Common use of General Program Clause in Contracts

General Program. 2.8.1 LIDDA shall provide services to all individuals without regard to the individual’s criminal history. 2.8.2 LIDDA shall provide individual benefits assistance in accordance with section 2.8.2(A) through 2.8.2(I) of this Attachment A-1 and comply with Tex. Health and Safety Code §533A.008(e) regarding individual benefits training. A. LIDDA shall ensure at least one staff member receives training that is provided semi-annually through the Texas Council’s Individual Benefits Organization; B. LIDDA shall identify a staff member designated by LIDDA to serve as a liaison to Health and Human Services Disability Determination Services; C. LIDDA shall annually screen all current individuals to determine their potential eligibility for Supplemental Security Income (“SSI”), Social Security Disability Income (“SSDI”), and Medicaid; D. LIDDA shall screen all new individuals found eligible for services to determine their potential eligibility for SSI, SSDI, and Medicaid; E. LIDDA shall ensure a staff member who has received the training required in section 2.8.2(A) of the Contract reviews all cases screened as having low eligibility potential to determine the screening’s accuracy; F. LIDDA shall ensure all cases reviewed and determined to have moderate to high eligibility potential for Medicaid, SSDI and SSI will be assisted with the benefits applications; G. LIDDA shall assist all individuals who have been denied SSI or SSDI benefits to appeal their denial of benefits, from the initial appeal (Reconsideration) level to the second level (Administrative Hearing). H. LIDDA shall ensure the LIDDA’s billing staff are notified of individuals’ benefits approval and application dates, to allow completion of retroactive billing within 90 days for allowable Medicaid services from the date of the application. The Social Security Administration (“SSA”) will contact the individual's designated representative; and I. LIDDA shall identify staffing that is adequate to ensure sufficient focus and capacity to provide benefits assistance in accordance with the requirements in sections 2.8.2(A) through 2.8.2(H) of this Attachment. Referral to contractors paid on contingency fees for benefits assistance does not meet the requirements of section 2.8.2 of this Attachment. 2.8.3 LIDDA shall ensure all service coordinators are trained in job duties as outlined in this Performance Contract and have access to and use of a complete copy of this Performance Contract and the LIDDA handbook. HHSC will post the Contract on the Agency website. 2.8.4 LIDDA, as requested by HHSC, shall assist in transferring an individual’s Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (“ICF/IID”) Program, Home and Community-based Services Program (“HCS”) or Texas Home Living (“TxHmL”) Program services, or financial management services agency services from one provider to another due to closure of the provider’s facility or termination of the provider’s contract. 2.8.5 LIDDA shall provide meaningful access to its programs, services, and activities and ensure adequate communication through language assistance services for individuals and legally authorized representatives (“LARs”) with limited English proficiency, sensory impairments, and/or speech impairments. 2.8.6 LIDDA shall cooperate with other LIDDAs, Area Agencies on Aging (“AAAs”), and HHSC local community services regional offices to ensure efficient access and intake processes for all HHSC services and programs. 2.8.7 LIDDA shall cooperate with Managed Care Organizations (“MCOs”) to ensure efficient access and intake and programmatic processes for all HHSC services and programs and Community First Choice (“CFC”) services. 2.8.8 This Contract references CARE (“Client Assignment and Registration”). Certain functions of CARE may transition to new data management systems during the contract period stated in section III of the Signature Document (Contract Period and Renewal). The impacted functions and the effective date of the transition will be communicated to the LIDDA at a later date. Such communication will include a crosswalk identifying the data management system to the applicable contract provision. The provisions of the crosswalk (relating to which data management system applies) shall take precedence over those identified in this Contract. 2.8.9 LIDDA shall establish a public phone number for each county in the LSA to access IDD services and ensure the phone number remains dedicated for that purpose and is not reassigned. LIDDA may have the same phone number for more than one county. The phone number(s) for the county or counties must be submitted on Form S (Contact List). Form S may be obtained upon request from the HHSC IDD Performance Units Contracts Section.

General Program. 2.8.1 LIDDA shall provide services to all individuals without regard to the 2.8.2 In response to an inquiry for information about programs and services for an individual with an intellectual or developmental disability, the individual’s criminal historyLIDDA must fulfill duties outlined in Section 6200, Inquires for Information in the LIDDA Handbook. 2.8.2 2.8.3 LIDDA shall provide individual benefits assistance in accordance with section 2.8.2(ASection 2.8.3(A) through 2.8.2(I2.8.3(H) of this Attachment A-1 Section and comply with Tex. Health and Safety Code §533A.008(e) regarding individual benefits training. A. LIDDA shall ensure at least one staff member receives training that is provided semi-annually through the Texas Council’s Council of Community Centers Individual Benefits Organization; B. LIDDA shall identify a staff member designated by LIDDA to serve as a liaison to Health and Human Services Disability Determination Services; C. LIDDA shall annually screen all current individuals found eligible at intake and all individuals currently being served annually to determine their potential or ongoing eligibility for Supplemental Security Income (“SSI”), Social Security Disability Income Insurance (“SSDI”), and Medicaid; D. LIDDA shall screen all new individuals found eligible for services to determine their potential eligibility for SSI, SSDI, and Medicaid; E. LIDDA ▇▇▇▇▇ shall ensure a staff member who has received the training required in section 2.8.2(A2.8.3(A) of the Contract reviews all cases screened as having low eligibility potential to determine the screening’s accuracy;scr F. E. LIDDA shall ensure all cases individuals reviewed and determined to have moderate to high eligibility potential for Medicaid, SSDI and SSI will be assisted with the benefits applications; G. F. LIDDA shall assist all individuals who have been denied SSI or SSDI benefits to appeal their denial of benefits, from the initial appeal (Reconsideration) level to the second level (Administrative Hearing). H. LIDDA shall ensure the LIDDA’s billing staff are notified of individuals’ G. benefits approval and application dates, to allow completion of retroactive billing within 90 days for allowable Medicaid services from the date of the application. The Social Security Administration (“SSA”) will contact the individual's designated representative; and I. H. LIDDA shall identify staffing that is adequate to ensure sufficient focus and capacity to provide benefits assistance in accordance with the requirements in sections 2.8.2(A2.8.3(A) through 2.8.2(H2.8.3(H) of this Attachmentsection. Referral to contractors paid on contingency fees for benefits assistance does not meet the requirements of section 2.8.2 2.8.3 of this Attachmentsection. 2.8.3 2.8.4 LIDDA shall ensure all service coordinators are trained in job duties as outlined in this Performance Contract Contract, Texas Administrative Code, and have access to and use of a complete any applicable program specific handbooks including the LIDDA Handbook. Service coordinators shall be provided an electronic copy of this Performance Contract and the LIDDA handbook. HHSC will post the Contract on the Agency websiteHandbook. 2.8.4 LIDDA, as requested by HHSC, 2.8.5 LIDDA shall assist in transferring an individual’s Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (“ensure all service coordinators complete the LIDDA Coordination 101 training within the first ninety days of performing service coordination duties. 2.8.6 ICF/IID”) IID Program, Home and Community-based Services HCS Program (“HCS”) or Texas Home Living (“TxHmL”) TxHmL Program services, or financial management services agency services Financial Management Services Agency from one provider to another due to closure of the provider’s facility or termination of the provider’s contract.of 2.8.5 2.8.7 LIDDA shall provide language assistance services for individuals and Legally Authorized Representatives (LARs) with limited English proficiency, sensory impairments, or speech impairments that allows for meaningful access in accordance with Tex. Health and Safety Code §592.017, to its programs, services, and activities and ensure adequate communication through language assistance services for individuals and legally authorized representatives (“LARs”) with limited English proficiency, sensory impairments, and/or speech impairmentscommunication. 2.8.6 2.8.8 LIDDA shall cooperate with other LIDDAs, Area Agencies on Aging, Aging (“AAAs”)and Disability Resource Centers, and HHSC local community services regional offices to ensure efficient access and intake processes for all HHSC services and programs. 2.8.7 2.8.9 LIDDA shall cooperate ensure coordination of services with Managed Care Organizations (“MCOs”) to ensure efficient access and intake and programmatic processes for all HHSC services and programs and including Community First Choice (“CFC”) services. 2.8.8 2.8.10 This Contract references CARE (“Client Assignment and Registration”)Registration (CARE) System. Certain functions of CARE may transition to new data management systems during the contract Contract period stated in section III of the Signature Document (Contract Period and Renewal). The impacted functions and the effective date of the transition will be communicated to the LIDDA at a later date. Such communication will include a crosswalk identifying the data management system to the applicable contract Contract provision. The provisions of the crosswalk (relating to which data management system applies) shall take precedence over those identified in this Contract. 2.8.9 LIDDA shall establish a public phone number for each county in the LSA to access IDD services and ensure the phone number remains dedicated for that purpose and is not reassigned. LIDDA may have the same phone number for more than one county. The phone number(s) for the county or counties must be submitted on Form S (Contact List). Form S may be obtained upon request from the HHSC IDD Performance Units Contracts Section.

General Program. 2.8.1 LIDDA shall provide services to all individuals without regard to the individual’s criminal history. 2.8.2 LIDDA shall provide individual benefits assistance in accordance with section 2.8.2(A) through 2.8.2(I) 2.8.3 of this Attachment A-1 A and comply with Tex. Health and Safety Code §533A.008(e) regarding individual benefits training. A. 2.8.3 LIDDA shall ensure at least one staff member receives training that is provided semi-annually through the Texas Council’s Individual Benefits Organization; ▇. ▇▇▇▇▇ shall identify a staff member designated by LIDDA to serve as a liaison to Health and Human Services Disability Determination Services; B. LIDDA shall identify a staff member designated by LIDDA to serve as a liaison to Health and Human Services Disability Determination Services; C. LIDDA shall annually screen all current individuals to determine their potential eligibility for Supplemental Security Income (“SSI”), Social Security Disability Income (“SSDI”), and Medicaid; D. LIDDA shall screen all new individuals found eligible for services to determine their potential eligibility for SSI, SSDI, and Medicaid; E. LIDDA ▇. ▇▇▇▇▇ shall ensure a staff member who has received the training required in section 2.8.2(A2.8.3(A) of the Contract reviews all cases screened as having low eligibility potential to determine the screening’s accuracy; F. LIDDA shall ensure all cases reviewed and determined to have moderate to high eligibility potential for Medicaid, SSDI and SSI will be assisted with the benefits applications; G. LIDDA ▇. ▇▇▇▇▇ shall assist all individuals who have been denied SSI or SSDI benefits to appeal their denial of benefits, from the initial appeal (Reconsideration) level to the second level (Administrative Hearing). H. LIDDA shall ensure the LIDDA’s billing staff are notified of individuals’ benefits approval and application dates, to allow completion of retroactive billing within 90 days for allowable Medicaid services from the date of the application. The Social Security Administration (“SSA”) will contact the individual's designated representative; and I. LIDDA shall identify staffing that is adequate to ensure sufficient focus and capacity to provide benefits assistance in accordance with the requirements in sections 2.8.2(A2.8.3(A) through 2.8.2(H2.8.3(H) of this Attachment. Referral to contractors paid on contingency fees for benefits assistance does not meet the requirements of section 2.8.2 2.8 of this Attachment. 2.8.3 2.8.4 LIDDA shall ensure all service coordinators are trained in job duties as outlined in this Performance Contract and have access to and use of a complete copy of this Performance Contract and the LIDDA handbook. HHSC will post the Contract on the Agency website. 2.8.4 2.8.5 LIDDA, as requested by HHSC, shall assist in transferring an a individual’s Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (“ICF/IID”) Program, Home and Community-based Services Program (“HCS”) or Texas Home Living (“TxHmL”) Program services, or financial management services agency services from one provider to another due to closure of the provider’s facility or termination of the provider’s contract. 2.8.5 2.8.6 LIDDA shall provide meaningful access to its programs, services, and activities and ensure adequate communication through language assistance services for individuals and legally authorized representatives (“LARs”) with limited English proficiency, sensory impairments, and/or speech impairments. 2.8.6 2.8.7 LIDDA shall cooperate with other LIDDAs, Area Agencies on Aging (“AAAs”), and HHSC local community services regional offices to ensure efficient access and intake processes for all HHSC services and programs. 2.8.7 . LIDDA shall cooperate with Managed Care Organizations (“MCOs”) to ensure efficient access and intake and programmatic processes for all HHSC services and programs and Community First Choice (“CFC”) services. 2.8.8 This Contract references CARE (“Client Assignment and Registration”). Certain functions of CARE may transition to new data management systems during the contract period stated in section III of the Signature Document (Contract Period and Renewal). The impacted functions and the effective date of the transition will be communicated to the LIDDA at a later date. Such communication will include a crosswalk identifying the data management system to the applicable contract provision. The provisions of the crosswalk (relating to which data management system applies) shall take precedence over those identified in this Contract. 2.8.9 LIDDA shall establish a public phone number for each county in the LSA to access IDD services and ensure the phone number remains dedicated for that purpose and is not reassigned. LIDDA may have the same phone number for more than one county. The phone number(s) for the county or counties must be submitted on Form S (Contact List). Form S may be obtained upon request from the HHSC IDD Performance Units Contracts Section.