SECTION 259.263. Time Frames for Providing Adaptive Aids to Individuals

(a) Except as provided for a medical supply described in subsection (c) of this section, for an adaptive aid costing less than $500 and authorized by HHSC, a DSA must ensure that an individual receives the adaptive aid no later than 14 business days after one of the following dates, whichever is later:

(1) the date HHSC approves the individual's proposed IPC that includes the recommended adaptive aid; or

(2) the effective date of the individual's proposed IPC as determined by the service planning team.

(b) Except as provided for a medical supply as described in subsection (c) of this section, for an adaptive aid costing $500 or more and authorized by HHSC, a DSA must ensure that an individual receives the adaptive aid no later than 30 business days after one of the following dates, whichever is later:

(1) the date HHSC approves the individual's proposed IPC that includes the recommended adaptive aid; or

(2) the effective date of the individual's proposed IPC as determined by the service planning team.

(c) For an adaptive aid that is a medical supply, as listed in the Community Living Assistance and Support Services Provider Manual, a DSA must ensure that an individual receives the medical supply as follows:

(1) for a medical supply that is not immediately needed by the individual, no later than five business days after one of the following dates, whichever is later:

(A) the date HHSC approves the individual's proposed IPC that includes the recommended adaptive aid; or

(B) the effective date of the individual's proposed IPC as determined by the service planning team; and

(2) for a medical supply that is immediately needed by the individual, no later than two business days after the date HHSC approves the individual's proposed IPC that includes the recommended adaptive aid.

(d) If a DSA cannot provide an adaptive aid in the time frame described in subsections (a), (b), or (c)(1) of this section, the DSA must comply with this subsection.

(1) Other than for a medical supply, for an adaptive aid costing less than $500, the DSA must notify the individual and the individual's case manager, orally or in writing, before the 14-day time frame described in subsection (a) of this section expires:

(A) that the adaptive aid will not be provided within the 14-day time frame; and

(B) of a new proposed date for provision of the adaptive aid.

(2) Other than for a medical supply, for an adaptive aid costing $500 or more, the DSA must notify the individual and the individual's case manager, orally or in writing, before the 30-day time frame described in subsection (b) of this section expires:

(A) that the adaptive aid will not be provided within the 30-day time frame; and

(B) of a new proposed date for provision of the adaptive aid.

(3) For an adaptive aid that is a medical supply and not immediately needed by the individual, the DSA must notify the individual and the individual's case manager, orally or in writing, before the five-day time frame described in subsection (c)(1) of this section expires:

(A) that the adaptive aid will not be provided within the five-day time frame;

(B) the reasons why the medical supply will not be provided within the five-day time frame; and

(C) of a new proposed date for provision of the medical supply.

Source Note: The provisions of this §259.263 adopted to be effective January 30, 2023, 48 TexReg 362