petty cash fund ledger that includes: (A) the date and amount of each transaction;(B) the name of the individual for whom each transaction was made; and(C) the balance after each transaction.(e) Interest. If personal funds accrue interest, a program provider must prorate and distribute the interest earned to each participating individual.(f) Depositing personal funds. A program provider must deposit in a trust fund account all funds that it receives on behalf of the individual. If the deposit slip documents deposits for more than one individual, the program provider must indicate on the deposit slip the amount allocated to each individual.(g) Access to personal funds. (1) An individual's IDT must, based on the individual's assessment described in § 261.253 of this chapter (relating to Determining Management of Personal Funds), determine: (A) if there is a need for a budgeted amount and, if so, set the amount; and(B) if there is a need to restrict the individual's use of personal funds and, if so, make a recommendation to the specially constituted committee.(2) If the individual's IDT makes a recommendation to the specially constituted committee to restrict an individual's use of to personal funds, the specially constituted committee's decision is documented, signed by the specially constituted committee members, and made a part of the individual's IPP.(h) Personal funds record. (1) A program provider must maintain a personal funds record for each individual that includes: (A) the name of the individual;(B) the name of the individual's LAR and representative payee, as applicable;(C) the date of the individual's admission to the facility;(D) the individual's budgeted amount;(E) the account number and location of all accounts in which the individual's personal funds are managed;(F) a personal ledger that includes the date and amount of each transaction and the balance after each transaction; and(G) any contribution acknowledgment as described in § 261.261 of this chapter (relating to Contributions).(2) The personal ledger reconciled in accordance with subsection (b)(4) of this section must not be less than zero. If reconciled balance is less than zero, the program provider must deposit in and credit to the individual's trust fund account the amount that increases such balance to zero.(3) At least quarterly, and within 72 hours after receiving a request from the individual or LAR, the program provider must provide to the individual or LAR a copy of the individual's personal ledger.(i) Documenting expenditures and deposits. (1) Expenditures. (A) Except as provided in subparagraph (C) of this paragraph, a program provider must retain a sales receipt for each expenditure. (i) If a sales receipt documents an expenditure for more than one individual, the program provider must indicate on the sales receipt the amount allocated to each individual.(ii) If a sales receipt does not include the specific item or service purchased or the name of the seller, the program provider must attach such documentation.(B) The program provider must explain each expenditure to the individual and request that the individual sign the receipt. If the program provider determines that the individual does not understand the explanation, the individual does not sign the receipt, or the individual's signature is illegible, a witness to the expenditure must sign the receipt. The witness must not be responsible for managing personal funds or responsible for supervising persons performing such duties.(C) A sales receipt is not required for an expenditure: (i) if the program provider makes a purchase on behalf of an individual from a vending machine;(ii) if an expenditure is within the individual's budgeted amount and the program provider obtains an acknowledgment signed by the individual indicating that the funds were received;(iii) if the program provider releases funds in response to a written request in accordance with § 261.257 of this chapter (relating to Requests for Personal Funds from Trust Fund Accounts); or(iv) if the program provider obtains written approval for alternative documentation from DADS before the expenditure is made.(2) Deposits. Except for deposits made electronically, a program provider must retain a deposit slip issued by the financial institution for each deposit.26 Tex. Admin. Code § 261.256
Adopted to be effective January 1, 2001, 25 TexReg 12790; amended to be effective September 1, 2001, 26 TexReg 5384; Transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 4, 2013, 38 TexReg 7724; Transferred from Title 40, § 9.256 by Texas Register, Volume 45, Number 35, August 28, 2020, TexReg 6127, eff. 10/1/2020