Appendix II, Cost Limit for Purchased Services

Revision 24-4; Effective Sept. 1, 2024

Under state law, the Texas Health and Human Services Commission (HHSC) may not purchase alternate care for a person when the cost per day of the care exceeds the cost per day in a nursing facility. Few combinations of Community Care Services Eligibility (CCSE) services even approach this cost. However, caseworkers must be careful when authorizing maximum levels of personal attendant services with another CCSE service.

To determine rates for services that vary by region or contract such as Family Care, Emergency Response Services or Home-Delivered Meals, the highest allowable rate is used. To ensure the correct amount of services are purchased, contact the regional contract manager to get the actual unit rate in a specific region.

When a person receives multiple services, contact the regional contract manager to:

  • obtain current unit rates that apply to the services authorized; and
  • determine the total cost of services to ensure that the nursing facility average is not exceeded.