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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 355REIMBURSEMENT RATES
SUBCHAPTER ACOST DETERMINATION PROCESS
RULE §355.114Consumer Directed Services Payment Option

(a) For all programs providing consumer directed services (CDS) except the Home and Community-based Services (HCS) program:

  (1) The monthly payment to the contracted CDS agency is determined by modeling the estimated cost to carry out the responsibilities of the CDS agency.

  (2) The rates for CDS that provide the funds available to the consumers participating in CDS are modeled and are based on the payment rates paid to contracted agencies for providing services to consumers who do not participate in CDS, and then removing from those rates amounts needed to fund CDS agencies responsibilities.

  (3) The sum of the payments to the contracted CDS agencies for a 12-month period and the funds available to the consumers participating in CDS for the same 12-month period will not exceed, in the aggregate, the amount that would have been paid to agencies for the same 12 month period if the consumers were not participating in CDS.

(b) For the HCS program:

  (1) The monthly payment to the contracted CDS agency is determined by modeling the estimated cost of carrying out the responsibilities of the CDS agency.

  (2) The rates for CDS that provide the funds available to the consumer participating in CDS are modeled and are based on the direct care costs plus a portion of the operating costs included in the HCS rate.

  (3) The monthly payment to the contracted CDS agency for a 12-month period and the funds available to the consumer participating in CDS for that same 12-month period will not exceed the amount that would have been paid to an agency for the same 12 month period if the consumer was not participating in CDS.

(c) Support Consultation services. The hourly payment rate for Support Consultation services is determined by modeling the cost of providing this service, as defined by the Department of Aging and Disability Services, using staff costs and other statistics from the most recently audited cost reports from providers for staff whose required qualifications are similar to the qualifications required for individuals delivering Support Consultation services. The requirements for a Support Advisor are found at 40 TAC §41.603 (relating to Support Advisor Qualifications).


Source Note: The provisions of this §355.114 adopted to be effective December 1, 2001, 26 TexReg 9375; amended to be effective June 17, 2003, 28 TexReg 4544; amended to be effective September 1, 2004, 29 TexReg 7667; amended to be effective December 2, 2004, 29 TexReg 10912; amended to be effective February 1, 2007, 32 TexReg 42; amended to be effective September 1, 2007, 32 TexReg 5336; amended to be effective August 17, 2008, 33 TexReg 6361

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