(a) Except as provided in subsection (b) of this section, only an MRA may request enrollment of an applicant by DADS.
(b) A program provider may request enrollment of an applicant by DADS in accordance with subsection (k) of this section if the applicant:
(1) has received ICF/MR services from a non-state operated facility during the 180 days before the enrollment request; and
(2) is not moving from or seeking admission to a state school or state center.
(c) An MRA must request an applicant's enrollment if:
(1) the program provider selected by the applicant or LAR notifies the MRA in writing that admission to the program provider's facility has been offered to the applicant; and
(2) the applicant or LAR notifies the MRA that the applicant or LAR chooses to accept the admission offered by the program provider.
(d) If an MRA receives the notifications described in subsection (c) of this section, the MRA must comply with §5.159(c) of this title (relating to Assessment of Individual's Need for Services and Supports) including providing an explanation to the applicant or LAR of the services and supports for which the applicant may be eligible. For an applicant under 22 years of age, an MRA must also comply with the following requirements:
(1) Except as provided in paragraphs (2) and (3) of this subsection, before placement of an applicant in a facility, the MRA must inform the LAR:
(2) If an MRA is notified of a request for enrollment after the applicant is admitted to the facility, the MRA must provide the information described in paragraph (1) of this subsection to the LAR not later than the 14th working day after the date the MRA is notified of the request for the enrollment, unless this time period is extended by the LAR.
(3) An MRA does not have to comply with paragraph (1) or (2) of this subsection if the applicant has been committed to a facility under Chapter 46B, Code of Criminal Procedure, or Chapter 55, Family Code.
(e) To request an applicant's enrollment, an MRA must, within 15 working days after the MRA receives both notifications described in subsection (c) of this section:
(1) initiate, monitor, and support the processes necessary to obtain a financial eligibility determination for the applicant if Medicaid financial eligibility has not been established;
(2) obtain an ICAP score for the applicant by:
(3) request or review an LOC determination and LON for the applicant by:
(f) Upon notification of a request for enrollment of an applicant under 22 years of age, an MRA must take or ensure that the following actions are taken to conduct permanency planning:
(1) The MRA must convene a permanency planning meeting with the LAR and, if possible, the applicant before admission or, if notified of a request for enrollment after the applicant's admission, not later than the 14th working day after the date the MRA is notified of the request.
(2) Before the permanency planning meeting, the MRA staff must review the applicant's records and, if possible, meet the applicant.
(3) During the permanency planning meeting, the meeting participants must discuss and choose one of the following goals:
(4) To accomplish the goal chosen in accordance with paragraph (3) of this subsection, the meeting participants must discuss and identify:
(5) The MRA must make reasonable accommodations to promote the participation of the LAR in a permanency planning meeting, including:
(6) The MRA must develop a permanency plan using, as appropriate:
(7) The MRA must:
(g) If an applicant is under 22 years of age, the MRA must inform the applicant and LAR that they may request a volunteer advocate to assist in permanency planning. The applicant or LAR may:
(1) select a person who is not employed by or under contract with the MRA or a program provider; or
(2) request the MRA to designate a volunteer advocate.
(h) If an applicant or LAR requests that the MRA designate a volunteer advocate or the MRA cannot locate the LAR, the MRA must attempt to designate a volunteer advocate to assist in permanency planning who is, in order of preference:
(1) an adult relative who is actively involved with the applicant;
(2) a person who:
(3) a person or a child advocacy organization representative who:
(i) If the MRA is unable to locate a volunteer advocate locally, the MRA must request assistance from a statewide advocacy organization in identifying an available volunteer advocate who meets the requirements described in subsection (h) of this section. If the statewide advocacy organization is unable to assist the MRA in identifying a volunteer advocate, the MRA must document all efforts to designate a volunteer advocate in accordance with subsection (h) of this section.
(j) If DADS notifies an MRA that it has authorized an applicant's LOC, the MRA must immediately notify the applicant or LAR of such authorization and provide the selected program provider with copies of all enrollment documentation and associated supporting documentation including relevant assessment results and recommendations and the applicant's ICAP booklet and, if available, the applicant's service plan.
(k) To request an applicant's enrollment as permitted by subsection (b) of this section, a program provider must ensure that the applicant has a current LOC.
(1) If an applicant does not have a current LOC, the program provider must complete and electronically submit an MR/RC Assessment to DADS.
(2) If the program provider submits an MR/RC Assessment, DADS notifies the program provider electronically if the LOC is authorized or sends written notification to the program provider and the applicant or LAR if the LOC is denied.
(l) An applicant's enrollment is complete if:
(1) DADS has authorized an LOC for the applicant;
(2) the Social Security Administration has determined that the applicant is eligible for SSI or the Health and Human Services Commission determines the applicant is financially eligible for Medicaid;
(3) the program provider has electronically submitted a completed Client Movement Form to DADS; and
(4) admission to the facility has been approved by the DADS commissioner or designee for the applicant who is under 22 years of age, based on information submitted as described in subsection (f) of this section.
(m) A program provider must maintain a paper copy of the completed MR/RC Assessment with all the necessary signatures and documentation supporting the recommended LOC and LON.
Source Note: The provisions of this §261.244 adopted to be effective September 1, 2001, 26 TexReg 5384; amended to be effective March 31, 2002, 27 TexReg 2475; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective September 1, 2006, 31 TexReg 6795; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127