1. (a) For all programs providing consumer directed services (CDS) except the Home and Community-based Services (HCS) program, the sum of the payment rate for the contracted CDS agency and the payment rate for the consumer participating in CDS must not exceed the payment rate made to contracted providers in these programs. The payment rate for the contracted CDS agency is determined by modeling the estimated cost to carry out the responsibilities of the CDS agency. The payment rate for the consumer is determined by subtracting the contracted CDS agency payment rate from the payment rate made to contracted providers in these programs.
2. (b) For the HCS program the payment rate for the contracted CDS agency is determined by modeling the estimated cost to carry out the responsibilities of the CDS agency. The payment rate for the consumer is modeled and is based on the direct care rate plus a portion of the operating costs from the case management fee. The sum of the payment rate for the contracted CDS agency, the consumer participating in CDS, and the case management fee remaining for the provider agency cannot exceed, on average, the amount paid to contracted providers for non-CDS consumers in these programs.

Source Note:The provisions of this §355.114 adopted to be effective December 1, 2001, 26 TexReg 9375; amended to be effective June 17, 2003, 28 TexReg 4544; amended to be effective September 1, 2004, 29 TexReg 7667; amended to be effective December 2, 2004, 29 TexReg 10912; amended to be effective February 1, 2007, 32 TexReg 42.