SECTION 263.4. Description of the HCS Program and CFC

(a) The HCS Program is a Medicaid waiver program approved by CMS pursuant to §1915(c) of the Social Security Act. It provides community-based services and supports to eligible individuals as an alternative to the ICF/IID Program. The HCS Program is operated by HHSC.

(b) Enrollment in the HCS Program is limited to the number of individuals in specified target groups and to the geographic areas approved by CMS.

(c) HCS Program services described in §263.5 of this subchapter (relating to Description of HCS Program Services) and CFC services described in §263.6 of this subchapter (relating to Description of CFC Services) are selected for inclusion in an individual's IPC to ensure the individual's health, safety, welfare, and integration in the community. HCS Program services and CFC Services supplement rather than replace the individual's natural supports and other community services for which the individual may be eligible and prevent the individual's admission to an institutional setting.

(d) CFC is a state plan option governed by 42 CFR Chapter 441, Subpart K, regarding Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice).

(e) HHSC has grouped Texas counties into geographical areas, referred to as "local service areas," each of which is served by a LIDDA. HHSC has further grouped the local service areas into "waiver contract areas." A list of the counties included in each local service area and waiver contract area is available on the HHSC website.

(1) A program provider may provide HCS Program services and CFC services only to persons residing in the counties specified for the program provider in the HHSC automated enrollment and billing system.

(2) A program provider must have a separate contract for each waiver contract area served by the program provider.

(3) A program provider may have a contract to serve one or more local service areas within a waiver contract area, but the program provider must serve all of the counties within each local service area covered by the contract.

(4) A program provider may not have more than one contract per waiver contract area.

(f) A program provider must comply with all applicable state and federal laws, rules, and regulations.

(g) The CDS option is a service delivery option, described in 40 TAC Chapter 41 (relating to Consumer Directed Services Option), in which an individual or LAR employs and retains service providers and directs the delivery of a service through the CDS option, as described in 40 TAC §41.108 (relating to Services Available Through the CDS Option).

Source Note: The provisions of this §263.4 adopted to be effective March 1, 2023, 48 TexReg 1080