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TITLE 26 - HEALTH AND HUMAN SERVICES
PART 1 - HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 259 - COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES (CLASS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER H - ADDITIONAL DSA REQUIREMENTS
SECTION/RULE §259.361 - Respite and Dental Treatment

(a) An individual may receive a maximum of 30 days of in-home and out-of-home respite combined, during an IPC period. (b) A DSA must ensure that: (1) in-home respite is provided in the individual's residence or the residence of a relative or friend that is not one of the settings listed in paragraph (2) of this subsection; (2) out-of-home respite is provided in one of the following settings: (A) an agency foster home; (B) a nursing facility; (C) an ICF/IID; (D) an approved outdoor camp accredited by the American Camping Association; (E) the residence of another person receiving a Medicaid waiver service; or (F) an ALF; and (3) the setting in which out-of-home respite is provided is: (A) acceptable to the individual or LAR; and (B) an accessible, safe, and comfortable environment for the individual and promotes the individual's health and welfare. (c) If a DSA provides out-of-home respite in a residence described in subsection (b)(2)(E) of this section, the DSA must: (1) obtain written approval from each person residing in the residence who is receiving a Medicaid waiver service, or LAR, for the provision of respite in the residence; and (2) ensure that no more than four persons receiving a Medicaid waiver service are residing in the residence. (d) The maximum amount HHSC approves as payment to a DSA for all dental treatment and adaptive aids combined for an individual is $10,000 per IPC period. (e) A DSA must follow the process for requesting authorization to purchase dental treatment described in the Community Living Assistance and Support Services Provider Manual.

Source Note: The provisions of this §259.361 adopted to be effective January 30, 2023, 48 TexReg 362.

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