Aging and Disability Services Council Sharon Swift Butterworth ...

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Agenda Item No. : 7d September 14, 2011 Page 3 SERVICES IMPACT STATEMENT Does this proposed policy promote the most integrated setting appropriate to the needs of the individual? Yes No N/A X Does this proposed policy provide every opportunity for individual choices? Yes No N/A X FISCAL IMPACT DADS has determined that there are foreseeable implications relating to costs or revenues of state government, but no foreseeable implications relating to costs or revenues of local governments. RULE DEVELOPMENT SCHEDULE September 8, 2011 Present to Medical Care Advisory Committee September 14, 2011 Present to Aging and Disability Services Council October 2011 Publish proposed rules in Texas Register November 2011 Publish adopted rules in Texas Register December 1, 2011 Effective date RECOMMENDATION It is recommended that the Council consider the proposed rule action as discussed in this memorandum, as well as in the draft rule item and preamble attached to this memorandum, and that the Council vote to recommend the proposal, with or without changes to the attached rule.
September 2, 2011/11R11 TITLE 40 SOCIAL SERVICES AND ASSISTANCE PART 1 DEPARTMENT OF AGING AND DISABILITY SERVICES CHAPTER 9 MENTAL RETARDATION SERVICES--MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES The Health and Human Services Commission (HHSC) proposes, on behalf of the Department of Aging and Disability Services (DADS), amendments to §9.158, concerning process for enrollment of applicants; §9.159, concerning IPC; and §9.166, concerning renewal and revision of an IPC; new §9.192, concerning service limits; and new §9.193, concerning exception to service limits, in Chapter 9, Mental Retardation Services--Medicaid State Operating Agency Responsibilities. 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 Home and Community-Based Services (HCS) Program services. The rules in Chapter 9, Subchapter D, describe the requirements for operation of the HCS Program. Regarding the requirement to adjust community services, the amendments and new rules establish service limits, effective through August 31, 2013, for the following HCS Program services: adaptive aids, audiology, behavioral support, dietary services, occupational therapy services, physical therapy, social work, speech and language pathology, supported employment, and supported home living. 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 HCS Program may receive without being granted an exception. In addition, the amendments and new rules describe the exception process by which a service coordinator or program provider (based on information from an individual, legally authorized representative, service coordinator, or program provider) may request that DADS allow an individual to receive services in excess of these service limits. Further, the new rules provide that an exception may not be requested to the existing service limit for dental treatment, minor home modifications, and respite. The new rules also provide that the current limits for adaptive aids and supported employment remain in place even if DADS grants an exception to the new, lower service limits. SECTION-BY-SECTION SUMMARY The proposed amendment to §9.158(n)(2) requires that a service coordinator, when submitting an initial individual plan of care (IPC) that includes a service component for which a service limit is described in new §9.192(b) is exceeded, submit a completed Request for Exception to Service Limit form to DADS and keep a copy of the completed form in the individual's record. The proposed amendment to §9.159(c) adds new paragraph (2) requiring a service coordinator or - 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
Page 33 and 34: (2) written or oral examination as
Page 35 and 36: easonable accommodations for medica
Page 37 and 38: (3) The examination must be given a
Page 39 and 40: (ii) a student enrolled in an accre
Page 41 and 42: (1) administer a medication by any
Page 43 and 44: accredited school of nursing. (4) D
Page 45 and 46: (B) a statement that all of the req
Page 47 and 48: (2) If, after review, DADS determin
Page 49 and 50: (9) A permit that is not renewed du
Page 51 and 52: (I) allowable and prohibited practi
Page 53 and 54: (A) the issuance of an initial perm
Page 55 and 56: (B) If a suspension overlaps a rene
Page 57 and 58: Agenda Item No. : 7c September 14,
Page 59 and 60: TAKINGS IMPACT ASSESSMENT DADS has
Page 61 and 62: (b) - (e) (No change.) This agency
Page 65 and 66: (b) - (g) (No change.) This agency
Page 69 and 70: Convictions Barring Facility Licens
Page 73 and 74: [begin addition] Denial or Refusal
Page 77 and 78: (b) - (f) (No change.) This agency
Page 81 and 82: (C) a controlling person of the app
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Page 87 and 88: Jon Weizenbaum, DADS Deputy Commiss
Page 89 and 90: accordance with §9.157 of this sub
Page 91 and 92: United States mail and provide an o
Page 93 and 94: (B) ensure the electronically trans
Page 95 and 96: individual's authorized IPC. (e) A
Page 97 and 98: must be revised; and (C) upon reque
Page 99 and 100: (E) for physical therapy, 30 hours;
Page 101 and 102: after a review of the request submi
Page 103 and 104: equested services will be denied or
Page 105 and 106: in subsection (f), or exceeds the s
Page 107 and 108: DADS has determined that the propos
Page 109 and 110: Legend: [begin addition] Single Und
Page 111 and 112: (8) Business day--A day when DADS s
Page 113 and 114: (v) dental sedation, which is sedat
Page 115 and 116: (II) planning or preparing meals fo
Page 117 and 118: significantly sub-average general i
Page 119 and 120: and (E) transportation between the
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
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(relating to Renewal and Revision o
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in accordance with §45.403(c) of t
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(relating to Renewal and Revision o
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(d) If the individual or LAR, case
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(ii) the IPPs; and (I) the individu
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determination and sends written not
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y the health and human services age
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TITLE 40 SOCIAL SERVICES AND ASSIST
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(C) complete Part C of the Adaptive
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[begin deletion] (b) The DSA must o
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e within the agency's legal authori
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[(B) the individual's IPP as descri
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(D) documentation regarding bids as
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(e) The person who developed the sp
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[(1)] completes [begin addition] tr
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K of this title (relating to Minimu
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the date. DADS applies the error to
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authorized by DADS, unless purchase
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TITLE 40 SOCIAL SERVICES AND ASSIST
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September 1, 2013. The proposed ame
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agency determined that small and mi
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of action. [begin addition] (2) Den
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[begin deletion] or additional modi
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(2) supplement rather than replace
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[begin addition] (A) [end addition]
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[begin addition] (A) [end addition]
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Services (DHS) work days of [end de
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(2) Specialized therapy services (o
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ISP year, the maximum service ceili
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[end addition] [DHS] applies the er
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the [begin addition] HCSSA [end add
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of the amount on the [begin additio
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deletion] does not meet the medical
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deletion] or its designee receives
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§48.6104. Crisis Intervention Requ
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(2) the regulatory reference, if ap
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FISCAL NOTE Gordon Taylor, DADS Chi
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Legend: [begin addition] Single Und
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individual's residence. (b) Respite
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Eligibility Requirements). [end add
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