26 Tex. Admin. Code § 259.163 - Termination of CLASS Program Services and CFC Services with Advance Notice Because of Non-compliance with Mandatory Participation Requirements

(a) HHSC may terminate an individual's CLASS Program services and CFC services if the individual refuses to comply with a mandatory participation requirement described in § 259.103 of this chapter (relating to Mandatory Participation Requirements of an Individual).

(b) If a CMA becomes aware that an individual has not complied with a mandatory participation requirement described in § 259.103 of this chapter, the CMA must immediately attempt to resolve the situation, including facilitating at least one in-person meeting between:

(1) the individual or LAR;

(2) a representative from the CMA; and

(3) a representative from the DSA.

(c) If, after making attempts to resolve the situation as required by subsection (b) of this section, a CMA determines that the situation cannot be resolved, the CMA must request, in writing, that HHSC terminate CLASS Program services and CFC services for the individual. The request must be sent to HHSC no later than two business days after the CMA's determination that the situation cannot be resolved and be supported by written documentation. The written documentation must include a description of:

(1) the situation that resulted in the request to terminate CLASS Program services and CFC services; and

(2) the attempts by the CMA and DSA to resolve the situation, including in-person meetings with the individual or LAR.

(d) HHSC notifies the individual's CMA, in writing, of whether it authorizes the proposed termination of CLASS Program services and CFC services.

(e) After receiving a written notice from HHSC authorizing the proposed termination of CLASS Program services and CFC services, a CMA must, in accordance with the Community Living Assistance and Support Services Provider Manual:

(1) send written notice of the proposed termination of services to the individual or LAR within two business days, copying the individual's DSA and, if selected, FMSA; and

(2) include in the written notice the individual's right to request a fair hearing in accordance with § 259.101 of this chapter (relating to Individual's Right to a Fair Hearing).

(f) If an individual or LAR requests a fair hearing before the effective date of the termination of CLASS Program services and CFC services, as specified in the written notice, the DSA must provide the services to the individual in the amounts authorized in the IPC while the appeal is pending.

Notes

26 Tex. Admin. Code § 259.163

Adopted by Texas Register, Volume 48, Number 04, January 27, 2023, TexReg 0381, eff. 1/30/2023