Revision 23-1; Effective Dec. 20, 2023

The following changes were made.

Section	Title	Change
1100	Definitions	Updates language throughout definitions. Changes ECC or Enhanced Community Coordinator to ECC coordinator. Adds the term person to the definition of individual.
3210	Criteria for Diverting from NF Admission	Updates definitions.
3230	Enrolling in HCS as a Diversion to NF Admission	Updates language. Adds guidance concerning pre-move site review.
3230.1	Enhanced Community Coordination Funds	Updates language. Adds new process for accessing ECC funds.
3240	Post Enrollment in HCS as a Diversion to NF Admission	Re-orders monitoring duties to list chronologically. Updates language for inclusivity. Adds guidance for ECC lasting for more than 365 days.
6110	Assigning a Service Coordinator or Enhanced Community Coordinator	Edits title to Assigning an Enhanced Community Coordination (ECC) Coordinator and updates language.
6110.1	Unassigning a Service Coordinator or Enhanced Community Coordinator	Edits title to Unassigning an ECC Coordinator and updates language.
6120	Working with the Relocation Specialist	Updates language.
6130	Relocation Specialist and MCO SC Responsibilities	Updates language. Adds guidance regarding relocation day.
6140	Enhanced Community Coordination Funds to Assist with Certain Costs Related to Transitioning	Edits title to Enhanced Community Coordination Funds  and updates language. Adds new process for accessing ECC funds.
6200	Transition Planning	Updates language.
6210.1	Service Coordinator/Enhanced Community Coordinator Participation	Edits title to ECC Coordinator Participation. Updates language.
6210.2	Habilitation Coordinator Participation	Updates language.
6210.3	Program Provider and Relocation Specialist Participation	Updates language.
6300	Developing and Revising the Transition Plan	Updates language.
6310	Transition Plan	Updates language.
6320	Admission Type on PL1	Updates language.
6330	PL1 Submission	Adds section.
6340	Individual Profile	Updates language.
6350	Sharing the Transition Plan, Individual Profile, and Transition Packet	Updates language.
6360	SPT Member Believes Transition Plan Does Not Accurately Reflect SPT Decisions	Updates language.
6400	Pursuing the Selected Community Medicaid Program for Transition	Updates language. Removes ICF/IID from list of non-HCS community programs eligible for ECC.
6530	Transitioning to the Community by Enrolling in HCS	Updates language. Adds guidance related to transfer of LIDDAs.
6540	Transition Day	Changes title to Transitioning to a Community Medicaid Program. Moves existing information to section 6540. Incorporates information previously in section 6600. Updates language.
6600	Transitioning to a Community Medicaid Program	Edits title to Post-Transition to the HCS Program. Moves existing information to section 6700. Incorporates information previously in section 6800.
6610	Post-Move Monitoring Visits	Adds new section using information previously in section 6810. Updates language.
6620	Monitoring Activities for One Year Post-Move	Adds new section using information previously in section 6820. Updates language.
6700	Transition Day	Changes title to Transitioning to a Community Medicaid Program. Moves existing information to section 6540. Incorporates information previously in section 6600. Updates language.
6710	Transition Day	Adds new section using information previously in section 6700. Updates language.
6800	Post-Transition to HCS Program	Edits title to Post-Transition into a Community Medicaid Program. Moves existing information section 6600. Incorporates information previously in section 6900. Updates language. Removes ICF/IID from transition options for ECC.
6820	Monitoring Activities for One Year Post-Move	Deletes section and moves information to new section 6620.
6900	Post-Transition into a Medicaid Community Program	Edits title to Readmission to a Nursing Facility. Moves existing information to section 6800. Adds new information on providing guidance for when ECC should be restarted.

 

Revision 22-1; Effective Nov. 28, 2022

The following changes were made.

Section	Title	Change
1000	Introduction to PASRR	Updates Texas Administrative Code (TAC) references.
1100	Definitions	Updates definitions.
2000	PL1 and PE	Edits throughout section to update acronyms and section numbers and make clarifications such as adding “calendar” to days.
2100	Purpose of PASRR	Updates language.
2200	Referring Entity	Updates and adds new text.
2300	PASRR Level 1 Screening (PL1)	Updates title by removing (PL1).
2310	Spousal Co-Payment	Incorporates policy from MEPD and TW Bulletin 22-09,  2. Spousal Impoverishment Dependent Allowance, released on June 1, 2022.
2320	PL1 Screening Form	Incorporates policy from MEPD and TW Bulletin 22-09,  2. Spousal Impoverishment Dependent Allowance, released on June 1, 2022.
2320.1	PL1 Submission	Updates and adds new text.
2320.2	Positive PL1	Adds new information after enhancement in LTC online portal and additional instructions how to complete section E of PL1 if positive for PASRR.
2320.3	Negative PL1	Updates language.
2320.4	Additional PL1 Responsibilities	Adds new section.
2330	Admission Types
2330.1	Exempted Hospital Discharge	Updates language.
2330.2	Expedited Admission	Updates admission information relating to the LTC online portal.
2330.3	Preadmission	Updates language.
2340	Admission Type on PL1	Updates language.
2350	PL1 Submission	Adds section.
2400	PASRR Level II Evaluation (PE)	Updates language and removes (PE) from title.
2410	Purpose, PASRR Status, and Staff Qualifications	Updates language about performing PE for people with positive P1.
2410.1	PASRR Positive	Updates determination status language.
2410.2	PASRR Negative	Updates determination status language.
2410.3	Staff Qualifications	Updates language.
2420	LTC Online Portal Notification	Updates P1 automatic alert process.
2420.1	Timing of Alert is Based on Admission Type	Updates language and link.
2420.2	Change of Ownership (CHOW)  Extensions	Changes title to Change of Ownership Extensions. Updates language.
2420.3	Information Gathered by a LIDDA Following an Alert to Conduct a PE	Adds note about PE Evaluator login information in LTC online portal.
2420.4	Using Information Gathered by a LIDDA Following an Alert to Conduct a PE	Adds reference to Section 4910, Medicaid Eligibility Guidelines.
2430	Completing and Submitting the PE	Updates language and list of LIDDA requirements.
2430.1	Interpreter Services	Edits language.
2430.2	Person/LAR Refuses to Participate in PE	Changes title to Person or LAR Refuses to Participate in PE. Edits language.
2430.3	Documentation Review for PE Completion	Removes some acronyms and updates language.
2430.4	Information about Certain Community Programs in Section F0700 of the PE	Edits language.
2430.5	Presenting Information about Community Services as Part of the PE	Moves title and information about Person’s PE is Negative for ID or DD.
2430.6	PE for Resident Review	Changes title to Completing Section F, Return to Community Living. Adds new section related to Section F of the PE. Moves original section 2430.6 information to 2430.7.
2430.7	When a DID is Required to Adequately Complete the PE	Changes title to PE for Resident Review. Includes original and updated text formerly under section 2430.6. Clarifies information about expectations and process when completing PE for resident review.
2430.8	PE Submission	Changes title to When a DID is Required to Adequately Complete the PE. Moves information that was previously under section 2430.7.
2430.9	Specialized Services Recommendation Mapping.	Changes title to PE Submission. Moves information that was previously under section 2430.8 and updates language.
2430.10	Fair Hearing Related to Negative PE	Changes title to Specialized Services Recommendation Mapping. Moves information that was previously under section 2430.9 and updates language.
2430.11	PE Retention Period	Removes outdated information related to the replacement Medicaid card and aligns the MBI and MBIC sections. Adds related policy. (MBI/MBIC)
2430.12	PE Retention Period	Removes link to MIPPA application processing instructions. (MSP)
2430.13	Preadmissions involving Two LIDDAs	Incorporates policy from MEPD and TW Bulletin 21-22, 1. Eligibility for Federal Benefits for Afghan Evacuees, released on Nov. 1, 2021. (All Programs). Clarifies existing glossary definitions.
2500	PASRR Initial IDT/SPT Meeting	Incorporates policy from MEPD and TW Bulletin 22-09, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2022.
2510	NF Enters Initial IDT/SPT Meeting Information	Changes title to NF Enters Initial IDT and SPT Meeting Information.
2520	Confirmation of IDT/SPT Meeting Information	Changes title to Confirmation of IDT and SPT Meeting Information. Edits text.
2600	Initiating NF Specialized Services	Edits text.
3000	Diversion from NF Admission	Updates and makes minor edits throughout section.
3100	Diversion from Nursing Facility Admission	Edits language.
3200	Diverting from NF Admission	Edits language.
3210	Criteria for Diverting from NF Admission	Edits language.
3220	Requesting a Targeted NF HCS Diversion Slot	Edits language.
3230	Enrolling in HCS as a Diversion to NF Admission	Edits language and clarifies where essential supports are identified.
3230.1	Enhanced Community Coordination Funds	Edits language.
3240	Post Enrollment in HCS as a Diversion to NF Admission	Edits language.
4000	Admission to a NF	Updates and makes minor edits throughout section.
4100	Eligibility for Habilitation Coordination Funded by Medicaid	Adds note about hospice services not affecting person’s eligibility for Habilitation Coordination or PASRR specialized services.
4200	Assignment of Habilitation Coordinator	Edits language.
4300	Program Overview	Changes title to Initial IDT and SPT Meeting. Edits language.
4310	Budgeting Concepts	Changes title to Attendance at Initial IDT and SPT Meeting. Edits language.
4400	Eligibility Income Budgeting	Updates and makes minor edits throughout section.
4410	Budgeting Steps	Edits language.
4420	Charts for Premium Amounts	Adds note about need for Habilitative Assessment Form 1064 even if the person has refused Habilitation Coordination.
4500	Developing Individual Profile and Habilitation Service Plan at First SPT meeting	Adds expectation that habilitation coordinators complete and send individual profile and habilitation service plan to SPT members within 10 calendar days following SPT meetings. Also adds expectation that habilitation coordinators ask NF to ensure all PASRR specialized services are in NF comprehensive care plans.
4510	Specialized Services Requiring an Assessment	Updates language. Clarifies when lack of IDT/SPT consensus to obtain an assessment for specialized services. Assessments are not completed for people refusing services or when there is no funding.
4520	Specialized Services that Do Not Require an Assessment	Edits language.
4530	Frequency and Duration of Habilitation Coordination	Edits language.
4600	Initiating IDD Habilitative Specialized Services after First SPT Meeting	Edits language.
4700	Providing Habilitation Coordination	Edits language.
4800	2022 Income and Resources Reference Chart	Adds new section
4810	Determining Guardianship	Adds new section on determining guardianship for people in the PASRR program.
4820	Communication of Complaint Process	Adds new section about the complaint process in the PASRR program.
4900	Medicaid and Medicare	Adds new section related to Medicaid and Medicare.
4910	Medicaid Eligibility Guidelines	Adds new section. Includes chart of TOA and program codes to determine PASRR eligibility.
4920	Responsibility to Reestablish Medicaid Eligibility	Adds new section about LIDDA responsibility to help in reestablishing Medicaid eligibility for people in the PASRR program.
4930	Individual Does Not Have an MCO	Adds new section for people who need to select an MCO.
4930.1	Spousal Co-Payment	Adds new section to help a person who does not have an MCO assigned.
4940	Individual is Dual Eligible	Adds new section for a person who is dual eligible for both Medicaid and Medicare.
5000	Habilitation Coordination	Updates section.
5100	Required Face-to-Face Visits	Adds language about HHSC’s ability to waive face-to-face requirements if an emergency is declared.
5200	Assess/Reassess Habilitative Needs	Changes title to Assess or Reassess Habilitative Needs. Edits language.
5210	Reviewing Assessments	Edits language.
5300	SPT Meetings	Adds new expectation that habilitation coordinator must ensure all SPT members receive a notice of 10 business days to participate in meetings.
5310	First SPT Meeting	Updates revision notice and effective date.
5320	Quarterly SPT Meetings	Adds clarifications to timeline expectations about quarterly SPT meetings.
5320.1	Required Activities during a Quarterly SPT Meeting	Edits language.
5320.2	Documenting Summary of Quarterly SPT Meeting	Edits language.
5320.3	Replacement Medicaid Card	Edits language.
5330	Update SPT Meetings	Updates list. Include information for completing ANSA or address any outstanding issues
5330.1	Update SPT Meeting Because of a Change in Medical Condition or a Change in Service	Removes title of section. Information remained in section 5330.
5330.2	Update SPT Meeting For An Issue Not Addressed in Section 5330.1	Removes title and section information.
5340	Annual IDT/SPT Meeting	Changes title to Annual IDT and SPT Meeting.
5340.1	Annual IDT/SPT Meeting	Changes title to Annual IDT and SPT Meeting. Edits language.
5340.2	HC Preparation for Annual IDT/SPT Meeting	Changes title to Preparation for Annual IDT and SPT Meeting. Edits language.
5340.3	IDT Agrees to Habilitation Coordination	Edits language.
5340.4	Refusal of Habilitation Coordination	Edits language.
5340.5	Annual SPT Meeting	Edits language.
5350	SPT Member that is a Provider of a Specialized Service	Edits language.
5360	Determination that Participation in SPT Meeting is Not Necessary	Edits language.
5370	Guidance for Convening SPT Meeting When an Individual or LAR Does Not Want to Attend	Edits language.
5400	Develop and Revise Habilitation Service Plan and Individual Profile	Edits language.
5410	Person-centered Planning	Replaces “Federal Poverty Income Limit (FPIL)” with “Federal Poverty Level (FPL)”. Updates for plain language. (MBI, MBIC)
5420	Discovery Process	Edits language.
5430	Developing Habilitation Service Plan and Individual Profile	Edits language.
5430.1	Specialized Services Requiring an Assessment	Edits language.
5430.2	Specialized Services that Do Not Require an Assessment	Edits language.
5430.3	Barriers to Transitioning to the Community or Selecting a Community Program Identified During CLO	Edits language.
5430.4	Charts for Premium Amounts	Edits language.
5440	Revising the Habilitation Service Plan and Individual Profile	Edits language.
5440.1	Revising the HSP Because an Assessment for an NF Specialized Service is Complete	Removes outdated information related to the replacement Medicaid card and aligns the MBI and MBIC sections. Adds related policy. (MBI/MBIC)
5440.2	Revising the HSP Because an Assessment for an IDD Habilitative Specialized Service is Completed	Edits language.
5440.3	Revising the HSP to Address Barriers Identified During CLO	Edits language.
5450	New Habilitation Service Plan for Next HSP Year	Edits language.
5460	2022 Income and Resources Reference Chart	Edits language.
5460.1	Individual Profile	Edits language.
5460.2	Habilitation Service Plan	Edits language.
5470	Sharing the Habilitation Service Plan, Individual Profile and Habilitation Packet	Edits language.
5480	SPT Member Believes HSP or Individual Profile Does Not Accurately Reflect SPT Decisions or Information about the Individual	Edits language.
5500	Assisting with Access to Needed Specialized Services	Updates revision number and effective date.
5510	Initiating IDD Habilitative Specialized Services	Edits language.
5520	Monitoring the Initiation and Delivery of all Specialized Services	Edits language.
5530	Accessing Other Habilitative Programs	Edits language.
5540	Assisting Individual/LAR with Requesting a Fair Hearing for Denial of NF Specialized Services	Changes title to Assisting Individual or LAR with Requesting a Fair Hearing for Denial of NF Specialized Services. Edits language.
5600	Coordination	Edits language.
5700	Monitoring and Follow-up Activities	Updates language to include need for habilitation coordinator to include the perspective of the person and LAR when monitoring for progress or satisfaction.
5800	Community Living Options (CLO), Visits to Community Programs, and Educational Opportunities	Changes title to Community Living Options, Visits to Community Programs, and Educational Opportunities.
5810	Presenting CLO	Edits language.
5810.1	When CLO is Presented	Updates language for clarifications about CLO timeline and expectations if individual is not interested in habilitation coordination or transition to the community.
5810.2	Six-Month Base Schedule	Changes title to Six-month Base Schedule. Edits to clarify CLO timeline.
5810.3	CLO Materials Provided to Individual/LAR	Changes title to CLO Materials Provided to Individual or LAR. Edits language.
5820	Documenting CLO	Updates language to clarify that section 4 of CLO form 1054 should be filled out even if the individual is not interested in transition.
5830	HC Actions Following CLO	Changes title to Habilitation Coordinator Actions Following CLO. Edits language.
5830.1	Individual/LAR Wants to Transition and has Selected a Community Program	Changes title to Individual/LAR Wants to Transition and has Selected a Community Program. Edits language.
5830.2	Individual/LAR Wants to Transition, but has NOT Selected Community Program	Changes title to Individual or LAR Wants to Transition but has NOT Selected Community Program. Edits language.
5830.3	Individual/LAR Does Not Want to Transition, is Undecided or Desire of Individual/LAR Cannot be Determined	Changes title to Individual or LAR Does Not Want to Transition, is Undecided or Desire of Individual or LAR Cannot be Determined. Edits language.
5840	Exploring Community Programs	Edits language.
5850	Educational Opportunities	Edits language.
5900	Explanation of Rights	Changes title to Additional Habilitation Coordinator Responsibilities.
5910	Explanation of Rights	Clarifies program information. Adds related policy. (All Programs)
5920	Activities Related to Guardianship	Clarifies program information. Adds related policy. (All Programs)
5920.1	Individual Has a Guardian	Adds policy for electronic correspondence. (All Programs)
5920.2	Individual Does Not Have a Guardian	Adds new section with information for a person who does not have a guardian.
6000	Transition From NF to Community	Edits text.
6110	Assigning a Service Coordinator or Enhanced Community Coordinator	Updates language and clarifies timeline for assigning an SC/ECC is seven calendar days.
6110.1	Unassigning a Service Coordinator or Enhanced Community Coordinator	Updates and clarifies language.
6120	Working with the Relocation Specialist	Adds clarity that habilitation coordinator should ask person or LAR directly whether they object to MCO service coordinator attendance at meetings.
6130	Relocation Specialist and MCO SC Responsibilities	Updates and clarifies language.
6140	Enhanced Community Coordination Funds to Assist with Certain Costs Related to Transitioning	Edits language.
6200	Transition Planning	Adds new expectation for habilitation coordinators. Must give SPT members a 10-business day notice before SPT meetings.
6210	SPT Meeting Participation by Service Coordinator/Enhanced Community Coordinator and Habilitation Coordinator	Changes title to SPT Meeting Participation.
6210.1	Service Coordinator/Enhanced Community Coordinator Participation	Edits language.
6210.2	Habilitation Coordinator Participation	Edits language.
6210.3	Program Provider and Relocation Specialist Participation	Adds new section. Reminds habilitation coordinators to invite the community program provider and the RS t o all SPT meetings.
6300	Developing and Revising the Transition Plan	Directs SC/ECC to send Transition Plan to the SPT members within 10 calendar days after the SPT meeting.
6310	Transition Plan	Edits language.
6320	Barriers to Preventing a Transition to the Community	Updates revision number and effective date.
6330	Documents in an Individual’s Transition Packet	Updates revision number and effective date.
6340	Individual Profile	Edits language.
6350	Sharing the Transition Plan, Individual Profile, and Transition Packet	Adds expectation to send documents to SPT members within 10 calendar days after meetings.
6360	SPT Member Believes Transition Plan Does Not Accurately Reflect SPT Decision	Updates revision number and effective date.
6400	Pursuing the Selected Community Medicaid Program for Transition	Updates language and clarifies SC/ECC responsibilities.
6500	Transitioning to the HCS Program	Edits language.
6510	Criteria for Transitioning to the HCS Program	Edits language.
6520	Requesting a Targeted NF HCS Transition Slot	Clarifies process and updates language.
6530	Transitioning to the Community by Enrolling in HCS	Updates language and includes weekend trial visits.
6600	Transitioning to the Community by Enrolling in HCS	Edits language.
6700	Transition Day	Updates revision number and effective date.
6800	Post-transition to HCS Program	Changes title to Post-Transition to HCS Program
6810	Post-move Monitoring Visits	Changes title to Post-Move Monitoring Visits and clarifies timelines are based on calendar days.
6820	Monitoring Activities for One Year Post-move	Changes title to Monitoring Activities for One Year Post-Move and updates language.
6900	Post-transition into a Medicaid Community Program	Changes title to Post-Transition to a Medicaid Community Program and clarifies timelines are based on calendar days.
7000	Required PASRR Training	New Section specific to training requirements about PASRR.
7100	Required Training for a Habilitation Coordinator	Adds information related to training requirements for habilitation coordinators.
7110	Training Completed Prior to Habilitation Coordination	Adds information about the list of required trainings that need to be completed before habilitation coordination.
7120	Training Completed Within the First 60 Days of Habilitation Coordination	Adds information about list of required trainings that need to be completed within the first 60 days of habilitation coordination. Supervisors must sign off on all work until trainings completed.
7200	HHSC-developed Training	Changes title to HHSC-Developed Training. Adds information specific about HHSC trainings in the learning portal.

 

Effective July 7, 2019

The Intellectual and Developmental Disability Preadmission Screening and Resident Review (IDD-PASRR) Handbook contains policies and procedures regarding the responsibilities of local intellectual and developmental disability authorities related to the PASRR program.