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Revision 25-1; Effective Nov. 12, 2025
HHSC may make available a targeted NF HCS transition slot for a person who meets the criteria described in 6510, Criteria for Transitioning to the HCS Program.
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 25-1; Effective Nov. 12, 2025
If a LIDDA determines 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 the 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.
6530 Enrollment in HCS as an NF Transition
Revision 25-1; Effective Nov. 12, 2025
For a person transitioning to the community by enrolling in the HCS program, a LIDDA must enroll the person in the HCS Program per HCS rules and 13000, Medicaid Program Enrollment Requirements, of the LIDDA Handbook. The ECC coordinator must:
- comply with the rules governing service coordination for a person with an intellectual disability per 26 TAC Chapter 331, LIDDA Service Coordination, and 26 TAC Section 263.901, LIDDA Requirements for Providing Service Coordination in the HCS Program;
- facilitate 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;
- develop and revise, as needed, Form 8665, Person-Directed Plan, using all available assessments and including the person’s strengths, preferences and support needs:
- strengths and preferences; and
- medical, nursing, clinical, dietary and other support needs.
- initiate development of the individual plan of care as outlined in 13240, Individual Plan of Care, of the LIDDA Handbook;
- conduct, in-person, a pre-move site review using Form 1042, Pre-Move Site Review, to determine if essential supports are in place and any areas of concern have been addressed before the person enrolls in the HCS Program; and
- complete 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:
- convene the SPT to resolve the issues; and
- conduct 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 transferring LIDDA’s ECC coordinator should invite the receiving LIDDA’s ECC coordinator to all transition planning meetings. The receiving LIDDA’s ECC coordinator may attend transition planning meetings either in person, by audio-visual technology or by phone.
The transferring and receiving LIDDAs must work together to make sure essential supports are in place before the person’s discharge from the NF. This includes determining who will be responsible for conducting the pre-move site review, considering time and distance to the site and sharing a copy of the pre-move visit with the other LIDDA. The sending LIDDA should document any discussions with the receiving LIDDA.
The transfer of LIDDAs must not occur until all essential supports have been verified through a pre-move visit.
At its discretion, HHSC may determine the designated LIDDA for any person or assign a LIDDA the duties of the designated LIDDA for any person.
A non-designated LIDDA is not prohibited from serving a person who is currently being served by their designated LIDDA.
6540, Transition Day
Revision 25-1; Effective Nov. 12, 2025
The MCO SC and RS are expected to be present at the new address on transition day to make sure all services are in place. They also assist in setting up the household as needed. The ECC coordinator is also encouraged to be present.
Note: If the transition plan includes essential supports that are due to be delivered or transferred with the person on transition day, the ECC coordinator must verify the supports are in place.