Revision 11-1; Effective January 20, 2011

 

 

8100 Overview

Revision 10-1; Effective September 27, 2010

 

Section 8000 describes the requirements for:

  • transferring an individual's Home and Community-based Services (HCS) or Texas Home Living (TxHmL) program services from one program provider or Consumer Directed Services Agency (CDSA) to another;
  • transferring an individual's HCS or TxHmL program services to another waiver contract area whether or not the program provider changes;
  • changing an individual's HCS or TxHmL service delivery option to add or delete CDS; and
  • reassigning an LA when an individual moves from one LA's service area into another LA's service area without changing program provider within a waiver contract area. Click here and scroll to the last page to see a list of LAs by waiver contract area (WCA).

Texas Administrative Code Title 40, Chapter 9, Subchapter D, requires the service coordinator (SC) to manage the transfer process as stated in §9.190.

§9.190. MRA Requirements for Providing Service Coordination in the HCS Program.

(e) A service coordinator must:

(24) manage the process to transfer an individual's HCS Program services from one program provider to another or one CDSA to another in accordance with DADS instructions, including:

(A) informing the individual or LAR who requests a transfer to another program provider or CDSA that the service coordinator will manage the transfer process;

(B) informing the individual or LAR that the individual or LAR may choose to receive HCS Program services from any available program provider (i.e., a program provider whose enrollment has not reached its service capacity in CARE) or CDSA; and

(C) if the individual or LAR has not selected another program provider or CDSA, provide the individual or LAR a list of available HCS Program providers and CDSAs and contact information in the geographic locations preferred by the individual or LAR;

 

8200 Requirement for Program Provider to Notify Service Coordinator (SC)

Revision 11-1; Effective January 20, 2011

 

 

 

8210 Transfers Must be Planned

Revision 11-1; Effective January 20, 2011

 

The Department of Aging and Disability Services (DADS) requires an individual's transfer to be planned in order for the receiving provider to be knowledgeable about the individual's needs and to be prepared to deliver necessary services. Therefore, the transfer effective date must be a future date to allow for adequate planning. An exception to this requirement may be made when a transfer meets the criteria for an emergency (as described in Section 8230, Emergency Transfer). If an individual/LAR requests a transfer, the program provider or the SC must inform the individual/LAR or family that the transfer must be scheduled for a future date in order to ensure appropriate planning occurs.

If an individual's program provider receives information that the individual/LAR wants to transfer to another program provider or CDSA, including information from another program provider or CDSA, the program provider must, within 24 hours, notify the individual's SC of such information.

If the program provider does not know who the individual's SC is, it must notify the HCS service coordination supervisor with the LA currently providing service coordination of the individual/LAR's desire for transfer.

If a potential receiving provider is contacted by an individual/LAR who requests to transfer to its contract, the provider must direct the individual/LAR to notify his/her SC of the request. The potential receiving provider must let the individual/LAR know that a transfer will not be valid until the SC conducts a transfer individual plan of care (IPC) meeting. The potential receiving program provider is not authorized to begin providing services and will not be reimbursed for services provided before meeting with the individual/LAR and SC to develop and sign the transfer IPC. An exception to this requirement may be made when a transfer meets the criteria for an emergency (as described in Section 8230).

 

8220 No Prior SC Notification

Revision 11-1; Effective January 20, 2011

 

If an SC is notified that an individual is already receiving services from a potential receiving provider/contract without going through the transfer process, the SC must document the date they were notified and by whom. The SC must contact the individual/LAR no later than three business days after receiving this notification to verify the individual wanted to transfer, and to determine their choice of providers. If the individual does not agree with the transfer and wants to remain with his or her previous provider or contract, the SC arranges for such. If the individual indicates this was their choice or chooses another provider, the SC has an additional five business days to conduct the transfer IPC meeting. The receiving provider should be aware that the transfer effective date will not be before the date the transfer IPC is signed unless the situation meets the criteria for an emergency transfer.

 

8230 Emergency Transfer

Revision 11-1; Effective January 20, 2011

 

The HCS rule defines emergency as "an unexpected situation in which the absence of an immediate response could reasonably be expected to result in risk to the health and safety of an individual or another person." For an emergency transfer, the "immediate response" referenced would be a transfer before an IPC meeting can be held. If an individual's transfer to another contract must occur before the transfer IPC meeting can be held, the transfer may be considered an "emergency transfer." If an IPC meeting is held before the transfer takes place, then the transfer is not processed as an emergency transfer.

If the SC is unaware that the individual requires an emergency transfer, the provider is responsible for notifying the SC as soon as the emergency situation allows in order to complete the transfer process.

The SC completes the transfer process with the transfer effective date as the date the individual began receiving services from the new provider or new contract. Signature dates on the transfer IPC will be the date of the IPC meeting. This means the transfer effective date may be earlier than the IPC meeting dates and the IPC signature dates.

The SC must submit with the transfer packet to DADS Program Enrollment (PE) supporting documentation that shows the transfer meets the criteria for an emergency. Whoever addressed the emergency situation is responsible for providing the supporting documentation. Based on the supporting documentation, DADS PE determines whether or not the criteria for an emergency transfer have been met.

If DADS PE determines the criteria for an emergency transfer have been met, the receiving provider may be reimbursed for services provided before the transfer IPC meeting.

 

8231 CARE Data Entry of Emergency Transfer

Revision 11-1; Effective January 20, 2011

 

The LA enters the transfer data in CARE for all transfers except an emergency transfer.

For an emergency transfer, DADS PE enters the transfer data in CARE.

 

8300 Miscellaneous Information and Requirements

Revision 10-1; Effective September 27, 2010

 

 

 

8310 Simultaneous Transfer of Program Provider and CDSA

Revision 10-1; Effective September 27, 2010

 

If an individual/LAR wants to transfer to another program provider and to another CDSA, the SC, the LA and the transferring and receiving program providers must follow the steps in Section 8600, CDSA Transfer and Changing Service Delivery Option, Section 8400, Program Provider Transfer Involving One Local Authority (LA), or Section 8500, Program Provider Transfer Involving Two Local Authorities (LAs), at the same time using one Form 3617, Request for Transfer of Waiver Program Services.

 

8320 Form 3617 and Instructions

Revision 10-1; Effective September 27, 2010

 

Form 3617, Request for Transfer of Waiver Program Services, is used to document transfer information. The persons required to complete portions of this form must do so in accordance with the instructions.

 

8330 CARE Data Entry

Revision 10-1; Effective September 27, 2010

 

The CARE User's Guide includes step-by-step instructions for entering an individual's transfer data and is online at: http://www2.mhmr.state.tx.us/655/cis/training/files/waiver/mra%20guide/consumer%20transfer.pdf

Note: The CARE User's Guide is only available to those who have access to the CARE system.

 

8340 Verification of Guardianship

Revision 10-1; Effective September 27, 2010

 

To prevent a delay in the authorization of a transfer, the SC must determine whether an individual has a legal guardian and verify that guardianship information is correct in CARE by checking Screen C61.

  • If the individual has a current legal guardian listed in CARE, then all forms must be signed by the guardian.
  • If the individual does not have a legal guardian listed in CARE, then all forms must be signed by the individual.
  • If the guardian listed in CARE is not current, the SC should obtain signatures of both the individual and the person listed as guardian, until appropriate steps can be taken to update guardianship information. The SC can update guardianship information for an individual on CARE Screen L20.

 

8350 Transfer Process Checklist

Revision 10-1; Effective September 27, 2010

 

When completing transfer activities, the SC may use Form 3612, Transfer Process Checklist.

 

 

8360 Contacting DADS

Revision 11-1; Effective January 20, 2011

 

The LA may, at any time during the transfer process, consult with the DADS PE contact assigned to the receiving program provider if the LA encounters problems completing the process.

The SC must consult with the DADS PE contact when a program provider does not submit required documentation within the time frames described in this section.

 

8400 Program Provider Transfer Involving One Local Authority (LA)

Revision 10-1; Effective September 27, 2010

 

Sections 8410 through 8470 describe the requirements for a program provider transfer involving one LA.

 

8410 Confirming the Desire to Transfer

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 Within three days after receiving information that an individual/LAR wants to transfer to another program provider, the SC must contact the individual/LAR to:

 

  • confirm the individual/LAR wants to transfer; and
  • explain that the individual/LAR may transfer to the program provider of his/her choice.
2 If the SC confirms that the individual/LAR wants to transfer, the SC must:

 

  • complete the individual's identifying information on Form 3617, Request for Transfer of Waiver Program Services, check the appropriate box for the type of transfer and obtain the signature of the individual/LAR, indicating the desire to transfer;
  • determine if the individual/LAR has selected a receiving program provider; and
  • notify the state support living center (SSLC) admissions placement coordinator that the individual wants to transfer, if the individual is on community placement from an SSLC and is being monitored in accordance with a community living discharge plan (CLDP).

 

8420 Selecting a Receiving Program Provider

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 The SC must inform the individual/LAR that they have a choice of program providers, even if the individual/LAR has already selected a receiving program provider.
2 If the individual/LAR has not selected a receiving program provider, the SC must give the individual/LAR a list of program providers and contact information in the geographic locations preferred by the individual/LAR within five days after the date the SC confirms the individual/LAR wants to transfer.
3 After the individual/LAR has selected a receiving program provider, the SC must document the individual/LAR's choice of a receiving program provider in Section II on Form 3617.

 

8430 Ensuring Agreement on Transfer Effective Date

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 At the time the individual/LAR selects a receiving program provider, the SC must obtain a proposed transfer effective date from the individual/LAR.
2 The SC must contact the receiving program provider to determine if the date proposed by the individual/LAR is acceptable.
3 Once the receiving program provider and individual/LAR agree on a transfer effective date, the SC must contact the transferring program provider to determine if that date is agreeable to the transferring program provider. If the date is agreeable, the SC completes the steps in Section 8440, Completing Form 3617.
4 If the date is not agreeable, the SC must facilitate communication between the individual/LAR and the transferring and receiving program providers to reach a mutually agreeable transfer effective date.
5 If a transfer effective date is not agreed upon within five days after the date the individual/LAR selects a receiving program provider, the SC must consult DADS Program Enrollment for direction.
Step Receiving Program Provider Action
1 When contacted by the SC, the receiving program provider must comply with the SC's request for a transfer effective date.
2 If the proposed transfer effective date is not acceptable to the receiving program provider, the provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and transferring program provider.
Step Transferring Program Provider Action
1 When contacted by the SC, the transferring program provider must comply with the SC's request for a transfer effective date.
2 If the proposed transfer effective date is not acceptable to the transferring program provider, the provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and receiving program provider.

 

8440 Completing Form 3617

Revision 11-1; Effective January 20, 2011

 

Step Service Coordinator Action
1 The SC must enter the mutually agreed upon transfer effective date in Section I, Transferring Program Provider's Information, and Section II, Receiving Program Provider's Information, of Form 3617.
2 The SC must send Form 3617 to the transferring program provider and request that the provider complete Section I and return it to the SC within three business days.
3 After receiving a completed copy of Form 3617 from the transferring program provider, the SC must send the same Form 3617 to the receiving program provider and request that the provider complete Section II and return it to the SC within three business days.
4 The SC must ensure all signatures are on the same copy of Form 3617. The SC must sign Form 3617 after both program providers have completed their sections.
Step Transferring Program Provider Action
1 The transferring program provider must accurately complete Section I of Form 3617 in accordance with the form's instructions and sign and date the form indicating agreement with the information in Section I.
2 The transferring program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.
Step Receiving Program Provider Action
1 The receiving program provider must accurately complete Section II of Form 3617 in accordance with the form's instructions and sign and date the form indicating agreement with the information in Section II.
2 The receiving program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.

 

8450 Developing the Transfer IPC

Revision 11-1; Effective January 20, 2011

 

Step Service Coordinator Action
1 On or before the transfer effective date, the SC must meet with the individual/LAR and the receiving program provider to review the individual's current IPC and develop a transfer IPC. This must be a face-to-face meeting, if feasible.
2 The SC must ensure that the transfer IPC includes services already provided by the transferring program provider, and services to be provided by the transferring program provider before the transfer effective date. This information can be found in:

 

  • CARE Screen C72 (Services provided and billed); and
  • Section I of the completed Form 3617 (services provided but not yet billed, and services not yet provided).

The SC must also ensure that the transfer IPC includes services to be provided by the receiving program provider.

3 The SC must ensure the transfer IPC:

 

  • complies with the requirements described in §9.159(c); and
  • is signed and dated by the individual/LAR, receiving program provider, and SC.
4 At the transfer IPC meeting, the SC ensures the receiving program provider completes Section II of Form 3617 and returns it to the SC.
Step Receiving Program Provider Action
1 The receiving program provider must meet with the individual/LAR and SC to develop and sign a transfer IPC, as requested by the SC.
2 The receiving program provider must complete Section II of Form 3617 and return it to the SC.

 

8460 Sharing Documents

Revision 11-1; Effective January 20, 2011

 

Step Service Coordinator Action
1 The SC must submit current copies of the following documents to the receiving program provider before the transfer effective date:

 

  • IPC
  • ID/RC assessment
  • person-directed plan (PDP)
2 Before the transfer effective date, the SC must request from the transferring program provider the current (or the most recent) copies of the following documents for the individual:

 

  • pertinent medication records and/or medical information, including:
    • a list of medications
    • scheduled medical appointments
    • list of medical professionals
    • skilled nursing routines
    • therapy evaluations
    • major illnesses/injuries, surgeries or hospitalizations in the past year
    • drug allergies
    • lab results, including blood sugars
    • adaptive equipment
    • current medication administration records and immunization records
    • records of current weight and vital signs
  • Medicaid card
  • Medicare information, if applicable
  • Inventory for Client and Agency Planning (ICAP) booklet and summary sheet
  • trust fund/financial records and any money due the individual
  • behavior support plan, if applicable
  • guardianship information, if applicable
  • any other pertinent information to ensure health and safety or continuity of services.
3 The SC must submit the documents listed in Step 2 to the receiving program provider within two days after receiving them from the transferring program provider. If the SC does not receive all documents from the transferring program provider within three days after requesting them, the SC must notify DADS PE.
Step Transferring Program Provider Action
1 The transferring program provider must submit copies of the documents listed in Step 2 to the SC within three days after the SC's request.

 

8470 Completing CARE Data Entry and Faxing Documents to DADS

Revision 11-1; Effective January 20, 2011

 

Step LA Action
1 Within 10 days after the transfer effective date, the LA must complete all data entry to finalize a transfer. See Section 8330, CARE Data Entry, for more information. For an emergency transfer, DADS PE enters the transfer data in CARE.
2 If the individual is transferring to a group home or foster care setting and the receiving program provider does not have access to the CARE system to set up a location, the LA should contact DADS PE for assistance.
3 After the LA has completed the data entry described in Step 1, but within 10 days after the transfer effective date, the SC must fax the completed transfer IPC and Form 3617 to the DADS PE staff handling the transfer (i.e., the DADS PE staff assigned to the receiving program provider).
Step Receiving Program Provider Action
1 If the individual is transferring to a group home or foster care setting, the receiving program provider must assign a location code for the individual's residence and set up the location in CARE. If the individual will be assigned to a location that has already been set up, the program provider must ensure that the status of the location is "open" and will not exceed the capacity for that residence. If the receiving program provider does not have access to CARE, the program provider must notify the LA of such.
2 The receiving program provider must assign a local case number for its component code for the individual for data entry by the LA. If the individual already has a local case number with the program provider's component code, no additional number is required.

 

8500 Program Provider Transfer Involving Two Local Authorities (LAs)

Revision 10-1; Effective September 27, 2010

 

Sections 8510 through 8570 describe the requirements for a program provider transfer involving two LAs. The SC for the transferring LA and the SC for the receiving LA must both be involved to coordinate the individual's transfer.

 

8510 Confirming the Desire to Transfer

Revision 10-1; Effective September 27, 2010

 

Step Transferring Service Coordinator Action
1 If the individual has not already relocated to the receiving LA's local service area, the transferring SC must:

 

  • complete the steps in Section 8410, Confirming the Desire to Transfer; and
  • contact the receiving LA to identify the receiving SC (by accessing CARE Screen C87 for the receiving LA's information, or by contacting DADS PE for this information).
Step Receiving LA/Service Coordinator Action
1 The receiving LA must assign an SC to the individual transferring to the LA's local service area.
2 If the individual has already relocated to the receiving LA's local service area, the receiving SC must complete the steps in Section 8410.

 

8520 Selecting a Receiving Program Provider

Revision 10-1; Effective September 27, 2010

 

Step Transferring Service Coordinator Action
1 If the individual has not already relocated to the receiving LA's local service area, the transferring SC must complete the steps in Section 8420, Selecting a Receiving Program Provider.
Step Receiving Service Coordinator Action
1 If the individual has already relocated to the receiving LA's local service area, the receiving SC must complete the steps in Section 8420.

 

8530 Ensuring Agreement on Transfer Effective Date

Revision 10-1; Effective September 27, 2010

 

Step Transferring Service Coordinator Action
1 If the individual has not already relocated to the receiving LA's local service area, the transferring SC must complete the steps in Section 8430, Ensuring Agreement on Transfer Effective Date.
Step Receiving Service Coordinator Action
1 If the individual has already relocated to the receiving LA's local service area, the receiving SC must complete the steps in Section 8430.
Step Receiving Program Provider Action
1 The receiving program provider must complete the steps in Section 8430.
Step Transferring Program Provider Action
1 The transferring program provider must complete the steps in Section 8430.

 

8540 Completing Form 3617

Revision 10-1; Effective September 27, 2010

 

Step Transferring Service Coordinator Action
1 If the individual has not already relocated to the receiving LA's local service area, the transferring SC must complete the steps in Section 8440, Completing Form 3617.
Step Receiving Service Coordinator Action
1 If the individual has already relocated to the receiving LA's local service area, the receiving SC must complete the steps in Section 8440.

 

8550 Developing the Transfer IPC

Revision 10-1; Effective September 27, 2010

 

Step Transferring Service Coordinator Action
1 If the individual has not already relocated to the receiving LA's local service area, on or before the transfer effective date, the transferring SC must complete the steps in Section 8450, Developing the Transfer IPC.
Step Receiving Service Coordinator Action
1 If the individual has already relocated to the receiving LA's local service area, on or before the transfer effective date, the receiving SC must complete the steps in Section 8450.
2 The receiving SC must fax the following documents to the transferring SC for data entry:

 

  • the completed and signed transfer IPC; and
  • the completed and signed Form 3617, Request for Transfer of Waiver Program Services.
Step Receiving Program Provider Action
1 The receiving program provider must complete the steps in Section 8450.

 

8560 Sharing Documents

Revision 11-1; Effective January 20, 2011

 

Step Transferring Service Coordinator Action
1 The transferring SC must submit current copies of the following documents to the receiving SC before the transfer effective date:

 

  • IPC
  • ID/RC assessment
  • PDP
2 Before the transfer effective date, the transferring SC must request from the transferring program provider the current (or the most recent) copies of the following documents for the individual:

 

  • pertinent medication records and/or medical information, including:
    • a list of medications
    • scheduled medical appointments
    • list of medical professionals
    • skilled nursing routines
    • therapy evaluations
    • major illnesses/injuries, surgeries or hospitalizations in the past year
    • drug allergies
    • lab results, including blood sugars
    • adaptive equipment
    • current medication administration records and immunization records
    • records of current weight and vital signs
  • Medicaid card
  • Medicare information, if applicable
  • ICAP booklet and summary sheet
  • trust fund/financial records and any money due the individual
  • behavior support plan, if applicable
  • guardianship information, if applicable
  • any other pertinent information to ensure health and safety or continuity of services.
3 The transferring SC must submit the documents listed in Step 2 to the receiving SC within two days after receiving them from the transferring program provider. If the SC does not receive all documents from the transferring program provider within three days after requesting them, the SC must notify DADS PE.
Step Receiving Service Coordinator Action
1 The receiving SC must submit to the receiving program provider the documents received from the transferring SC within two days after receiving them from the transferring SC.
Step Transferring Program Provider Action
1 The transferring program provider must submit copies of the documents listed in Step 2, Transferring Service Coordinator Action, to the SC within three days after the SC's request.

 

8570 Completing CARE Data Entry and Faxing Documents to DADS

Revision 11-1; Effective January 20, 2011

 

Step Transferring LA/Service Coordinator (SC) Action
1 Within 10 days after the transfer effective date, the transferring LA must complete all data entry to finalize a transfer. See Section 8330, CARE Data Entry, for more information. For an emergency transfer, DADS PE enters the transfer data in CARE.
2 If the individual is transferring to a group home or foster care setting and the receiving program provider does not have access to the CARE system to set up a location, the transferring LA must contact DADS PE for assistance.
3 No later than one day after the data is entered in CARE, the transferring SC must fax the transfer IPC and Form 3617 to the DADS PE staff handling the transfer (i.e., the DADS PE staff assigned to the receiving program provider) and then notify the receiving SC that data entry and document submission to DADS are both complete.
Step Receiving Program Provider Action
1 The receiving program provider must complete the steps in Section 8470, Completing CARE Data Entry and Faxing Documents to DADS.

 

8600 CDSA Transfer and Changing Service Delivery Option

Revision 10-1; Effective September 27, 2010

 

Sections 8610 through 8660 describe the requirements for transferring to another CDSA and changing service delivery options.

 

8610 Confirming the Desire to Transfer or Change Service Delivery Option

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 Within three days after receiving information that an individual/LAR wants to transfer to another CDSA or change their service delivery option, the SC must contact the individual/LAR to:

 

  • confirm the individual/LAR wants to transfer or change their service delivery option; and
  • explain that the individual/LAR may choose any CDSA or receiving program provider, as appropriate.
2 If the SC confirms that the individual/LAR wants to transfer or change their service delivery option, the SC must:

 

  • complete the individual's identifying information on Form 3617, Request for Transfer of Waiver Program Services, check the appropriate box for the type of transfer using the form instructions, and obtain the signature of the individual/LAR, indicating the desire to transfer or change the service delivery option; and
  • determine if the individual/LAR has selected a receiving CDSA/program provider, as appropriate.

 

8620 Selecting a Receiving CDSA or Receiving Program Provider

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 The SC must inform the individual/LAR that they have a choice of CDSAs/program providers, even if the individual/LAR has already selected a receiving CDSA/program provider.
2 If the individual/LAR has not selected a receiving CDSA/program provider, the SC must give the individual/LAR a list of CDSAs/program providers, and contact information in the geographic locations preferred by the individual/LAR within five days after the date the SC confirms the individual/LAR wants to transfer or change their service delivery option.
3 After the individual/LAR has selected a receiving CDSA/program provider, the SC must document the individual/LAR's choice of a receiving CDSA/program provider in Section II/Section IV on Form 3617.

 

8630 Ensuring Agreement on Transfer Effective Date

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 At the time the individual/LAR selects a receiving CDSA/program provider, the SC must obtain a proposed transfer effective date from the individual/LAR. (For a change of service delivery option, the transfer effective date is also the date the change of service delivery option would become effective.)
2 The SC must contact the receiving CDSA/program provider to determine if the date proposed by the individual/LAR is acceptable.
3 Once the receiving CDSA/program provider and individual/LAR agree on a transfer effective date, the SC must contact the transferring CDSA/program provider to determine if that date is agreeable to the transferring CDSA/program provider. If the date is agreeable, the SC completes the steps in Section 8640, Completing Form 3617.
4 If the date is not agreeable, the SC must facilitate communication between the individual/LAR and all involved CDSAs/program providers to reach a mutually agreeable transfer effective date.
5 If a transfer effective date is not agreed upon within five days after the date the individual/LAR selects a receiving CDSA/program provider, the SC must consult DADS PE for direction.
Step Receiving CDSA/Program Provider Action
1 When contacted by the SC, the receiving CDSA/program provider must comply with the SC's request for a transfer effective date. (For a change of service delivery option, the transfer effective date is also the date the change of service delivery option would become effective.)
2 If the proposed transfer effective date is not acceptable to the receiving CDSA/program provider, the CDSA/program provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and transferring CDSA/program provider.
Step Transferring CDSA/Program Provider Action
1 When contacted by the SC, the transferring CDSA/program provider must comply with the SC's request for a transfer effective date. (For a change of service delivery option, the transfer effective date is also the date the change of service delivery option would become effective.)
2 If the proposed transfer effective date is not acceptable to the transferring CDSA/program provider, the CDSA/program provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and receiving CDSA/program provider.

 

8640 Completing Form 3617

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 The SC must enter the mutually agreed upon transfer effective date in the appropriate sections on Form 3617 as follows:

 

  • Section I, Transferring Program Provider's Information;
  • Section II, Receiving Program Provider's Information;
  • Section III, Transferring CDSA's Information; and
  • Section IV, Receiving CDSA's Information.
2 Depending on the CDSAs/program providers involved, the SC must ensure the appropriate sections of Form 3617 are completed in the following order:

 

  • Section I, Transferring Program Provider's Information;
  • Section III, Transferring CDSA's Information;
  • Section II, Receiving Program Provider's Information; and
  • Section IV, Receiving CDSA's Information.

The SC is responsible for faxing Form 3617 to the involved CDSA/program provider in the above order and to request that the CDSA/program provider complete its section of the form and return it to the SC within three business days.

3 The SC must ensure all signatures are on the same copy of Form 3617. The SC must sign Form 3617 after the involved CDSAs/program providers have completed their sections.
Step Transferring CDSA/Program Provider Action
1 The transferring CDSA/program provider must accurately complete Section I/Section III of Form 3617, in accordance with the form's instructions, and sign and date the form, indicating agreement with the information in Section I/Section III.
2 The transferring CDSA/program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.
Step Receiving CDSA/Program Provider Action
1 The receiving CDSA/program provider must accurately complete Section II/Section IV of Form 3617, in accordance with the form's instructions, and sign and date the form, indicating agreement with the information in Section II/Section IV.
2 The receiving CDSA/program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.

 

8650 Developing the Transfer IPC

Revision 10-1; Effective September 27, 2010

 

Step Service Coordinator Action
1 On or before the transfer effective date, the SC must meet with the CDS employer (individual/LAR) and the receiving program provider, if applicable, to review the individual's current IPC and develop a transfer IPC. This must be a face-to-face meeting, if feasible.
2 The SC must ensure that the transfer IPC includes services already provided by the transferring CDSA/program provider, as well as those to be provided by the transferring CDSA/program provider before the transfer effective date. This information can be found in:

 

  • CARE Screen C72 (Services provided and billed); and
  • Section I and Section III of the completed Form 3617 (services provided but not yet billed and services not yet provided).

The SC must also ensure that the transfer IPC includes services to be provided beginning on the day of the transfer effective date.

3 The SC must ensure the transfer IPC:

 

  • complies with the requirements described in §9.159(c); and
  • is signed and dated by the individual/LAR, receiving CDSA/program provider and SC.
Step Receiving Program Provider Action
1 The receiving program provider must meet with the CDS employer and SC to develop and sign a transfer IPC, as requested by the SC.
Step Receiving CDSA Action
1 The receiving CDSA must sign a transfer IPC, as requested by the SC.

 

8660 Completing CARE Data Entry and Faxing Documents to DADS

Revision 10-1; Effective September 27, 2010

 

Step LA Action
1 Within 10 days after the transfer effective date, the LA must complete all data entry to finalize a transfer. See Section 8330, CARE Data Entry, for more information.
2 Following data entry, but within 10 days after the transfer effective date, the SC must fax the completed transfer IPC and Form 3617 to the DADS PE staff handling the transfer (i.e., the DADS PE staff assigned to the current or receiving program provider or, if the individual is only receiving the CDS option, the staff assigned to the LA's program provider).
Step Receiving CDSA/Program Provider Action
1 The receiving CDSA/program provider must assign a local case number for its component code for the individual for data entry by the LA. If the individual already has a local case number with the CDSA's/program provider's component code, no additional number is required.

 

8700 Notification by DADS Program Enrollment (PE)

Revision 10-1; Effective September 27, 2010

 

DADS PE reviews the completed Form 3617, Request for Transfer of Waiver Program Services, and the transfer IPC to determine if a transfer is authorized. If DADS authorizes a transfer, DADS PE notifies the individual/LAR of the authorization by mail, and notifies all involved program providers, CDSAs and LAs of the authorization in writing. A transfer under Section 8000 is not effective unless authorized by DADS.

 

8800 Local Authority (LA) Reassignment

Revision 10-1; Effective September 27, 2010

 

Step Transferring LA Action
1 If an individual moves to a different LA's service area without changing program provider within a waiver contract area*, the transferring LA must:

 

  • notify the receiving LA of the move by completing Form 8575, Notification of Local Authority (LA) Reassignment;
  • enter the data from the form into CARE Screen L30; and
  • notify the state supported living center (SSLC) admissions placement coordinator that the individual has moved to a different LA's service area, if the individual is on community placement from an SSLC and is being monitored in accordance with a community living discharge plan (CLDP).

* Click here and scroll to the last page to see a list of LAs by waiver contract area (WCA).

The CARE User's Guide includes step-by-step instructions for entering an individual's LA reassignment and may be found at: http://www2.mhmr.state.tx.us/655/cis/training/files/waiver/mra%20guide/mra%20assignment%20notification.pdf.

Note: The CARE User's Guide is only available to those who have access to the CARE system.

2 After the transferring LA has entered the data, the transferring LA must fax Form 8575 to the receiving LA.
3 Within three days after the transferring LA faxes Form 8575 to the receiving LA, the transferring SC must submit to the receiving SC a copy of the individual's:

 

  • current PDP (if developed because of recent enrollment or IPC renewal);
  • current ID/RC assessment;
  • current IPC;
  • current guardianship documents, if applicable; and
  • address and other contact information of the individual's LAR or actively involved family member.
Step Receiving LA Action
1 Within five days after receiving the faxed Form 8575 from the transferring LA, as described in Step 2 above, the receiving LA must:

 

  • complete its portion of the form; and
  • enter that data of the form in CARE Screen L30.

The CARE User's Guide includes step-by-step instructions for entering an individual's LA reassignment and may be found at: http://www2.mhmr.state.tx.us/655/cis/training/files/waiver/mra%20guide/mra%20assignment%20notification.pdf.

Note: The CARE User's Guide is only available to those who have access to the CARE system.

2 Within five days after receiving the faxed Form 8575 from the transferring LA, as described in Step 2 above, the receiving LA must assign an SC to the individual transferring to the LA's local service area.
 

 

Contact Information

Questions regarding these requirements may be directed to the DADS Program Enrollment general email box at: enrollmenttransferdischargeinfo@dads.state.tx.us or the DADS Program Enrollment general phone message line at 512-438-5055.

Texas Home Living (TxHmL) and Home and Community-based Services (HCS) reference material are available online at:
hhs.texas.gov/laws-regulations/handbooks/texas-home-living-txhml-program
hhs.texas.gov/laws-regulations/handbooks/texas-home-living-txhml-program/txhml-forms
hhs.texas.gov/laws-regulations/handbooks/home-and-community-based-services-handbook
http://www2.mhmr.state.tx.us/655/cis/training/WaiverGuide.html
http://www2.mhmr.state.tx.us/655/cis/training/txhmlGuide.html
http://www2.mhmr.state.tx.us/655/cis/training/MRAGuide.html
http://www2.mhmr.state.tx.us/655/cis/training/CDSAGuide.html