Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 26. HEALTH AND HUMAN SERVICES |
PART 1. HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 261. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM--CONTRACTING |
SUBCHAPTER E. ELIGIBILITY, ENROLLMENT AND REVIEW |
SECTION 261.236. Eligibility Criteria
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(a) To be eligible for the ICF/MR Program, a person must: (1) meet the LOC I or LOC VIII criteria described in §419.238 of this title (relating to Level of Care I Criteria) and §419.239 of this title (relating to Level of Care VIII Criteria); (2) be in need of and able to benefit from the active treatment provided in the 24-hour supervised residential setting of an ICF/MR; and (3) be eligible for Supplemental Security Income (SSI) or be determined by TDHS to be financially eligible for Medicaid. (b) Circumstances under which a person is not in need of and able to benefit from active treatment include when the person: (1) has been diagnosed by a licensed physician as having "brain death"; (2) does not respond in any way to the living environment; (3) has a health condition that prevents participation in active treatment; or (4) is generally able to function with little supervision or without a program of continuous active treatment. Source Note: The provisions of this §261.236 adopted to be effective September 1, 2001, 26 TexReg 5384; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127