9000, Suspensions

Revision 22-2; Effective May 1, 2022 

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This section describes the process for suspending an individual's Home and Community-based Services (HCS) or Texas Home Living (TxHmL) Program waiver services and requesting a continuation of the suspension beyond 270 days.

A program advisor in the Texas Health and Human Services Commission (HHSC) Program Eligibility and Support (PES) unit will request information from the service coordinator (SC) every 30 days, or as appropriate, during the period an individual's waiver program services are suspended.

The individual's services will remain suspended until it is appropriate for the individual's services to resume or the decision is made to terminate the individual's services.

HHSC may request that an individual's HCS or TxHmL services be terminated at any time, if appropriate.

9100, Reasons for Suspension of Waiver Program Services

Revision 22-2; Effective May 1, 2022

There are situations that may cause an individual to become temporarily ineligible for HCS or TxHmL program services. If an individual is temporarily admitted to one of the following settings, the individual's HCS or TxHmL program services must be suspended in the HHSC data system:

  • a hospital;
  • an ICF/IID;
  • a nursing facility;
  • an ALF;
  • a residential child care facility licensed by HHSC unless it is an agency foster home;
  • an inpatient chemical dependency treatment facility;  
  • a mental health facility;
  • a residential facility operated by the Texas Workforce Commission; or
  • a residential facility operated by the Texas Juvenile Justice Department, a jail or a prison.

9200, Program Provider Responsibilities

Revision 22-2; Effective May 1, 2022

The program provider must:

  • immediately inform the SC if the program provider becomes aware that an individual is ineligible for HCS or TxHmL program services;
  • enter a "suspension" in the HHSC data system;
  • keep the SC informed by communicating any change(s) in the situation immediately upon becoming aware of the change(s);
  • update the suspension record in the HHSC data system to change the suspension reason if the reason changes during the suspension period; this is done without entering a new suspension record or changing the suspension begin date; and
  • immediately inform the SC and end the "suspension" in the HHSC data system when an individual has resumed participation in the HCS or TxHmL program.

9300, HHSC Activities

Revision 22-2; Effective May 1, 2022

HHSC PES program advisors request periodic status reports from the service coordinator (SC) for suspensions that exceed 30 days by sending a Suspension of Waiver Services Status Report (PDF) form to the Local Intellectual and Developmental Disability Authority (LIDDA). The program advisor completes the top section and sends the form by secure email to the SC contact at the LIDDA after an individual has been on suspension for 30 days or longer. Thereafter, the program advisor sends the form requesting a status update as often as the advisor determines is necessary while the individual is on suspension.

9400, Service Coordinator Responsibilities

Revision 22-2; Effective May 1, 2022

The SC must:

  • immediately inform the program provider if the SC becomes aware that an individual is ineligible for HCS or TxHmL program services;
  • monitor the situation during the entire period of suspension; and
  • complete and return by secure email the Suspension of Waiver Services Status Report form documenting the individual’s current status on or before the status due date designated on the form, noting whether the suspension will continue and for how long, or that the individual is not expected to resume services (i.e., termination of services is being recommended).

If the suspension continues for 270 days, the SC discusses with the individual or LAR and the program provider whether the individual will be able to resume services or if services should be terminated.

  • If continuation of the suspension beyond 270 days is recommended, the SC submits a request to continue the suspension of HCS or TxHmL program services for an additional 30 days in accordance with Section 9410 below.
  • If termination of services is recommended, the SC completes and returns by secure email the Suspension of Waiver Services Status Report form noting that the individual is not expected to resume services.

HHSC PES reviews all recommendations for terminations of services. If HHSC agrees that termination is appropriate, HHSC will contact the SC to advise the SC to submit a request for termination in accordance with Section 10100, Process for Requesting Termination of Waiver Services – Texas Home Living and Home and Community-based Services.

9410 Request to Continue Suspension of Waiver Program Services

Revision 22-2; Effective May 1, 2022

If it is foreseeable that the individual will be able to resume HCS or TxHmL program services, the SC requests that program services be continued for 30 days by submitting the following documentation to HHSC no later than the 277th day of suspension:

  • a completed Form 3615, Request to Continue Suspension of Waiver Program Services; and
  • documentation explaining the reason for the requested continuation.

The request may be returned to the program advisor via secure email, faxed to 512-438-4249 or mailed to:

Health and Human Services Commission
Program Eligibility and Support, Mail Code W-551
P.O. Box 149030
Austin, TX 78714-9030

Contact Information

Questions regarding this process should be directed to the HHCS Program Eligibility Support general email box at HHSC IDD-Program Eligibility and Support IddProgEligSpt@hhs.texas.gov or telephone message line at 512-438-5055.