Aging and Disability Services Council Sharon Swift Butterworth ...

TITLE 40 SOCIAL SERVICES AND ASSISTANCE
PART 1 DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 51 MEDICALLY DEPENDENT CHILDREN PROGRAM
The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of
Aging and Disability Services (DADS), amendments to §51.215, concerning home visit,
§51.217, concerning individual plan of care, and §51.231, concerning service limitations, and
new §51.232, concerning exception to service limit, in Chapter 51, Medically Dependent
Children Program.
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, 82 nd Legislature,
Regular Session, 2011), which requires DADS to adjust the amount of all community services,
which includes MDCP services. The amendments and new rules to Chapter 51 are proposed to
implement these requirements. The rules in Chapter 51 describe the requirements for operation
of MDCP. Regarding the requirement to adjust community services, the amendments and new
rules establish service limits, effective through August 31, 2013, for respite and adjunct support
services. 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 enrolled in MDCP may receive without being
granted an exception. In addition, the amendments and new rules describe the exception process
by which an individual may request that DADS allow the individual to receive respite and
adjunct support services in excess of these service limits. Further, the amendments provide an
individual may not request an exception to existing service limits for adaptive aids and minor
home modifications. The new rules also provide that the current limit for facility-based respite
remains in place even if DADS grants an exception to the new, lower service limits. The
amendments further provide that the service limit for facility-based respite that was in effective
before the adoption of these amendments and new sections will again be in effect as of
September 1, 2013.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §51.215, concerning Home Visit, requires a case manager and
DADS RN must develop an IPC in accordance with §51.231, concerning Service Limitations.
The proposed amendment to §51.231, concerning Service Limitations, restructures the section to
establish service limits, effective through August 31, 2012, for certain MDCP services, and
establish that service limits for certain MDCP services that were in effect before the adoption of
the amendments and new section will again be in effect as of September 1, 2013.
Proposed new §51.232, concerning Exception to Service Limits, describes the exception process
by which DADS may allow an individual to receive services in excess of the service limits
described in revised §51.231.
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