(a) DAHS facilities receive written referrals from caseworkers based on the following priorities:
(1) client's choice;
(2) physician's choice, if stated; and
(3) rotation of eligible providers.
(b) When a DAHS facility receives a referral from the caseworker, the DAHS facility nurse must make every effort to request prior approval for the client within 14 days after the referral date on DADS' authorization for community care services form.
(c) If the DAHS facility cannot request prior approval within 14 days, the DAHS facility must notify the caseworker about the reason for delay. This notification must be sent on DADS' Case Information form within 14 days after the referral date.
(d) Within the same 14 days after receipt of DADS' authorization for community care services form from the caseworker and before requesting prior approval, the nurse must conduct a health assessment/plan of care with the client, using DADS' Client Health Assessment/Plan of Care form. If the client is unable to participate due to cognitive impairment, the client's responsible party should participate.
(e) If the nurse cannot conduct the health assessment within 14 days after the referral date, the DAHS facility must notify the caseworker about the reason for delay on DADS' Case Information form within the 14-day period.
(f) Within the same 14 days after receipt of DADS' authorization for community care services form from the caseworker, the nurse must obtain a physician's order for the client by sending DADS' Physician's Order for Day Activity and Health Services form to the client's physician. The nurse sends a copy of DADS' Client Health Assessment/Plan of Care form to the physician.
(g) If the DAHS facility cannot obtain physician's orders within 14 days after the referral date, the DAHS facility must notify the caseworker about the reason for delay. The notification must be sent on DADS' Case Information form within the 14-day period. DADS' Case Information form must include the date of the health assessment/plan of care and must be dated after the health assessment/plan of care date, if one has been conducted.
(h) If the physician fails to date DADS' Physician's Order for Day Activity and Health Services form or if the signature date is illegible, the DAHS facility stamp-in date will be considered the date of the physician's order. The date stamp must include the day, month, year, and the name of the DAHS facility. An abbreviated name or initials are acceptable.
Source Note: The provisions of this §98.203 adopted to be effective May 1, 1999, 24 TexReg 3100; amended to be effective October 1, 2000, 25 TexReg 9644; amended to be effective April 1, 2007, 32 TexReg 1749