Texas Register, Volume 49, Number 7, Pages 805-932, February 16, 2024 Page: 896
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apy, continued family services, dental treatment, dietary, employment
assistance, minor home modifications, nursing, occupational therapy
services, physical therapy services, specialized therapies, speech and
language pathology, support family services and transition assistance
services.
The renewal request proposes to make the following changes:
Main Attachment #2: Home and Community-Based Settings Waiver
Transition Plan
HHSC removed the attachment #2 transition plan language from the
main appendix. CMS is proposing to remove the attachment #2 Home
and Community-Based Settings Waiver Transition Plan option from
their updated CMS Home and Community-Based Services (HCBS)
waiver application template in 2024.
Appendix A: Waiver Administration and Operation
HHSC added an Administrative Authority Performance Measure as re-
quested by CMS as follows: A.a.1 Number and percent of individu-
als on the CLASS interest list who are offered waiver services on a
first-come, first served basis by HHSC. N: Number of individuals on
the CLASS interest list who are offered waiver services on a first come,
first-served basis. D: Number of individuals who are offered enroll-
ment from the interest list.
Appendix B: Participant Access and EligibilityHHSC clarified in the "Cost Limit" section that all individuals have
access to services up to the cost limit if they have an identified need
that is supported and justified.
HHSC increased the unduplicated number of participants served, and
the point-in-time totals, for all five waiver years and maintained the
same number of reserve capacity slots across all five waiver years.
HHSC clarified in the "Selection of Entrants to the Waiver" that when
an individual is placed on the interest list the individual's name, mailing
address, and date of birth is required.
HHSC clarified that anyone may request for an individual's name to be
added to the interest list by calling or submitting a written request to
HHSC.
HHSC clarified that the level of care (LOC) documentation may be
submitted electronically by fax or mail and that qualified intellectual
and developmental disability professionals (QIDP) review the LOC.
HHSC also clarified the annual resubmission and provider process.
HHSC updated the "Maintenance of Evaluation/Reevaluation
Records" section to include HHSC as an agency for records mainte-
nance.
HHSC updated the "Access to Services by Limited English Proficiency
Persons" section to align with current policy.
Appendix C: Participant ServicesHHSC updated provider qualifications throughout Appendix C to align
with current policy.
HHSC changed provider training for abuse, neglect, and exploitation
(ANE) from "within 60 days of employment" to "before assuming job
duties" to align with current policy.
HHSC updated provider qualifications reporting requirement training
for ANE to require reporting immediately, but no later than 24 hours.
HHSC revised information in the service provider qualifications about
who can be a service provider.HHSC updated the "Frequency of Verification" section for Supported
Employment to remove, "Individual/employer and financial manage-
ment services agency (FMSA) prior to hiring" and "HHSC Contract
staff verifies provider qualifications during on-site reviews, completed
every three years at a minimum" to align with current policy.
HHSC updated the Prevocational Services definition to reflect "goals
identified in the individual's individual program plan (IPP)." instead
of the "individual's habilitation plan" to align with current policy and
rules. Within the definition, replaced the term "employment" with
"competitive employment" to align with policies.
HHSC changed the term "face to face" to "in person" to reflect the ac-
curate terminology for habilitation services, and respite services defi-
nitions.
HHSC revised one of the locations in which respite care can be pro-
vided from "Individuals home or place of residence" to "Individual's
residence or the residence of a relative or friend". Added "The resi-
dence of another person receiving a Medicaid waiver service;" as an
additional location Respite care can be provided.
HHSC updated the verification of provider qualifications for respite
(out-of-home) Adult Foster Care Four Person Residence provider ser-
vice. New language reflects the current policy stating "HHSC Regu-
latory Services licenses four bed adult foster care homes as a Type A
or B, but only renews the limited number of Type C Assisted Living
facilities who were originally licensed as Type C."
HHSC removed "Vendor Drug" from the reference to the provider
agreement for prescription medications to align with current policy.
HHSC clarified that financial management services are services pro-
vided by an FMSA to an employer, not an individual. Clarified lan-
guage in the "Financial Management Services in the Frequency of Ver-
ification" section to make information requested in this section more
accurate. Clarified Texas Administrative Code (TAC) references to in-
clude Chapter 41 and included chapter titles.
HHSC clarified in the "Frequency of Verification" section that contract
staff conducts monitoring reviews at least every three years and each
contract is monitored at least every three years thereafter to align with
current policy.
HHSC clarified language that FMSAs must attend periodic trainings
conducted by HHSC.
HHSC updated reference to Internal Revenue Service Form 2678 to
include form name of Employer/Payer Appointment of Agent.
HHSC clarified that the supports for participant direction is provided by
a support advisor and provides a level of assistance beyond that pro-
vided by the FMSA. HHSC clarified that support consultation helps
the employer to meet the required employer responsibilities of the con-
sumer directed services (CDS) option.HHSC clarified in the "Provider Qualifications" section for both agency
and CDS options that the support advisor cannot be the individual or
the individual's spouse, the legally authorized representative (LAR) or
the legally authorized representative's spouse, or the designated repre-
sentative or the designated representative's spouse to align with current
policy.
HHSC clarified in the "Provider Qualifications" section that the FMSA
must have support consultation services available to be provided by a
support advisor upon request by the individual or individual's LAR.
HHSC clarified that the support advisor, not the provider, must have a
support advisor certificate issued by HHSC to indicate successful com-
pletion of required training conducted or approved by HHSC.49 TexReg 896 February 16, 2024 Texas Register
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Texas. Secretary of State. Texas Register, Volume 49, Number 7, Pages 805-932, February 16, 2024, periodical, February 16, 2024; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1657764/m1/92/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.