1. (a) HHSC terminates an individual's CLASS Program services and CFC services if:

   1. (1) the CMA or DSA has factual information confirming the death of the individual;
   2. (2) the CMA or DSA receives a clear written statement signed by the individual that the individual no longer wishes to receive CLASS Program services and CFC services;
   3. (3) the individual's whereabouts are unknown, and the post office returns mail directed to the individual by the CMA or DSA, indicating no forwarding address; or
   4. (4) the CMA or DSA establishes that the individual has been accepted for Medicaid services by another state.
2. (b) Within two business days after a CMA becomes aware that a situation described in subsection (a) of this section exists, the CMA must send a written request to HHSC to terminate CLASS Program services and CFC services for the individual. The written request to HHSC must include documentation supporting the request.
3. (c) HHSC notifies an individual's CMA, in writing, of whether it authorizes the termination of CLASS Program services and CFC services for the individual.

4. (d) After receiving a written notice from HHSC authorizing the termination of CLASS Program services and CFC services, a CMA must, in accordance with the Community Living Assistance and Support Services Provider Manual:

   1. (1) send written notice to the individual or LAR of the proposed termination, copying the individual's DSA and, if the individual is receiving a service through the CDS option, the FMSA; and
   2. (2) include with the written notice the individual's right to request a fair hearing in accordance with §259.101 of this chapter (relating to Individual's Right to a Fair Hearing).

Source Note:The provisions of this §259.165 adopted to be effective January 30, 2023, 48 TexReg 362.