Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 26. HEALTH AND HUMAN SERVICES |
PART 1. HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 565. HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS |
SUBCHAPTER F. CERTIFICATION STANDARDS: QUALITY ASSURANCE |
SECTION 565.27. Finances and Rent
Latest version.
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(a) The program provider must comply with this subsection regarding charges against an individual's personal funds. (1) The program provider must, in accordance with this paragraph, collect a monthly amount for room from an individual who lives in a three-person or four-person residence. The cost for room must consist only of: (A) an amount equal to: (i) rent of a comparable dwelling in the same geographical area that is unfurnished; or (ii) the program provider's ownership expenses, limited to the interest portion of a mortgage payment, depreciation expense, property taxes, neighborhood association fees, and property insurance; and (B) the cost of: (i) shared appliances, electronics, and housewares; (ii) shared furniture; (iii) monitoring for a security system; (iv) monitoring for a fire alarm system; (v) property maintenance, including personnel costs, supplies, lawn maintenance, pest control services, carpet cleaning, septic tank services, and painting; (vi) utilities, limited to electricity, gas, water, garbage collection, and a landline telephone; and (vii) shared television and Internet service used by the individuals who live in the residence. (2) Except as provided in subparagraphs (B) and (C) of this paragraph, a program provider must collect a monthly amount for board from an individual who lives in a three-person or four-person residence. (A) The cost for board must consist only of the cost of food, including food purchased for an individual to consume while away from the residence as a replacement for food and snacks normally prepared in the residence, and of supplies used for cooking and serving, such as utensils and paper products. (B) A program provider is not required to collect a monthly amount for board from an individual if collecting such an amount may make the individual ineligible for the Supplemental Nutrition Assistance Program operated by the Texas health and Human Services Commission(HHSC). (C) A program provider must not collect a monthly amount for board from an individual if the individual chooses to purchase the individual's own food, as documented in the individual's implementation plan. (3) To determine the maximum room and board charge for each individual, a program provider must: (A) develop a process or formula that divides the rent equitably and considers: (i) the number of residents receiving HCS Program services or similar services that the residence has been developed to support plus the number of service providers and other persons who live in the residence; and (ii) the features or space to which an individual has exclusive or shared access, unless the additional space is requested and needed for accessibility purposes; (B) divide the board cost described in paragraph (2) of this subsection by the number of persons consuming the food; and (C) add the amounts calculated in accordance with subparagraphs (A)and (B) of this paragraph. (4) A program provider must not increase the charge for room and board because a resident moves from the residence. (5) A program provider: (A) must not charge an individual a room and board amount that exceeds an amount determined in accordance with paragraphs (1) - (3)of this subsection; and (B) must maintain documentation demonstrating that the room and board charge was determined in accordance with paragraphs (1) - (3)of this subsection. (6) Before an individual or legally authorized representative (LAR)selects a residence, the program provider must ensure the individual or LAR has a written residential agreement with: (A) the program provider if the individual lives in a three-person residence or four-person residence; or (B) the service provider of host home/companion care if the individual does not own the residence or lease the residence from another person. (7) Except as provided in paragraph (8) of this subsection, a program provider may not charge or collect payment from any person for room and board provided to an individual receiving host home/companion care. (8) If a program provider makes a payment to an individual's host home/companion care provider while waiting for the individual's federal or state benefits to be approved, the program provider may seek reimbursement from the individual for such payments. (9) For a program provider who manages personal funds of an individual who receives host home/companion care, the program provider: (A) must pay the agreed upon amount for the host home/companion care services; (B) must pay the host home/companion care provider directly from the individual's account; (C) may pay a room and board charge for the individual that is less than the host home/companion care provider's cost of room and board, as determined using the calculations described in paragraphs (1) and(2) of this subsection, for a three-person or four-person residence, divided by the number of persons living in the host home/companion care provider's home; and (D) must not pay a host home/companion care provider a room and board charge that exceeds the host home/companion care provider's cost of room and board, as determined using the calculations described in paragraphs (1) and (2) of this subsection for a three-person or four-person residence, divided by the number of persons living in the host home/companion care provider's home. (10) For an item or service other than room and board, the program provider must apply a consistent method in assessing a charge against the individual's personal funds that ensures that the charge for the item or service is reasonable and comparable to the cost of a similar item or service generally available in the community. (b) The program provider must inform the individual and LAR orally or in writing of any charges assessed by the program provider against the individual's personal funds, the purpose of those charges, and effects of the charges in relation to the individual's financial status. (c) The program provider must ensure that the individual or LAR has agreed in writing to all charges assessed by the program provider against the individual's personal funds before the charges are assessed. (d) The program provider must not assess charges against the individual's personal funds for costs for items or services reimbursed through the HCS Program or through CFC. (e) At the written request of an individual or LAR, the program provider must manage the individual's personal funds entrusted to the program provider, without charge to the individual or LAR in accordance with this subsection. (1) The program provider must not commingle the individual's personal funds with the program provider's funds. (2) The program provider must maintain a separate, detailed record of: (A) all deposits into the individual's account; and (B) all expenditures from the individual's account. (3) If an expenditure is for the individual to use as personal spending money, the program provider must have a process to show the individual acknowledged receiving the funds. (4) The program provider may accrue an expense for necessary items and services for which the individual's personal funds are not available for payment, such as room and board, medical and dental services, legal fees or fines, and essential clothing. (5) If an expense is accrued as described in paragraph (4) of this subsection, the program provider must enter a written payment plan with the individual or LAR for reimbursement of the funds. Source Note: The provisions of this §565.27 adopted to be effective June 21, 2023, 48 TexReg 3246