§9.570: Permanent Discharge from the Txhml Program and Suspension of Txhml Program Services

(a) An individual may be permanently discharged from the TxHmL Program if:

(1) the individual no longer meets the eligibility criteria specified in §9.556 of this subchapter (relating to Eligibility Criteria);

(2) the individual or LAR requests permanent discharge; or

(3) the individual or LAR refuses to cooperate in the delivery or planning of services and:

(A) such refusal is documented by the program provider and the service coordinator; and

(B) the service coordinator has explained to the individual or LAR in writing that such refusal may result in discharge from the TxHmL Program.

(b) DADS may propose permanent discharge of an individual at its own initiation or based on an MRA's request for permanent discharge of an individual.

(c) To request permanent discharge of an individual by DADS, the individual's service coordinator must, within 14 calendar days of determining that one of the criteria in subsection (a) of this section is met, submit a written request containing the following information to DADS and provide a copy of the request to the individual or LAR:

(1) the reason permanent discharge is requested;

(2) a discharge plan documenting, as appropriate:

(A) that, before submission of the request for permanent discharge, the individual or LAR was informed of the individual's option to transfer to another program provider and the consequences of permanent discharge for receiving future TxHmL Program services; and

(B) the service linkages that are in place following the individual's discharge from the TxHmL Program; and

(3) if permanent discharge is recommended for the reason stated in subsection (a)(3) of this section:

(A) a description of the action by the individual or LAR demonstrating refusal to cooperate in the delivery or planning of services and the effect of such action on the planning or delivery of services;

(B) a description of the action by the program provider and service coordinator, including face-to-face meetings between the service coordinator and individual or LAR, to resolve the circumstances causing the individual's or LAR's refusal to cooperate; and

(C) a copy of the written explanation sent by the service coordinator to the individual or LAR explaining the consequences of refusal to cooperate.

(d) If DADS proposes to permanently discharge an individual, DADS sends a written discharge notification to the individual or LAR, the program provider, and the MRA indicating the effective date of the discharge and the individual's right to a fair hearing in accordance with §9.571 of this subchapter (relating to Fair Hearings).

(e) If the reason for the proposed permanent discharge is that the individual no longer meets the eligibility criteria described in §9.556(a)(5) and (8) of this subchapter, DADS instructs the service coordinator to:

(1) inform the individual or LAR that DADS, based on availability, offers the individual a program vacancy in the HCS Program in accordance with §9.164(a)(3) of this chapter (relating to Process for Enrollment of Applicants); and

(2) offer to assist the individual or LAR to apply for other services for which the individual may be eligible including other home and community-based service programs and ICF/MR Program services.

(f) If an individual is temporarily admitted to one of the following settings, DADS suspends TxHmL Program services during that admission:

(1) a hospital;

(2) an ICF/MR licensed or subject to being licensed in accordance with Texas Health and Safety Code, Chapter 252 or certified by DADS;

(3) a nursing facility licensed or subject to being licensed in accordance with Texas Health and Safety Code, Chapter 242;

(4) a residential child-care operation licensed or subject to being licensed by DFPS;

(5) a facility licensed or subject to being licensed by the Department of State Health Services;

(6) a facility operated by the Department of Assistive and Rehabilitative Services; or

(7) a residential facility operated by the Texas Youth Commission, a jail, or a prison.

Comments

Source Note: The provisions of this §9.570 adopted to be effective January 5, 2003, 27 TexReg 12254; amended to be effective March 11, 2004, 29 TexReg 2317; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective March 1, 2007, 32 TexReg 544; amended to be effective June 1, 2008, 33 TexReg 4340