26 Tex. Admin. Code § 262.4 - Description of the TxHmL Program and CFC
(a) The TxHmL
Program is a Medicaid waiver program approved by CMS pursuant to §1915(c)
of the Social Security Act. It provides community-based services and supports
to eligible individuals who live in their own homes or in their family
homes.
(b) Enrollment in the TxHmL
Program is limited to the number of individuals in specified target groups and
to the geographic areas approved by CMS.
(c) TxHmL Program services described in
§
262.5 of this subchapter (relating
to Description of TxHmL Program Services) are selected for inclusion in an
individual's IPC to ensure the individual's health, safety, welfare, and
integration in the community. TxHmL Program services and CFC Services
supplement rather than replace the individual's natural supports and other
community services for which the individual may be eligible and prevent the
individual's admission to an institutional setting.
(d) CFC is a state plan option governed by 42
CFR Chapter 441, Subpart K, regarding Home and Community-Based Attendant
Services and Supports State Plan Option (Community First Choice) that provides
the following services to individuals:
(1)
CFC PAS/HAB;
(2) CFC ERS;
and
(3) CFC support management for
an individual receiving CFC PAS/HAB.
(e) HHSC has grouped Texas counties into
geographical areas, referred to as "local service areas," each of which is
served by a LIDDA. HHSC has further grouped the local service areas into
"waiver contract areas." A list of the counties included in each local service
area and waiver contract area is available on the HHSC website.
(1) A program provider may provide TxHmL
Program services and CFC services only to persons residing in the counties
specified for the program provider in the HHSC automated enrollment and billing
system.
(2) A program provider must
have a separate contract for each waiver contract area served by the program
provider.
(3) A program provider
may have a contract to serve one or more local service areas within a waiver
contract area, but the program provider must serve all of the counties within
each local service area covered by the contract.
(4) A program provider may not have more than
one contract per waiver contract area.
(f) A program provider must comply with all
applicable state and federal laws, rules, and regulations.
(g) The CDS option is a service delivery
option, described in 40 TAC Chapter 41 (relating to Consumer Directed Services
Option), in which an individual or LAR employs and retains service providers
and directs the delivery of a service through the CDS option, as described in
40 TAC §
41.108(relating to Services
Available Through the CDS Option).
Notes
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