2500, Provision of Direct Services by CMA

Revision 24-1; Effective Jan. 1, 2024

A CMA or any other division of the agency must not provide any other CLASS program services to a person receiving case management services from the CMA. This interpretation is consistent with CLASS rules in TAC, specifically 26 TAC Section 259.307(b)(3). This rule states a case manager is not employed by or contracting with a DSA to provide a direct service to a person served by the CMA.

Title 42 of the Code of Federal Regulations (CFR) in 42 CFR Section 441.301(c)(1)(vi) specifies providers of home and community-based services for the person, or those who have an interest in or are employed by a provider of home and community-based services for the person. They must not provide case management or develop the person-centered service plan. After reviewing the CLASS waiver application, HHSC has determined the Centers for Medicare and Medicaid Services (CMS) intends to maintain CMA services and DSA services separately. CMS had concerns in other Texas 1915(c) waivers about conflict of interest.