Section 12000, Protocol for Offering an HCS Crisis Diversion Slot

Revision 19-4; Effective September 9, 2019

 

The number of offers for a Home and Community-based Services (HCS) Crisis Diversion slot made each month is based on budgetary guidelines, in accordance with the legislative allocation for the biennium.

 

12100 Purpose

Revision 19-4; Effective September 9, 2019

 

Texas Health and Human Services Commission (HHSC) may offer an HCS Crisis Diversion slot to a person with an intellectual or developmental disability:

 

12200 Definition of Imminent Risk of Admission to an Institution

Revision 19-4; Effective September 9, 2019

 

A person is at imminent risk of admission to an institution if one or more of the following exists:

 

12300 Qualifications for the HCS Reserved Capacity Group for Crisis Diversion

Revision 19-4; Effective September 9, 2019

 

A person qualifies as a member of the Home and Community-based Services (HCS) Reserved Capacity Group for Crisis Diversion if:

Note: Persons who only meet the criteria for ICF/IID LOC VIII are not eligible.

 

12400 Process

Revision 19-4; Effective September 9, 2019

 

The local intellectual and developmental disability authority (LIDDA) conducts an interview with the person and legally authorized representative (LAR) or an actively involved party about the circumstances creating imminent risk of the person’s admission to an institution. The LIDDA provides an explanation of intellectual or developmental disability (IDD) services and supports.

If the LIDDA determines the person is at imminent risk of admission to an institution, as described in Section 12200, Definition of Imminent Risk of Admission to an Institution, and meets the criteria for a community intermediate care facility for individuals with intellectual disabilities or related conditions (ICF/IID) level of care (LOC) I, and that adequate and appropriate community resources are not available, as evidenced by attempts to locate and use community-based services and supports, the LIDDA begins the process for requesting a Home and Community-based Services (HCS) Crisis Diversion slot.

The LIDDA requests an HCS Crisis Diversion Slot request to the designated staff person in Texas Health and Human Services Commission (HHSC) IDD Services by submitting a packet that includes:

Upon receipt, designated HHSC staff reviews the packet for completeness.

HHSC staff will meet to discuss the request and determine whether the person meets the qualifications described in Section 12300, Qualifications for the HCS Reserved Capacity Group for Crisis Diversion.

The LIDDA initiates the enrollment process within three working days of receipt of the authorization letter from HHSC. The LIDDA is required to complete the enrollment process, in accordance with the rules governing the HCS Program, specifically 40 Texas Administrative Code, §9.157, Process of Enrollment of an Applicant, within the time frames as required by the LIDDA Performance Contract.

If, while waiting for an offer of an HCS Crisis Diversion slot, HHSC determines the person no longer meets the qualifications for the HCS Reserved Capacity Group for Crisis Diversion, as described in Section 12300, HHSC will, within one business day, notify the LIDDA and the person or LAR in writing of the denial of an HCS Crisis Diversion slot and provide the person or LAR with an opportunity for an appeal through a fair hearing.