January 1st, 2023

Update From Twogether Consulting!

     Happy New Year! 2022 was a pretty tough year personally for me and I know it has been difficult for many IDD providers as well.  Lots of new changes are coming in 2023, but let’s hope they will be for the better!
     So many changes are happening right now for LTC Providers, especially those in the HCS/TxHmL programs. HCS & Texas Billing Requirements were updated in 2022.  The Interpretive Guidance Booklet for HCS & TxHmL was released and hopefully has brought some clarity to survey team expectations.  ISS services will begin shortly and I hope to keep you up to date.  Don’t forget the new rules for ISS are now available and are on our “updates” post as well. Please remember the last day of billable Day Hab services will be Feb. 28th, 2023. We also expect to see a big change in the rules for HCS in the near future, so please be on the lookout.


The CIMS (Critical Incident Management Reporting System) is now in place as of Nov. 1st, 2023, so please let us know how this is going.  Current feedback from providers would imply that it is going well for those of you who have started using the reporting system.  We would encourage providers to take a look at the critical incident reporting form that your facility uses and ensure it captures elements that must be entered into CIMS monthly. Unfortunately, the transition from CARE to TMHP does not seem to have gone very well according to our provider feedback.  I would continue to encourage all providers for HCS and TxHmL to inform their provider associations (PPAT, PACSTX, etc..) and HHSC about their concerns.  Please continue to review the HCS & TxHmL Waiver Programs Trending Issues Volumes
put out regularly by TMHP, with recommendations and “fixes” as well as any current TMHP FAQ’s.

      2023 will also be a big year of change!   Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com. We are happy to say that we can still continue to provide for most of your needs at this time.  We are happy to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, IT and security, Nursing, or general survey requirements from LTCR department in these programs.  We also still provide assistance with the ICF/IID program and expect to have some webinars in the near future for ICF including nursing.  We continue to provide requested on-site live training at this time and we will resume regular live training after March of 2023.
     Many of you have asked about whether or not we will provide additional training for billing/claims in TMHP and entering IPC’s and IDRC’s.  At this time we are not providing that service, but we will continue to keep providers updated on any fixes we learn for provider issues in TMHP.  Please continue to check our “Updates” posts on the Twogether Consulting website. We do have some subcontracted persons that can help with these areas and we can recommend some other options as well, such as companies who can provide either software and/or billing services.  
FYI-We do still have “mentoring” assistance (especially great for new nurses) from our RN consultant on an as-needed basis.
     Twogether Consulting has a new IDD Consultant who has been with us since May of 2022, Sheila Hanson.  We are so happy to have Sheila join us.  She has been of great assistance with  POC’s (Plans of Correction)  and POR’s (Plans of Removal) for Immediate Threats/Jeopardy for HCS/TxHmL and ICF as well as Directive Inservice Training as needed. Sheila has also been helping us with survey prep and assisting providers ICAPs and ICAP scoring.  She is also an HCS provider herself in the San Antonio area, for the past 12 years or so and has been a much-needed member of the team this year.  We also want to thank Marcus Denman, who has been a member of our team for quite some time.  He continues to help us with so many needs of our providers.  Marcus has many years of experience in the HCS, TxHmL and ICF programs which is invaluable to Twogether Consulting. For many of you just starting out, he has been a  super resource for HR and New Hire practices, billing, budgeting, ppening a group home and staff training, etc…We would also like to give special thanks to our administrative assistant, Meghan Jones, without which I couldn’t function, lol. Many of you may know Meghan from registering for our classes and webinars. Meghan also assists me with the application process for many soon-to-be HCS & TxHmL providers.  Lastly, I would like to say our goodbyes to our dear departed colleague, Kim Littlejohn.  Kim worked for Twogether Consulting on and off over the years, primarily with HCS & TxHmL applicants and she assisted me with our conferences and workshops in the past. We recently lost Kim this December to cancer very suddenly.  She will be missed.
      Twogether Consulting will be posting more of our upcoming webinar classes for the rest of January and February very soon, so feel free to check the website: www.twogetherconsulting.com or our next newsletter.
   We have recently updated a few items on our website:
1. The page on our website previously called “Shop” on the dropdown menu under “Services”, is now called “Service Pricing” I hope this makes it much easier for providers we currently serve and new providers to find some of our services with regular pricing posted.  We do not post all of our rates and fees as most of the services providers need our help with must be tailored to the client for their specific needs.
Before mid 2023, we hope to add a few packages with set prices for new providers.  Some examples are:
 “On-site Assistance With Opening A Group Home” for brand new HCS providers and  “On-site Assistance With a New Admission”  (GH or HH/CC clients in HCS only)
2. We have changed the look of our “Satisfied Customers” page a bit. Please submit any quotes you have by clicking on “Contact Us” and sending us a small statement of how you feel Twogether Consulting has helped your agency, the company name and your name, and contact information.  We could really use some new quotes.
3.  We do accept payments via Venmo, as well as Paypal now:  Our Venmo address is @Twogether2004
4.  We also gladly accept Zelle.  You may just use our phone # for payment:  512-294-8032.  Please inform us before you do so, thanks.
5. Once again, please don’t forget our “Updates” page on the Twogether Consulting website. This is where we post anything new from HHSC and anything going on with Twogether Consulting. It is fairly easy to navigate from one “post” to the other. If you want to read more on each section, just click on “read more”.
5.  I would like to remind everyone again, that if you need “Off-site Consultation” and you would like to purchase a block of time (1, 3 or 6 hrs at a time), please go to our  “Services” page to pay directly from the site.  There is a tab called “Service Pricing” in the drop-down menu where you pay your payment. Remember there is a discount for blocks of time larger than 3 hours, purchased on the site.  This discount is only available online on this page on the dropdown menu under “Service Pricing”.
6.There are also some additional services at a flat rate, for purchase on this page.  This includes “Off-site” ICAP Scoring, General or Nurse Consultation, and the initial consultation for HCS Provider Applicants.  

Currently, we do provide on-site (per request) and off-site training (webinars) but we are happy to announce that we have begun providing scheduled “live” training for small groups and on-site assistance to providers as well of course.  We hope to resume regular “live” sessions after March of 2023, so look for our website advertisements on social media-FB, Instagram, and Linkedin!



 Please see below for specific information for 2023 Services:

  • In-person group trainings/conferencesAvailable as requested. Most of these classes have already been moved to online webinars or training, but we can come on-site if you need us to do so.  We also have pre-recorded sessions of some of these trainings as well if you prefer.
  • Online training (Webinars): 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”  https://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, QIDP’s, 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 $45-$175 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).
    • Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:  Abuse/Neglect/Exploitation, Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),  Elements of the Behavior Support Plan & The Importance of Your Documentation, Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations),  When and What to Report To The Nurse, SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), Preparing For Survey in the Group Home/Surveyor Expectations in the Group Home, Host Home/Companion Care Service Provider Responsibilities, What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.
  • 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 but also on-site now if requested..
  • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  Our current pricing will remain at $85/hr and we can offer blocks of time for more than 3 hrs at a slight discount if you pay online at: https://twogetherconsulting.com/services/off-site-services/
    • if there is an extensive project (anything over 6 hrs, we will discuss flat rate options or daily rates.)  This will involve a formal contract
    • We continue to provide as-needed off-site consultation including, but not limited to Development or assistance with policy and procedure, Monthly/Quarterly QA via Taskmaster Pro, 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 case management and nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is available as requested, but please understand we need ample time to schedule as we are backed up right now!:  
    • General On-Site Assistance is based on a daily flat fee (ranges from $550-$1050 per day), depending on your location and additional travel expenses.
    • On-site Training for groups is a daily flat fee however due to prep time, and additional costs for materials, # of attendees, the cost is a bit more (ranges from $850-$2800 per day).
  • The request for on-site is up to you and if you feel comfortable. We will of course respect any protocol you have for us if we do come on-site, including rapid testing for COVID (additional cost).
  • 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 as usually the time to complete them is limited and we are often booked already with appts. at such short notice, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know.
  • Payments:  We prefer payment via Zelle or our PayPal Invoices, with Credit Card/Debit/ or PayPal or Venmo.  You are also welcome to pay via check,  e-check, or request to pay directly to Venmo.  You may also use our online link below to pay:  https://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



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