(a) HHSC may allow a program provider to use one or more of the exceptions described in subsections (c) - (p) 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 §259.61(a)(2) 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) Notwithstanding §259.61(h)(1)(A) and (B) of this chapter, a DSA staff person may complete the requirements described in §259.61(h)(1)(A) of this chapter for an individual who resides in the disaster area by videoconferencing or in person.
(e) Notwithstanding §259.61(h)(2) of this chapter, an appropriate professional may complete an adaptive behavior screening assessment of an individual who resides in the disaster area by videoconferencing in accordance with the professional's licensing requirements or in person.
(f) Notwithstanding §259.61(h)(3)(A) - (C) and §259.75(a)(1)(B) of this chapter (relating to Annual Review by HHSC of Whether an Individual Meets LOC VIII Criteria), an RN may complete the HHSC CLASS/DBMD Nursing Assessment form, the HHSC Related Conditions Eligibility Screening Instrument, and the ID/RC Assessment of an individual who resides in the disaster area by videoconferencing in accordance with the RN's licensing requirements or in person.
(g) Notwithstanding §259.65(c)(1)(A) of this chapter (relating to Development of an Enrollment IPC), a case manager is not required to ensure an individual who resides in the disaster area or LAR signs and dates an enrollment IPC and IPP if:
  (1) the meeting required by §259.65(a)(1) of this chapter is conducted by videoconferencing;
  (2) the individual or LAR orally agrees with the enrollment IPC and IPPs; and
  (3) the case manager documents the individual's or LAR's oral agreement on the enrollment IPC and IPPs.
(h) Notwithstanding §259.79(a)(1) and (2) of this chapter (relating to Renewal and Revision of an IPC), a case manager may conduct all IPP service review meetings with an individual who resides in the disaster area and LAR in person or by videoconferencing.
(i) Notwithstanding §259.79(b)(6) of this chapter, a case manager is not required to ensure that an individual who resides in the disaster area or LAR signs the HHSC IPP Service Review form, if:
  (1) the meeting required by §259.79(a) of this chapter is conducted by videoconferencing;
  (2) the individual or LAR orally agree with the HHSC IPP Service Review form; and
  (3) the case manager documents the individual's or LAR's oral agreement on the HHSC IPP Service Review form.
(j) If a service planning team meeting described in §259.79(c) is conducted by videoconferencing for an individual who resides in the disaster area, a case manager may:
  (1) on a renewal or revised IPP:
    (A) notwithstanding §259.79(f)(2)(A) of this chapter, replace the signature of an individual or LAR by documenting on the renewal or revised IPP that the individual or LAR orally agreed to the renewal or revised IPP; and
    (B) notwithstanding §259.79(f)(2)(C) of this chapter, obtain the signature of the DSA after the service planning team meeting; and
  (2) on a proposed renewal or proposed revised IPC:
    (A) notwithstanding §259.79(g)(1)(A) of this chapter, replace the signature of the individual or LAR 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
    (B) notwithstanding §259.79(g)(1)(C) of this chapter, obtain the signature of the DSA after the service planning team meeting.
(k) Notwithstanding §259.73(a)(1) of this chapter (relating to Service Limits), the combined cost for adaptive aids and dental treatment may exceed $10,000 during an IPC period if:
  (1) the requested adaptive aid or repair that causes the combined cost to be exceeded is:
    (A) an adaptive aid that replaces an adaptive aid that was destroyed as a result of the disaster; or
    (B) a 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 result in the combined cost of dental treatment and adaptive aids to exceed $15,000 during the IPC period, which includes the cost of repair and maintenance of an adaptive aid.
(l) Notwithstanding §259.255(a) of this chapter (relating to Requirements for Authorization to Purchase an Adaptive Aid Costing Less Than $500), if an individual requests the repair or replacement of an adaptive aid damaged or destroyed as a result of a disaster:
  (1) a DSA must provide to the case manager:
    (A) a description of the repair or replacement of the adaptive aid that was damaged or destroyed as a result of the disaster; and
    (B) the cost of the repair or replacement of the adaptive aid;
  (2) the case manager must:
    (A) include the cost of the adaptive aid or repair, which must be within the cost described in subsection (k)(2) of this section, in the individual's:
      (i) proposed renewal or proposed revised IPC; and
      (ii) renewal or revised IPP;
    (B) obtain the individual or LAR's oral agreement to the proposed renewal or proposed revised IPC and IPP;
    (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 DSA must sign the proposed renewal or proposed revised IPC and IPP; and
  (4) the CMA 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 of the repair or replacement described in paragraph (1) of this subsection; and
    (D) a written statement of the case manager that the requested adaptive aid or repair is not available through a third-party resource.
(m) Notwithstanding §§259.257, 259.259, and 259.261 of this chapter (relating to Requirements for Authorization to Purchase an Adaptive Aid Costing $500 or More, Requirements for Specifications for an Adaptive Aid, and Requirements for Bids of an Adaptive Aid), if an individual requests the repair or replacement of an adaptive aid costing $500 or more damaged or destroyed as a result of a disaster:
  (1) the DSA must provide to the case manager:
    (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 repair or replacement of an adaptive aid from a vendor that includes:
      (i) the cost of the repair or replacement of the adaptive aid, which may be from a catalog, website, or brochure price list;
      (ii) the amount of any additional expenses related to the delivery of the adaptive aid, 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 adaptive aid or repair, which must be within the cost described in subsection (k)(2) of this section, in the individual's:
      (i) proposed renewal or proposed revised IPC; and
      (ii) renewal or revised IPP;
    (B) obtain the individual's 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
Cont'd...
(D) sign the proposed renewal or proposed revised IPC and IPP;
  (3) the DSA must sign the proposed renewal or proposed revised IPC and IPP; and
  (4) the CMA 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 description and bid of the repair or replacement described in paragraph (1) of this subsection;
    (B) the proposed renewal or proposed revised IPC and IPP, completed as described in paragraphs (2) and (3) of this subsection; and
    (C) a written statement of the case manager that the requested adaptive aid or repair is not available through a third-party resource.
(n) Notwithstanding §259.73(a)(2) of this chapter, the service limit for minor home modifications for an individual who resides in the disaster area may exceed $10,000 during the time the individual is enrolled in the CLASS program if:
  (1) the requested minor home modification or repair 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 $15,000 for minor home modifications during the time the individual is enrolled in the CLASS program.
(o) Notwithstanding §§259.275, 259.277, and 259.279 of this chapter (relating to Requirements for Authorization to Purchase a Minor Home Modification, Requirements for 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 DSA must provide to the case manager:
    (A) a description of the repair or replacement of the minor home modification that was damaged or destroyed as a result of the disaster; and
    (B) one bid for the repair or replacement of the minor home modification from a vendor that includes:
      (i) the cost of the repair or replacement of the 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, which must not exceed the cost described in subsection (n)(2) of this section, in the individual's:
      (i) proposed renewal or proposed revised IPC; and
      (ii) renewal or revised 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 DSA must sign the proposed renewal or proposed revised IPC and IPP; and
  (4) the CMA 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 description and bid of the repair or replacement described in paragraph (1) of this subsection;
    (B) the proposed renewal or proposed revised IPC and IPP, completed as described in paragraphs (2) and (3) of this subsection; and
    (C) a written statement of the case manager that the requested adaptive aid or repair is not available through a third-party resource.
(p) Notwithstanding §259.357(b)(1)(B) and (b)(2)(B) of this chapter (relating to Training of DSA Staff Persons, Service Providers, and Volunteers), 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 §259.451 adopted to be effective January 30, 2023, 48 TexReg 362