6500, Transitioning to the HCS Program

Revision 22-1; Effective Nov. 28, 2022

HHSC may make available a targeted nursing facility (NF) HCS transition slot for a person who meets the criteria described in Section 6510, Criteria for Transitioning to the HCS Program, below.

6510 Criteria for Transitioning to the HCS Program

Revision 22-1; Effective Nov. 28, 2022

A person is eligible for a targeted NF HCS transition slot if:

  • the person has a PASRR Evaluation (PE) that was conducted when the person was admitted to the NF and the PE is positive for intellectual disability (ID) or developmental disability (DD);
  • it is after the 30th day of the person’s admission if the person was admitted to the NF for rehabilitative purposes;
  • the person is at least 21 years old;
  • the person currently lives in a NF; and
  • the person has expressed a desire to live in a community setting.

6520 Requesting a Targeted NF HCS Transition Slot

Revision 22-1; Effective Nov. 28, 2022

If a LIDDA determines that a person meets the criteria for a targeted NF HCS transition slot and the person or LAR wants to enroll in HCS, the  diversion coordinator requests a targeted NF HCS transition slot for the person by completing and submitting Form 1046, Request for HCS Adult NF Transition Slot, per the form’s instructions.

Upon receipt, HHSC staff reviews the completed Form 1046. HHSC staff may request additional information or documentation. If HHSC determines the person meets the criteria for the targeted NF HCS transition slot, HHSC will send a letter to the LIDDA authorizing the LIDDA to offer the person the opportunity to enroll in HCS. The LIDDA enrolls the person in the HCS program per the requirements in the HCS rules, LIDDA Handbook and Section 6530, Transitioning to the Community by Enrolling in HCS, below.

6530 Transitioning to the Community by Enrolling in HCS

Revision 23-1; Effective Dec. 20, 2023

For a person transitioning to the community by enrolling in the HCS program, the ECC coordinator:

  • facilitates trial visits to HCS program providers in the community for the person, including overnight or weekend visits where feasible, as requested by the person or LAR;
  • develops and revises, as necessary, Form 8665, Person-Directed Plan, using all available assessments, and to include the person’s:
    • strengths and preferences; and
    • medical, nursing, clinical, nutritional management and other support needs;
  • conducts a pre-move site review using Form 1042, Pre-Move Site Review, to:
    • ensure any concerns of the program provider, staff or family member are being addressed; and
    • determine whether all essential supports identified on Form 1053, Transition Plan, are in place before the person transitions; and
  • completes the following activities before the person transitions if, during the pre-move site review, any one of the essential supports is not in place or if issues are raised about the suitability of the site:
    • convenes the SPT to resolve the issues; and
    • conducts another pre-move site review following resolution.

When a person expresses the desire to transition from an NF to a home in another LIDDA’s service area, the sending LIDDA’s ECC coordinator must invite the receiving LIDDA to all transition planning meetings.

The sending and receiving LIDDAs must work together to ensure essential supports are in place prior to the person’s discharge from the NF. This includes scheduling the pre-move visit at a time when the receiving LIDDA’s ECC coordinator is available to be present.

The transfer of LIDDAs must not occur until all essential supports have been verified through a pre-move visit.

6540, Transition Day

Revision 23-1; Effective Dec. 20, 2023

The MCO SC and RS are expected to be present at the new address on transition day to ensure all services are in place and to assist in setting up the household, as needed. The ECC coordinator is encouraged to be present as well.