(a) HHSC may allow a program provider to use one or more of the exceptions described in subsections (c) - (n) of this section while an executive order or proclamation declaring a state of disaster under Texas Government Code §418.014 is in effect. HHSC notifies program providers:

(1) if HHSC allows an exception to be used; and

(2) if an exception is allowed to be used, the date the exception must no longer be used, which may be before the declaration of a state of disaster expires.

(b) In this section "disaster area" means the area of the state specified in an executive order or proclamation described in subsection (a) of this section.

(c) Notwithstanding §260.61(c) of this chapter (relating to Process for Enrollment of an Individual), an initial visit for an individual who resides in the disaster area may be conducted by videoconferencing or in person.

(d) If the initial visit described in subsection (c) of this section is conducted by videoconferencing:

(1) the case manager may complete the requirements described in §260.61(c)(1) - (3) of this chapter by videoconferencing;

(2) the case manager or an appropriate professional must not complete an adaptive behavior screening assessment required by §260.61(c)(6) of this chapter by videoconferencing;

(3) the case manager or an RN must not complete a Related Conditions Eligibility Screening Instrument required by §260.61(c)(7) of this chapter by videoconferencing;

(4) an RN may complete a nursing assessment of an individual who resides in the disaster area required by §260.61(c)(8) in accordance with the RN's licensing requirements by videoconferencing or in person;

(5) the case manager must not perform the assessment needed to complete the ID/RC Assessment required by §260.61(c)(4) of this chapter by videoconferencing; and

(6) the signature of the individual or LAR on a Waiver Program Verification of Freedom of Choice form required by §260.61(c)(5) of this chapter may be replaced by the case manager noting on the form that the individual or LAR chose the DBMD Program over the ICF/IID Program.

(e) Notwithstanding §260.67(a) of this chapter (relating to Development of a Proposed Enrollment IPC), a service planning team meeting for an individual who resides in the disaster area may be conducted by videoconferencing or in person.

(f) If the service planning team meeting described in subsection (e) of this section is conducted by videoconferencing:

(1) the case manager may obtain the signatures of the service planning team members other than the individual or LAR on the proposed enrollment IPC required by §260.67(c)(1) of this chapter after the service planning team meeting; and

(2) the case manager may replace the signature of the individual or LAR on the proposed enrollment IPC required by §260.67(c)(1) of this chapter by noting on the enrollment IPC that the individual or LAR orally agreed to the proposed enrollment IPC.

(g) Notwithstanding §260.77(a) of this chapter (relating to Renewal and Revision of an IPP and IPC), a case manager may meet with an individual who resides in the disaster area and the LAR by videoconferencing or in person.

(h) Notwithstanding §260.77(b)(1)(E), (c)(1), or (d)(1) of this chapter, a service planning team meeting for an individual who resides in the disaster area may be conducted by videoconferencing or in person.

(i) If a service planning team meeting described in subsection (h) of this section is conducted by videoconferencing, a case manager must:

(1) replace the signature of an individual or LAR required by §260.77(a)(5)(A), (b)(1)(E)(vii), (c)(3), or (d)(3) of this chapter by documenting on the new or revised IPP that the individual or LAR orally agreed to the new or revised IPP;

(2) obtain the signatures of the service planning team members required by §260.77(a)(5)(A), (b)(1)(E)(vii), (c)(3), or (d)(3) of this chapter, other than the individual or LAR, on the revision or renewal IPP after the service planning team meeting;

(3) replace the signature of the individual or LAR on a proposed renewal or proposed revised IPC required by §260.77(a)(5)(A), (b)(1)(E)(vii), (c)(3), or (d)(3) of this chapter by documenting on the proposed renewal or proposed revised IPC that the individual or LAR orally agreed to the proposed renewal or proposed revised IPC; and

(4) obtain the signatures of the service planning team members required by §260.77(a)(5)(A), (b)(1)(E)(vii), (c)(3), or (d)(3) of this chapter, other than the individual or LAR, on the revision or renewal IPC after the service planning team meeting.

(j) Notwithstanding §260.77(a)(2)(C) of this chapter, a case manager is not required to ensure that an individual who resides in the disaster area or LAR sign the HHSC IPP Service Review form or a form the program provider developed, if:

(1) the meeting required by §260.77(a) of this chapter is conducted by telephone or videoconferencing;

(2) the individual or LAR orally agree with the HHSC IPP Service Review form or a form the program provider developed; and

(3) the case manager documents the individual's or LAR's oral agreement on the HHSC IPP Service Review form or a form the program provider developed.

(k) Notwithstanding §260.301(a) of this chapter (relating to Authorization Amount and Other Limits for Adaptive Aids), the service limit may be exceeded if:

(1) the requested adaptive aid or repair that causes the service limit to be exceeded is: (A) an adaptive aid that replaces an adaptive aid that was destroyed as a result of the disaster; or (B) the repair of an adaptive aid that was damaged as a result of the disaster; and

(2) the requested adaptive aid or repair added to the individual's IPC does not exceed a total limit of $15,000 during the IPC period, which includes the cost of repair and maintenance of an adaptive aid.

(l) Notwithstanding §260.303(a)(1) and (b) of this chapter (relating to Requirements for Authorization to Purchase or Lease an Adaptive Aid) and §260.305(a)(1), (c), (d), (f) and (g) of this chapter (relating to Requirements for Bids for an Adaptive Aid), if an individual requests the repair or replacement of an adaptive aid damaged or destroyed as result of a disaster:

(1) instead of the service planning team completing the HHSC Rationale for Adaptive Aids, Medical Supplies, and Minor Home Modifications form, the program provider must obtain: (A) a description of the repair or replacement of an adaptive aid that was damaged or destroyed as a result of the disaster; and (B) one bid for the requested repair or replacement of an adaptive aid from a vendor that complies with §260.305(b) of this chapter; and

(2) the case manager must submit to HHSC, no later than 180 days after the effective date of the order or proclamation described in subsection (a) of this section: (A) the renewal or revised IPC; (B) the renewal or revised IPP; (C) the description and bid of the repair or replacement described in paragraph (1) of this subsection; and (D) a written statement that the requested adaptive aid or repair is not available through a third-party resource.

(m) Notwithstanding §260.315(a) of this chapter (relating to Authorization Limit for Minor Home Modification and Amount for Repair and Maintenance), the service limit of minor home modifications for an individual who resides in the disaster area may be exceeded if:

(1) the requested minor home modification that causes the service limit to be exceeded is: (A) a minor home modification that replaces a minor home modification that was destroyed as a result of the disaster; or (B) a repair of a minor home modification that was damaged as a result of the disaster; and

(2) the requested minor home modification or repair added to the individual's IPC does not exceed the total limit of $15,000 for a minor home modification during the time the individual is enrolled in the DBMD program.

(n) Notwithstanding §§260.317, 260.319, 260.321, and 260.323 (relating to Requesting Authorization to Purchase a Minor Home Modification that Costs Less than $1,000, Requesting Authorization to Purchase a Minor Home Modification that Costs $1,000 or More, Specifications for a Minor Home Modification, and Bid Requirements for a Minor Home Modification), if an individual requests the repair or replacement of a minor home modification damaged or destroyed as a result of a disaster:

(1) the program provider must obtain: (A) a description of the repair or replacement of a minor home modification that was damaged or destroyed as a result of the disaster; and (B) one bid for the requested repair or replacement of a minor home modification from a vendor that includes: (i) the total cost of the requested minor home modification, which may be from a catalog, website, or brochure price list; (ii) the amount of any additional expenses related to the delivery of the minor home modification, including shipping and handling, taxes, installation, and other labor charges; (iii) the date of the bid; and (iv) the name, address, and telephone number of the vendor, who may not be a relative of the individual;

(2) the case manager must: (A) include the cost of the minor home modification or repair in the individual's proposed renewal or proposed revised IPC and IPP; (B) obtain the individual or LAR's oral agreement; (C) document the individual's or LAR's oral agreement on the proposed renewal or proposed revised IPC and IPP; and (D) sign the proposed renewal or proposed revised IPC and IPP;

(3) the program director or the RN designated by the program provider must sign the proposed renewal or proposed revised IPC and IPP; and

(4) the program provider must submit to HHSC, no later than 180 days after the effective date of the order or proclamation described in subsection (a) of this section: (A) the proposed renewal or proposed revised IPC; (B) the renewal or revised IPP; (C) the description and bid of the repair or replacement described in paragraph (1) of this subsection; and (D) a written statement that the requested minor home modification or repair is not available through a third-party resource.

(o) Notwithstanding §260.205(c)(1) and (2) of this chapter (relating to Training), a program director, a case manager, an intervener, and a service provider may complete an online training course in cardiopulmonary resuscitation and choking prevention but an in-person evaluation by a qualified instructor is not required to be completed, if:

(1) as a result of the disaster, the service provider is unable to arrange for the in-person evaluation; and

(2) the in-person evaluation is completed within 90 calendar days after the disaster ends.

Source Note: The provisions of this §260.451 adopted to be effective February 26, 2023, 48 TexReg 896