26 Tex. Admin. Code § 263.4 - Description of the HCS Program and CFC
(a) The HCS 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 as an alternative to the ICF/IID Program. The HCS Program
is operated by HHSC.
(b) Enrollment
in the HCS Program is limited to the number of individuals in specified target
groups and to the geographic areas approved by CMS.
(c) HCS Program services described in §
263.5 of this subchapter (relating
to Description of HCS Program Services) and CFC services described in §
263.6 of this subchapter (relating
to Description of CFC Services) are selected for inclusion in an individual's
IPC to ensure the individual's health, safety, welfare, and integration in the
community. HCS 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).
(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 HCS
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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