26 Tex. Admin. Code § 357.305 - Eligibility
(a) To be eligible for independent living services, a
person must:
(1) have a significant disability as defined in §
357.105 of this chapter (relating to
Definitions); and
(2) reside in Texas.
(b) For
purchased services, a service provider determines eligibility based on the documented diagnosis of a licensed practitioner, either at the at the time
of eligibility or prior to the purchase of goods and services. For core services, a service provider may determine eligibility without a documented
diagnosis.
(c) Eligibility requirements are applied without regard to a person's race, religion, color,
national origin, disability, age, sex, or in retaliation for prior civil rights activity.
(d) After a
service provider documents a person is eligible for services, the service provider:
(1) notifies the person or the
person's representative in writing about the person's fee, as described in §
357.401 of this chapter (relating to Consumer
Participation System);
(2) verifies all potential comparable services or benefits that may be covered for
independent living services, as provided under this chapter; and
(3) maintains all related
documentation.
(e) If a service provider determines that a person is ineligible based on the
criteria described in this section, the service provider must document the determination of ineligibility and provide HHSC with a copy that is signed
and dated by the service provider's executive director or designee.
(1) A service provider may determine a person
to be ineligible for independent living services only after consultation with the person or the person's representative or after providing a clear
opportunity for consultation.
(2) A service provider notifies a person in writing of the action taken and
informs the person or the person's representative about the person's rights and the means by which the person may appeal the action taken or file a
complaint.
(3) A service provider refers the person to other agencies and facilities, if appropriate,
including to the Texas Workforce Commission's vocational rehabilitation program.
(4) If a service
provider determines that a person is ineligible for independent living services, the service provider reviews the person's status again within 12
months of the determination and whenever the service provider determines that the person's status has materially changed.
(5) A service provider does not conduct a review of an ineligibility determination if:
(A) the person refuses one;
(B) the person no longer resides in Texas;
or
(C) the person's whereabouts are unknown.
Notes
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(a) To be eligible for independent living services, a consumer must:
(1) have a significant disability as defined in § 357.105(24) of this chapter (relating to Definitions); and
(2) be present in Texas.
(b) Eligibility is determined by the service provider, based on the documented diagnosis of a licensed practitioner.
(c) Under Texas Government Code § 531.02002, § 531.02014, and Texas Labor Code § 351.002, consumers who are determined to be eligible for independent living services on or before August 31, 2016, remain eligible on September 1, 2016, and are considered grandfathered under the former DARS independent living program and do not need to reapply for independent living services to the respective receiving agency on September 1, 2016.
(d) Eligibility requirements are applied without regard to a person's age, color, creed, gender, national origin, race, religion, or length of time present in Texas.
(e) Once a consumer is determined to be eligible for services, the service provider:
(1) notifies the consumer or the consumer's representative in writing about the consumer's fee for service, as described in § 357.401 of this chapter (relating to Consumer Participation System); and
(2) verifies the benefits of all consumers who may be covered for independent living services by comparable services or benefits, as provided under this chapter, and maintains all related documentation.
(f) If a service provider determines that a consumer is not eligible based on the criteria explained in this section, the service provider documents the determination of ineligibility and provides DARS with a copy that is signed and dated by the service provider's executive director or designee.
(1) The service provider may determine a consumer to be ineligible for independent living services only after consultation with the consumer or after providing a clear opportunity for consultation.
(2) The service provider notifies the consumer in writing of the action taken and informs the consumer about the consumer's rights and the means by which the consumer may appeal the action taken or file a complaint.
(3) The service provider refers the consumer to other agencies and facilities, if appropriate, including referring the consumer to the State's vocational rehabilitation program.
(4) If a service provider determines that a consumer is ineligible for independent living services, the service provider reviews the consumer's status again within 12 months of the determination and whenever the service provider determines that the consumer's status has materially changed.
(5) A review of an ineligibility determination need not be conducted if the consumer has refused one, the consumer is no longer present in Texas, or the consumer's whereabouts are unknown.