(a) An individual is eligible for DBMD Program services if:
(1) the individual meets the financial eligibility criteria as described in Appendix B of the DBMD Program waiver application approved by CMS and available on the HHSC website;
(2) the individual is determined by HHSC to meet the LOC VIII criteria described in §261.239 of this title (relating to ICF/MR Level of Care VIII Criteria);
(3) the individual, as documented on the ID/RC Assessment:
(4) the individual has an IPC with a cost for DBMD Program services at or below $114,736.07;
(5) the individual is not enrolled in another waiver program or receiving a service that may not be received if the individual is enrolled in the DBMD Program, as identified in the Mutually Exclusive Services table in Appendix V of the Deaf Blind with Multiple Disabilities Program Manual;
(6) the individual does not reside in:
(7) at least one program provider is willing to provide DBMD Program services to the individual;
(8) the individual resides or moves to reside in a county served by a program provider; and
(9) the individual requires the provision of:
(b) Except as provided in subsection (c) of this section, an individual is eligible for a CFC service under this chapter if the individual:
(1) meets the criteria described in subsection (a) of this section;
(2) requires the provision of the CFC service; and
(3) is not receiving licensed assisted living or licensed home health assisted living.
(c) To be eligible for a CFC service under this chapter, an individual receiving MAO Medicaid must, in addition to meeting the eligibility criteria described in subsection (b) of this section, receive a DBMD Program service at least monthly, as required by 42 CFR §441.510(d).
Source Note: The provisions of this §260.51 adopted to be effective February 26, 2023, 48 TexReg 896