IDD Services. 2.9.1 LIDDA shall meet the quarterly IDD Community Service Target as identified in the Performance Measures and Outcome Targets.
2.9.2 LIDDA shall meet the quarterly performance measures and outcome targets as identified in the Performance Measures and Outcome Targets.
2.9.3 LIDDA shall obtain written approval from HHSC prior to using contract funds to:
A. Develop a new residential program location; or
B. Provide residential services to an individual.
2.9.4 LIDDA shall comply with the following Medicaid-related items:
A. Contract with HHSC to participate in Targeted Case Management (“TCM”) (i.e., service coordination for Medicaid recipients and Preadmission Screening and Residential Review (“PASRR”)) and contract with HHSC to participate in Administrative Claiming.
B. Limit its participation as a waiver program provider to the capacity indicated in the CARE Screen C70, except that HHSC may grant a temporary increase in the enrollment capacity in accordance with the LIDDA handbook.
C. Perform the enrollment for the waiver programs in accordance with the Medicaid Program Enrollment Requirements and HHSC rules governing the HCS Program and the TxHmL Program.
D. Review each individual enrolling in the HCS Program to determine if the individual is eligible for inclusion in the Money Follows the Person (“MFP”) Demonstration Project as described in the LIDDA handbook.
E. Perform Medicaid Estate Recovery Program (“MERP”) responsibilities in accordance with MERP requirements.
F. Enter into an agreement with managed care organizations (“MCOs”) in their local service areas related to eligibility determinations, assessments, and service coordination for certain individuals participating in Community First Choice (“CFC”).
G. Refrain from contracting with an MCO as a provider of CFC services for which the LIDDA fulfills the service coordination and assessment role.
H. Assist a resident of a state supported living center (“SSLC”) with completing a move from the SSLC within 180 days after the interdisciplinary team (“IDT”) refers the resident for community placement (as indicated on the CARE XPTR report HC023200).
I. Provide services to individuals referred by the Texas Youth Commission, in accordance with 37 Tex. Admin. Code Chapter 380, Subchapter B, Division 2, Programming for Youth with Specialized Treatment Needs, §380.8779, (relating to Discharge of Non-Sentenced Offenders with Mental Illness or Intellectual Disability).
J. Ensure that all required services identifi...
IDD Services. 2.9.1 LIDDA shall meet the quarterly IDD Community Service Target as identified in the Performance Measures and Outcome Targets.
2.9.2 LIDDA shall meet the quarterly performance measures and outcome targets as identified in the Performance Measures and Outcome Targets.
IDD Services. The LIDDA shall:
1. Meet the quarterly Service Targets identified in Attachment A (Service Targets) and quarterly performance measures and outcome targets as identified in Attachment B (Performance Measures and Outcome Targets);
2. Obtain written approval from DADS prior to using contract funds to:
a. develop a new residential program location; or
b. provide residential services to a consumer;
3. Comply with the following Medicaid-related items:
a. Contract with DADS to participate in Targeted Case Management (TCM) (i.e., service coordination for Medicaid recipients) and Preadmission Screening and Residential Review (PASRR) and contract with HHSC to participate in Administrative Claiming;
b. Limit its participation as a waiver program provider to the capacity indicated in the CARE Action Code C70, except that DADS may grant a temporary increase in the enrollment capacity as a result of appropriate documentation of consumer choice;
c. Perform the enrollment for the waiver programs in accordance with Attachment K (Medicaid Program Enrollment Requirements) and DADS rules governing the HCS Program and the TxHmL Program;
d. Perform the Medicaid Estate Recovery Program responsibilities in accordance with Attachment R (Medicaid Estate Recovery Program);
e. Refrain from providing TCM to a consumer who is receiving TCM through the local mental health authority;
f. Enter into an agreement with MCOs in their local service areas related to Community First Choice (CFC) activities; and
g. Refrain from contracting as a provider of CFC services with MCOs.
4. Assist a resident of a state supported living center (SSLC) with completing a move from the SSLC within 180 days after the IDT refers the resident for community placement (as indicated on the CARE XPTR report HC023200);
5. Provide services to consumers referred by the Texas Youth Commission, pursuant to 37 TAC Chapter 87, Subchapter B, Special Needs Offender Programs, §87.79, (relating to Discharge of Non-sentenced Offenders with Mental Illness or Mental Retardation);
6. Ensure the provision of all required services identified in Attachment F (Description of IDD Services) each quarter;
7. Submit all required service encounters per the IDD Service Grid Instructions, DADS Service Grid and Field Definitions, and submit supplemental assignment data in CARE as necessary to ensure accuracy of individual consumer service record;
8. Review annually with each consumer currently receiving General Revenue services or the consume...
