1000, A Referral to Guardianship Contractor's Procedures

Revision 22-1; Effective Nov. 1, 2022

When to Make a Referral of Wards for Successor Guardianship

Texas Health and Human Services Commission (HHSC) reviews the cases where a court has appointed the agency to serve as guardian of the person to determine if a referral to a contractor is appropriate.

The guardianship supervisor consults with the contract manager for the Oversight and Community Support (OCS) Unit regarding all referrals before they are sent to the contractors. Following this consultation, the contract manager determines if the referral is appropriate and notifies the supervisor of the decision. If approved, the guardianship supervisor completes the referral process. The contractor accepts all referrals within the slots allocated in the contract if the contractor has not reached full capacity, unless the individual who is the subject of the referral is not in the population normally served by the contractor. Contracts awarded by the program stipulate the characteristics of individuals the contractor will serve. HHSC guardianship only contracts for guardian of the person cases.

When a guardianship supervisor determines an active HHSC guardianship case appears appropriate for transfer to a contracted provider for a successor guardianship, the supervisor considers the following:

  • number of individuals the contractor can serve and available slots;
  • stability of the case;
  • only guardian of the person cases; and
  • geographic region or area in which the ward resides.

If the OCS Manager determines a ward meets the criteria listed above, the supervisor consults with the OCS contract manager. Once the referral is approved by the contract manager, the supervisor completes a referral packet.

A referral packet to the contractor contains:

  • the original completed referral checklist;
  • the original completed contractor referral;
  • copies of the following:
    • ward's photograph;
    • ward's demographic page;
    • original application of guardianship (for historical information), if available;
    • letters of guardianship;
    • oath of guardianship;
    • original orders;
    • annual report of person;
    • individual service plan and updates to include person future or directed plan reviews;
    • inventory of personal property, including furniture;
    • current financial statements (bank, certificates of deposit, money markets), as applicable and available;
    • medical information;
    • Guardianship Online Database (GOLD) case notes, as applicable;
    • Certificate of Medical Examination (CME) or determination of intellectual disability; and
    • HHSC assessment.

The guardianship supervisor must ensure the referral packet is completed, as required in policy.

The guardianship supervisor sends a copy of the referral form and referral checklist to the contract manager in state office for all cases approved for the successor to a contractor. The referral form is sent via email. Following receipt of the referral form and referral checklist from the supervisor, the contract manager enters a case note reflecting the referral was approved and attaches the referral form and referral checklist into GOLD.

The contractor referral form must be completed accurately; legal names, correct Social Security number and correct dates are required on all documents. The information from the referral form will be entered into the Claims Management System electronic billing database by OCS state office staff. Incomplete information could result in a delay in payment to the contractor.

After the contractor receives the referral, the contractor has up to five business days to review, accept the ward as a referral, and return the signed referral form and checklist to the guardianship supervisor with a copy to the contract manager. Both the referral form and the checklist must be signed by a representative of the contracted guardianship provider with signature authority. The contractor signs the referral checklist form to identify the date a complete packet was received. The referral form is signed by the contractor to determine the date the ward was accepted as a referral by the contractor. The acceptance date on the referral form determines the date payment begins.

If the referral is remanded to the guardianship supervisor, the referral is suspended to allow time for HHSC regional staff to obtain the needed information to complete the referral. The guardianship supervisor must ensure the referral is completed accurately before sending it to the contractor.

Begin Date of Reimbursement

The date of acceptance on the contractor referral form is the date payment begins to the contractor. This date serves as the service authorization date entered in the Claims Management System for electronic billing. If a referral form is submitted with a date of acceptance before the 16th of the month, the contractor will be paid the full unit rate for the month. Referral forms with a date of acceptance after the 15th of the month will not be paid for the current month but are processed for the next month. Exceptions cannot be made to this payment system.

Extensions for Applications of Guardianship

A contractor may request an extension if the application for guardianship is not filed within 30 calendar days from the date the referral is accepted by the contractor. The request for the extension must be received by the contract manager before the 30th day deadline for filing the application for guardianship. The contractor must provide justification for the extension to the contract manager via email. All extensions approved by the contract manager are valid for 30 calendar days.

If the contracted provider does not file the application for guardianship within the extension period, reimbursement for the referral will be suspended until guardianship is obtained by the contractor. The contractor is required to notify the guardianship supervisor and the contract manager via email with the file date of the application for guardianship to release the suspension and resume payment. After guardianship is obtained by the contractor, the file stamped letters of guardianship and copy of the oath must be emailed, mailed, or faxed by the contractor to the contract manager and guardianship supervisor. The Administrative Assistant will scan and attach the letters and oath in the ward’s case record in GOLD.

Resignation of HHSC as Guardian for Referred Cases

HHSC will complete the resignation documents and file them with the court before the hearing. The contractor and the guardianship supervisor determine if the HHSC guardianship specialist is required to attend the hearing. The contractor must notify the guardianship supervisor within 24 hours of being notified of a hearing to become successor guardian for an HHSC referred case. The HHSC regional attorney must be consulted regarding HHSC resignation as guardian.

Transfer of Records for Successor Guardianship

Upon receipt of the letters of guardianship from the contractor, the guardianship supervisor ensures the ward’s current documents are copied and mailed or emailed to the contractor within seven calendar days of the notification of qualification of the successor guardianship. In some instances, original documents may be transferred to the contractor and HHSC maintains scanned copies of the documents in GOLD.

Transfer information must include:

  • financial records;
  • checkbook registry;
  • will;
  • birth certificate;
  • Social Security card;
  • burial policies;
  • insurance policies;
  • medical information;
  • advanced directives;
  • bank account statements;
  • deeds records;
  • placement documents:
    • trust fund statements, and
    • facility staffing reports;
  • any significant communications with collaterals;
  • Individual Education Plan (IEP), Admission, Reviews, and Dismissals (ARD) staffing, as applicable;
  • behavior plans, as applicable; and
  • social histories, interdisciplinary team (IDT) meeting staffing, notes, as applicable.

The guardianship supervisor ensures any personal property of the ward in the possession of HHSC is transferred to the contractor.

The contractor is responsible for securing and safeguarding the ward’s resources, benefits and property immediately upon appointment as guardian, and for becoming the representative payee for the ward, as applicable. The contractor must not engage in activities or seek to transfer the ward’s resources or benefits in the contractor’s name, prior to being appointed guardian. After the appointment, it is important for the contractor to make every effort to secure the ward’s financial information and to become the identified guardian of the record so the ward’s bills are paid timely. The contractor must have the ward’s financial accounts restyled and signature cards completed upon appointment.

A contractor may not charge the ward for case management, legal or bond fees for obtaining, maintaining or closing guardianship of the person cases referred by HHSC.

Referrals Resulting in Payment from HHSC

A referral form from the guardianship supervisor is the only form accepted for payment. The date of acceptance on the form will serve as the date of the service authorization. No other information will be used to establish the service authorization date. If the contractor receives a referral from the court (referred to the court by Adult Protective Services) for a ward who should have been referred to HHSC, it is the responsibility of the contractor to contact the Department of Family and Protective Services (DFPS) and the guardianship supervisor. DFPS and the HHSC supervisors must determine if a referral can be made by DFPS to HHSC. If a referral is made, HHSC reviews the referral and makes the determination how to proceed. HHSC only pays for contracted wards if HHSC was first appointed guardian by the court.

If a contractor provides services prior to the acceptance date of the referral, HHSC is not responsible to reimburse the contractor for that time. The contractor can only be paid by HHSC upon receipt and approval of the signed contractor referral form and can only continue payment if letters of guardianship and the oath accepting guardianship are provided to the supervisor and contract manager.

Documentation in the Guardianship Online Database (GOLD)

The guardianship supervisor or designee enters data related to the referral into the GOLD system, and documents in GOLD the referral was sent to the OCS contract manager. The Administrative Assistant documents in GOLD the referral was reviewed and accepted or denied. After the referral acceptance form has been signed, dated and returned by the contractor to the contract manager and guardianship supervisor, the Administrative Assistant scans and attaches the signed referral acceptance form in GOLD with a case note indicating the outcome. The Administrative Assistant enters the referral data, including the acceptance date and the contractor information, in the Contractors’ Module in GOLD. The contractor is required to send the regional supervisor and the contract manager a copy of the letters of guardianship and a copy of the oath upon appointment of guardianship. The supervisor closes the case in GOLD when HHSC has been discharged as guardian by the court. The Administrative Assistant scans and attaches the letters of guardianship and a copy of the oath with a supporting case note. All information concerning reimbursement and service authorizations will be maintained by the OCS unit in the Claims Management System, the Single Service Authorization System and in the Contractors’ Module in GOLD.

HHSC Responsibilities When a Case is Transferred

When the contractor accepts a referral for successor guardianship, the guardianship supervisor follows the notification requirements as found in the Texas Estates Code or other applicable statutes and this handbook.

HHSC staff continue to perform the duties of guardian for the ward until the contracted agency qualifies as guardian to ensure no lapse in service. It is imperative the contractor file the application for guardianship within 30 calendar days from the date of acceptance to assume full responsibility for the ward.