Information Letter 14-41 – Expansion of Medicaid Acute Care Services – Provision of Day Activity and Health Services and Primary Home Care for Individuals in Intellectual and Developmental Disabilities Waivers –
In accordance with the provisions of Senate Bill 7, 83rd Texas Legislature, Regular Session, 2013, many individuals receiving long term services and support (LTSS) through the Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), or Deaf Blind with Multiple Disabilities (DBMD) waiver programs will receive acute care services through a STAR+PLUS managed care organization beginning September 1, 2014.
Acute care services are typically provided in a primary care physician’s office, a specialty physician’s office, or a hospital or clinic emergency room as treatment for an isolated event or part of routine health maintenance. The service delivery model through which the individual is currently receiving HCS, TxHmL, CLASS, or DBMD LTSS will remain the same.
Individuals in these programs who are currently receiving Day Activity and Health Services or Primary Home Care services will continue to receive these services through the Department of Aging and Disability Services after September 1, 2014. Eligibility to receive state plan services at the same time an individual is enrolled in a waiver program will not change as part of this expansion. If you have a question about which services may be combined, please see http://dadsview.dads.state.tx.us/handbooks/appendix/res/apx12.pdf