4710 Description

Revision 25-3; Effective June 1, 2025

Residential care (RC) services include RC and emergency care (EC).

Residential Care

• Contracted facilities serve eligible adults who require round-the-clock access to services. In RC services, the person must contribute to the cost of care, including a room and board payment and a copayment, if applicable.
• Review 4721, Residential Care Eligibility, for details about eligibility for RC.
• Review 4730, Special Casework Procedures for Residential Care, for special casework procedures for RC.

Emergency Care

• EC is available to eligible people for up to 30 days while the caseworker seeks permanent care arrangements. EC may be provided in adult foster care (AFC) homes and in RC facilities. If a person is not placed in a permanent care arrangement within the initial 30-day period, they are eligible to receive services for one 30-day extension for a total of up to 60 days.
• Review 4722, Emergency Care Eligibility, for details about eligibility for EC.
• Review 4770, Ongoing Casework Procedures, for special casework procedures for EC.

4711 Required Services

Revision 25-3; Effective June 1, 2025

Refer to 26 Texas Administrative Code Section 276.41(b), Required services.

A person in a residential care (RC) facility has access to services on an as-needed basis. Therefore, the frequency of a task is not designated.

4720 Eligibility for Service

Revision 17-1; Effective March 15, 2017

4721 Residential Care Eligibility

Revision 26-2; Effective June 1, 2026

Eligibility for residential care is based on the following criteria:

• A person must be income eligible or Medicaid eligible and not in an institution.
• The person must meet the functional need criteria as set by HHSC.
• The person’s needs may not exceed the facility’s capability under its licensed authority.
• The person must have financial resources at or below the level established by HHSC.
• The person must contribute to the total cost of care they receive, including payment for room and board.
• The room and board amount is calculated from the person’s gross income.
• The person is responsible for paying this amount directly to the provider agency.
• The person may be required to pay a copayment based on the amount of income remaining after all allowances are deducted. 

A person must score at least 18 on Form 2060, Needs Assessment Questionnaire, Task and Hour Guide, and have adequate income to pay the required room and board payment to become or remain eligible for Residential Care (RC). For other eligibility requirements, review:

• Age Limits, 3111;
• Resource Eligibility Criteria, 3200;
• Income Eligibility, 3300; and
• Residential Care and Emergency Care Mental and Physical Characteristics, Appendix VIII.

Related Policy

26 Texas Administrative Code Section 271.85

4722 Emergency Care Eligibility

Revision 25-5; Effective Dec. 1, 2025

Refer to 26 Texas Administrative Code Section 271.87, Eligibility for emergency care criteria.

4730 Special Casework Procedures for Residential Care

Revision 17-1; Effective March 15, 2017

4731 Assessment

Revision 25-5; Effective Dec. 1, 2025

If a person requests RC services, determine if services are open and space is available in an RC facility. If services are not open at that time, place the person on the interest list. If funding and RC spaces are available or if the person is released from the interest list, proceed with the eligibility determination and assessment.

Advise the person of spaces available in the RC facilities in their area and recommend the person visit the facilities. If the person selects a facility and wants to move to the facility, continue with eligibility determination.

To assess if an applicant qualifies for RC, interview the applicant to determine:

• if they meet the Community Care Services Eligibility (CCSE) income and resource limits;
• if they have adequate income to pay the required room and board payment;
• the extent of the applicant's functional disability by scoring their response to Form 2060, Needs Assessment Questionnaire, Task and Hour Guide;
• the applicant's appropriateness using the guidelines for appropriate and inappropriate mental and physical characteristics in Appendix VIII, Residential Care and Emergency Care Mental and Physical Characteristics; and
• if their needs can be adequately met at an RC facility.

A person is inappropriate for placement if their needs exceed the facility's capability under its licensed authority. Licensing Standards for Assisted Living Facilities are in 26 Texas Administrative Code Section 553.259. In general, an RC facility may provide services to a person whose needs correspond with those listed in the Appropriate Characteristics column of the mental and physical characteristics in Appendix VIII. The facility may not be capable of providing services to a person whose needs correspond with those listed in the Inappropriate Characteristics column. Because each person's case must be reviewed per the setting where care will be provided, the appropriate and inappropriate characteristics are only examples.

An assessment of a person being considered for RC should include a review of their personal abilities to perform activities of daily living, measured by Form 2060, Needs Assessment Questionnaire, Task and Hour Guide, and other functional areas, such as the need:

• for the routine daily care offered in a group-care setting;
• for a structured environment and the ability to tolerate it;
• and ability to interact with groups and to socialize daily;
• for a home or for one different from their current living environment; and
• for and ability to tolerate daily monitoring or supervision for behavior control or both.

By carefully assessing people in relation to the environment of RC facilities, the caseworker can develop care plans that make maximum use of the facilities' benefits.

Share findings with facility staff to determine if the person is a suitable candidate for RC and to facilitate a smooth transition.

Discuss money management with the person during the assessment. If the person expresses an interest in money management, inform the facility on Form 2067, Case Information, or in the comments section of Form 2101, Authorization for Community Care Services. Per 26 TAC  Section 276.61, Trust Fund Management, the facility must help the person manage their finances only if the person requests help in writing. The facility is not allowed to help a person write checks without first establishing a trust fund account for them.

4732 Freedom of Choice

Revision 25-3; Effective June 1, 2025

The applicant maintains freedom of choice among the facilities that serve their area.

The applicant can:

• select the facility; or
• choose to take the next facility on the rotation list.

The applicant must indicate their choice of available facilities before beginning the assessment process. If an applicant already has a facility in mind that has no space available, they may elect to remain on the interest list until a space is available in that facility.

4733 Referral

Revision 25-3; Effective June 1, 2025

Negotiate a move in date with the person and the facility once the applicant has:

• met all eligibility requirements;
• selected a facility; and
• been determined appropriate for placement in residential care (RC).

Refer to 26 Texas Administrative Code Section 276.39, Service Initiation.

To refer the applicant to the facility:

• complete Form 2059, Summary of Client's Need for Service, and Form 2101, Authorization for Community Care Services; and
• send these forms to the facility administrator.

If the applicant needs help managing their money, inform the facility:

• on Form 2067, Case Information; or
• in the comments section of Form 2101.

4733.1 Delay of Entry into the Facility

Revision 25-3; Effective June 1, 2025

If the person changes their mind, or for another reason does not move into the facility on the negotiated date, inform them that  they have three days from the negotiated date to enter the facility. If they do not move into the facility within those three days, the facility may give the bed space to another person, the referral for services may be withdrawn, and their request for services will be denied. If there are extenuating circumstances and the facility is willing to renegotiate a move in date, the date may be changed.

4733.2 Termination

Revision 25-3; Effective June 1, 2025

If the person does not move in and the move in date is not re-negotiated, begin termination procedures. Inform the person that their request for services will be denied and if they want to reconsider residential care (RC) placement later, their name will be placed on the interest list with a new request date.

Send the person Form 2065-A, Notification of Community Care Services. Cite Failure to follow the service plan as the denial reason. Send the facility Form 2101, Authorization for Community Care Services, to close the referral.

4734 Inappropriate for Residential Care

Revision 25-3; Effective June 1, 2025

Reassess the person upon return to the Residential Care (RC) facility if they were hospitalized or temporarily at a nursing facility or other institution. Complete the reassessment using the list of appropriate characteristics in Appendix VIII, Residential Care and Emergency Care Mental and Physical Characteristics, to ensure the person's needs do not exceed the facility's licensed capability to provide service to the person. Other circumstances may also require that the person be assessed for appropriateness. If the person no longer meets the appropriate characteristics, work closely with the facility to explore all available resources to arrange for the person's move. When arranging the move consider these other resources. This is a partial list:

• other agencies involved with the person;
• the person's family;
• area ambulance service; or
• the local sheriff's department.

4735 Duplication of Services

Revision 25-3; Effective June 1, 2025

A residential care (RC) person may receive Day Activity and Health Services (DAHS) only if the services the DAHS facility provides are medical services that the RC facility cannot provide. Documentation must clearly specify that at least one medical service is being provided at the DAHS facility that cannot be provided at the RC facility. For example, a person's needs are being met at the RC facility except for a daily insulin injection. The person goes to DAHS each morning for the DAHS nurse to administer the injection.

The number of units authorized to an RC person must be limited to the time needed by the DAHS facility to provide the medical services. Because most RC people are not high medical need people, the authorized services are limited to one unit, three but less than six hours per day.

4736 Transfers

Revision 25-3; Effective June 1, 2025

Once the person is in a facility, they have the right to move from one contracted residential care (RC) facility to another. If the person decides to move to another facility, contact the new facility to share information about the person's needs and to ensure that their needs can be met in the new facility. If the person is appropriate for the facility, negotiate a date of transfer, and update Form 2101, Authorization for Community Care Services, to reflect the change in facility. Send a copy of this form to the new facility and the former facility, noting in the comments section that the person's transfer was completed.

4740 Personal Contribution to the Cost of Care

Revision 25-5; Effective Dec. 1, 2025

A person must contribute to the total cost of the care they receive, including payment for room and board. The room and board amount is calculated from the person’s gross income. The person is responsible for paying this amount directly to the provider agency. The person may be required to pay a copayment based on the amount of income remaining after all allowances are deducted

A person is not eligible for residential care if they are required to contribute to the cost of their care but refuses to do so.

Related Policy 

26 Texas Administrative Code Section 271.85(b)
26 Texas Administrative Code Section 271.155(e) 

4740.1 Room and Board Payments

Revision 25-3; Effective June 1, 2025

People entering residential care (RC) are required to pay for room and board. The room and board payment is determined by a specific daily rate based on the type of residential setting. After deducting the room and board payment, the person's copayment is calculated based on personal needs allowance and any other approved deductions. The caseworker must complete Form 1032, Residential Care Copayment Worksheet. Form 1032 is an automated calculation worksheet for determining room and board and copayment amounts. A copy of the worksheet must be filed in the case record.

4740.2 Copayments

Revision 25-3; Effective June 1, 2025

Residential care (RC) includes a copayment system where the person is expected to contribute to the cost of care. Emergency care (EC) people do not contribute any copayment. Under the copayment system, each person is allowed certain monthly deductions for personal expenses and contributes the remainder of their income to the cost of care.

Withholding tax can be deducted from unearned income. Both withholding tax and Federal Insurance Contributions Act (FICA) tax can be deducted from earned income provided the deduction is mandatory. Other forms of mandatory deductions may be deducted if the caseworker can get documentation from the employer to confirm that the person does not have control of the expense being deducted. This includes mandatory repayments to the Social Security Administration (SSA) or other governmental agencies.

The copayment system takes into consideration the costs of non-Medicaid people who must pay for their own medical expenses. Medicaid people also keep a small allowance for medical expenses that are not covered by their Medicaid or Medicare insurance. If a person chooses to receive RC services, inform them about the mandatory contribution to the cost of care, and implications for their income and eligibility.

Review Form 1032, Residential Care Copayment Worksheet, and Instructions, for step by step instructions on calculating the person's total contribution to the cost of care.

4741 People on Services Before Sept. 1, 2003

Revision 25-3; Effective June 1, 2025

Beginning Sept. 1, 2003, people in residential care (RC) are required to pay room and board. People authorized for RC before that date were converted to the new payment system by dividing the current copayment into a room and board payment and a copayment.

A special payment system was implemented using non-Title XX funds for people authorized for RC before Sept. 1, 2003, with inadequate income to pay room and board. People in this category were automatically enrolled for the room and board payment with new service codes of 19O for the apartment setting or 19N for the non-apartment setting. The amount authorized is the difference between the person’s income and the room and board amount owed to the provider. People receiving the special room and board payment continue to be eligible for the payment if they remain in RC without a break in service. However, these people must pursue all possible sources of income and report new income to the caseworker. The new income is applied to the room and board fee.

State payment of room and board is available only for this group of people and does not apply to new applicants or people. Anyone authorized for RC after Sept. 1, 2003, must have enough income to pay the room and board fee for program eligibility.

4742 Caseworker Calculation Procedures

Revision 25-3; Effective June 1, 2025

The person's room and board is a set amount, however, the copayment amount varies based on their income and if they have Medicaid, Qualified Medicare Beneficiary (QMB) or Specified Low Income Medicare Beneficiary (SLMB) recipient. If a non-Medicaid, non-QMB or non-SLMB person receives Social Security or Railroad Retirement benefits, their Medicare premium is deducted from the gross amount of the benefit before the allowances are deducted. No other deduction is allowed. If the person has earned income, consider only the amount of net income over $65 per month. The net earned income is what the person takes home after all the deductions for such things as taxes and Social Security. Review Form 1032, Residential Care Copayment Worksheet, and Instructions, for instructions on calculating copayments.

Determine the amount that the person must contribute and enter the amount in Items 20 and 21 of Form 2101, Authorization for Community Care Services. Item 20 reflects the amount of copayment due for the first month of service. Item 21 reflects the ongoing copayment amount. Whenever cost-of-living changes increase benefits, review the affected person's cases and increase the copayment amounts accordingly. Increases are effective the first day of the month following the end of the 12-calendar day notification period.

Inform the person, in writing, about the fees they must contribute and advise them that if fees are not paid, they will no longer be eligible for residential care (RC). Send a copy of Form 2065-A, Notification of Community Care Services, to the person and the RC provider whenever there are changes in the fees the person must contribute.

The person's contribution to the cost of care must never exceed the daily RC rate established by the department.

4743 Waiver of Copayment

Revision 25-3; Effective June 1, 2025

A person's copayment, but not the room and board payment, may be reduced or waived because of unusual financial obligations such as high medical expenses or a need to purchase mobility aids. Consult with the supervisor to determine who in the region has the authority to waive the copayment for a residential care (RC) person.

Evaluate the persons circumstances to determine if their copayment should be reduced or waived. Regional staff may not allow a blanket reduction or waiver for all people served in an RC facility. Determine a specific period when the reduction or waiver is applied.

Document the basis for the reduction or waiver in the person's case folder if the copayment is reduced or waived. Forward a copy of the documentation to the provider. Complete Items 20 and 21 on Form 2101, Authorization for Community Care Services, to reflect waived or reduced copayments. Enter a statement in the comments section. Review the waiver or reduction before the waiver expires to determine if it should be continued. Document any continuation of the waiver.

4744 Adjusting Payments

Revision 25-3; Effective June 1, 2025

The caseworker is responsible for calculating the change in the person's copayment amount whenever there is a change in the person's income or an increase in the room and board rates.

Notify the person about a copayment increase or room and board rate change by using Form 2065-A, Notification of Community Care Services. The person must be given at least 12 calendar days after the Form 2065-A date to appeal the increase. If the person does not appeal, the increase is effective the first day of the following month.

The same day the person is notified, send the facility a copy of Form 2065-A with the new amounts. Send the facility Form 2101, Authorization for Community Care Services, showing the new copayment amount for increases in copayment. This gives the facility time to prepare to collect the new amounts. Send the facility another Form 2101 authorizing the original amount until the fair hearing is completed if the person appeals the increase during the 12-calendar day notification period.

Room and board rates are set amounts based on the living arrangement and will not change unless there is an across-the-board rate change. Only people designated on Sept. 1, 2003, to receive a room and board payment will have adjustments based on changes in their income. Review 4741, People on Services Before Sept. 1, 2003, for more details.

Copayments are based on the person's income. They will change at least yearly with the Retirement, Survivors and Disability Insurance (RSDI) or Supplemental Security Income (SSI) benefit cost-of-living increase. Caseworkers will be notified yearly of the increased amounts and procedures for adjusting the copayments.

4745 Collection of the Person's Contribution to the Cost of Care

Revision 25-3; Effective June 1, 2025

The facility must collect the person's room and board payment and copayment and must keep receipts for all copayments collected. The facility must deduct the copayment amount entered on Form 2101, Authorization of Community Care Services, and in the Service Authorization System Online (SASO) from reimbursement claims submitted to the department.

The facility collects the room and board payment and copayment monthly from the person by a set due date determined by the facility. If full payment is not made by the due date, the facility sends a notice to the person and notifies the caseworker using Form 2067, Case Information, by the first working day after the due date. When the due date falls on a holiday or a weekend, the facility collects the room and board payment by the first business day following the holiday or weekend.

Refer to 4774.1, Termination Due to Failure to Pay the Required Contribution to the Cost of Care, for procedures when Form 2067 is received from the facility stating that the person has failed to pay the required payments.

The facility must:

• keep receipts for each room and board payment collected;
• keep receipts for each copayment collected; and
• deduct all copayments from reimbursement claims submitted to the Texas Health and Human Services Commission (HHSC).

The person must pay their entire room and board payment. The person must also pay the entire copayment or request that the caseworker ask for a waiver, if financially unable to pay. Review 4743, Waiver of Copayment, for procedures.

4750 Personal Leave

Revision 25-5; Effective Dec. 1, 2025

The person is eligible for 14 days of personal leave from the Residential Care (RC) facility each calendar year. If the person does not pay the bed-hold charge for days of personal leave that exceed the limits, they may lose their space in the facility.

Inform the person that they are allowed up to 14 days per year of personal leave from the facility. Vacations and visits with family or friends are examples of personal leave. The person must pay the copayment and room and board charges for personal days. The facility may not bill HHSC for more than 14 days of personal leave taken by a person each calendar year.

If a person exceeds the allowable limit of 14 days of personal leave, they are responsible for paying all charges for services, per any existing contract or agreement between the person and the facility.

People who use excessive days of personal leave, as many as 30 days per year, but continue to pay bed-hold charges should be assessed to determine their need for RC. Determine if the institutional placement is still necessary, appropriate and in the person’s best interest.

Excessive use of personal leave may indicate that family members or friends are able and willing to have the person live with them. This option should be explored. Discuss excessive use of personal leave with the person to make sure they understand RC service limitations and requirements.

Related Policy

26 Texas Administrative Code Section 271.85(c) 

4760 Hospital, Nursing Home or Institutional Facility Stays

Revision 25-5; Effective Dec. 1, 2025

For the person to reserve their space in the facility during a hospital, nursing facility or institutional stay, the facility receives a bed-hold charge payment. The bed-hold charge is a set rate established by HHSC. As part of the bed-hold charge, the person is responsible for paying an amount equal to their room and board charge. HHSC then pays the difference up to the bed-hold charge. The amount HHSC pays is called the bed-hold rate.

The person does not pay their copayment while out of the facility for a hospital, nursing facility or institutional stay. If the copayment has been paid for the month and the person goes into a hospital, nursing home or institution, the facility must refund the copayment for the days the person is out of the facility.

After a hospital or nursing home stay, review the person’s condition to determine if the facility can continue to meet their needs per Appendix VIII, Residential Care and Emergency Care Mental and Physical Characteristics. Refer to 4734, Inappropriate for Residential Care, for other procedures if the person is no longer appropriate for residential care (RC). 

Related Policy

26 Texas Administrative Code Section 271.85(d)  

4770 Ongoing Casework Procedures

Revision 17-1; Effective March 15, 2017

4771 Facility Reporting and Notification Requirements

Revision 25-5; Effective Dec. 1, 2025

Refer to 26 Texas Administrative Code Section 276.45 Required Notifications.

If the caseworker receives a notice from the facility about a significant change, they must determine if the change is necessary within 14 calendar days of receiving the notice. Review 2811, Effective Dates, if the nature of the change requires termination of services.

4772 Monitoring

Revision 25-3; Effective June 1, 2025

Monitor the person's situation every six months. Review 2710, Monitoring Visits and Contacts for monitoring procedures. Assess the person's satisfaction with the facility and services delivered and the appropriateness of the service plan. If the person has any complaints about the facility or service delivery, report the situation to the facility directly or send Form 2067, Case Information. Work with the person and the facility to resolve the problem.

Report chronic problems to the unit supervisor, who may forward the information to the program manager and the contract manager.

4773 Annual Reassessment

Revision 25-3; Effective June 1, 2025

The caseworker must reassess the person annually for functional eligibility and redetermine financial eligibility within 24 months of the previous determination of financial eligibility. Review 2663, Reassessment of Functional Need, and 2662, Redetermination of Financial Eligibility, for more information about reassessments. Update any information on Form 2059, Summary of Client's Need for Services, and any changes to services on Form 2101, Authorization for Community Care Services. Send to the residential care (RC) facility.

Review 4774, Termination of Services, and 4734, Inappropriate for Residential Care, for procedures to help the person in relocation and termination if the person stops meeting eligibility requirements or being appropriate for placement in RC.

4774 Termination of Services

Revision 25-3; Effective June 1, 2025

The residential care (RC) person is not eligible for services if the person:

• dies;
• is admitted to an institution for more than 30 days;
• requests service termination;
• refuses to comply with their service plan;
• jeopardizes their or others' health or safety;
• loses Medicaid or becomes financially ineligible for services; or
• can contribute to the cost of their care but refuses to do so.

Do not terminate services if there is an adverse change in the person's health, but their needs can still be met by the facility.

Follow procedures in 2800, Procedures for Denying or Reducing Services when terminating services. Send the person Form 2065-A, Notification of Community Care Services, 12-calendar days before the effective date of denial, except in situations threatening the health or safety of the person or other people. Terminate services immediately in situations threatening health or safety as outlined in 2840, Threats to Health and Safety, and 2811, Effective Dates for Service Reduction and Termination.

The person has the right to appeal any adverse action within 90 calendar days of the date of Form 2065-A. The person may continue to receive services pending the outcome of the appeal hearing if the person:

• is provided with 12 calendar days advance notice, as specified in Section 2800 and Appendix IX, Notification/Effective Date of Decision; and
• notifies the caseworker within those 12 calendar days that they want to appeal the decision.

If the person does not appeal the service termination, the termination is final. If the person appeals the service termination notice, follow the Texas Health and Human Services Commission (HHSC) appeal procedures in 2830, Appeal Procedures.

4774.1 Termination Due to Failure to Pay the Required Contribution to the Cost of Care

Revision 25-3; Effective June 1, 2025

The facility must notify the person or representative and the caseworker in writing that payment was not received by the first business day after the due date if the person fails to pay the required contribution to the cost of care, room and board, or copayment by the facility's due date. The facility may notify the caseworker by the next business day, and follow up in writing within five calendar days of when the person or the person's representative fails to pay the required payments.

Upon receipt of the notice, the caseworker will:

• Coordinate with the facility to convene a meeting of the interdisciplinary team (IDT) within five business days of receipt of the notification.
• Include in the IDT the person, a facility representative, the caseworker and the person's authorized representative(s), if applicable.
• Explore with the person and IDT if there are new circumstances preventing the person from making the required payment.
• Consider these circumstances:
  • the person has a situation involving a mandatory recoupment or other changes in income requiring an adjustment in countable income;
  • the person meets any of the criteria for waiving the copayment amount, such as increased medical bills with more information in  4743, Waiver of Copayment;
  • circumstances indicate that the person is being exploited by another person; and
  • other situations exist where the person and facility can work out an agreement for the person to pay the required payments;
• Make every effort to resolve the problem with the person and the facility.
• Advise the person of the consequences that will result from refusal to make the required payments to the RC facility, including:
  • termination of eligibility;
  • eviction; and
  • being placed at the end of the interest list if they reapply for services in the future; and
• Ask the person to read and sign Form 2119, Residential Care, Adult Foster Care or Assisted Living Contribution Acknowledgement, if the situation cannot be resolved and the person continues to refuse to pay the required payments.

The form states that they refuse to pay the required payments and understand the consequences of not meeting this eligibility requirement. If the person refuses to sign, document the refusal on the form and have a witness sign. Leave the person a copy of the form and keep the original copy with the signature in the person's case record. Advise the person that they will receive a notice to terminate services. Also advise the person that they will not be allowed to move to another RC facility while they have an outstanding balance at the current facility, and the current facility may evict the person for refusal to pay. Coordinate the notice of termination with the facility.

After the IDT meeting, make any appropriate referrals to adjust countable income, request a waiver of copayment or refer to Adult Protective Services (APS), if exploitation is suspected.

If the situation cannot be resolved and the person is refusing to pay for any reason, the caseworker sends Form 2065-A, Notification of Community Care Services, giving the person a 30 calendar day notice that services will be terminated unless the person pays the required payments. In the comments section of the form, advise the person that services will end and the facility may evict the person if payment is not made by the 30th day. Send the facility a copy of Form 2065-A.

The facility may initiate the eviction proceedings by giving the person an eviction notice in writing.

If the person does not appeal, terminate services 30 calendar days from the Form 2065-A notice. The facility will receive payment from HHSC during the 30-day period. If the person has not made other living arrangements at the end of the 30 calendar days, make a referral to APS. Provided the facility is in compliance with the provisions of its license and contract for the eviction of people, the facility may evict the person on the date provided on the written eviction notice.

4774.2 Services During the Appeal

Revision 25-3; Effective June 1, 2025

The person may appeal the decision to terminate services. If the person makes the appeal request on or before the date of the action to terminate services, their case will remain open until a hearing decision is made. However, the facility has the right to continue with eviction proceedings and may evict the person with appropriate notice to the person, even if the hearing decision has not been made. No services will be provided.

4774.3 Requests to Transfer to Another Residential Care Facility

Revision 25-3; Effective June 1, 2025

The person may not transfer to another Residential Care (RC) facility if the outstanding payment was not made to the previous facility. The caseworker must maintain clear documentation about the person's refusal to pay and the subsequent actions.

If the person contacts another facility or the caseworker requests placement in a new facility, the gaining caseworker must contact the current caseworker to determine if the person is current on all required payments. If the person has outstanding payments to a facility, the caseworker will not approve ongoing RC services at a new facility and the request to transfer will not be processed. The person may receive other services, if determined eligible, but will remain ineligible for RC services until all outstanding payments are made.

4780 Special Casework Procedures for Emergency Care

Revision 17-1; Effective March 15, 2017

4781 Caseworker Assessment

Revision 25-3; Effective June 1, 2025

Respond to a request for emergency care (EC) the same day the report is received. If a person is in an emergency situation because they need a home and no other care arrangement is available, determine if they meet the remaining eligibility criteria for EC. If they do, complete the eligibility determination process within one business day after they enter the facility.

A person who moves into a residential care (RC) facility or an adult foster care (AFC) home for EC must meet eligibility requirements for EC and meet the mental and physical characteristics specified in Appendix VIII, Residential Care and Emergency Care Mental and Physical Characteristics. If necessary, consult the regional nurse.

4782 Immediate Placement

Revision 25-3; Effective June 1, 2025

Make the referral by phone to expedite the person's move into the facility. If space is available, help them and their caregivers arrange for transportation to the adult foster care (AFC) home or the residential care (RC) facility. If the caseworker determines that the person does not meet the eligibility criteria and the appropriate characteristic criteria for emergency care (EC), help them make other arrangements. An ineligible person must leave the EC facility within five calendar days of the date they entered.

The provider is entitled to payment for EC services for up to five calendar days after date of entry, no matter the applicant's eligibility status.

If the provider determines that the person's needs exceed the facility's capability under its licensed authority, the provider may request another review by the supervisor in consultation with the regional nurse. Regional staff are responsible for developing review procedures. The caseworker is responsible for making the final decision on the person's appropriateness for RC services.

4783 Length of Stay

Revision 25-3; Effective June 1, 2025

Residential Care (RC) is provided for up to 30 calendar days while you seek a permanent care arrangement within the initial 30-day period. Get your supervisor's approval to extend Emergency Care (EC) beyond 30 calendar days. Get this approval before the first 30-day period expires.

Note: An extension must not exceed 30 calendar days.