Twogether Updates

HELPFUL TIPS: For Individualized Skills & Socialization (ISS) Providers

July 31st, 2023 Just wanted to post some helpful tips for all of the new ISS providers out there.  #1. Be sure you date your ISS policies, and specifically for any Evacuation &/or Emergency Response Procedures  When you revise them, show the revision dates on those policies. ISS Service Providers can receive a violation from the survey team for not doing so. #2. Be sure to get with your local emergency response coordinators in your areas, to help you with developing your Evac/ER Response...

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FREE 2023 Positive Behavior Management and Support (PBMS) Zoom Workshop

July 29th, 2023 Texas HHSC is hosting a FREE 2023 Positive Behavior Management and Support (PBMS) Zoom Workshop. HHSC will be providing Continuing Education Units (CEUs) for:            Social workers, certified nurse aides, licensed nursing facility administrators, nursing facility activity directors, assisted living facility managers, day activity and health services managers, qualified developmental disabilities professionals, and qualified intellectual disabilities professionals. See...

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Abuse, Neglect, & Exploitation Training for ISS

July 6th, 2023 If you need some help with training your On-Site and Off-Site ISS staff on Abuse, Neglect, and Exploitation, Twogether Consulting has developed a short 45 min-1hr training to address everyone from direct support staff at your ISS to your Administrator. Included are but not limited to: definitions of Abuse (Physical, Mental, and Sexual), Neglect, Exploitation, and Mistreatment as well as signs and symptoms of each one of these. This session also discusses who to report to, CII...

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TxHmL & CFC Certification Standards-New TAC Rules-Adopted

June 20th, 2023 TxHmL & CFC Certification Standards Adopted  As of June 21st, 2023 the new HCS & CFC Standards will be effective. These rules were transferred from Chapter 9 to Chapter 566, including both newly added rules (Ch. 262) and rules from Chapter 9  which have been revised to ensure clarity.  HHSC intends to post an Information Letter regarding the rules which will review each section of the rules in the document we have included below, as well as, those rules which have been...

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Electronic Visit Verification (EVV) Policies

June 26th, 2023 EVV Policies Policy Handbook EVV Policy Handbook Policy Handbook Revision Log Jan. 6, 2023, revisions (PDF) Sept. 1, 2022, revisions (PDF) June 1, 2022, revisions (PDF) March 1, 2022, revisions (PDF) Jan. 7, 2022, revisions (PDF) Nov. 1, 2021, revisions (PDF)

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Medicaid Resource: State Strategies & Programs To Support Adults with IDD & Their Caregivers

July 25th, 2023 Thought I would share this information from a recent Linkedin post I received. "Centers for Medicare & Medicaid Services (CMS) offers this resource for state Medicaid and partner agencies seeking to address the needs of adults with intellectual and developmental disabilities (I/DD) and their aging caregivers with the aim of improving access to high-quality home and community-based services (HCBS) for people eligible for Medicaid. This resource synthesizes information on...

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HCS & CFC Certification Standards-New TAC- Adopted- Effective June 21st, 2023

June 19th, 2023 HCS & CFC Certification Standards Adopted  As of June 21st, 2023 the new HCS & CFC Standards will be effective. These rules were transferred from Chapter 9 to Chapter 565, including both newly added rules (Ch. 263) and rules from Chapter 9  which have been revised to ensure clarity.  HHSC intends to post an Information Letter regarding the rules which will review each section of the rules in the document we have included below, as well as, those rules which have been...

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Recent Legislative Bills Passed during 88th Legislature

June 15th, 2023  Legislative Bills:  The following 3 bills passed by the 88th Legislature were discussed: ~   HB 4169 (Price) relating to prevocational services:  The bill directs HHSC to either add pre-vocational services as part of ISS or to create a stand alone pre-vocational service. Access to HB 4169:  https://capitol.texas.gov/tlodocs/88R/billtext/pdf/HB04169F.pdf#navpanes=0 ~  HB 54 (Thompson) relating to increasing the personal needs allowance of persons in a nursing home or ICF/IID...

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NewTMHP Portal Enhancement Training Information HCS/TxHmL

June 15th, 2023 New Portal Enhancement Training Information: More Info and Registration From the TMHP website: "Registration is now available for two training webinars to discuss the Long-Term Care (LTC) Online Portal enhancements for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs. The webinars are offered by the Texas Medicaid & Healthcare Partnership (TMHP). A TMHP training services representative will conduct the webinars, which will include...

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HCS Certification Rule-Transfer from Ch.9 to Ch.565 -June 21st, 2023

June 14th, 2023 New! HCS Certification Rule:  HHSC announced that the rules being transferred from Chapter 9 to Chapter 565 will be published in the June 21, 2023 Texas Register  The announcement will be accompanied by an Information Letter. According to HHSC, the letter will explain rules and specify which rules are new, which have been revised to ensure clarity and which have been removed. **In addition, HHSC will conduct several webinars to review the rules with providers. Providers can...

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Assistance With Eligibility Issues Due To The End of Continuous Medicaid Coverage

June 15th, 2023 HHSC stated that If people are not able to obtain assistance from the community partners or 211, they can contact the Office of the Ombudsman 877-787-8999 or complete our online form  . More information on the initiative can be found at:  https://www.hhs.texas.gov/providers/medicaid-business-resources/end-continuous-medicaid-coverage-ambassador-toolkit

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Registration is Open: 2023 Quality in Long-Term Care Conference-August 22nd and 23rd (Austin, Tx)

June 10th, 2023 HHS, in collaboration with The University of Texas Steve Hicks School of Social Work, will host an informative two-day, free conference on quality in long-term care. Aug. 22-23 This year’s theme is, “Making a Commitment to Person-Centered Long-Term Care.” The conference offers presentations from nationally and internationally recognized experts. Topics include: Caring for people with dementia. Infection prevention and control. Long COVID considerations in long-term care Current...

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mySchedules Training Webinars & Other Resources From MITC

May 13th, 2023 "The labor shortage has made it more important than ever to manage available resources effectively. Allowing existing employees to view and request open shifts can be a big help to over-stressed managers." Our friends at MITC have asked us to share some information on one of their very important resources, scheduling software for your shift staff in group homes and employees in general.  Please check all their info below and feel free to go to their website for more info on...

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Reminder: Implementation Plan Form 2125 (HCS/TxHmL)

June 5th, 2023 Form 2125 from HHSC used int the HCS and TxHmL programs as the Implementation Plan form, was updated in Oct. 2022.  The form currently has a box to check this document if consent was obtained from the individual or LAR concerning receiving services via Synchronous Audio Visual Technology . Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the...

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Important Reminder: Consent For Synchronous Audio-Visual Technology

June 5th, 2023 Just A Reminder About Consent For Synchronous Audio-Visual Technology Revision 22-3; Effective Oct. 19, 2022 As appropriate for the individual and as permitted by service-specific requirements, the modalities for delivering services to an individual includes: In-person Synchronous audio-visual Audio only In addition to meeting service requirements, providers must defer to the needs of the individual receiving services, ensuring the mode of service delivery is accessible,...

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ISS (Individual Socialized Services) FAQ’s

June 5th, 2023 HHSC's Response to Three Recent ISS-Related Questions From Providers   Question 1: May an Individualized Skills and Socialization (ISS) provider charge families for after-hour care?  Many times families cannot get off work at the time the program closes/services stop.  Some providers will keep their doors open until 5 or 6 (with staff present of course), until families get off work.  In these cases, the ISS providers charge families for that service. HHSC’s Response: If the...

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IDD Ombudsman “Client’s Rights & Complaints”

May 28th, 2023 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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Reminder: Complete Attestation & Reporting For HCBS Provider Retention Payments To Prevent Recoupment

May 27th, 2023  Attestation and Initial & Final Reports  HHSC's Home and Community-Based Services (HCBS) Provider Retention Payments are part of the HHSC ARPA (American Rescue Plan Act) Spending Plan. These "Retention Payments" were meant to be a temporary rate add-on on eligible service claims with dates of service from March 1, 2022 to August 31, 2022, to agency providers and consumer-directed services (CDS) employers. HHSC adopted 1 Texas Administrative Code Section 355.207 governing...

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Webinar From ANCOR: What You Need to Know to Comply with Wage and Hour Laws Now that the Public Health Emergency Has Ended

May 10th, 2023 The PHE is Over, Now What?  What You Need to Know to Comply with Wage and Hour Laws Now that the Public Health Emergency Has Ended   Check out this webinar from ANCOR. This webinar does have a registration fee.  It is open to members and non-members of ANCOR! Wednesday, May 24, 1-2 pm EDT "The Impact of the PHE Unwinding On Wage and Hour Compliance" Register Today Now that the public health emergency (PHE) has ended, providers are navigating how to unwind from emergency...

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Resources on Aging From HHSC

May 15th, 2023 From HHSC Resources on Aging Know Your Neighbor Food Security Nutrition at Any Age Understanding Nutrition Social Determinants of Health in Aging Aging: By the Numbers Why Age Well Live Well

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Direct Care Careers Connect Coming Soon!

May 15th, 2023 New Tool To Help Providers & Direct Support Staff/Community Attendants With Employment! HHSC is launching Direct Care Careers Connect to help community attendants and employers connect beginning June 1, 2023. The online platform will allow community attendants to list work history, skills, certifications, trainings, and other job qualifications. Employers will be able to post job descriptions, job specifications, and other information to help find quality candidates....

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Long-Term Care Provider Webinar Recording on the End of Continuous Medicaid Coverage (ALF’s, NF’s, ICF’s & HCS)

May 15th, 2023 Recording Available of Webinar For LTC Provider Webinar on the End of Continuous Medicaid Coverage! HHSC hosted additional live webinars in March and April of 2023, to inform providers about the end of continuous Medicaid coverage. The webinar provided information about how long-term care providers (including nursing facilities, assisted living facilities, home and community support services agencies, Medicaid waiver providers, and intermediate care facilities for individuals...

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Guidance for HCS, HCSSA, ICF, and TxHmL Providers Related to Cooperation with HHSC Provider Investigations (PL 2023-11)

May 14th, 2023  Guidance Related to Cooperation with HHSC Provider Investigations (PL 2023-11) HHSC has published PL 2023-11 Cooperation with HHSC Provider Investigations (PDF). The letter reminds providers that they must cooperate with Health and Human Services Commission Provider Investigators who are conducting investigations of abuse, neglect, and exploitation.

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Clarification on HCS and TxHmL IPCs status in “Pending DADS Review”

May 14th, 2023 Reminder Last updated on 12/7/2022 Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs) and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) have been submitting forms and claims to the Texas Medicaid & Healthcare Partnership (TMHP). In response to questions and concerns related to the processing of...

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Avoid Recoupment From TMHP (HCS/TxHmL)

May 14th, 2023 On a quarterly basis, TMHP will calculate all services that have been paid through Client Assignment and Registration System (CARE) and TMHP and will recoup services that exceed the authorized IPC amount. (From May 1st, 2023 forward) View the full alert here.

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Pay Increase For Community Attendants & Direct Care/Support Workers: 

May 13th, 2023 Community Attendants & Direct Care/Support Workers: Direct care/support workers & community attendants are a huge part of the Medicaid long-term services and supports system. Without these persons working with our individuals, HCS, TxHmL, CLASS, ICF and other programs would not be able to provide services. The long-term services and supports system in Texas would simply not exist without a workforce of direct care/support workers. The Texas House and Senate have passed...

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Important- Recordings Available From HCS and ICF Webinar COVID-19 from HHSC

May 13th, 2023 May 2023 MCS COVID-19 Stakeholder Information Session Thank you for your interest in listening to the May 2023 Texas Medicaid CHIP COVID-19 Information Session. The audio from this session can be found here. Email us for transcript The presentation can be found here. This is the last scheduled stakeholder recording for COVID-19 updates. For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us. January 12th, 2023  January 12 Texas Medicaid CHIP COVID-19...

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Termination of Waiver Services Due to Denial of Medicaid Eligibility

May 12th, 2023 Important Reminder:  Denial of Medicaid Eligibility HHSC has published IL2023-16 Termination of Waiver Services Due to Denial of Medicaid Eligibility. On Dec. 29, 2022, Congress passed the 2023 Consolidated Appropriations Act, which separated continuous Medicaid coverage requirement from the Public Health Emergency declaration. The requirement for states to maintain continuous Medicaid coverage ended as of March 31, 2023. States may begin disenrolling members effective Apr. 1,...

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Infection Control Resources (2023 Update)

May 2nd, 2023 Infection Control Resources from HHSC Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF) Infection Control Basics & PPE Training for Essential Caregivers (PDF) Helping Individuals with Intellectual Disabilities and Related Conditions Prevent the Spread of COVID-19 (PDF) Long-term Care COVID-19 Vaccination Options (PDF) Resources Created by HHSC Evidence-Based Best Practices: Infection Control is a guide for developing a facility-wide...

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ISS Program Basic Overview Webinar

April 27th, 2023 HHSC Long-term Care Regulation will be providing recurring one-hour webinars for Individualized Skills and Socialization providers. These webinars will cover the basics of a license application, and an overview of the survey process. Additional topics will include reporting abuse, neglect, exploitation or incidents to HHSC. All sessions are duplicates and offer multiple opportunities to facilitate provider attendance. Friday, April 28 3–4 p.m. Click here to register. Monday,...

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Did You Miss The Last HCS & TxHmL Town Hall Meeting?

April 14th, 2023 April 12, 2023 town hall meeting April topics included: Using the Provider Location Update (PLU) Form for moves/updates Entering Individualized Skills and Socialization in TMHP Highlighting Individualized Skills and Socialization Available Resources Questions and Answers – HCS/TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding the LTC Online Portal for HCS and TxHmL. You can register for the recorded session at:...

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TMHP Training Resources For HCS/TxHmL Providers (Videos, FAQ’s, Quick Check Guides, CBT training)

April 11th, 2023 **Please also check the HCS/TxHmL joint training website from HHSC, for periodic related webinars.  Training Resources (Videos, FAQ's, Quick Check Guides, CBT training) It is highly recommended that program providers, LIDDAs, and FMSAs create a TMHP Learning Management System (LMS) account at learn.tmhp.com to access current training related to the LTC Online Portal and claims submissions. New TMHP LMS users can access the Learning Management System (LMS) Registration and...

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HCS/TxHmL Resources: ISS Provider in San Antonio

March 30th, 2023 I wanted to share the website for one of the ISS providers in the San Antonio area as they do also offer competitive employment for individuals and have employment assistance (EA) and supported employment (SE). Hope this is a good resource from some HCS/TxHmL providers in their area. https://www.texasfoundationofhope.org/    2845 Thousand Oaks Dr. San Antonio, TX 78232 (210) 265-3351 txfoundationofhope@gmail.com Office Hours: Monday – Friday  9:00 AM to 5:00...

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HCS TAC 9.174 (23) Service Delivery: On-Site Residential Expectations Including Hot Water Temps & Locks On Bedroom Doors

March 30th, 2023 Review of this important section in 9.174 Service Delivery 9.174  (23)  (concerning HH/CC, RSS, SL on-site expectations including locks on bedrooms and hot water temps in the home) (23) ensure that, for an individual receiving host home/companion care, residential support, or supervised living:   (A) the individual lives in a home that is a typical residence within the community;   (B) the residence, neighborhood, and community meet the needs and choices of the...

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ISS Service Delivery Logs -Update

March 30th, 2023 Service Delivery Logs for Individualized Skills and Socialization As of March 14th, 2023, information from the HHSC ISS SDL website page: ISS SDL Logs Form 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log, and Form 8616, In-Home Individualized Skills and Socialization Service Delivery Log, are no longer mandatory to document a service claim of on-site, off-site, or in-home individualized skills and socialization. A program provider may...

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TMHP: Where Do HCS/TxHmL Providers Go To Find The Information To Complete Their Cost Reports For 2022?

March 30th, 2023 Update HHSC's Response to Some Of The Questions Concerning Cost Reports for 2022:  The HCS/TxHmL Units of Service Look-up tool was created at the providers’ request to assist them in completing the 2022 cost report.  Providers have questioned whether it captures all that is needed for the cost report and if HHSC is responsible for ensuring there is an appropriate report page for providers to collect this information in TMHP and/or Texas Med Connect. HHSC has stated that...

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 Heightened Scrutiny: Process For ISS

March 29th, 2023  Heightened Scrutiny Process For ISS (Individualized Skills and Socialization) Individualized skills and socialization has replaced day habilitation in these programs: HCS, TxHmL & DBMD. Individualized skills and socialization will include an on-site component and an off-site component. The heightened scrutiny process will be required if a setting in which on-site individualized skills and socialization is provided: (1) is located in a building in which a state supported...

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Info Concerning Medicaid HCBS Settings Compliance Requirements Including CMS Toolkit

March 26th, 2023 HHSC published PL 2023-06 Compliance with New HCBS Settings Rules HHSC Long-term Care Regulation published Provider Letter 2023-06 regarding Compliance with New HCBS Settings Rules on March 24, 2023. This letter explains how LTCR surveyors will assess HCS providers for compliance with the new HCBS settings requirements. March 15th, 2023 The Center for Medicaid and CHIP Services (CMCS) is sharing this toolkit with State Medicaid Agencies, Operating Agencies, and other...

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Bills Submitted During Texas’s 88th Legislative Session

March 20th, 2023 ​88th Legislative Session in Texas! Here Are A Few House Bills Submitted That May Affect Long-Term Care & Other Services For Persons With Disabilities HB 54: Personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities. HB 144: Possible Exemption from ad valorem taxation of the total appraised value of the residence homestead of an unpaid caregiver of an individual. HB 166: The appointment of an educational representative for...

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1-Day Live Training- Austin, Tx- Introduction To ISS (Individualized Skills & Socialization) April 3rd, 2023

March 19th, 2023 Individualized Skills and Socialization Joint Training Opportunities For:  Applicants For ISS Licensure and New ISS Providers HHSC Joint Provider Trainings will host a 1-day live training (Austin, Tx) that will cover the licensing process for the Individualized Skills and Socialization Program, as well as an overview of the rules, survey process, and reporting requirements for allegations of abuse, neglect, and exploitation. Introduction to Individualized Skills and...

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1915(c) Waiver Interest Lists: Find By Legislative Districts

March 5th, 2023 Thanks to our friends at ARC for posting this in one of their recent newsletters 1915(c) Waiver Interest Lists by Legislative District Find below maps produced by The Arc of Texas showing how many Texans on Medicaid waiver interest lists live within each State House, State Senate, and Congressional district. The Medicaid waivers being tracked are all CLASS, DBMD, HVC, MDCP, STAR+ PLUS, and TXHML. The darker the hue of the district, the more people there are on any interest list...

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Letter IL 2023-09: Host Home Provider’s Who Are Immediate Family Members & New CMS Rules For HCS

February 27th, 2023 Letter IL 2023-09 discusses that Sections 263.502 and 263.503 (a)(1)(A) and (b) through (m) of the new Chapter 263 CMS rules do not apply to HH/CC providers in which the HH/CC provider is an immediate family member of the person receiving HH services.  See page 1, 2nd paragraph of the IL for the definition of an immediate family member.  Sections 263.502 and 23.503 (a)(1)(A) and (b) through (m) will however, apply if a HH/CC provider does not meet the definition of an...

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HCBS Settings Rules Adopted for HCS, TxHmL & TAS (Transition Assistance Services)

February 25th, 2023 Please click on links below to find the referenced rules which were published as adopted on February 24th, 2023, with an effective date of March 1, 2023. HCS Rules TxHmL Rules Please be aware of the following: Only the rule provisions to which changes were made are included in the links above.  I believe HHSC will post the complete set soon. You are urged to read the preamble to the rules, in particular HHSC's responses to comments received from stakeholders, before reading...

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PHE (Public Health Emergency) & New ISS Services

February 22nd, 2023 I know providers have really been concerned about the period of time between March 1st and May 11th while the PHE has been extended, as to whether or not this will include ISS services for In-Home ISS. HHSC stated it would release a notice soon stating that beginning March 1, 2023 in-home ISS can be done without the justification (medical or behavioral justification or anyone 55 years of age and older should they request such) for such that will be required in the rules,...

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 In-Home ISS in Host Home Companion Care (HH/CC) Settings: Update

February 22nd, 2023  In-Home ISS in HH/CC Settings:  If persons receiving HH/CC services receive in-home ISS only, the provider does not have to be licensed.  If the person receiving HH/CC services engages in community activities (known as off-site ISS), then the provider of the off-site ISS must be a licensed ISS provider.  Note:  EVV is NOT required for in-home DH or in-home ISS in a HH Setting - EVV is only required in own home/family home settings.  Also, the requirement for EVV matching...

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Modifications to CMS Regs HCBS Settings Rules: Access To Food, Locks On Individual’s Doors & More

February 21st, 2023 Update on Who Qualifies To Assess The Need For A Modification According to HHSC (and the proposed rules that will now be under Chapter 263) modifications to the door lock requirement must be based on a documented, assessed need and brought to the SPT for review and documentation in one's PDP As to whom determines the assessed need, HHSC stated at recent training sessions in Lake Jackson and Austin I believe, that a licensed professional, defining such as a doctor, RN,...

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Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565

February 14th, 2023   Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565 Attached please find the proposed changes to the HCS certification principles. The proposed changes repeal rules under Chapter 9, Subchapter D and move to Chapter 565.  Remember that in addition to moving the rules to Chapter 565, several new rules are mentioned to be put in place as well as changes to existing rules for purposes of either updating, streamlining or providing clarity in...

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PAT: Provider Applicant Test-Update 2023

February 10th, 2023 From HHSC's PAT  FAQ's as of Jan. 1st, 2023 "Frequently Asked Questions for Providers Applicant Training (PAT) for HCS/TXHML" -When is the Provider Applicant Training (PAT) Online available? This training is now available online. The PAT training is the first step for applicants to obtain a contract with HHSC. Please do not submit your application without the PAT certificate that reflects a passing score of 85% or above. -Who can take the training? Applicants listed on Form...

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Important: Re-evaluation of Medicaid Eligibility!!

March 2nd, 2023 Unwinding of Continuous Medicaid Coverage:  HHSC will stagger Medicaid Eligibility Determinations, separating into 3 groups.  IDD will be in the last group, meaning that packets will be sent in June with persons having 30 days to reply.  More information can be found at:  https://www.hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information/end-continuous-medicaid-coverage-ambassador-toolkit February 9th, 2023 The Biden administration plans to...

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TMHP’s 1915(c) Waiver YouTube Training Videos Website: PEMS (Program Enrollment Management Systems) & More

February 9th, 2023 Where can you find helpful Training Videos on the PEMS process? Check out the TMHP page with their Youtube videos for PEMS. In addition, you will find information on removing TPI's and a Video series on running and utilizing your R&S Reports 1915 (c) waiver page at TMHP For YouTube Training Videos Specific link to R&S Report Video Series Specific link to Removal of TPI From Forms Video

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Proposed HCS and TxHmL Billing Requirements

February 5th, 2023 Proposed HCS and TxHmL Billing Requirements Home and Community-based Services and Texas Home Living stakeholders can now comment on the proposed revisions to the HCS and TxHmL Billing Requirements by Feb. 14. The proposed billing requirement revisions and a summary of changes are located on the Long-term Care Providers webpage and are outlined below: HCS HCS Billing Requirements Draft Revision 23-2 (MS Word) HCS Billing Requirements Draft Revision 23-2 Summary of Changes...

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IMT and IPC Form Enhancements Pertaining To Location Code Issues in TMHP Now Available!

January 5th, 2023 IMT and IPC Form Enhancements and IBI Guide Updates Now Available Last updated on 1/27/2023 From HHSC: "On January 13, 2023, a text box replaced the location code drop-down box on the following Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Individual Movement (IMT) and Individual Plan of Care (IPC) form fields: IPC transfers (3608/8582) field 39a: Receiving Program Provider Location Code IMT (all-purpose codes) field 18: Location Code IMT Individual...

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Twogether Consulting 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.     February 2023   Common Nursing Violations:  Prevention & Correction  February 23rd, 2023 10 AM-12:00 PM (ICF/IID)     The HCS/TxHmL...

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Migration of In-Home DH to In-Home ISS Update

January 27th, 2023 As of 1/27/23, there have been no new alert letters concerning the extension of temporarily waiving certain requirements for In-Home DH  due to the Public Health Emergency, past  January 31st, 2023. This was the date we were given in Letter No. 2022-55. My understanding is providers would receive notice at least 30 days prior to ending the PHE.  I am assuming at this time that the PHE will extend through Feb. 28th, 2023.  In-Home DH billing will discontinue in TMHP as of...

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HHSC Form 4719 Required for Fire Drills for ISS Providers

January 27th, 2023 HHSC Form Required for Fire Drills for ISS Providers Click on link below Form 4719 * Some providers have noted that this form seems a bit inappropriate for ISS providers as the form has locations that seem more appropriate for a "home" setting, as opposed to maybe a "building" used by a licensed ISS provider, but it does have a box for "other" locations.

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STATEWIDE TRANSITION PLAN: HCBS

January 16th, 2023 Statewide Transition Plan CMS requires states to submit a transition plan describing the state’s planned initiatives and activities for achieving compliance with the federal HCBS Settings Rule. HHSC has received initial approval of its transition plan and has updated the plan to include additional information required for CMS to grant final approval. This version of the STP includes new information about site-specific assessments, ongoing monitoring and oversight,...

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When Will HCS New Rules and Status of Statewide Transition Plan (STP) Be Adopted?

January 16th, 2023 Adoption Date of HCS Rules and Status of Statewide Transition Plan (STP):  gave HHSC preliminary approval of its STP on 12/21/2022.  The STP will be posted for public comment this Friday (Jan. 20th, 2023). It is unclear when the HCS rules will be adopted. See graph of draft rules below (pages 12-17 for HCS).  Includes CLASS, TxHML, MDCP, and DMDB programs as well. Appendix A: Home and Community-Based Services (HCBS) Settings Statewide Transition Plan  ...

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HCS/TxHML: /TMHP Recoupment, Due To Overpayment

January 15th, 2023 TMHP Recoupment Letters Recoupment Letters:   Upon request, TMHP will send a list of affected/over-paid claims to providers. Providers who experience any issues receiving the list should contact Marie Redman at HHSC (marie.redman@hhs.texas.gov). HHSC urges providers to keep their ticket numbers.  Why? Because the calls are recorded, and if there's an issue, the ticket number allows HHSC to listen to the call associated with the ticket number.  This is just one of the...

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On-Site Assessments of HCS Group Homes & Certain HH Settings From CMS

January 15th, 2023 Help With The New Residential Agreements Concerning the on-site assessments, HHSC plans to help providers with the soon-to-be required residential agreements. According to HHSC, the assistance is to ensure providers' agreements meet the minimum requirements of the rule.  There was no elaboration of the type help to be offered other than HHSC will reach out to each provider. HHSC further stated that an Information Letter would soon be posted directing providers to initiate...

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Initial Critical Incident Management Services (CIMS) User Account Email

January 14th, 2023 Have You Signed Up For CIMS (Critical Incident Management System)Yet?  There are still quite a few providers who have not done so.  HCS & TxHmL providers please do so right away. TMHP has stated that FEI Systems sent emails to required users who had yet to log into CIMS.  Some providers have indicated that they did not receive an email.  According to HHSC FEI Systems did send emails out using a DONOTREPLY/FEI email address.  If you did not receive this email, please...

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AAIDD Texas Chapter: Link To Follow Bills During The Texas 88th Legislative Session

January 12th, 2022 From our good friends at the Texas Chapter of AAIDD, some important info about the Texas 88th Legislative Session See actual TAAIDD link   Dion White, Center for Life Resources AAIDD Texas Chapter Board Member "Texas is home to more than 500,000 adults and children with intellectual and developmental disabilities (IDD). This legislative session will be very important to address specific changes happening within the IDD systems of care across the State. ​ Our system of care...

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Employment Assistance & Supported Employment Training Options From HHSC

Employment Assistance & Supported Employment Training Options From HHSC   January 12th, 2022 Please see notice below from Monty Chamberlain, HHSC. "HHSC is pleased to announce the delivery of in-person Employment First / Employment Services training for the first time since 2019.  This free one-day training opportunity has proven to be a very valuable opportunity to various levels of staff involved in the support of individuals who set the goal of competitive and integrated employment...

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Public Health Emergency (PHE) Renewed

January 11th, 2023   RENEWAL OF DETERMINATION THAT A PUBLIC HEALTH EMERGENCY EXISTS   "As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)  pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020,...

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ISS Rates

January 11th, 2023  Revised Information Letter (IL) 2023-01 related to ISS Payment Rates (replaces IL 2022-56):   HHSC has published Revised Information Letter (IL) 2023-01, which replaces 2022-56 related to payment rates for Individualized Skills and Socialization Services, effective January 1, 2023. HHSC has also approved payment rates for the Individualized Skills and Socialization in the Deaf Blind with Multiple Disabilities waiver (DBMD), Home and Community-based Services waiver (HCS),...

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Trainings Initiatives: From HHSC

January 10th, 2023 Below are just some of the trainings offered by HHSC on their "Trainings Initiative" page. Some live and some via webinar. For more information, please go to: https://www.hhs.texas.gov/providers/provider-training/training-initiatives SSI/SSDI Benefits Overview The SSI/SSDI Benefits Overview web-based training provides a basic foundation for understanding Supplemental Security Income and Supplemental Security Disability Insurance and provides contact information for people...

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STATUS OF HCS RATES!

Status of HCS Rates as of Jan. 1st, 2023 (includes new ISS rates) HCS Rates Jan. 1st, 2023 including ISS services Status of HCS Rates as of June 3rd  2022 Provider Rate Updates for HCS and TxHmL Providers In early May, HHSC identified missing or incorrect rate keys for some Home and Community-based Services and Texas Home Living providers. On May 11–12, HHSC completed updates to rate keys for these HCS and TxHmL providers based on rates published on the Provider Finance website. Read the full...

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Free Provider Resource Webinar Series

Free Webinars!! Our free webinar session recordings previously recorded are currently posted on our "Gotostage" page. https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b January 2023 Webinars   Core-VA Solutions "Virtual Healthcare Assistants For LTC Programs" Virtual Healthcare Assistants Services and Training for Long-Term Care Programs, including HCS, TxHmL, and ICF Free Webinar Series Hosted By: Twogether Consulting (1/10/22 from noon-1pm)   Pre-Registration is...

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Starting Jan. 2023: New HCS& TxHmL Provider Application Process

January 2nd, 2023 Effective January 2023, the open enrollment application process to get a provisional contract to provide Home and Community-based Services (HCS) and Texas Home Living (TxHmL) services will change. You must be enrolled as a Texas Medicaid provider through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment System (PEMS) before applying. 2. To apply, you must complete the Provider Applicant Training (PAT). The PAT is now available on the HHS Learning...

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Expedited PPE Delivery for Long-Term Care Providers

January 2nd, 2023 HHSC published an alert on Dec. 21, 2022, informing long-term care providers that expedited delivery is available for a limited time for personal protective equipment through the Texas Division of Emergency Management. This resource is available to all long-term care providers, including: Nursing Facilities Assisted Living Facilities Intermediate Care Facilities Home and Community-based Services Home and Community Support Services Agencies, including Community Living...

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HCS & ICF Emergency & Disaster Preparation Updates

January 1st, 2023 LTC Winter and Extreme Freezing Weather Preparedness HHSC encourages long-term care facilities and agencies to review and update emergency plans for freezing temperatures and snow. Emergency plans for extreme weather should include the provider’s plan to address: Power loss Water and food needs Communication to families and staff Staffing shortages Sheltering in place and evacuation as applicable Providers must follow emergency preparedness rules and their own internal...

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Out-of-Hospital Do-Not-Resuscitate Order (From DSHS)

Out-of-Hospital Do-Not-Resuscitate Order Out-of-Hospital Do-Not-Resuscitate (OOH DNR) order. Both the English and Spanish versions can be downloaded on the EMS and Trauma Systems website, along with “Frequently Asked Questions About OOH DNR,” also in both languages. For questions related to OOH DNR orders, email EMSInfo@dshs.texas.gov.

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“Moving Forward Together” 2022 Conference for ICF Surveyors and Providers- Dec. 1st, 2022

“Moving Forward Together” 2022 Conference for ICF Surveyors and Providers- Dec. 1st, 2022 Dec. 1 ICF Conference Recordings Available The “Moving Forward Together” Intermediate Care Facilities Conference session recordings from Dec. 1 are available for viewing. Note that a certificate of completion will be generated upon completion, but no professional CE awards are available. Listen to the ICF session recordings. Email questions to LTCR Joint Training.

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ICF COVID-19 Response & COVID-19 FAQs Retired By HHSC-Dec. 13th, 2022

December 18th, 2022  HHSC Long-term Care (LTC) Regulation has retired the COVID-19 Response for ICF for Individuals with an Intellectual Disability or Related Conditions Response Plan and the ICF Frequently Asked Questions documents, effective Dec. 13, 2022. Facilities can obtain guidance along with resources for infection prevention, control measures, and Personal Protective Equipment (PPE) through the Infection Prevention and Control Measures for Common Infections in LTC Facilities...

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HHSC Complaint and Incident Intake Voicemail Reporting Option Ends on Dec. 31 (ICF/IID)

December 11th, 2022 The provider self-reporting voicemail option will be transitioned out of service on Dec. 31, 2022. Effective Jan. 1, 2023, provider self-reported incidents must be submitted using one of the methods indicated below: This does not apply to HCS or TxHmL, only ICF and other LTC programs such as ALF's, SNF's, DAH's... Online via Tulip Email ciicomplaints@hhs.texas.gov Call 800-458-9858 (available Monday–Friday, 7 a.m.–7 p.m.) Please ensure that all initial self-reported...

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HHSC Retires LTCR Provider Investigations Policy Mailbox

December 11th, 2022 The Health and Human Services Commission (HHSC) created the Regulatory Services Division in 2017 as regulatory functions consolidated from the Department of Family and Protective Services, the Department of Aging and Disability Services and the Department of State Health Services. As part of this consolidation effort, effective Jan. 30, 2023, HHSC will retire the Provider Investigation policy mailbox at PIPolicy@hhs.texas.gov. For questions about investigations, please use...

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IMPORTANT: Clarification on HCS/TxHmL IPC Status in “Pending DADS Review” 

December 06th, 2022 Please see this alert that was just sent to the 3 IDD associations from HHSC  In an effort to identify potential IPC forms processing delays for Providers and LIDDAs, HHSC identified sixty-six (66)% of the form statuses on the portal are in a Pending DADS Review.  Forms in this status typically require action to be taken by the submitter of the form per the attached HHSC clarification.    Please share the attached alert document to your case managers, program managers, and...

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ISS (Individualized Skills & Socialization) Provider Webinar Recording

Recording of Individualized Skills and Socialization- Provider Licensing Application Process Webinar December 06, 2022 If you were not able to listen to the November 30th webinar on navigating TULIP/applying for an ISS license, the recording of the webinar and the presentation are now posted.  See below for details.  Though assumed that persons who listen to the recording will also be able to download a certificate, HHSC has yet to confirm that Listen to the webinar recording. Read the...

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Pre-enrollment Site Visit Required for HCS and TxHmL Providers That Enrolled Through PEMS

December 1st, 2022 Home and Community-based Services and Texas Home Living waiver program providers that enrolled through the Texas Medicaid and Healthcare Partnership Provider Enrollment and Management System will be subject to a pre-enrollment site visit from TMHP. Read the full alert. Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver program providers that enrolled through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management...

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Determination of Intellectual Disability Information Update

Texas Health and Human Services Commission (HHSC) updated the following information regarding the Determination of Intellectual Disability (DID): DID Best Practice Guidelines website DID Best Practice Guidelines (PDF) Become a Certified Authorized Provider to Conduct a DID website For more information, email the IDD Services Team.

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LTC Online Portal Enhancements for HCS and TxHmL Waiver Programs- Starting December 2022

December 1st, 2022 Overview of Upcoming LTC Online Portal Enhancements for HCS and TxHmL Waiver Programs On December 12, 2022, the Texas Medicaid and Healthcare Partnership will implement several enhancements to the TMHP Long-Term Care Online Portal. After the enhancements are implemented, existing information and training materials will be updated. Read full alert. -IPC Forms -Termination Forms -Pre-Enrollment Forms -Individual Movement (IMT) Local Authority (LA) Reassignment Forms -Provider...

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American Rescue Plan Act (ARPA): Provider Retention Payments Regarding HCS/TxHmL Billing Claims from March 2022-August 2022

November 14th, 2022 Don't forget: HHSC has extended the time for any providers eligible for these ARPA payments to complete the attestation, so that the initial and final reports are not due, until 30 calendar days after the end of the COVID Public Health Emergency (PHE).  Failure to submit the attestation and initial and final reports will result in recoupment of the funds. There appear to be quite a few members who have yet to submit the attestation or even the initial report.  Don't forget...

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TMHP Enhancements Release Dates

November 11th, 2022 TMHP Enhancements According to HHSC the enhancements (improvements) planned for release this month will most likely be posted later this week or early next week.  These posted enhancements will not be effective until Dec. 12, 2022. HHSC will go over these enhancements in depth at the December 8th, 2022 Migration Webinar September 23rd, 2022 There are 2 sets of HHSC and TMHP 'enhancements' (or 'fixes' or 'improvements' to the system) to be released in the near future.  HHSC...

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Public Health Emergency (PHE) Status

November 11th, 2022 At this time, according to HHSC the PHE is set to end on January 11, 2023.  Currently, it is not known whether it will be extended beyond January 11th, 2022.  It is possible providers will be notified this week in some alerts if PHE will be extended beyond January 11, 2023. Why is this important? *This is important as COVID-19 flexibilities may end and Medicaid status may be lost for those individuals in our waiver  and ICF programs where provider has not responded to...

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THERAP Information and Resources

Previous Webinars Hosted ByTwogether Consulting:  Therap during our free resource webinar series below.  Just click on the links and register. October 2022 https://attendee.gotowebinar.com/recording/2347988816141652494   August 2022 https://attendee.gotowebinar.com/recording/1388286687336697103 If you need assistance with your current Therap services or with information on getting these services, please contact: Calvin Christensen(Business Development Consultant at Therap Services, LLC)...

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TaskMaster Pro Information & Resources

October 31st, 2022 Previous Webinars Hosted ByTwogether Consulting:  TaskMaster Pro (TMP) during our free resource webinar series below.  Just click on the links and register. October 20th, 2022 https://attendee.gotowebinar.com/recording/1488497278022599682 We couldn’t find an innovative IDD Practice Management software that focused on delivering better care, so we built one! Software features for Service Providers Our IDD software is designed by Service Providers and built for Service...

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Monthly Webinars on Migration of CARE to TMHP

January 15th, 2023 Jan. 11th TMHP LTC Migration Webinar Monthly Webinars:  See January 11th migration webinar. I believe the next one will be February 6, 2022. If you missed the January 11th webinar, a recording will be posted soon.  The February webinar will focus on cost reports. R & S Reports and Other Notices:  Please see R & S Video Series for LTC Providers & FMSAs: There are 3 videos related to this topic:....

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Don’t Forget To Get Ready For Flu Season!

October 17th, 2022 From HHSC: LTC Providers Encouraged to Get Ready for Flu Season CDC recommends everyone be vaccinated against the flu by the end of October to avoid peak flu season. Long-term care providers should review their program requirements for guidance related to vaccination requirements and infection control. Some of the CDC’s recommendations for vaccinating patients in congregate healthcare settings are: The CDC recommends that LTC facilities offer the flu vaccine to all residents...

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Texas Culture Change Coalition Conference-“A Day Focused On Person-Centered Senior Care” Nov. 3rd, 2022-Austin, Tx

October 16th, 2022 Register for Texas Culture Change Coalition Conference The Texas Culture Change Coalition will host their in-person fall 2022 conference, “Texans Coming Together for Residents, for Staff, for All!” This year’s theme is “A Day Focused on Person-Centered Senior Care.” Nov. 3 8 a.m.–5 p.m. Commons Conference Center (J.J. Pickle Research Campus) 10100 Burnet Road, Bldg. 137 Austin, TX 78758 Continuing education credit for multiple disciplines will be provided for this event....

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HCS Provider Response & Visitation Emergency Rules: COVID-19-Update 2022

October 17th, 2022 HHSC HCS Program Provider Response to COVID-19 Emergency Rule Expired Oct. 14 The emergency rule for Home and Community-based Services waiver program providers that contain the HCS Program Provider Response to COVID-19 Emergency Rule expired Oct. 14. The following rule expired Oct. 14: 40 Texas Administrative Code Section 9.198 - Program Provider Response to COVID-19 Emergency Rule HCS program providers must continue to comply with visitation requirements for essential...

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HCS/TxHmL Proposed Rules: HCBS Setting Compliant: October 2022

HCS/TxHmL proposed rules should align with the federal HCBS settings rule. These are currently in the formal comment phase.  These comments are due to HHSC on October 17, 2022.  To view the rules and instructions for submitting comments, go to the following link: https://www.hhs.texas.gov/regulations/policies-rules/health-human-services-rulemaking/comment-proposed-draft-rules

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CARE Migration To TMHP HCS &TxHmL: Updates

October 13th, 2022 Update on Some Migration Issues  Enhancements planned for release in November will now not be released until December; the 2nd set of enhancements will be released in June, 2023.  A notice about the enhancements will be posted in the next few weeks. HHSC will post recordings of their monthly TMHP Migration webinars, but not sure where they could be accessed. Sometimes the original registration links end up leading to the recordings, but we will keep you posted when there is...

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Reminder: Avoiding HCS and TxHmL Overpayment of Services Effective Jan. 2, 2023

October 10th, 2022 Texas Medicaid and Healthcare Partnership (TMHP) will perform monthly calculations on services for the Individual Plan of Care that overlaps the May 1, 2022 implementation of the new process for submitting Home and Community-based Services and Texas Home Living forms and claims. On a quarterly basis, TMHP will calculate all services that have been paid through (CARE) Client Assignment and Registration System and TMHP and will recoup services that exceed the authorized IPC...

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WS&C Mailbox for HHSC To Be Discontinued As of Oct. 31st, 2022

October 10th, 2022 As part of the on-going transformation efforts, HHSC will no longer use the following mailbox, effective Oct. 31, 2022: WaiverSurvey.Certification@hhsc.state.tx.us For a complete list of current contact information, program providers should refer to PL 2021-26 or e-mail Survey Operations at LTCRSurveyOperation@hhs.texas.gov. For policy questions related to HCS and TxHmL, providers should e-mail LTCRPolicy@hhs.texas.gov.

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IPC Renewals Submissions, Transfers, How To Submit IPC into LTCOP

Timely Submission of IPC Renewals HHSC reminds HCS and TxHmL providers and local intellectual and developmental disability authorities (LIDDAs) to submit individual plan of care (IPC) renewals for individuals enrolled in the HCS and TxHmL waiver programs as early as program rules allow. For HCS, renewal IPCs must be submitted at least 30, but no more than 60, calendar days before the current IPC end date. TxHmL program providers and LIDDAs are encouraged to use the same timeframe for the...

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Related Conditions: Diagnostic Codes Updated

October 3rd, 2022 HHSC has updated the Approved Diagnostic Codes for Persons with Related Conditions effective Oct. 1, 2022 to Sept. 30, 2023. The list of diagnostic codes has not changed for this year and can be viewed at HHSC Approved Diagnostic Codes for Persons with Related Conditions.

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