SECTION 259.63. Determination by HHSC of Whether an Individual Meets LOC VIII Criteria

(a) To determine if an individual meets the LOC VIII criteria required by §259.51(a)(2) of this subchapter (relating to Eligibility Criteria for CLASS Program Services and CFC Services), HHSC reviews the documentation submitted by an individual's DSA:

(1) described in §259.61(i)(2) of this division (relating to Process for Enrollment of an Individual); or

(2) described in §259.75(a)(2) of this subchapter (related to Annual Review by HHSC of Whether an Individual Meets LOC VIII Criteria).

(b) HHSC may request current data obtained from standardized evaluations and formal assessments related to the LOC VIII criteria. If HHSC makes such a request, a DSA must submit the information to HHSC no later than 10 calendar days after the date of the request.

(c) If HHSC determines that an individual meets the LOC VIII criteria:

(1) HHSC notifies the individual's DSA of the determination, in writing; and

(2) the LOC VIII is effective:

(A) on a date determined by HHSC; and

(B) through the last calendar day of the IPC period.

(d) If HHSC determines that an individual does not meet the LOC VIII criteria, HHSC notifies an individual's DSA and CMA of the determination, in writing.

Source Note: The provisions of this §259.63 adopted to be effective January 30, 2023, 48 TexReg 362