General Program. 2.8.1 LIDDA shall provide services to all individuals without regard to the individual’s criminal history.
2.8.2 LIDDA shall provide individual benefits assistance in accordance with section 2.8.2(A) through 2.8.2(I) of this Attachment A-1 and comply with Tex. Health and Safety Code §533A.008(e) regarding individual benefits training.
A. LIDDA shall ensure at least one staff member receives training that is provided semi-annually through the Texas Council’s Individual Benefits Organization;
B. LIDDA shall identify a staff member designated by LIDDA to serve as a liaison to Health and Human Services Disability Determination Services;
C. LIDDA shall annually screen all current individuals to determine their potential eligibility for Supplemental Security Income (“SSI”), Social Security Disability Income (“SSDI”), and Medicaid;
D. LIDDA shall screen all new individuals found eligible for services to determine their potential eligibility for SSI, SSDI, and Medicaid;
E. LIDDA shall ensure a staff member who has received the training required in section 2.8.2(A) of the Contract reviews all cases screened as having low eligibility potential to determine the screening’s accuracy;
F. LIDDA shall ensure all cases reviewed and determined to have moderate to high eligibility potential for Medicaid, SSDI and SSI will be assisted with the benefits applications;
G. LIDDA shall assist all individuals who have been denied SSI or SSDI benefits to appeal their denial of benefits, from the initial appeal (Reconsideration) level to the second level (Administrative Hearing).
H. LIDDA shall ensure the LIDDA’s billing staff are notified of individuals’ benefits approval and application dates, to allow completion of retroactive billing within 90 days for allowable Medicaid services from the date of the application. The Social Security Administration (“SSA”) will contact the individual's designated representative; and
I. LIDDA shall identify staffing that is adequate to ensure sufficient focus and capacity to provide benefits assistance in accordance with the requirements in sections 2.8.2(A) through 2.8.2(H) of this Attachment. Referral to contractors paid on contingency fees for benefits assistance does not meet the requirements of section 2.8.2 of this Attachment.
2.8.3 LIDDA shall ensure all service coordinators are trained in job duties as outlined in this Performance Contract and have access to and use of a complete copy of this Performance Contract and the LIDDA handbook. HH...
General Program. (A) In general
(B) Reservation for emergency grants
General Program. The LIDDA shall:
1. Provide services to all consumers without regard to the consumer’s criminal history;
2. Provide consumer benefits assistance in accordance with Attachment L (Consumer Benefits Assistance Requirements) and comply with THSC §533.008(e) regarding consumer benefits training;
3. Ensure all service coordinators are able to access and use: xxx.xxx.xxxxx.xx.xx/xxxx/xxxxxxxx.xxxxx;
4. As requested by DADS, assist in transferring a consumer’s ICF/IID Program, HCS or TxHmL Program services, or financial management services agency services from one provider to another due to closure of the provider’s facility or termination of the provider’s contract;
5. Provide meaningful access to its programs, services, and activities and ensure adequate communication through language assistance services for consumers and legally authorized representatives (LARs) with limited English proficiency, sensory impairments, and/or speech impairments;
6. Cooperate with other LIDDAs, Area Agencies on Aging (AAAs), and DADS local community services regional offices to ensure efficient access and intake processes for all DADS services and programs;
8. Cooperate with Managed Care Organizations (MCOs) to ensure efficient access and intake and programmatic processes for all DADS services and programs and Community First Choice (CFC) services; and
7. This Contract and its attachments include many references to CARE (Client Assignment and Registration System). Certain functions of CARE will transition to new data management systems during this contract term. The impacted functions and the effective date of the transition will be communicated to the LIDDA at a later date. Such communication will include a crosswalk identifying the data management system to the applicable contract provision. The provisions of the crosswalk (relating to which data management system applies) shall take precedence over those identified in the contract.
