Section 354.1364 - Services and Limitations(a) Subject to the specifications, conditions, requirements, and limitations established by HHSC, Community First Choice (CFC) services are provided subject to provisions in RSA 441.500 - RSA 441.590. Services include: (1) CFC personal assistance services. CFC personal assistance services include: (A) non skilled assistance with the performance of the ADLs and IADLs through hands-on assistance, supervision, and/or cueing;(B) household chores necessary to maintain the home in a clean, sanitary, and safe environment;(C) escort services, which consist of accompanying, but not transporting, and assisting an individual to access personal assistance services or activities in the community; and(D) assistance with health-related tasks.(2) CFC habilitation. CFC habilitation is provided to allow an individual to reside successfully in a community setting by assisting the individual to acquire, retain, and improve self-help, socialization, and daily living skills or assisting with and training the individual on ADLs and IADLs. Personal assistance may be a component of CFC habilitation for some individuals. CFC habilitation services include habilitation training, which is interacting face-to-face with an individual, to train the individual in activities such as: (F) community integration, including how to get around in the community;(G) use of adaptive equipment;(I) personal decision making;(J) interpersonal communication;(K) reduction of challenging behaviors;(L) socialization and the development of relationships;(M) participating in leisure and recreational activities;(N) use of natural supports and typical community services available to the public; and(O) self-administration of medication and other health-maintenance activities.(3) CFC emergency response services. CFC emergency response services are available for individuals who live alone, who are alone for significant parts of the day, or have no regular caregiver for extended periods of time, and who would otherwise require extensive routine supervision.(4) CFC support management. The CFC support management benefit is available to individuals receiving CFC personal attendant services or CFC habilitation services regardless of service delivery option.(b) CFC services can only be delivered in a home and community-based setting. These settings do not include: (1) a hospital providing long-term services;(3) an institution for mental disease;(4) an intermediate care facility for individuals with an intellectual disability or related conditions; or(5) a setting with the characteristics of an institution as described in RSA 441.530(a)(2)(v).(c) Individuals receiving services through CFC are not precluded from receiving other home and community-based long-term services and supports through other Medicaid state plan, waiver, grant, or demonstration authorities.(d) Services are limited by functional need as determined by the assessment described in §354.1363(b) of this division (relating to Assessment).(e) MCOs are required to offer all CFC services to those MCO members who are eligible and are determined to need the services based on an assessment conducted in accordance with §354.1363 of this division.1 Tex. Admin. Code § 354.1364
Adopted by Texas Register, Volume 40, Number 21, May 22, 2015, TexReg 2746, eff. 6/1/2015; Amended by Texas Register, Volume 41, Number 22, May 27, 2016, TexReg 3905, eff. 6/2/2016