Twogether Updates

Letter From Twogether Consulting To Providers During This Crisis-Update

 

Hello Friends,

Twogether Consulting is continuing to work to ensure minimal disruptions to our business while putting the safety and well-being of our providers, their individuals in the program, and our contractors as our highest priority. Please see below for specific information:

  • In-person group trainings/conferencesSuspended until at least September 30th, 2020 at this time.  Most of these classes have already been moved to online webinars or training.  We also have pre-recorded sessions of some of these trainings as well.
  • Online training (Webinars): Proceeding as planned.  We will be posting upcoming webinars to the website regularly on the homepage: www.twogetherconsulting.com 
    • Webinar Registration:  Click on calendars on our website at www.twogetherconsulting.com or https://events.time.ly/anatx6f
    • Recordings of Free Webinar Series:  https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b
    • “Updates Page”  http://twogetherconsulting.com/updates/
    • We will continue to provide 1 on 1 webinar training and any general trainings done for a specific facility/ provider for Care Coordination, Nursing Services, Direct Support Staff, etc.…
    • We have pre-recorded sessions with handouts for those of you who can’t attend live sessions or can’t wait for a live session. They range from $25-$150 per session.  These range from 1 hr- 3.5 hrs per session.
    • “Pop-Up Webinars”:  We will occasionally send out invitations to some webinars to those of you who are already clients of Twogether Consulting or who are on our mailing listThese won’t be posted for the general public.  These will be fairly short notice and based on topics that we receive a large number of requests to provide.  They will also be limited registration.  (15-30 persons max). .
  • Consultant Support: Twogether Consultants continue to be available to assist with your HCS/TxHmL and ICF needs as usual.  We will provide anything you request of us, that we can off-site.
    • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  We charge $75/hr and we can offer blocks of time for more than 3 hrs at a slight discount if you contact us directly at:  info@twogetherconsulting.com
    • if there is an extensive project (anything over 6 hrs, we will discuss flat rate options or daily rates.)
    • We continue to provide as-needed off-site consultation including, but not limited to: Development or assistance with policy and procedure, (LON) Level of Need increase packets, Monthly/Quarterly QA via Taskmaster Pro, Therap, or any other cloud-based services, Survey and Audit Prep, and you are welcome to contact us if you need us to QA or review documents through our secure cloud storage system. We also provide off-site nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is temporarily suspended at this time, due to the recent Guidelines from HHSC for HCS/TxHmL providers as of 3/17/20 by HHSC.  See link below:
  • https://apps.hhs.texas.gov/providers/communications/2020/letters/PL2020-12.pdf
  • We are not considered “essential visitors” at this time, according to HHSC.
  • Concerning our ICF providers, we will follow the same guidelines ICF has provided at this time.
  • Remember for ICF we can still provide Directive Inservice Trainings (DIT) if necessary, but we prefer to provide these off-site via webinar, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know. If this must be done in person, it must be for 8 or less attendees at a time. All attendees must be screened for possible Covid-19 symptoms.
  • Payments:  We prefer payment via our PayPal Invoices, with Credit Card/Debit/ or PayPal.  You are also welcome to pay via e-check, or request to pay by Venmo.  You may also use our online link below to pay:  http://twogetherconsulting.com/payments/
    • If you must pay by check, please let us know prior to mailing the check.  Thank you.  Send all checks to:

Twogether Consulting  P.O. Box 90426 Austin, Tx 78709.

Any updates to our COVID-19 response will be posted at:  http://twogetherconsulting.com/updates/

Note: We will continue to send out the newsletter 2 x per month.  If you want to me on the mailing list, please contact us at:  info@twogetherconsulting.com

You may contact us by phone with any questions at:  512-294-8032.  You may email me directly at:  javasbja@aol.com or javasbja@gmail.com

Thank you and be well,

Julie Andrews Blacklock/Owner & IDD Waiver Consultant

 

COVID-19 Information

LTCR COVID-19 Response for HCS Residential Providers and WSC Surveyors Webinar 

This webinar will review guidance to HCS residential providers on response actions in the event of a COVID-19 exposure.

Date: July 6
Time: 3 p.m. – 4 p.m.

Register for the LTCR COVID-19 Response for HCS Residential Providers and WSC Surveyors Webinar.

 

Home and Community-based Services and Texas Home Living providers are invited to join Long-term Care Regulation for a webinar discussing updates related to COVID-19

Date: July 2
Time: 2 p.m – 3 p.m.

Register for the COVID-19 Updates with LTCR for HCS/TxHmL Program Providers webinar.

 

June 25, 2020

State Supported Living Center transitional activities are allowed under PL 2020-22 (PDF). HHSC is issuing this guidance to service providers of people receiving Home and Community-based Services.

Transitional activities include:

  • Home tours
  • Staff interviews
  • Staff training
  • Pre-move site reviews
  • Post move monitoring visits

Transitional activities have not been suspended and should continue. Program providers should take precautions and screen all people entering the residence.

 

COVID-19 HCS Interest List Reduction and Promoting Independence Slot Releases 

Information letter (IL) 2020-27 was released to provide updated information on Home and Community-based Services and Local Intellectual and Developmental Disability Authorities. It replaces IL 20-15, COVID-19 HCS Interest List Reduction Slots, previously issued on April 9 and revised on April 23, 2020.

HHSC is resuming the release of HCS Interest List Reduction Slots starting June 1, 2020. HHSC is continuing releases of HCS Promoting Independence Slots. LIDDAs will request the following HCS Promoting Independence Slots:

  • Crisis diversion
  • Nursing facility diversion
  • Young adults aging out of foster care
  • Nursing facility transition
  • Nursing facility transition for children
  • SSLC transition

 

The weekly webinars for Medicaid CHIP COVID-19 Information have been canceled and instead, HHSC will be providing a post to a  pre-recorded session online for viewing at your convenience to reduce the potential for technical difficulties. These information sessions will continue to share information about the actions taken to implement various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic. HHSC will continue to work on additional flexibilities across the programs and will update stakeholders each week on new implementations and issued guidance. Links to each week’s information session will be posted on the HHS COVID-19 Medicaid & CHIP webpage (https://hhs.texas.gov/services/health/coronavirus-covid-19/medicaid-chip-services-information-providers) by 1:00 p.m. CT on April 16, and each Thursday going forward.


LTC Providers Required to Report COVID-19 to HHSC

Effective immediately, a provider must report every confirmed case (only confirmed cases) of COVID-19 in staff and individuals receiving services from the provider as a self-reported incident. A presumptive or confirmed case is considered a critical incident.

Providers (other than HCS and TxHmL providers) must notify HHSC through TULIP or by calling Complaint and Incident Intake (CII) at         1-800-458-9858.

HCS and TxHmL providers must notify HHSC at waiversurvey.certification@hhsc.state.tx.us

Though not stated in the message below, in accordance with the April 8, 2020 HHSC COVID-19 HCS/TxHmL webinar, HCS and TxHmL providers are to include the following information when reporting confirmed COVID-19 cases to  waiver, survey and certification: 
~  Provider Name
~  Component Code
~  Contract #
~  Point of Contact Name and Contact Information
~  Individuals:  Name & CARE ID; Number at home; and Number in hospital
~  Number of Staff
 
Report Only Confirmed COVID-19 Cases to HHSC
Providers report only confirmed cases of COVID-19 in staff and individuals receiving services from the provider as a self-reported incident. This is effective immediately. Providers, other than HCS and TxHmL providers, must notify HHSC through TULIP or by calling Complaint and Incident Intake at 800-458-9858. HCS and TxHmL providers must email HHSC.
HHSC previously required reporting of both presumptive and confirmed cases of COVID-19.
Providers are also required to report communicable diseases to the health authority with jurisdiction over their facility. This is in accordance with the Communicable Disease and Prevention Act, Texas Health and Safety Code, Chapter 81. It’s also specified in Title 25 of the Texas Administrative Code, Chapter 97.

List of Local Health Authorities for COVID-19 from DSHS

https://www.dshs.texas.gov/regions/Coronavirus-(2019-nCoV)-Local-Health-Entities/

See Link below to handout on the role of the Local Health Authorities 

https://www.dshs.state.tx.us/region1/documents/tmp-LocalHealthAuthority.pdf 

 

Obtaining an HHSC Letter Requesting a Store Waiver for Product

Purchase Limits  

An HCS program provider operating a three or four-person residence may request a letter from HHSC requesting that a store waive product purchase limits for food and personal care items implemented because of the COVID-19 crisis.

Send letter requests to the HCS Policy inbox at HCSPolicy@hhsc.state.tx.us.

Include:

  • HCS program provider name
  • Number of the contract the program provider has with HHSC
  • Address of the three-person or four-person residence
  • Location code of the residence
  • Program provider tax ID.

HHSC will review the CARE and verify the information in the request. Then, HHSC will email a letter to the HCS program provider requesting that a store waive product purchase limits for food and personal care items because of the COVID-19 crisis. Program providers can only use the letter when purchasing such items for a three or four-person residence.

Even though a store is given the letter, it may choose not to waive the purchase limit for the program provider. A program provider can reprint the emailed letter

 

 

FAQ’s From “Coping With Covid-19″  Webinar

Webinar Was Presented By Twogether Consulting-3/30/20

We will be having a COVID-19 Update Webinar on 5/1/20.  Check our calendars for more information on our next webinars, at:  http://www.twogetherconsulting.com 

Question #1. 

Can someone provide and bill for Day Hab For a Group Home or Host Home Via video conferencing/video chat (i.e.-Zoom, JoinMe, Gotomeeting, freeconferencecall.com, etc…).

Answer: 

From HHSC:  “Day Habilitation is only provided face to face. No other method of service delivery is allowed or approved, even during the COVID-19 crisis.” 

Question #2.

In reference to question #1, would that be considered “In-Home DH” or regular “DH” for billing purposes, if you can bill?

Answer:  Not applicable, see answer to question #1.

Question #3.

Can an individual receiving day hab in the group home (during Covid-19 while in-home billable services normal billable guidelines are waived), go to another group home to get their in-home DH with other individuals who already live in that other home who are getting DH?  Or is this considered risking bigger exposure to Covid-19?  Is this billable as “in-home DH”?  The issue is that some homes are not full and hard to staff for DH with 1 individual only living in the home.

Update To Answer: 4/23/20- No.  We received conflicting information during today’s stakeholder’s meeting on COVID-19.  We apologize for any misinformation as our previous answer was the response we received in writing from the HCS policy specialists department, via email.  I have asked for this to be clarified.   

Previous Answer:  Yes. This can be done as long it is not violating the Governor’s order of no more than 10 people gathering or local shelter in place orders.

 Question #4.

How does the Texas Board of Nursing (TBON) feel about telemedicine being utilized by LVN’s?

Answer: “HHSC has contacted TBON for further guidance and is waiting on a response.” Is the response I have received from HCS policy.

Update on this answer: 04/22/20 response to PPAT from the BON:

Telehealth Guidance on Nursing for HCS/TxHmL, CLASS & DBMD:
Due to COVID-19, nursing services can be provided by telehealth. For people enrolled in the waiver programs, HHSC allows a nursing assessment and a comprehensive nursing assessment through telehealth. The nursing service must be done within the scope of the nurse’s license and standards of practice. The program provider must not direct a nurse to complete an assessment using telehealth if the nurse deems it inappropriate. The registered nurse who completes the assessment has the sole discretion to determine if this method can be used.  In the fee-for-service Medicaid 1915(c) waiver programs, provide nursing services in accordance with:
  • Texas Occupations Code, Chapter 301 (Nursing Practice Act);
  • 22 TAC Chapter 217 (relating to Licensure, Peer Assistance, and Practice);
  • 22 TAC Chapter 224 (relating to Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments); and
  • 22 TAC Chapter 225 (relating to RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions).
The Board of Nursing recently provided resources, including an FAQ about telehealth.
Below is my initial answer, but both items are true and allow for doing these assessments.  The BG is partially based on the BON rules of course. 

My initial answer:  In reference to telemedicine/telehealth (by phone), same rules as always, no telephonic triage by an LVN, of course, and complete duties as necessary by phone as long as it does not fall out of LVN’s normal scope of practice.  But in reference to questions specifically about using video conferencing to complete f/f focused assessment, I believe LVN’s have already been able to do the specific task of completing a focused assessment via video conferencing.   

This is because our current billing guidelines already allow for this in HCS.  https://hhs.texas.gov/sites/default/files/documents/laws-regulations/handbooks/HCSBG/HCS_Billing_Guidelines_2019_Accessible.pdf

See Section 4420 of billable activity for an RN, Under #3 B.  It states:  “The only billable activities for the registered nursing component are:  (skipping #1 and 2),  3: Interacting by video conferencing with an individual who has a medical need for registered nursing, including (A) Observing Administration of Medication (B) Assessing and individuals health status, including conducting a focused Assessment or an RN Nursing Assessment.” 

And for LVN’s the section 4471.2 Billable activity #3 B, which says   3. “Interacting by video conferencing with an individual who has a medical need for licensed vocational nursing, including (A) Observing Administration of Medication (B) Conducting a Focused Assessment of the individual’s health status.”

All other activities via telehealth that are not via the phone, but rather via some kind of video conferencing platform, we still are waiting on a specific answer from the BON concerning LVN’s.  The rules on the BON concerning telehealth seem to refer to the RN specifically, not the LVN (at least not that we can see).  

Question # 5.

Has HHSC decided to allow a 5th person in a 4-person home and how would that be implemented?  What steps would they need to take for HHSC compliance? And how is this addressed in the CARE system?

Answer:  HHSC Response-
At this time, we are not considering having additional individuals in a three-person residence. Our concerns include the health and safety of individuals if there are more than 3 individuals in a residence. Another concern is not having awake staff. HHSC has received a waiver allowing an additional individual in an approved 4-bed group home (so up to 5 persons in a 4-bed home).”

Question #6 .

Is Medicaid and/or Medicare going to waive their rules against not allowing 60-90 day prescriptions & refills for prescriptions during Covid 19 crisis?  Currently persons with Medicaid and Medicare can only get 30-day prescriptions.

Answer: 

Still waiting on an answer on this question.  Sent Inquiry to PPAT (Private Provider’s Association of Texas) to find out from MCO’s. This is what HHSC told us: “This question has been referred to Medicaid Benefits Policy and is waiting a response.”

Question #7

For HCS – Can family members living with an individual in their “Own Family Home” be paid to deliver essential CFC services.  Previous billing guidelines dictated that CFC could not be provided by someone living in the same residence as the individual.

Answer:

HHSC Response: HCS and TxHmL Billing Guidelines Section 4660(1) and CFC Billing Guidelines Section 3710(a)(1) prohibit a person from receiving respite or Community First Choice Personal Attendant Services/Habilitation from someone who lives in the same home as the person.

HHSC is suspending the service provider qualification described in the HCS and TxHmL Program Billing Guidelines and the CFC Billing Guidelines that prohibits a service provider of respite or CFC PAS/HAB from having the same residence as the individual receiving the service. This restriction is being removed for individuals who live in their own home or family home and will be in effect from March 27th to April 30th. At this time, HHSC is not allowing parents of minor children or spouses to be paid caregivers.

Regarding background checks, a federal waiver is required to eliminate certain provider qualifications during the disaster. HHSC is considering which requirements can be waived and still maintain the health and safety of individual’s being served.

Please review alert released by HHSC on 4/6/20.

https://hhs.texas.gov/about-hhs/communications-events/news/2020/04/temporary-change-hcs-txhml-policy-service-providers-respite-cfc-pashab 

Contact Information For Other Questions:

 

FAQ’s For Covid-19

04/02/20

From Stakeholder’s Meetings March 16th-31st  (Draft)

Can individuals eat meals together?

Answer: As stated in PL 20-22, HHSC recommends canceling communal dining, however, HHSC is not prohibiting individuals in a three-person, four-person, or host home/companion care residence from dining together. HHSC recommends that if individuals dine together, staff members help ensure that the individuals practice social distancing at the dining table. HHSC also recommends that staff members plate the individuals’ food and help ensure they do not share serving spoons, utensils, plates, cups, or other related items.

Do local shelter-in-place orders prohibit an individual from leaving and returning to the home?

Answer: Shelter-in-place orders issued by local governments may vary, but in many instances require individuals to stay home unless they need to take care of a medical-related issue, go to the grocery store, or exercise outdoors while practicing social distancing. Many also require non-essential businesses to close. They do not prevent persons from returning to their residence. Program providers will need to comply with the restrictions and orders issued by their local government. Departures that are not health-related are strongly discouraged, and HHSC recommends that if an individual chooses to temporarily leave a three-person, four-person, or host home/companion care residence, the individual be allowed to return to the residence. If an individual leaves a residence temporarily for any reason, the individual must be screened upon return. If the individual meets any of the screening criteria described on page 2 of PL 20-22, HHSC recommends that the program provider isolate that individual in one area of the residence to protect other individuals in the residence.

Can providers tell people not to return for a period of time after vacation, home visit, etc.?

Answer: HHSC recommends that a program provider advise an individual of any local social distancing requirements, public gathering restrictions, or shelter-in-place orders. Departures that are not health related are strongly discouraged, and HHSC also recommends that if an individual chooses to temporarily leave a three-person or four-person residence or residence in which host home/companion care is provided, the individual be allowed to return to the residence. If an individual leaves a residence temporarily for any reason, the individual must be screened upon return. If the individual meets any of the screening criteria listed on page 2 of PL 20-22, HHSC recommends that the program provider isolate that individual in one area of the residence to protect other individuals in the residence.

What signage should be posted at the entrance of a home?

Answer: HHSC’s recommendations about signage at a three-person or four-person residence or a residence in which host home/companion care is provided are addressed on page 3 of PL 20-22.

If there is a fire or an emergency medical situation, do emergency responders need to be screened before entering a home?

Answer: Three-person, four-person or host home/companion care homes should not require screening of emergency services personnel in the event of an emergency.

Who is expected to screen PAS/HAB staff at an own home or family home?

Answer: HHSC does not have requirements governing the screening of these staff before they enter an individual’s own home or family home. HHSC recommends that the program provider assist the individual or the individual’s family members in monitoring the health of CFC PAS/HAB service providers as much as possible.

Are individuals required to continue receiving all services, or will there be exceptions for non-essential services?

Answer: As stated in PL-20-22, program providers are required to ensure that an individual’s critical needs are met. HHSC is not prohibiting the provision of non-critical services to individuals; however, providers must comply with any social distancing requirements, public gathering restrictions, or shelter-in-place orders issued by local governments. Providers can arrange for non-critical services to be delivered to an individual through a method other than an in-person visit to a health care professional, such as by telephone, Skype etc.

Can providers suspend routine doctor visits/therapy visits and/or use electronic visits instead?

Answer: Program providers can reschedule appointments for non-critical services, including routine doctor and therapy visits, or arrange for those services to be delivered through a method other than an in-person visit, such as by telephone, Skype etc.

Are individuals allowed to attend day hab if they want to attend?

Answer: HHSC has issued IL 20-09, which explains changes to allow day habilitation to be provided in the home. HHSC recommends program providers protect individuals by refraining from attending day habilitation, and events in public where more than 10 people are gathered. HHSC is not prohibiting the provision of non-critical services to individuals, which might include day habilitation. However, program providers must comply with any social distancing requirements, public gathering restrictions, or shelter-in-place orders issued by local governments.

Can providers bill for in-home day habilitation for host home companion care? If so, when?

Answer: HHSC has issued IL 20-09, which explains changes to billing requirements for the provision of day habilitation in an individual’s residence.

I have staff who have called in sick and simply can no longer work due to child care issues. What do I do when there are not enough staff for coverage?

Answer: As stated in PL-20-22, program providers are required to staff homes and ensure that an individual’s critical needs are met.

We have quite a few service recipients working. The guidance calls for limiting visitors but does not speak to whether providers should try to keep people home from work. What do we do?

Answer: HHSC recommends that a program provider advise an individual of any local social distancing requirements, public gathering restrictions, or shelter-in-place orders. Further, if an individual chooses to leave a three-person, four-person, or host home/companion care residence to work, HHSC recommends the individual be allowed to return to the residence but be screened upon the return. If the individual meets any of the screening criteria described on page 2 of PL 20-22, HHSC recommends that the provider isolate the individual in one area of the residence to protect other individuals in the residence.

How do HCS and TxHmL program providers get personal protective equipment (PPE)?

Answer: Program providers can contact the following organizations to ask about obtaining PPE:

  • State of Texas Assistance Request (STAR)

https://olympus.soc.texas.gov/files/docs/StarGuides/2020_STAR_SOC_QuickReference_Guide.pdf

  • Public Health Region

https://www.dshs.state.tx.us/regions/default.shtm

  • Local Public Health Organizations

https://www.dshs.state.tx.us/regions/lhds.shtm

  • Texas Division of Emergency Management:

https://tdem.texas.gov/

  • Regional Advisory Councils

https://dshs.texas.gov/emstraumasystems/etrarac.shtm

Where do HCS and TxHmL program providers go for COVID-19 information?

Answer: Reliable sources of information include:

  • The Centers for Disease Control and Prevention
  • The Texas Department of State Health Services
  • The Health and Human Services Commission

Who do I call if staff or individual tests positive for COVID-19?

Answer: Contact the local health department, or the Department of State Health Services (DSHS) if there is no local health department. Additionally, program providers must also report this information to HHSC at:waiversurvey.certification@hhsc.state.tx.us

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ICF COVID-19 Info from HHSC

April 13, 2020

A recording of the April 9, 2020, ICF/IID COVID-19 Q&A with HHSC LTC Regulatory and DSHS is now available. It’s for those who could not attend the webinar.

View the COVID-19 Q&A recording here.

TCDD
The Texas Council for Developmental Disabilities (TCDD) is seeking stories about the impact of COVID-19 on persons with disabilities.  The information will be used to inform state agencies, legislators and other state leaders about the needs of the ID/DD population as they make critical decisions regarding policy and funding related to this crisis.
We encourage you to share this information with persons you serve and their families. 
To access details about this TCDD initiative, go to:  https://tcdd.texas.gov/resources/covid-19-information/texas-covid-stories/

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New Guidance for LTCR Providers on Coronavirus

LTCR urges all providers to review the Centers for Disease Control’s new guidance on strategies to prevent the spread of COVID-19 in long-term care facilities. To ensure you have the most current information on COVID-19, visit the CDC and DSHS websites. For questions or guidance, call one of the DSHS hotlines:

  • 888-963-7111
  • 877-570-9779

All providers must continue to follow all laws, regulations, guidance and their own internal policies and procedures related to infection control.

 

From The CDC website:

Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs)

COVID-19 cases have been reported in all 50 states, the District of Columbia, and multiple U.S. territories; many having wide-spread community transmission. Given the high risk of spread once COVID-19 enters a LTCF, facilities must act immediately to protect residents, families, and staff from serious illness, complications, and death.

  1. Keep COVID-19 from entering your facility:
    • Restrict all visitors except for compassionate care situations (e.g., end-of- life).
    • Restrict all volunteers and non-essential healthcare personnel (HCP), including consultant services (e.g., barber, hairdresser).
    • Implement universal use of source control for everyone in the facility.
    • Actively screen anyone entering the building (HCP, ancillary staff, vendors, consultants) for fever and symptoms of COVID-19 before starting each shift; send ill personnel home. Sick leave policies should be flexible and non-punitive.
    • Cancel all field trips outside of the facility.
  1. Identify infections early:
    • Actively screen all residents daily for fever and symptoms of COVID-19; if symptomatic, immediately isolate and implement appropriate Transmission-Based Precautions.
      • Older adults with COVID-19 may not show typical symptoms such as fever or respiratory symptoms. Atypical symptoms may include new or worsening malaise, new dizziness, or diarrhea. Identification of these symptoms should prompt isolation and further evaluation for COVID-19.
    • Notify your state or local health department immediately (<24 hours) if these occur:
      • Severe respiratory infection causing hospitalization or sudden death
      • Clusters (≥3 residents and/or HCP) of respiratory infection
      • Individuals with suspected or confirmed COVID-19
  1. Prevent spread of COVID-19:
    • Actions to take now:
      • Cancel all group activities and communal dining.
      • Enforce social distancing among residents.
      • Ensure all residents wear a cloth face covering for source control whenever they leave their room or are around others, including whenever they leave the facility for essential medical appointments.
      • Ensure all HCP wear a facemask or cloth face covering for source control while in the facility. Cloth face coverings are not considered personal protective equipment (PPE) because their capability to protect healthcare personnel (HCP) is unknown. Cloth face coverings should NOT be worn instead of a respirator or facemask if more than source control is required.
    • If COVID-19 is identified in the facility, restrict all residents to their rooms and have HCP wear all recommended PPE for care of all residents (regardless of symptoms) on the affected unit (or facility-wide depending on the situation). This includes: an N95 or higher-level respirator (or facemask if a respirator is not available), eye protection, gloves, and gown. HCP should be trained on PPE use including putting it on and taking it off.
      • This approach is recommended because of the high risk of unrecognized infection among residents. Recent experience suggests that a substantial proportion of residents could have COVID-19 without reporting symptoms or before symptoms develop.
      • When a case is identified, public health can help inform decisions about testing asymptomatic residents on the unit or in the facility.
  1. Assess supply of personal protective equipment (PPE) and initiate measures to optimize current supply:
    • If you anticipate or are experiencing PPE shortages, reach out to your state/local health department who can engage your local healthcare coalition.
    • Consider extended use of respirators, facemasks, and eye protection or prioritization of gowns for certain resident care activities.
  1. Identify and manage severe illness:
    • Designate a location to care for residents with suspected or confirmed COVID-19, separate from other residents.
    • Monitor ill residents (including documentation of temperature and oxygen saturation) at least 3 times daily to quickly identify residents who require transfer to a higher level of care.

Very Important HHSC Alerts!

June 26, 2020

Survey

WS&C will resume survey activities as of July 1st, 2020 for HCS/TxHmL.

 

Administrative Penalties Update!
Administrative Penalties will begin being enforced starting September 1st, 2020!
Please sign up for the following webinar.

Home and Community-based Services and Texas Home Living providers are invited to join Long-term Care Regulation to discuss questions and answers related to administrative penalties.

Date: July 9
Time: 2:30 p.m. – 3:30 p.m.

Register for the WSC Q&A Webinar Regarding Administrative Penalties.

If you missed the initial Joint Provider’s webinar on June 25th discussing Administrative Penalties, you may see the webinar recording of the session below. 

June 25, 2020

A recording of June 25, 2020, HCS and TxHmL Joint Provider Training on Administrative Penalty Rules webinar is available for those unable to attend.

View the webinar recording here

June 7th, 2019

Revised: IL20-11 Temporary Guidance Extended Through June 30 for IPC’s & IDRC’s  

To ensure people do not experience a gap in services due to the temporary suspension of face to face service coordination visits for COVID-19, the Texas Health and Human Services Commission will extend Intellectual Disability/Related Condition assessments and individual plans of care expiring at the end of June 2020. This is for people enrolled in the Home and Community- based Services Program or the Texas Home Living Program.

HHS revised IL20-11, Extensions of Eligibility and Individual Plan of Care Revisions for Individuals in HCS and TxHmL Due to COVID-19 (PDF). It was previously issued on March 26 and extends the temporary guidance through June 30, 2020.

Call the IDD Program Enrollment Support message line at 512-438-2484 for ID/RC assessment questions.

Call the IDD Utilization Review message line at 512-438-5055 for IPC extension or revision.

HHSC Issues Guidance to HCS/TxHmL Providers on Covid-19!!!!

Provider Letter 20-12, HHSC Guidance to HCBS and TxHmL Program Providers on Covid-19, is now available. HHSC encourages program providers to review this guidance. Remember, no non-essential visitors, see definition in the letter and providers must refrain from sending individuals to Day Habilitation and Community Events!  See link below.

https://hhs.texas.gov/about-hhs/communications-events/news/2020/03/hhsc-issues-guidance-hcs-txhml-providers-covid-19

Save The Date:

2020 HHS Long Term Care Regulatory Waiver Survey and Certification Joint Provider Training  (Date has been moved!)

September 30 – Oct.2, 2020

Crowne Plaza
6121 N IH 35
Austin, TX 78752

This free collaborative conference will focus on a variety of topics central to the Home and Community-based Services and Texas Home Living waiver programs. Featured topics will include Administrative Penalties, Amelioration, Informal Dispute Resolution, Nursing Services, Aging, Residential Surveys, Critical Incidents and more.

( I am assuming these topics may change including adding COVID-19)

Program provider staff, leadership, nurses and HHS surveyors are encouraged to attend.

Registration will be available Summer 2020.

Questions? Contact Kristin Priddy at 512-438-3297.

 

Billing Guideline Updates For HCS

November 20, 2019

The HCS, TxHml, and CFC billing guidelines have been updated effective Nov. 15, 2019. A summary of the revisions can be found on page 25 of the CFC PDFpage 147 of the HCS PDF and page 129 of the TxHmL PDF. Send questions about the billing guidelines to HCS.TxHml.BPR@hhsc.state.tx.us.

TAC Updates for HCS

Effective Oct. 1, 2019

Texas Administrative Code has been updated effective Oct. 1, 2019.

Locate program rule updates at 40 TAC Chapter 9 – Home and Community-based Services and Texas Home Living Programs and 40 TAC Chapter 49 Contracting for Community Services.

Send questions about rule updates to hcspolicy@hhsc.state.tx.us or txhmlpolicy@hhsc.state.tx.us and to COS_CFCMTools@hhsc.state.tx.us
for 40 TAC Chapter 49 Contracting for Community Services.

Please pay particular attention to 9.175 (ANE Reporting Rules) in HCS and changes to Tac 9.178 Quality Assurance

Please see the link below to verify the current TAC changes.

https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=9

. Both HCS and TxHmL rules can be accessed here.

Email medical_and_social_services@hhsc.state.tx.us with your questions.

HHSC Launches IDD Operations Portal for HCS, TxHmL, ICF-IID, CFC Non-Waiver Providers and LIDDAs

The Texas Health and Human Services Commission is pleased to announce implementation of the Intellectual and Developmental Disability Operations Portal. Local Intellectual and Developmental Disability Authorities, Home and Community-based Services, Texas Home Living, Intermediate Care Facility for Individuals with Intellectual Disabilities providers may begin registering to use the IDD Operations Portal starting April 1, 2019.

The IDD Operations Portal is an online system that allows secure submission of electronic documents to and from the IDD Program Eligibility and Support and IDD Utilization Review departments. This portal is not replacing any of the systems you use today, such as TMHP or CARE. It is intended to result in a more timely and efficient submission of documents, and allows providers to check the status of submissions online.

A staggered implementation is happening now. Providers and LIDDAs with DBAs starting with C-G can now register for portal access.

Please see the full implementation schedule detailed in the information letter listed here.

Enhanced Provider Portal, Relief Fund Payments Available For Providers!

Tuesday, June 9, 2020

HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid & CHIP Providers

Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution. HHS is also announcing the distribution of $10 billion in Provider Relief Funds to safety-net hospitals that serve our most vulnerable citizens. The safety net distribution will occur this week.

“Healthcare providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19,” said HHS Secretary Alex Azar. “HHS is using funds from Congress, secured by President Trump, to provide new targeted help for America’s safety-net providers and clinicians who treat millions of Medicaid beneficiaries.”

HHS is providing support to healthcare providers fighting the COVID-19 pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers, including those disproportionately impacted by this pandemic.

ENHANCED PROVIDER RELIEF FUND PORTAL

On Wednesday, HHS is launching an enhanced Provider Relief Fund Payment Portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve.

The initial General Distribution provided payments to approximately 62 percent of all providers participating in state Medicaid and CHIP programs. The Medicaid and CHIP Targeted distribution will make the Provider Relief Fund available to the remaining 38 percent. HHS has already provided relief funding to over one million providers, and today’s announcement is expected to reach several hundred thousand more providers, many of whom are safety net providers operating on thin margins.

Clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received General Distribution funding may submit their annual patient revenue information to the enhanced Provider Relief Fund Portal to receive a distribution equal to at least 2 percent of reported gross revenues from patient care. This funding will supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19. Examples of providers serving Medicaid/CHIP beneficiaries possibly eligible for this funding include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based services, providers.

To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. Close to one million health care providers may be eligible for this funding.

More information about eligibility and the application process is available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/index.html

For updated information and data on the Provider Relief Fund, visit hhs.gov/providerrelief

News Releases below:                                                                                                                                                                                           

media@hhs.gov
www.hhs.gov/news
Twitter @SpoxHHS

ICF/IID Updates

Survey Operations Resume as of June 15th, 2020

From HHSC
As of June 15, 2020, Survey Operations has begun to resume some normal survey activity, and Enforcement is also resuming enforcement processes and activities. This means we will be issuing various due process notice letters to individuals, agencies, and facilities that have been on hold due to COVID.
Please contact Enforcement Director Derek Jakovich by email at derek.jakovich@hhsc.state.tx.us if you have questions.
In response to questions regarding what normal survey and enforcement activities are resuming as of June 15 and what programs are affected, HHSC replied as follows:
As of June 15, 2020 Survey Operations is resuming some survey activity such as complaints with lower priorities, and possibly some licensure and certification surveys. For Enforcement, due process notice letters such as denials, revocations, and imposition of administrative penalties will be issued and the opportunity to appeal will be provided. Of course, the COVID circumstances may affect these activities.
The notice applies to NF, ALF, DAHS, PPECC, HCSSA, and ICF/IID.

Providers Must Log Residents’ Leave

All community-based ICF/IID program providers must submit an absence request in the TMHP ICF/IID Online Portal for a resident away from the facility for one or more full days. See the TMHP ICF/IID Online Portal User Guide (PDF) starting on page 52 for more information. The program provider must submit a return request within three days after a resident returns to the facility. See page 58 of the Online Portal User Guide for an explanation.

Please ensure that information entered in the portal for absences is current. HHSC uses the information to determine how many residents are absent from their facilities and the length of those absences.

 

Very Important Information:  ICF License Renewals!!!

Regardless of whether HHSC sends advance notice that a license is expiring, providers are responsible for applying to renew their licenses in a timely manner. Furthermore, operating an ALF, DAHS facility, HCSSA, ICF/IID, NF, or PPECC without a license is a violation of state law.2.0Policy Details & Provider ResponsibilitiesSubject to certain narrow exceptions, state law requires a person to have a license if the person:•establishes or operates an ALF;1•operates a DAHS facility;2•engages in the business of providing home health, hospice, habilitation, or personal assistance services, or represents to the public 1Texas Health and Safety Code §247.021.2Human Resources Code, §103.0041.

PL 20-03 January 9, 2020
If a person is a provider of home health, hospice, habilitation, or personal assistance services for pay establishes, conducts, or maintains an ICF/IID or an NF owner or operates a PPECC, the expiration date of a license is printed on the license.
A provider must apply for a renewal license before its current license expires if the provider intends to engage in the activity that requires a license after the current license expires.
If a provider submits a sufficient application to renew its license, including applicable fees, to HHSC before its license expires, the license continues in effect and the provider may continue to operate while HHSC is processing the renewal application. If a provider does not submit a sufficient application to renew its license before it expires and continues to engage in the activity that requires a license after the license expires, the person is violating state law. HHSC may take enforcement action or pursue civil remedies against a person under those circumstances as per the statute and regulations applicable to that provider type. If a license expires without being renewed, the person who held the license must apply for an initial license as a new applicant. The person may not engage in the activity for which a license is required until HHSC issues a new initial license. The applicant must meet all requirements for an initial license, including any Life Safety Code or construction requirements. Any waivers, such as waivers of requirements related to room size in a facility, that were granted under the expired license will no longer be in effect.

Texas Health and Safety Code §142.002.4Texas Health and Safety Code §252.031.5Texas Health and Safety Code §242.031.6Texas Health and Safety Code §248A.051. 726 Texas Administrative Code (TAC) §553.15(a)(2) and (e) for ALF, 40 TAC §98.15(a)(2) and (e) for DAHS, 26 TAC §558.17(a) and (g)(2)and (3)for HCSSA, 26 TAC §551.15(d) for ICF/IID, 40 TAC §19.208(e) for NF, and 26 TAC §550.106(a) and (e) for PPECC.

PL 20-03 January 9, 2020
The Texas Unified Licensure Information Portal, which is the system HHSC uses for issuing and renewing licenses, has not been notifying providers that their licenses are about to expire. This PL is to remind providers that the expiration date of a license is printed on the license and, regardless of whether HHSC sends advance notice of an upcoming expiration, a provider must take necessary action to renew a license so the provider is operating in compliance with state law.
Contact Information
If you have any questions about this letter, please contact the Policy, Rules and Training Section by email at

PolicyRulesTraining@hhsc.state.tx.us or call (512) 438-3161.

Provider Joint Training Opportunities

Check out Joint Provider Trainings link from HHSC, for more info:
https://apps.hhs.texas.gov/providers/training/jointtraining.cfm#course_112

 

 

Survey Process for ICF Has Changed: Please Be Aware

You may check your SOMA (Surveyor’s Operational Manual for ICF in Appendix J) for these changes.

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_j_intermcare.pdf 

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018Downloads/R178SOMA.pdf

Look for our live training session coming in July 2020 on Appendix Q changes!

“Changes to Appendix Q-Immediate Jeopardy for ICF and What That Means For The Provider”

Webinar in July, 2020

Appendix Q of SOMA (Immediate Jeopardy) Changes

http://www.tmhp.com/News_Items/2019/04-Apr/CMS%20Releases%20Revision%20to%20Appendix%20Q%20Immediate%20Jeopardy%20Guidelines.pdf

CMS clarifications letter

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QSO19-09-ALL.pdf

Online basic training for Core Appendix Q is available on the Integrated Surveyor Training
Website at the following link:https://surveyortraining.cms.hhs.gov/
This basic training is intended to provide Regional Office and State Survey Agency surveyors, management staff, and
training coordinators, as well as providers, suppliers, and laboratories, and other stakeholders with
the ability to identify immediate jeopardy
.
NOTE: This is a required training for RO and SA staff involved in immediate jeopardy
determinations. All RO and SA surveyors, members of management, and training coordinators
are expected to take this training as soon as practicable, but not later than March 22, 2019.
Point of Contact:
For questions related to this information, please add in subject line
“Immediate Jeopardy Inquiry” and send your email to:
QSOG_GeneralInquiries@cms.hhs.gov  
.
Effective Date:
Immediately-This policy should be communicated to all survey and certification staff, their managers and the State
and Regional Office training coordinators within 30 days of this memorandum.

 

SOMA appendix Q Section  Immediate Jeopardy 

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_q_immedjeopardy.pdf

 

II.  Proposed ICF/IID Rates: Below please find the link to information about the August 2, 2019 HHSC public hearing on the proposed ICF/IID rates.  The hearing will be at 3:00 p.m. and held in the HHSC public hearing room (first floor of HHSC).  Additional information about the hearing (specifically, needed member action) will be forthcoming.
Though the above link provides the proposed rates, below is a chart which reflects both the current and proposed ICF/IID rates.  Note that with the exception of LON 9, all LON categories and facility settings/sizes are proposed to receive an increase.  Also, at this time, the specifics regarding the impact of the increases on the rate categories (residential direct and indirect  & day habilitation direct and indirect) are not yet available.  According to HHSC the ‘specifics’ should be available on or after this Friday (July 19, 2019).

LON & Facility Size

Current Rates

Proposed Rates

SMALL

 

 

LON 1

$144.25

$150.31

LON 5

$160.74

$167.90

LON 8

$182.82

$191.85

LON 6

$223.88

$236.59

LON 9

$406.11

N/C

MEDIUM

 

 

LON 1

$118.04

$123.14

LON 5

$134.06

$140.24

LON 8

$158.90

$166.92

LON 6

$190.24

$200.79

LON 9

$385.84

N/C

LARGE

 

 

LON 1

$112.09

$116.30

LON 5

$119.64

$124.64

LON 8

$133.22

$139.44

LON 6

$179.40

$188.96

LON 9

$387.25

N/C

 

 

EVV (Electronic Visit Verification) Updates

CURES Act EVV Training is Underway for HCS/TxHmL Providers

Program providers and FMSAs affected by the Cures Act EVV expansion must complete EVV policy and EVV Portal training before Dec. 1, 2020, and then annually. See the EVV Required Training Checklist (PDF) for more information.

To meet the training requirement, program providers and FMSAs attending these webinars must:

  1. Register for Session 1.
  2. Register for Session 2.
  3. Attend both sessions from start to finish.

To register, click the links below:

FMSAs

HCS/TxHmL

Additional Training Opportunities

Program providers and FMSAs can also meet training requirements by completing computer-based training online in the HHSC Learning Portal and TMHP Learning Management System. HHSC and TMHP are planning additional live training events this fall and will provide more information when available.

Email TMHP for questions about registration or the EVV Portal.

Email questions about EVV training requirements.

 For more Cures Act information, visit the HHS EVV Cures Act webpage.

 

If you miss the EVV training dates, you may take them on the HHSC learning portal:

https://learningportal.dfps.state.tx.us/

 

Please go to HHSC’s page on Electronic Visit Verification for the latest information/ updates to EVV.  Please see Training & Joint Training pages from HHSC as well!

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/electronic-visit-verification

Updated Timeline for Cures Act EVV Expansion     

The updated timeline for expanding the Cures Act EVV requirement to all Medicaid personal care services is now available on the HHS Cures Act EVV website.

The timeline includes new information and resources about the EVV Practice Period beginning July 1, completing training requirements, and more.

This information is for Cures Act program providers and FMSAs (PDF) required to use Electronic Visit Verification by Jan. 1, 2021.

For questions, contact EVV.

 

New EVV Proprietary System Onboarding Documents Available

TMHP has posted new information about the EVV proprietary system onboarding process on the TMHP EVV Proprietary Systems webpage.

The documents located in the Onboarding section provide an overview of the approval process that a program provider or FMSA must complete before using their own EVV proprietary system. For more information, refer to the article on the TMHP EVV website (PDF).

Resources

 

Trainings Available:

EVV Policy Training (Provided by your payer)

  • The HHSC EVV Policy computer-based training (CBT).
  • The MCO Policy training. Contact your MCO for EVV Policy training opportunities.

EVV Aggregator and EVV Portal Training (Provided by TMHP)

There will also be instructor-led trainings (EVV Roadshow) in October. Find the schedule and register on the HHS Learning Portal.

Additional training resources are available on the HHSC EVV website and the TMHP EVV Provider Training webpage.

For questions about this alert, email Electronic_Visit_Verification@hhsc.state.tx.us.

 

Online, interactive EVV training courses are available

in the HHS Learning Portal and TMHP Learning Management System. Completing these courses help program providers meet EVV training requirements.

The HHS Learning Portal includes training about HHSC EVV Policy.

The TMHP Learning Management System includes training about:

  • EVV Vendor Selection
  • EVV Portal
  • EVV Portal Standard Reports and Search Tools
  • EVV Claims Submission and Billing

Webinars

Please go to www.twogetherconsulting.com for more information and registration. Click on  “the calendar” of the Webinar you want to attend. 
********We also have pre-recorded webinars you can purchase for use at your facility.  Please contact Meghan Jones at: meghanjones.tx@gmail.com for more information, registration, and payment.

June & July

 

“Prep Session For HCS Provider Applicant Test” (Webinar)
(We will be reviewing some TxHmL information as well)

Date:  Tuesday- July 2nd, 2020

Time:  (6pm-8:30pm)  Central time

Cost:  $150/person

 

 

 

“Description & Development of The Comprehensive Nursing Assessment”  (HCS/TxHmL)

Date:  July 20th, 2020   

Time:  10AM-12:30 PM

Cost: $55/person

For:  Nursing Staff, Quality Assurance Staff, Program Managers, Administrators

Presenter:  Gina Peterson, RN Consultant

Please register for this webinar on or before June 20th, 2020  10:00 AM CDT

After you have made payment for this webinar,  you will receive a confirmation email containing the handouts and a link to register with “Gotowebinar” to attend that session.  

 

The Importance of SAM’s & Special Needs Training:                                     “RN Considerations for Training In IDD Programs”

(HCS/TxHmL/ICF)  July 30th, 2020  

 

Case Management/Care Coordination Webinar Series for HCS Providers 

(You can purchase pre-recorded sessions)

LIDDA Vs. HCS Provider: “Roles And Responsibilities-Timelines And Communication”

Webinar via Go To Webinar

Time:  2.5 hrs

Cost:  $50/person

You will receive a link to register for the webinar and the training handouts once we have received payment for the session.

For:  HCS Care Coordinator/Case Manager,  Program Manager, Administrator, Quality Assurance Staff, Nurses and more

Description:  This class is designed for anyone who is first starting out in the HCS Waiver Program as a new provider and for those persons coordinating services (case management) for the individuals in the HCS Waiver Program. This class is also effective for Nursing staff who need to know how the program works overall as they are part of the coordination of services for the individuals in the program.  Lastly, this is also a great session for those providing oversight and quality assurance for the program.

The discussion will include:

-What Does the LIDDA (Local IDD Authority) do?

-Who is the SC (Service Coordinator) at the LIDDA and what is their role and responsibilities?

-What are the HCS Provider’s role and responsibilities?

-When does the provider have to communicate with the SC?

-What are the timelines for certain responsibilities and expected communications on both sides?

-Who does “what” during enrollments, transfers, temporary suspensions, and permanent discharges?

-And much more

 

“Developing The IP (Implementation Plan) with Person-Centered Thinking in The HCS Program”

 

Time:  2.5 hrs

QA Session from 12:30 pm – 12:45 pm 

Cost: $50 per person

For:  Program Administrators, Program Directors, Care Coordinators, LIDDA Representatives- Service Coordinators, etc..

The webinar will be via “Go To ”Webinar

Instructions for the webinar and training handouts will be sent to your email after payment is made online or check is received.

Topics:

A review of basic components of a PDP (Person Directed Plan) completed by the LIDDA service coordinator and how this fits in with the IP (Implementation Plan) completed by the HCS provider.

Review of IP components and how to use the PDP to develop the complete IP. Review of some sample IP’S for various services on the IPC ( Individual Plan of Care).

Defining the terms: Action Plan, Desired Outcome, Objective, strategies, justifications.

 

 

LON/ICAP/IDRC Training for HCS, TxHmL, and ICF/IID Programs

 

 

Time:  2.5 hrs

QA Session from 12:30 pm – 12:45 pm 

Cost: $50 per person

For:  Program Administrators, Program Managers, Care Coordinators/Case Managers, Service Coordinators, Nurses etc..

The webinar will be via “Go To ”Webinar

Instructions for the webinar and training handouts will be sent to your email after payment is made online or check is received.

Topics:

-A review of the definition of LON (Level of Need) in the HCS, TxHmL, and ICF/IID programs

-What is the ICAP (Inventory for Client & Agency Planning) and how is it utilized?

-When does the provider complete an ICAP and Why Do They Need To?

-What is the IDRC (Intellectual Disability/Related Condition) form

-When is the IDRC filled out and by who?

-What does LON mean (Level of Need)?  (assistance needed, dollars required for that assistance level, etc…)

-How do I get a Level of Need increase?  Who applies for the Level of Need increase?  

-Utilization Review Department- what is their role?  (Monitoring units in CARE and Utilization of services, Approving Levels of Needs, etc…)

 

 

“Billable Services In The HCS Program″

You will receive a link to register for the webinar and handouts after we receive payment.

 

Time:2.5 hrs

Cost:  $65 per person

Presenter:  Julie Blacklock/IDD Waiver Consultant

For: Administrators, Program Managers, Quality Assurance Staff, Care Coordinators, Nurses, Billing/Data Entry Staff

Topics:  

-Definition of all Billable Services on the IPC (Individual Plan of Care)

Hourly and Daily Unit services such as RSS/SL, HH/CC, CFC (PAS-HAB), DH, REH, PT, OT, SP, DI, BES, CRT, AU, SW, CDS, etc…

-Other Services (Units in dollars only):  Adaptive Aids, Minor Home Modifications, Dental, Pre-Minor Home Mod and OT Assessment, TAS

– Recent and some Upcoming Changes in the HCS Billing Guidelines

-How does this affect the Provider?

-How can I use this change to improve services

-How do I document to capture the most billing?-How to prevent billing for non-billable services?

 

ADP Services

 

http://accountantprogram.adp.com/accept/?EID=ca25cd37-5048-4115-96c3-fcffcdabb0a1&amp;type=ShareUrl

ADP

How is ADP addressing Covid-19 with their clients?  See links below:

Don’t forget if you are trying to develop training and policies around Covid-19, ADP can help!!

https://www.adp.com/about-adp/data-security/client-resources/adp-covid-19-preparedness.aspx

https://www.adp.com/spark/articles/2020/03/covid-19-protecting-your-employees-and-business.aspx

http://chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/https://www.adp.com/-/media/who%20we%20are/pdf/business-resiliency-brochure.ashx?la=en&hash=0125A6ECCCF06EDBF9E503030B18EA7023358032

 

EVV

EVV requirements take effect January 2020 for Medicaid funded personal care services and January 2023 for Home Healthcare Services.  Get all your services (payroll/HR support) plus EVV, without having to pay for another company’s service.  

ADP is now partnering with TSheets, which will be great for our HCS/TxHmL providers who use ADP or who want to use ADP for Payroll and HR support.

Even if you have ADP already and want to upgrade your package, call or email Laura Throneberry at ADP ( she is Twogether Consulting’s liaison we have been working with) to assist our HCS/TxHmL and ICF providers. I hope this makes it easier for some of you who are concerned about having to get another separate service for Electronic Visit Verification.

Supercharge your ADP Time Cards with T-Sheets!

EVV (Electronic Visit Verification) Tracking

Manage Scheduling

Track Time By The Job

Easy Accurate Time Sheets

Mobile Time Tracking

Who’s Working Now and Where?

Alerts & Approvals

Reports

If you have questions concerning COVID-19  HR concerns: 
  EIDL (Economic Injury Disaster Loans), 
-CARES Act,(Coronavirus Aid, Relief, and Economic Security) and 
-FFCRA (Families First Corona Virus Response Act)  
 
Laura can provide you with assistance as well as with your “Policy & Procedure” needs surrounding COVID-19.  ADP also can provide you with some free resources through ADP, even if you do not currently use ADP Payroll & HR services! 
 
Example:  An employee advocacy center-where employees can call in to see where they can get free testing and set up a telehealth appointment with a real doctor, if you already have health insurance through your business already, a free COVID-19 tool kit for small businesses including a podcast and more to help you. 
Laura can discuss some other ways ADP can help you as well: other HR issues, staying in compliance and developing a safety manual.
 
 
Please see the presentation from Laura on these topics at our Gotostage channel

Laura Throneberry at: Office: (512)-795-6764 or Cell:  (713) 517-4715 or you can email her at : laura.throneberry@adp.com 

Mention how you found out about ADP through “Twogether Consulting/ Julie Blacklock” to receive discounted rate for limited time on your first month of service.

For those of you looking for payroll and HR services for your HCS , TXHmL, and ICF Programs, especially in the Houston and surrounding areas, I urge you to contact Laura at ADP about these services and more.  She is our contact and works with HCS/TxHmL provider client base in the Austin and Houston area for the most part, and their specific needs.  She does work with providers in other parts of the state as well. They have now also added OIG and LEIE monthly checks to part of the HR services they can provide.  Woo hoo!

ADP can help you with everything from payroll, to employee handbooks for your company, to tracking items due for your HR files, etc… Whether you are new, small, or large business we could all use some help.  At a time when Providers really need to watch every penny, it is nice to also be informed or updated about changes coming!

Some of The Helpful ADP Free Training Webinars & Recordings

Title: PPP Loan Forgiveness Guidelines Explained

Date: Wednesday, June 24, 2020

Time: 12:00 PM Eastern Daylight Time

Duration: 1 hour

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&referrer=https%3A%2F%2Fwww.adp.com%2Fresources%2Fevents.aspx&eventid=2415042&sessionid=1&key=8EC1A5F3386371E11188458C8916AE14&regTag=&sourcepage=register

Title: Workplace Spotlight: COVID-19 Legislative Updates – How the Paycheck Protection Program Flexibility Act (PPPFA) Changed PPP Loan Forgiveness

Duration: 1 hour

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2425491&sessionid=1&key=BA14109722A0F3C21600A063428446C4&regTag=&sourcepage=register

Title: How to Create Instant Cash-flow for Small Businesses Leveraging CARES Act and R&D Tax Credits

Duration: 1 hour, 3 minutes

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&referrer=https%3A%2F%2Fwww.adp.com%2Fresources%2Fevents.aspx&eventid=2386032&sessionid=1&key=A4098DF17F17CDBB4582C737C4113CA4&regTag=&sourcepage=register

Title: Workplace Spotlight: CARES Act & COVID-19: Understanding the Employee Retention Tax Credit and Other Tax Implications

Duration: 1 hour, 1 minute

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2281116&sessionid=1&key=811BF8DD403E27DEC8601E210E210CCD&regTag=&sourcepage=register

Title: SPECIAL EDITION: Protecting Your Workforce and Understanding Policies as Your Organization Responds to COVID-19- Part I

Duration: 35 minutes

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2218023&sessionid=1&key=B0D8739554A6735C19B30AA5ECDAE3FD&regTag=&sourcepage=register

Title: SPECIAL EDITION – PART 2: Protecting Your Workforce and Understanding Policies as Your Organization Responds to COVID-19

Duration: 1 hour, 2 minutes

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2225067&sessionid=1&key=1E14A512E04471768B1056BB7453393A&regTag=&sourcepage=register

PEO 101: HOW HR OUTSOURCING CAN HELP YOU AND YOUR CLIENTS DURING UNCERTAIN TIMES

Register

Cost Free

CPE Credits1.0 hour

CE Credits0.0 hours

Course Description

During these uncertain times, it is even more important for businesses to have help navigating employee issues like workplace safety, compliance, HR, payroll and employee benefits.  Outsourcing HR through a Professional Employer Organization (PEO) solution is something accounting professionals and their clients can consider for that level of support. Join our panel of CPAs and industry experts as they discuss the most critical elements you need to know about PEOs, from how they work and their benefits to the role they can help play in a crisis so your firm and your clients can both continue moving your business forward.

 

ADPhttps://www.adp.com/

 

 

 

HHSC Provider Applicant Training (HCS/TxHmL)

Update:  HCS/TxHmL Provider Applicant Training/Testing

Currently, we do not have a definitive date for when HHSC will offer live Provider Applicant Training and Testing again.  There has been some mention of a possible live training and testing session August, but most likely this is doubtful to occur, due to COVID-19 precautions and rules of social distancing, really limit the options of a live testing session. 

We have had quite a few of our HCS/TxHmL provider applicants since the end of May, recently receive letters referring to them to take online orientation in the form of online training modules. (Online Provider Applicant Training through the HHSC learning portal which is a series of 13 modules).

The directions to these same provider applicants after taking the online orientation seems to indicate that the testing part of the application process is a bit of a “holding pattern”.  They have been told that they will be notified of further instruction on testing after completion of the “online provider applicant training modules” as soon as testing is scheduled.

**It has been suggested by a few of the applicant specialists at HHSC we have heard back from, that the quizzes being taken as part of the orientation modules may count as the testing part of the application process.

I will keep you posted on any new changes.   

 

Texas Workforce Commission (Supported Employment)

Texas Workforce Commission

Update on TWC services Provider Manual and Resources 

The following revisions to the Vocational Rehabilitation Standards for Providers Manual (VR-SFP) are available for 30-day review on the Vocational Rehabilitation Providers’ Resources page and will go into effect on June 29, 2020.

Chapter 2: Obtaining a Contract for Goods and Services—updated Section 2.8.1 Adding Counties or Services, Goods, and/or Equipment to a Contract, to indicate that provider contracts awarded after January 2020 will be statewide and therefore will not list the counties to be served.

Chapter 17: Basic Employment Services—updated Section 17.4.1 Bundled Job Placement Services Service Description and its associated form VR1845B, Bundled Job Placement Services Plan—Part B and Status Report, to clarify which types of placements are acceptable for VR customers.

Chapter 18: Supported Employment Services—updated Section 18.1, Supported Employment Overview, and its associated form VR1643, Supported Employment Services Plan 2—Placement, Job Analysis &Training Plan, to clarify which types of placements are acceptable for VR customers.

Cost Reporting Update!

Cost Report/Accountability Report has been extended to June 15, 2020

A notice has been posted to the LTSS web-page and the vendor will be updating the STAIRS system by Monday.  HHSC has stated they do not anticipate any additional extensions will be made at this point; however, if this occurs they will keep everyone updated.

Notice:

The new due date for submission of the 2019 Cost Report and/or 2019 Accountability Report has been extended to June 15, 2020.

This new due date supersedes the original notification and any reminder emails that providers may have already received. 

This extension is for the following program types/services. 

  • Community Living Assistance and Support Services – Direct Service Agency (CLASS-DSA)
  • Deaf-Blind Multiple Disabilities Waiver (DBMD)
  • Early Childhood Intervention (ECI) – Case Management
  • Early Childhood Intervention (ECI) – Specialized Rehabilitative Services
  • Home and Community-based Services / Texas Home Living (HCS/TxHmL)
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions State Supported Living Centers/Bond Homes (SSLC/BH)
  • Nursing Facility (NF)
  • Primary Home Care (PHC)
  • Rehabilitation Services – Mental Health
  • Residential Care (RC)
  • School and Health and Related Services (SHARS)
  • Service Coordination – ICF/IID
  • STAR+PLUS services affiliated with the above service types
  • Targeted Case Management (TCM) – Mental Health

 The deadline for 24-Hour Residential Child Care (24RCC) and Day Activity and Health Services (DAHS) is still May 15, 2020, with one exception. If the 24RCC or DAHS provider is serving a COVID-19 confirmed positive client(s), the provider can be granted an extension to June 15, 2020. 

These providers will need to contact costinformation@hhsc.state.tx.us to request the extension to June 15, 2020.

Utilization Review Department News!

Last Friday HHSC posted the following CARE banner:  Due to the 09/01/2019 HCS rate increase, service authorizations are being updated to ensure they are in line with their corresponding IPCs. This will not cause any payment changes.
Upon inquiry as to what this meant, Holly Lindsey, UR, HHSC provided the explanation below.  Hopefully the explanation and guidance will be of assistance to you should an action (revision, renewal or transfer) be taken on an IPC which prompts a notice that the IPC exceeds the cost cap.
Message from Holly Lindsey:  Since the effective dates of the rate increases, providers have been paid at the appropriate rate for the corresponding service. However, the C62 and C72 screens do not update until a provider takes an action on the IPC that was effected. This can be a revision, a renewal, or a transfer. That is why providers are suddenly seeing “Exceeds” messages in CARE for the same services that were under the 100% capitation rate ($83,734) previously. The services cost more so the total cost is higher. This actually occurred months ago with the rate increase, however, it takes an action on the IPC for it to update.
Any IPC that is over the $83,734 level requires a packet to be submitted (TAC 9.160(d). However, since we are removing flags to allow for billing during COVID, it is not necessary to send a packet at this time. The next time an action is taken on the IPC, however, an “Exceeds” message will occur again, and CARE will prompt them to send a packet.
Removing the flag is currently a manual process, so providers can contact me (Holly Lindsey) directly through this email for flags related to cost.
Note from Twogether Consulting: If you have tried to enter a renewal on an IPC or IDRC into CARE and you are having problems, remember that IPC’s and IDRC’s are automatically renewed through April 30th, 2020.
For Assistance with either issue:
They can call the main UR # 512-438-5055 or
Holly Lindsey:  512-438-5704;  holly.lindsey@hhsc.state.tx.us

Free Webinar Series

The free webinars in April & May will be posted on our “Gotostage” page after the live session.
 We are pleased to announce our guest for the first session in July in our “free webinar series”:  
 
 
The Fox Alliance (Tax, Bookkeeping, and Payroll Services)  will be our next guest presenter:  moved to July 2020!

 Free Webinar--Date and Topics To Be Announced in the near future

 

 

Training Resources

College of Direct Support  http://www.directcourseonline.com/direct-support/about/

DirectCourse | “College of Direct Support brings training in line with the latest research and partners with other leaders in the field of Intellectual and Developmental Disabilities”

Has a fantastic training curriculum for Direct Support Staff and their supervisors.  See a list of courses from the 2019 catalog in the link below:

https://www.directcourseonline.com/wp-content/uploads/2019/07/2019-CDS-catalog_Final.pdf

 

 

Free Online Training at The Center For Start Services:  The  National Leaders in the Mental Health Aspects
of Intellectual and Developmental Disabilities                                                                                                                                                                                                     For all their training go to  https://www.centerforstartservices.org/community-resources

Free Video Training from the NADSP and AADMD  “The Role of The DSP and The Corona Virus”,  Part I-check out this amazing training video.    https://youtu.be/ud4Q4e_hcuw

Part II of this DSP Video Training session is as follows:  “The Role Of The DSP and The Corona Virus” Part II  https://youtu.be/VfErVzMn9-A

Free Training For Those Who Support Persons With IDD

https://hhs.texas.gov/about-hh s/communications-events/news/2017/01/free-training-people-who-support-clients-idd

Live Classes

Please go to www.twogetherconsulting.com for more information and registration.

 

” HCS Provider Applicant Prep Session” to be announced in the near future, but the orientation and applicant testing was recently postponed, so will keep you updated.

“Appendix Q-Immediate Jeopardy Changes/Scope & Severity/Admin Penalties” 2-day ICF/IID session in Austin end of March 2020 in Austin, Tx

No other live training has been scheduled at this time, these sessions are suspended until we hear more about the Covid-19 virus to decide on whether or not these sessions would be advisable at this time.  We will continue with webinars and on-site training, until further notice. 

 

   

On-Site Trainings Available Upon Request

Live Trainings On-Site (Please contact us if you want us to provide these trainings on-site for your program):

HCS/TxHmL: Care Coordination in the HCS Program, Using Person-Centered Thinking To Develop The IP (Implementation Plan), Changes in the HCS Progam, Quality Assurance, Changes in The Survey Process In HCS (we are adding one for ICF), Changes in The Billing Audit Process in HCS and TxHmL, Nursing in HCS/TxHmL Programs, Common Nursing Errors In The HCS/TxHmL Programs & Corrective Action Planning, ICAP/IDRC/ and LON Increase Packet Training.

ICF: The Role & Responsibilities of the QIDP, DIT on Active Treatment, Changes To the ICF Surveyor’s Guide-Appendix J- “How It Affects Your Program”, as well as DIT Trainings-A/N/E,  “Common Nursing Tags in the ICF Program-How to Prevent & Correct Them“, Nursing In The ICF Program as well as ICAP/IDRC/ and LON Increase Packet Training.

Direct Support Staff Training:  “Expectations of the Nurse from the Direct Support Staff”, “Abuse, Neglect, and ANE” (including recent changes in the HCS TAC), “When and What to Report To The RN”, Documentation Expectations for Direct Support Staff”, “Behavior Support Plans-general concepts and purpose of support plans”, “Interacting With Individuals with Developmental Disabilities in Your Program” (Effective Communication, Verbal Intervention, Appropriate/Inappropriate Reactions, Body Language, and more).

HCS/ICF Provider Job Openings & Job Positions Desired

Based on the many phone calls, emails and contacts through our social media pages concerning Job Positions Desired and Job Openings with HCS providers, I have decided to use our “Updates” page to provide a place where both those persons desiring a position with an HCS Provider and those Posting a Job Position can find each other!

We will not be posting the job description or information on this page directly.  If you contact Meghan Jones at meghanjones.tx@gmail.com and let her know where you are posting a position and who to contact, we can put a link and the contact person’s name, # and/or email.  For example, you are posting on Indeed, Linkedin, BenefitMall, Facebook, PACSTX job postings, an online newspaper, etc…

We will also continue to repost openings when we can on our Linkedin page as well as our Facebook and Instagram pages for Twogether Consulting.

There is no charge, we just ask you all to keep referring us to others who don’t know about us for their HCS business needs and of course we hope you will continue to use our services to assist you with your training needs, on-site and off-site assistance. 

Julie Blacklock/ Owner

 

Current Job Postings (See below)

Regency Health Care  (Posted 3/9/20)                                                                                                                                                                                                                             (Round Rock, Tx)
Position opening:  Case Manager
Contact Robert Morris  : 
Email: regencycarehome@hotmail.com
555 Round Rock W. Dr.   Bld. E, Ste 203.
Round Rock, Tx 78681
KENMAR Residential HCS
(Round Rock, Tx)
575 Round Rock West Suite F-360
Round Rock, Tx 78681
Currently have opening for Program Director  Posted 2/1/20
Contact:  Janet Simoneau
Office: 512-334-9192
Cell: 713-204-8071
The Center For Pursuit
(Houston, Tx)
Office location:  810 Marston St. Houston, TX 77019
Position is in Brookshire, Tx
Currently have opening for a QIDP  Posted 2/13/20
Location:  Willow River Farms- ICF
(Qualified Intellectual Disabilities Professional)
Contact:   Kevin R. Kern, MPA, C.A.L.A.  ( Chief Operating Officer)
Cell: 281-830-2686

 

We Have New Services!

Twogether Consulting has added some new services this year to include:

In February, we will begin to develop CNE’s again for future nursing training concerning HCS/ICF/TxHmL and this will be one of our first classes!  We hope to have it in place by early fall at the latest of 2020.  Currently, we do provide assistance though with the Nursing Peer Review Process on and off-site!

  • Providing assistance with the development of a ” Nursing Peer Review Process” for your program as well as implementing the “Nursing Peer Review Process” if requested.

If you have 10 or more nurses working for your program (ICF, HCS, TXHmL, etc….), the BON requires the facility to have a “Nursing Peer Review Committee” to review Nursing Infractions and all facilities should have some kind of “Nursing Peer Review Process” in place.

 [NPR §303.0015 ]

“Any person or entity that employs, hires, or contracts for the services of 10 or more nurses (RNs, LVNs or any combination thereof) must have a Peer Review Plan; however, peer review of RNs is not mandatory if the facility employs less than 5 RNs. A person or entity required to have nursing peer review may contract with another entity to conduct nursing peer review.”

 What is Peer Review? [Nursing Peer Review (NPR) §303.001(5)]

Peer review is the evaluation of nursing services, the qualifications of a nurse, the quality of patient care rendered by nurses, the merits of a complaint concerning a nurse or nursing care, and a determination or recommendation regarding a complaint including:

  1. the evaluation of the accuracy of a nursing assessment and observation and the appropriateness and quality of the care rendered by a nurse;
  2. a report made to a nursing peer review committee concerning an activity under the committee’s review authority;
  3. a report made by a nursing peer review committee to another committee or to the Board as permitted or required by law; and
  4. implementation of a duty of a nursing peer review committee by a member, an agent, or an employee of the committee.

A Peer Review Committee may review the nursing practice of an LVN, RN, or APN (RN with advanced practice authorization).

There are two kinds of nursing peer review:

  1. Incident-based (IBPR), in which case peer review is initiated by a facility, association, school, agency, or any other setting that utilizes the services of nurses; or
  2. Safe Harbor (SHPR), which may be initiated by an LVN, RN or APN prior to accepting an assignment or engaging in requested conduct that the nurse believes would place patients at risk of harm, thus potentially causing the nurse to violate his/her duty to the patient(s). Invoking safe harbor in accordance with rule 217.20 protects the nurse from licensure action by the BON as well as from retaliatory action by the employer.

See revised rules 217.19 (Incident-Based Nursing Peer Review and Whistleblower Protections) and 217.20 (Safe Harbor Peer Review and Whistleblower Projections){http://www.bon.state.tx.us/nursinglaw/rr.html}

 

Training now being offered by Twogether Consulting

  • Training (on and off-site) to Providers concerning Direct Care staff’ssurvey interviewer interaction with Surveyors during interviews and how this can affect the provider, particularly the nursing department, as well as preparing for the survey in general.  (HCS, TXHmL, and ICF)
  • Training (on-site) to Providers concerning “Nursing Expectations of Direct Care Staff and It’s Importance”  (HCS, TXHmL, and ICF)
  • Training (on and off-site) to Providers concerning Nursing Staff’s interaction with the Surveyors, particularly during the interview process with the nurse.  (HCS, TXHmL, and ICF)

BenefitMall

 

 

  Brittany Brown/Medicaid Waiver Program-Payroll Specialist

How can BenefitMall help?

Assistance to HCS/TxHmL/and DH providers with their HR needs as well as payroll. Benefits Mall has some exciting new products for a very low cost that can possibly make a huge difference in ensuring quality assurance with your HR services and needs! Not all payroll companies are created equal. Brittany Brown is our contact at BenefitMall, and she is THE expert in working with Medicaid Waiver Programs.

Information on specific areas with your program that BenefitMall can assist you with.  Please give Brittany a call for more information and assistance:

  • Payroll cash flow issues
  • What does the IRS Tax Code really say about paying host home/foster parents and how can we alleviate some of the anxiety parents experience around their payments
  • Tracking employee time – dealing with employees working multiple division at different rates
  • Labor allocation to help ease the pain with cost reporting
  • Work Opportunity Tax Credits (WOTC)
  • So much more!

Contact Information for Brittany Brown

Mention “Twogether Consulting” when you contact Brittany Brown right now, for a free month of service and a full year of free W-2’s.  

Cell:  832-425-6410          Email: brittany.brown@benefitmall.com

 

 

Person Centered Planning/ Practices Training Opportunities

Person-Centered Training Opportunities

 

HHSC Person Centered Planning/Practice Training Information

What Training Is Required?

Online Introductory Course

The Texas Health and Human Services Online Introductory Course is appropriate for any member of the planning team, including:

  • Legally authorized representatives
  • Family members
  • Friends
  • Nurses (required in some instances)
  • Behavior specialists (required in some instances)
  • Employment specialists (required in some instances)
  • Attendants (required in some instances)
  • Direct support professionals (required in some instances)
  • Anyone asked to be a member of the planning team

Note: To access and complete this free online training, please go to the HHS Learning Portal, create a user login, and follow instructions to complete the training.

 

Person-Centered Thinking Classroom Course

To register for the Person-Centered Thinking 2-day classroom course, please go to the HHS Learning Portal, create a user login, and follow instructions to register for a class that is most convenient to your location. Begin Training An introductory course also is offered by DirectCourseOnline. The online offering includes courses in Person-Centered Counseling (PCC) and Person-Centered Thinking and Practice. There are 12 lessons in all.

HHS Approved Full Training

The following training is approved by Texas Health and Human Services for people required to take the full training, specifically case managers, service managers and service coordinators. If you would like to submit a training course to HHS for approval, email: Medicaid_HCBS_Rule@hhsc.state.tx.us. Remember to keep your training certificate.

STATUS OF HCS RATES!

Status of HCS Rates as of Oct. 11th, 2019:

As of October 11th, 2019, members of the HHSC Rate Workgroup were notified that the proposed rule amendments to implement the HCS rates that will be effective Jan. 1, 2020 thru August 31, 2021 have been sent to the Texas Register and will be published next Friday. 
. Any claims with DOS 11/10/19, and after will pay at the new rates. Claims billed prior to 11/10/19 will be reprocessed over the next three months and conclude by January 31.  Provider letter should go out next week.
These are the increases that will be applied to the LON 1, 5 & 8 residential rates and the additional rate increases that will be applied to the LON 6 & 9 residential rates. 
 Note:  A public hearing on the rule amendments and rates will be held at HHSC in its Public Hearing Room on November 4, 2019.
 HHSC Rate Analysis Director, has indicated that the rate increases for RSS LON 6 and 9, Day Habilitation and Supported Home Living/CFC will be posted Monday, October 14, 2019 (at the latest, Tuesday, October 15, 2019).
Remember:  These rates will be implemented as proposed in July, 2019 and will be retroactively effective to September 1, 2019.

SUMMARY OF PROPOSED PAYMENT RATES
Effective September 1, 2019

PROPOSED RATES:   HHSC proposes to increase the payment rates for the HCS Supervised Living / Residential Support Services, Day Habilitation, Supported Home Living Transportation, Community First Choice (CFC) Supported Home Living, and CFC Consumer Directed Services Supported Home Living in accordance with the 2020-21 General Appropriations Act, 86th Legislature, Regular Session, 2019 (Article II, HHSC, Rider 44).
METHODOLOGY AND JUSTIFICATION
The proposed payment rates were calculated in accordance with 1 TAC Section 355.723, which addresses the reimbursement methodology for the HCS program.  See HCS rates packet proposal below for Sept 1st, 2019.  Click on link to HCS rates document. 

09-01-19-hcs-rate-packet

Please contact the Rate Analysis Department’s Customer Information Center at (512) 424-6637 or by email at RAD-LTSS@hhsc.state.tx.us should you have any questions regarding the information in this document.

BEHAVIORAL SUPPORT SERVICES PROVIDER POLICY TRAINING

Behavioral Support Services

HCS and TxHmL Behavioral Support Services Provider Policy Training

(Has been mandated for HCS & TxHmL providers to ensure their contracted Behavioral Support Services providers to take since March 2015)

This course informs service providers of behavioral support services in the HCS and TxHmL programs related to the provision of behavioral support services in those programs.  All new behavior support service providers must complete the WBT before providing services to an individual. All providers must complete the course every three years.

***To document successful course completion, participants must print a copy of the certificate provided at the end of the training and submit a copy to a program provider with whom they are employed or contracted.

Status of ICF/IID Rates!

Approved ICF Rates:  09/12/19

Click on the link below to read HHSC’s notice to ICF/IID providers about the ICF/IID rates.  The notice informs providers that the rates have been approved but at a lower rate than proposed.  The notice further explains that errors in the calculation of the rates resulted in the variance between the rates proposed versus the rates finally approved. 
The rates will be retroactive to September 1, 2019.  Providers will receive a supplemental payment to cover the difference between services already billed/payments already received based on the FY 2019 rates and the newly adopted FY 2020 rates.

 

Enforcement of ICF/IID Administrative Penalties Begins Sept. 1

HHSC Long-term Care Regulatory has issued Provider Letter 19-20 Enforcement of State Licensure Violations. The provider letter informs ICF/IID license holders that, effective Sept. 1, 2019, HHSC will begin assessing administrative penalties for licensure violations based on the scope and severity of the violation. Read the details here.

 ICF/IID providers, please remember to contact us for assistance with Survey Prep, Plans of Corrections and especially Directive Inservice Trainings, so we can assist in helping providers avoid administrative penalties, whenever possible!

**Note- I have already put in an email asking about other dates for the scope and severity training webinars as the ones on Sept. 5th are full.

HCS Survey Review Process, Billing Guideline Changes Summary & Provider User Guide for CARE

 

Survey Process:  Timelines

As everyone is aware, due to the COVID pandemic, the past several months have affected the Long-Term Care survey and enforcement processes and activities that are unrelated to the virus. As of June 15, 2020, Survey Operations has begun to resume some normal survey activity, and Enforcement is also resuming enforcement processes and activities, such as complaints or issues related to COVID-19.  No other regular survey activities have begun for HCS/TxHmL programs.
Please contact Enforcement Director Derek Jakovich by email at derek.jakovich@hhsc.state.tx.us if you have questions.
In response to questions regarding what normal survey and enforcement activities are resuming as of June 15 and what programs are affected, HHSC replied as follows:
To clarify, as of June 15, 2020, Survey Operations is resuming some survey activity such as complaints with lower priorities, and possibly some licensure and certification surveys. For Enforcement, due process notice letters such as denials, revocations, and imposition of administrative penalties will be issued and the opportunity to appeal will be provided. Of course, the COVID circumstances may affect these activities.
At this point, since we’re not enforcing administrative penalties in HCS/TxHmL until September, the notice applies to NF, ALF, DAHS, PPECC, HCSSA, and ICF/IID.

 Billing Guideline Changes

November 20, 2019

The HCS, TxHml, and CFC billing guidelines have been updated effective Nov. 15, 2019. A summary of the revisions can be found on page 25 of the CFC PDFpage 147 of the HCS PDF and page 129 of the TxHmL PDF. Send questions about the billing guidelines to HCS.TxHml.BPR@hhsc.state.tx.us.

HHSC Provider User Guide (CARE)       

Please go to the following link:

https://hhsportal.hhs.state.tx.us/helpGuide/Content/16_CARE/WaiverPDF/HCS%20Provider%20User%20Guide.pdf

.

Our Awesome Admin. Asst.

Meghan Jones

Meghan Jones is our awesome Admin. Assistant, otherwise known as our “Jill of All Trades”.  She handles our registration, keeps up with our enormous provider contact list, our company schedule and calendar, and she is our main point of contact for scheduling, other than myself.  We couldn’t make it without our Meghan!  I know many of you have talked to Meghan over the phone.

You may contact her to complete registrations, set up on-site visits from our consultants, request invoice sent to you directly, or for other questions at: meghanjones.tx@gmail.com

TASKMASTER PRO “Cloud-Based” Services For HCS, TXHmL, ICF, and CLASS Providers

logo

Discounted Rates Available for Small Providers (20 individuals or less) if you demo with Twogether Consulting to get signed up for TMP! 

As you know, we often provide webinars for providers receiving TaskMaster Pro services and this year some exciting new changes are taking place.  We are having a webinar on January 28th to review some of the new changes added to the nursing component of TaskMaster Pro, which include Comprehensive Nursing Assessment addition.  For those of you who are not receiving TaskMaster Pro currently, we also provide free demos.  Contact us at:  javasbja@gmail.com or meghanjones.tx@gmail.com to sign up for demo!

Developed by a provider for providers!

TaskMaster Pro is a web-based cloud computing system designed specifically for managing Waiver and ICF/DD programs. TaskMaster Pro was created by Larry Hill of Hill Resources in Abilene and his team. Through the internet, you will be able to access information and monitor activity from wherever you are and whenever you want and when regulatory changes occur or required forms are updated, TaskMaster Pro is updated so it will never be obsolete. Now this user-friendly, integrated system is available to you.

Request a TaskMaster Pro Demonstration

Manage your program anytime and from anywhere in the world with TaskMaster Pro!

This comprehensive, easy-to-use system has these features:

  •   Secure Communication Center
  •   Program Planning for QMRP’s, Case Managers, and Program Managers
  •   Complete Medical Module
  •   Psychological/Behavioral Module
  •   Service Delivery Log/Billing Waivers
  •   Client Budget
  •   Direct Care Reporting
  •   Incident/Accident Reporting
  •   Scheduling
  •   Report Tracking
  •   Human Resources
  •   Staff Development and Training Module
  •   Time and Attendance
  •   Electronic Data Signature
  •   Off-Site Secure Hosting
  •   Automated File Backup
  •  Customizable Access Control

Whether you have a large, mid-size, small or new start-up company, TaskMaster Pro will work for you!

For a FREE on-line demonstration of how TaskMaster Pro can save you time and money, please contact Julie Blacklock at  512-294-8032 or click on the Request a TaskMaster Pro Demonstration link to sign up.

Please note that before you can receive a demonstration, you must download and complete the Non-disclosure agreement and either fax the form to 512-291-9075 or scan it in and email it back to us available on our website: www.twogetherconsulting.com on the “TaskMaster Pro” page.

Additional Training Opportunities

 

HHSC JOINT PROVIDER LIVE TRAINING

Save The Date:  2020 Waiver, Survey & Certification Training

The training will cover a host of topics related to the HCS and TxHmL programs including, but not limited to, Administrative Penalties, Nursing Services, Amelioration and Informal Dispute Resolutions.  Registration information will be available online at HHSC in Spring 2020.        

2020 HHS Long Term Care Regulatory

Waiver Survey and Certification Joint Provider Training

SAVE THE DATE

June 30, 2020 to July 2, 2020  (3 days of training)

Location:

Crowne Plaza

6121 N IH 35

Austin, TX 78752

This collaborative conference will focus on a variety of topics central to the Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) waiver programs.

Featured topics will include, but are not limited to: Administrative Penalties, Amelioration, Informal Dispute Resolution, Nursing Services, Aging, Residential Surveys, Critical Incidents, and more!

Program provider staff, leadership, nurses, and HHS surveyors are encouraged to attend.  Registration will be available Spring 2020.

Questions? Please contact Tahoe Fintel at (512) 438-3161

MEDICAID WAIVER PROGRAM WEB-BASED TRAINING FROM HHSC

Abuse Neglect and Exploitation Competency Training and Exam     

( WE RECOMMEND HCS/TXHML PROVIDERS HAVE DIRECT SUPPORT STAFF COMPLETE THIS TRAINING)

This training is designed to meet the basic ANE training requirements for staff providing direct care in a community setting. By the end of the training, staff should be able to identify which acts constitute ANE, how to recognize ANE, understand risk factors for ANE, and what methods can be used to address ANE. Additionally, this training includes an introduction to trauma and its impact on the people we serve.

Service providers must complete a test with a score of 80 percent or higher. A training certificate can be printed at the end of this training and kept in staff personnel files to meet training requirements.

To access and complete this free online training, please go to the HHS Learning Portal’s ANE Competency Training course page, create a user login, and follow instructions.

Texas Oasis Dementia Training Academy

P.O.W.E.R. ANE Training Academy

NF Culture Change – Transforming Care within the Regulations

Emergency Preparedness (FYI-Directed towards Nurses in Facilities)

For more information please see the following link:

https://apps.hhs.texas.gov/PROVIDERS/Training/jointtraining.cfm to register and learn more about each of these events.

Scope and Severity Webinar Now Available

HHSC is currently offering a webinar to explain scope and severity for providers impacted by House Bill 2025, 85th Texas Legislature, Regular Session, 2017. The training is designed specifically for providers for whom scope and severity is new to the survey process.

Register for the Scope and Severity Training for ALF, DAHS, ICF/IID and PPECC Providers webinar to see available dates and times here.

Please continue to monitor the website for additional dates and times if you are unable to participate during the dates currently being offered. The webinar will be offered on a regular basis for the next few months.

There are 2 more on Nov. 6th have opened up..  Register at:   https://apps.hhs.texas.gov/providers/training/jointtraining.cfm

Changes to the MWH-IDD Website where TIC Training is Accessed

HHSC Long-term Care Regulatory has issued Provider Letter (PL) 19-08: Trauma-informed Care (TIC) Training to replace PL 16-15. The PL informs providers of changes to the Mental Health Wellness for Individuals with Intellectual and Developmental Disabilities website where TIC training is accessed.

This PL is addressed to Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions providers. Read the details of this PL here.