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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 9INTELLECTUAL DISABILITY SERVICES--MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER DHOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM
RULE §9.159IPC

(a) An MRA must initiate development of a proposed initial IPC for an applicant as required by §9.158(k)(4) of this subchapter (relating to Process for Enrollment of Applicants).

(b) A program provider must initiate development of a proposed renewal and proposed revised IPC for an individual as required by §9.166 of this subchapter (relating to Renewal and Revision of an IPC).

(c) An IPC must be based on the PDP and specify the type and amount of each service component to be provided to an individual, as well as services and supports to be provided by other sources during the IPC year.

  (1) The type and amount of each service component in the IPC must be supported by:

    (A) documentation that other sources for the service component are unavailable and the service component does not replace existing supports, including natural supports or other sources for the service;

    (B) assessments of the individual that identify specific service components necessary for the individual to live in the community, to ensure the individual's health, safety, and welfare in the community, and to prevent the need for institutional services; and

    (C) documentation of deliberations and conclusions of the service planning team that the service components are based on the desired outcomes in the PDP and are necessary for the individual to live in the community, to ensure the individual's health, safety, and welfare in the community, and to prevent the need for institutional services.

  (2) If the IPC includes a service component that has a service limit described in §9.192(b) of this subchapter (relating to Service Limits) and the service limit is exceeded, the MRA or program provider, as appropriate, must request an exception to the service limit in accordance with §9.193(c) of this subchapter (relating to Exception to Service Limits).

(d) A program provider must provide HCS Program services in accordance with an individual's authorized IPC.

(e) A program provider must retain in an individual's record results and recommendations of individualized assessments that support the individual's current need for each service component included in the IPC.


Source Note: The provisions of this §9.159 adopted to be effective June 1, 2010, 35 TexReg 4441; amended to be effective December 1, 2011, 36 TexReg 8043

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