(a) An IRP must:
  (1) prepare for the individual's effective transition to the community;
  (2) promote the individual's inclusion into the community;
  (3) protect the individual's health and welfare in the community;
  (4) supplement, rather than replace, the individual's natural support systems and resources;
  (5) be designed to prevent or reduce the individual's likelihood of:
    (A) an inpatient psychiatric facility admission;
    (B) a correctional facility admission; and
    (C) an emergency department visit in which services are delivered;
  (6) include the most appropriate type and amount of services to meet the individual's needs;
  (7) prevent the provision of unnecessary or inappropriate care;
  (8) be based on the individual's preferences, needs, and goals; and
  (9) be developed with the individual, LAR, individual's treatment team and providers, and other persons according to the needs and desire of the individual.
(b) An HHSC-approved designee must review the IRP and submit it to HHSC for its approval.
(c) An HHSC-approved designee must submit to HHSC, with the IRP:
  (1) an HCBS-AMH assessment of the individual identifying the individual's needs and supporting the HCBS-AMH included in the IRP; and
  (2) documentation that non-HCBS-AMH support systems and resources are unavailable or are insufficient to meet the goals specified in the IRP.
(d) A provider must obtain HHSC's approval of the IRP before the provider may deliver HCBS-AMH program services.
(e) HHSC may conduct a utilization review of an IRP and supporting documentation at any time to determine if the services specified in the IRP meet the requirements described in subsection (a) of this section.
(f) If HHSC determines one or more of the services specified in the IRP do not meet the requirements described in subsection (a) of this section, HHSC may:
  (1) deny, reduce, or terminate the service; or modify the IRP; and
  (2) send written notification to the individual, LAR, and the provider according to §307.57 of this subchapter (relating to Fair Hearings Process).
(g) The cost of the IRP must be reasonable as determined by HHSC.

Source Note: The provisions of this §307.54 adopted to be effective July 23, 2019, 44 TexReg 3637