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Revision 11-2; Effective March 1, 2011
6610 Service Coordinator Review Process Overview
Revision 22-2; Effective May 1, 2022
The SC is responsible for reviewing in the HHSC data system all IPC renewals and all IPC revisions, except IPC revisions that add or change a requisition fee only. After the provider enters the IPC in the HHSC data system, the SC has six days to review it in the HHSC data system. Within three days after entering the IPC, the provider is responsible for sending the SC a hard copy of the IPC (i.e., completed Form 3608).
The SC reviews the IPC in the HHSC data system by ensuring:
- the information in the HHSC data system is the same as the information on the hard copy of the IPC and reflects what was discussed during the IPC meeting, if appropriate; and
- that the IPC effective date is in accordance with the requirements in Section 6323, Section 6421.1 or Section 6431.1, as appropriate.
If an SC does not review an IPC within six days after data entry, the HHSC data system will automatically send the IPC to HHSC for authorization without an SC review. Reports will be available for state office and LIDDA management staff noting those IPCs not reviewed by the SC.
6611 Reasons the IPC is Returned to the Provider
Revision 22-2; Effective May 1, 2022
The SC returns the IPC electronically in the HHSC data system to the provider if the SC is unable to agree or disagree with the IPC because:
- the SC did not receive the IPC hard copy within the required time frame and the SC is unable to review the IPC in in the HHSC data system before the six-day review time frame ends;
- an error was made in in the HHSC data system related to a unit of service, the name of the SC (not a just minor misspelling) or a signature date;
- the SC was not notified by fax or email of an IPC revision for which an IPC meeting is not needed;
- the SC determined an IPC meeting was necessary for an IPC revision in accordance with Section 6432.4;
- the SC did not participate in the development of an IPC for which an IPC meeting is needed; or
- the IPC effective date is not in accordance with the requirements in Section 6323, Section 6421.1 or Section 6431.1, as appropriate.
6612 Service Coordinator's Agreement/Disagreement with IPC
Revision 22-2; Effective May 1, 2022
The SC must agree that the HCS services on the IPC are:
- not available through other resources, and do not replace existing and natural supports;
- necessary to assure the individual's health and safety and prevent institutionalization; and
- based on the outcomes in the individual's PDP.
6620 Service Coordinator Responsibilities
Revision 11-2; Effective March 1, 2011
6621 If the IPC is Returned to Provider
Revision 22-2; Effective May 1, 2022
If the SC returns the IPC to the provider, the SC enters a comment in the HHSC data system to explain the reason for returning the IPC. Additionally, the SC contacts the provider the same day that an IPC is returned and discusses with the provider how to resolve the issue.
6622 Service Coordinator's Agreement/Disagreement with IPC
Revision 22-2; Effective May 1, 2022
If the SC does not return the IPC in the HHSC data system to the provider, the SC completes the review by entering the agreement or disagreement in in the HHSC data system before the IPC proceeds to HHSC for authorization.
6622.1 Agreement with IPC
Revision 22-2; Effective May 1, 2022
The SC must agree with the IPC in the HHSC data system to move it forward for review.
6622.2 Disagreement with IPC
Revision 22-2; Effective May 1, 2022
If the SC does not agree with the requirements in Section 6612, Service Coordinator’s Agreement/Disagreement with IPC, the SC contacts the program provider to discuss concerns related to the HCS services in the IPC for which the SC is unable to agree.
If the SC's concerns are not resolved and the SC continues to disagree, the SC completes Form 8579, Notification of Service Coordinator Disagreement, and submits it to HHSC UR, and sends a copy to the program provider. The SC completes the form on the same day that the SC enters the disagreement in the HHSC data system.
6630 Provider Responsibilities
Revision 22-2; Effective May 1, 2022
The provider ensures that the SC has a hard copy of the IPC within three days after the provider enters the IPC data into the HHSC data system.
6631 Service Coordinator Returns IPC in the HHSC Data System
Revision 22-2; Effective May 1, 2022
If the SC returns an IPC to the provider in the HHSC data system, the SC notifies the provider that same day of the returned IPC. Additionally, the SC enters a comment in the HHSC data system to explain the reason for returning the IPC.
6632 Activity to Address a Returned IPC
Revision 22-2; Effective May 1, 2022
The IPC remains in "Returned to Provider" status until the provider takes some action in the HHSC data system to address the returned IPC. Depending on the reason the IPC was returned, the provider may take one of the following HHSC data system actions:
- delete and re-enter the IPC; or
- correct any errors.
Before taking HHSC data system action to send the IPC on to the SC for review again, the provider is responsible for resolving the issue that was the basis for the IPC being returned.