Section 3000, Diversion from Nursing Facility Admission

Revision 19-0; Effective July 7, 2019

 

3100 Diversion Coordinator Duties

Revision 19-0; Effective July 7, 2019

 

A LIDDA designates a qualified staff as the diversion coordinator pursuant to the performance contract. A LIDDA must ensure that the diversion coordinator performs the following duties:

 

3200 Diverting from NF Admission

Revision 19-0; Effective July 7, 2019

 

HHSC may make available a targeted NF HCS diversion slot to an individual with ID or DD who is determined to be at imminent risk of a long term stay in an NF. After a positive PL1 for preadmission is completed and entered in the LTC online portal, a LIDDA must conduct a PE on the individual to determine if the individual:

 

3210 Criteria for Diverting from NF Admission

Revision 19-0; Effective July 7, 2019

 

To be eligible for a targeted NF HCS diversion slot, a diversion coordinator must document the following:

*If a LIDDA determines that the individual meets the criteria for both ICF LOC I and VIII, then the LIDDA documents “ICF LOC I.” If the individual only meets the criteria for ICF LOC VIII, then the LIDDA documents “ICF LOC VIII.”

 

3220 Requesting a Targeted NF HCS Diversion Slot

Revision 19-0; Effective July 7, 2019

 

If a LIDDA determines that an individual meets the criteria for a targeted NF HCS diversion slot, the diversion coordinator requests a targeted NF HCS diversion slot for the individual by completing and submitting Form 1047, Request for HCS Targeted NF Diversion Slot, in accordance with the form’s instructions.

Upon receipt, HHSC staff reviews the completed Form 1047. HHSC staff may request additional information or documentation. Within three working days after receipt of Form 1047 and any necessary additional documentation, HHSC determines whether the individual meets the criteria for a targeted NF HCS diversion slot.

 

3230 Enrolling in HCS as a Diversion to NF Admission

Revision 19-0; Effective July 7, 2019

 

A LIDDA enrolls an individual in the HCS program as an alternative to NF admission, in accordance with the requirements in the HCS rules, LIDDA Handbook and this section. A LIDDA ensures an assigned SC or enhanced community coordinator (ECC) completes the following:

 

3230.1 Enhanced Community Coordination Funds

Revision 19-0; Effective July 7, 2019

 

Enhanced community coordination funds are available to LIDDAs through the HHSC/LIDDA performance contract for an individual who is enrolling in HCS as a diversion to NF admission. The purpose of the funds is to enhance an individual’s natural supports and promote successful community living. Funds are intended to pay for:

A LIDDA should contact its HHSC contract manager to discuss how to access funds.

 

3240 Post Enrollment in HCS as a Diversion to NF Admission

Revision 19-0; Effective July 7, 2019

 

For one year after an individual has enrolled in the HCS program as a diversion to NF admission, an SC or ECC must: