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

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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 Section 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	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.