Twogether Updates

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.

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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: ...

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

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:...

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

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

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

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

Currently, all "On-site Training" is on hold due to COVID-19.  If you require any of these trainings, please check our calendars on our website for current webinars or contact us at:  info@twogetherconsulting.com for some of our pre-recorded training options. Live Training On-Site (Please contact us if you want us to provide these trainings on-site for your program): HCS/TxHmL: Care Coordination in the HCS Program, Using Person-Centered Thinking To Develop The IP (Implementation Plan), Changes...

Tuesday, June 9, 2020 HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid & CHIP Providers Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs. HHS expects to distribute...

Update on TWC services Provider Manual and Resources  The following revisions to the Vocational Rehabilitation Standards for Providers Manual (VR-SFP) are available for 30-day review on the Vocational Rehabilitation Providers' Resources page and will go into effect on June 29, 2020. Chapter 2: Obtaining a Contract for Goods and Services—updated Section 2.8.1 Adding Counties or Services, Goods, and/or Equipment to a Contract, to indicate that provider contracts awarded after January 2020 will...

Last Friday HHSC posted the following CARE banner:  Due to the 09/01/2019 HCS rate increase, service authorizations are being updated to ensure they are in line with their corresponding IPCs. This will not cause any payment changes. Upon inquiry as to what this meant, Holly Lindsey, UR, HHSC provided the explanation below.  Hopefully the explanation and guidance will be of assistance to you should an action (revision, renewal or transfer) be taken on an IPC which prompts a notice that the IPC...

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

Behavioral Support Services HCS and TxHmL Behavioral Support Services Provider Policy Training (Has been mandated for HCS & TxHmL providers to ensure their contracted Behavioral Support Services providers to take since March 2015) This course informs service providers of behavioral support services in the HCS and TxHmL programs related to the provision of behavioral support services in those programs.  All new behavior support service providers must complete the WBT before providing...

Seniors have always ignored health promotion activities meant to promote their health. This is because their health status is perfectly normal, and they do not consider themselves at significant risk of falling ill. However as a senior ages; a number of things can happen which can leave the senior injured or sick and possibly needing 24-hour nursing care like the one provided at www.carltonseniorliving.com/ and residencesatplainview.com/community/your-retirement-community/. It is common...