DADS published an information letter to inform Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers and local intellectual and developmental disabilities authorities (LIDDA) about the implementation of the Community First Choice (CFC) benefit for individuals in the HCS and TxHmL programs, effective June 1, 2015. This letter does not address CFC services through the consumer directed services (CDS) option or through Medicaid managed care. Requirements regarding CFC services delivered through the CDS option are addressed in IL 2015-29.
For your convenience, a table of contents for this letter is set forth below:
Table of Contents
Introduction 1 Important Things to Know About CFC 2 Services Offered Under the CFC Benefit 2 Impact of CFC in the HCS and TxHmL Waiver Programs 4 Program Provider and Service Coordinator Responsibilities related to Implementation of CFC 4 Service Provider Requirements 6 Compliance Requirements 6 Billing and Rates 8 Eligibility Requirements/Fair Hearings 9 Service Coordinator and Program Provider Requirements 10 HCS and TxHmL Form Revisions 11 Information Letters and Rule Changes 12
Introduction
CFC is a state plan benefit governed by Code of Federal Regulations (CFR), Title 42, Chapter IV, Subchapter C, Part 441, Subpart K, regarding Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice) that provides certain services and supports to individuals living in the community, including individuals in the HCS and TxHmL
programs. CFC services are Medicaid state plan services, not waiver services.
Important Things to Know About CFC
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The CFC benefit offers CFC personal assistance services (PAS), CFC Habilitation (HAB), CFC emergency response services (ERS), and CFC support management services.
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For HCS and TxHmL, the CFC services of PAS and HAB are combined into one CFC service, CFC PAS/HAB, which is considered the same service as supported home living (SHL) in HCS and community support (CS) in TxHmL.
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All of the tasks and activities delivered through SHL or CS will be delivered through CFC PAS/HAB.
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ERS will be provided through CFC ERS, not as an adaptive aid.
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The reimbursement rate for CFC PAS/HAB will be the same as the current HCS SHL and
TxHmL CS reimbursement rates.
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Individuals receiving host home/companion care, supervised living, or residential support will
not receive CFC services.
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Service provider qualifications are expanded to allow for qualified service provider of CFC
PAS/HAB to live in the same home as the individual receiving CFC PAS/HAB.
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CFC PAS/HAB and CFC ERS will not be included in the calculation of the individual plan of
care (IPC) annual cost for the HCS and TxHmL Program services. However, the CFC service
costs will be included separately on the IPC.
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Electronic visit verification (EVV) will not apply to HCS and TxHmL program providers
delivering CFC services to individuals enrolled in HCS and TxHmL.
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Individuals in the HCS and TxHmL Programs will not receive personal assistance services
through the Health and Human Services Commission (HHSC) Medicaid benefit of Personal Care Services (PCS). Services currently provided to individuals through PCS will be transitioned over to CFC PAS/HAB. The individual’s HCS or TxHmL provider will be responsible to provide for all of the individual’s personal attendant service and habilitation needs. More information about the transition of PCS to CFC PAS/HAB will be provided at a later date.
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