(a) An individual is eligible for DBMD Program services if:
  (1) the individual meets the financial eligibility criteria as described in Appendix B of the DBMD Program waiver application approved by CMS and available on the HHSC website;
  (2) the individual is determined by HHSC to meet the LOC VIII criteria described in §261.239 of this title (relating to ICF/MR Level of Care VIII Criteria);
  (3) the individual, as documented on the ID/RC Assessment:
    (A) has one or more diagnosed related conditions and, as a result:
      (i) has deafblindness;
      (ii) has been determined to have a progressive medical condition that will result in deafblindness; or
      (iii) functions as a person with deafblindness; and
    (B) has one or more additional disabilities that result in impairment to independent functioning;
  (4) the individual has an IPC with a cost for DBMD Program services at or below $114,736.07;
  (5) the individual is not enrolled in another waiver program or receiving a service that may not be received if the individual is enrolled in the DBMD Program, as identified in the Mutually Exclusive Services table in Appendix V of the Deaf Blind with Multiple Disabilities Program Manual;
  (6) the individual does not reside in:
    (A) an ICF/IID;
    (B) a nursing facility;
    (C) an ALF, unless it provides licensed assisted living in the DBMD Program;
    (D) a residential child-care facility unless it is an agency foster home;
    (E) a hospital;
    (F) a mental health facility;
    (G) an inpatient chemical dependency treatment facility;
    (H) a residential facility operated by the Texas Workforce Commission;
    (I) a residential facility operated by the Texas Juvenile Justice Department;
    (J) a jail; or
    (K) a prison;
  (7) at least one program provider is willing to provide DBMD Program services to the individual;
  (8) the individual resides or moves to reside in a county served by a program provider; and
  (9) the individual requires the provision of:
    (A) at least one DBMD Program Service per month or a monthly monitoring by a case manager; and
    (B) at least one DBMD Program Service during an IPC period.
(b) Except as provided in subsection (c) of this section, an individual is eligible for a CFC service under this chapter if the individual:
  (1) meets the criteria described in subsection (a) of this section;
  (2) requires the provision of the CFC service; and
  (3) is not receiving licensed assisted living or licensed home health assisted living.
(c) To be eligible for a CFC service under this chapter, an individual receiving MAO Medicaid must, in addition to meeting the eligibility criteria described in subsection (b) of this section, receive a DBMD Program service at least monthly, as required by 42 CFR §441.510(d).

Source Note: The provisions of this §260.51 adopted to be effective February 26, 2023, 48 TexReg 896