Revision 17-1; Effective November 1, 2017
The Community Living Assistance and Support Services (CLASS) program provides home and community-based services to people with related conditions as defined in Texas Administrative Code (TAC), Chapter 45, Subchapter A, §45.104. The CLASS program is funded by Title XIX Medicaid through a federal waiver that provides the opportunity for the Texas Health and Human Services Commission (HHSC) to offer specialized services that are not available under the regular Medicaid program. Individuals who receive CLASS program services may not also receive services from a program included in Appendix III, HHSC Operated Program CLASS Mutually Exclusive Services.
HHSC supports the expectation that every person has the opportunity to participate in their community, gain and maintain relationships of their choosing, express preferences, make choices, fulfill goals, and live with dignity and respect. The fundamental framework for delivering program services to individuals is based on tailoring program services to the individual's needs and circumstances. Services offered in the CLASS program supplement, but do not supplant, other Medicaid services, generic services, and other family and community supports to assist individuals successfully live and work in the community.
The goal of the CLASS program is to support individuals with related conditions to achieve their desired lifestyles and to be valued members of the community by:
- addressing health and safety;
- offering opportunities to better achieve their goals; and
- making the most efficient use of all available resources to accomplish these goals.
CLASS program services must:
- protect the individual's health and welfare in the community;
- address the individual's related condition;
- not be available to the individual through any other source, including Medicaid state plan, other governmental programs, private insurance or the individual's natural supports;
- prevent the individual's admission to an institution;
- be the most appropriate type and amount to meet the individual's needs; and
- be cost effective.
HHSC obtains Medicaid provider agreements with qualified provider agencies to deliver CLASS program services. The case management agency (CMA) provides case management services and the direct services agency (DSA) provides all other CLASS services, except Support Family Services (SFS), Transition Assistance Services (TAS) and Consumer Directed Services (CDS) delivery options. All provider agencies must work cooperatively to ensure that the individual's needs are met.
Rules governing the CLASS program are in Title 40 of the Texas Administrative Code (TAC), Chapter 45.