SECTION 87.111. Referrals to Other HHS Offices or Other Entities

OO staff inform the consumer, the consumer's LAR, or a health care provider of any referral made to other HHS offices or other entities regarding their contact with OO and document the referral in the HEART system. Referrals include:

(1) Department of Family and Protective Services, for a contact that includes information that makes OO staff suspect abuse, neglect, or exploitation;

(2) HHSC Civil Rights Office, for a contact alleging a violation of civil rights or discrimination regarding the delivery of HHS programs or services, including those concerning lack of access to benefits and services due to language or disability;

(3) Office of Inspector General, for a contact that includes allegations of fraud, waste, or abuse regarding HHS programs or services;

(4) HHSC Appeals Division staff, for a request for a fair hearing;

(5) Medicaid managed care organization, for a request to appeal a decision by a Medicaid managed care organization;

(6) HHSC Regulatory Services Division, for a contact related to an entity regulated by HHSC; and

(7) LBHA or LMHA closest to the consumer or local law enforcement, for a contact that includes threats of violence to a consumer or others.

Source Note: The provisions of this §87.111 adopted to be effective January 10, 2019, 44 TexReg 252; amended to be effective December 21, 2022, 47 TexReg 8273