Section 260.51 - Eligibility Criteria for DBMD Program Services and CFC Services(a) An individual is eligible for DBMD Program services if: (1) the individual meets the financial eligibility criteria as described in Appendix B of the DBMD Program waiver application approved by CMS and available on the HHSC website;(2) the individual is determined by HHSC to meet the LOC VIII criteria described in § 261.239 of this title (relating to ICF/MR Level of Care VIII Criteria);(3) the individual, as documented on the ID/RC Assessment:(A) has one or more diagnosed related conditions and, as a result: (ii) has been determined to have a progressive medical condition that will result in deafblindness; or(iii) functions as a person with deafblindness; and(B) has one or more additional disabilities that result in impairment to independent functioning;(4) the individual has an IPC with a cost for DBMD Program services at or below $114,736.07;(5) the individual is not enrolled in another waiver program or receiving a service that may not be received if the individual is enrolled in the DBMD Program, as identified in the Mutually Exclusive Services table in Appendix V of the Deaf Blind with Multiple Disabilities Program Manual;(6) the individual does not reside in: (C) an ALF, unless it provides licensed assisted living in the DBMD Program;(D) a residential child-care facility unless it is an agency foster home;(F) a mental health facility;(G) an inpatient chemical dependency treatment facility;(H) a residential facility operated by the Texas Workforce Commission;(I) a residential facility operated by the Texas Juvenile Justice Department;(7) at least one program provider is willing to provide DBMD Program services to the individual;(8) the individual resides or moves to reside in a county served by a program provider; and(9) the individual requires the provision of: (A) at least one DBMD Program Service per month or a monthly monitoring by a case manager; and(B) at least one DBMD Program Service during an IPC period.(b) Except as provided in subsection (c) of this section, an individual is eligible for a CFC service under this chapter if the individual:(1) meets the criteria described in subsection (a) of this section;(2) requires the provision of the CFC service; and(3) is not receiving licensed assisted living or licensed home health assisted living.(c) To be eligible for a CFC service under this chapter, an individual receiving MAO Medicaid must, in addition to meeting the eligibility criteria described in subsection (b) of this section, receive a DBMD Program service at least monthly, as required by 42 CFR § 441.510(d).26 Tex. Admin. Code § 260.51
Adopted by Texas Register, Volume 48, Number 07, February 17, 2023, TexReg 0907, eff. 2/26/2023