SECTION 261.255. Items and Services Purchased with Personal Funds

(a) A program provider may charge an individual or allow an individual to expend personal funds for the following items and services:

(1) an item or service that the program provider is responsible for providing, if the individual requests a specific type or brand of item or service that the program provider does not provide, and the program provider documents in the individual's record:

(A) the individual's written, signed request for a specific type or brand and the reason a specific type or brand has been requested or if the individual is determined not to have the ability to make such a request, the IDT's approval for a specific type or brand;

(B) the type or brand that is provided at the program provider's expense; and

(C) the reason the program provider does not provide the type or brand requested;

(2) the difference between the Medicaid payment and the actual cost of the eyeglasses, if the individual chooses a style or feature not paid for by Medicaid;

(3) clothing;

(4) cosmetic dental procedures;

(5) transportation costs, other than those described in §419.254(17) of this title (relating to Items and Services Provided by the Program Provider):

(A) if reimbursement to a third party for private transportation does not exceed the current state mileage reimbursement rate; and

(B) if adequate documentation is provided by a third party to the program provider to support the expenditure;

(6) repair or replacement of personal property that is damaged, lost, or stolen by the individual, if the expenditure is approved by the committee;

(7) snacks and meals, if the individual chooses items not listed on the program provider's menu;

(8) the individual's budgeted amount;

(9) activities that are not part of the program provider's recreational program and are independently chosen by the individual;

(10) dry cleaning;

(11) hair setting, permanent waves, hair color treatments, and beauty supplies, such as hair rollers and hair spray;

(12) cosmetics and perfume;

(13) cosmetic manicures, pedicures, and facials;

(14) charges to hold the individual's residential placement in the facility as described in §419.227(j) of this title (relating to Discharge From a Facility)

(15) school supplies, school fees, and other educational expenses;

(16) fees charged by a financial institution, if the individual manages his or her personal funds or the individual requests that the program provider manage his or her personal funds in a separate account; and

(17) applied income.

(b) Items purchased with an individual's personal funds must not be available for general use by program provider staff or other individuals.

Source Note: The provisions of this §261.255 adopted to be effective January 1, 2001, 25 TexReg 12790; amended 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