Twogether Updates

CMS Vaccine Mandate- LTC Providers (Update)

February 14th, 2022 The CMS Interim Final Rule related to the vaccine mandate only applies to certified providers regulated by CMS such as ICFs/IID, Nursing Homes, certain Home Health Agencies, etc. See complete list at:  https://ogletree.com/insights/cms-gives-a-boost-and-takes-a-shot-at-full-vaccination-for-millions-of-u-s-healthcare-workers/ ***The end of the list states that home and community-based services are not included.  As such (and confirmed by HHSC), the CMS Interim Final...

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CARE as of March 1st: Client Assessment, Review, and Evaluation (CARE) Report and Screen Crosswalks Now Available

February 13th, 2022 HCS/TxHmL Providers & LIDDA's: Client Assessment, Review, and Evaluation (CARE) Report and Screen Crosswalks Now Available The CARE report and screen crosswalks for HCS, TxHmL providers and LIDDAs are now available to assist with daily operations. Click the following link to view the files: Provider and LIDDA CARE Report Crosswalk Provider and LIDDA CARE Screen Crosswalk HCS and TxHmL providers will use these crosswalks to locate relevant individual and provider data...

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CBT (Computer Based Training) For Entering Claims For HCS & TxHmL Services As Of March 1st, 2022

February 8th, 2022 CBT (Computer Based Training) For TMHP Billing of Services/Entering Claims For those of you asking where to submit claims for HCS & TxHmL services after March 1st, this will be via TMHP.  CARE will no longer be used to submit these claims as of March 1st, 2022.  Training on how to submit your claims can be found on the TexMedConnect for LTC Providers portal via CBT training. TexMedConnect for Long-Term Care (LTC) Providers "This CBT contains information about using...

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Can An HCS Program Provider Provide Services To Their Own Child Or Family Member?

I recently received this response from HHSC and thought it might be helpful to some providers who may have this concern: There is no rule or regulation that prohibits an HCS Program Provider from providing services to their own child or family member. You can pop over to this site to get in touch with the best lawyers who will help you to claim this scheme. The program provider’s operations must prevent conflict of interest as required by 40 TAC §9.177(f): §9.177 Certification Principles:...

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HCS/TxHmL Writing Acceptable Plans of Correction Webinar-Feb. 9th, 2022

February 1st, 2022 HCS/TxHmL Writing Acceptable Plans of Correction Webinar   "WHAT IS A POC? 42 CFR §488.401 defines a Plan of Correction to mean a plan developed by the facility and approved by CMS or the survey agency that describes the actions the facility will take to correct deficiencies and specifies the date by which those deficiencies will be corrected.Apr 19, 2021" Program providers can register for the Writing Acceptable Plans of Correction for HCS and TxHmL webinar. This...

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Allowance of Delivery of PT, OT, and ST Services Via Telehealth (IL 2022-08)

February 1st, 2022 HHSC Publishes Information on Delivery of PT, OT, and ST Services (IL 2022-08) HHSC is issuing interim guidance allowing telehealth delivery of physical therapy, occupational therapy, and speech therapy services. Access Information Letter No. 2022-08, HB4: Physical Therapy, Occupational Therapy, Speech Therapy Services Delivered by Synchronous Audio-Visual. The letter notes which therapies are not allowed to be delivered through telehealth modalities because the service...

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COVID-19 Cases Continue to Rise – What Should LTC Providers Do?

February 1st, 2022 Guidance for LTC Providers COVID-19 cases continue to increase across Texas. HHSC reminds providers to follow the guidelines listed below and ensure their emergency plan is up to date. Staff must be aware of what to do in the event of any sort of emergency, including an outbreak of flu or COVID-19. Please review the following rules, guidelines, and policies: COVID-19 mitigation and visitation rules for your provider type Any applicable COVID-19 response plans for your...

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HHSC has published ICF and HCS Emergency Staffing Requests Letter – Jan. 10th, 2022

HHSC has published ICF and HCS Emergency Staffing Requests – Jan. 10 HHSC has published ICF and HCS Emergency Staffing Requests (Provider Letter 2022-02). This letter provides information for Intermediate Care Facilities for Individuals with an Intellectual Disability (ICFs) or Related Conditions and Home and Community-based Services (HCS) program providers facing staffing shortages related to the COVID-19 public health emergency.

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ICF & HCS Surveys: Backlog of Surveys and Compliance Expectations

January 14th, 2022 ICF/IID and HCS Surveys:  HHSC has responded to questions providers have asked regarding the current backlog of surveys and what time period will be reviewed/surveyed when a provider finally receives its survey. Should you have further questions, please email HHSC at:  LTCRPolicy@hhs.texas.gov In regards to ICF surveys, the facility needs to be able to show compliance at all times.  Some areas of compliance require (at least) annual updates (i.e. Individual program plans),...

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Vaccine Mandate Updates

January 14th, 2022 Vaccine Mandates: Earlier today the Supreme Court issued its rulings on the CMS and OSHA Vaccine Mandates. The Supreme Court stayed the OSHA mandate and permitted the CMS mandate.  As a reminder, the CMS mandate applies to ICFs/IID.  For further details, go to:  https://www.supremecourt.gov/ December 1st, 2021 Judge Doughty, U.S. District Court, Western District of Louisiana, blocked enforcement of the CMS Interim Final Rule (which among other LTC programs, applies to...

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Texas COVID-19 Coronavirus Resources & Guidance for People with Disabilities

Check Out These Resources For Persons With Disabilities From The              Office of Texas Governor Greg Abbott https://gov.texas.gov/organization/disabilities/coronavirus Government COVID 19 Information and Resources https://tcdd.texas.gov/resources/covid-19-information/government/ Other Texas Organizations There are a number of disability-related organizations in Texas that are sharing information and resources related to COVID-19. Below you’ll find links to their COVID-19 webpages and...

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HHSC’s, DSHS & CDC Update: COVID-19 Omicron Variant

January 10th, 2022 When was Omicron Variant First Found in Texas and What is This Variant of COVID-19?  (Please see article below) Texas Identifies Case of COVID-19 Omicron Variant News Release Dec. 6, 2021 The first known Texas case of the COVID-19 B.1.1.529 variant has been identified in a resident of Harris County. The adult female resident was recently diagnosed with COVID-19. Results of genetic sequencing this week showed that the infection was caused by the Omicron variant strain. The...

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Free Webinar Series

Our free webinar session recordings previously recorded are currently posted on our "Gotostage" page. https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b Free Webinars!! January 2021 Free Webinar  “1099 Contractor Concerns” Presented by ADP Payroll & HR" Twogether Consulting is happy to have ADP Payroll & HR Services again as a resource for IDD providers in our free webinar series for the month of January 2022! Free Webinar Series Hosted By: Twogether Consulting...

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Revised Guidance for LTC Facilities Experiencing COVID-19 Staffing Shortages

Revised Guidance on Staff Work Restrictions and Return to Work HHSC has issued revised guidance for long-term care providers experiencing staffing shortages due to COVID-19. The requirement to contact LTCR before implementing CDC guidance on staff work restrictions and return-to-work has been removed. "Guidance and Protocol for Long-Term Care Facilities Experiencing Staffing Shortages due to the COVID-19 Public Health Emergency. This checklist provides guidance for long-term care facilities...

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LTC (Long Term Care) Online Portal BasicsWebpage

January 9th, 2022 Please click on link below to take you to the "LTC Online Portal Basics" page with important information on usages for the portal,  e-learning training sessions, and pdfs of manuals needed for navigating the portal LTC Online Portal Basics page By Provider Training Services Published: Mar 5, 2021 Duration1h This interactive training provides a basic overview of the Long Term Care (LTC) Online Portal including an overview of the features of the blue navigational bar and the...

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TMHP LTC and HHSC IDD Operations Portal For Providers-Additional Trainings Update 2022

January 9th, 2022 Register for HCS and TxHmL Webinars, Additional Training Resources Texas Medicaid and Healthcare Partnership is hosting Long-term Care Home and Community-based Services and Texas Home Living Waiver Program webinars for program providers, Local Intellectual and Developmental Disability Authorities, and financial management services agencies that submit claims on behalf of Consumer Directed Services employers. Each webinar is composed of two sessions. Attendees can register for...

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HCS Provider Applicant- Provider Applicant Training (PAT) and Test Information Update

December 30th, 2021 “Study & Prep Session For HCS Provider Applicant Test”  Contact us for a copy of pre-recorded session from November 3rd, 2021 This Training is Not Affiliated In Any Way with HHSC It is Provided by Twogether Consulting, a private consulting company for HCS/TxHmL & ICF providers  (As well as persons  seeking Information about these Medicaid programs) (We will be reviewing some TxHmL information as well) Cost:  $150/person To register, please go to:   Topics:    ...

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Important-HCS and TxHmL Webinars and Claim Payment Account Setup (Coming Soon!)

HCS and TxHmL program providers, Local Intellectual and Developmental Disability Authority agencies, and Financial Management Services Agencies billing on behalf of Consumer Directed Services employers can register for webinars starting next month. These webinars will cover information about the Long-Term Care Online Portal and forms that HCS and TxHmL program providers will use. The webinars will: Include a live Q&A session Begin in February 2022 Details, including dates, times, and...

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HHSC Publishes Active, Unemployable Work-Around (Provider Letter 2021-44)

December 20th, 2021 Check LEIE/OIG and check With the implementation of FBI-based fingerprinting in 2021, Long-term Care Regulation (LTCR) also implemented Occupations Code (OC), Chapter 53, related to the consequences of a criminal conviction, specifically the 2019 legislative update to OC §53.023 concerning additional factors for licensing authorities to consider after determining a conviction directly relates to the occupation. Policy Details & Provider Responsibilities Long-term care...

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SB8- New HHSC Grants Webpage

December 17th, 2021 The link doesn't inform providers about current information but will provide future information about ARPA funds, and will be available on the newly created HHSC Grants webpage. Press Release: Governor Abbott, HHSC Announce $128 Million To Support Staffing Needs At Rural Hospitals, Nursing Facilities | Office of the Texas Governor | Greg Abbott HHSC Grants Webpage: COVID-19 in Healthcare Relief Grants | Texas Health and Human Services According to the HHSC Provider Finance...

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Transition of DH to ISS

December 12th, 2021 ISS (Individualized Skills and Socialization)   Changes to Day Habilitation (DH) programs are coming for HCS/TxHmL!  The link below contains a discussion concerning the implementation of a recommendation in the Rider 21 Report (General Appropriations Act for FY 2020-2021, 86th Session) related to the monitoring of DH programs which will transition to the provision of ISS. To view, the report go to: ...

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Don’t Forget Annual Vendor Submission Due (Nov.1st-Jan31st) HCS/TxHmL!

November 4th, 2021 HCS and TxHmL Annual Vendor Submission Timeframe The timeframe to submit for annual vendor approval is Nov.1, 2021 through Jan. 31, 2022. Required documentation for annual vendor requests are in the HCS and TxHmL Billing Guidelines, Section 6160(b)(2), Approval of Annual Vendor. Email packet submissions to Billing and Payment with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received. If you are unable to meet the...

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HHSC E-Learning Portal

The HHS Learning Portal  Please bookmark the new location or click here and save to “Favorites” The new web address for the HHS Learning Portal is: https://learningportal.hhs.texas.gov New & Current HCS/TxHmL Providers, Please Take These Trainings The e-learning portal. This is where Abuse, Neglect, Exploitation Training ( the ANE training) for you and your staff is. All staff at the facility should take this at least initially and maybe every 1-2 years ANE E-Learning page ***You may need...

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Following Suspensions Still In Place Related To COVID-19 (HCS): Recap

November 23rd, 2021  While most of the suspensions related to COVID-19 have ended, the following HCS suspensions are still in place. HHSC will still allow an HCS four-person residence to add up to two additional individuals temporarily if the residence has the space to accommodate them and has been approved as a four-person residence by HHSC. (Rule: 40 TAC §9.153(39)(B)) Suspension of the requirement for HCS providers to ensure at least one complete staff shift change per day for individuals...

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Recording Available -11-10-21: HCS, TxHmL, CLASS, DBMD Webinar

November 10, 2021, HCS, TxHmL, CLASS, DBMD Webinar Recording Available Last updated on 11/22/2021 A recording of the November 10, 2021, Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), and Deaf-blind Multiple Disabilities (DBMD) Webinar with Texas Health and Human Services Commission (HHSC) Long-term Services and Supports is available for those who could not attend. Read the HCS, TxHmL, CLASS, and DBMD Webinar (PDF)....

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Ways To Assist Providers Currently Using TASKMASTER PRO “Cloud-Based” Services (HCS/TxHmL/ICF/CLASS)

As some of you may know, Twogether Consulting does not work for Taskmaster Pro, but we do have quite a bit of experience with their software and I love the benefits of this "cloud-based" program.  In the past, I have also used the software for my own HCS program as we had HCS contracts in over 32 counties.  Electronic Records were a must for us with that many counties to keep track of and service providers to monitor!  No matter who you choose to provide those services.  I do, however, highly...

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Provider Resource: ADP Payroll & HR Services

Get Your Promotions for Becoming A New ADP Clients:  - 1st  3 months free   - Other Discounts Available! November 21st, 2021 Twogether Consulting strives to find a variety of good resources for our IDD providers and hope that ADP may be able to help some of you out there with Payroll and HR needs. Our newest contact from ADP is, Rachel Sawyer. She is the Major Accounts District Manager for Austin, Texas area, but can help you if your business needs accounting, wherever you are located.  She...

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Texas Lawsuits Filed Against COVID-19 Vaccine Mandate Now Includes Challenge To CMS Federal Contractor Rules

November 16th, 2021 Many states have already filed lawsuits against the COVID-19 Vaccine Mandate. This includes lawsuits against the CMS Interim Final rule, the OSHA  Emergency Temporary Standard (ETS) and the Federal Contractors rule.  The Texas Attorney General (AG) Office announced it is also challenging the CMS Federal Contractors rules. Not sure what this means for providers yet, but you may need to continue to prepare for implementation until otherwise directed. See links below for more...

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PEM (Provider Enrollment Management) System

November 16th, 2021 Starting August 2021, HHSC has begun the transition to one system for Provider Enrollment Management which will move to 1 "smart system" if you want to become a Medicaid vendor/Medicaid provider, re-enrollment every 5 years, and the forms/application will be uniform.  They will go directly into TMHP system, not to HHSC.  The current paper application forms will not be required.  They have begun the process with existing providers. One system=PEMS One NPI-based enrollment...

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Reminder: LTC Providers May Request COVID-19 Emergency Support

November 6th, 2021 LTC Providers May Request COVID-19 Emergency Support For Emergency Staffing Support: The Office of the Governor directed DSHS to use staffing agencies to provide medical personnel from out-of-state to Texas health care facilities to assist in COVID-19 operations. This support will be available to residential long-term care providers. -Providers must demonstrate that they have exhausted all other options. -Also that they have urgent need for assistance before requesting...

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HCS Certification Principals Training Webinars & Recordings

August 12th, 2021 HCS/TxHmL Certification Principle Interpretive Guidance Series Starting August 12, 2021, the HCS/ TxHmL Joint Training Program bgan presenting a series of nine webinars designed to provide interpretive guidance on the HCS and TxHmL Principles of Certification, as outlined in the Texas Administrative Code. You may click on the links to previously recorded trainings below to watch any of the nine sessions on Certification Principles from the Texas Administrative Codes....

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CMS and OSHA Issue Temporary Interim Rules on the Vaccine Mandate

CMS and OSHA just released their respective interim final rules on the vaccine mandate.  Below are links to their rules, webinars and other related items. For further details see below as well as the information at the following link:  https://homehealthcarenews.com/2021/11/cms-releases-emergency-regulation-requiring-covid-19-vaccinations-for-medicare-medicaid-providers/?euid=6e81729339&utm_source=hhcn-newsletter&utm_medium=email&utm_campaign=c7ada108f8 CMS: Link to Interim Final...

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HHSC Publishes Acceptable Documentation for a Criminal History Check for Contractors (IL 2021-48)

HHSC Publishes Acceptable Documentation for a Criminal History Check for Contractors (IL 2021-48) HHSC has published IL 2021-48 (PDF). This letter is provided as a companion letter to PL 2019-01 (PDF) which describes acceptable documentation a contractor may use to demonstrate the contractor conducted a criminal history check of an employment applicant or an employee. Licensed contractors must continue to follow the guidance outlined in PL 2019-01. Unlicensed contractors must follow the...

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HHSC Publishes Information to Assist People with Terminated SSI (IL 2021-47)

HHSC Publishes Information to Assist People with Terminated SSI (IL 2021-47) HHSC has published IL 2021-47 (PDF). It assists people with terminated Supplemental Security Income. In Texas, people who get Supplemental Security Income benefits are eligible for Medicaid. Under normal circumstances, termination of SSI benefits results in losing Medicaid coverage.  When the continuous Medicaid coverage period ends, these individuals will lose their Medicaid coverage unless their SSI benefits are...

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From Our Friends At The ARC of TEXAS: Update on Disability Voting Rights & Virtual Support Group For Persons With Disabilities

Vote early in Texas through Friday, October 29 DOWNLOAD CHECKLIST If you are registered to vote, you have the right to vote! Although you are not allowed to use your phone or electronics for notes, you can take handwritten or printed notes with you into the voting booth. That’s why we created a free Plan Your Vote downloadable checklist, which includes the number for Disability Rights Texas’s Voting Hotline in case you encounter issues casting your ballot. It may also help to review your...

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SB 8 (ARPA funds) Passed by the Senate and House!

October 18th, 2021 SB 8 (ARPA funds) Passed by the Senate and House! The Senate passed SB 8. and the House passed SB 8 as of this evening!  The bill appropriates $13 billion of the $16 billion available in ARPA funds. The bill reflects agreements reached by the conference committee and can be viewed at: https://lrl.texas.gov/scanned/87ccrs/sb0008_3c.pdf#navpanes=0 In reviewing the document, please note the following: Pages 3-24 contain the committee report in bill language.  To view bill...

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HCS/TxHmL Interpretive Guidance Page With Tools For Rule Interpretations

October 3rd, 2021 HHSC Announces HCS and TxHmL Interpretive Guidance Page HHSC Long-term Care Regulation created the HCS and TxHmL Interpretive Guidance page. This page connects program providers with relevant tools for rule interpretation. It includes the Interpretative Guidance booklet and Certification Principle training. October 3rd, 2021 Twogether Consulting highly recommends you read through the HCS/TxHmL Interpretive Guidance Booklet and keep this PDF downloaded on your desktop for...

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HHSC Publishes Amended Statutory Cap Regarding Administrative Penalties for ICFs (PL 21-34)

September 30th, 2021 CAP Update: Administrative Penalties for ICFs (PL 21-34) HHSC published Provider Letter 21-34 Amended Statutory Cap Regarding Administrative Penalties for Intermediate Care Facilities. PL 21-34 notifies providers of changes to how HHSC determines and imposes administrative penalties based on changes made by House Bill 3720 (87th Legislature, Regular Session, 2021).

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COVID Vaccine Information- HCS, TxHmL, ICF

September 21st, 2021 Updated CDC Guidance for LTC Facilities on Accessing COVID-19 Vaccine – Sept. 2021 The Centers for Disease Control and Prevention has recently updated resources for long-term care facilities on how to help residents and staff access COVID-19 vaccines: Vaccine Access in Long-term Care Settings Care Administrators and Managers: Options for Coordinating Access to COVID-19 Vaccines Jurisdictions Can Ensure COVID-19 Vaccine Access for Staff and Residents in Long-term Care...

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COVID-19 Information

September 21, 2021 COVID-19 FAQ's Updated For HCS/TxHmL HHSC has revised the Updated HCS and TxHmL COVID-19 FAQ (PDF)  in response to the revised HCS and TxHmL COVID-19 Mitigation and Visitation rules.   September 21st,2021 COVID-19 Response Plan Revised HCS/TxHmL   COVID-19 Response Plan (PDF) in response to the revised HCS and TxHmL COVID-19 Mitigation and Visitation rules 9/21/21 Updated to reflect changes in response to GA-38 regarding facemasks and updated CDC guidance The Table...

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Montessori Webinar Series: Montessori Methods With Older Adults With Dementia

HHSC and Money Follows the Person Demonstration Grant Bringing webinar series to health care professionals. It discusses the work of Dr. Montessori and the Montessori Method when working with older adults with dementia. Dr. Cameron Camp provides this series. The series will also focus on understanding the application of Montessori principles to improving staff engagement. Discussions includes specific principles and techniques. Montessori Inspired Lifestyle: Montessori Based Dementia...

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Guidance for Ending of the Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak (PL 2021-29)

HHSC Publishes Guidance for Ending of the Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak (PL 2021-29) Updated September 15th, 2021  (Originally posted on August 15th, 2021) HHSC has published Provider Letter 2021-29 (replaces PL 2020-21 and 2020-26) - End of Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak (PDF). The letter describes the rule suspensions that ended, the rule suspensions that are still in place, and the rule suspensions that...

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Day Habilitation: Update on “Off-Site” DH Services

September 5th, 2021 HHSC Publishes In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2021-39) The Texas HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines. This is in response to COVID-19 and to provide access to needed day habilitation services. HHSC has published a revision to this guidance, IL 2021-39 In-Home Day...

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Informal Dispute Resolution Process-HCS/TxHmL/ICF

September 5th, 2021  HHSC Publishes Revised Informal Dispute Resolution (PL 2021-07) HHSC published a revised version of Provider Letter 2021-07, Informal Dispute Resolution (PDF). A revision was made to update the contact phone number. . The Informal Dispute Resolution (IDR) process gives nursing facilities, assisted living facilities, intermediate care facilities, Home and Community-based Service and Texas Home Living waiver providers the opportunity to informally dispute regulatory survey...

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HHSC Changes To Structure, Organization, and Contact Info: Survey & Certification (HCS/TxHmL)

September 1st, 2021 The Health and Human Services Commission created the Regulatory Services Division (RSD) in 2017 as regulatory functions consolidated from the Department of Family and Protective Services (DFPS), the Department of Aging and Disability Services (DADS), and the Department of State Health Services (DSHS). As part of this consolidation effort, new teams were developed while keeping the division’s core values of quality, consistency, efficiency, and accountability in mind. RSD...

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Disaster Preparedness: Requests To Exceed License Capacity Due to an Emergency

Requests For Exceeding Licensed Capacity During Severe Gulf Coast Weather HHSC Long-term Care Regulation is reminding providers to be ready to implement emergency preparedness plans. If your facility is impacted by severe weather such as wind or flooding, or is in an area under mandatory evacuation orders, contact the HHSC LTCR Regional Director in the region where the facility is located. In addition to contacting the HHSC LTCR RD, all requests to exceed licensed capacity due to an emergency...

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LTC Provider Reporting Guidelines as COVID-19 Cases Surge (ICF Providers)

August 26, 2021 Assisted living facilities, nursing facilities, and intermediate care facilities for people with intellectual disabilities are only required to report COVID-19 cases in residents or staff to HHSC if: It is the facility’s first ever COVID-19 case It is the facility’s first case after having had no COVID-19 cases among staff or residents for 14 days or longer Read Provider Letter 2021-04 (PDF). Email questions to LTCR Policy for more information, including a decision tree on when...

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LTC COVID-19 and Visitation Expansion Rules For in HCS in Texas

August 25th, 2021 Program Provider Response to COVID-19 and Visitation Expansion for HCS (PL 2021-30) HHSC published Provider Letter 2021-30 Program Provider Response to COVID-19 and Visitation Expansion for HCS. This letter replaces PL 2021-09.  This letter describes the actions a program provider must take to mitigate COVID-19 according to Executive Order GA-38(link is external) and CDC guidance and the criteria for expanded indoor and outdoor visitation as well as essential caregiver...

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HCS/TXHML Survey Operations Transformation (PL 2021-26)

August 15th, 2021 HHSC Publishes HCS and TxHmL Survey Operations Transformation (PL 2021-26) In advance of the HCS Waiver Survey and Certification unit’s transition to Long-term Care Survey Operations, HHSC has published PL 2021-26, HCS and TxHmL Survey Operations Transformation (PDF). The letter provides information about HHSC’s transformation efforts and what HCS and TxHmL program providers can expect on August 30, 2021.

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Information Letter No. 21-32 –Requirements for IPC Submissions for Individuals Requesting Services Funded with GR

August 1st, 2021 Information Letter No. 21-32 –Requirements for IPC Submissions for Individuals Requesting Services Funded with General Revenue This information letter describes the documentation that a CLASS case manager, DBMD program provider, HCS service coordinator, or HCS program provider must submit to HHSC to request the use of general revenue to pay for services above the individual cost limit of a waiver program. To justify a request to use general revenue when an individual is...

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Update to COVID-19 Guidance for SC’s Concerning SC Visits & Contacts

Update to COVID-19 Guidance for Service Coordinators Fee-for-service Medicaid 1915(c) waiver case managers and service coordinators may use telehealth or the phone to conduct service coordination visits. This temporary policy change extends through Aug. 31, 2021. SC's are encouraged to complete visits by phone, telehealth or telemedicine. Program providers must complete the required background checks for all service providers. They must follow: The Texas Administrative Code, Title 40, Part 1,...

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Employment Assistance & Supported Employment Training Options From HHSC

Employment Assistance & Supported Employment Training Options From HHSC   August 1st, 2021 Live HHSC Training Workshop! HHSC is announcing a free, one-day Employment First / Employment Services Training event to be offered in six cities from September 2021 thru December 2021. Employment promotes a more independent living setting and creates independence for a person in many ways. This training is another tool to increase the Employment First focus and provide better tools for...

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Links to Long-Term Care Bulletins

  See link to August 2021 edition below: The August 2021 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com. Visit the TMHP LTC homepage regularly for news, reminders, training opportunities, and other important program updates. For questions, see the Provider Resources section of the bulletin. See link to February 2021 edition below:...

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Texas Medicaid 1115 Transformation Waiver Update

July 17th, 2021 Texas Medicaid 1115 Transformation Waiver Extension HHSC announces its submission of an extension application to the Centers for Medicare & Medicaid Services (CMS) for the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act. The extension request is for approximately 10 years, which will provide the 1115 waiver authority through 2030. The extension reflects the same terms and conditions agreed to and...

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Stakeholder Webinar: HCS Funding-American Rescue Plan Act – July 15, 2021

July 14, 2021 The American Rescue Plan Act (ARPA) of 2021 was signed into law on March 11, 2021. Section 9817 of ARPA provides states with a temporary ten (10) percentage point increase to the federal medical assistance percentage (FMAP) for Medicaid Home and Community-Based Services (HCBS), if certain federal requirements are met. States must use funds equivalent to the amount of federal funds attributable to the increased FMAP to implement activities that enhance or strengthen Medicaid HCBS....

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Proposed Billing Guidelines HCS/TxHmL

Stakeholder Comments Requested for HCS, TxHmL Billing Guidelines, As Well As Proposed Billing Requirements, Provider Fiscal Compliance and TMHP Revisions HCS and TxHmL Stakeholders can now comment to the HCS, TxHmL and CFC Billing Guidelines by July 18, 2021 about the proposed revisions: Proposed Billing Requirements Provider Fiscal Compliance TMHP revisions The proposed billing guidelines revisions and a summary of changes were posted on June 18, 2021. They are located on the Long-term Care...

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Announcement Of The STAR+PLUS Pilot Program Site

July 2nd, 2021 HHSC selected the Bexar service area as the primary service area in which to operate the STAR+PLUS Pilot Program Yesterday members of the IDD SRAC and STAR+PLUS Pilot Program Workgroup were sent the notice below regarding selection of the STAR+PLUS Pilot site.   As the result of HB 4533 (Klick - 86th Session) Chapter 534, Government Code was amended and, among other changes, directs the pilot to assist in evaluating and developing a plan for the transition of all or some of the...

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EVV Contact Information

July 3rd, 2021 Updates to HHSC EVV Mailboxes and Website HHSC EVV Mailboxes By June 28, HHSC EVV Operations will update their electronic mailboxes to the following email addresses: HHSC Electronic Visit Verification Mailbox: EVV@hhs.texas.gov Previous email address: Electronic_Visit_Verification@hhsc.state.tx.us HHSC EVV Proprietary Systems Mailbox: EVVPSO@hhs.texas.gov Previous email address: EVV_PSO@hhs.texas.gov Additional Information Assess all personal materials, such as contact matrices,...

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House Bill 3240 – Enforcement of Administrative Penalties For HCS/TxHmL/ICF

May 31st, 2021 Status of HB 3240 (Klick) Turn of Events:  Good News For Providers We are happy to say that we were made aware late yesterday that through the efforts of many people including Representative Klick, Representative Frank and Senator Kolkhorst, an agreement was reached to attach the text of HB 3240 (Klick) to HB 3720 (Frank) related to the IDD Waiver Interest Lists.  Though a long shot, late in the afternoon on 5/30/21, HB 3720, as amended, was passed by both the House and...

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Attention HCS and TxHmL Providers: Issue With CARE System

May 28th, 2021     Due to issues with CARE in the past week or so, HHSC  extended the claim submission deadline through Sunday, 05/23/2021 Noon.  A special run took place to encompass claims submitted from Sunday 5/23/2021 - Wednesday, 05/26/2021.  ** Claims submitted after cutoff Wednesday 5/26/2021 – Friday 5/28/2021, are expected to be processed on normal processing cycle.    

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FCC Offers Emergency Broadband Benefit with New Program

May 25th, 2021 The Federal Communications Commission is offering an Emergency Broadband Benefit. This new benefit will: Help families and households struggling to afford Internet service during the COVID-19 pandemic. Connect eligible households to jobs, critical health care services, virtual classrooms and more. Read information about the benefit and eligibility requirements here.

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THERAP Information and Resources

Upcoming Webinar: How to Create a Culture of Data-Driven Decision Making! "The Value of Data-Driven Service Provision" Date: June 11, 2021  Time:  1:00 PM (EST) Presenter: Jason Laws (Director of Quality & Data Initiatives) jason.laws@therapservices.net Are you looking to create a culture of data-driven decision-making at your organization? Join us for an engaging webinar presentation to learn more about: Defining key metrics and indicators Identifying what data has meaning Tracking...

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CDC Guidance & Governor’s Executive Order GA-36

May 19, 2021  Updated CDC Guidance and Governor's Executive Order GA - 36:  In light of the Governor's Executive Order GA-36 issued yesterday, HHSC and DSHS were asked when providers would receive notice of not only the updated CDC Guidance issued last week and its impact on the programs they operate (including the DSHS Day Habilitation Guidance), but also Executive Order GA-36 .  Below are the responses from HHSC received.   HHSC: "We are currently working through the implications of...

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UNTWISE Offers Free On-Demand, Pre-recorded Webinar: “Ethics of Informed Choice” 1 CEU

The University of North Texas Workplace Inclusion & Sustainable Employment (UNTWISE) is offering a free on-demand, prerecorded webinar called Ethics of Informed Choice, which is available through April 22, 2022. This training outlines informed choice and helps contractors, vendors, and Vocational Rehabilitation (VR) staff understand its importance in the VR process. Information on the training can be found on the UNTWISE web page. "This training will define Informed Choice and help...

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“Social Media A Practical Guide To Improving Safety”: Free Video To Help Plan For Your Individuals With IDD

Please click on the link below and enjoy this free video presented by Michelle Garcia, Psy.D Clinical Psychologist, and her group.  Super helpful in these times! Social Media A Practical Guide to Improving Safety with Dr. Garcia & Associates     To learn more about their innovative services where Michelle's group can come to your location to improve quality of life, visit their NEW website at: www.drmgarcia.com "In addition to counseling and curriculum, Michelle and her team...

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TAC 9.175 Certification Principles: Requirements Related to ANE of an Individual

May 16th, 2021 For those of you wanting a separate copy of the ANE TAC principles that were put into the HCS TAC in October of 2019, I have attached links to a few pdf versions for you to use at your facility.  These particular set of HCS principles are important to keep handy, especially concerning follow-up timelines as well as who to contact, when to contact and report and what to report. after an allegation.   40 Tex. Admin. Code § 9.175 Certification Principles: Requirements Related to...

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IDD Ombudsman “Client’s Rights & Complaints”

May 16th, 2021 When to Call the IDD Ombudsman The IDD Ombudsman receives complaints from individuals, family members, and the general public about the care, treatment, or services provided to an individual. Individuals receiving services or family members of the individual may prefer to call the IDD Ombudsman to assist in resolving an issue rather than speaking with their LIDDA service coordinator (SC) or HCS provider. (In addition, if you are not sure where to make a complaint or who to make...

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Find Us On Social Media

Twogether Consulting Social Media pages. Facebook page:   https://www.facebook.com/TwogetherConsultingIDDWaiverConsultants Instagram Page:   https://www.instagram.com/twogetherconsulting/    

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HHSC Resuming Termination of Waiver Services: HHSC, TxHmL, DMDB and CLASS

May 3rd, 2021 Information Letter No. 2021-19 Termination of Waiver Services during the Public Health Emergency was on hold for eligibility issues, but that is now back in effect as of May 10th, 2021. This information letter is to notify you that, starting May 10, 2021, HHSC will resume ending waiver services of an individual who is not eligible for CLASS, DBMD, HCS, or TxHmL. This is being done in accordance with a rule promulgated by the federal Centers for Medicare and Medicaid Services...

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Draft Rules: Requirements During an Infectious Disease Outbreak, Epidemic or Pandemic

April 20th, 2021  HHSC is seeking comments on their draft rules..  The rules apply to a host of LTC programs and, once adopted, will be permanent rules for LTC providers during an infectious disease outbreak, epidemic or pandemic.  See attached pages 38-47 which apply to ICF, HCS and TxHmL Infection Control-Outbreak Practices-HHSC draft-ICF-HCS-TxHmL-041921 Please review and send feedback to your provider associations. To ease your review, please note the following: Table of Contents:    ...

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Medicaid Eligibility Training-HCS

E-Learning Portal Training From HHSC Direct link to main E-Learning portal page for Medicaid training below: https://learningportal.hhs.texas.gov/course/index.php?categoryid=42 Monitoring and Maintaining Medicaid Eligibility for HCS/TxHmL   This training will cover initial and ongoing eligibility requirements for participation in Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) programs. Financial Eligibility – Medicaid Medicaid or SSI Medicaid Program Transfers...

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Status of IDD-Related Bills

April 17th, 2021 Status of IDD-Related Bills That Are of Relevance To Certain IDD Providers  HB 149 (Reynolds & Shaheen) related to a study to evaluate state and local regulation of certain facilities and group homes:  The bill is anticipated to pass in the House today after which it will go to the Senate. https://capitol.texas.gov/tlodocs/87R/billtext/pdf/HB00149H.pdf#navpanes=0 HB 326 (Howard) related to workplace violence prevention in certain facilities:  As amended on the House Floor,...

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HCS Retainer Payments

April 17th, 2021 HCS Retainer Payments Status We have been informed that CMS has finally approved retainer payments for HCS.  Certain provider associations will have the opportunity to review and provide feedback on the draft Information Letter related to the payments.  HHSC is also developing rules related to this initiative, but those associations will not be able to provide feedback on them.   HHSC  will conduct a webinar on the HCS retainer payments.

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Additional Training Opportunities

  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...

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Re: Governor’s Orders for Masks and Re-Openings of Businesses

Re: Governor's Orders for Masks and Re-Openings of Businesses Until further notice providers must continue to adhere to all current COVID-related guidance, rules and infection control policies, according to HHSC.  At this time changes to these policies will only occur when CMS and/or the CDC issues revised guidance. HHSC's position also applies to rules and guidance related to attendance at DHs:  HCS Rules:...

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Tax Deadline Extensions for Individuals and Businesses

Tax Deadline Extensions for Individuals and Businesses The IRS announced last week that because of last month's winter storms, Texans will have until June 15, 2021, to file their individual and business tax returns and make tax payments. This includes 2020 individual and business returns normally due on April 15, as well as various 2020 business returns due on March 15. Among other things, this also means that affected taxpayers will have until June 15 to make 2020 IRA contributions. The June...

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Resources For Emergencies (Includes Recent Winter Storm)

HHSC Notice:  In the event you did not receive or inadvertently overlooked, see below for the notice HHSC issued earlier today regarding resources for LTC providers during the winter storm, or click HERE LTC Provider Resources During an Emergency Long-term care providers impacted by the current severe weather event should be implementing emergency management plans. LTC providers in need of resources or assistance during an emergency, such as the current severe weather, are reminded that you...

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HHSC Contacts for HCS, TxHmL, ICF, and CLASS

HCS/TxHmL & CLASS Programs If you have questions about CLASS Program Policy, call 512-438-5077, 877-438-5658 or email ClassPolicy@hhsc.state.tx.us. For questions about HCS Program Policy, call 512-438-4478 or email HCSPolicy@hhsc.state.tx.us. For questions about TxHmL Program Policy, call 512-438-4639 or email TxHmlPolicy@hhsc.state.tx.us. (TxHmL) billing and payment reviews, call the Billing and Payment Hotline at: 512-438-5359 or email: HCS.TxHml.BPR@hhsc.state.tx.us. For questions about...

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IRS-Certain Medicaid Waiver Payments May Be Excludable From Income

Certain Medicaid Waiver Payments May Be Excludable From Income See the following IRS page for the full FAQ https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income Last Update: New Q&A's 1-20 were added on February 23, 2015. The original text and Q&A's follow at the end. On January 3, 2014, the Internal Revenue Service issued Notice 2014-7, 2014-4 I.R.B. 445. Notice 2014-7 provides guidance on the federal income tax treatment of certain payments to...

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Please Check Out “Instant Purchase” Services At Our “Store”

Check out our instant services you can purchase at our "Store" page on the website:  https://twogetherconsulting.com/store/   OFF-SITE CONSULTATION:  $75/hr You can purchase 1, 3, 6, 9 or 12 hrs of off-site consultationfor assistance with HCS, TxHmL, or ICF and Additional IDD Waiver Programs. This includes: research, phone calls, video chats, webinars, emails and texts.  You may use this off-site consultation time as needed or all at once.  You can schedule a conference call, video chat...

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Renewals of ID/RC Assessments/ and IPC’s and  Requirements for Revised IPCs and Transfer IPC

12/28/20 IMPORTANT REMINDER! HCS and TxHmL Program Providers and LIDDA Service Coordinators- IL20-45 HHSC is automatically renewing individual plans of care and Intellectual Disability/Related Condition assessments that expire on or before Dec. 30, 2020. This is due to the COVID public health emergency. The renewal is for one year from the expiration date. HHSC is not automatically renewing IPCs and ID/RCs that expire on or after Dec. 31, 2020.  This is explained in IL 20-45 (PDF). Program...

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Flu Vaccine Guidance During COVID-19

January Webinar - Flu & COVID: What You Need to Know HHSC is holding this webinar for all our providers to offer guidance on flu and COVID-19. In this webinar, we will review: The similarities and the differences between flu and COVID-19 The importance of getting a flu shot How flu vaccination along with good infection control practices protect everyone Centers for Disease Control and Prevention guidance on administering flu vaccines this season amid the coronavirus pandemic. This webinar...

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(AADMD) American Academy Of Developmental Medicine & Dentistry

D E C // 1 8 // 2 0 2 0 AADMD Releases Statement on Covid-19 Vaccine Equity for People with IDD Read the Official Statement - and Join the Movement The Covid-19 vaccine is here - and AADMD joined forces with like-minded organizations to issue a Joint Position Statement on “Equity for People with Intellectual and Developmental Disabilities (IDD) Regarding COVID-19 Vaccine Allocation and Safety.” NCD Opportunity Through board member Rick Rader, MD — who was appointed to the National Council on...

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Our Services!

Twogether Consulting has added some new services to include: DEVELOPMENT OF INFECTION CONTROL POLICIES & PROCEDURES, or at least to update your one with COVID-19 policies and protocols.   (Based on Guidance noted in the HCS & ICF COVID-19 Response Plans                                                       HCS-covid-response-plan.pdf     ICF-covid-19-plan.pdf DEVELOPMENT OF EMERGENCY EVACUATION PLANS  In particular, so HCS/TxHmL providers are able to meet  compliance with Appendix K: ...

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Pre-Webinar Survey For: “Round Table Discussion For Nursing Concerns In IDD Programs” (HCS/TxHmL/ICF)

Pre-Webinar Survey For those Nurses registered or planning to register for our Dec 11th, 2020 follow-up session:                                                                                      “Round Table Discussion For Nursing Concerns In IDD Programs” (HCS/TxHmL/ICF) We did not get to at least 4 of our questions primarily on COVID during the 1st Round Table Discussion on 11/5/20.  We still have some questions on RN Delegations that we need feedback on for future sessions and COVID-19. ...

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Very Important HHSC Alerts!

November 22nd, 2020 COVID-19 Guidance for Activities, Dining, and Volunteers for the Holidays (PL 20-53) HHSC publishes Provider Letter 20-53 Guidance for Activities, Dining, and Volunteers (PDF). The letter outlines provider responsibilities for resident activities, including communal dining and holiday-related activities. The letter also gives specific stipulations on the use of volunteers and guidance on the protocol for residents who leave a facility. This guidance can be used as a general...

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Direct Support 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:...

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TxHmL Rules & Regs-COVID-19 Mitigation-New

September 21st, 2021 Updated: COVID-19 Mitigation Rules for TxHmL Providers HHSC Long-term Care Regulation has published revised COVID-19 mitigation rules (PDF) for TxHmL program providers. The rules address changes in response to Executive Order No. GA-38(link is external) regarding facemasks and updated CDC guidance. The rules became effective Sept 19, 2021.   Emergency Rule Adoption for TxHmL and COVID-19 Mitigation See new rule at link below:...

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HCS Billing Guidelines Revised-Sept. 2020

September 6, 2020 HCS Billing Guidelines Revised-Sept. 2020 Please pay special attention to the changes and clarifications for Nursing Services!  We will be reviewing these in our "Billable Services-HCS-2020" webinar on Sept. 21st, 2020.  For more information please contact Meghan Jones to register:  meghanjones.tx@gmail.com   If you attended the recent Billable Nursing Services training in August (Part I and II) we did add these to your handouts at the time of the training.  You have the...

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TMHP-Launching Redesigned Website

Texas Medicaid Health Portal TMHP is announcing the launching of their newly redesigned website available on September 14, 2020! As TMHP.com receives approximately 2.5 million views per month, it important to have a website that is functional and easy to navigate.  Major improvements have been made to increase the website user experience for providers. Highlights of new improved features include: o   Simplified navigation with program information, topics, and resources are more easily...

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HCBS Settings Regulation Implementation -Timeline Extension!

Frequently Asked Questions: HCBS Settings Regulation Implementation and Heightened Scrutiny Reviews of Presumptively Institutional Settings: July 2020 Update 1.Question: What is the new deadline for states to assure that all settings are in compliance with the home and community-based services (HCBS) settings criteria? Answer: States have been granted an additional year to demonstrate compliance and should ensure all settings are in full compliance with the HCBS settings criteria by March 17,...

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On-Site Trainings Available Upon Request

Currently, all "On-site Training" is on hold due to COVID-19.  If you require any of these trainings, please check our calendars on our website for current webinars or contact us at:  info@twogetherconsulting.com for some of our pre-recorded training options. Live Training 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...

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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...

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Texas Workforce Commission (Supported Employment)

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...

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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...

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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...

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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...

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Live Classes

  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.       

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