Aging and Disability Services Council Sharon Swift Butterworth ...

section.
§45.405. Reduction of a CLASS Program Service.
(a) DADS reduces a CLASS Program service on an individual's IPC, based on a review
described in §45.223 of this chapter (relating to Renewal and Revision of an IPC) or §45.225 of
this chapter (relating to Utilization Review of an IPC by DADS), if:
[begin addition] (1) [end addition] DADS determines that the IPC does not meet;
[begin addition] (A) [end addition] the requirements described in §45.214(b) of this chapter
(relating to Development of Enrollment IPC); or
[begin addition] (B) [end addition] the requirements described in Subchapter F of this chapter
(relating to Adaptive Aids and Minor Home Modifications);[.]
[begin addition] (2) the service is transition assistance services and the service limit described in
§45.218(c)of this division (relating to Service Limits) is exceeded; or
(3) DADS denies a request for an exception to the service limit of a service described in
§45.218(b) of this division submitted in accordance with §45.219(c) of this chapter (relating to
Exception of Service Limits). [end addition]
(b) DADS notifies the individual's CMA, in writing, if it proposes to reduce a CLASS
Program service. DADS sends a copy of the modified IPC to the CMA .
(c) Upon receipt of a written notice from DADS proposing to reduce a CLASS Program
service, the CMA must, in accordance with the CLASS Provider Manual, send written notice to
the individual or LAR of the proposal to reduce the service, copying the individual's DSA and, if
selected, CDSA. The CMA must include in the notice the individual's right to request a fair
hearing in accordance with §45.301 of this chapter (relating to Individual's Right to a Fair
Hearing).
(d) If the individual or LAR requests a fair hearing before the effective date of the reduction
of a CLASS Program Service, as specified in the written notice, the modified IPC described in
subsection (b) of this section may not be implemented and the DSA must provide the service to
the individual in the amount authorized in the prior IPC while the appeal is pending.
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to
be within the agency's legal authority to adopt.
Issued in Austin, Texas, on .
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