8000, Transfers and Local Intellectual and Developmental Disability Authority (LIDDA) Reassignments

8100 Overview

Revision 22-2; Effective May 1, 2022

Section 8000 describes the requirements for:

transferring an individual's Home and Community-based Services (HCS) or Texas Home Living (TxHmL) program services from one program provider or Financial Management Services Agency (FMSA) to another;
transferring an individual's HCS or TxHmL program services to another waiver contract area whether or not the program provider changes;
changing an individual's HCS or TxHmL service delivery option to add or delete CDS; and
reassigning a Local Intellectual and Developmental Disability Authority (LIDDA) when an individual moves from one LIDDA's service area into another LIDDA's service area. Click here and scroll to the last page to see a list of LIDDAs by waiver contract area (WCA).

Texas Administrative Code Title 40, Chapter 9, Subchapter D, requires the service coordinator (SC) to manage the transfer process as stated in Section 9.190(e)(25) and (26).

8200 Requirement for Program Provider to Notify Service Coordinator (SC)

Revision 11-1; Effective January 20, 2011

8210 Transfers Must be Planned

Revision 22-2; Effective May 1, 2022

Texas Health and Human Services Commission (HHSC) requires an individual's transfer to be planned in order for the receiving provider to be knowledgeable about the individual's needs and to be prepared to deliver necessary services. Therefore, the transfer effective date must be a future date to allow for adequate planning. An exception to this requirement may be made when a transfer meets the criteria for an emergency (as described in Section 8230, Emergency Transfer). If an individual/LAR requests a transfer, the program provider or the SC must inform the individual/LAR or family that the transfer must be scheduled for a future date to ensure appropriate planning occurs.

If an individual or LAR informs their current program provider that the individual/LAR wants to transfer to another program provider or FMSA, or the individual’s current program provider receives information from another program provider or FMSA that the individual/LAR wants to transfer to another program provider or FMSA, the individual’s current program provider must, within 24 hours, notify the individual's SC or the LIDDA’s service coordination supervisor of the individual’s/LAR's desire for transfer.

If an individual or their LAR contacts a program provider and informs them of their desire to transfer to the program provider, the program provider must instruct the individual/LAR to notify his/her LIDDA or SC. The potential receiving provider must inform the individual/LAR that before the program provider can begin providing services to the individual, the SC must conduct a transfer individual plan of care (IPC) meeting and a transfer effective date must be agreed to by all parties involved in the transfer. The potential receiving program provider may not begin providing services until the transfer effective date. The potential program provider will not be reimbursed for services provided before the transfer effective date unless the situation meets the emergency transfer criteria described in Section 8230, Emergency Transfer.

8220 No Prior SC Notification

Revision 22-2; Effective May 1, 2022

If an SC is notified that an individual is already receiving services from a potential receiving program provider without going through the transfer process, the SC must document the date they were notified and the name of the person who provided notification. No more than three business days after receiving this notification, the SC must contact the individual/LAR to verify the individual requested a transfer and to confirm their choice of program provider.

If the individual/LAR says transferring was not their choice, the SC must confirm whether the individual want to remain with his or her previous program provider or select a different program provider.
If the individual/LAR says it was their decision to transfer, within five business days, the SC must conduct a transfer IPC meeting and inform the receiving program provider that the transfer effective date cannot be prior to the date of the transfer IPC meeting unless the situation meets the emergency transfer criteria described in Section 8230.

8230 Emergency Transfer

Revision 22-2; Effective May 1, 2022

40 Texas Administrative Code §9.153 defines emergency as follows:

Emergency – An unexpected situation in which the absence of an immediate response could reasonably be expected to result in risk to the health and safety of an individual or another person.
Emergency situation – An unexpected situation involving an individual's health, safety, or welfare, of which a person of ordinary prudence would determine that the LAR should be informed, such as:
1. an individual needing emergency medical care;
2. an individual being removed from his residence by law enforcement;
3. an individual leaving his residence without notifying a staff member or service provider and not being located; and
4. an individual being moved from his residence to protect the individual (for example, because of a hurricane, fire, or flood).

In an emergency, the individual must be transferred immediately; therefore, the transfer effective date will be prior to the transfer IPC meeting date.

If the SC is unaware that the individual is in an emergency situation that requires an emergency transfer, the receiving program provider must notify the SC as soon as the transfer has occurred to allow the SC to complete the transfer process.

In an emergency transfer, the transfer effective date is the date the individual began receiving services from the new program provider. The signature dates on the transfer IPC will be the date of the IPC meeting. This means the transfer effective date may be earlier than the IPC meeting dates and the IPC signature dates.

The SC must submit the transfer packet and documentation supporting the reason for the emergency transfer to HHSC Program Eligibility and Support (PES). HHSC PES determines whether the emergency transfer criteria is met based on the supporting documentation received from the SC.

If HHSC PES determines the documentation supports the emergency transfer criteria, the receiving provider may be reimbursed for services provided before the transfer IPC meeting.

8231 Data Entry of Emergency Transfer in the HHSC Data System

Revision 22-2; Effective May 1, 2022

For an emergency transfer, HHSC PES enters the transfer in the HHSC data system.

8300 Miscellaneous Information and Requirements

Revision 10-1; Effective September 27, 2010

8310 Simultaneous Transfer of Program Provider and FMSA

Revision 22-2; Effective May 1, 2022

If an individual/LAR wants to transfer to another program provider and to another FMSA, the SC, the LIDDA and the transferring and receiving program providers must follow the steps in 8600, FMSA Transfer and Changing Service Delivery Option, 8400, Program Provider Transfer Involving One Local Intellectual and Developmental Disability Authority (LIDDA), or 8500, Program Provider Transfer Involving Two Local Intellectual and Developmental Disability Authorities (LIDDAs), at the same time using one Form 3617 , Request for Transfer of Waiver Program Services.

8320 Form 3617 and Instructions

Revision 10-1; Effective September 27, 2010

Form 3617, Request for Transfer of Waiver Program Services, is used to document transfer information. The persons required to complete portions of this form must do so in accordance with the instructions.

8330 Reserved for Future Use

Revision 22-2; Effective May 1, 2022

8340 Verification of Guardianship

Revision 22-2; Effective May 1, 2022

To prevent a delay in the authorization of a transfer, the SC must determine whether an individual has a legal guardian and verify that guardianship information is correct in the HHSC data system.

If the individual has a current legal guardian listed in the HHSC data system, then all forms must be signed by the guardian.
If the individual does not have a legal guardian listed in the HHSC data system, then all forms must be signed by the individual.
If the guardian listed in the HHSC data system is not current, the SC should obtain signatures of both the individual and the person listed as guardian, until appropriate steps can be taken to update guardianship information.

8350 Transfer Process Checklist

Revision 10-1; Effective September 27, 2010

When completing transfer activities, the SC may use the Transfer Process Checklist (PDF).

8360 Contacting HHSC

Revision 22-2; Effective May 1, 2022

The LIDDA may, at any time during the transfer process, consult with HHSC PES if the LIDDA encounters problems completing the process.

The SC must consult with HHSC PES when a program provider does not submit required documentation within the time frames described in this section.

8400 Program Provider Transfer Involving One Local Intellectual and Developmental Disability Authority (LIDDA)

Revision 22-2; Effective May 1, 2022

Sections 8410 through 8470 describe the requirements for a program provider transfer involving one LIDDA.

8410 Confirming the Desire to Transfer

Revision 10-1; Effective September 27, 2010

Step	Service Coordinator Action
1	Within three days after receiving information that an individual/LAR wants to transfer to another program provider, the SC must contact the individual/LAR to: confirm the individual/LAR wants to transfer; and explain that the individual/LAR may transfer to the program provider of his/her choice.
2	If the SC confirms that the individual/LAR wants to transfer, the SC must: complete the individual's identifying information on Form 3617, Request for Transfer of Waiver Program Services, check the appropriate box for the type of transfer and obtain the signature of the individual/LAR, indicating the desire to transfer; determine if the individual/LAR has selected a receiving program provider; and notify the state support living center (SSLC) admissions placement coordinator that the individual wants to transfer, if the individual is on community placement from an SSLC and is being monitored in accordance with a community living discharge plan (CLDP).

Step

Service Coordinator Action

Within three days after receiving information that an individual/LAR wants to transfer to another program provider, the SC must contact the individual/LAR to:

confirm the individual/LAR wants to transfer; and
explain that the individual/LAR may transfer to the program provider of his/her choice.

If the SC confirms that the individual/LAR wants to transfer, the SC must:

complete the individual's identifying information on Form 3617, Request for Transfer of Waiver Program Services, check the appropriate box for the type of transfer and obtain the signature of the individual/LAR, indicating the desire to transfer;
determine if the individual/LAR has selected a receiving program provider; and
notify the state support living center (SSLC) admissions placement coordinator that the individual wants to transfer, if the individual is on community placement from an SSLC and is being monitored in accordance with a community living discharge plan (CLDP).

8420 Selecting a Receiving Program Provider

Revision 10-1; Effective September 27, 2010

Step	Service Coordinator Action
1	The SC must inform the individual/LAR that they have a choice of program providers, even if the individual/LAR has already selected a receiving program provider.
2	If the individual/LAR has not selected a receiving program provider, the SC must give the individual/LAR a list of program providers and contact information in the geographic locations preferred by the individual/LAR within five days after the date the SC confirms the individual/LAR wants to transfer.
3	After the individual/LAR has selected a receiving program provider, the SC must document the individual/LAR's choice of a receiving program provider in Section II on Form 3617.

8430 Ensuring Agreement on Transfer Effective Date

Revision 22-2; Effective May 1, 2022

Step	Service Coordinator Action
1	At the time the individual/LAR selects a receiving program provider, the SC must obtain a proposed transfer effective date from the individual/LAR.
2	The SC must contact the receiving program provider to determine if the date proposed by the individual/LAR is acceptable.
3	Once the receiving program provider and individual/LAR agree on a transfer effective date, the SC must contact the transferring program provider to determine if that date is agreeable to the transferring program provider. If the date is agreeable, the SC completes the steps in 8440, Completing Form 3617.
4	If the date is not agreeable, the SC must facilitate communication between the individual/LAR and the transferring and receiving program providers to reach a mutually agreeable transfer effective date.
5	If a transfer effective date is not agreed upon within five days after the date the individual/LAR selects a receiving program provider, the SC must consult HHSC PES for direction.

Step	Receiving Program Provider Action
1	When contacted by the SC, the receiving program provider must comply with the SC's request for a transfer effective date.
2	If the proposed transfer effective date is not acceptable to the receiving program provider, the provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and transferring program provider.

Step	Transferring Program Provider Action
1	When contacted by the SC, the transferring program provider must comply with the SC's request for a transfer effective date.
2	If the proposed transfer effective date is not acceptable to the transferring program provider, the provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and receiving program provider.

8440 Completing Form 3617

Revision 11-1; Effective January 20, 2011

Step	Service Coordinator Action
1	The SC must enter the mutually agreed upon transfer effective date in Section I, Transferring Program Provider's Information, and Section II, Receiving Program Provider's Information, of Form 3617.
2	The SC must send Form 3617 to the transferring program provider and request that the provider complete Section I and return it to the SC within three business days.
3	After receiving a completed copy of Form 3617 from the transferring program provider, the SC must send the same Form 3617 to the receiving program provider and request that the provider complete Section II and return it to the SC within three business days.
4	The SC must ensure all signatures are on the same copy of Form 3617. The SC must sign Form 3617 after both program providers have completed their sections.

Step	Transferring Program Provider Action
1	The transferring program provider must accurately complete Section I of Form 3617 in accordance with the form's instructions and sign and date the form indicating agreement with the information in Section I.
2	The transferring program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.

Step	Receiving Program Provider Action
1	The receiving program provider must accurately complete Section II of Form 3617 in accordance with the form's instructions and sign and date the form indicating agreement with the information in Section II.
2	The receiving program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.

8450 Developing the Transfer IPC

Revision 22-2; Effective May 1, 2022

Step	Service Coordinator Action
1	On or before the transfer effective date, the SC must meet with the individual/LAR and the receiving program provider to review the individual's current IPC and develop a transfer IPC. This should be a face-to-face meeting, if feasible.
2	The SC must ensure that the transfer IPC includes services already provided by the transferring program provider, and services to be provided by the transferring program provider before the transfer effective date. This information can be found in: the HHSC data system; and Column 3 of the completed Form 3617 (services provided but not yet billed, and services not yet provided). The SC must also ensure that the transfer IPC includes services to be provided by the receiving program provider.
3	The SC must ensure the transfer IPC: complies with the requirements described in §9.159(c); and is signed and dated by the individual/LAR, receiving program provider, and SC.
4	At the transfer IPC meeting, the SC ensures the receiving program provider completes Section II of Form 3617 and returns it to the SC.

Step	Receiving Program Provider Action
1	The receiving program provider must meet with the individual/LAR and SC to develop and sign a transfer IPC, as requested by the SC.
2	The receiving program provider must complete Section II of Form 3617 and return it to the SC.

8460 Sharing Documents

Revision 22-2; Effective May 1, 2022

Step	Service Coordinator Action
1	The SC must submit current copies of the following documents to the receiving program provider before the transfer effective date: IPC ID/RC assessment person-directed plan (PDP)
2	Before the transfer effective date, the SC must request from the transferring program provider the current (or the most recent) copies of the following documents for the individual: pertinent medication records and/or medical information, including: a list of medications scheduled medical appointments list of medical professionals skilled nursing routines therapy evaluations major illnesses/injuries, surgeries or hospitalizations in the past year drug allergies lab results, including blood sugars adaptive equipment current medication administration records and immunization records records of current weight and vital signs Medicaid card Medicare information, if applicable Inventory for Client and Agency Planning (ICAP) booklet and summary sheet trust fund/financial records and any money due the individual behavior support plan, if applicable guardianship information, if applicable any other pertinent information to ensure health and safety or continuity of services.
3	The SC must submit the documents listed in Step 2 to the receiving program provider within two days after receiving them from the transferring program provider. If the SC does not receive all documents from the transferring program provider within three days after requesting them, the SC must notify HHSC PES.

Step

Service Coordinator Action

The SC must submit current copies of the following documents to the receiving program provider before the transfer effective date:

IPC
ID/RC assessment
person-directed plan (PDP)

Before the transfer effective date, the SC must request from the transferring program provider the current (or the most recent) copies of the following documents for the individual:

pertinent medication records and/or medical information, including:
- a list of medications
- scheduled medical appointments
- list of medical professionals
- skilled nursing routines
- therapy evaluations
- major illnesses/injuries, surgeries or hospitalizations in the past year
- drug allergies
- lab results, including blood sugars
- adaptive equipment
- current medication administration records and immunization records
- records of current weight and vital signs
Medicaid card
Medicare information, if applicable
Inventory for Client and Agency Planning (ICAP) booklet and summary sheet
trust fund/financial records and any money due the individual
behavior support plan, if applicable
guardianship information, if applicable
any other pertinent information to ensure health and safety or continuity of services.

The SC must submit the documents listed in Step 2 to the receiving program provider within two days after receiving them from the transferring program provider. If the SC does not receive all documents from the transferring program provider within three days after requesting them, the SC must notify HHSC PES.

Step	Transferring Program Provider Action
1	The transferring program provider must submit copies of the documents listed in Step 2 to the SC within three days after the SC's request.

8470 Completing Data Entry in the HHSC Data System and Submitting Documents to HHSC

Revision 22-2; Effective May 1, 2022

Step	LIDDA Action
1	Within 10 days after the transfer effective date, the LIDDA must complete all data entry to finalize a transfer. For an emergency transfer, HHSC PES enters the transfer data in HHSC data system.
2	If the individual is transferring to a three-person or four-person residence or host home/companion care setting and the receiving program provider does not have access to the HHSC data system to set up a location, the LIDDA should refer the receiving program provider to contact HHSC PES for assistance.
3	After the LIDDA has completed the data entry described in Step 1, but within 10 days after the transfer effective date, the SC must submit the completed transfer IPC and Form 3617 to HHSC PES through the IDD Operations Portal.

Step	Receiving Program Provider Action
1	If the individual is transferring to a group home or host home/companion care setting, the receiving program provider must assign a location code for the individual's residence and set up the location in the HHSC data system. If the individual will be assigned to a location that has already been set up, the program provider must ensure that the status of the location is "open" and will not exceed the capacity for that residence. If the receiving program provider does not have access to the HHSC data system, the program provider should contact HHSC PES for assistance.
2	The receiving program provider must assign a local case number for its component code for the individual for data entry by the LIDDA. If the individual already has a local case number with the program provider's component code, use the existing local case number. Do not create a new local case number.

Step

Receiving Program Provider Action

If the individual is transferring to a group home or host home/companion care setting, the receiving program provider must assign a location code for the individual's residence and set up the location in the HHSC data system. If the individual will be assigned to a location that has already been set up, the program provider must ensure that the status of the location is "open" and will not exceed the capacity for that residence. If the receiving program provider does not have access to the HHSC data system, the program provider should contact HHSC PES for assistance.

The receiving program provider must assign a local case number for its component code for the individual for data entry by the LIDDA. If the individual already has a local case number with the program provider's component code, use the existing local case number. Do not create a new local case number.

8500 Program Provider Transfer Involving Two Local Intellectual and Developmental Disability Authorities (LIDDAs)

Revision 22-2; Effective May 1, 2022

Sections 8510 through 8570 describe the requirements for a program provider transfer involving two LIDDAs. The SC for the transferring LIDDA and the SC for the receiving LIDDA must both be involved to coordinate the individual's transfer.

8510 Confirming the Desire to Transfer

Revision 22-2; Effective May 1, 2022

Step	Transferring Service Coordinator Action
1	If the individual has not already relocated to the receiving LIDDA’s local service area, the transferring SC must: complete the steps in Section 8410, Confirming the Desire to Transfer; contact the receiving LIDDA to identify the receiving SC; and submit an Individual Movement (IMT) form/LA reassignment form in the HHSC data system.

Step

Transferring Service Coordinator Action

If the individual has not already relocated to the receiving LIDDA’s local service area, the transferring SC must:

complete the steps in Section 8410, Confirming the Desire to Transfer;
contact the receiving LIDDA to identify the receiving SC; and
submit an Individual Movement (IMT) form/LA reassignment form in the HHSC data system.

Step	Receiving LIDDA/SC Action
1	The receiving LIDDA must assign an SC to the individual.
2	If the individual has already relocated to the receiving LIDDA’s local service area, the receiving SC must complete the steps in Section 8410.
3	The receiving LIDDA must acknowledge the IMT/LA reassignment form in the HHSC data system.

8520 Selecting a Receiving Program Provider

Revision 22-2; Effective May 1, 2022

Step	Transferring Service Coordinator Action
1	If the individual has not already relocated to the receiving LIDDA's local service area, the transferring SC must complete the steps in Section 8420, Selecting a Receiving Program Provider.

Step	Receiving SC Action
1	If the individual has already relocated to the receiving LIDDA's local service area, the receiving SC must complete the steps in Section 8420.

8530 Ensuring Agreement on Transfer Effective Date

Revision 22-2; Effective May 1, 2022

Step	Transferring Service Coordinator Action
1	If the individual has not already relocated to the receiving LIDDA's local service area, the transferring SC must complete the steps in Section 8430, Ensuring Agreement on Transfer Effective Date.

Step	Receiving SC Action
1	If the individual has already relocated to the receiving LIDDA's local service area, the receiving SC must complete the steps in Section 8430.

Step	Receiving Program Provider Action
1	The receiving program provider must complete the steps in Section 8430.

Step	Transferring Program Provider Action
1	The transferring program provider must complete the steps in Section 8430.

8540 Completing Form 3617

Revision 22-2; Effective May 1, 2022

Step	Transferring Service Coordinator Action
1	If the individual has not already relocated to the receiving LIDDA's local service area, the transferring SC must complete the steps in Section 8440, Completing Form 3617.

Step	Receiving SC Action
1	If the individual has already relocated to the receiving LIDDA's local service area, the receiving SC must complete the steps in Section 8440.

8550 Developing the Transfer IPC

Revision 22-2; Effective May 1, 2022

Step	Transferring Service Coordinator Action
1	If the individual has not already relocated to the receiving LIDDA's local service area, on or before the transfer effective date, the transferring SC must complete the steps in Section 8450, Developing the Transfer IPC.

Step	Receiving SC Action
1	If the individual has already relocated to the receiving LIDDA's local service area, on or before the transfer effective date, the receiving SC must complete the steps in Section 8450.
2	The receiving SC must email fax the following documents to the transferring SC for data entry: the completed and signed transfer IPC; and the completed and signed Form 3617, Request for Transfer of Waiver Program Services.

Step

Receiving SC Action

If the individual has already relocated to the receiving LIDDA's local service area, on or before the transfer effective date, the receiving SC must complete the steps in Section 8450.

The receiving SC must email fax the following documents to the transferring SC for data entry:

the completed and signed transfer IPC; and
the completed and signed Form 3617, Request for Transfer of Waiver Program Services.

Step	Receiving Program Provider Action
1	The receiving program provider must complete the steps in Section 8450.

8560 Sharing Documents

Revision 22-2; Effective May 1, 2022

Step	Transferring Service Coordinator Action
1	The transferring SC must submit current copies of the following documents to the receiving SC before the transfer effective date and submission of the IMT form in the HHSC data system: IPC ID/RC assessment PDP
2	Before the transfer effective date, the transferring SC must request from the transferring program provider the current (or the most recent) copies of the following documents for the individual: pertinent medication records and/or medical information, including: a list of medications scheduled medical appointments list of medical professionals skilled nursing routines therapy evaluations major illnesses/injuries, surgeries or hospitalizations in the past year drug allergies lab results, including blood sugars adaptive equipment current medication administration records and immunization records records of current weight and vital signs Medicaid card Medicare information, if applicable ICAP booklet and summary sheet trust fund/financial records and any money due the individual behavior support plan, if applicable guardianship information, if applicable any other pertinent information to ensure health and safety or continuity of services.
3	The transferring SC must submit the documents listed in Step 2 to the receiving SC within two days after receiving them from the transferring program provider. If the SC does not receive all documents from the transferring program provider within three days after requesting them, the SC must notify HHSC PES.

Step

Transferring Service Coordinator Action

The transferring SC must submit current copies of the following documents to the receiving SC before the transfer effective date and submission of the IMT form in the HHSC data system:

IPC
ID/RC assessment
PDP

Before the transfer effective date, the transferring SC must request from the transferring program provider the current (or the most recent) copies of the following documents for the individual:

pertinent medication records and/or medical information, including:
- a list of medications
- scheduled medical appointments
- list of medical professionals
- skilled nursing routines
- therapy evaluations
- major illnesses/injuries, surgeries or hospitalizations in the past year
- drug allergies
- lab results, including blood sugars
- adaptive equipment
- current medication administration records and immunization records
- records of current weight and vital signs
Medicaid card
Medicare information, if applicable
ICAP booklet and summary sheet
trust fund/financial records and any money due the individual
behavior support plan, if applicable
guardianship information, if applicable
any other pertinent information to ensure health and safety or continuity of services.

The transferring SC must submit the documents listed in Step 2 to the receiving SC within two days after receiving them from the transferring program provider. If the SC does not receive all documents from the transferring program provider within three days after requesting them, the SC must notify HHSC PES.

Step	Receiving SC Action
1	The receiving SC must submit to the receiving program provider the documents received from the transferring SC within two days after receiving them from the transferring SC.

Step	Transferring Program Provider Action
1	The transferring program provider must submit copies of the documents listed in Step 2 to the SC within three days after the SC's request.

8570 Completing Data Entry in the HHSC Data System and Faxing Documents to HHSC

Revision 22-2; Effective May 1, 2022

Step	Receiving LIDDA/Service Coordinator (SC) Action
1	Within 10 days after the transfer effective date, the receiving LIDDA must complete all data entry to finalize a transfer. For an emergency transfer, the LIDDA must send the transfer documents to HHSC PES. HHSC PES enters the emergency transfer in the HHSC data system.
2	If the individual is transferring to a three- or four-person residence or a host home/companion care setting and the receiving program provider does not have access to the HHSC data system to set up a location, the receiving LIDDA must contact HHSC PES for assistance.
3	Within a day after the data is entered in the HHSC data system, the receiving SC must submit the transfer IPC and Form 3617 to HHSC PES.

Step	Receiving Program Provider Action
1	The receiving program provider must complete the steps in Section 8470, Completing Data Entry in the HHSC Data System and Submitting Documents to HHSC.

8600 FMSA Transfer and Changing Service Delivery Option

Revision 22-2; Effective May 1, 2022

Sections 8610 through 8660 describe the requirements for transferring to another FMSA and changing service delivery options.

8610 Confirming the Desire to Transfer or Change Service Delivery Option

Revision 22-2; Effective May 1, 2022

Service Coordinator Action

Step	Action
1	Within three days after receiving information that an individual/LAR wants to transfer to another FMSA or change their service delivery option, the SC must contact the individual/LAR to: confirm the individual/LAR wants to transfer or change their service delivery option; and explain that the individual/LAR may choose any FMSA or receiving program provider, as appropriate.
2	If the SC confirms that the individual/LAR wants to transfer or change their service delivery option, the SC must: complete the individual's identifying information on Form 3617, Request for Transfer of Waiver Program Services, check the appropriate box for the type of transfer using the form instructions, and obtain the signature of the individual/LAR, indicating the desire to transfer or change the service delivery option; and determine if the individual/LAR has selected a receiving FMSA/program provider, as appropriate.

Step

Action

Within three days after receiving information that an individual/LAR wants to transfer to another FMSA or change their service delivery option, the SC must contact the individual/LAR to:

confirm the individual/LAR wants to transfer or change their service delivery option; and
explain that the individual/LAR may choose any FMSA or receiving program provider, as appropriate.

If the SC confirms that the individual/LAR wants to transfer or change their service delivery option, the SC must:

complete the individual's identifying information on Form 3617, Request for Transfer of Waiver Program Services, check the appropriate box for the type of transfer using the form instructions, and obtain the signature of the individual/LAR, indicating the desire to transfer or change the service delivery option; and
determine if the individual/LAR has selected a receiving FMSA/program provider, as appropriate.

8620 Selecting a Receiving FMSA or Receiving Program Provider

Revision 22-2; Effective May 1, 2022

Service Coordinator Action

Step	Action
1	The SC must inform the individual/LAR that they have a choice of FMSAs/program providers, even if the individual/LAR has already selected a receiving FMSA/program provider.
2	If the individual/LAR has not selected a receiving FMSA/program provider, the SC must give the individual/LAR a list of FMSAs/program providers, and contact information in the geographic locations preferred by the individual/LAR within five days after the date the SC confirms the individual/LAR wants to transfer or change their service delivery option.
3	After the individual/LAR has selected a receiving FMSA/program provider, the SC must document the individual/LAR's choice of a receiving FMSA/program provider in Section II/Section IV on Form 3617.

8630 Ensuring Agreement on Transfer Effective Date

Revision 22-2; Effective May 1, 2022

Service Coordinator Action

Step	Action
1	At the time the individual/LAR selects a receiving FMSA/program provider, the SC must obtain a proposed transfer effective date from the individual/LAR. (For a change of service delivery option, the transfer effective date is also the date the change of service delivery option would become effective.)
2	The SC must contact the receiving FMSA/program provider to determine if the date proposed by the individual/LAR is acceptable.
3	Once the receiving FMSA/program provider and individual/LAR agree on a transfer effective date, the SC must contact the transferring FMSA/program provider to determine if that date is agreeable to the transferring FMSA/program provider. If the date is agreeable, the SC completes the steps in 8640, Completing Form 3617.
4	If the date is not agreeable, the SC must facilitate communication between the individual/LAR and all involved FMSAs/program providers to reach a mutually agreeable transfer effective date.
5	If a transfer effective date is not agreed upon within five days after the date the individual/LAR selects a receiving FMSA/program provider, the SC must consult HHSC PES for direction.

Receiving FMSA or Program Provider Action

Step	Action
1	When contacted by the SC, the receiving FMSA/program provider must comply with the SC's request for a transfer effective date. (For a change of service delivery option, the transfer effective date is also the date the change of service delivery option would become effective.)
2	If the proposed transfer effective date is not acceptable to the receiving FMSA/program provider, the FMSA/program provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and transferring FMSA/program provider.

Transferring FMSA or Program Provider Action

Step	Action
1	When contacted by the SC, the transferring FMSA/program provider must comply with the SC's request for a transfer effective date. (For a change of service delivery option, the transfer effective date is also the date the change of service delivery option would become effective.)
2	If the proposed transfer effective date is not acceptable to the transferring FMSA/program provider, the FMSA/program provider must have a valid reason for not accepting the date, and must suggest an alternate date to be discussed with the individual/LAR and receiving FMSA/program provider.

8640 Completing Form 3617

Revision 22-2; Effective May 1, 2022

Service Coordinator Action

Step	Action
1	The SC must enter the mutually agreed upon transfer effective date in the appropriate sections on Form 3617 as follows: Section I, Transferring Program Provider's Information; Section II, Receiving Program Provider's Information; Section III, Transferring FMSA's Information; and Section IV, Receiving FMSA's Information.
2	Depending on the FMSAs/program providers involved, the SC must ensure the appropriate sections of Form 3617 are completed in the following order: Section I, Transferring Program Provider's Information; Section III, Transferring FMSA's Information; Section II, Receiving Program Provider's Information; and Section IV, Receiving FMSA's Information. The SC is responsible for faxing Form 3617 to the involved FMSA/program provider in the above order and to request that the FMSA/program provider complete its section of the form and return it to the SC within three business days.
3	The SC must ensure all signatures are on the same copy of Form 3617. The SC must sign Form 3617 after the involved FMSAs/program providers have completed their sections.

Step

Action

The SC must enter the mutually agreed upon transfer effective date in the appropriate sections on Form 3617 as follows:

Section I, Transferring Program Provider's Information;
Section II, Receiving Program Provider's Information;
Section III, Transferring FMSA's Information; and
Section IV, Receiving FMSA's Information.

Depending on the FMSAs/program providers involved, the SC must ensure the appropriate sections of Form 3617 are completed in the following order:

Section I, Transferring Program Provider's Information;
Section III, Transferring FMSA's Information;
Section II, Receiving Program Provider's Information; and
Section IV, Receiving FMSA's Information.

The SC is responsible for faxing Form 3617 to the involved FMSA/program provider in the above order and to request that the FMSA/program provider complete its section of the form and return it to the SC within three business days.

The SC must ensure all signatures are on the same copy of Form 3617. The SC must sign Form 3617 after the involved FMSAs/program providers have completed their sections.

Transferring FMSA or Program Provider Action

Step	Action
1	The transferring FMSA/program provider must accurately complete Section I/Section III of Form 3617, in accordance with the form's instructions, and sign and date the form, indicating agreement with the information in Section I/Section III.
2	The transferring FMSA/program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.

Receiving FMSA or Program Provider Action

Step	Action
1	The receiving FMSA/program provider must accurately complete Section II/Section IV of Form 3617, in accordance with the form's instructions, and sign and date the form, indicating agreement with the information in Section II/Section IV.
2	The receiving FMSA/program provider must return the completed and signed Form 3617 to the SC within three business days after receiving it from the SC.

8650 Developing the Transfer IPC

Revision 22-2; Effective May 1, 2022

Service Coordinator Action

Step	Action
1	On or before the transfer effective date, the SC must meet with the CDS employer (individual/LAR) and the receiving program provider, if applicable, to review the individual's current IPC and develop a transfer IPC. This must be a face-to-face meeting, if feasible.
2	The SC must ensure that the transfer IPC includes services already provided by the transferring FMSA/program provider, as well as those to be provided by the transferring FMSA/program provider before the transfer effective date. This information can be found in: the HHSC data system; and Column 3 of the completed Form 3617 (services provided but not yet billed and services not yet provided). The SC must also ensure that the transfer IPC includes services to be provided beginning on the day of the transfer effective date.
3	The SC must ensure the transfer IPC: complies with the requirements described in Section 9.159(c); and is signed and dated by the individual/LAR, receiving FMSA/program provider and SC.

Step

Action

On or before the transfer effective date, the SC must meet with the CDS employer (individual/LAR) and the receiving program provider, if applicable, to review the individual's current IPC and develop a transfer IPC. This must be a face-to-face meeting, if feasible.

The SC must ensure that the transfer IPC includes services already provided by the transferring FMSA/program provider, as well as those to be provided by the transferring FMSA/program provider before the transfer effective date. This information can be found in:

the HHSC data system; and
Column 3 of the completed Form 3617 (services provided but not yet billed and services not yet provided).

The SC must also ensure that the transfer IPC includes services to be provided beginning on the day of the transfer effective date.

The SC must ensure the transfer IPC:

complies with the requirements described in Section 9.159(c); and
is signed and dated by the individual/LAR, receiving FMSA/program provider and SC.

Receiving Program Provider Action

Step	Action
1	The receiving program provider must meet with the CDS employer and SC to develop and sign a transfer IPC, as requested by the SC.

Receiving FMSA Action

Step	Action
1	The receiving FMSA must sign a transfer IPC, as requested by the SC.

8660 Completing Data Entry in the HHSC Data System and Submitting Documents to HHSC

Revision 22-2; Effective May 1, 2022

LIDDA Action

Step	Action
1	Within 10 days after the transfer effective date, the LIDDA must complete all data entry to finalize a transfer.
2	Following data entry, but within 10 days after the transfer effective date, the SC must submit the completed transfer IPC and Form 3617 to HHSC PES.

Receiving FMSA or Program Provider Action

Step	Action
1	The receiving FMSA/program provider must assign a local case number for its component code for the individual for data entry by the LIDDA. If the individual already has a local case number with the FMSA’s/program provider's component code, use the existing local case number. Do not create a new local case number.

8700 Notification by HHSC Program Eligibility and Support (PES)

Revision 22-2; Effective May 1, 2022

HHSC PES reviews the completed Form 3617, Request for Transfer of Waiver Program Services, and the transfer IPC to determine if a transfer is authorized. A transfer under Section 8000 is not effective unless authorized by HHSC.

8800 Local Intellectual and Developmental Disability Authority (LIDDA) Reassignment

Revision 22-2; Effective May 1, 2022

Step	Transferring LIDDA Action
1	If an individual moves to a different LIDDA’s service area without changing program provider within a waiver contract area, the transferring LIDDA must: notify the receiving LIDDA of the move by completing Form 8575, Notification of Local Authority (LA) Reassignment; enter the data from the form into the HHSC data system; submit an Individual Movement (IMT) form/LA reassignment form in the HHSC data system; and notify the state supported living center (SSLC) admissions placement coordinator that the individual has moved to a different LIDDA’s service area, if the individual is on community placement from an SSLC and is being monitored in accordance with a community living discharge plan (CLDP). Click here and scroll to the last page to see a list of LIDDAs by waiver contract area (WCA).
2	After the transferring LIDDA has entered the data, the transferring LIDDA must send Form 8575 to the receiving LIDDA.
3	Within three days after the transferring LIDDA sends Form 8575 to the receiving LIDDA, the transferring SC must submit to the receiving SC a copy of the individual's: current PDP (if developed because of recent enrollment or IPC renewal); current ID/RC assessment; current IPC; current guardianship documents, if applicable; and address and other contact information of the individual's LAR or actively involved family member.

Step

Transferring LIDDA Action

If an individual moves to a different LIDDA’s service area without changing program provider within a waiver contract area*, the transferring LIDDA must:

notify the receiving LIDDA of the move by completing Form 8575, Notification of Local Authority (LA) Reassignment;
enter the data from the form into the HHSC data system;
submit an Individual Movement (IMT) form/LA reassignment form in the HHSC data system; and
notify the state supported living center (SSLC) admissions placement coordinator that the individual has moved to a different LIDDA’s service area, if the individual is on community placement from an SSLC and is being monitored in accordance with a community living discharge plan (CLDP).

* Click here and scroll to the last page to see a list of LIDDAs by waiver contract area (WCA).

After the transferring LIDDA has entered the data, the transferring LIDDA must send Form 8575 to the receiving LIDDA.

Within three days after the transferring LIDDA sends Form 8575 to the receiving LIDDA, the transferring SC must submit to the receiving SC a copy of the individual's:

current PDP (if developed because of recent enrollment or IPC renewal);
current ID/RC assessment;
current IPC;
current guardianship documents, if applicable; and
address and other contact information of the individual's LAR or actively involved family member.

Step	Receiving LIDDA Action
1	Within five days after receiving Form 8575 from the transferring LIDDA, as described in Step 2 above, the receiving LIDDA must: complete its portion of the form; acknowledge the IMT/LA reassignment form in the HHSC data system; and enter that data of the form in the HHSC data system.
2	Within five days after receiving Form 8575 from the transferring LIDDA, as described in Step 2 above, the receiving LIDDA must assign an SC to the individual transferring to the LIDDA’s local service area.

Step

Receiving LIDDA Action

Within five days after receiving Form 8575 from the transferring LIDDA, as described in Step 2 above, the receiving LIDDA must:

complete its portion of the form;
acknowledge the IMT/LA reassignment form in the HHSC data system; and
enter that data of the form in the HHSC data system.

Within five days after receiving Form 8575 from the transferring LIDDA, as described in Step 2 above, the receiving LIDDA must assign an SC to the individual transferring to the LIDDA’s local service area.

Contact Information

Questions regarding these requirements may be directed to the HHSC Program Eligibility and Support general email box at: enrollmenttransferdischargeinfo@hhs.texas.gov or the HHSC Program Eligibility and Support general phone message line at 512-438-2484.

Texas Home Living (TxHmL) and Home and Community-based Services (HCS) reference material are available online at: