SECTION 263.103. HCS Interest List

(a) A LIDDA must maintain an up-to-date interest list of applicants interested in receiving HCS Program services for whom the LIDDA is the applicant's designated LIDDA in the HHSC data system.

(b) A person may request that an applicant's name be added to the HCS interest list by contacting the LIDDA serving the Texas county in which the applicant or person resides.

(c) If a request is made in accordance with subsection (b) of this section for an applicant who resides in Texas, a LIDDA must add the applicant's name to the HCS interest list using the date the LIDDA receives the request as the HCS interest list date.

(d) For an applicant under 22 years of age who is residing in an ICF/IID or nursing facility located in Texas, HHSC adds the applicant's name to the HCS interest list using the date of admission to the ICF/IID or nursing facility as the HCS interest list date.

(e) For an applicant determined diagnostically or functionally ineligible during the enrollment process for the Community Living Assistance and Support Services (CLASS) Program, Deaf-Blind with Multiple Disabilities (DBMD) Program, or Medically Dependent Children Program (MDCP):

(1) if the applicant's name is not on the HCS interest list, at the request of the applicant or LAR, HHSC adds the applicant's name to the HCS interest list using the applicant's interest list date for the program for which the applicant was determined ineligible as the HCS interest list date;

(2) if the applicant's name is on the HCS interest list and the applicant's interest list date for the program for which the applicant was determined ineligible is earlier than the applicant's HCS interest list date, at the request of the applicant or LAR, HHSC changes the applicant's HCS interest list date to the applicant's interest list date for the program for which the applicant was determined ineligible; or

(3) if the applicant's name is on the HCS interest list and the applicant's HCS interest list date is earlier than the applicant's interest list date for the program for which the applicant was determined ineligible, HHSC does not change the applicant's HCS interest list date.

(f) This subsection applies to an applicant who was enrolled in MDCP and, because the applicant did not meet the LOC criteria for medical necessity for nursing facility care or did not meet the age requirement of being under 21 years of age, was determined ineligible for MDCP after November 30, 2019.

(1) At the request of the applicant or LAR, HHSC adds the applicant's name to the HCS interest list:

(A) using the MDCP interest list date as the HCS interest list date, if the applicant's name is not on the HCS interest list but it was previously on the HCS interest list; or

(B) using the date HHSC receives the request as the HCS interest list date, if the applicant's name is not on the HCS interest list and it never has been on the HCS interest list.

(2) At the request of the applicant or LAR, HHSC changes the HCS interest list date to the MDCP interest list date if the applicant's MDCP interest list date is earlier than the applicant's HCS interest list date.

(g) HHSC or the LIDDA removes an applicant's name from the HCS interest list if:

(1) the applicant or LAR requests in writing that the applicant's name be removed from the HCS interest list, unless the applicant is under 22 years of age and residing in an ICF/IID or nursing facility;

(2) the applicant moves out of Texas, unless the applicant is a military family member living outside of Texas:

(A) while the military member is on active duty; or

(B) for less than one year after the former military member's active duty ends;

(3) the applicant declines an offer of HCS Program services or, as described in §263.104(f) of this subchapter (relating to Process for Enrollment of Applicants), an offer of HCS Program services is withdrawn, unless:

(A) the applicant is a military family member living outside of Texas:

(i) while the military member is on active duty, or

(ii) for less than one year after the former military member's active duty ends; or

(B) the applicant is under 22 years of age and residing in an ICF/IID or nursing facility;

(4) the applicant is a military family member living outside of Texas for more than one year after the former military member's active duty ends;

(5) the applicant is deceased; or

(6) HHSC has denied the applicant enrollment in the HCS Program and the applicant or LAR has had an opportunity to exercise the applicant's right to appeal the decision in accordance with §263.801 of this chapter (relating to Fair Hearing) and did not appeal the decision or appealed and did not prevail.

(h) If HHSC or the LIDDA removes an applicant's name from the HCS interest list in accordance with subsection (g)(1)-(4) of this section, the LIDDA receives an oral or written request from a person to add the applicant's name to the HCS interest list within 90 calendar days after the name was removed, and the request is the applicant's first request:

(1) the LIDDA must notify HHSC of the request; and

(2) HHSC:

(A) adds the applicant's name to the HCS interest list using the HCS interest list date that was in effect at the time the applicant's name was removed from the HCS interest list; and

(B) notifies the applicant or LAR in writing that the applicant's name has been added to the HCS interest list in accordance with subparagraph (A) of this paragraph.

(i) If HHSC or the LIDDA removes an applicant's name from the HCS interest list in accordance with subsection (g)(1)-(4) of this section, the LIDDA receives an oral or written request from a person to add the applicant's name to the HCS interest list more than 90 calendar days after the name was removed, and the request is the applicant's first request:

(1) one of the following occurs:

(A) the LIDDA adds the applicant's name to the HCS interest list using the date the LIDDA receives the oral or written request as the HCS interest list date; or

(B) if HHSC determines that extenuating circumstances exist, HHSC adds the applicant's name to the HCS interest list using the HCS interest list date that was in effect at the time the applicant's name was removed from the HCS interest list as the HCS interest list date; and

(2) HHSC notifies the applicant or LAR in writing that the applicant's name has been added to the HCS interest list in accordance with paragraph (1) of this subsection.

(j) If HHSC or the LIDDA removes an applicant's name from the HCS interest list in accordance with subsection (g)(1)-(4) of this section, the LIDDA receives an oral or written request from a person to add the applicant's name to the HCS interest list, and the request is not the applicant's first request:

(1) the LIDDA adds the applicant's name to the HCS interest list using the date the LIDDA receives the oral or written request as the HCS interest list date; and

(2) HHSC notifies the applicant or LAR in writing that the applicant's name has been added to the HCS interest list in accordance with paragraph (1) of this subsection.

(k) If HHSC or the LIDDA removes an applicant's name from the HCS interest list in accordance with subsection (g)(6) of this section and the LIDDA subsequently receives an oral or written request from a person to add the applicant's name to the HCS interest list:

(1) the LIDDA must add the applicant's name to the HCS interest list using the date the LIDDA receives the oral or written request as the HCS interest list date; and

(2) HHSC notifies the applicant or LAR in writing that the applicant's name has been added to the HCS interest list in accordance with paragraph (1) of this subsection.

Source Note: The provisions of this §263.103 adopted to be effective March 1, 2023, 48 TexReg 1080