Section 277.67 - Service Delivery Plan Changes(a) Increase in hours or terminations. (1) A provider must submit written notification to the case worker within seven days after learning of any change that may: (A) require an increase in hours in the individual's service delivery plan; or(B) result in the termination of services due to the individual receiving no ADLs, except for the FC Program .(2) The notification must include the: (A) date the provider learned of the need for the change;(B) reason for the change;(C) type of change, including the number of hours of service; and(D) signature and date of the provider representative.(b) Decrease in hours. The provider must develop a new service delivery plan, as described in § 47.45(a)(2) of this chapter (relating to Pre-Initiation Activities), within 21 days of the provider identifying the need for an ongoing decrease in hours from the service delivery plan currently approved by the individual.(c) Immediate increase in hours of service. (1) The provider must notify the case worker , or designee, of the reason an individual requires an immediate increase in hours of service, and must obtain approval from HHSC of both the number of additional hours of service to be provided the individual and the effective date of the change.(2) The provider must implement the immediate increase in hours of service on the negotiated effective date of the change.(3) The provider must document the immediate increase in hours of service. Documentation must include: (A) the date the provider received approval for the change;(B) the name of the HHSC staff who approved the change;(C) the effective date of the change; and(D) the number of hours of service authorized.(4) The provider must maintain documentation regarding an immediate increase in hours of service(d) Implementation of service delivery plan changes described in subsections (a) - (c) of this section. The provider must implement the service delivery plan change on the following date, whichever is later: (1) the authorization begin date on HHSC's Authorization for Community Care Services form; or(2) five days after the date the provider receives HHSC's Authorization for Community Care Services form, unless the provider fails to stamp the receipt date on the form, in which case the authorization begin date on the form will be used to determine timeliness.(e) Delay in implementation of service delivery plan changes described in subsections (a) - (c) of this section. If a provider does not implement a service delivery plan change on the effective date of the change, the provider must set a new implementation date. The provider must document by the next working day any failure to implement a service delivery plan change on the effective date of the change. The documentation must include: (1) the reason for the failure to timely implement the service delivery plan change; and(2) the new implementation date.(f) Temporary service delivery plan changes. (1) A provider may temporarily change an individual's service delivery plan if: (A) the individual requests and requires temporary assistance with allowable tasks not identified on the service delivery plan due to a change in circumstances or available supports; and (B) the change in tasks does not increase the total approved hours of service or continue for more than 60 days. (2) If a temporary change in tasks on the service delivery plan will continue for more than 60 days or result in more hours of service provided than have been approved, a provider must: (A) request and obtain a new HHSC Authorization for Community Care Services form; and(B) provide services according to HHSC's Authorization for Community Care Services form until the provider receives a new form from the case worker.(3) A provider must maintain the following documentation in an individual's file regarding a temporary change in the service delivery plan: (A) the specific change in the service delivery plan;(B) the duration of the temporary change; and (C) the reason for the temporary change.26 Tex. Admin. Code § 277.67
Transferred from 40 TAC § 47.67 Texas Register, Volume 49, Number 24, June 14, 2024, TexReg 4436, eff. 7/1/2024