Section 13000, Medicaid Program Enrollment Requirements

Revision 20-4; Effective October 15, 2020

 

In accordance with Texas Health and Human Services Commission (HHSC) rules, the local intellectual and developmental disability authority (LIDDA) must complete the processes described in this section for each person authorized by HHSC to receive a Home and Community-based Services (HCS) or Texas Home Living (TxHmL) enrollment offer.

 

13100 LIDDA Required Training

Revision 20-4; Effective October 15, 2020

 

In accordance with the local intellectual and developmental disability authority (LIDDA) Performance Contract, the LIDDA must designate staff to complete enrollments for the Home and Community-based Services (HCS) Program, Texas Home Living (TxHmL) Program and the Community First Choice (CFC) Program. The LIDDA must require all designated staff to complete all Texas Health and Human Services Commission (HHSC) online enrollment training before performing enrollment activities, and at least annually thereafter, for as long as the staff performs enrollment activities for the LIDDA.

Training is found at found at LIDDA Training Opportunities and includes:

 

 

13200 Persons Authorized to Enroll from the HCS Interest List

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) notifies the local intellectual and developmental disability authority (LIDDA) in writing when the LIDDA is authorized to offer a person enrollment into the Home and Community based Services (HCS) Program.

 

13210 Notification of HCS Offer

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) strongly encourages local intellectual and developmental disability authorities (LIDDAs) to notify a person or their legally authorized representative (LAR) of a Home and Community-based Services (HCS) enrollment offer within three working days of receiving the notice from HHSC.  

The LIDDA checks the Client Assignment and Registration (CARE) System screens 397, W26 and C63 for a person’s most recent contact information. A person who is receiving Medicaid has a current address displayed in CARE screen C63. If the LIDDA is unsure of the person’s current contact information, the LIDDA must mail the notice to all addresses and attempt to contact the person or LAR at all available phone numbers available in these CARE screens.

The LIDDA makes a written offer of HCS enrollment to the person or LAR by regular U.S. Postal Service (USPS) mail or hand delivery using one of the following:

Note: The LIDDA must also include Form 8592, Deadline Notification.

If the LIDDA learns the person has relocated to another LIDDA’s local service area (LSA), the LIDDA must follow the instructions in Section 13211, Person Relocated to Another LIDDA’s Local Service Area (LSA). If the person or LAR does not respond to the offer of HCS notification within 30 calendar days, the LIDDA follows the instructions in Section 13212, Withdrawal of HCS Offer.

If the person or LAR responds to the notification letter, the LIDDA schedules a meeting to discuss HCS in detail with the person or LAR. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL. Refer to the Initial Meeting Packet checklist (PDF).

A LIDDA must inform a person who is receiving General Revenue (GR) funded services and receiving an HCS offer that the LIDDA is required to end the GR services if the person declines the HCS enrollment offer.

 

13211 Person Relocated to Another LIDDA’s Local Service Area (LSA)

Revision 20-4; Effective October 15, 2020

 

In accordance with the local intellectual and developmental disability authority (LIDDA) Performance Contract, if the authorized LIDDA attempts to contact a person or their legally authorized representative (LAR) and learns that the person or LAR has relocated to another LIDDA’s local service area (LSA), the authorized LIDDA must determine the person’s designated LIDDA. See Section 5000, Guidelines for Determining and Changing Designated LIDDA.

If the authorized LIDDA is the designated LIDDA, then the authorized LIDDA will continue with all enrollment activities.

If the authorized LIDDA determines that another LIDDA is the designated LIDDA, then the authorized LIDDA must notify the assigned slot monitor at Texas Health and Human Services Commission (HHSC) by emailing LIDDARequests@hhsc.state.tx.us. The authorized LIDDA forwards the following to the designated LIDDA:

Once the designated LIDDA receives the information from the authorized LIDDA, then the designated LIDDA becomes the authorized LIDDA and is responsible for meeting required time frames for enrollment or requesting an extension, if needed.

Note: The authorized LIDDA must delete any enrollment screens they may have already entered in the Client Assignment and Registration (CARE) System.

 

13212 Withdrawal of HCS Offer

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) may request that Texas Health and Human Services Commission (HHSC) withdraw the Home and Community-based Services (HCS) offer if the person or legally authorized representative (LAR) does not:

The LIDDA must notify the person or LAR of the withdrawal of HCS offer in writing, by certified U.S. Postal Service (USPS) mail using one of the following:

The LIDDA must email or fax a copy of the following documents to the assigned slot monitor:

Note: Send emails to LIDDARequests@hhsc.state.tx.us or fax to 512-438-5220.

When the slot monitor confirms the withdrawal notice has been delivered, HHSC assigns a Status 7 (removed) to the person’s HCS interest list record. A person under 22 years of age and living in an institution is automatically placed back on the HCS interest list with a new "begin date."

 

13213 Declining the Offer

Revision 20-4; Effective October 15, 2020

 

If the person or legally authorized representative (LAR) declines the Home and Community-based Services (HCS) enrollment offer, the local intellectual and developmental disability authority (LIDDA):

Note: As mentioned in Section 13210, Notification of HCS Offer, the LIDDA must inform a person who is receiving GR funded services and receiving an HCS offer that the LIDDA is required to end the GR services if the person declines the HCS enrollment offer.

Texas Health and Human Services Commission (HHSC) may request the LIDDA provide additional information or documentation for review. HHSC updates the person’s interest list record to a Status 8 (declined).  

The LIDDA adds the person back to the interest list with a new interest list date at the request of the person or LAR. See Section 7000, HCS and TxHmL Interest Lists.

 

13214 Accepting the Offer

Revision 20-4; Effective October 15, 2020

 

If the person or legally authorized representative (LAR) accepts the Home and Community-based Services (HCS) enrollment offer, the local intellectual and developmental disability authority (LIDDA):

The LIDDA must discuss the provider selection process with the person or LAR in addition to:

Although the LIDDA must not direct the person or LAR to choose a specific program provider, the LIDDA may assist the person or LAR with the following:

The LIDDA must instruct the person or LAR to document their selection of the program provider on Form 1049, Initial Documentation of Provider Choice.

If the LIDDA operates an HCS program and is selected by the person or LAR as the HCS program provider, the LIDDA must complete Form 1052, Public Provider Choice Request.

Before submitting the form, the LIDDA must determine whether it is operating at or over its capacity as identified in CARE Screen C70 as “CAP.”

If the LIDDA HCS program is operating below its capacity, the LIDDA intellectual and developmental disability (IDD) director completes Section IV of Form 1052.

If the LIDDA HCS program is operating at or over its capacity, the LIDDA may request a temporary capacity increase to accommodate the person or family-specific circumstance on Form 1052 as follows:

The LIDDA submits Form 1052 to LIDDARequests@hhsc.state.tx.us.

 

13220 Initial Meeting

Revision 20-4; Effective October 15, 2020

 

The initial meeting is conducted with the person or legally authorized representative (LAR) or actively involved family member. The local intellectual and developmental disability authority (LIDDA) shall provide both an oral and a written explanation of the services and supports for which the person may be eligible using Texas Health and Human Services Commission (HHSC) documents listed in the LIDDA Initial Meeting Packet Checklist. The LIDDA must also ensure the person or LAR is provided information about the Medicaid Estate Recovery Program (MERP) once they have chosen to enroll in the Home and Community-based Services (HCS) program, as described in Section 14000, Medicaid Estate Recovery Program (MERP) Overview, using Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement.

 

13221 Person Selects Provider in Another LIDDA’s Local Service Area (LSA)

Revision 20-4; Effective October 15, 2020

 

In accordance with the local intellectual and developmental disability authority (LIDDA) Performance Contract, if the authorized LIDDA contacts a person or legally authorized representative (LAR) and begins the enrollment process and the person or LAR selects a provider in a different LIDDA’s local service area (LSA), the authorized LIDDA must conduct all pre-enrollment activities, such as:

Once the receiving LIDDA receives the information from the authorized LIDDA, the receiving LIDDA is responsible for meeting required time frames for enrollment.

The receiving LIDDA must complete the data entry of all enrollment screens in a timely manner and request an extension if the enrollment is not expected to be approved by the required time frame.

 

13222 Person is Enrolled in Other Waivers

Revision 20-4; Effective October 15, 2020

 

When a person accepts a Home and Community-based Services (HCS) enrollment offer, the local intellectual and developmental disability authority (LIDDA) must check the Service Authorization System Online (SAS0) to determine if the person is currently enrolled in another waiver program. If the person is enrolled in another waiver program, the LIDDA must coordinate the HCS begin date and the end date of the other program with the service coordinator or case manager of the other program to ensure there is no service interruption and to prevent enrollment in dual waiver programs. See Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL.

The STAR+PLUS Waiver and the Medically Dependent Children Program (MDCP) STAR Kids programs operate through a managed care organization (MCO). Therefore, the person’s discharge date must be the last day of the month for which the MCO has already been paid to provide services to the person. HCS can begin the next day (the first day of the next month).

The LIDDA must complete the HCS enrollment screens in the Client Assignment and Registration (CARE) System before the 20th day of the previous month to allow time for Program Eligibility and Support (PES) to process the enrollment by the first day of the month. Example: A person is enrolled in the STAR+PLUS Waiver on March 15; the MCO has been paid through March 31; the person can discharge from STAR+PLUS on March 31 and enroll in HCS on April 1 if the LIDDA completed the enrollment process and entered all enrollment screens in CARE by March 20. Otherwise, the STAR+PLUS discharge date must be changed to April 30; the HCS enrollment begin date must change to May 1; and the LIDDA must complete the data entry in CARE by April 20.

 

13222.1 If Person is in Texas Home Living (TxHmL)

Revision 20-4; Effective October 15, 2020

 

For a person enrolled in Texas Home Living (TxHmL), as soon as the Home and Community-based Services (HCS) begin date is agreed on by the person or their legally authorized representative (LAR) and HCS program provider, the local intellectual and developmental disability authority (LIDDA) service coordinator must complete Form 3616, Request for Termination of Services by HCS/TxHmL Program Provider. The TxHmL termination date is the day before the HCS begin date. The LIDDA obtains the signature from the person/LAR and the TxHmL program provider on the form. This form must be submitted to Program Eligibility and Support (PES) after the Client Assignment and Registration (CARE) System C18 and L18 screens are completed.

PES prefers to receive documents through the IDD Operations Portal but submissions can be made by email to enrollmenttransferdischargeinfo@hhsc.state.tx.us or fax to 512-438-4249.

 

13230 Enrollment Process

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must conduct pre-enrollment activities outlined in Section 15000, Pre-enrollment Activities and Financial Eligibility Related to HCS and TxHmL, and Section 14000, Medicaid Estate Recovery Program (MERP) Overview.

 

13231 Enrollment Due Dates

Revision 20-4; Effective October 15, 2020

 

An enrollment due date is the date Texas Health and Human Services Commission (HHSC) expects the local intellectual and developmental disability authority (LIDDA) to complete the enrollment process for a person. The LIDDA must complete the enrollment process by the enrollment due date described below or have an enrollment extension approved by HHSC. Enrollment due dates are:

Note: Notify the assigned slot monitor if the person resides in a facility.

HHSC considers the enrollment process to be “complete” when:

The LIDDA must request an extension if it cannot meet the enrollment due date. See Section 13232, Requesting an Extension (below).

 

13232 Requesting an Extension

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) may approve an extension if the local intellectual and developmental disability authority (LIDDA) is able to demonstrate, in writing, the LIDDA attempted to complete the process timely but unavoidable circumstances resulted in delays the LIDDA could not prevent. To request an extension, the LIDDA must submit a completed Form 1045, Request for Extension of Enrollment Offer Due Date, to HHSC. If the reason for delay is due to a pending Medicaid determination, the LIDDA must proceed with Client Assignment and Registration (CARE) System data entry.

Note: HHSC does not approve an extension request for a quarter if it is received after the 15th day of the last month of the quarter.

 

13233 Processing the Offer Before the Due Date

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must submit one of the following to Texas Health and Human Services Commission (HHSC) by the due date described in Section 13231, Enrollment Due Dates:

 

13234 Determination of Intellectual Disability (DID)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) reviews records to determine if the person has a diagnosis of an intellectual disability. The LIDDA must use the Determination of Intellectual Disability (DID) Best Practice Guidelines and conduct a new DID or endorse a previous DID.

Related Conditions: The LIDDA verifies a related condition diagnosis with documentation from a physician. The LIDDA verifies that the person has been diagnosed by a licensed physician as having a related condition and meets specific requirements for intelligence quotient (IQ).

 

13235 Level of Care (LOC) and Level of Need (LON)

Revision 20-4; Effective October 15, 2020

 

An LOC is a person’s eligibility determination based on the diagnostic and functional data submitted on the Intellectual Disability and Related Conditions (ID/RC) Assessment. An LON is a payment rate assigned to the person for certain Home and Community-based Services (HCS).

To determine a recommended LOC/LON, the local intellectual and developmental disability authority (LIDDA) administers the Inventory for Client and Agency Planning (ICAP) for the person and completes Form 8578, Intellectual Disability/Related Condition (ID/RC) Assessment. The LIDDA enters the information from Form 8578 in the Client Assignment and Registration (CARE) System screen L23, Waiver ID/RC Assessment, using a purpose code 2.

 

13235.1 HHSC Activities

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) Program Eligibility and Support (PES) reviews Form 8578, Intellectual Disability and Related Condition (ID/RC) Assessment, for level of care (LOC) eligibility. Once Form 8578 is approved, the local intellectual and developmental disability authority (LIDDA) continues data entering the remaining enrollment screens in the Client Assignment and Registration (CARE) System. PES continues its review to verify the services on the individual plan of care (IPC) and financial eligibility (Medicaid). During this time, PES may refer the IPC to Utilization Review (UR). PES may contact the LIDDA for information regarding Medicaid. PES authorizes enrollment when the IPC is approved and Medicaid is verified. The LIDDA must submit the documents to PES immediately upon return of Form 8578. The LIDDA can use CARE JHSXPTR “HC063587 Purpose Code 2 Daily Status Report” to check the purpose code 2, ID/RCs that have been returned, denied or approved.

Note: The LIDDA can check the status of an ID/RC in CARE screens C68 or C83.

For additional guidance on Inventory for Client and Agency Planning (ICAP), LOC, level of need (LON) and ID/RC, the LIDDA may contact PES.

 

13236 Permanency Planning

Revision 20-4; Effective October 15, 2020

 

If a person is under age 22 and enrolling in Home and Community-based Services (HCS) from a family-based setting into an HCS residential setting (i.e., residential support services or supervised living), the LIDDA must conduct permanency planning at the time of the person’s enrollment. A description of his/her permanency planning outcomes must be included in the person-directed plan (PDP). The permanency plan must be completed in accordance with the rules governing the HCS program, specifically 40 Texas Administrative Code §9.167, and the LIDDA Performance Contract.

Note: Refer to the HHSC website for guidance and required forms on Permanency Planning.

 

13237 Consumer Directed Services

Revision 20-4; Effective October 15, 2020

 

If a person lives in his/her own home or a family's home (OHFH) and supported home living, respite, nursing, cognitive rehabilitation therapy, supported employment, employment assistance or Community First Choice Personal Assistance Services/Habilitation (CFC PAS/HAB) is identified on the person-directed plan (PDP), the local intellectual and developmental disability authority (LIDDA) service coordinator must inform the person or their legally authorized representative (LAR) of the right to participate in the Consumer Directed Services (CDS) option. The LIDDA must review the following HHSC forms with the person or LAR:

The LIDDA starts with Form 1581 and if the person or LAR is interested in the CDS option, moves to the next form. However, at any point, if the person or LAR declines the CDS option, the LIDDA can complete Form 1584 indicating the person’s choice is the "Agency Option" and omit the remaining forms.

Form 1581 is an introduction to the CDS option. It includes an explanation of the differences between the CDS option and the provider-managed option. The person or LAR signs this form to acknowledge having received a verbal and written explanation of the CDS option in the Home and Community-based Services (HCS) program from the LIDDA.

Form 1582 provides detailed information about the responsibilities of using the CDS option. It includes a CDS Consumer Self-Assessment to be used by the LIDDA to:

The self-assessment is not meant to determine whether a person or LAR is able to self-direct services. If a person or their LAR has difficulty responding to the self-assessment questions, it is likely a designated representative (DR) is needed to assist the person or LAR to implement the CDS option. If the person or LAR chooses to self-direct services, they must select a financial management services agency (FMSA). It is the FMSA’s responsibility to assist the person or LAR with appointing a DR.

Form 1583 provides important definitions used with the CDS option. It includes information about who can be a CDS employer, who can be a DR and who can and cannot be hired as an employee in the CDS option for HCS.

Form 1584 is used to document the person’s or LAR’s service delivery option.

If the person or LAR chooses to self-direct services, they must select an FMSA. The LIDDA prints a list of FMSAs serving the person’s local service area from the HHSC financial management services agency website. The LIDDA should encourage the person or LAR to call and interview several FMSAs before selecting one.

FMSAs are not required to be in the town where the person resides. FMSAs provide a monthly financial management services (FMS) to the person. FMS does not require ongoing face-to-face contact. While FMSAs are required to make one visit to the person’s home to conduct the CDS orientation prior to initiating service, the FMSA conducts the remainder of their business electronically with the person or LAR or, if appointed, the DR.

Form 1586 provides information to the person or LAR about support consultation in the HCS program, which is optional. Support consultation includes practical skills training, coaching and assistance related to:

If the person or LAR requests support consultation, it must be included in the PDP and the individual plan of care (IPC).

If the person or LAR chooses to participate in the CDS option, the LIDDA must document a description of the service components provided through CDS in the person’s PDP and whether the service is critical to meeting the person’s health and safety and would need a service back-up plan.

 

13238 Money Follows the Person

Revision 20-4; Effective October 15, 2020

 

Review each person enrolling in Home and Community-based Services (HCS) to determine if the person is eligible for inclusion in the Money Follows the Person (MFP) Demonstration Project as follows:

  1. A person is eligible for inclusion in the MFP Demonstration Project if the person meets all the following criteria:
    1. the person must reside continuously in an institutional setting (i.e., intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID), nursing facility, hospital or state hospital) for at least 90 days prior to the HCS enrollment date and be enrolled in HCS from a nursing facility, a large ICF/IID (14 beds or more) or a medium ICF/IID (9-13 beds);
    2. the person’s 90-day stay in the institutional setting, as required by the above, excludes any days funded by Medicare;
    3. the person must be Medicaid eligible under Title XIX of the Social Security Act; and
    4. the person must transition from the nursing facility or ICF/IID into a qualifying residence, which is the person’s own home or family home, a host home or companion care home, a three-person group home or a four-person group home.
  2. A person is eligible for inclusion in the MFP Demonstration Project if:
    1. the person is a resident of a small ICF/IID (1-8 beds), a medium ICF/IID (9-13 beds) or large ICF/IID (14 beds or more);
    2. the facility owner has an approved plan to participate in the MFP Demonstration Voluntary Closure Pilot; and
    3. the person meets the eligibility criteria described here in Section 13238, Money Follows the Person.
  3. A person is eligible for inclusion in the MFP Demonstration Project if the person is under 22 years of age and:
    1. is a resident of a small ICF/IID (1-8 beds);
    2. meets the eligibility criteria described in 1) (a)-(c) above except the ICF/IID may be a small facility; and
    3. transitions from the small ICF/IID into the person’s own home or family home or a host home or companion care home.

If the person is eligible for the MFP Demonstration Project, the LIDDA will:

If the person or LAR agrees to participate, the LIDDA will follow the instructions on Form 1580, including completion of the “For Official Use Only” section of the form. The LIDDA must complete the form as soon as possible and send it using an encrypted email to MFP-Project@hhsc.state.tx.us immediately after completion, but no later than two weeks before the person is discharged from the facility. The LIDDA must keep a copy in the person’s files and follow the retention schedule set forth in the Performance Contract.

Note: The LIDDA is not required to comply with this provision for a resident of a state supported living center (SSLC) who is eligible for the MFP Demonstration Project. SSLC staff are responsible for the explanation, completion and faxing of Form 1580.

If the person or LAR agrees to participate and signs the form, the LIDDA must enter “Y” on the Client Assignment and Registration (CARE) System screen L01 for the question “MFP DEMO Y_ N_.”  

On a case-by-case basis, HHSC may determine a person eligible for the MFP Demonstration Project and direct the LIDDA to comply with providing a brief explanation of the project using Form 1580 to the person or LAR and enter the “Y” response in CARE screen L01, as identified above.

 

13239 Person-Directed Plan (PDP)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) service coordinator develops a PDP after the authorization for enrollment into the Home and Community-based Services (HCS) program has been approved, with the person or legally authorized representative (LAR) using the Person Directed Planning Guidelines, the Discovery Guide and the Discovery Tool. Form 8665, Person Directed Plan, is used to document the information gathered through the discovery process.

 

13240 Individual Plan of Care (IPC)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) service coordinator initiates development of a proposed individual plan of care (IPC) to document the number of units or hours of each service component identified on the person-directed plan (PDP) that will be needed for an IPC year. The IPC must include both Home and Community-based Services (HCS) and non-waiver services.

After the person has chosen an HCS program provider and/or a financial management services agency (FMSA), the service coordinator must conduct a meeting with the program provider to review the initial proposed IPC and develop a final proposed IPC.

If the person or legally authorized representative (LAR) chooses a program provider to deliver supported home living, nursing, host home/companion care, residential support, supervised living, respite, employment assistance, supported employment, day habilitation or Community First Choice (CFC) PAS/HAB, the LIDDA must ensure the initial proposed IPC complies with 40 Texas Administrative Code (TAC), §9.158(9) and (10).

The IPC must comply with the requirements in 40 TAC, §9.159. The LIDDA ensures all the appropriate persons have signed the hard copy IPC.

After enrollment, a program provider can initiate development of a proposed revised IPC for the person as required by 40 TAC, §9.166.

 

13241 CARE Data Entry

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must enter the following Home and Community-based Services (HCS) Client Assignment and Registration (CARE) System enrollment screens in sequential order:

The LIDDA must check CARE JHSXPTR report “HC062490.W, LIDDA Enrollment Packet Exceptions” weekly to determine information missing from CARE causing delay for an HCS enrollment.

PES reviews the HCS pending enrollment report twice a week. However, a person does not appear on the pending enrollment report until the CARE enrollment screens have been completed by the LIDDA. Therefore, the LIDDA must ensure all these screens have been completed before contacting PES about the status of an enrollment or submitting a request for an extension to Local Procedure Development and Support (LPDS).

 

13242 Records

Revision 20-4; Effective October 15, 2020

 

Prior to the service begin date, the local intellectual and developmental disability authority (LIDDA) must provide the program provider and with the following information:

The LIDDA must retain the following documents in the person’s record:

 

13250 Additional Procedures for HCS

Revision 20-4; Effective October 15, 2020

 

 

 

13251 Nursing Facility Diversion

Revision 20-4; Effective October 15, 2020

 

For details on a nursing facility (NF) diversion, criteria and the process for requesting an NF slot, see the Intellectual and Developmental Disability Preadmission Screening and Resident Review (IDD-PASRR) Handbook.

 

13252 Enrollment from an ICF/IID

Revision 20-4; Effective October 15, 2020

 

For persons enrolling from an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID), the enrollment process is the same as listed in Section 13230, Enrollment Process. However, the LIDDA must notify the person or legally authorized representative (LAR) of the requirement to respond to the opportunity to enroll within 20 days of the notification.

For information regarding enrollments into the Home and Community-based Services (HCS) program from a State Support Living Center (SSLC), see Section 9400, Enrollment in HCS as an SSLC Transition.

 

13253 Assisting with Medicaid Eligibility

Revision 20-4; Effective October 15, 2020

 

A person must be verified for an eligible Medicaid program that pays for Home and Community-based Services (HCS) on the individual plan of care (IPC) begin date for the enrollment to be approved. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL, for the Medicaid program types accepted for the HCS program.

 

13254 Medicare Requirements

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) determines whether the person is a Medicare beneficiary. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL, for the steps to take if someone is a Medicare beneficiary.

 

13255 Use of LIDDA Enrollment SFTP Site Instructions

Revision 20-4; Effective October 15, 2020

 

The secure file transfer protocol (SFTP) is a secure site that Texas Health and Human Services Commission (HHSC) requires the local intellectual and developmental disability authority (LIDDA) to use for submission of certain documents related to HCS and TxHmL slot releases and the Medicaid Estate Recovery Program (MERP) forms within the MRA Enrollment folder. To gain access to SFTP, send an email to LIDDARequests@hhsc.state.tx.us.

Documents must be uploaded to the SFTP as a portable document format (PDF). To upload a document, it must be closed; this is a common oversight. The SFTP is used to transfer documents; not for storage. HHSC recommends documents be claimed within seven calendar days from posting and deleted within one month.

To access the SFTP, the user must have been granted access by HHSC Information Technology Security and must be able to access to the internet. Once access to the SFTP has been granted, copy/paste or type the following path into the internet web browser: https://sftp.hhs.texas.gov/EFTClient/Account/Login.htm. In the MRA Enrollment folder, there are two subfolders, the IN folder and the OUT folder:

When uploading VFC or MERP forms to HHSC via the SFTP, the LIDDA must use the following naming conventions:

 

13300 Persons Authorized to Enroll in the TxHmL Program

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) notifies the local intellectual and developmental disability authority (LIDDA), in writing, when the LIDDA is authorized to offer a person enrollment into the Texas Home Living (TxHmL) Program.
 

13310 Notification of TxHmL Offer

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) strongly encourages local intellectual and developmental disability authorities (LIDDAs) to notify a person or their legally authorized representative (LAR) of a Texas Home Living (TxHmL) enrollment offer within three working days of receiving the notice from HHSC.  

The LIDDA checks the Client Assignment and Registration (CARE) System screens 397, W26 and C63 for a person’s most recent contact information. A person who is receiving Medicaid has a current address displayed in CARE screen C63. If the LIDDA is unsure of the person’s current contact information, the LIDDA must mail the notice to all addresses and attempt to contact the person or LAR at all available phone numbers available in these CARE screens.

The LIDDA makes a written offer of TxHmL enrollment to the person or LAR by regular U.S. Postal Service (USPS) mail or hand delivery using its own TxHmL offer letter which complies with 40 Texas Administrative Code (TAC), §9.567(d). Note: The LIDDA must also include Form 8592, Deadline Notification.

If the LIDDA learns that the person has relocated to another LIDDA’s local service area (LSA), the LIDDA must follow the instructions in Section 13311, Person Relocated to Another LIDDA’s Local Service Area (LSA). If the person or LAR does not respond to the offer of TxHmL notification within 30 calendar days, the LIDDA follows the instructions in Section 13312, Withdrawal of TxHmL Offer.

If the person or LAR responds to the notification letter, the LIDDA schedules a meeting to discuss the TxHmL program and services in detail with the person or LAR. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL. Refer to the Initial Meeting Packet checklist (PDF).

In accordance with 40 Texas Administrative Code §9.567, if a person receiving a TxHmL offer receives LIDDA services funded by General Revenue (GR), the LIDDA must inform the person that if the person declines the TxHmL enrollment offer, the LIDDA is required to end GR services which are similar to TxHmL services.

 

13311 Person Relocated to Another LIDDA’s Local Service Area (LSA)

Revision 20-4; Effective October 15, 2020

 

In accordance with the local intellectual and developmental disability authority (LIDDA) Performance Contract, if the authorized LIDDA attempts to contact a person or their legally authorized representative (LAR) and learns that the person or LAR has relocated to another LIDDA’s LSA, the authorized LIDDA must determine the person’s designated LIDDA. See Section 5000, Guidelines for Determining and Changing Designated LIDDA.

If the authorized LIDDA is the designated LIDDA, then the authorized LIDDA will continue with all enrollment activities.

If the authorized LIDDA determines that another LIDDA is the designated LIDDA, then the authorized LIDDA must notify the assigned slot monitor at Texas Health and Human Services Commission (HHSC) by emailing LIDDARequests@hhsc.state.tx.us. The authorized LIDDA forwards the following to the designated LIDDA:

Once the designated LIDDA receives the information from the authorized LIDDA, then the designated LIDDA becomes the authorized LIDDA and is responsible for meeting required time frames for enrollment or requesting an extension, if needed.

Note: The authorized LIDDA must delete any enrollment screens they may have already entered in the Client Assignment and Registration (CARE) System.

 

13312 Withdrawal of TxHmL Offer

Revision 20-4; Effective October 15, 2020

 

In accordance with 40 Texas Administrative Code (TAC) §9.567(f), the local intellectual and developmental disability authority (LIDDA) may request that Texas Health and Human Services Commission (HHSC) withdraw the Texas Home Living (TxHmL) offer if the person or legally authorized representative (LAR) does not:

The LIDDA must notify the person or LAR of the withdrawal of TxHmL offer in writing, by certified U.S. Postal Service (USPS) mail using its own TxHmL withdrawal letter which must contain the same information as Form 1068, Withdrawal of Offer for Home and Community-based Services (HCS) Program.

The LIDDA must provide copies of the following documents to the slot monitor:

Note: The LIDDA emails the documents to LIDDARequests@hhsc.state.tx.us or faxes them to 512-438-5220.

When the slot monitor confirms the withdrawal notice has been delivered, HHSC assigns a Status 7 (removed) to the person’s TxHmL interest list record.

 

13313 Declining the Offer

Revision 20-4; Effective October 15, 2020

 

If the person or legally authorized representative (LAR) declines the Texas Home Living (TxHmL) enrollment offer, the local intellectual and developmental disability authority (LIDDA):

Note: See Section 13310, Notification of TxHmL Offer.

Texas Health and Human Services Commission (HHSC) may request the LIDDA provide additional information or documentation for review. HHSC updates the person’s interest list record to a Status 8 (declined).  

The LIDDA adds the person back to the interest list with a new interest list date at the request of the person or LAR. See Section 7000, HCS and TxHmL Interest Lists.

 

13314 Accepting the Offer

Revision 20-4; Effective October 15, 2020

 

If the person or legally authorized representative (LAR) accepts the Texas Home Living (TxHmL) enrollment offer, the local intellectual and developmental disability authority (LIDDA):

The LIDDA must discuss the provider selection process with the person or LAR in addition to:

Although the LIDDA must not direct the person or LAR to choose a specific program provider, the LIDDA may assist the person or LAR with the following:

The LIDDA must instruct the person or LAR to document their selection of the program provider on Form 1049, Initial Documentation of Provider Choice.

Note: If the person or LAR chooses to self-direct all their services using the Consumer Directed Services (CDS) option, this form is not required. See Section 13336, Consumer Directed Services (CDS).

If the LIDDA operates a TxHmL program and is selected by the person or LAR as the TxHmL program provider, the LIDDA must complete Form 1052, Public Provider Choice Request.

Before submitting the form, the LIDDA must determine whether it is operating at or over its capacity as identified in CARE Screen C70 as “CAP.”

If the LIDDA TxHmL program is operating below its capacity, the LIDDA intellectual and developmental disability (IDD) director completes Section IV of Form 1052.

If the LIDDA TxHmL program is operating at or over its capacity, the LIDDA may request a temporary capacity increase to accommodate the person or family-specific circumstance on Form 1052 as follows:

The LIDDA submits Form 1052 to LIDDARequests@hhsc.state.tx.us.

 

13320 Initial Meeting

Revision 20-4; Effective October 15, 2020

 

The initial meeting is to be conducted with the person and their legally authorized representative (LAR), or actively involved family member. The local intellectual and developmental disability authority (LIDDA) shall provide both an oral and a written explanation of the services and supports for which the person may be eligible using Texas Health and Human Services Commission (HHSC) documents listed in the LIDDA Initial Meeting Packet Checklist. The LIDDA must also ensure the person or LAR is provided information about the Medicaid Estate Recovery Program (MERP) once they have chosen to enroll in the Texas Home Living (TxHmL) program as described in Section 14000, Medicaid Estate Recovery Program (MERP) Overview, using Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement.

 

13321 Person Selects Provider in Another LIDDA’s Local Service Area (LSA)

Revision 20-4; Effective October 15, 2020

 

In accordance with the local intellectual and developmental disability authority (LIDDA) Performance Contract, if the authorized LIDDA contacts a person or legally authorized representative (LAR) and begins the enrollment process and the person or LAR selects a provider or financial management services agency (FMSA) in a different LIDDA’s local service area (LSA), the authorized LIDDA must conduct all pre-enrollment activities, such as:

Once the receiving LIDDA receives the information from the authorized LIDDA, the receiving LIDDA is responsible for meeting required time frames for enrollment.

The receiving LIDDA must complete the data entry of all enrollment screens in a timely manner and request an extension if the enrollment is not expected to be approved by the required time frame.

 

13322 Person is Enrolled in Other Waivers

Revision 20-4; Effective October 15, 2020

 

When a person accepts a Texas Home Living (TxHmL) enrollment offer, the local intellectual and developmental disability authority (LIDDA) must check the Service Authorization System Online (SAS0) to determine if the person is currently enrolled in another waiver program. If the person is enrolled in another waiver program, the LIDDA must provide information about the TxHmL waiver program in comparison to the services and eligibility criteria of the other program to ensure the person/LAR makes an informed decision. The LIDDA must explain that if TxHmL is chosen over the other program, the person must be discharged from the other waiver program before TxHmL services begin. If TxHmL is chosen, the LIDDA must coordinate the TxHmL begin date and the end date of the other program with the service coordinator or case manager of the other program to ensure there is no service interruption and to prevent enrollment in dual waiver programs. See Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL.

The STAR+PLUS Waiver and the Medically Dependent Children Program (MDCP) STAR Kids programs operate through a managed care organization (MCO). Therefore, the person’s discharge date must be the last day of the month for which the MCO has already been paid to provide services to the person. The LIDDA must coordinate TxHmL services to begin the next day (the first day of the next month).

To ensure enough time for Program Eligibility and Support (PES) to process the TxHmL enrollment by the first day of a month, the LIDDA must complete the TxHmL enrollment screens in the Client Assignment and Registration (CARE) system before the 20th day of the previous month. For example: An MCO has been paid to provide STAR+PLUS waiver services to the person through March 31. The LIDDA coordinates the STAR+PLUS disenrollment for March 31 and the TxHmL begin date for April 1. The LIDDA must complete CARE data entry for the TxHmL enrollment before March 20 to ensure TxHmL can begin April 1. If the LIDDA is not able to complete the TxHmL enrollment screens in CARE by the 20th day of the month before the TxHmL begin date, the LIDDA must coordinate a new STAR+PLUS end date and TxHmL begin date for the first day of the next month.

 

13330 Enrollment Process

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must conduct pre-enrollment activities outlined in Section 15000, Pre-enrollment Activities and Financial Eligibility Related to HCS and TxHmL, and Section 14000, Medicaid Estate Recovery Program (MERP) Overview.

 

13331 Enrollment Due Dates

Revision 20-4; Effective October 15, 2020

 

An enrollment due date is the date Texas Health and Human Services Commission (HHSC) expects the local intellectual and developmental disability authority (LIDDA) to complete the slot offer process and, if accepted, the enrollment process for a person. The LIDDA must complete the process by the enrollment due date as described below or have an extension approved by HHSC. Due dates are:

Note: The LIDDA must inform the assigned slot monitor if the person resides in a facility.

HHSC considers the enrollment process to be “complete” when one of the following occurs:

  1. The person’s enrollment has been approved by HHSC, which is indicated by a status of “active” in the Client Assignment and Registration (CARE) System’s C61, Consumer Demographics Inquiry screen;
  2. The person’s enrollment has been denied by HHSC, which is indicated by a status of “denied” in the CARE C61 screen;
  3. HHSC has processed the LIDDA’s request to withdraw the slot offer, which is indicated by a status of 7 (withdrawn) in CARE screens 397 and W21; or
  4. HHSC has received Form 8601, Verification of Freedom of Choice, from the LIDDA, which has been signed by the person/LAR to indicate their decision to decline and their reason for declining, which is indicated by status 8 (declined) in CARE screens 397 and W21.

The LIDDA must request an extension if the process cannot be completed by the due date. See Section 13332, Requesting an Extension, below.

 

13332 Requesting an Extension

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) may extend the due date if the local intellectual and developmental disability authority (LIDDA) is able to demonstrate in writing the LIDDA attempted to complete the process timely but unavoidable circumstances resulted in delays the LIDDA could not prevent. To request an extension, the LIDDA must submit a completed Form 1045, Request for Enrollment Extension of Enrollment Offer Due Date, to HHSC. If the reason for delay is due to a pending Medicaid determination, the LIDDA must proceed with CARE data entry while Medicaid eligibility is pending.

Note: HHSC does not approve an extension request for a quarter if it is received after the 15th day of the last month of the quarter.

 

13333 Processing the Offer Before the Due Dates

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must submit one of the following to Texas Health and Human Services Commission (HHSC) by the due date described in Section 13331, Enrollment Due Dates:

 

13334 Determination of Intellectual Disability (DID)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) reviews a person’s records to determine if the person has a diagnosis of an intellectual disability. The LIDDA must use the Determination of Intellectual Disability (DID) Best Practice Guidelines and conduct a new DID or endorse a previous DID.

Related Conditions: The LIDDA verifies a related condition diagnosis with documentation from a physician. The LIDDA verifies that the person has been diagnosed by a licensed physician as having a related condition and meets specific requirements for intelligence quotient (IQ).

 

13335 Level of Care (LOC) and Level of Need (LON)

Revision 20-4; Effective October 15, 2020

 

An LOC is a person’s eligibility determination based on the diagnostic and functional data submitted on the Intellectual Disability and Related Conditions (ID/RC) Assessment. An LON is a payment rate assigned to the person for certain Texas Home Living (TxHmL) services.

To determine a recommended LOC/LON, the local intellectual and developmental disability authority (LIDDA) administers the Inventory for Client and Agency Planning (ICAP) for the person and completes Form 8578, Intellectual Disability/Related Condition Assessment. The LIDDA enters the information from the form into the Client Assignment and Registration (CARE) System screen L23, Waiver ID/RC Assessment, using a purpose code “2.”

 

13335.1 HHSC Activities

Revision 20-4; Effective October 15, 2020

 

Texas Health and Human Services Commission (HHSC) Program Eligibility and Support (PES) reviews the Intellectual Disability and Related Condition (ID/RC) Assessment for level of care (LOC) eligibility. PES may return the ID/RC to the LIDDA for additional information. If requested, the LIDDA must submit the documents to PES immediately upon return of the ID/RC.

If PES denies LOC, enrollment is denied and no other data entry is needed by the LIDDA. However, if the ID/RC is approved, the LIDDA continues data entering the remaining enrollment screens. When the last enrollment screen is entered, the person appears on PES’ pending enrollment report and PES continues their review for enrollment.

After an ID/RC is approved by PES and all enrollment screens are entered by the LIDDA, the person’s information appears on the pending enrollment report for PES. PES reviews the services on the individual plan of care (IPC) and verifies financial eligibility (Medicaid).

During their review, PES may refer the IPC to Utilization Review (UR) and PES and/or UR may contact the LIDDA for additional information. PES authorizes enrollment when LOC is approved, the IPC is approved and TxHmL Medicaid eligibility is verified.

Note: The LIDDA can use CARE JHSXPTR -HC063587, Purpose Code 2 Daily Status Report, to check the status of the purpose code 2 ID/RC. The LIDDA can also check the status of an ID/RC in CARE screens C68 or C83.

For additional guidance on ICAP, LOC, LON and ID/RC, the LIDDA may contact PES.

 

13336 Consumer Directed Services (CDS)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) service coordinator must inform the person or their legally authorized representative (LAR) of the right to participate in the CDS option. The LIDDA must review the following HHSC forms with the person or LAR:

The LIDDA starts with Form 1581 and if the person or LAR is interested in the CDS option, moves to the next form. However, at any point, if the person or LAR declines the CDS option, the LIDDA can complete Form 1584 indicating the person’s choice is the "Agency Option" and omit the remaining forms.

Form 1581 is an introduction to the CDS option. It includes an explanation of the differences between the CDS option and the provider-managed option. The person or LAR signs this form to acknowledge having received a verbal and written explanation of the CDS option in the Texas Home Living (TxHmL) program from the LIDDA.

Form 1582 provides detailed information about the responsibilities of using the CDS option. It includes a CDS Consumer Self-Assessment to be used by the LIDDA to:

The self-assessment is not meant to determine whether a person or LAR is able to self-direct services. If a person or their LAR has difficulty responding to the self-assessment questions, it is likely a designated representative (DR) is needed to assist the person or LAR to implement the CDS option. If the person or LAR chooses to self-direct services, they must select a financial management services agency (FMSA). It is the FMSA’s responsibility to assist the person or LAR with appointing a DR.

Form 1583 provides important definitions used with the CDS option. It includes information about who can be a CDS employer, who can be a DR and who can and cannot be hired as an employee in the CDS option for TxHmL.

Form 1584 is used to document the person’s or LAR’s service delivery option.
If the person or LAR chooses to self-direct services, they must select an FMSA. The LIDDA prints a list of FMSAs serving the person’s local service area from the HHSC financial management services agency website. The LIDDA should encourage the person or LAR to call and interview several FMSAs before selecting one.

FMSAs are not required to be in the town where the person resides. FMSAs provide a monthly financial management services (FMS) to the person. FMS does not require ongoing face-to-face contact. While FMSAs are required to make one visit to the person’s home to conduct the CDS orientation prior to initiating service, the FMSA conducts the remainder of their business electronically with the person or LAR or, if appointed, the DR.

Form 1586 provides information to the person or LAR about support consultation in the TxHmL program, which is optional. Support consultation includes practical skills training, coaching and assistance related to:

If the person or LAR requests support consultation, it must be included in the PDP and the individual plan of care (IPC).

If the person or LAR chooses to participate in the CDS option, the LIDDA must document a description of the service components provided through CDS in the person’s PDP and whether the service is critical to meeting the person’s health and safety and would need a service back-up plan.

 

13337 Person-Directed Plan (PDP)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) service coordinator develops a PDP after the authorization for enrollment into the Texas Home Living (TxHmL) program has been approved with the person or legally authorized representative (LAR) using the Person Directed Planning Guidelines, the Discovery Guide and the Discovery Tool. Form 8665, Person-Directed Plan, is used to document the information gathered through the discovery process.

 

13338 Individual Plan of Care (IPC)

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) service coordinator initiates development of a proposed individual plan of care (IPC) to document the number of units or hours of each service component identified on the person-directed plan (PDP) that will be needed for an IPC year. The IPC must include both Texas Home Living (TxHmL) and non-waiver services.

After the person has chosen a TxHmL program provider and/or a financial management services agency (FMSA), the service coordinator must conduct a meeting with the program provider to review the initial proposed IPC and develop a final proposed IPC.

If the person or legally authorized representative (LAR) chooses a program provider to deliver supported home living, nursing, host home/companion care, residential support, supervised living, respite, employment assistance, supported employment, day habilitation, or Community First Choice (CFC) PAS/HAB, the LIDDA must ensure the initial proposed IPC complies with 40 Texas Administrative Code (TAC) §9.567.

The IPC must comply with the requirements in 40 TAC §9.558. The LIDDA ensures all the appropriate persons have signed the hard copy IPC.

After enrollment, a program provider can initiate development of a proposed revised IPC for the person as required by 40 TAC §9.568.

 

13339 CARE Data Entry

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must enter the following Texas Home Living (TxHmL) Client Assignment and Registration (CARE) System enrollment screens in sequential order:

The LIDDA must check CARE JHSXPTR-HC062490.W, LIDDA Enrollment Packet Exceptions report, weekly to determine information missing from CARE causing delay for a TxHmL enrollment.

PES reviews the TxHmL pending enrollment report twice a week. However, a person does not appear on the pending enrollment report until the CARE enrollment screens have been completed by the LIDDA. Therefore, the LIDDA must ensure all these screens have been completed before contacting PES about the status of an enrollment or submitting a request for an extension to Local Procedure Development and Support (LPDS). If the LIDDA has entered all enrollment screens and the person has current Medicaid for the TxHmL program, the LIDDA must contact PES for information regarding the status of their review and include the reason on Form 1045, Request for Extension Enrollment Offer Due Date, when requesting an extension.

 

13340 Records

Revision 20-4; Effective October 15, 2020

 

Prior to the service begin date, the local intellectual and developmental disability authority (LIDDA) must provide the program provider and with the following information:

The LIDDA must retain the following documents in the person’s record:

 

13350 Additional Procedures for TxHmL

Revision 20-4; Effective October 15, 2020

 

 

 

13351 Enrollment from an ICF/IID

Revision 20-4; Effective October 15, 2020

 

For persons enrolling from an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID), the enrollment process is the same as listed in Section 13330, Enrollment Process. However, the LIDDA must notify the person or legally authorized representative (LAR) of the requirement to respond to the opportunity to enroll within 20 days of the notification.

 

13352 Assisting with Medicaid Eligibility

Revision 20-4; Effective October 15, 2020

 

A person must be verified for an eligible Medicaid program that pays for Texas Home Living (TxHmL) services on or before the individual plan of care (IPC) begin date for enrollment to be approved. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related tor HCS and TxHmL, for the Medicaid program types accepted for the TxHmL program. If the person is not certified for an eligible Medicaid program that pays for TxHmL services on or before the individual plan of care (IPC) begin date, the provider may choose to delay service provision until Medicaid can be verified and the IPC begin date may be changed.

 

13353 Medicare Requirements

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) determines whether the person is a Medicare beneficiary. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related tor HCS and TxHmL, for the steps to take if someone is a Medicare beneficiary.

 

13354 Use of LIDDA Enrollment SFTP Site Instructions

Revision 20-4; Effective October 15, 2020

 

The secure file transfer protocol (SFTP) is a secure site that Texas Health and Human Services Commission (HHSC) requires the local intellectual and developmental disability authority (LIDDA) to use for submission of certain documents related to HCS and TxHmL slot releases and the Medicaid Estate Recovery Program (MERP) forms to the MRA Enrollment folder. To gain access to SFTP, send an email to LIDDARequest@hhsc.state.tx.us.

Documents must be uploaded to the SFTP as a portable document format (PDF). To upload a document, it must be closed; this is a common oversight. The SFTP is used to transfer documents; not for storage. HHSC recommends documents be claimed within seven calendar days from posting and deleted within one month.

To access the SFTP, the user must have been granted access by HHSC Information Technology Security and must be able to access to the internet. Once access to the SFTP has been granted, copy/paste or type the following path into the internet web browser: https://sftp.hhs.texas.gov/EFTClient/Account/Login.htm. In the MRA Enrollment folder, there are two subfolders, the IN folder and the OUT folder:

When uploading VFC or MERP forms to HHSC via the SFTP, the LIDDA must use the following naming conventions:

 

13400 Enrollment in the ICF/IID Program

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) must:

Note: A person with Medicaid only is not affected by the Medicare Prescription Drug Program and will continue to receive his or her drugs through Medicaid.

 

13410 Medicare Requirements

Revision 20-4; Effective October 15, 2020

 

The local intellectual and developmental disability authority (LIDDA) determines whether the person is a Medicare beneficiary. Refer to Section 15000, Pre-Enrollment Activities and Financial Eligibility Related to HCS and TxHmL, for the steps to take if someone is a Medicare beneficiary.