Aging and Disability Services Council Sharon Swift Butterworth ...

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modifications. DADS applies the error to the total number of dollars reimbursed in excess of the amount on the invoice/receipt [begin deletion], plus the appropriate dollar amount of the requisition fee, if applicable [end deletion]. (12) If there is no invoice/receipt for the purchase of adaptive aids/vehicle modifications or for the completion of minor home modifications for which the provider has been reimbursed, DADS applies the error to the total dollar amount reimbursed for adaptive aids/vehicle modifications or minor home modifications in question [begin deletion], including the requisition fee [end deletion]. 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 . - 69 -
TITLE 40 SOCIAL SERVICES AND ASSISTANCE PART 1 DEPARTMENT OF AGING AND DISABILITY SERVICES CHAPTER 48 COMMUNITY CARE FOR AGED AND DISABLED The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §§48.6002, 48.6003, 48.6006, 48.6010, 48.6026, 48.6052, 48.6068, 48.6078, 48.6084, 48.6090, 48.6092, 48.6098, 48.6100, 48.6102, and 48.6104, concerning community based alternatives (CBA) definitions, eligibility criteria, individual plan of care, client’s right to appeal, home and community support services agency (HCSSA) qualifications, cost-effective purchases of adaptive aids, cost-effective purchases of minor home modifications, billable units, service claim limits, fiscal monitoring and recoupment, initiation of community based alternatives (CBA) home and community support services (HCSS), circumstances requiring denial of services with advance notice, circumstances requiring denial of services and Medicaid eligibility without advance notice, circumstances which may result in denial of services and require advance notice, and crisis intervention requiring immediate suspension or reduction of services without advance notice; and new §§48.6085, 48.6109, and 48.6110, concerning exception to service limit, denial of a CBA program service, and reduction of a CBA program service, in Chapter 48, Community Care for Aged and Disabled. BACKGROUND AND PURPOSE The purpose of the amendments and new sections is to implement the 2012-2013 General Appropriations Act (Article II, Special Provisions, Section 17, House Bill 1, 82nd Legislature, Regular Session, 2011), which requires DADS to adjust the amount of all community services, including Community Based Alternatives (CBA) Program services, and make reductions related to provider requisition and specification fees as cost saving measures for the state budget. The rules in Chapter 48, Subchapter J describe the requirements for operation of the CBA Program. Regarding the requirement to adjust community services, the amendments and new rules establish service limits, effective through August 31, 2013, for the following CBA Program services: adaptive aids, medical supplies, dental services, minor home modifications, respite, occupational therapy, personal assistance services, physical therapy, speech, hearing and language therapy. For each service, the service limit is based on the 90th percentile of paid units for individuals who received the service during fiscal year 2010. These service limits describe the maximum amount of services an individual in the CBA Program may receive without being granted an exception. In addition, the amendments and new rules describe the exception process by which DADS may allow an individual to receive services in excess of these service limits. The new rules also provide that the current limits for adaptive aids and medical supplies, minor home modifications, and respite remain in place even if DADS grants an exception to the new, lower service limits. The new rules add limits for dental services that an exception granted by DADS may not exceed. The amendments further provide that the current limits for adaptive aids, medical supplies, and minor home modifications and new limits for dental services that were in effect before December 1, 2011 will continue to be in effect as of September 1, 2013. Regarding the requirement to reduce requisition fees, the amendments eliminate the process by which a CBA provider requests and DADS authorizes payment for a specification fee for adaptive aids - 1 -
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Aging and Disability Services Counc
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Aging and Disability Services Counc
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SUBJEC CT: Agenda a Item No. : 7a 7
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July 11, 2008/11R12 TITLE 40 SOCIAL
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Legend: [begin addition] Single Und
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(B) whose family intends to apply f
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are not limited to, 24-hour supervi
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(a) of this section, the MRA must p
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TAKINGS IMPACT ASSESSMENT DADS has
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and requires multiagency services.
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(ii) has documentation of a profici
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Agenda Item No. : 7b September 14,
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for each year of the first five yea
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(1) submitting an application for a
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PUBLIC BENEFIT AND COSTS Veronda Du
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possible to test with the same NATC
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(2) written or oral examination as
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easonable accommodations for medica
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(3) The examination must be given a
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(ii) a student enrolled in an accre
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(1) administer a medication by any
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accredited school of nursing. (4) D
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(B) a statement that all of the req
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(2) If, after review, DADS determin
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(9) A permit that is not renewed du
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(I) allowable and prohibited practi
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(A) the issuance of an initial perm
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(B) If a suspension overlaps a rene
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Agenda Item No. : 7c September 14,
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(b) - (e) (No change.) This agency
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(b) - (g) (No change.) This agency
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Convictions Barring Facility Licens
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[begin addition] Denial or Refusal
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(b) - (f) (No change.) This agency
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(C) a controlling person of the app
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Agenda Item No. : 7d September 14,
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September 2, 2011/11R11 TITLE 40 SO
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Jon Weizenbaum, DADS Deputy Commiss
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accordance with §9.157 of this sub
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United States mail and provide an o
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(B) ensure the electronically trans
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individual's authorized IPC. (e) A
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must be revised; and (C) upon reque
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(E) for physical therapy, 30 hours;
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after a review of the request submi
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equested services will be denied or
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in subsection (f), or exceeds the s
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DADS has determined that the propos
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Legend: [begin addition] Single Und
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(8) Business day--A day when DADS s
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(v) dental sedation, which is sedat
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(II) planning or preparing meals fo
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significantly sub-average general i
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Page 121 and 122: espite on the same day the individu
Page 123 and 124: (67) Specialized registered nursing
Page 125 and 126: [begin addition] (13) [end addition
Page 127 and 128: (1) verify that the individual resi
Page 129 and 130: (1) assign a registered nurse to pe
Page 131 and 132: provided to an individual; (ii) [be
Page 133 and 134: [begin addition] (III) [end additio
Page 135 and 136: (relating to Renewal and Revision o
Page 137 and 138: in accordance with §45.403(c) of t
Page 139 and 140: (relating to Renewal and Revision o
Page 141 and 142: (d) If the individual or LAR, case
Page 143 and 144: (ii) the IPPs; and (I) the individu
Page 145 and 146: determination and sends written not
Page 147 and 148: y the health and human services age
Page 149 and 150: TITLE 40 SOCIAL SERVICES AND ASSIST
Page 151 and 152: (C) complete Part C of the Adaptive
Page 153 and 154: [begin deletion] (b) The DSA must o
Page 155 and 156: e within the agency's legal authori
Page 157 and 158: [(B) the individual's IPP as descri
Page 159 and 160: (D) documentation regarding bids as
Page 161 and 162: (e) The person who developed the sp
Page 163 and 164: [(1)] completes [begin addition] tr
Page 165 and 166: K of this title (relating to Minimu
Page 167 and 168: the date. DADS applies the error to
Page 169: authorized by DADS, unless purchase
Page 173 and 174: September 1, 2013. The proposed ame
Page 175 and 176: agency determined that small and mi
Page 177 and 178: of action. [begin addition] (2) Den
Page 179 and 180: [begin deletion] or additional modi
Page 181 and 182: (2) supplement rather than replace
Page 183 and 184: [begin addition] (A) [end addition]
Page 185 and 186: [begin addition] (A) [end addition]
Page 187 and 188: Services (DHS) work days of [end de
Page 189 and 190: (2) Specialized therapy services (o
Page 191 and 192: ISP year, the maximum service ceili
Page 193 and 194: [end addition] [DHS] applies the er
Page 195 and 196: the [begin addition] HCSSA [end add
Page 197 and 198: of the amount on the [begin additio
Page 199 and 200: deletion] does not meet the medical
Page 201 and 202: deletion] or its designee receives
Page 203 and 204: §48.6104. Crisis Intervention Requ
Page 205 and 206: (2) the regulatory reference, if ap
Page 207 and 208: FISCAL NOTE Gordon Taylor, DADS Chi
Page 209 and 210: Legend: [begin addition] Single Und
Page 211 and 212: individual's residence. (b) Respite
Page 213: Eligibility Requirements). [end add
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