SECTION 354.1362. Eligibility

(a) To be eligible for a CFC service, an individual must:

(1) be eligible for medical assistance under the state plan;

(2) as determined annually, be in an eligibility group under the state plan that includes an institutional level of care; and

(3) receive a determination, at least annually, that in the absence of the home and community-based personal assistance services and supports, the individual would otherwise require the level of care furnished in a hospital, a nursing facility, an intermediate care facility for individuals with an intellectual disability or related condition, an institution providing psychiatric services for individuals under age 21, or an institution for mental disease for individuals age 65 or over, if the cost could be reimbursed under the state plan.

(b) Individuals who qualify for medical assistance under the special home and community-based waiver eligibility group defined at section 1902(a)(10)(A)(ii)(VI) of the Social Security Act must meet all section 1915(c) waiver requirements and receive at least one home and community-based service per month.

Source Note: The provisions of this §354.1362 adopted to be effective June 1, 2015, 40 TexReg 2746