26 Tex. Admin. Code § 330.9

Current through Reg. 49, No. 49; December 6, 2024
Section 330.9 - Access, Intake, and Enrollment Related Responsibilities
(a) Access. A LIDDA must have a place of business reasonably accessible to the residents of the local service area where an individual can request services and supports. The LIDDA must assist an individual for whom it is the designated LIDDA with accessing such services and supports.
(b) Screening.
(1) A LIDDA must develop and implement policies and procedures related to screening an individual seeking services and supports that address:
(A) providing an oral and written explanation of services and supports to the individual and LAR or actively involved person and family member using DADS-approved documents;
(B) gathering and documenting information to determine a need for services and supports;
(C) triaging immediate needs to be responsive to a crisis situation;
(D) determining whether a request can be met with resources at the LIDDA or whether the individual will be directed to alternate resources in the community;
(E) assisting the individual or LAR in identifying services and supports preferences, documenting those preferences on the DADS-approved form, and maintaining a copy of the documentation; and
(F) if the services and supports preferred by the individual or LAR are not available:
(i) assisting the individual or LAR in gaining access to alternative services and supports and registering the individual's name on the appropriate interest lists;
(ii) documenting efforts undertaken by the LIDDA to obtain the requested services and supports, including the names and addresses of programs and facilities to which the individual or LAR was referred; and
(iii) documenting the services and supports for which the individual is waiting.
(2) If the individual or LAR is seeking residential services, the LIDDA must develop and implement policies and procedures that address:
(A) providing to the individual, LAR, and, unless the LAR is a family member, at least one family member (if possible) both an oral and written explanation of the residential services and supports for which the individual may be eligible, including:
(i) as required by THSC, §533.038(d):
(I) state supported living centers;
(II) community ICFs/IID;
(III) waiver services under §1915(c) of the Social Security Act; and
(IV) other community-based services and supports;
(ii) as required by THSC, §533.038(g)(1), a copy of the DADS-approved publication relating to residential options for individuals with an intellectual disability or related condition; and
(iii) as required by THSC, §533.038(g)(2), information relating to whether appropriate residential services are available in each program for which the individual may be eligible, including state supported living centers, community ICFs/IID, waiver services, or other services located nearest to the residence of the individual; and
(B) if an individual is under 22 years of age, providing to the LAR an explanation of permanency planning.
(c) Intake. A LIDDA must develop and implement policies and procedures related to intake that address:
(1) determining if an individual seeking services and supports is a member of the LIDDA priority population in accordance with Chapter 5, Subchapter D, of this title (relating to Diagnostic Assessment), and eligible for general revenue services;
(2) determining an individual's eligibility for service coordination in accordance with §2.554 of this chapter (relating to Eligibility) contained in Subchapter L (relating to Service Coordination for Individuals with an Intellectual Disability), and documenting a description of the individual's preferences and needs using a person-directed planning process that is consistent with DADS Person Directed Planning Guidelines;
(3) conducting a financial assessment as required by Subchapter C of this chapter (relating to Charges for Community Services) and assisting an individual with applying for Medicaid benefits, Supplemental Security Income, or Social Security Disability Income, if appropriate;
(4) providing an explanation of rights of individuals with an intellectual disability in accordance with Chapter 4, Subchapter C of this title (relating to Rights of Individuals with an Intellectual Disability); and
(5) providing information to the individual and LAR about the LIDDA complaint, notification, and appeal processes in accordance with Subchapter A of this chapter (relating to Local Authority Notification and Appeal).
(d) Service coordination.
(1) A LIDDA must offer an individual service coordination if the individual:
(A) is eligible for Medicaid and service coordination; or
(B) is not eligible for Medicaid, but is eligible for service coordination and will be enrolled in general revenue services other than service coordination.
(2) A LIDDA must designate a staff member to authorize and monitor an individual's service need in accordance with the performance contract if the individual:
(A) is not eligible for service coordination; and
(B) will be enrolled in a general revenue service other than service coordination.
(e) Enrollment into general revenue services.
(1) A LIDDA must develop and implement policies and procedures related to enrollment into general revenue services that address:
(A) developing a written plan of services and supports that uses a person-directed planning process and includes:
(i) current services and supports, including existing natural supports;
(ii) outcomes to be achieved by the individual and the general revenue services to be provided to the individual;
(iii) any assessment to be conducted after enrollment;
(iv) the reason for each general revenue service to be provided; and
(v) the amount and duration of each general revenue service to be provided; and
(B) authorizing the provision of the general revenue services identified in the plan.
(2) Except for the provision of respite in an emergency, the LIDDA may not provide general revenue services unless authorized in accordance with the policies and procedures required by paragraph (1) of this subsection.
(f) Enrollment activities for the ICF/IID, HCS, and TxHmL programs.
(1) A LIDDA must enroll an individual in the ICF/IID, HCS, or TxHmL program, in accordance with the performance contract and DADS rules relating to those programs.
(2) A LIDDA must conduct permanency planning for an individual under 22 years of age who is enrolling in an HCS Program residential setting or an ICF/IID in accordance with the performance contract and DADS rules relating to those programs.
(g) Enrollment activities for Community First Choice (CFC). A LIDDA must conduct enrollment activities for an individual who is referred to the LIDDA by a Medicaid managed care organization and who is enrolling in CFC in accordance with the performance contract and the LIDDA contract with the Medicaid managed care organization.
(h) Commitment or admission to a state supported living center (SSLC).
(1) A LIDDA must perform its responsibilities related to an individual's commitment or admission to an SSLC in accordance with Subchapter F of this chapter (relating to Continuity of Services--State Facilities).
(2) A LIDDA must conduct permanency planning for an individual under 22 years of age who resides in an SSLC in accordance with § 2.283 of this chapter (relating to MRA and State MR Facility Responsibilities) contained in Subchapter F (relating to Continuity of Services--State Facilities), and the performance contract.
(i) Safety net functions. A LIDDA must develop policies and procedures related to safety net functions that reflect the priorities of its local planning efforts and are responsive to the needs of its local service area.
(j) PASRR Evaluations. A LIDDA must conduct Pre-admission Screening and Resident Review (PASRR) Evaluations as required by Chapter 17 of this title (relating to Pre-admission Screening and Resident Review (PASRR)) and the performance contract.

26 Tex. Admin. Code § 330.9

Transferred from 40 TAC § 2.307 Texas Register, Volume 49, Number 24, June 14, 2024, TexReg 4433, eff. 7/15/2024