Common use of IDD Services Clause in Contracts

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 identified in the Description of IDD Services are provided each quarter. K. Submit all required service encounters per the IDD Service Grid Instructions, HHSC Service Grid and Field Definitions, and submit supplemental assignment data in CARE as necessary to ensure accuracy of individual's service record. L. Review annually with each individual currently receiving General Revenue services or the individual’s LAR the Explanation of IDD Services and Supports referenced in the Options for IDD Services and Supports. M. Ensure LIDDA staff monitoring an individual who is on community placement status from an SSLC complies with the applicable requirements of §2.278 of 40 Tex. Admin. Code, Chapter 2, Subchapter F (Continuity of Services—State [IDD] Facilities). (1) LIDDA must submit the first written report required by §2.278 of 40 Tex. Admin. Code to the SSLC within the first 90 days after the individual has moved from the SSLC and submit subsequent reports at least every 90 days thereafter for the duration the LIDDA is responsible for monitoring the individual in accordance with §2.278. N. Access the long-term services and supports (“LTSS”) screening portal on a routine basis, acknowledge receipt of a referral within 14 calendar days after the referral was transmitted to the LIDDA, and follow up on the referral in accordance with the LIDDA’s established processes.

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 handbookMedicaid Program Enrollment Requirements, Section 1.2.14 of this Contract. 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 Perform 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 requirementsthe Medicaid Estate Recovery Program. F. E. 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 X. Xxxxxxx from contracting with an MCO as a provider of CFC services for which the LIDDA fulfills the service coordination and assessment role. H. G. 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. H. 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. I. Ensure that the provision of all required services identified in the Description of IDD Services are provided each quarter. K. J. Submit all required service encounters per the IDD Service Grid Instructions, HHSC Service Grid and Field Definitions, and submit supplemental assignment data in CARE as necessary to ensure accuracy of individual's service record. L. K. Review annually with each individual currently receiving General Revenue services or the individual’s LAR the Explanation of IDD Services and Supports referenced in the Options for IDD Services and Supports. M. L. Ensure LIDDA staff monitoring an individual who is on community placement status from an SSLC complies with the applicable requirements of §2.278 of 40 Tex. Admin. Code, Chapter 2, Subchapter F (Continuity of Services—State [IDD] Facilities). (1) LIDDA must submit Submit the first written report required by §2.278 of 40 Tex. Admin. Code to the SSLC within the first 90 days after the individual has moved from the SSLC and submit subsequent reports at least every 90 days thereafter for the duration the LIDDA is responsible for monitoring the individual in accordance with §2.278. N. (2) Access the long-term services and supports (“LTSS”) screening portal on a routine basis, acknowledge receipt of a referral within 14 calendar days after the referral was transmitted to the LIDDA, and follow up on the referral in accordance with the LIDDA’s established processes.