Twogether Updates

April 28th, 2022 Very Important! Recorded Webinar For Claims Submission in TMHP   Below is the link to the recording of the claims submission webinar TMHP conducted.   Additional information about the migration will be sent under separate cover. Note:  HHSC will not conduct another webinar on claims submission!  https://tmhp.exceedlms.com/student/enrollments/create_enrollment_from_token/fEmzWuXLDuXzfc3jncsErHWU   March 1st, 2022 HCS and TxHmL Programs Forms and Claims Submissions to...

April 28th, 2022 STAR+PLUS Pilot:  Attached are handouts from the November, 2021 and February, 2022 joint meeting of the IDD SRAC and STAR+PLUS Pilot Program Workgroup related to the pilot and decisions (including eligibility) made thus far. See pages 52 - 102 of the February, 2022 document for information about the pilot. HHSC has created a webpage on the Pilot Program. The link to this webpage...

April 28th, 2022 Effective May 1, 2022, HHSC will transition certain COVID-19 flexibilities to interim guidance in accordance with House Bill (H.B.) 4 (87th Legislature, Regular Session, 2021). The following activities are authorized through interim guidance to be provided through a telehealth (synchronous audio-visual) modality: Renewal ID/RC assessments Renewal, revised and transfer IPCs This guidance applies to the following programs: Community Living Assistance and Support Services Home...

April 28th, 2022 Details On Hearing Date, Time & Location:  Thursday, May 5, 2022 at 10:00 a.m., Capitol Extension, E2.030 Purpose:  To receive invited testimony on several of its interim charges:  #1 related to Healthy Families and Healthy Texas Initiative. When looking at healthy aspects of families, everything from hygiene to food, especially food since lots of people ask is mazola corn oil healthy?  These are all related to the 1115 Waiver, and, the one of importance to PPAT members, ...

April 20th, 2022 HHSC will hold a public hearing on the rules this summer.  Date and time not shared by HHSC yet. Lengthy discussion regarding the proposed provision related to lease agreements and the potential for eviction if R&B payments are not received, has occurred. A process is needed to ensure Providers receive R& B payments However, It is clear that further discussion regarding the proposed process/requirement is needed.

April 18th, 2022 HHSC Updates the ICF/IID COVID-19 Response Plan and FAQ Documents – April 18 HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions program. HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions program. Read the...

April 16th, 2022 Effective April 16, 2022 the Public Health Emergency (Pancemic) has been extended another 90 days.  This means, that if not terminated during that 90-day period, it will either end July 15, 2022, or, if deemed necessary, will be extended for another 90-day period

April 13th, 2022 Texas Providers have been reminded that they can be surveyed at any time by a CMS/Federal Surveyor and will need to be in compliance if this occurs. In short, at this time, HHSC Regulatory will not survey for compliance with the federal mandate. The federal mandate and HHSC position apply to certified-only HCSSAs, Hospice, Nursing Homes and ICFs/IID. 

April 12th, 2022 Information As of Now on Draft ISS Rules: The program rules will go to MCAC on August 11, 2022.  The regulatory or license rules will go to the HHSC Executive Council but no date set yet. The program and regulatory rules will be published in the Texas Register for formal comment in late July, and HHSC will hold a public hearing on the rules. HHSC has decided to eliminate the on-site ratios. Though the off-site ratios have not been eliminated, HHSC is considering revisions to...

April 10th, 2022 HHSC Launches Individualized Skills and Socialization Portal Information Page HHSC launched a new Individualized Skills and Socialization Services Provider Portal. This new portal allows providers access to information on Individualized Skills Socialization services. Including: Complete and review trainings. Find and review provider letters and other information and releases. Link to rules and other services. March 9th, 2022 At the recent HHSC IID Coordination Workgroup...

March 7th, 2022  (See link below to FAQ's) HCS/TxHmL FAQ Document Answers to Additional Questions related to the Migration Can you clarify the next steps to get providers registered for the billing training? The claims training will be provided from TMHP. Providers need to sign up to receive TMHP alerts as the announcement will come from a TMHP alert. HHSC may send out an alert also, but providers have been missing out on announcements because they do not get TMHP alerts. What does a provider...

March 10, 2022 Draft of ISS Rules below: Texas Administrative Code, Title 26, Part 1, Chapter 559, Subchapters A and H, Individualized Skills and Socialization Email comments before March 28th, 2022 to Long-term Care Regulation Policy and Rules.

March 9th, 2022 CARE Banner In CARE system for HCS/TxHmL providers: Moving the date of migration of HCS and TxHmL waivers has resulted in significant technology changes. In preparation for this migration, TMHP and HHSC will begin deployment activities on 04/06/22. Some Provider/LIDDA data entry screens in CARE will be unavailable starting COB 04/06/22 until 04/30/22. A Gov Delivery notice will be sent with a complete list of affected screens next week.  HHSC will notify you if the migration...

March 7th, 2022 Public Comment Period for STP HHSC will submit a Statewide Transition Plan to the Centers for Medicare and Medicaid Services. This is required by the federal Home and Community Based Services Settings Rule. The STP describes HHSC’s plan to meet the requirements of the HCBS Settings Rule. HHSC invites members of the public, including HCBS recipients and their families, providers, and other stakeholders, to submit comments on the STP. Comments will be accepted until 11:59 pm on...

March 4th, 2022 If you attended the 2/9/22 Plans of Correction (POC's) training webinar for HCS & TxHmL, here are the answers to some of the follow-up questions asked during the session:  Q: I have experienced that the POC has a date that is 8 days in the past but the postage stamp would be 2 days ago. This leaves me with 6 days to complete the POC. Do I use the date on the letter or the postage date for the 14-day time period? A: §9.183(f) states the program provider must submit the POC...

LTC Providers May Need to Update Fire Alarm System Cellular Communication Services In 2022 cellular companies will retire their older 3G technology. These companies include T-Mobile, Sprint, Verizon and AT&T. LTC providers relying on fire alarm systems that utilize outdated cellular communicators operating on 3G networks must consider upgrading their fire alarm communication apparatus. The majority of these systems depend on cellular communication devices to dispatch signals to a 24-hour...

March 1st, 2022 HCS and TxHmL Form Submission on LTC Online Portal Unavailable Until May 1, 2022 Due to Postponement, submissions of Home and Community-based Services and Texas Home Living forms using the Texas Medicaid and Healthcare Partnership Long-Term Care Online Portal are unavailable until May 1st, 2022. Data migration to the TMHP LTC Online Portal took place prior to March 1st, 2022. FYI-Any HCS and TxHmL form submitted to the LTC Online Portal before March 1 could be removed and...

March 1st, 2022 Claims & Forms Submissions:    The March 1 release of claims and forms submissions to Texas Medicaid & Healthcare Partnership is postponed to May 1, 2022. Home and Community-based Services Texas Home Living program providers Providers should continue to use the Client Assignment and Registration system for submitting claims and forms until May 1, 2022. The postponement allows more time for Providers to set up the necessary TMHP accounts and take relevant training...

February 27th, 2022 HCS and TxHmL Webinar Slated for March 3 moved to March 10th, 2022 Program providers and other interested stakeholders can now register for the upcoming HCS and TxHmL webinar. Webinar topics include: HCS & TxHmL Forms and Claims Migration Project Critical Incident Management System HCS and TxHmL Webinar March 10, 2022 3:30 - 4:30 p.m. Register for the webinar Email questions about the webinar to your program policy mailbox: HCS Policy TxHmL...

February 26th, 2022 If you missed part II of the LTC TMHP Migration HCS & TxHmL Waiver Webinar Training, you will have an additional chance on March 10th, 2022 10am-12:30pm Central Please click here register here The Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs is a two-part webinar for providers and Local Intellectual and Developmental Disability Authorities (LIDDAs). Attendees can register for any of...

February 8th, 2022 For those of you who missed today's training (part I) or who did not download the documents, I have provided them on this "Updates" post from Twogether Consulting Link to Resource Document from Webinar on 2/8/22 (TMHP Training Part I) Webinar Handout Part I Training  LTC TMHP Portal Provider User Guide TMHP Migration (HCS & TxHmL) FAQ's This webinar will be repeated on March 8th, 2022 10am-1pm central The Long-Term Care (LTC) Online Portal Training for Home and...

February 23rd, 2022 Claims Training For The Transition To TMHP Next Week  ~  HHSC and TMHP will conduct the training next week. They will let us know in the next few days when the training is set. ~  Webinar will be 2 hours.  Training will include a step-by-step walk-through. A  large portion of time will be used to answer questions providers have about billing. Look at the considerations to use applications to improve your business. ~  HHSC & TMHP webinars have a 1,000 person limit. ...

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...

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...

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...

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:...

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...

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...

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...

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.

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),...

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...

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...

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...

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...

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...

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:    ...

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...

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...

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...

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: ...

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...

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...

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)....

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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).

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

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...

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,...

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...

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....

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...

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...

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,...

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...

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.    

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.

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...

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...

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...

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...

Attention: HCS, TxHmL, CDS, CLASS, DBMD, ICF/IID, SNF's, and other HHSC programs Providers can sign up to receive Gov Delivery, an electronic mailer from HHSC that includes current news and topics of interest for LTC providers.

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

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...

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:    ...

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...

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,...

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.

  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...

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:...

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...

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...

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...

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...

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...

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...

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...

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: ...

Check out our page at "Gotostage" where we are providing  recordings of our free webinar sessions and other education For HCS, TxHmL, and ICF Providers https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b

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...

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:...