26 Tex. Admin. Code § 277.67 - Service Delivery Plan Changes
(a) Increase in
hours or terminations.
(1) A provider must
submit written notification to the case worker within seven days after learning
of any change that may:
(A) require an
increase in hours in the individual's service delivery plan; or
(B) result in the termination of services due
to the individual receiving no ADLs, except for the FC
Program.
(2) The
notification must include the:
(A) date the
provider learned of the need for the change;
(B) reason for the change;
(C) type of change, including the number of
hours of service; and
(D) signature
and date of the provider representative.
(b) Decrease in hours. The provider must
develop a new service delivery plan, as described in § 47.45(a)(2) of this
chapter (relating to Pre-Initiation Activities), within 21 days of the provider
identifying the need for an ongoing decrease in hours from the service delivery
plan currently approved by the individual.
(c) Immediate increase in hours of service.
(1) The provider must notify the case worker,
or designee, of the reason an individual requires an immediate increase in
hours of service, and must obtain approval from HHSC of both the number of
additional hours of service to be provided the individual and the effective
date of the change.
(2) The
provider must implement the immediate increase in hours of service on the
negotiated effective date of the change.
(3) The provider must document the immediate
increase in hours of service. Documentation must include:
(A) the date the provider received approval
for the change;
(B) the name of the
HHSC staff who approved the change;
(C) the effective date of the change;
and
(D) the number of hours of
service authorized.
(4)
The provider must maintain documentation regarding an immediate increase in
hours of service
(d)
Implementation of service delivery plan changes described in subsections (a) -
(c) of this section. The provider must implement the service delivery plan
change on the following date, whichever is later:
(1) the authorization begin date on HHSC's
Authorization for Community Care Services form; or
(2) five days after the date the provider
receives HHSC's Authorization for Community Care Services form, unless the
provider fails to stamp the receipt date on the form, in which case the
authorization begin date on the form will be used to determine
timeliness.
(e) Delay in
implementation of service delivery plan changes described in subsections (a) -
(c) of this section. If a provider does not implement a service delivery plan
change on the effective date of the change, the provider must set a new
implementation date. The provider must document by the next working day any
failure to implement a service delivery plan change on the effective date of
the change. The documentation must include:
(1) the reason for the failure to timely
implement the service delivery plan change; and
(2) the new implementation date.
(f) Temporary service delivery
plan changes.
(1) A provider may temporarily
change an individual's service delivery plan if:
(A) the individual requests and requires
temporary assistance with allowable tasks not identified on the service
delivery plan due to a change in circumstances or available supports; and
(B) the change in tasks does not
increase the total approved hours of service or continue for more than 60 days.
(2) If a temporary
change in tasks on the service delivery plan will continue for more than 60
days or result in more hours of service provided than have been approved, a
provider must:
(A) request and obtain a new
HHSC Authorization for Community Care Services form; and
(B) provide services according to HHSC's
Authorization for Community Care Services form until the provider receives a
new form from the case worker.
(3) A provider must maintain the following
documentation in an individual's file regarding a temporary change in the
service delivery plan:
(A) the specific
change in the service delivery plan;
(B) the duration of the temporary change; and
(C) the reason for the temporary
change.
Notes
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