January 7th, 2025

From Twogether Consulting!

Happy Holidays!

Bon Jour and Happy New Year to all of you.  I spent some of my final holiday time in Paris.  It was wonderful and I was so glad I got to see some incredible places including the newly renovated Notre Dame Cathedral and eat some amazing food!  I  am feeling refreshed and am looking forward to coming home soon so I can assist providers with their needs.

Twogether Consulting will be officially open to provide services again as of January 13th, 2025.  Thank you everyone for your patience during the holidays and we would be happy to assist you, so please feel free to email me at info@twogetherconsulting.com or my general email address, if you already have it.  You can also contact meghanjones.tx@gmail.com to schedule an appointment or make an inquiry if you can’t reach me for some reason.

FYI- Remember that HCS/TxHmL Billing Guidelines were updated in January of 2025.

I will be setting up webinars for January and February shortly, as well as some possible live sessions in Houston and/or Austin.  We do have a variety of pre-recorded trainings for program managers, case managers and nurses,  so feel free to email us at info@twogetherconsulting.com to inquire. Let us know what areas of training you would like, to help us plan future sessions.

We do have our free provider resource webinar for January with Dr. Amanda Frias, OT posted on the website for January 30th, 2025 from noon-1pm.  Please check out our home page at www.twogetherconsulting.com and click on our training calendars for more information on next year’s live webinars and live training.

Please see our “Updates” section of the website for the latest news for IDD providers.

January 6th, 2024

From HHSC:

The Promoting Independence Plan report has been publicly posted in accordance with Executive Order RP-13 and is now available for viewing

This plan outlines accomplishments in the last two years as well as key strategies and goals that support people with disabilities to live independently within their communities. Highlights of the 2024 plan include activities to expand and improve services and an overarching theme of collaboration between multiple state agency partners.

Please review the Promoting Independence Plan and explore how it aims to improve the quality of life for people with disabilities by promoting independent living across Texas.

View the report here: Click here to view the Promoting Independence Plan 2024.

The report can also be found on the HHSC Reports and Presentations website located here: Reports and Presentations | Texas Health and Human Services

If you have comments or questions, please email HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov

January 5th, 2024

FEI Systems will host a monthly provider demonstration webinar on Jan. 14, 2025, from 10–11 a.m. Monthly provider demonstration webinars are offered to providers with access to the Critical Incident Management System. HHSC encourages providers to take advantage of these live training opportunities.

This applies to:

• Community Living Assistance and Support Services providers (CLASS).
• Deaf Blind with Multiple Disabilities providers (DBMD).
• Home and Community-based Services providers (HCS).
• Texas Home Living providers (TxHmL).
• Local intellectual and developmental disability authorities (LIDDAs).

Register for the webinars by logging into CIMS and navigating to Help (top right of dashboard). Click on Help, followed by Training. Choose Register for Provider Demonstrations from the available courses.

Email MCS_CIMS@hhs.texas.gov with any questions or concerns.

November 3rd, 2024

Note: All Critical Incidents are entered into the CIMS system for HCS/TxHmL providers.  FYI-ISS providers please report all critical incidents to CIIS in Tulip, not CIMS.

Monthly provider demonstration webinars are offered to providers with access to CIMS. HHSC encourages providers to take advantage of these live training opportunities.

This applies to:

• Community Living Assistance and Support Services providers (CLASS).
• Deaf Blind with Multiple Disabilities providers (DBMD).
• Home and Community-based Services providers (HCS).
• Texas Home Living providers (TxHmL).
• Local intellectual and developmental disability authorities (LIDDAs).

Register for the webinars by logging into CIMS and navigating to Help (top right of dashboard). Click on Help, followed by Training. Choose Register for Provider Demonstrations from the available courses.

Email MCS_CIMS@hhs.texas.gov with any questions or concerns.

Joint Training Page Available for HCS/TxHmL/ICF/ISS Providers

The HCS and TxHmL programs now have a Joint Training Opportunities page where providers can register for upcoming classes. Class size will be limited to maximize participation, but classes will be offered regularly. Providers should check the page often for updates. There will be recordings of special presentations available for viewing on-demand later.

November 10th, 2023

November 2023 HCS/TxHmL Provider Training Opportunities

Death Notifications for HCS/TxHmL Providers
Monday, Nov. 20
4–5 p.m.
Register here for webinar.

Writing Acceptable Plans of Correction for HCS and TxHmL Providers                                                                                                                                                                                                                     

Wednesday, November 15, 2023

9:30 AM – 4:00 PM

Texas Health and Human Services Commission
535 S. Loop 288, Suite 2001
Room: Conference Room 2134
Denton, TX 76205
(19 MAX)  Register For Live Training here

Writing Plans of Correction for Individualized Skills and Socialization Providers
2:30 p.m.–4:30 p.m.
Tuesday, November 28, 2023 

Register here for webinar

October 15th, 2023

October 2023 HCS/TxHmL Provider Training Opportunities

Writing Plans of Correction for Individualized Skills and Socialization Providers
Monday, Oct. 30
2–4 p.m.
Register here for webinar.

What Surveyors Look for in Intermediate Care Facilities – ICF
Tuesday, Oct. 31
10–11 a.m.
Register here for webinar.

Understanding the Survey Process
Tuesday, Oct. 31
1–2:30 p.m.
Register here for webinar.

August 24th, 2023

September 2023 HCS/TxHmL Provider Training Opportunities

Individualized Skills and Socialization Survey Process and ANE Overview
Friday, Sept. 1
9–10:30 a.m.
Register here for webinar.

Top 10 Citations for HCS and TxHmL Providers for FY 2022
Tuesday, Sep. 5
3:30–4:30 p.m.
Register here for webinar.

Writing Plans of Correction for Individualized Skills and Socialization Providers
Tuesday, Sept. 19
1:30–3:30 p.m.
Register here for webinar.

Administrative Penalties for HCS and TxHmL Providers
Thursday, Sept. 21
11:30 a.m.–12:30 p.m.
Register here for webinar.

HCS Certification Standards: An Overview of Changes
Thursday, Sept. 28
3–4:30 p.m.
Register here for webinar.

Coming in July 2023!

HCS Certification Standards: An Overview of Changes (course description)

Wednesday, July 5, 2023

11:30 AM – 1:30 PM

Register

Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)

Thursday, July 6, 2023

3:30 PM – 4:00 PM

Register

Infection Control Basics for HCS and TxHmL Program Providers (course description

Wednesday, July 12

9:30 AM – 10:30 AM

Register

Hurricane and Flooding Readiness for Home and Community Based Services and Texas Home Living and Individualized Skills and Socialization (course description)

Wednesday, July 19, 2023

3:00 PM – 4:00 PM

Register

and more coming

June 13th, 2023

June 2023 HCS/TxHmL Provider Training Opportunities

Hurricane and Flooding Readiness for HCS and TxHmL Providers and Individualized Skills and Socialization Providers
Tuesday, June 13
4:30 p.m.–5:30 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Tuesday, June 20
1–2 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Thursday, June 22
10–11 a.m.
Register here for webinar.

Understanding the Health Maintenance Activity (HMA) Rules ALF
Thursday, June 22
2–3 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Thursday, June 22
10–11 a.m.
Register here for webinar.

Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)

Monday, June 26, 20232:30 PM – 3:00 PM

Register

Hurricane and Flooding Readiness for ICFs
Tuesday, June 27
1–3 p.m.
Register here for webinar.

Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)

Monday, June 26, 2023

2:30 PM – 3:00 PM

Register

Writing Acceptable Plans of Correction of HCS and TxHML (course description)

Wednesday, June 28, 2023

9:00 AM – 4:00 PM  (Live Session in Conroe)

Register

HCS & TxHmL Training

ISS Training

April 2023 HCS/TxHmL Provider Training Opportunities

Most Cited Deficiencies for HCS & TxHmL Providers
Wednesday, April 12
11:30 a.m.–12:30 p.m.
Register here for webinar

Individualized Skills and Socialization Basic Program Overview
Wednesday, April 12
4–5 p.m.
Register here for webinar

Writing Acceptable Plans of Correction of HCS and TxHmL
Thursday, April 20
9 a.m.–4 p.m.
Marshall, TX
Register here for in-person class

Individualized Skills and Socialization Program Basic Overview (1 hour) (course description)

Friday, April 28, 20233:00 PM – 4:00 PM

Register here for webinar

February 2023 HCS/TxHmL Provider Training Opportunities

Infection Control Basics for HCS and TxHmL Program Providers (course description)

Wednesday, February 8, 2023 11:30 AM – 12:30 PM

Register here for webinar

Administrative Penalties and Related Processes in HCS & TxHmL Settings (course description)

Tuesday, February 28, 20231:30 PM – 2:30 PM

Register here for webinar

Dec. 2022 HCS/TxHmL Provider Training Opportunities

Emergency Preparedness 101 for HCS and TxHmL Providers

Tuesday, Dec. 1311:30 a.m.–12:30 p.m.

Register here for webinar

HCS/TxHmL Program Provider Responsibilities in Death Reviews and Provider Investigating Reports

Wednesday, Dec. 211–2 p.m.

Register here for webinar

Writing Acceptable Plans of Correction for HCS and TxHmLThursday, Dec. 29

9 a.m.–4 p.m.Nacogdoches, Texas

Register here for in-person class

Oct./Nov. 2022 HCS/TxHmL Provider Training Opportunities

Top 10 Most Cited Deficiencies for HCS and TxHmL Providers (course description) 

Wednesday, October 5, 20221:30 PM – 2:30 PM

Register for webinar

Hurricane and Flooding Readiness for HCS/TxHmL (course description)

Wednesday, October 12, 20221:30 PM – 2:30 PM

Register for webinar

Infection Control Basics for HCS and TxHmL Program Providers (course description)

Wednesday, October 19, 20222:00 PM – 3:00 PM

Register for webinar

Emergency Preparedness 101 for HCS Program Providers (course description)

Tuesday, November 1, 20221:00 PM – 2:00 PM

Register for webinar

July 2022 HCS/TxHmL Provider Training Opportunities

Long-term Care Regulation staff and program providers are invited to attend the following trainings hosted in July:

Writing Acceptable Plans of Correction for HCS and TxHmL
Wednesday, July 6
10:30 a.m.–12:30 p.m.
Register for the webinar.

Writing Acceptable Plans of Correction for HCS and TxHmL
Wednesday, July 6
10:30 a.m.–12:30 p.m.
Register for the webinar.

Hurricane and Flooding Readiness for HCS and TxHmL
Tuesday, July 12
1–2:45 p.m.
Register for the webinar.

Hurricane and Flooding Readiness for HCS and TxHmL
Tuesday, July 12
1:30–2:45 p.m.
Register for the webinar.

Administrative Penalties and Related Processes for HCS and TxHmL
Wednesday, July 20
1:30–2:45 p.m.
Register for the webinar.

Administrative Penalties and Related Processes for HCS and TxHmL
Wednesday, July 20
1:30–2:45 p.m.
Register for the webinar.

Infection Control Basics for HCS and TxHmL
Thursday, July 28
1:30–3 p.m.
Register for the webinar.

Additional classes may be added, and all available training opportunities can be found on the following websites:

• Joint Training website.
• HCS and TxHmL Training website.

July 5th, 2022

Nursing in HCS and TxHmL Settings -Recorded Session:  April 5th, 2022

This three-hour webinar covers requirements for the provision and delegation of nursing care in HCS and TxHmL settings. A Texas Board of Nursing representative will be a guest presenter. The most frequently cited deficiencies related to these requirements will be noted during the training. No CEs are offered for this webinar. However, a certificate of attendance will be provided.

**You can still watch the recording from this session, click on the registration link below.

From April 5, 2022
11 a.m. – 2 p.m.
Register here for the webinar.

Registration is limited. A recording will be available after the presentation for those unable to attend. Contact LTCR Policy with questions.

Missed a COVID-19 training? Many COVID-19 presentations for long-term care providers are recorded and are available 24/7. Please be sure to select the most appropriate recording for your program. Note that recordings are accurate as of the date of presentation and that updated guidance may be available.

Visit the recording library at https://www.gotostage.com/channel/covid-19webinarsforltc.

December 30th, 2024

HHSC reminds 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.
• Medical and pharmaceutical supplies.
• Communication to families and staff.
• Staffing shortages.
• Sheltering in place and evacuation, as applicable.

Providers must follow emergency preparedness rules and their own internal emergency preparedness policies and procedures.

Facilities with generators should perform any maintenance or needed testing while the weather is mild. This will ensure the equipment functions in case of extreme cold or power loss.

It’s important to review building integrity and identify any areas that may need repair, reinforcement, or weatherproofing. Multi-story buildings should review any other needed measures should evacuation be required and have a plan in place for how to move residents around or out of the building if there’s a loss of power.

Preparing for disaster is the most important step in protecting the Texans we serve and reducing the risk for loss of life.

Email questions to LTCRpolicy@hhs.texas.gov.

December 26th, 2024

 Individualized Skills and Socialization FAQ’s:  Updated Dec 2024

HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on December 4, 2024.

Read the FAQ here.

June 5th, 2023

HHSC’s Response to Three Recent ISS-Related Questions From Providers

January 13th, 2023

ISS FAQs:  Updated January 13th, 2023

August 23rd, 2022

Frequently Asked Questions HHSC shared during the ISS draft rules webinar on August 23rd, 2022.

These are questions received during the ISS webinar on July 19th, 2022

Q1: Will current day hab providers be grandfathered into the new
program? Or do they have to be program provider to have a day hab
contract with HHSC?
A1: No, Day Hab Providers are not grandfathered into the Individualized Skills and
Socialization program. Any provider who is interested in delivering Individualized
Skills and Socialization services must obtain a Day Activity Health Services or DAHS
– Individualized Skills and Socialization service category license, even those who
are currently providing day habilitation services.

Q2: Are the off-site activities generated from the individual PDPs or does the
ISS facility plan the activities?
A2: Off-site activities are generated from the individual’s Individual Plan of Care
and Individual Program Plan in the DBMD waiver program. In TxHmL and HCS, an
Individualized Skills and Socialization provider must provide off-site Individualized
Skills and Socialization in accordance with an individual’s PDP, IPC, and
implementation plan.

Q3: If the in-home service provider does not need to be an ISS
provider, does that mean that they can be a parent?
A3: A person who meets the Service Provider Qualifications for In-Home
Individualized Skills and Socialization, including a parent of an adult child
can provide Individualized Skills and Socialization.

Q4: What is the enhanced staffing rate? How does that work?
A4: An enhanced staffing rate is available in the HCS and TxHmL Programs
for an individual who requires more service provider support than the
individual would receive with the individual’s assigned LON. The requirement
for additional support may be because of the individual’s mobility, medical,
or behavioral needs. The program provider may request the enhanced
staffing rate for an individual with an LON 1 or LON 5 in the HCS Program, or
any LON in the TxHmL Program.

Q5: If the PDP do not specify how often a client needs to go out, will that be up
to the discretion of the individualized skills organization to decide how often
they go out?
A5: It is the individual’s choice for how they choose to receive off-site Individualized
Skills and Socialization and off-site Individualized Skills and Socialization must align with
the individual’s PDP, IPC, IP, and in DBMD the individual’s IPP.

Q6: Do we need to provide meals and snacks? Have a paid nurse on site? Can it
be an LVN?
A6: An Individualized Skills and Socialization provider does not need to provide meals
and snacks to the individuals, but they must provide personal assistance for an
individual who cannot manage personal care needs including eating during an
Individualized Skills and Socialization activity. An Individualized Skills and Socialization
provider must also be able to provide assistance with medications and the performance
of tasks delegated by a registered nurse.

Q7: Is there going to be an open enrollment period for ISS with times of the year
that are closed, or is it an open enrollment?
A7• An individual in the HCS, TxHmL, and DBMD Program can add Individualized Skills
and Socialization to their IPC at any point during the plan year. It is the individual’s or
their LAR’s choice if they would like to receive individualized skills and socialization.
• Any provider who is interested in delivering Individualized Skills and Socialization
services must obtain a Day Activity Health Services or DAHS – Individualized Skills
and Socialization service category license. The provider may apply at any time once
the online licensure portal (TULIP) is operational. HHSC anticipates that the license
application process will be available late November or December.

Q8: Are staffing ratios minimum or maximum? Will providers be reimbursed if
they go over the ratio?
A8: The staffing ratios described in the rule indicate that they are “no higher than” i.e.,
they describe the maximum ratio of individuals to service providers of Individualized
Skills and Socialization. To receive reimbursement and avoid recoupment of funds,
Individualized Skills and Socialization services (on-site, off-site, or in-home) must be
provided in accordance with the HCS, TxHmL, or DBMD Program rules.

Q9: Will ISS providers be required to have RNs as part of staff now that
medication management is part of the program? Additionally, our day hab does
not currently enroll individuals that need help with toileting or feeding needs,
will the program require that we do enroll these LONs individuals?
A9: If an individual receiving Individualized Skills and Socialization needs assistance
with medication or other nursing tasks, the HCS program provider’s nurse must ensure
the Individualized Skills and Socialization service providers are delegated/trained to
deliver the service. Individualized Skills and Socialization providers like day habilitation
providers can refuse to accept a person for services.

Q10: Is there any guidance regarding scheduling? For example, is the service
only Monday-Friday, etc.
A10: There is not a requirement for how many hours per day an Individualized Skills
and Socialization provider needs to provide services. There is a service limit for the
combined total of on-site, off-site, and in-home Individualized Skills and Socialization for
HCS and TxHmL of 1560 hours during an IPC year, six hours per calendar day, and five
days per calendar week.

Q11: Does an HCS, TxHmL or DBMD provider have to apply to be licensed as ISS
provider?
A11: An active day habilitation site could choose not to participate in Individualized Skills and
Socialization and not apply for a license. They would no longer be able to provide day
habilitation to individuals in HCS, TxHmL, and DBMD after March 1, 2023, since day hab will
no longer be a service at that point. Any provider who wishes to deliver Individualized Skills
and Socialization services will be required to have a Day Activity and Health Services –
Individualized Skills and Socialization license. A provider must obtain a temporary license
prior to delivering Individualized Skills and Socialization services and may choose to do so at
any time once the licensing system is available. HHSC Long-term Care Regulatory will issue a
provider a final license after conducting an on-site visit that results in final approval of the
license.
Q12: In the examples of ratios given, there was not an example that included an ICF
client. What are the expectations when mixing ICF clients with waiver clients?
A12: If a person is not in the TxHmL, HCS, or DBMD Program and is receiving services by a
staff member who is also providing on-site Individualized Skills and Socialization to an
individual in the DBMD Program or off-site to an individual in the HCS, TxHmL, and DBMD
Program, the appropriate HCS, TxHmL, and DBMD staffing ratio must be applied, and that
individual must be included in the staffing ratio.

Q13: If someone’s PDP says they need XX hours in the community, but we do
not have the manpower, are we still able to work with the client?
A13: Waiver providers can engage the Individualized Skills and Socialization

providers in the development of the implementation plan by identifying free or low-
cost activities (affordable by the individual) the Individualized Skills and Socialization

providers can offer within their community and match well with the individual’s
interests. Off-site Individualized Skills and Socialization is provided in a community
setting chosen by the individual from among available community setting options.
Community settings are settings accessible to the general public within an
individual’s community.

Q14: Day hab allowed for 5-hour minimum days, so now under ISS is it going
to be required to be 6 direct services timer?
A14: The service limit for the combined total of on-site, off-site, and in-home
Individualized Skills and Socialization for HCS and TxHmL is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
Individuals can receive less than six hours per calendar day.

Q15: If the individual/LAR choses not to utilize the ISS program, will
they still be able to receive funding from TxHmL/HCS?

A15: The individual or LAR can choose to receive in-home Individualized
Skills and Socialization if the individual meets the policy for in-home
delivery. Individuals living in three and four person residences would need
to participate in employment or day activity with natural supports if the
LAR or individual does not choose to receive individualized skills and
socialization and does not meet the policy guidance for in-home
individualized skills and socialization. Access to HCS and TxHmL waiver
services is not dependent upon receiving individualized skills and
socialization.

Q16: Can we have a combination of HCS waivers and private pay? Does private
pay also need to be in the community?
A16: Individualized Skills and Socialization providers will have a choice about how to
conduct business. They will be allowed to accept all payor sources, or they may choose
to accept only waiver (HCBS) or non-waiver. The HCBS settings regulations do not apply
to ICF/IID, private pay or general revenue and therefore, day habilitation can continue
to be provided without changing the service to individualized skills and socialization;
however, if a provider wants to serve individuals in the waiver programs, the provider
must do so as a licensed individualized skills and socialization provider after March 1,
2023. Individualized skills and socialization has both on-site and off-site services that
must be offered to individuals in the waivers.

Q17: Will ISS provided in the client’s home require EVV verification for HCS and
TxHmL funded clients? If the client lives in a group home or a Host
Home/Companion Care home, will the EVV verification be required?
A17: In-home Individualized Skills and Socialization provided in the individual’s own
home or family home will require the use of EVV verification, similar to in-home day
habilitation today. If the individual lives in a 3-person or 4-person residence, or a host
home/companion care residence, EVV verification will not be required.

Q18: Will we need a separate license for each day hab our individuals
attend including any families that provided in-home day hab due to
their LON and medical need?
A18: Each physical location that provides on and off-site Individualized Skills
and Socialization services will require its own license and application process.
In-home services will not require a license.

Q19: Can you give a few examples of offsite locations?
A19:Visits to the museums, libraries and parks are examples of off-site
Individualized Skills and Socialization activities if they are chosen by the
individual, integrate the individual into the community, and promote the
development of skills and behavior that support independence and personal
choice.

For further questions, contact:

HCSPolicy@hhs.texas.gov
TxHmLPolicy@hhs.texas.gov
LTCRPolicy@hhs.texas.gov

HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon.  To register for the virtual hearing, go to:  https://attendee.gotowebinar.com/register/927810115195515152

December 20th, 2024

TMHP Email:  TMHP sent this email to keep providers up to date regarding a recently published article, which details the recent Provider Revalidation Extension that was granted by the Health and Human Services Commission (HHSC).

The fully published article can be found here: https://www.tmhp.com/news/2024-12-13-revalidation-due-dates-extended-and-retroactive-enrollment-period-be-implemented. It covers the recently granted revalidation extension, how it will affect currently applied enrollment gaps and enrollment effective dates and enrollment periods for providers, as well as general timeframes for implementation, and future claims filing and enrollment instructions. Additional publications and notifications are also in the works, and we will share these, as well, once they are publicly available.

If you have questions about the article mentioned above, and wish to contact TMHP directly for assistance, please call the TMHP Contact Center at 800-925-9126, or email provider.relations@tmhp.com.

12/02/24

Revalidation Due Date Extension and Grace Period

The Texas Health & Human Services Commission (HHSC) and the Texas Medicaid & Healthcare Partnership (TMHP) are taking actions to assist providers experiencing difficulty completing the provider enrollment revalidation process in the Provider Enrollment Management System (PEMS). The actions described in this notification are designed to provide near-term relief for providers while HHSC and TMHP pursue longer-term system and process improvements. HHSC and TMHP continue to analyze the scenarios that must be addressed with these actions and will provide additional clarification and information as needed. These flexibilities are currently planned to last through May 31, 2025.

Please read the full notice Revalidation Due Date Extension and Retroactive Enrollment Period Effective Dates | TMHP.

December 18th, 2024

Guidance Related to the Regional Offsite Review Process for Critical Incidents Reported into CIMS

HHSC Long-term Care Regulation published Provider Letter 2024-22, Regional Offsite Review (ROR) Process for Critical Incidents Reported into the Critical Incident Management System (CIMS), for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers and a frequently asked questions document. Both documents are available on the HCS and TxHmL provider portals.

December 16th, 2024

Changes are coming to CIMS!

December 14th, 2024

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 5 p.m. on December 16.

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 25-1
• HCS Billing Requirements Draft Revision 25-1 Summary of Changes (PDF)

TxHmL

• TxHmL Billing Requirements Draft Revision 25-1
• TxHmL Billing Requirements Draft Revision 25-1 Summary of Changes (PDF)

Email stakeholder comments to TxHmL Policy.

December 13th, 2024

Subject: TMHP LMS Knowledge Management Bulletin

December 15th, 2024

HHSC has published the Information Letter (IL) 2024-XX regarding the 2024 Cost Report and 2024 or 2025 Accountability Report Training Information.

Information on Cost and Accountability Report Training Information can be accessed on the Provider Finance Department’s (PFD) webpage.

Review the IL for more information. If you have further questions, contact PFD-LTSS@hhs.texas.gov or (737) 867-7817.

Employment Assistance & Supported Employment Training Options From HHSC

December 10th, 2024

The Texas Health and Human Services Commission (HHSC) is pleased to host a free in-person Employment First / Employment Services training on January 28, 2025, at the Starlight Event Center – Trans Mountain Room, 6650 Continental Drive, El Paso, Texas 79925.

Training will be one day in duration and is scheduled for 9 a.m. to 4 p.m, MST.

Training topics will cover:

• Overview of Employment First and the National movement with Employment First.
• Providing Employment Services
• Family Concerns and Disability Inclusive Communities
• Employment Readiness Skills
• Apprenticeship Programs
• Employer Relationships

This training is valuable to anyone who has a role either indirectly or directly in promoting employment services and helping individuals achieve their goal of competitive and integrated employment.

November 11th, 2024

June 28th, 2021

There were 2 Home and Community-based Services and Texas Home Living trainings in this series:

• HCS and TxHmL Employment Assistance Training
• HCS and TxHmL Supported Employment Training

The web-based trainings cover employment services provided through HCS and TxHmL, information about the payer of first resort for employment assistance, and the basics of providing these services. They are designed to enhance staff knowledge about providing quality employment services to people enrolled in the waivers.

Each training has a corresponding quiz.

• HCS and TxHmL Employment Assistance Quiz
• HCS and TxHmL Supported Employment Quiz

The Direct Service Workers web-based training provides information about employment services and how direct service workers can support people achieve their employment goals. The training covers federal and state initiatives related to employment for people with disabilities and touches on issues related to people who work and receive SSI or SSDI benefits. The training has a corresponding quiz.

• Direct Service Workers Training
• Direct Service Workers Quiz

December 5th, 2024

Reminder – Compliance Review Grace Period Ends Dec. 31, 2024

The compliance reviews grace period for EVV Usage and EVV Landline Phone Verification reviews for, personal care services and home health care services, will end on Dec. 31, 2024. Beginning Jan. 1, 2025, program providers, financial management service agencies (FMSAs) and Consumer Directed Services (CDS) employers, that do not fully comply with the EVV usage and landline review requirements will be subject to enforcement actions.

October 30th, 2024

Don’t Forget Your Annual EVV Training Requirement!

October 2nd, 2024

Compliance Review Grace Period Ends Dec. 31st, 2024!

The compliance reviews grace period for EVV Usage and EVV Landline Phone Verification reviews for, personal care services and home health care services, will end on Dec. 31, 2024.

Beginning January 1, 2025, program providers, financial management service agencies (FMSAs) and Consumer Directed Services (CDS) employers, that do not fully comply with the EVV usage and landline review requirements will be subject to enforcement actions.

Payers conduct EVV compliance reviews to make sure program providers, FMSAs and CDS employers are in compliance with EVV requirements and policies.

Payers will conduct reviews and initiate contract or enforcement action if the program providers, FMSAs or CDS employers do not meet any of the following EVV compliance requirements:

• Usage Reviews
  • Meet and maintain the minimum EVV Usage Score of 80%.
  • Ensure staff is properly trained and consistently using EVV to record visits.
• Landline Reviews
  • Payers will review landline reports generated from the EVV systems to determine compliance with the EVV Landline requirements.
  • Program providers and FMSAs must ensure the phone number entered in the EVV system is a valid landline for members and CDS employers who have chosen to use a landline for clocking in and clocking out.

Next Steps

Program Providers, FMSAs, and CDS employers are encouraged to review their EVV Usage Reports monthly to ensure compliance with EVV requirements.

• Program providers and FMSAs can generate EVV Usage reports from the TMHP EVV Portal.
• Option 1 and Option 2 CDS employers can generate EVV Usage reports directly from their EVV system.
• Option 3 CDS employers must request a copy of their EVV Usage report from their FMSA.

Resources

Review section 11000 of the EVV Policy Handbook for more information about EVV Compliance Reviews.

Contact HHSC EVV Operations for questions.

September 12th, 2024

How to bill for HHCS delivered in-home versus out-of-home. 

Refer to the EVV Home Health Care Services Bill Codes Table (PDF) on the HHSC EVV webpage to ensure you’re using the appropriate Healthcare Common Procedure Coding System (HCPCS) and Modifiers before submitting the EVV claim.

Billing Combinations for HHCS

HHSC created new Long-Term Care billing combinations to submit claims for EVV and non-EVV service delivery locations.

• HCS and TxHmL Own Home/Family Home (OHFH) should be billed as outlined in the EVV HHCS Service Bill Codes Table – version 2.1 (Excel).
• Out-of-home should use the existing billing combinations with the KX modifier found in the HCS and TxHmL Bill Code Crosswalk (Excel).
• Other Residential Types should use the existing billing combinations with the HQ modifier found in the HCS and TxHmL Bill Code Crosswalk (Excel).

**Services that begin or end in a member’s OHFH setting will require an EVV visit match.

**Services provided out-of-home in the Community or in Other Residential Type settings will not require an EVV visit match.

HHSC has published training resources for program providers and FMSAs to prevent EVV claim mismatches when submitting EVV claims for HCS and TxHmL services:

• Best Practices to Avoid Claim Mismatches for HCS and TxHmL (PDF)
• HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (Video)

June 19th, 2024

FYI- there are also additional modifiers for EVV-required services (such as TG for Specialized Nursing and UC for CDS Nursing).

Useful EVV tool: 

June 7th, 2024

Reminder: 

Please Use Appropriate Modifiers To Be Reimbursed Properly For Nursing & Other Specific Therapies That Occur In (OFH) In-Home Services!

Updates LTC HCS and TxHmL Bill Code Crosswalks for EVV Home Health Care Services 

May 25th, 2024

EVV Proprietary Systems

May 2nd, 2024

January 7th, 2024

Clarification Landline Vs. Mobile

EVV Program providers and financial management services agencies (FMSAs) must enter and maintain correct information in the EVV system for their service providers or Consumer Directed Services (CDS) employees.

Program providers and FMSAs must not enter an unallowable landline phone type into the EVV system as the member’s home phone landline.

An unallowable landline phone type is a cellular phone or cellular-enabled device, such as a tablet or a smart watch.   A phone used to clock in or clock out through the landline method must be a landline phone, and not a cellular phone or device.  Cellular phones, tablets, smart watches, and laptops come under “mobile devices” and should be entered as such..

TMHP Published EVV Known Issues and Resolutions, Vol. 2

January 1st, 2024

HHSC has revised the Electronic Visit Verification (EVV) rules in Texas Administrative Code (TAC), Title 1, Chapter 354, Subchapter O. The new TAC rules are effective Jan. 1, 2024.

The new EVV TAC rules:

• Add the home health care services required by the 21st Century Cures Act, 1903(l) of the Social Security Act (42 U.S.C. §1396b(l)).
• Add the current policies regarding training, visit maintenance, and requests by program providers and FMSAs to become Proprietary System Operators (PSOs).
• Add definitions related to the addition of the new TAC rules.
• Reorganize the structure of the existing EVV-required personal care services list for clarity.

Email questions to HHSC EVV.

December 31st, 2023

December 6th, 2023

Discontinuation of EVV Free Text Reviews

November 11th, 2023

Prepare for EVV Cures Act Home Health Care Services Implementation

October 16th, 2023

IMPORTANT NOTICE: EVV Data Access & Conversion

August 20th, 2023

 EVV Alternative Device Policy For New State EVV Vendor

August 19th, 2023

Hurry Before It’s Too Late!   EVV Onboard with HHAeXchange by Aug. 31

June 13, 2023

Next Steps and Timeline for Transition to New Electronic Visit Verification State Vendor System

June 10th, 2023

https://www.hhs.texas.gov/provider-news/2023/06/01/registration-available-hhsc-evv-policy-training-webinars-program-providers-fmsas-cds-employers

Registration Available for HHSC EVV Policy Training Webinars for Program Providers, FMSAs and CDS Employers

June 2nd, 2023

May 13th, 2023

Reminder:  EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023

This is a reminder that Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin on May 1, 2023. EVV claims with dates of service of May 1, 2023, and after that do not have an EVV visit match will deny.

For more information about billing updates for HCS and TxHmL, including resources to help avoid future payment denials or recoupments, reference the notice located on the EVV web page, “EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023”.

Email EVV Operations for questions.

April 3rd, 2023

Session 4 ORR Schedules Added to TMHP EVV Proprietary Systems Web Page

HHSC created the Session 4 Operational Readiness Review, which is a special abbreviated Electronic Visit Verification Proprietary System Operator onboarding path that supports additional PSO ORRs. This additional path allows program providers and financial management services agencies to onboard with a previously approved proprietary system or a proprietary system that is participating in the Session 3 Standard Path ORR.

The Texas Medicaid and Healthcare Partnership has updated the EVV ORR section of the EVV Proprietary Systems web page to include ORR schedules, requirements and information about the Session 4 ORR.

Email the TMHP EVV PSO inbox for questions.

January 12th, 2023

Electronic Visit Verification (EVV) for Individualized Skills and Socialization (ISS) IL-2023-03 alert letter

Electronic Visit Verification (EVV) for Individualized Skills and Socialization
Program providers must ensure EVV is used when delivering in-home individualized skills and socialization in an own home/family home (OHFH) setting. For dates of services on and after March 1, 2023,

HHSC will deny or recoup a claim for in-home individualized skills and socialization in the own home/family home setting without a matching EVV visit record. For more information about EVV claims matching, refer to the EVV notice, “EVV Claims Matching for HCS and TxHmL Starts March 1, 2023”.
Program providers must input the Texas EVV Attendant ID for in-home EVV individualized skills and socialization OHFH claims.

Email TMHP EVV Operations for questions or refer to the document, HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF), for more information to help avoid EVV claim mismatches.

to the LTC Billing Crosswalk for more information about Staff ID requirements.

By January 13, 2023, HHSC will update the EVV Personal Care Services Bill Codes Table, located on the HHSC EVV web page, to include the specific Individualized Skills and Socialization billing codes which require EVV. Sign up for EVV GovDelivery to receive updates by email.

For EVV-related contact information, reference the EVV Contact Information Guide for Program Providers and FMSAs (PDF).

To read more, please click on link below, for Information Letter 2023-03 related to ISS automatic service authorizations and EVV

IL-2023-03

January 2nd, 2023

EVV Vendor Systems Will Display Individualized Skills and Socialization Services Starting 1/1/2023 Before New Authorizations Are Available

This notice is for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies required to use Electronic Visit Verification.

As shared in the EVV notice published on Oct. 26, Individualized Skills and Socialization bill codes will replace day habilitation bill codes; therefore, the EVV vendor systems will display 1/1/23 as the effective date for these new services; however, HHSC has extended the date when the new authorizations for Individualized Skills and Socialization services will be available, which is the week of 1/9/23.

Program providers and FMSAs required to use EVV must continue to use EVV.

HHSC will continue posting related updates.

As a reminder, EVV claims matching for HCS and TxHmL starts March 1, 2023. EVV Operations will be posting the updated bill codes, including helpful information to avoid future payment denials or recoupments, following the publication of other HHSC materials.

For other EVV questions, email the EVV Operations inbox.

For questions about Individualized Skills and Socialization services, email the Long-Term Services and Supports Policy inbox.

December 17th, 2022

EVV Training Updates

This notice from HHSC lists Electronic Visit Verification training updates for program providers, financial management services agencies and Consumer Directed Services employers required to use EVV.

Resources from the following training webinars are now available in the HHS Learning Portal by selecting EVV Policy Training – Webinar Recordings FY23:

• Español – EVV Compliance for CDS Employers (PDF) – Aug. 25 non-required training webinar

• Annual EVV Policy Training for Program Providers and FMSAs – Sept. 30 and Oct. 27 webinars

If new to EVV and need to complete the EVV policy training requirement, complete one of the applicable computer-based training courses located in the HHS Learning Portal:

• EVV Policy Training for Program Providers and FMSAs FY23
• Initial EVV Policy Training for CDS Employers FY23

An account is required to access the training webinar resources and CBTs, including to obtain a certificate of completion. Note that a “non-required training” does not include a completion certificate because it is considered optional training. Reference the EVV HHS Learning Portal Guide (PDF) for instructions.

For more information on EVV training requirements, reference section 4200 from the EVV Policy Handbook.

Sign up for GovDelivery to receive EVV updates, such as training updates, by email.

Email EVV Operations for questions.

2023 EVV Operational Readiness Review Session & Business Rules for Proprietary Systems Version 3.0

EVV Operations has posted the following notice: Notice of 2023 EVV Operational Readiness Review Sessions and EVV Business Rules for Proprietary Systems Version 3.0 (PDF).

This notice is to inform program providers and financial management services agencies about the publication of the 2023 Operational Readiness Review Sessions, as well as the new EVV Business Rules for Proprietary Systems Version 3.0.

EVV Guidance on Program and Service Requirements for Schedules

HHSC has published the document, Program and Service Requirements for Schedules (PDF), under the Resources section on the Electronic Visit Verification web page. This document describes HHSC requirements related to using schedules in the EVV system.

Email HHSC EVV Operations for questions.

December 1st, 2022

Reminder for STAR+PLUS, STAR Kids and STAR Health: New EVV Bill Codes and Modifier Combinations Effective Dec. 1

As a reminder, starting Dec. 1, new Electronic Visit Verification personal care services Healthcare Common Procedure Coding System and modifier combinations will be effective for:

• STAR+PLUS
• STAR Kids
• STAR Health

Refer to HHSC’s Oct. 31 notice for more information.

Contact your managed care organization for questions about these updates. Refer to the last page of the EVV contact guide (PDF) for MCO contact information.

December 1st, 2022

HCS and TxHmL Updates

The effective dates were updated for HCS and TxHmL services.

Refer to the bill codes table’s revision history dated Dec. 1, 2022, for more information.

For questions, email EVV Operations.

October 16th, 2022

Potential Electronic Visit Verification Changes Coming in 2023

The purpose of this notice is to inform stakeholders that HHSC’s contract for the current Electronic Visit Verification vendor systems (AuthentiCare and Vesta EVV) is scheduled to expire on Aug. 31, 2023.

On April 26, 2022, HHSC posted a competitive solicitation on the Electronic State Business Daily for EVV System Management Services. Contractor responsibilities will include:

• Providing and managing a single EVV vendor system
• Review and approval of provider-operated EVV proprietary systems  If you have an outside vendor (proprietary vendor), these will be reviewed as well.
• Coordinating EVV system integration with the EVV aggregator
• Providing operational and technical support for the functions listed above

Notification of contract award is anticipated in March 2023.

HHSC, at its sole discretion, may publish updates about the anticipated award date to the Procurement Forecast on the HHS Procurement Opportunities web page. Respondents are responsible for periodically checking the ESBD and the HHSC Procurement Forecast web page for updates.

HHSC must maintain the confidentiality and integrity of the procurement process; therefore, no additional information is available at this time. HHSC will provide more information in future announcements.

Email questions about this solicitation to Andrick Reese.

September 25th, 2022

EVV Updates for HCS and TxHmL Program Providers and FMSAs

HHSC and the Texas Medicaid and Healthcare Partnership posted helpful information for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies required to use Electronic Visit Verification.

HHSC Notice

This notice is to help program providers and FMSAs that are receiving EVV mismatches for Day Habilitation services.

Refer to the Sept. 15 notice for information on billing requirements, such as which Day Habilitation bill codes to use.

TMHP Notice

This notice provides information about EVV requirements for In-Home Day Habilitation and about EVV claims matching starting Nov. 1 for HCS and TxHmL.

Refer to the Sept. 19 notice for more information and resources.

Email EVV Operations for questions.

September 25th, 2022

EVV Claims Matching Refresher for HCS and TxHmL

Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin for dates of service starting Nov. 1.

To help prepare, the Texas Medicaid and Healthcare Partnership will host a refresher webinar on Oct. 13, for:

• HCS program providers
• TxHmL program providers
• Financial management services agencies

Refer to TMHP’s Sept. 15 notice for more information and to registerl

Click here for more information

September 18th, 2022

EVV Compliance Job Aids Updated

August 31st, 2022

Annual EVV Policy Webinars for Program Providers & FMSAs

July 28th, 2022

EVV Portal and Training Updates

Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on July 14.

Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.

Email questions to TMHP.

July 5th, 2022

EVV Claims for HCS and TxHmL Will Deny for Dates of Service Starting Sept. 1

HHSC has extended the start date when Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living will deny for no matching EVV visit. This will begin for the dates of service of Sept. 1, 2022, and after.

The extension gives HCS and TxHmL program providers and financial management services agencies more time to improve their claims matching. Texas Medicaid and Healthcare Partnership will provide more outreach and training on this topic. Trainings will be announced at a future date.

Refer to the HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF) for technical guidance.

HCS and TxHmL EVV claims must continue to be submitted through the Client Assignment and Registration System or TMHP.

• Submit EVV claims to CARE for dates of service before May 1, 2022.
• Submit EVV claims to TMHP for dates of service of May 1, 2022, and after.

Program providers, FMSAs and Consumer Directed Services employers must continue to use EVV during this period. However, HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance..

Email EVV Operations for questions.

July 1st, 2022

EVV Claims for HCS and TxHmL Will Deny for Mismatched Visits Starting July 1

Starting July 1, Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living must have a matching EVV Visit, or claims will deny.

Refer to the June 20 notice for more information and resources.

Email EVV Operations for questions.

June 12th, 2022

EVV Portal and Training Updates

Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on June 9.

There are also two new visit rejection codes related to EVV system transfers.

Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.

Email questions to TMHP.

June 6th, 2022

EVV Policy Handbook Revision and Training Updates

The Electronic Visit Verification Policy Handbook has been revised.

Revisions include:

• Adding new sections for the Consumer Directed Services option.
• Updating Schedules policy.
• Updating Visit Maintenance Reduction Features policy.

These revisions are effective June 1 and are outlined in the new revision log (PDF), located on the EVV webpage.

The handbook’s policies include EVV standards and policy requirements for:

• Program providers
• Financial Management Services Agencies
• Consumer Directed Services employers
• Payers, such as HHSC and managed care organizations

Computer-based training on the HHS Learning Portal were updated to include the policy revisions.

• EVV Policy Training for Program Providers and FMSAs CBT
• Initial EVV Policy Training for CDS Employers CBT
  • Note: The updates to the Spanish CBT will publish in June.

Email HHSC EVV Operations for questions about this notice.

May 30th, 2022

EVV Claims Matching for HCS and TxHmL Will Resume July 1

Electronic Visit Verification claims matching will resume for all Home and Community-based Services and Texas Home Living billing code combinations with dates of service of July 1, 2022 or after.

HHSC will post another notice with more information and resources to avoid EVV claims mismatches before July 1, 2022.

Email EVV Operations for questions about this notice.

May 8th, 2022

EVV Portal and Training Updates

Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on April 29.

Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.

Email TMHP EVV Operations with questions

March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

The migration of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) forms and claims entry to Texas Medicaid & Healthcare Partnership (TMHP) has been moved from March 1, 2022, to May 1, 2022. The postponement allows more time for program providers to set up the necessary TMHP accounts and take relevant training courses. HCS and TxHmL program providers must continue to use the Client Assignment and Registration (CARE) system to submit claims using existing billing code combinations for service groups 12 and 15 for dates of service prior to May 1, 2022.

HHSC is aware that some program providers updated authorizations in the EVV systems to reflect the new billing code combinations for service groups 21 and 22 that were scheduled to take effect March 1. To avoid the re-entry of authorizations, HHSC and TMHP will take the following actions:

• By March 4, the EVV Aggregator will accept billing code combinations for service groups 12, 15, 21 and 22 on EVV visits for dates of service through April 30, 2022, to prevent visit rejections.
  • For dates of service on or after May 1, 2022, the EVV Aggregator will only accept billing code combinations for service groups 21 and 22.
• Turn on the EVV07 claims matching bypass for all HCS and TxHmL billing code combinations to avoid claim denials through May 31, 2022.
  • Claims matching for all HCS and TxHmL billing code combinations will resume June 1, 2022.
• Publish an updated EVV Service Bill Codes Table to reflect these changes.

HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance.

**For visits that have been rejected by the aggregator due to incorrect billing code combinations, program providers must re-export the visit and ensure it is accepted in the EVV aggregator prior to submitting claims.

Please refer to HHSC’s ‘Continue Submitting Claims and Forms Using CARE System Until May 1, 2022’ notice for more information.

For technical questions related to the EVV Aggregator, contact TMHP. For other general EVV inquiries, contact HHSC EVV Operations.

March 3rd, 2022

EVV Policy Handbook Revisions Now Available

HHSC revised sections and appendices of the Electronic Visit Verification Policy Handbook.

The handbook includes EVV standards and policy requirements for:

• Program providers.
• Financial Management Services Agencies.
• Consumer Directed Services employers.
• Payers, such as HHSC and managed care organizations.

The revisions are effective March 1 and are briefly described in the 22-2 notice. For more information about the policy changes, refer to the new revision log (PDF) located on the EVV webpage.

Email HHSC EVV Operations with questions.

February 28th, 2022

EVV Portal and Training Updates

Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on Feb. 28.

For more information, refer to the EVV Portal and Training Updates article on TMHP’s EVV webpage.

For questions, email TMHP EVV Operations.

January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

HHSC revised parts of the Electronic Visit Verification Policy Handbook. These revisions are effective Jan. 7 and are listed in Revision Notice 22-1.

The handbook’s policies include EVV standards and policy requirements for:

• Program providers.
• Financial Management Services Agencies.
• Consumer Directed Services employers.
• Payers, such as HHSC and managed care organizations.

For questions, email HHSC EVV Operations.

November 21st, 2021

EVV Portal and Training Updates for November 2021

Texas Medicaid and Healthcare Partnership made improvements to the EVV Portal and related training materials on Nov. 11.

For more information, access the November 2021 EVV Portal and Training Updates article on TMHP’s EVV webpage.

FYI- When you click on the link above for updates from HHSC, please be sure to scroll to the bottom and click on “accept” as this is a disclaimer page.  You must do this 1st.   I have received some comments that some providers get confused when they see this page on the EVV website first pop up and they think they are on the wrong page, or there is a problem with the website page, etc…

Email TMHP with questions about these updates.

November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

The handbook’s policies are effective Nov. 1, 2021 and include EVV standards and policy requirements for:

• Program providers
• Financial Management Services Agencies
• Consumer Directed Services employers
• Payers such as HHSC and managed care organizations

The handbook replaces policies previously on the HHSC EVV webpage.  See EVV Policy Handbook Revisions – November 2021 (PDF) for differences between previously published policies and the revised handbook.

The following computer-based training courses on the EVV Training page of the HHS Learning Portal now reflects the revised EVV Policy Handbook:

• Initial EVV Policy Training for CDS Employers
• EVV Policy Training for Program Providers and FMSAs

Use the applicable checklist within EVV Training Requirements Checklist (PDF) for EVV training requirements and completion options.

Email questions to HHSC EVV Operations.

November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

These updates let the user request corrections to data element(s) on an EVV visit transaction(s) after the visit maintenance time frame has expired.

Program providers, Financial Management Services Agencies and Consumer Directed Services employers must use the request spreadsheets found on the EVV webpage.

The updates to the program provider and FMSA Request (Excel) include:

• New fields
• Added drop-down lists to applicable fields
• Updated and simplified field headers
• Revised instructions to:
  • Reflect EVV policy updates
  • List detailed steps and notes to complete the Request

The new Request for Consumer Directed Services employers (Excel) include:

• A new request spreadsheet for CDS employers who selected Option 1 on Form 1722, Employer’s Selection for EVV Responsibilities, to complete visit maintenance. This includes:
  • Drop-down lists for applicable fields
  • Sections for CDS employers and payers to complete
• Instructions reflect:
  • EVV policy updates
  • Detailed steps and notes to complete the request

  Review the instructions on the spreadsheets for more information.

  Email questions to your payer, either HHSC or a managed care organization

  ---

July 4th, 2021

EVV Visit Maintenance Policy Now Available

The Electronic Visit Verification Visit Maintenance Policy (PDF) is now available on the HHSC EVV webpage. The policy is effective July 1, 2021 and:

• Requires the program provider, Financial Management Services Agency or Consumer Directed Services employer to ensure each EVV visit transaction is complete, accurate and validated.
• Incorporates the Visit Maintenance: Last Visit Maintenance Date Policy.
• Incorporates the Visit Maintenance Unlock Request Policy.
• Includes the new visit maintenance time frame of 95 calendar days. (previously 60 calendar days) from the date of service delivery.

Email questions to HHSC EVV Operations at EVV@hhs.texas.gov.

July 4th, 2021

HHSC EVV Webpage Updates Now Available

The Texas Health and Human Services Commission updated and archived web sections and content, updated and added additional information related to the 21st Century Cures Act (Section 12006) and added new resources for the following Electronic Visit Verification webpages:

• EVV Home page,
• EVV Consumer Directed Services Option,
• EVV Cures Act,
• EVV Training and
• EVV Proprietary Systems.

Email questions to HHSC EVV Operations at EVV@hhs.texas.gov.

July 3rd, 2021

Revised EVV Visit Transaction Rejection Guide Now Available

The Electronic Visit Verification Visit Transaction Rejection Guide (PDF) was revised and is now available.

The guide provides step-by-step instructions for program providers and Financial Management Services Agencies to identify and correct issues that result in transaction rejections in the EVV system.

The guide is published on TMHP’s EVV Training webpage.

Email TMHP with questions.

April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

The computer-based training course, Initial EVV Policy Training for CDS Employers, is available in Spanish on the HHS Learning Portal.

To translate the HHS Learning Portal to Spanish, select Español from the drop-down menu in the upper left-hand corner of the webpage.

The policy training is tailored to the selection on Form 1722, Employer Selection for Electronic Visit Verification Responsibilities.

Registrants are not required to complete the Form 1722 Pre-Course Survey.

Follow the instructions throughout the course to complete and receive certification.

Email the HHSC EVV Mailbox for questions about EVV policy training.

March 16th, 2021

HHSC Publishes EVV Requirements of Signatures on Enrollment Documentation           (IL 2021-13)

HHSC has published IL 2021-13, EVV Notification Requirement (PDF), replacing IL 2020-01.

The letter addresses revisions on instructing LIDDAs on the requirements of signatures on enrollment documentation.

It also addresses new activity requirements for HCS, TxHmL, CDS program providers and LIDDA service coordinators.

For questions, email HCS Policy or CDS.

March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

In response to the recent severe winter weather, HHSC issued Temporary EVV Policies for Severe Winter Weather (PDF).

The flexibilities are for dates of service from Feb. 10, 2021 through Feb. 24, 2021.

The flexibilities are for program providers, financial management services agencies and consumer directed services employers required to use EVV.

Email questions to the HHSC EVV Mailbox.

February 7th, 2021

EVV Refresher Training on Feb. 19

The Texas Health and Human Services Commission and Texas Medicaid & Healthcare Partnership are hosting an Electronic Visit Verification webinar.

This training is a refresher and covers topics for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies who submit EVV claims for HCS and TxHmL EVV-required services.

The training is not required and is not a substitute for annual EVV training requirements.

Certificates of completion will not be issued.

Attendees will have the opportunity to submit questions throughout the training.

Both HHSC and TMHP will conduct a live question and answer session.

The registration link is below and provides details, such as agenda topics.

HCS/TxHmL EVV Refresher Training – Claims Submission/Claims Matching Policies & Best Practices to Avoid EVV Claim Mismatches
Friday Feb. 19
10 a.m. – Noon
Register for the webinar.

Email HHSC EVV for questions.

Reminder:  Entering Schedules for EVV-Required Services

The Electronic Visit Verification system allows Home and Community-based Services, Texas Home Living program providers, CDS Employers and Financial Management Services Agencies to enter schedules for EVV-required services. This is not an HHSC requirement. Program Providers, FMSAs and CDS employers can choose to enter a schedule into the EVV system.

EVV is only required for the following services:

• Community First Choice Personal Assistance Services/Habilitation
• In-Home Day Habilitation in own home or family home settings
• In-Home Respite in own home or family home settings

Email hcspolicy@hhsc.state.tx.us or txhml@hhsc.state.tx.us with questions.

January 24th, 2021

EVV Portal and Training Updates for January

On Jan. 14, Texas Medicaid & Healthcare Partnership made improvements to the Electronic Visit Verification Portal by updating the EVV Reason Code Usage and Free Text Report and updated the related training materials.

Read the TMHP article EVV Portal Improvements and Training Updates for details.

Email TMHP with questions about these updates.

January 24th, 2021

HCS & TxHmL Best Practices to Avoid EVV Claim Mismatches for CFC PAS/HAB Services

HHSC has published Best Practices to Avoid Electronic Visit Verification Claim Mismatches for Home and Community-based Services and Texas Home Living (PDF) program providers and financial management services agencies.

The best practices help HCS and TxHmL providers avoid claim denials related to EVV.

The best practices are linked above and on the HHS EVV Training webpage in the Best Practices section.

Email questions about EVV policy to HHSC EVV.

January 18th, 2021

EVV Compliance Oversight Reviews Delayed for EVV Usage and Misuse of EVV Reason Codes

HHSC told managed care organizations to delay compliance oversight reviews for EVV Usage and Misuse of EVV Reason Codes. Evaluation of visit data collected during the grace period ensures the compliance measures continue to align with current EVV policy.

EVV Usage and Misuse of EVV Reason Codes reviews for the compliance grace period ended on Aug. 31, 2020 for:

• EVV visits with Sept. 1, 2019 to Aug. 31, 2020 dates of service.
• Program providers required to use EVV by state law before the Cures Act Implementation identified on pages 3 and 4 of the Programs and Services Required to Use EVV (PDF) document.

Next Steps

• HHSC will notify program providers 90 calendar days before reviews begin for EVV Usage and Misuse of EVV Reason Codes for EVV visits with dates of service on and after Sept. 1, 2020.
• HHSC and MCOs will continue reviews for EVV Landline Phone Verification and Required Free Text.
• Program providers can use the EVV Usage Report, and EVV Reason Code Usage and Free Text Report in the EVV Portal to track these compliance measures.

Program providers can contact their payer or email HHSC EVV with their questions or concerns.

January 10th, 2021

EVV Notification Requirement for HCS/TxHmL Program Providers 

HHSC has published IL 2021-01 Electronic Visit Verification Notification Requirement (PDF).

The letter informs HCS and TxHmL program providers they are now required to use the EVV system for CFC PAS/HAB, in-home respite, and day habilitation provided in the home of an individual who has a residential location of “own/family home.”

Texas Government Code, §531.024172(c), requires that HHSC inform an individual who receives a service requiring the use of EVV that the individual is required to comply with the EVV system. HHSC has developed a form for providers to comply with this statute.

The Electronic Visit Verification Responsibilities and Additional Information form is included with the IL 2021-01 (PDF).

January 4th, 2021

 EVV for HCS and TxHmL providers has gone live since January 1, 2021 (includes CDS and FMSA’s)

Resources for providers, including escalation processes, regarding EVV questions & concerns:

December 20th, 2020

Cures Act EVV:

Preparing for Jan. 1, 2021 Implementation

HHSC will require Electronic Visit Verification for all Medicaid personal care services beginning on Jan. 1, 2021. This requirement is mandated by the federal 21st Century Cures Act. If HHSC does not comply, Texas will lose federal funding for Medicaid services.

Beginning Jan. 1, 2021:

• Document all delivery visits for an EVV-required service in the EVV system. EVV-required services on the Programs, Services, and Service Delivery Options Required to Use EVV (PDF) document.
• An EVV-required service claim will be paid only if:
  1. The EVV visit transaction that supports the claim is accepted into the EVV Portal before claim submission.
  2. The claim receives an “EVV01 – EVV Match” result code in the EVV Portal after the claims matching process is performed.

Program providers and financial management services agencies must complete the following before Jan. 1, 2021, to avoid impacts to EVV claims payment:

• EVV system onboarding. This includes system setup and training.
  • If an EVV vendor system is selected from the state vendor pool, the EVV vendor provides the training. Refer to the TMHP EVV Vendors webpage for more information about EVV vendors and their contact information.
  • If an EVV proprietary system is selected, the program provider or FMSA handles system training.
• EVV training requirements outlined in the Cures Act EVV: Training Requirements Checklists (PDF).
• Document all visits for EVV-required services in the EVV system.

CDS employers must complete the following before Jan. 1, 2021, to avoid delays in payment to their CDS employees:

• Form 1722, Employers Selection for Electronic Visit Verification Responsibilities. Submit the signed form to their FMSA, which is the company that helps with CDS employee payroll.
• EVV system onboarding. CDS employers can contact their FMSA to complete onboarding and schedule training.
• EVV training requirements outlined in the Cures Act EVV: Training Requirements Checklists (PDF).
• Employees must start documenting all visits for EVV-required services in the EVV system.

HHSC is providing the following support to program providers, FMSAs, and CDS employers. This is to reduce impacts to claims payment and payment to CDS employees as they adjust to the new EVV requirements.

• If a visit is not captured through an electronic verification method, enter the visit manually into the EVV system and confirm acceptance into the EVV Portal to avoid claim denials. Instructions for manually entering a visit are posted in the following locations:
  • DataLogic/Vesta EVV system.
  • First Data/AuthentiCare EVV system in the “Custom Links” section.
• HHSC has published Best Practices to Avoid EVV Claim Mismatches (PDF) to help program providers and FMSAs ensure a claim is not denied for reasons related to EVV.
• HHSC has issued the 90 Day Visit Maintenance Temporary Policy (PDF). extending the time to complete visit maintenance for dates of service between Jan. 1, 2021 and March 31, 2021.
• An EVV compliance grace period will be applied for one year to all Cures Act EVV Expansion services with dates of service between Jan. 1, 2021 and Dec. 31, 2021 for the compliance measures listed in EVV Compliance Oversight Reviews Policy (PDF).

The EVV Contact Information Guides provide points of contact for EVV-related questions and issues:

• CDS Employer EVV Contact Information Guide (PDF)
• Program Provider and FMSA Contact Information Guide (PDF)

Visit the HHS EVV website for more information.

November 28, 2020

HCS and TxHmL CARE Service Authorization instructions for EVV

HCS and TxHmL are required to manually enter each individual’s service authorization in the EVV Vendor System.

Providers can find instructions here on how to find their service authorizations in CARE.

If additional assistance is needed after the service authorization is obtained, program providers can contact their EVV vendor for further instructions.

Existing EVV Users: Temporary EVV Policies for COVID-19 to End Dec. 31

HHSC is extending the Temporary EVV Policies for COVID-19 (PDF) through Dec. 31, 2020 for program providers currently required to use Electronic Visit Verification. HHSC will end the temporary policies after Dec. 31, 2020.

Program providers submitting EVV claims for dates of service on and after Jan. 1, 2021:

• Must ensure a matching EVV visit transaction is accepted in the EVV Portal before billing the claim, or the claim will be denied.
• Will no longer receive an EVV07 match code in the EVV Portal.
• Will no longer have 180 days to complete visit maintenance.

Reminder: HHSC extended the practice period for the Cures Act Expansion. Claims for EVV services included in the Cures Act Expansion, will be denied without a matching EVV visit transaction for dates of service on and after Jan. 1, 2021.

Best Practices for Temporary EVV Policies for COVID-19

Program providers should continue to follow the Best Practices for Temporary EVV Policies for COVID-19 (PDF) to avoid recoupments for claims submitted between March 21, 2020 and Dec. 31, 2020.

Contact your payer for questions or email HHSC EVV.

Visit the HHS EVV webpage.

HCS and TxHmL Program Providers Required to Select an EVV Vendor

11/18/2020

HCS and TxHmL Program Providers Required to Select an EVV Vendor Effective Jan. 1, HHSC will require HCS and TxHmL program providers to use EVV for the following services: Community First Choice Personal Assistance Services/Habilitation In-Home Respite In-Home Day Habilitation (Own Home or Family Home only) HCS and TxHmL program providers are required to select an EVV vendor and complete EVV training to meet the Jan.1 deadlines. The requirement to select an EVV vendor and complete training applies to all contracted HCS and TxHmL program providers. Beginning Jan. 1, 2020, service claims for CFC PAS/HAB will be denied by the claims adjudication system and not paid by HHSC if the program provider has not onboarded with an EVV vendor. Read IL 20-07 (PDF) for more information about selecting an EVV vendor and completing training to be EVV-compliant by the Jan. 1 deadline.

Deadline Approaching Soon!!

Remember everyone:  Effective Dec. 1, HHSC will require HCS and TxHmL program providers to use EVV for the following services:

• Community First Choice Personal Assistance Services/Habilitation (CFC PAS/HAB)
• In-Home Respite
• In-Home Day Habilitation (Own Home or Family Home only)

HCS and TxHmL program providers are required to select an EVV vendor and complete EVV training to meet the Dec.1 deadlines. The requirement to select an EVV vendor and complete training applies to all contracted HCS and TxHmL program providers.

Beginning Dec. 1, 2020, service claims for CFC PAS/HAB will be denied by the claims adjudication system and not paid by HHSC if the program provider has not onboarded with an EVV vendor.

Click here to read IL 20-07 (PDF) for more information about selecting an EVV vendor and completing training to be EVV-compliant by the Dec. 1 deadline.

Contact EVV if you have questions about EVV requirements.

Oct. 11th, 2020

EVV Revised Policies Effective Oct. 1

HHSC has revised the following electronic visit verification policies, effective Oct. 1. The information is for program providers and financial management services agencies. It is on the Policy section of the HHS EVV webpage.

Claims Matching Policy (PDF)

The policy:

• Includes additional EVV claims match result codes
• Identifies exceptions to the claims matching process

Claims Submission Policy (PDF)

• The policy includes detailed information about the requirement to submit claims for EVV-required services to the appropriate HHSC claims management system.
• The EVV Billing Policy has been incorporated into the policy.

Email HHSC EVV with your questions.

Oct. 11th, 2020

Updated EVV Service Bill Codes Table Effective Oct. 1

The EVV Service Bill Codes Table is updated effective Oct. 1. The table is on the HHS EVV webpage in the Service Bill Codes Table section. See:

• Below for the major updates
• The Revision History in the table for a complete list of the changes

Program providers and FMSAs can refer to the table for the list of EVV-relevant services and bill code information to avoid EVV visit transaction rejections and EVV claim mismatches.

Units Matching

The updated table shows that during the EVV claims matching process for dates of service on and after Oct. 1, billable units on the EVV visit transaction will be matched to billed units on the claim for:

• EVV-relevant services delivered through the service responsibility option in Managed Care and fee-for-service Long-Term Care programs.
• Community First Choice Personal Assistance Services/Habilitation in the Community Living Assistance and Support Services program (Service Group 2, Service Code 10CFC T2026).

Home and Community-based Services and Texas Home Living Programs

• The table clarifies the EVV Requirements for In-Home Day Habilitation in the HCS Program when In-Home Day Habilitation and In-Home Respite services are provided in a member’s own home or family home setting.
• The “Claims Place of Service” column in the “CARE LTC FFS” tab only includes place of service code 12 (Home Location) because EVV is only required to capture services that need an in-home visit.

Email HHSC EVV for questions.

HHSC is issuing this guidance from CMS to Home and Community-based Services program providers. It clarifies electronic visit verification requirements for in-home day habilitation.

All service events occurring on or after Dec. 1, 2020, for an EVV-required service, must be captured in the EVV system and accepted into the EVV Aggregator.

EVV is not required for In-Home Day Habilitation provided to someone in a:

• Three or four-person home
• Host home
• Companion care residential setting

EVV is only required for the following services:

• Community First Choice Personal Assistance Services/Habilitation
• In-Home Day Habilitation in own home or family home settings
• In-Home Respite in own home or family home settings

See IL 20-07 Electronic Visit Verification in the HCS and TxHmL Program (PDF) for information about EVV requirements.

Additional Guidance on Day Habilitation Services

Program providers billing claims for In-Home Day Habilitation services requiring EVV will continue to use the current claims procedure code, T2020. The EVV Service Bill Codes Table lists this code on the HHS EVV website.

HHSC is developing separate bill codes for Out-of-Home Day Habilitation and will provide guidance before implementing the new codes.

Email hcspolicy@hhsc.state.tx.us with questions.

No EVV For In-Home DH: 3 & 4-bed Homes or Host Homes

August 20th, 2020

HHSC just informed the three IDD associations that it received clarification from CMS that EVV will not be required for in-home day habilitation delivered in a three- or four-bed home or host home. HHSC will send notice regarding this to all affected stakeholders.   This does however mean that In-Home DH provided in an individual’s “Own Family Home” will still require staff to utilize EVV.

CURES Act EVV Training is Underway for HCS/TxHmL Providers

Program providers and FMSAs affected by the Cures Act EVV expansion must complete EVV policy and EVV Portal training before Dec. 1, 2020, and then annually. See the EVV Required Training Checklist (PDF) for more information.

To meet the training requirement, program providers and FMSAs attending these webinars must:

1. Register for Session 1.
2. Register for Session 2.
3. Attend both sessions from start to finish.

To register, click the links below:

FMSAs

• Session 1 – June 2, 2020 – 8:30 a.m. to 12:30 p.m.
• Session 2 – June 3, 2020 – 8:30 a.m. to 12:30 p.m.

HCS/TxHmL

• Session 1 – June 9, 2020 – 8:30 am to 12:30 pm
• Session 2 – June 10, 2020 – 8:30 am to 12:30 pm

Additional Training Opportunities

Program providers and FMSAs can also meet training requirements by completing computer-based training online in the HHSC Learning Portal and TMHP Learning Management System. HHSC and TMHP are planning additional live training events this fall and will provide more information when available.

Email TMHP for questions about registration or the EVV Portal.

Email questions about EVV training requirements.

 For more Cures Act information, visit the HHS EVV Cures Act webpage.

If you miss the EVV training dates, you may take them on the HHSC learning portal:

https://learningportal.dfps.state.tx.us/

Please go to HHSC’s page on Electronic Visit Verification for the latest information/ updates to EVV.  Please see Training & Joint Training pages from HHSC as well!

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/electronic-visit-verification

Updated Timeline for Cures Act EVV Expansion     

The updated timeline for expanding the Cures Act EVV requirement to all Medicaid personal care services is now available on the HHS Cures Act EVV website.

The timeline includes new information and resources about the EVV Practice Period beginning July 1, completing training requirements, and more.

This information is for Cures Act program providers and FMSAs (PDF) required to use Electronic Visit Verification by Jan. 1, 2021.

For questions, contact EVV.

• •  

     EVV Proprietary System page 

    http://www.tmhp.com/Pages/EVV/EVV-Proprietary.aspx

    Providers currently required to use EVV must continue to use EVV under state law and HHSC policy. See the Programs and Services Currently Required to Use Electronic Visit Verification (PDF) 

    For questions about EVV vendors, email evv@TMHP.com

New EVV Proprietary System Onboarding Documents Available

TMHP has posted new information about the EVV proprietary system onboarding process on the TMHP EVV Proprietary Systems webpage.

The documents located in the Onboarding section provide an overview of the approval process that a program provider or FMSA must complete before using their own EVV proprietary system. For more information, refer to the article on the TMHP EVV website (PDF).

Resources

• Contact: Electronic_Visit_Verification@hhsc.state.tx.us
• Website: HHSC EVV Cures Act

Trainings Available:

• HHSC EVV Training webpage

EVV Policy Training (Provided by your payer)

• The HHSC EVV Policy computer-based training (CBT).
• The MCO Policy training. Contact your MCO for EVV Policy training opportunities.

EVV Aggregator and EVV Portal Training (Provided by TMHP)

• TMHP EVV CBT modules 1-6.
• TMHP EVV Webinar training.

There will also be instructor-led trainings (EVV Roadshow) in October. Find the schedule and register on the HHS Learning Portal.

Additional training resources are available on the HHSC EVV website and the TMHP EVV Provider Training webpage.

For questions about this alert, email Electronic_Visit_Verification@hhsc.state.tx.us.

December 5th, 2024

The STAR+PLUS Handbook updates Appendix XXII. This revision is effective Dec. 1, 2024.

Click this link to see the updates.

December 3rd, 2024

The Provider Investigations Handbook (PIH) revision 24-2 updates sections throughout the handbook. This revision is effective Dec. 2, 2024.  Does apply to HCS/TxHmL/ICF programs.

Click this link to see the updates.

December 1st, 2024

New Service: Employment Readiness is available in the following waiver programs: HCS, TxHmL, and DBMB 

As required by House Bill 4169 (88th Legislature, Regular Session, 2023), the Health and Human Services Commission (HHSC) is adding a new service similar to prevocational services to the Home and Community-based Services (HCS), Texas Home Living (TxHmL), and Deaf Blind with Multiple Disabilities (DBMD) waivers. The new service, employment readiness, will be available on Jan. 1, 2025.

Employment Readiness and Provider Fiscal Compliance Review Process Webinar

HHSC will host a webinar on Dec. 11 from 10 a.m. to noon for the Home and Community-based Services (HCS), Texas Home Living (TxHmL), and Deaf Blind with Multiple Disabilities (DBMD) program providers, local intellectual and developmental disability authorities, financial management service agencies and other interested parties.

The webinar will provide information on the new:

• Employment readiness service coming to the HCS, TxHmL and DBMD Programs on Jan. 1, 2025.
• Provider fiscal compliance review process in the HCS and TxHmL Programs, effective on Jan. 1, 2025. 

Register for the webinar.

Email questions about the webinar to your program policy:

HCS Policy

TxHmL Policy

DBMD Policy

What’s Employment Readiness?

Employment readiness provides assistance that prepares an individual for employment in the community. It helps an individual develop basic habilitative skills or achieve generalized vocational goals. Employment readiness activities cannot be directed at developing skills related to a specific type of employment.

December 1st, 2024

Register for the 2024 ICF Conference Webinar

The Intermediate Care Facility Conference webinar for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) program staff and providers will be held on Tuesday, Dec. 5. There is one track, so register for each session for the complete educational activity.

Welcome to the 2024 ICF Conference: Embracing Change to Enhance Value
8:30–8:45 a.m.
Register for Webinar

Keynote: Scott Abel, “The Strive to Thrive”
9–9:45 a.m.
Register for Webinar

ICF Deficiency Trends
10:15–11:45 a.m.
Register for Webinar

Understanding Survey Rules: What Surveyors Look for During an ICF/IID Survey
1–2:30 p.m.
Register for Webinar

Surrogate Decision Making
3–4:15 p.m.
Register for Webinar

November 28th, 2024

The informal comment period for new proposed changes to the rule for HCS & TxHmL (TAC 565 and 566) ended on November 27, 2024: Comment on Proposed & Draft Rules | Texas Health and Human Services.

These proposed new and amended rules implement House Bill (HB) 1009 by Turner the 88th Legislature, Regular Session, 2023. HB 1009 imposes a new requirement on a Medicaid provider providing services under a 1915(c) waiver to conduct criminal history record information and employee misconduct registry reviews and to suspend the employment or contracts of individuals who engage in reportable conduct. New rule language in §565.12 requires HCS providers to notify HHSC of opening a new location or the voluntary closure of an HCS residence. Added language under §565.15 prohibits minor children from sharing a bedroom with an adult in HCS residences, including host/home and companion care settings. Added language under §565.23 clarifies the authority of LTCR. 

November 26th, 2024

The TxHmL Handbook Has Been Revised

Texas Home Living (TxHmL) Program handbook revision 24-1 updates Appendix X.

This revision became effective Oct. 1, 2024. Click this link to see the updates.

November 26th, 2024

The HCS Handbook Has Been Revised

The Home and Community-based Services (HCS) Handbook revision 24-1 updates Appendix X.

This revision became effective Oct. 1, 2024. Click this link to see the updates.

November  16th, 2024

The LIDDA Handbook Has Been Revised

The Local Intellectual and Developmental Disability Authority (LIDDA) Handbook revision 24-4 updates Appendix V.

This revision is effective Nov. 16, 2024. Click this link to see the updates.

October 7th, 2024

The LIDDA Handbook Has Been Revised

Local Intellectual and Developmental Disability Authority Handbook (LIDDA) 24-3 revision updates sections throughout the handbook.

The revision is effective Sept. 30, 2024. Click here for a full-size view of the updates.

November 16th, 2024

From HHSC Weekly Digest Bulletin:

Adverse Childhood Experiences (ACES) and Trauma Informed Care (TIC) Conference Online, December 5, 2024

Join us for this online conference on best practices for person-centered care around Adverse Childhood Experiences (ACEs), traumatic stress, and trauma-informed care (TIC) interventions for adults and children with intellectual and/or developmental disabilities (IDD). The ACEs-TIC Conference will focus on equipping service providers, caregivers and any others interested in information that will enhance their understanding of the unique behaviors and needs of people with IDD or behavioral health (BH) issues who have or are experiencing traumatic situations.

Six (6) hours of FREE continuing education units (CEUs) will be provided by HHSC. See registration for details.

ASL and CART will be provided.

Presentations will include:

• “Recognizing and Responding to Adversity: Embracing Trauma-Informed Care in Intellectual and Developmental Disability Services” by John Keesler, Ph.D., MSW, LMSW Associate professor, School of Social Work, Indiana University Bloomington
• “The Road to Recovery: Supporting Children with Intellectual and Developmental Disabilities Who Have Experienced Trauma” by Laura Buckner, Community Education, Texas Center for Disability Studies, UT Austin; Mentor trainer, The Learning Community for Person-Centered Practices
• “Trauma and Healing in the Lives of People with Intellectual and Developmental Disabilities” by Karyn Harvey, Ph.D., Psychologist, author, and director of programs for the Park Avenue Group; and
• “Addressing the Impact of Adverse Childhood Experiences in Children with Intellectual and Developmental Disabilities” by Kynthia Brooks, Child Health Specialist, Family Health Strategy division, Texas Health and Human Services Commission

November 15th, 2024

Submitting HCS and TxHmL Individual Movement Forms

Home and Community-Based Services Waiver (HCS) and Texas Home Living Waiver (TxHmL) providers should refrain from submitting the following Individual Movement Forms (IMTs) via the Long-Term Care (LTC) Online Portal:

• IMT-Local Authority Reassignment

• IMT-Service Coordinator Update

These specific purpose codes are designated for LIDDA-use only and should not be submitted by HCS and TxHmL providers for any reason!

HCS and TxHmL providers can only submit the IMT for purpose codes “IMT-Suspension” and “IMT-Individual Update.”  See page 193 in the LTC HCS and TxHmL Waiver Programs Provider User Guide for details.

**Questions For issues encountered while submitting the IMT on the TMHP LTC Online Portal, call TMHP at 800-626-4117, select option 1, then option 1.

November 15th, 2024

Computer-Based Training in the TMHP Learning Management System

The following long-term care (LTC)-specific computer-based training (CBT) course is currently available on the Texas Medicaid & Healthcare Partnership (TMHP) Learning Management System (LMS):

• LTC Online Portal Basics—This interactive CBT provides a basic overview of the LTC Online Portal, including information about creating an administrator account and an overview of the features of 5 November 2024 LTC Provider Bulletin, No. 100 Training and Events the blue navigational bar and the yellow Form Actions bar. Demonstrations and simulations appear throughout the CBT to provide opportunities for an interactive experience.

• TexMedConnect for Long-Term Care (LTC) Providers—This CBT demonstrates effective navigation and use of the LTC TexMedConnect web application.

Providers will learn how to:

‒ Log in to TexMedConnect

.‒ Verify a client’s eligibility

.‒ Enter, save, and adjust different types of claims

.‒ Export Claim Data.

‒ Find the status of a claim

.‒ View Remittance and Status (R&S) Reports.

LTC Online Portal Training for HCS and TxHmL Waiver Programs Webinar – Provides information on the features and navigation of the LTC Online Portal, management of waiver program assessments and forms in the LTC Online Portal, and the purpose and workflow of the forms. For a list of webinar or CBT descriptions, upcoming broadcast dates, registration links, recordings of past webinars, and Q&A documents, visit the TMHP Learning Management System (LMS) at learn. tmhp.com.

The TMHP LMS can be accessed through the TMHP website or directly at learn.tmhp.com.

Providers must create an account to access the training materials on the LMS. To create an account, click Don’t have an account? Sign up here on the LMS home page. For questions about the LTC training CBTs and webinars, call the TMHP Contact Center at 800-626-4117 or 800-727-5436. For LMS login or access issues, email TMHP LMS support at TMHPTrainingSupport@ tmhp.com.

November 14th, 2024

Eligibility Information Available for Long-Term Care Providers and LIDDAs

LTC providers and LIDDAs that are seeking eligibility information can pull Medicaid Eligibility and Service Authorization Verification (MESAV) using any of the following field combinations through TexMedConnect.

This service can be accessed 24 hours a day, 7 days a week

. • Medicaid/Client No. and Last Name

• Medicaid/Client No. and Date of Birth

• Medicaid/Client No. and Social Security Number

• Social Security Number and Last Name

• Social Security Number and Date of Birth (DOB)

• Last Name, First Name, and DOB

MESAV can provide the Medicaid eligibility Program Type, Coverage Code, and Medicaid Recertification Due Date to help providers ensure appropriate and continued Medicaid eligibility for long-term care services.

November 13th, 2024

HHSC Rescinds PL 2024-20 Requirements for Tuberculosis Screening and Testing

HHSC rescinded PL 2024-20 Requirements for Tuberculosis Screening and Testing. Additional guidance regarding tuberculosis screening and testing will be forthcoming.

In the interim, providers should follow their program regulations and internal communicable disease and infection control policies and procedures to address tuberculosis screening and testing.

Providers may use recommendations from the Centers for Disease Control and the Texas Department of State Health Services to inform their policies.

For more information, follow the links below:

Clinical Testing Guidance for Tuberculosis: Health Care Personnel | TB Prevention in Health Care Settings | CDC

Frequently Asked Questions About TB | Texas DSHS

Tuberculosis Screening for Adults in Various Settings (PDF)

August 12th, 2024

PL 24-04 –Changes & Guidance To ICF/IID Provider Reporting Processes and HHSC Investigating Processes- Effective March 1, 2024.

March 10th, 2024

ICF/IID ANE Webinar- Very Important!

February 25th, 2024

New Reporting Process for ANE Reporting & Investigations for ICF/IID Program

January 20th, 2024

Surrogate Decision-Making Program (SDMP)

Randy Rowley, Manager, SDMP, HHSC, provided an overview of the surrogate decision-making program to the workgroup.  Click here for link to ppt

HHSC December 27, 2023 Bulletin:

The legislatively mandated Surrogate Decision-making Program (SDMP) authorizes Surrogate Consent Committees (SCCs), comprised of trained volunteers, to provide written informed consent for individuals residing in community-based ICFs/IID who have been assessed to lack the capacity to make certain treatment decisions for themselves and have no legal guardian or actively involved family members serving as Surrogate Decision Makers (SDMs) or the treatment decisions are beyond the scope of the SDMs.

The SDMP facilitates compliance with Code of Federal Regulations (CFR) Title 42 and state ICF/IID rules regarding protection of individuals rights.

For the list of treatment decisions that a SCC can make see the HHS SDMP webpage.

Watch for upcoming training event announcements.

For questions about SCCs, or if you want to volunteer to serve on a SCC, email SDMP Manager Randy Rowley or call 512-438-4306.

ICF Rules-TAC Code Draft Title 26 Part I Ch 551

Draft Rules

Personal Needs Allowance Information Letter

Personal Needs Allowance (PNA):  PNA of individuals residing in a nursing home or ICF/IID from $60/month to $75/month, and for couples from $120/month to $150/month effective January 1, 2024.   HHSC posted an information letter regarding this change:

IL 2023-45 Personal Needs Allowance (PNA) Adjustment (Replaces IL 2022-16) (texas.gov).

June 15th, 2023

Personal Needs Allowance Increase Bill passed during 88th legislature session 

December 15th, 2022

ICF Resources

These resources can also be found on the ICF Provider Portal page.

September 25th, 2022

HHSC Publishes Updated Guidance on the Amelioration of Administrative Penalties for ALF, ICF/IID, and NF Providers

HHSC Long-term Care Regulation has published Provider Letter 2022-24 – Amelioration of Administrative Penalties (replaces PL 2013-18).

The letter provides guidelines to assisted living facilities,

intermediate care facilities for individuals with an intellectual

disability or related conditions, and nursing facilities about

the amelioration of administrative penalties assessed for state licensure

violations.

Read the provider letter details.

June 12th, 2022

ICF COVID-19 Vaccination Reporting Emergency Rules Expired June 6!!

Emergency rules for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions that require COVID-19 vaccination reporting expired June 6.

This means that effective June 7, ICFs no longer have to report COVID-19 vaccination data for staff and individuals to HHSC.

The following rules expired June 6:

• 26 TAC §551.48 – ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.

Here is a copy of the previous rule that expired:

551.48.ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.

(a) An intermediate care facility administrator and one additional designee must enroll in an emergency communication system in accordance with instructions from Texas Health and Human Services Commission (HHSC).

(b) An intermediate care facility must respond to requests for information received through the emergency communication system in the format established by HHSC.

(c) Within 24 hours of becoming aware of a staff or resident’s COVID-19 vaccination, an intermediate care facility must accurately report COVID-19 vaccination data for staff and individuals in the format established by HHSC.

(d) Subsection (c) of this section does not apply to state supported living centers.

The agency certifies that legal counsel has reviewed the emergency adoption and found it to be within the state agency’s legal authority to adopt.

Filed with the Office of the Secretary of State on August 10, 2021.

Email questions to LTCR Policy.

April 29th, 2022

ICF Visitation Rules Update

An alert went out to remind providers that all visitation must be allowed. Essential caregiver and end-of-life visits must be allowed for all individuals with any COVID-19 status. A facility may be cited if visitation is not allowed.

Review ICF/IID visitation rules from April 4th, 2022, for additional information.

April 10th, 2022

COVID-19 ICF Mitigation, Response Rule Revised Effective April 6

HHSC Long-term Care Regulation has published a revised Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Mitigation and Response Emergency Rule. It is effective April 6, 2022.

The revised rule:

• Removes the requirements to have plans for obtaining and maintaining a two-week supply of full PPE.
• Clarifies that a facility does not have to provide the name of the person who tested positive for COVID-19 when reporting to CII.

April 10th, 2022

HHSC Publishes Description of Key Changes to 26 TAC 551, ICF/IID (PL 2022-07)

HHSC has published Provider Letter 2022-07, Description of Key Changes to 26 TAC 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, for ICF/IID providers. This letter describes the key changes to Title 26 of the Texas Administrative Code, Chapter 551, that were effective on Feb. 24.

Throughout the rule, HHSC updated citations, agency names, and terminology; corrected minor grammatical and punctuation errors; and revised sentence structures to make the chapter easier to read.  In addition, the following items are addressed in this letter:

– New Requirements for Infection Prevention and Control Policies and Procedures

-HHSC included a state rule that refers to each Centers for Medicare & Medicaid Services (CMS) Condition of Participation (CoP). Additions to 26 TAC 551 include • Governing Body • Client Protections • Facility Staffing • Active Treatment • Client Behavior and Facility Practices • Health Care Services • Physical Environment • Emergency Preparedness • Dietetic Services.

– transition from paper applications to the use of the online licensure portal, called the Texas Unified Licensure Information Portal (TULIP)  (Disclose information when applying for “relocation” and application information must be submitted through portal in “TULIP” system)

-Now require evaluation of the emergency preparedness and response plan at least every two years, instead of annually.

-ANE & Incident definitions

-Administrative penalties for each visit are limited to the cap amount, regardless of the number or duration of violations as of Sept. 1st, 2021

****If you have any questions about this letter, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161

April 6th, 2022

COVID Screening in ICF’s

ICF COVID-19 Mitigation and Provider Response emergency rules require an intermediate care facility must screen individuals according to HHSC guidance

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

ICFs must screen each employee or contractor for the following criteria (listed below) before entering the facility at the start of their shift.

•Staff screenings must be documented in a log kept at the facility entrance and must include the name of each person screened, the date and time of the evaluation, and the results of the evaluation.

**Staff who meet any of the criteria must not be permitted to enter the facility.

As per ICF/IID Expansion of Reopening Visitation Emergency rules, ICFs are required to screen all visitors for signs or symptoms of COVID-19.

*Visitor screenings must be documented in a log kept at the entrance to the facility, which must include the name of each person screened, the date and time of the screening, and the results of the screening. The visitor screening log may contain protected health information and must be protected in accordance with applicable state and federal law .

*A visitor may not participate in a visit if the visitor has signs and symptoms of COVID-19 or active COVID-19 infection.

Screening Criteria:

•fever, defined as a temperature of 100.4 Fahrenheit and above, or

signs or symptoms of a respiratory infection, such as cough, shortness of breath, or sore throat;

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

•any other signs and symptoms as outlined by the CDC in Symptoms or Coronavirus at cdc.gov;

•contact in the last 14 days with someone who has a confirmed diagnosis of COVID-19, is under investigation for COVID-19, or is ill with a respiratory illness, regardless of whether the person is fully vaccinated, unless the person is entering the facility to provide critical assistance; or

•testing positive for COVID-19 in the last 10 days.

April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

A facility must notify the Texas Health and Human Services Commission (HHSC) Complaint and Incident Intake of COVID-19 activity as described below.

(1) A facility must notify HHSC of the first confirmed case of COVID-19 in staff or individuals, and the first confirmed case of COVID-19 after a facility has been without cases for 14 days or more, at HHSC Complaint and Incident Intake (CII) through TULIP, or by calling 1-800-458-9858, within 24 hours of the positive confirmation.

(2) A facility must submit a Form 3613-A Provider Investigation Report, minus the name of the person who tested positive for COVID-19, to HHSC Complaint and Incident Intake, through TULIP, by email at ciiprovider@hhs.texas.gov, or by fax at 877-438-5827, within five working days from the day a confirmed case is reported to CII.

April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

HHSC Long-term Care Regulation has published a revised Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Mitigation and Response Emergency Rule.

It became effective April 6, 2022.

The revised rule:

•Points to guidance from the Texas Department of State Health Services and HHSC rather than the CDC.

•Removes the requirements to have plans for obtaining and maintaining a two-week supply of full PPE.

•Removes the requirement to have spaces to don and doff PPE

•Clarifies that a facility does not have to provide the name of the person who tested positive for COVID-19 when reporting to CII.

February 27th, 2022

HHSC Adopts Revised ICF/IID Rules – Effective Feb. 24th, 2022

HHSC Long-term Care Regulation has adopted updates to the Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID) or Related Conditions program rules. The revised rules are in the Texas Administrative Code Title 26, Chapter 551. They are effective Feb. 24, 2022.

Key changes to the rule are to:

• Implement House Bill 1848 from the 86th Legislature, Regular Session, 2019 which requires new infection control policies and procedures in long-term living facilities.
• Implement House Bill 3720 from the 87th Legislature, Regular Session, 2021 which limits the total amount of an administrative penalty assessed against an ICF/IID.
• Reintegrate the conditions of participation from the Code of Federal Regulations.
• Corrects legacy agency terms, update rule citations, and edit for clarity and consistency.

COVID-19 ICF/IID Webinar Recording from Feb. 14 Available

A recording of the Feb. 14 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available for those who could not attend.

There have been changes made to the PowerPoint based on the information provided by DSHS during the webinar.

Read the COVID-19 Q&A (PDF).

Listen to the webinar recording.

Email LTCR Policy for the transcript.

February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

Long-term Care Regulation and the Department of State Health Services will provide the latest information on the COVID-19 pandemic and take live questions from participants in this intermediate care facilities provider webinar.

Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend all COVID-19 webinars with LTCR and DSHS.

Those using Internet Explorer may have difficulties registering for the webinar. If so, try using another browser, such as Google Chrome or Microsoft Edge.

March 7, 2022
11 a.m.–12 p.m.
Register for the COVID-19 Webinar.

February 13th, 2022

HHSC is not currently assessing compliance with CMS’s Omnibus COVID-19 Health Care Staff Vaccination rules, published in the Federal Register on November 5, 2021.

ICF COVID-19 Vaccination Data Reporting and Emergency Communication System – Feb 7

HHSC Long-term Care Regulation has published a revised ICF/IID Provider COVID-19 Vaccination Data Reporting Rule (PDF). It became effective February 7, 2022 and includes Emergency Communication System Enrollment for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions providers.

The rule requires ICF/IIDs to:

• Report COVID-19 vaccine data within 24 hours
• Enroll in an emergency communication system

January 7th, 2022

ICF COVID-19 Response Plan and FAQ Updated – Jan. 7

Document   Version    Date    Change    Comments

Version 3.5                1/5/2022     Changes to pages 6, 31, 38, 39, 40, 51, 72 71, and Changes made to reflect the most updated CDC guidance.

Version 3.4               12/07/2021  Changes to pages 15, 16, 25, 26, 31, 35 Edited to include revised ICF COVID-19 Provider Response Mitigation Rules for ICFs/IID

For changes made previous to 12/07/2021,  please read the Table of Changes starting with page 7 of 19 of the Response Plan.

Update your Infection Control Policies and other related policies accordingly. 

HHSC has revised the ICF COVID-19 Response Plan and Frequently Asked Questions document in response to the most recent CDC guidance.

November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

HHSC published Provider Letter 2021-38 Medicaid Bed Reallocation which explains the process to request reallocated ICF/IID Medicaid beds from HHSC. This letter replaces Provider Letter 2019-21.

November 4th, 2021

Updated ICF/IID COVID-19 FAQ and COVID-19 Response Plan Revised

HHSC has revised the Frequently Asked Questions for ICF/IIDs about COVID-19 (PDF) and the ICF/IID COVID-19 Response Plan (PDF) in response to the revised COVID-19 Expansion of Reopening Visitation for ICF Providers rules.

October 24th, 2021

New PL 2021-21 COVID-19 – Expansion of Reopening Visitation for ICF Providers

Super important!!!!

HHSC has published Provider Letter 2021-21, COVID-19 Response – Expansion of Reopening Visitation (PDF) for ICF/IID providers. This letter replaces Provider Letter 2021-10. This letter describes the criteria for expanded visitation as well as address changes in response to Executive Order No. GA-38(link is external) and updated CDC guidance.

Updated COVID-19 Expansion of Reopening Visitation Emergency Rules for ICF Providers

HHSC Long-term Care Regulation has published revised COVID-19 Expansion of Reopening Visitation Emergency Rules for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) or Related Conditions (PDF). The rules address changes in response to Executive Order No. GA-38 (PDF)(link is external) and updated CDC guidance.The rules became effective on October 20, 2021.

September 15th, 2021

HHSC Publishes Amended Statutory Cap Regarding 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 5th, 2021

Guidance for Providers Regarding Entry into LTC Facilities (PL 2021-33)

HHSC Long-term Care Regulation has published Provider Letter 2021-33, Authority to Enter Long-term Care Facilities (PDF), for ALF, HCS, ICF/IID and NF providers. This letter reminds providers that they must allow persons providing critical assistance and providers of essential services to enter the facility if they pass the facility’s COVID-19 screening.

September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

HHSC has published IL 2021-42 ICF/IID Services During COVID-19 (PDF), which replaces IL 2020-43.

A resident must be discharged from the Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions, with or without a contract to hold the resident’s placement in accordance with 26 TAC Section 261.227(j), if the resident is absent from the ICF/IID for one full day or more and the absence is not during leave described in 26 TAC Section 261.226.

August 1st, 2021

HHSC Publishes Updated COVID-19 Response Plan and Frequently Asked Questions for ICF Providers

HHSC Long-term Care Regulation updated the ICF COVID-19 Response Plan and FAQ document on July 29, 2021.

Read the updated ICF COVID-19 Response Plan (PDF).

Read the updated ICF FAQs (PDF).

March 24th, 2021

HHSC Adopts New Expansion of Reopening Visitation Emergency Rules for ICF Providers!!!

HHSC has adopted new Expansion of Reopening Visitation (PDF) emergency rules that establish criteria for expanded indoor and outdoor visitation as well as essential caregiver visits. These rules are effective March 24, 2021.

HHSC Publishes COVID-19 Response – Expansion of Reopening Visitation for ICF Providers (PL 2021-10)

HHSC has published Provider Letter 2021-10, COVID-19 Response – Expansion of Reopening Visitation (PDF) for ICF/IID providers. This letter replaces Provider Letter 2020-43. This letter describes the criteria for expanded indoor and outdoor visitation as well as essential caregiver visits.

March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

A recording of the March 22, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

Listen to the COVID-19 Q&A recording.

Read the COVID-19 Q&A (PDF).

March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

A recording of the March 8, 2021 ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

Listen to the COVID-19 Q&A recording.

Read the COVID-19 Q&A (PDF).

February 8th, 2021

Draft ICF/IID Rule Changes

• Draft ICF/IID Rule Changes- See link:    https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:cf5ea154-04b4-4c75-8aec-7e230c3cfda0
• High Level Summary of Proposed Changes See link:  https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:2aa689d6-3018-4ab9-8d75-04578f4c922d

February 7th, 2021

Feb. 8- ICF/IID Provider Bed Hold Payments Webinar &

Reminder to Provide Letter to Families

IL 2020-43, ICF/IID Services During COVID-19 directed program providers to give a copy of the letter attached to that IL to each resident who was:

• Absent from an ICF/IID
• Not on leave
• Was not discharged from the ICF/IID

If you have not provided the letter to residents who meet that criteria, do so immediately. It was to be complete by Oct. 5, 2020.  You must assist residents in deciding to do only one of the following:

• Return to the facility.
• Continue to be absent from the facility, be discharged, but enter into an agreement with the ICF/IID to hold your place at the facility.
• Continue to be absent from the facility and be discharged.

HHSC Medicaid and CHIP Services will issue instructions to providers about entering COVID-19 therapeutic leave for days a resident was away from an ICF/IID to reduce the risk of COVID-19 transmission. Register for the following webinar to review the emergency rules authorizing this leave and the instructions for entering it.

ICF/IID Provider Bed Hold Payments Webinar
Friday, Feb. 5
9:30-11 a.m.
Register for the Bed Hold Payment Webinar.

The emergency rule authorizing payment for COVID-19 therapeutic leave (PDF) is effective Jan. 29, 2021.

January 19th, 2021

HHSC Updates the ICF COVID-19 Response Plan and FAQ Document

Please be sure to update your infection control and other related policies based on the updated Response Plan!!! 

Let us know if we can help.  We will be working on some of these addendums in the next few weeks. 

HHSC Long-term Care Regulation updated the ICF COVID-19 Response Plan and FAQ document on Jan. 12, 2021.

Read the updated ICF COVID-19 Response Plan (PDF).

Read the updated ICF FAQs (PDF).

Jan. 25 ICF Provider COVID-19 Webinar with HHSC LTC Regulation

Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance.

ICF/IID providers are strongly encouraged to attend this and all biweekly COVID-19 webinars with LTCR and DSHS.

Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.

ICF Provider Webinar
Jan. 25, 2021
11 a.m. – 12:30 p.m.
Register for the COVID-19 Webinar.

Recording of ICF COVID-19 Jan. 11 Provider Webinar Available

A recording of the January 11, 2021 ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

Listen to the COVID-19 Q&A recording.

Read the COVID-19 Q&A (PDF).

January 10th, 2021

Informal Comments on Draft Rules for ICF/IID or Related Conditions

HHSC is accepting informal comments from stakeholders on the following draft rules, which are now posted on the HHS Rulemaking page. The comment period ends Jan. 19, 2021.

This project implements two bills from the 86th Legislature, Regular Session, 2019. House Bill (H.B.) 1848 contains required elements for infection prevention and control. H.B. 3803 limits the daily amount of an administrative penalty assessed against an ICF/IID. The project will also update rule references and agency names, amend rules to align with Centers for Medicare & Medicaid Services conditions of participation in the ICF/IID program, and edit the rules for clarity and consistency.

HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

HHSC has published a revised version of Provider Letter 20-37, Reporting Guidance for Long-Term Care Providers (PDF). The revision includes information for ALF and ICF providers offering point-of-care testing for COVID-19 and clarifies reporting requirements for NF providers.

November 22nd, 2020

November 30 ICF Provider COVID-19 Webinar with HHSC LTC Regulation

LTCR and DSHS provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance.

ICF/IID providers are strongly encouraged to attend this and all biweekly COVID-19 webinars with HHSC Long-term Care Regulation and the Department of State Health Services.

Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

Register for the COVID-19 webinar.

Recording of November 16 ICF COVID-19 Q&A Provider Webinar Available

A recording of the November 16, 2020 ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

View the COVID-19 Q&A recording.

View the COVID-19 Q&A (PDF).

10/16/20

Important Information!

LTCR FORM 2195: Expansion of Reopening Visitation Status Attestation and Letter PL 20-43 (for ICF Only)

Note: to receive an approved general visitation designation, a small ICF/IID that cannot provide separate areas, units, wings, halls, or buildings for individuals who are COVID-19 positive, COVID-19 negative or unknown COVID-19 status, based on the status of the entire facility, must:

• have no facility-acquired COVID-19 cases in individuals for at least 14 consecutive days; and
• have no COVID-19 cases in staff.

An ICF/IID must provide instructional signage throughout the facility and proper visitor education regarding

• signs and symptoms of COVID-19;

• infection control precautions; and
• other applicable facility practices (e.g., the use of facemasks or other appropriate PPE, specified entries and exits, routes to designated visitation areas, and hand hygiene).

An ICF/IID that does not meet the criteria for a visitation designation must permit closed window visits and end-of-life visits for individuals regardless of their COVID-19 status, as well as essential caregiver visits for individuals with COVID-19 negative or unknown COVID-19 status.

Such an ICF/IID must also develop and implement a plan to meet the visitation criteria and submit the plan to the regional director in the Long-term Care Regulation (LTCR) region where the ICF/IID is located within five days of submitting the new 2195 Expansion of Reopening Visitation Status Attestation Form,

or

within five days of receiving notification from HHSC that the ICF/IID was not approved for general visitation designation. 

LTCR Form 2195

Each ICF/IID must submit LTCR Form 2195 to the Regional Director in the LTCR region where the facility is located and must provide information about whether the ICF/IID meets or does not meet the criteria for expanded general visitation.

Each ICF/IID must submit a completed form 2195 to the Regional Director no later than October 31, 2020.

An ICF/IID that does not meet the visitation designation criteria must attest that it:

• is permitting closed window visits, end of life visits, and essential caregiver visits;
• will develop and implement a plan to meet the visitation designation criteria as defined in 26 TAC §551.47; and
• has included the plan with the form or will submit the plan within five business days of submitting the form.

To seek a designation for general visitation, an ICF/IID must complete LTCR Form 2195, Expansion of Reopening Visitation Status Attestation, to notify LTCR that the ICF/IID seeks a designation as a visitation facility.

The form must be emailed to the LTCR regional director in the LTCR region where the facility is located. Any applicable pictures and facility maps must also be included with LTCR Form 2195.

The LTCR regional director or designee will review the form within three working days of submission and notify the ICF/IID whether it has received been approved for a visitation designation.

An ICF/IID with previous approval for visitation does not have to submit LTCR Form 2195 or other documentation unless the previous visitation approval has been withdrawn, rescinded, or canceled, or was for only indoor or outdoor visitation instead of both indoor and outdoor visitation.

If approved, the ICF/IID must allow outdoor visits, indoor plexiglass visits, open window visits, and vehicle parades in accordance with the applicable emergency rule. HHSC LTCR can conduct an on-site visit to confirm an ICF/IID’s compliance with the requirements. If HHSC determines that the ICF/IID does not meet the requirements for the designation as a visitation facility, the ICF/IID must immediately stop all visitation except a closed window visit, end-of-life visit, and visits by persons providing critical assistance, including designated essential caregivers.

If, at any time after a visitation designation is approved by HHSC, the ICF/IID experiences an outbreak of COVID-19, the ICF/IID must notify the Regional Director in the LTCR Region where it is located that the ICF/IID no longer meets visitation criteria, and the ICF/IID must immediately stop all visitation, except a closed window visit, end-of-life visit, or visits by persons providing critical assistance, including essential caregivers.

The ICF/IID can submit a new request for designation when it meets all visitation criteria.

Under Section 37.10 of the Texas Penal Code, a person commits a criminal offense if he or she makes a false entry in a governmental record; makes, presents, or uses any record or document with knowledge of its falsity and intent that it be taken as a genuine governmental record; or makes, presents, or uses a governmental record with knowledge of its falsity. In addition, making a false statement on the attestation form can result in the imposition of an administrative penalty as described in Texas Health and Safety Code, Chapter 252, section 252.065(a)

Contact Information for Submitting LTCR Form 2195 to the LTCR Regional Director: https://hhs.texas.gov/about-hhs/find-us/long-term-care-regulatory-regional-contact-numbers

If you have any questions about this letter, please contact the Policy, Rules and Training Section by email at PolicyRulesTraining@hhsc.state.tx.us or call (512) 438-3161.

10/05/20

Deadline for Decision To Return to Facility/Payment to Hold Bed/Discharge Option  

Information Letter No. 20-43 ICF/IID Services During COVID-19

10/03/20

Quick TIPS on New Changes for Expansion of Facility Visitation Rules & Other Policies Concerning COVID-19

Essential Caregiver Visits and Salon Services Visitor   (Visitor types above and beyond normal designated visiting facility type)

Essential Caregivers are allowed even if the facility does not have designated visitation.  They must be at least 18 years of age.  Can be family, friend, guardian.

• 1.They must wear a facemask. 2. They must have evidence of negative COVID-19 test in the past 14 days and must be screened by facility staff prior to the visit.  (Pay attention to the new additional symptoms and discontinuation of asking about international travel). 3. There is a 2- hr limit unless the facility allows a longer period of time. 4.They can have physical contact with their individual (and only their individual)  5.They must be limited to access to their person.  6.An assigned person must escort them to and from the location they are going to meet with the individual- room, outside…  7. The facility must approve the face mask they are going to wear or provide an appropriate mask.  8.If they do not have an appropriate face mask or the facility can’t provide one, they will need to reschedule the visit. 9. The facility must create an identifying badge for the essential caregiver or any salon service visitors. 10. The facility must have attestation stating the essential caregiver has visited and when they left (include time arrived, when they left, who they visited).  11. Essential caregivers must be trained on PPE and how to wear PPE, handwashing, and other infection control practices and there must be proof of this training that the facility maintains.   12..The individual must be COVID-19 negative to have an Essential caregiver visit or Salon Service Visitor.
• ***(If client status is unknown, the essential visitor would have to wear a face mask (not N-95, save that for your staff who need to work with COVID-19 + individuals), gown, gloves, goggles or face shield, so the facility might need to provide these other items)

Phase I Visitation Rules, no longer in effect!

Expanded Visitation Rules now in effect:  The facility must apply with form 2194  for the Designated Visitation Facility, do not require all these same requirements an essential visitor (or Salon Service Visitors)- Designated visits include: open window visits, closed window visits, parade visits (open window or closed) outside visits, (and in plexiglass separate areas).   Must use physical distance, visitor screening, individual will wear face mask or face covering if tolerated and the same for the visitor -they must wear a face mask or face covering.  Provider Letter 20-38 has the link with form 2194 at the end of it.  We encourage you to email the form.  Most staff at HHSC are not in the office  Visitation Designation department has 3 days to approve or deny the 2194 form request.  Only the administrator or director can fill out form 2194!!

Previous Level 1 Attestation Approval: If you previously submitted the 2192 and received approval, you do not need to request a new one with form 2194, if your status is the same.  If you want to change the visitation type, then you will need a new form. ( i.e. you did not want plexiglass partition previously and now you do.)

Small facilities must request visitation designation for the whole facility (unless you have a way to separate all cohort areas completely.) Do not fill out section #3.  That is only for NF’s. 

The provider must develop and must enforce policies and procedures including testing strategies for Essential Visitors, in addition to the testing that must occur at least 14 days prior to 1st visit and all other polices related, such as essential visitor requirements discussed above.  Remember your testing strategies  are required  to provide expectations for the essential visitor for how often they will be required to test and when, for any visits they are making, after the initial “essential caregiver visit”.

For vehicle parades, the individual needs to remain 10 ft or more from the vehicle for safety.

Plexiglass booths on the inside must be approved by a life safety person for your region.  Send in pictures.  Does have to be a plexiglass barrier, does not have to be 2 and 3 sided.

**Closed window and End of Life visits are the only visits an individual may have if they are COVID-19 + (positive)

Remember staff should be assigned to an appropriate cohort (COVID-19 +, COVID-19 Negative or Unknown) then they should stay with that Cohort.  In addition, there should be a policy at the facility for limiting the sharing of staff.  If you need help with your policy concerning “COHORTS” and ” Mitigation of COVID-19 by Limiting Sharing of Staff”, please contact us.  I do have some policies you can purchase if needed.  Please contact me at:  info@twogetherconsulting.com

FAQ’s (June 2020)

Survey Operations Resume as of June 15th, 2020

Providers Must Log Residents’ Leave

All community-based ICF/IID program providers must submit an absence request in the TMHP ICF/IID Online Portal for a resident away from the facility for one or more full days. See the TMHP ICF/IID Online Portal User Guide (PDF) starting on page 52 for more information. The program provider must submit a return request within three days after a resident returns to the facility. See page 58 of the Online Portal User Guide for an explanation.

Please ensure that information entered in the portal for absences is current. HHSC uses the information to determine how many residents are absent from their facilities and the length of those absences.

Provider Joint Training Opportunities

Check out Joint Provider Trainings link from HHSC, for more info:
https://apps.hhs.texas.gov/providers/training/jointtraining.cfm#course_112

Survey Process for ICF Has Changed: Please Be Aware

You may check your SOMA (Surveyor’s Operational Manual for ICF in Appendix J) for these changes.

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_j_intermcare.pdf 

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018Downloads/R178SOMA.pdf

Appendix Q of SOMA (Immediate Jeopardy) Changes

http://www.tmhp.com/News_Items/2019/04-Apr/CMS%20Releases%20Revision%20to%20Appendix%20Q%20Immediate%20Jeopardy%20Guidelines.pdf

CMS clarifications letter

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QSO19-09-ALL.pdf

SOMA appendix Q Section  Immediate Jeopardy 

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_q_immedjeopardy.pdf

November 13th, 2024

IDD and PI Quarterly Webinar with HHSC LTCR Recording Available

The Oct. 31 recording of the Intellectual and Developmental Disability Programs (IDD) and Provider Investigations (PI) quarterly webinar with Long-term Care Regulation (LTCR) is available.

Listen to the webinar recording.

Read the IDD and PI Quarterly Webinar (PDF).

Email LTCR Policy for the transcript.

October 30th, 2024

IDD and PI Quarterly Webinar with HHSC LTCR

HHSC Long-term Care Regulation will host a webinar for Individualized Skills and Socialization, HCS and TxHmL providers regarding the latest information from LTCR.

Those using Internet Explorer may have difficulties registering for the webinar. If so, try using another browser, such as Google Chrome or Microsoft Edge.

IDD/PI Quarterly Webinar
Oct. 31, 2024
3:30–4:30 p.m.
Register for the webinar.

November 12th, 2024

Reminder for HCS and TxHmL Providers Entering IPC Revisions to Add Individual Skills and Socialization

This is a reminder for Home and Community-based Services (HCS), Texas Home Living (TxHmL) program providers, and local intellectual and developmental disability authorities (LIDDAs) that are submitting an Individual Plan of Care (IPC) revision to add Individualized Skills and Socialization (ISS) on the IPC plan year.

When entering IPC revisions, if you update the effective date in field 12a, you must click the search icon located next to the date field. This will allow the individual’s data to refresh and prepopulate from the web service based on the new effective date.

If you don’t perform this step, the form processing will be delayed. Contact the Texas Medicaid & Healthcare Partnership (TMHP) Long-Term Care (LTC) Help Desk at 800-626-4117 or 800-727-5436 for assistance with submitting forms.

Renewal and Revision IPCs 

If they are in either Pending DADS Review or Pending Coach Review status require action from the submitter, usually the submission of supporting documentation. The IPC will not be reviewed until action is taken. This is the same process that is in place for Exceeds flags in ID-CARE.

A packet submitted to Utilization Review (UR) must include the following:

• IPC Cover Sheet (Form 8599, which can be found at hhs.texas.gov/regulations/forms/8000-8999/ form-8599-individual-plan-care-ipc-cover-sheet)

• Copy of signed IPC (all pages)

• Person-directed Plan

• Implementation Plans for all services on the IPC, including a breakdown of nursing and behavior hours if they are part of the request A packet may include the following, depending on the services that are requested: • Comprehensive Nursing Assessment (Form 8584 or a form with all the same elements) for nursing hours

• Occupational therapy (OT) evaluation, treatment plan, or assessment (including orders) for OT hours

• Physical therapy (PT) evaluation, treatment plan, or assessment (including orders) for PT hours

• Speech and language therapy evaluation, plan, or assessment (including orders) for speech hours

• Dietary evaluation for dietary hours (including orders)

• Dental treatment plan, if applicable

• Behavior support plan for behavioral support hours that meets HHSC criteria

• PAS/HAB Assessment (Form 8510) for personal assistance services and habilitation (PAS/HAB) hours

• Transportation Plan (Form 3598) for transportation hours

• Audiology treatment plan (including orders), if applicable

• Cognitive rehabilitation therapy plan, if applicable (in HCS)

• Support consultation plan, if applicable (in HCS) • Social work plan, if applicable (in HCS)

• All documentation for adaptive aids, if they are included in the request, including:

 ‒ A list of items to be purchased, the number of each item needed, and the cost (based on the lowest bid) for each item.

     ‒ Three bids for each item. Bids from online vendors are acceptable. If an annual vendor is used, three bids are needed only if an item costs $500 per month or more; otherwise, an annual vendor bid can be     submitted.

     ‒ Proof of Medicaid denial and professional recommendations, as required in Appendix VII of the HCS Program Billing Requirements.

See Section 6100 of the HCS Billing Requirements at hhs.texas.gov/sites/default/files/documents/ doing-business-with-hhs/provider-portal/long-term-care/hcs-billing-requirements.pdf for more information.

• All documentation for minor home modifications (three bids based on specs from licensed professional recommendations) if they are part of the request.

See Section 6200 of the HCS Billing Requirements.

Enrollment and Transfer IPCs

Enrollment and transfer IPCs remain in Pending DADS Review status while the enrollment or transfer is being processed.

Enrollment IPCs may require additional documentation to be submitted to Program Eligibility and Support (PES).

*If an enrollment requires additional documentation, PES will contact the LIDDA that submitted the enrollment IPC.

Transfer IPCs always require a transfer packet to be submitted to PES. If a transfer packet requires additional documentation, PES will contact the LIDDA that submitted the transfer IPC.

A transfer packet submitted to PES must include the following

: • Request for Transfer of Waiver Program Services (Form 3617)

• HCS only: Individual Plan of Care – HCS/CFC (Form 3608)

• TxHmL only: Individual Plan of Care – TxHmL/CFC (Form 8582)

If an enrollment or transfer requires utilization review, UR will contact the LIDDA that submitted the enrollment or transfer packet.

Packet and Documentation Submission Details

The most efficient way to submit HCS and TxHmL documentation is through the Attachment function in the Long-term Care Online Portal (LTCOP). For more details on attachments, refer to the “LTC Online Portal to Allow Electronic Attachments on HCS and TxHmL Waiver Program Forms” notification posted on tmhp.com on June 28, 2023.

For questions about renewal, revision, or requested call back of IPC review packets, call HHSC UR at 512-438-5055, or email deskURLONIPC@hhs.texas.gov. For questions about enrollments or transfers, call PES at 512-438-2484, or email enrollmenttransferdischargeinfo@hhs.texas.gov.

November 10th, 2024

REMINDER TO ALL LONG-TERM CARE PROVIDERS, BLACKBOARD CONNECT ENDED OCT. 31ST, 2024!

The current emergency communication system (Connect) for long-term care providers ended on Oct. 31 and will be replaced by the new system (AlertMedia), which is anticipated to go live no later than Dec. 1.

During this gap, no emergency communication system will be in place, so HHSC will communicate with providers through alerts, email and phone calls. Providers must respond to any request for information related to emergency preparedness and follow any instructions from HHSC.

Once AlertMedia is in place, HHSC will issue a separate communication on how to use the new system. Providers will be required to register in AlertMedia as defined by their Texas Administrative Code rule.

November 5th, 2024

From the October 28 Ambassador Program call. Presentation slides are also included below and resource links are below.

Actions You Can Take Now

• Visit the Ambassador Toolkit page on the HHS website.
• Visit the End of Continuous Medicaid Coverage page on the HHS website.
• If you know someone who could benefit from joining the Ambassador Program, invite them to sign up using this link: Ambassador Program Signup.

We Value Your Feedback

To help us improve the Ambassador Program and ensure it meets your needs, please take a moment to complete our brief survey: Ambassador Program Feedback Survey. Your insights are invaluable to us!

Next Ambassador Program Call

Ambassador Program calls are held once a month. The next call will be on November 18^th at 3:00 Central Time. If you have any questions or concerns, please feel free to reach out to this mailbox: update@hhs.texas.gov.

• Ambassador Check In Deck 10.28.2024 Slides.pdf

October 1st, 2024

Resources:
Actions You Can Take Now
1. Download Ambassador Toolkit
2. Visit End of Continuous Medicaid Coverage
3. Email Stakeholder Engagement with questions at:
update@hhs.texas.gov
4. Join the Ambassador Program –Ambassador
Program Contact List
5. Explore the Interview Toolkit: Questions About Your
Benefits | Texas Health and Human Services
6. Explore the Extended Postpartum Coverage Toolkit
https://www.hhs.texas.gov/services/health/women-
children

June 15th, 2024

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

October 30th, 2024

The HHSC Joint Training unit will host its annual Intermediate Care Facility Conference webinar, “Embracing Change to Enhance Value,” on Dec. 5.

This daylong virtual conference is for providers and survey staff of intermediate care facilities for people with intellectual disabilities or related conditions.

Registration for sessions begins Nov. 1. Links will be provided when registration opens.

October 26th, 2024

HHSC Publishes Revised PL 2023-01

 HHSC has published revised Provider Letter 2023-01 New Regulatory Rules for Long-term Care Regulation (LTCR) Individualized Skills and Socialization Services.

Revisions include information regarding the issuance of temporary initial licenses to applicants for DAHS-Individualized Skills and Socialization Only licensure, clarification on capacity, LTCR surveys, Form 3613-A requirements, emergency response plan requirements, and updates to contact information for TULIP Support.

September 9th, 2024

HHSC Publishes PL 2024-15:  Return To Temporary Licensure for DAH’s ISS Only Providers

HHSC has published Provider Letter 2024-15 Temporary Initial Licensure for DAHS-Individualized Skills and Socialization Only Providers. 

Beginning September 9^th, 2024, HHSC will resume issuing temporary initial licenses to DAHS-Individualized Skills and Socialization Only providers prior to conducting a health survey.

May 5th, 2024

UPDATED ISS FAQ’S

• Pages 18, 21 & 24
• Pages 32, 33, and 36 thru 39 
• Pages 41, 57 & 58,
• Pages 63, 68, 71, 73 and 75 thru 80. 

April 1st, 2024

ISS Administrative Penalties Scope and Severity Grid

Figure: 26 TAC §559.253(b)

March 18th, 2024

New Rules For ISS

PL-2023-01(Revised)

https://www.hhs.texas.gov/sites/default/files/documents/pl2023-01.pdf

March 7th, 2024

HHSC Hold Harmless Period Ending

Draft Amendments to ISS Licensing Rules 

February 14th, 2024

Delays In Receiving ISS Licenses

December 15th, 2023

Clarification on Licensure Renewals 

December 14th, 2023

ISS UPDATE WEBINAR DECEMBER of 2023

ISS Updates Webinar Handout

Please review webinar handout for changes to the Implementation Plan and Person-Directed Plan for ISS.

*PDP’s need to reflect type of ISS (In-Home, On-Site, Off-Site) and activities and schedule.

*IP’s need to also reflect type and objectives for type as well as hourly amount and dollar amount for each type of ISS.

August 18th, 2023

Transition to Individualized Skills and Socialization Survey Deadline Extended

July 17th, 2023

March 28th, 2023

Host Home Companion Care Providers Concerning ISS & PHE Flexibilities For In-Home ISS

Clarification Concerning Information Letter No. 2023-10 (Replaces IL 2023-06) from February 2023
In-Home Individualized Skills and Socialization Information for Program Providers for COVID-19 PHE

In response to COVID-19 and to provide access to day habilitation services, the Health and Human Services Commission (HHSC) temporarily waived certain requirements in Sections 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Requirements and the TxHmL Billing Requirements. Until the end of the COVID-19 PHE, this flexibility will continue as part of in-home individualized skills and socialization.

Effective May 12, 2023, these flexibilities will no longer be in effect:

The flexibility has allowed HCS and TxHmL program providers to provide in-home individualized skills and socialization to an individual in the individual’s residence, including those residing in their own homes or family homes, without having the required justification outlined below. Program providers and LIDDAs need to have transition plans ready for individuals who receive in-home individualized skills and socialization prior to this end date (before May 12th, 2023).

Beginning May 12th, 2023:

in order to receive in-home individualized skills and socialization, individuals must meet all requirements outlined in the HCS and TxHmL Program Rules, the HCS Billing Requirements, and the TxHmL Billing Requirements, which include:
• A physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or
• A licensed professional or behavioral support service provider has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or
• The individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.
In addition, after May 11, 2023, a service provider of host home/companion care will not be permitted to provide in-home individualized skills and socialization to the individual to whom they provide host home/companion care services.

Clarification & Answer to Question From Some of Our Readers: 

This letter indicates that HHSC does not appear to prevent a host home provider from becoming an ISS provider, nor does it prevent that licensed ISS provider from providing on-site and/or off-site services to their own individuals living with them.  In other words, it would appear they can be a HH/CC provider and licensed ISS provider at the same time and they can provide ISS services to their own individuals they are serving as HH/CC providers.   They can not provide their own in-home ISS (anymore) as an HH/CC provider as of May 12th, 2023.  The only ISS they can provide after May 11th, is if they are a licensed on-site and/or off-site provider.

March 1st, 2023

Reminder Must Be Licensed As ISS Provider To Bill As Of March 1st, 2023

For HCS/TxHmL Providers, you can’t bill for On-site &/or Off-site ISS as of today March 1st, 2023, if you send someone to an ISS location or have staff providing Off-site services (previously Community DH), if they are not listed as a licensed ISS program. 

The directories may be accessed at:  https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs  to find out if the ISS program is licensed.

**You can bill for In-Home ISS as persons providing In-Home ISS do not have to be licensed!  No justification is needed for In-Home through May 11th, 2023 I believe. I believe HH/CC providers can still provide In-Home (This was part of the PHE exception prior to March 1st) up through May 11th, 2023, but I am still unclear and will inquire and update everyone when I get some kind of definitive answer.

Previous DH providers & New ISS Provider applicants: If you do not have a temporary ISS license by March 1, 2023, you may not provide or bill HCS, TxHmL, or DBMD providers for on- and off-site ISS services until the temporary license is received.  HCS/TxHmL, DBMD Providers who have individuals attending an ISS program may not send persons to the program until they confirm that the operator of the program has received the license.  There are no exceptions.

February 21st, 2023

 Very Important:  Surveys of ISS Providers With Temporary Licenses

In case this information was overlooked by new ISS providers:

• Once HHSC issues a temporary license, HHSC may conduct a survey at any time.
• HHSC may conduct a survey of any licensed Individualized Skills and Socialization Providers prior to March 1, 2023.
  • i.e. if HHSC issues a temporary license on Feb. 21, 2023, HHSC may conduct an initial survey on Feb. 27, 2023.
• HHSC conducts unannounced surveys of ISS Providers.
• For on-site ISS providers, the address on the license must match the address for service provision.
• ISS providers must allow HHSC surveyors access to the on-site location and off-site activity locations.

Please refer to Texas Administrative Code Title 26, Chapter 559 for more info on the LTCR survey process.

February 10th, 2023

How Do I Find A Licensed ISS Provider?

HHSC has now posted directories on the DAHS webpage to help people find a licensed ISS Provider.

The directories may be accessed at:  https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs

Please note the following:

• There are 2 directories:  DAHS with ISS and DAHS-ISS Only.
• The DAHS with ISS Directory is intended to reflect entities licensed as just a DAHS, and entities licensed as DAHS with ISS.
  • At this time, this particular directory lists all entities as just having a DAHS license. This is because the commission has yet to approve any DAHS with ISS licenses.  The process for approving a DAHS with ISS application takes longer than that of a provider applying as an ISS-only entity.  According to HHSC, the entity must undergo an LSC and Health survey before a license is issued to a DAHS with ISS entity.  Once these have been approved, they will be listed in this directory as DAHS with ISS.
• Entities listed in the DAHS – ISS Only Directory, currently reflect a 6-month license.  This is because these licenses are considered ‘temporary’ at this time. Once the health survey is conducted the entities will receive a one, two or three-year license. 

February 5th, 2023

HHSC LTCR Updates the ISS FAQ’s

HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on Feb. 01, 2023.

Read the FAQ here.

January 27th, 2023

FYI- somehow I missed this alert back in November for Licensed ISS providers.  Please be sure to log in and set up your account.

PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System

The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.

The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.

Blackboard Connect sign-up process:

Go to this link and click “Sign Me Up!”

If you have any questions, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161.

Rember, this also applies to HCS, TxHmL and ICF providers among other services.

January 16th, 2023

• The ‘new’ IPC referenced in IL 2022-03 will most likely not be ready until March.  They did not have answers as to what providers should do in the interim or even how service logs should be revised until new ones are available. (The letter does indicate that those individuals receiving DH at the time of the switch to ISS (March 1st, 2023) will initially roll over automatically to ISS ).
• After Feb. 28th this would apply to all current clients as far as IPC units are concerned. Persons who don’t have any Day Hab units/days on their plan as of Feb. 28th, 2023 and want ISS hours, will have to do a new PDP and request IPC hours.   Providers will have a new IPC form, with ISS on it, before March 1st, 2023.
• To date, no provider has been issued an ISS license.
• Providers can confirm that an entity has an ISS license by checking the DAHS directory on the DAHS webpage:   https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs

January 12th, 2023

Information Letter No. 2023-03 Individualized Skills and Socialization Automatic Service Authorizations

Effective January 1, 2023, individualized skills and socialization became an available service in the HCS and TxHmL Programs.  For the time period of January 1, 2023 to February 28, 2023 both day habilitation and individualized skills and socialization will be allowable program services.

Day habilitation will no longer be a Medicaid-billable service in the HCS or TxHmL Programs for dates of service beginning March 1, 2023, and ongoing.

On January 9, 2023, HHSC will automatically add units of individualized skills and socialization for all individuals with day habilitation (including individuals receiving in-home day habilitation through the COVID-19 flexibility) currently authorized on their individual plan of care (IPC). The units will be available for billing immediately for the provision of on-site, off-site, or in-home individualized skills and socialization and will be visible to program providers in the Medicaid Eligibility Service Authorization Verification (MESAV). The added units will be authorized beginning January 1, 2023 through the end of the individual’s current IPC period. For individuals with an IPC period that must be renewed between January 1, 2023 – April 30, 2023, the added units will be authorized until December 31, 2023.
These units for individualized skills and socialization will not be visible to program providers or service coordinators on the IPC in the Long-term Care Online Portal (LTCOP) on the Texas Medicaid & Healthcare Partnership (TMHP) website nor on the dashboard until a revision or renewal IPC is entered. This automatic service authorization will give service coordinators additional time to meet with the individual’s service planning team (SPT) to update the individual’s person-directed plan (PDP) and for program providers to update the individual’s implementation plan (IP) as this new service takes effect. HHSC is implementing this process to minimize disruption to an individual’s desired services.

Service Plan Revisions
At the individual’s next service planning team meeting to complete a revision or renewal IPC (whichever occurs first) for individuals receiving individualized skills and socialization, service coordinators should update the individual’s PDP to reflect the new individualized skills and socialization service. During the service planning team meeting, any new goals related to the provision of on-site and off-site individualized skills and socialization should be discussed and documented in the new action plan. Until the PDP is updated, the individual’s current day habilitation goals, frequency, and duration should be followed for the individualized skills and socialization service.

Following the update to the PDP, the IPC and IP must be updated in accordance with applicable HCS or TxHmL Program rules with the appropriate units of individualized skills and socialization. HHSC will update the IPC and IP form to add individualized skills and socialization by March 1, 2023.
All individual’s PDPs, IPCs, and IPs must be updated with the appropriate units of individualized skills and socialization in accordance with applicable HCS or TxHmL Program rules by December 31, 2023.
For new enrollees and current enrollees who are not currently receiving day habilitation, individualized skills and socialization will need to be added, once the IPC and IP form have been updated, to the individual’s service plan because units will not be auto-authorized for these individuals. Day habilitation can be added and delivered until February 28, 2023.

To read more, please click on link below, for Information Letter 2023-03 related to ISS automatic service authorizations and EVV

IL-2023-03

January 3rd, 2023

Easier Format For ISS Licensing Rules effective Jan. 1, 2023

The link below provides a format that is easier to read and understand the newly adopted licensing rules rather than those when published as adopted in the Texas Register

December 23rd, 2022

NEW RULES FOR ISS & ISS LICENSE

HHSC Adds Individualized Skills and Socialization to Email and Text Updates

HHSC added an option to the HHSC email and text update GovDelivery system that subscribers can select to receive updates related to the Individualized Skills and Socialization services program. Users can select to receive Individualized Skills and Socialization program alerts from the “Provider Alerts” drop-down menu.

To sign up for updates, select this link Texas Health and Human Services Commission (govdelivery.com).

For questions about Individualized Skills and Socialization, please email LTCRPolicy@hhs.texas.

November 28th, 2022

Webinar for New Licensing Process Nov. 30th, 2022 Extended to 2 hrs

All providers interested in the new licensing process for the Day Activity Health Services Individualized Skills and Socialization program are invited to a 2-hour webinar on Nov. 30. Originally it was a 1 hr session but has now been extended to have enough time for questions and explanations.

HHSC Long-Term Regulation staff will discuss how to navigate TULIP, the licensing system, explain the license application process and provide an overview of the survey process. There will also be a Q&A session as time allows.

Register for the webinar: Licensing Process Webinar

November 19th, 2022

DAHS ISS Licensing Application Available!

On Dec. 1, 2022, HHSC will launch the Day Activity Health Services (DAHS) Individualized Skills and Socialization License Application in the Texas Unified Licensure Information Portal (TULIP).

Link to TULIP: https://txhhs.force.com/TULIP/s/

Email TULIP_Support@hhsc.state.tx.us with questions related to TULIP functionality or if you have issues gaining access.

Email LTC_NF_DAHS_Licensing@hhs.texas.gov with questions related to the DAHS Individualized Skills and Socialization licensing application

October 13th, 2022

Licensing Application Process For ISS:  

October 2nd, 2022

Register for Individualized Skills and Socialization Provider Portal Trainings

September 24th, 2022

HHSC Moved The Individualized Skills and Socialization Webpage

The Individualized Skills and Socialization webpage moved from the Resources webpage to the main Long-term Care Providers webpage. This was done so its location is consistent with other Long-term Care Regulation programs and is easier to find.

Individualized Skills and Socialization can be found under the “Community-based Programs” heading.

August 23rd, 2022

No Public Hearing on ISS Licensing Rules

Public Hearing on ISS Program Rules

HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon.  To register for the virtual hearing, go to:  https://attendee.gotowebinar.com/register/927810115195515152

For a copy of the proposed ISS license rules or go to:  https://www.hhs.texas.gov/regulations/policies-rules/health-human-services-rulemaking/comment-proposed-draft-rules

August 13th, 2022

Provider Communications

• PL 2021-42 – This Provider Letter offers a brief introduction to the new individualized skills and socialization service and what providers can expect as HHSC implements the service.
• Individualized Skills and Socialization Services webinar – This helpful webinar provides an introduction and overview to Individualized Skills and Socialization
• Individualized Skills and Socialization FAQs – revised April 26, 2022
• July 2022 – Individualized Skills and Socialization Provider Webinar – This webinar covers the service description, ratio requirements, and licensing information based on HHSC’s draft individualized skills and socialization rules.
  • July 2022 – Individualized Skills and Socialization Webinar (PDF)

August 6th, 2022

See Draft/Proposed Rules for ISS in HCS and TxHmL below:

Proposed ISS Rules   (Main portion of  rules start on page 13-52)

• The anticipated adoption date is October, 2022 with an effective date of November 2022.  These dates also apply to the proposed rules for the DBMD waiver program.
• Very few changes were made from comments HHSC received during the informal comment period earlier this year. Though we had been apprised of such before this positing, know that any comments you submitted during the informal comment period will need to be resubmitted.
• Carefully review the introduction to the HCS and TxHmL rules on pages 1 -4, including the sections on Issues and Alternatives and Stakeholder Involvement on page 3.
• Carefully review the preamble to the rules before reading the actual rules and pay attention to the sections on Impact to Small Businesses.
• The proposed HCS and TxHmL rules are included in one document.  To help you navigate the document, the following is offered:

October 25th, 2024

HCS and TxHmL Annual Vendor Submission Timeframe

The timeframe to submit for annual vendor approval is Nov.1, 2024 through Jan. 31, 2025. Required documentation for annual vendor requests are in the HCS and TxHmL Billing Guidelines, Section 6160(b)(2), Approval of Annual Vendor. Email packet submissions to Billing and Payment with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received.

Required documentation for annual vendor requests are in the HCS (PDF) and TxHmL (PDF) Billing Requirements, Section 6160(b)(2), Approval of Annual Vendor.

Email packet submissions to providerfiscalcompliance@hhs.texas.gov  with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received.

If you are unable to meet the deadline to submit, you may request an extension prior to Jan. 31, 2025. Email Provider Fiscal Compliance with any questions.   Call 512-438-5359  with your questions.

Submissions sent to any other email addresses may not be received.

October 20th, 2024

From HHSC:

LTC Providers Encouraged to Get Ready for Flu Season

CDC recommends everyone (six months and older) 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 vaccinations and infection control.

Some of the CDC’s recommendations for vaccinating residents in congregate health care settings are:

• The CDC recommends that LTC facilities offer the flu vaccine to all residents and health care staff throughout the flu season.
• People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults.
• CDC and ACIP preferentially recommend the use of higher-dose flu vaccines for people 65 years and older.

Adhere to standard precautions. They’re the foundation for preventing the transmission of infectious agents in all health care settings.

Implement droplet precautions for those with suspected or confirmed flu. Do this for seven days after illness onset or until 24 hours after the fever and respiratory symptoms resolve, whichever is longer, while the person is in a long-term care facility.

In compliance with TAC Title 25, Part 1, Chapter 97, report all outbreaks to the local health department, regardless of the provider type. Contact information for your local health department is on the DSHS website.

As a reminder, flu vaccines may be safely coadministered with other vaccines. In addition to getting a flu shot, people 65 years and older should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, washing hands often, and staying up-to-date with all recommended vaccines.

For more information, visit the following links:

• Advisory Committee on Immunization Practices Recommendations on Seasonal Influenza
• Vaccination Resources for Health Care Professionals
• Managing a Flu Outbreak
• CDC Flu Resources
• DSHS Flu Vaccine Information and Location Finder

October 17th, 2024

Please be sure to provide education about voting, if needed as well as opportunities for your individuals to vote. Twogether Consulting recommends checking out the “My Voter Portal” at the Secretary of State’s website before voting to look for your voting location and to ensure an individual is still registered, as the individual may not be registered anymore if they have moved for example.  FYI, the voter registration deadline ended on Oct. 7th, 2024.  Information on services for voting available to persons with disabilities can be found at: https://www.votetexas.gov/mobile/voter-with-special-needs.htm

Here is the information on dates for absentee and general voting deadlines

Important Action You Can Take With Your Individuals

• Make a voting plan with this guide for voters with disabilities from Disability Rights Texas.
• Watch this video for voters with disabilities and poll workers from Texas Council for Developmental Disabilities.
• Vote early Oct. 21-Nov. 1!
• If voting by mail, the deadline to apply for a mail-in ballot is Oct. 25.

If you need assistance in registering to vote, have questions regarding voting or feel that any of your voting rights have been violated, please contact:

Disability Rights Texas
2222 West Braker Lane
Austin, Texas 78758
1-888-796-VOTE (8683)
vote@drtx.org

Texas Secretary of State
P.O. Box 12060
Austin, Texas 78711-2060
512-463-5650 or 1-800-252-VOTE (8683)
Fax: 512-475-2811; TTY: 7-1-1
Texas Secretary of State website

October 16, 2024

Effective Oct. 16, HHSC moved the News and Information and the Provider Letter content to new locations on the Long-Term Care Regulation (LTCR) Provider webpages.

This change to the LTCR Provider webpages was made to improve the visibility of the content and to fix a technical issue that wouldn’t let people use the search feature of the Provider Letter content more than once.

News and Information and Provider Letters now have separate links accessible from the main webpage for each provider type. These links are found on the left-hand menu of each provide page along with the links for how to become a provider.

All providers listed here are affected by the updated web links.

Email questions to LTCR Policy.

October 13th, 2024

This is a reminder that HHSC will host Electronic Visit Verification training webinars for Consumer Directed Services (CDS) employers required to use EVV. Attending the webinar will complete the annual EVV policy training requirement.

Webinar Registration

Agendas are included in the registration link.

• Oct. 31, 2-3:30 P.M.

Alternatively, CDS employers can also complete the annual EVV policy training requirement on the HHS Learning Portal.

The EVV Required Training Checklists (PDF) will help track completed EVV trainings.

Email questions to HHSC EVV Operations.

October 13th, 2024

​Advocacy Groups:
Advocacy, Inc.
Best Buddies
Center for Public Policy Priorities
Disability Policy Consortium
The Arc of Texas
The Arc of San Antonio
The Arc of the United States
The Texas Council for Developmental Disabilities

October 13th, 2024

National Organizations:
American Association on Intellectual and Developmental Disabilities (AAIDD)
American Network of Community Options & Resources (ANCOR)
National Association of Qualified Developmental Disability Professionals
National Parent Network on Disabilities (NPND)
The Accreditation Council

State Associations:
Private Providers Association of Texas (PPAT)

Providers Alliance for Community Services of Texas (PACSTX)

Southwest Society of Service Coordinators (SWSSC)

Special Olympics Texas

Texas Council of Community Centers

October 12th, 2024

From OIG: Update emergency plans

October 9th, 2024

Tarrytown Expo Pharmacy Zoom Webinar  (Complimentary CE Credits)

Click here for the printable PDF version

October 8th, 2024

CLASS Program Manual Revised

The Community Living Assistance and Support Services (CLASS) Provider Manual revision 24-2 updates Section 2350 and Form 3595. The revision is effective Sept. 1, 2024.

Click here to review the updates.

September 14th, 2024

** This is especially important for all of you new HCS/TxHmL Providers.

Registration Available for HHSC EVV Policy Training Webinars for Program Providers, FMSAs and CDS Employers

HHSC is hosting Electronic Visit Verification (EVV) policy training webinars for program providers and financial management services agencies (FMSAs), and Consumer Directed Services (CDS) employers. You will complete the annual EVV policy training requirement by attending one of the webinars.

Webinar Registration

Agendas are included in the registration links. Select from the dates below to register for one webinar.

• Annual EVV Policy Training in September for Program Providers and FMSAs:
  • 19, 2-3:30 P.M.-Sept
  • 17, 2-3:30 P.M.
• Annual EVV Policy Training in October for CDS Employers:
  • 3, 2-3:30 P.M.
  • 31, 2-3:30 P.M.

Alternatively, program providers, FMSAs and CDS employers can also complete the annual EVV policy training requirement on the HHS Learning Portal.

The EVV Required Training Checklists (PDF) will help track completed EVV trainings.

Register for EVV GovDelivery to receive EVV notices by email, such as training updates and future webinar registrations.

Email questions to HHSC EVV Operations.

September 13th, 2024

The Texas Health and Human Services Commission (HHSC) is offering virtual Positive Behavior Management and Support (PBMS) and Advanced PBMS workshops at no cost for attendees on the following and times:

• September 23 (PBMS)
• October 9 (PBMS)
• October 25 (Advanced PBMS)
• November 8 (Advanced PBMS)

**Please click on a date above to register for that workshop.

The workshops are available to the public, including family members, caregivers, providers (educational, foster care, geriatric, long-term services and supports in the intellectual and developmental disabilities and aging population, and mental health), Adult Protective Services, and case managers.

Upon completion of the training, HHSC will issue 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. Behavior analyst certification board CEU will be issued by the University of North Texas.

For training resources, visit the Training Initiatives webpage.

Subscribe To The Twogether Consulting Mailing List!

2024

September 3rd, 2024

August 16th, 2024

August 5th, 2024

July 15th, 2024

July 2nd, 2024

June 17th, 2024

June 3rd, 2024

May 16th, 2024

May 1st, 2024

April 15th, 2024

April 1st, 2024

March 15th, 2024

March 1st, 2024

February 15th, 2024

February 1st, 2024

January 15th, 2024

January 3rd, 2024

2023

To Read previous newsletter editions from 2023, please click here

If you would like to be on our mailing list for this free publication, please click here to subscribe through Mailchimp for the newsletter subscription or if you prefer, you may click on our website link for newsletter subscription

September 11th, 2024

Effective September 1, HHSC began transitioning contracts for the STAR+PLUS program.

This document below provides STAR+PLUS members and providers with resources for assistance with go-live concerns.

 STAR+PLUS Providers by service area (MCO’s leaving, staying and new)

For any STAR+PLUS transition related issues, please contact the STAR+PLUS Go Live inbox.

May 12th, 2024

• Nine (9) of the 13 service areas were affected by the procurement and award processes:

• Letters from HHSC have been sent to current members in the nine (9) areas in which a change in MCOs is occurring.  The letters were sent In March.
• Members in the 9 affected service areas have until July 20, 2024 to pick a new health plan (MCO) and will be sent a reminder before the deadline.                                                                                  Note: Persons satisfied with their current MCO are not required to respond to the letter, but, if they want, may switch to the new MCO or any other MCO in their area.  Of course, persons currently enrolled in a MCO which was not awarded a ‘new’ contract will need to select a health plan from the MCOs in their service area.
  • Example:  If a person resides in the Jefferson STAR+PLUS Service Area, and is currently enrolled with United Healthcare, the person will need to choose either Wellpoint or Molina since , effective September 1, 2024, United Healthcare will no longer serve that area. On the other hand, if a person residing in Jefferson STAR+PLUS service area is currently enrolled with Molina, the person can either stay with Molina, or change to the other MCO (Wellpoint) in that area.
• HHSC is planning to conduct information sessions about the changes, but no dates were provided.

Star Plus Transition Member Information

Updates For Medicaid Interest Waiver List

September 10th, 2024

TxHmL New Rates

Click on link below:

TxHmL Rates: Sept. 1st, 2024- PDF Download

The Texas Health and Human Services Commission (HHSC) approved payment rates for Support Consultation under Community Attendant Services (CAS), the Community Living Assistance and Support Services (CLASS) waiver program, the Deaf Blind with Multiple Disabilities (DBMD) waiver program, Family Care (FC), the Home and Community-based Services (HCS) waiver program, Primary Home Care (PHC), and Texas Home Living (TxHmL) to be effective Sept. 1, 2024.

HHSC reviewed Support Consultation payment rates and methodology as part of the fiscal year 2024 biennial fee review.

The approved Support Consultation payment rates, effective Sept. 1, 2024, can be accessed at: https://pfd.hhs.texas.gov/long-term-services-supports

Contact PFD-LTSS@hhs.texas.gov or (737) 867-7817 if you have questions

September 3rd, 2024

September 1st, 2024

September 1st, 2024

The day before the House Human Services Committee hearing (August 27th, 2024 was the hearing date), Time to Care Coalition held a press conference in Houston urging Texas legislators to prioritize support for IDD funding.

Avondale House,

Center for Pursuit

Volunteers of America

These 3 programs all spoke about the workforce shortage crisis and the need for additional funds to increase direct care wages.  To view the press conference go to:   https://timetocaretx.org/updates/

July 16th, 2024

From our friends at PPAT, see information sent out today on data collected by Time To Care Texas organization:

New Data Shows Escalating Workforce Crisis Facing Community-Based DSPs Serving Texans With IDD

AUSTIN, TX – Today, the Time To Care: Save Texas Caregivers Now coalition released a statement on new data underscoring the escalating workforce crisis facing community-based direct support professionals (DSPs) serving Texans with intellectual and developmental disabilities (IDD). The data, collected from a statewide survey of IDD service providers conducted by the Texas Council of Community Centers (Texas Council), Providers Alliance for Community Services of Texas (PACSTX) and the Private Providers Alliance of Texas (PPAT), found that community-based service providers are facing unsustainable staff vacancy rates of 33-34% due to a lack of competitive wages for the DSP workforce.

“It is abundantly clear that the 88th Texas Legislature’s wage increase for DSPs from $8.11 per hour to $10.60 per hour has failed to address the workforce crisis among community-based providers of IDD services, as the issue has only been exacerbated,” Time To Care coalition spokespeople Sandy Batton and Carole Smith said. “Instead, we’re seeing more group homes close, along with an untenable increase in staff vacancies. With thousands of Texans with IDD relying on paid staff in small residential settings—including Home and Community-based Services (HCS) and Intermediate Care Facility (ICF) group homes—it’s imperative that we act now to protect our most vulnerable. The most recent statistics should serve as a clear call to action to Texas leaders, illustrating the urgent need to ensure that Texans with IDD receive the quality care and support they deserve.”

Additionally, the survey found that:

• Staff vacancy rates in HCS homes and ICF facilities rose from 30% in 2021 to 33-34% in 2024.
• DSPs in group homes currently work an average of 60 hours per week, with some working 100 hours per week or more,leading to fatigue-related errors and lower tolerance for stressful situations.
  • 48% of HCS homes and 57% of ICF facilities are struggling to meet federal access standards.
  • 20% of HCS homes and 22% of ICF facilities are reporting an increase in medication errors.
  • 30% of HCS homes and 43% of ICF facilities are experiencing an increase in behavioral issues.
  • 14% of HCS homes and ICF facilities are reporting an increase in hospitalizations.
• 94% of HCS providers and 96% of ICF providers indicated that $10.60 per hour is not sufficient to address the workforce shortage.
• A total of 179 HCS homes and 50 ICF facilities closed between January 2023 and February 2024.
• From March 2024 onward, there are an additional 92 HCS homes and 34 ICF facilities anticipated to close by the end of the year.

To read the full survey report, please click here.

To learn more about the workforce crisis facing community-based DSPs, please click here.

Time To Care: Save Texas Caregivers Now is a coalition dedicated to securing competitive wages for direct support professionals (DSPs) who provide essential care to Texans with intellectual or developmental disabilities (IDD). Through collaboration and grassroots efforts, the coalition strives to enact meaningful change at both the legislative and community levels. Learn more about how to get involved at https://timetocaretx.org/.

July 11th, 2024

“Time To Care Coalition”  

• Donating to the Coalition, though it’s important to note that a monetary donation is not required.
• Consenting to have your organization’s logo on the Time to Care website.  If interested in this option, complete this Release Form and send, along with your company logo, to:  IDD@pluspr.com.
• Sharing information about the Coalition with others both within your organization (staff, families and individuals you serve) and outside your organization (such as churches, vendors/businesses or parent groups).
• Posting information and news about the Coalition on one’s website, Facebook and any other social media one uses.

***Twogether Consulting would ask that you please share this information and website.

August 31st, 2024

From Our Friends At Neighborhood LTC Pharmacy

NRx Upcoming FREE Educational Webinar: Cannabinoid Science 101

August 30th, 2024

August 18th, 2024

The July 31 recording of the Intellectual and Developmental Disability Programs (IDD) and Provider Investigations (PI) quarterly webinar with Long-term Care Regulation (LTCR) is available.

Listen to the webinar recording.

Read the IDD and PI Quarterly Webinar (PDF).

Email LTCR Policy for the transcript.

August 18th, 2024

FYI- These training modules are very helpful to new HCS providers and/or HCS provider applicants 

New TxHmL Certification Principles modules available for Providers

HHSC Long Term Care Regulation has posted 4 recorded modules online, covering the new TxHmL Certification Principles for TxHmL Providers. These new principles became effective June 21, 2023. Each module is approximately 40-minutes in length. All current and potential TxHmL Providers are encouraged to access each of these modules.

Certificates of Attendance will not be offered for viewing the pre-recorded webinars.

Click here to access these pre-recorded modules.

August 16th, 2024

The Texas Department of State Health Services (DSHS) hosts a website that offers immunization information and tools for the general public, health care providers, and local health departments.

General public: Provides a user-friendly system for accessing services such as requesting immunization records, finding a vaccine provider, and staying updated on the immunization schedule.

Health Care Providers: Provides an overview of DSHS programs, webinar access, and a learning portal that offers training for providers in the Texas Vaccines for Children (TVFC) and Adult Safety Net (ASN) programs.

Health Departments: Provides effective support for department initiatives through access to contracts, grants, specialized training, and educational materials.

August 15th, 2024

LIDDA Handbook Revision

The Local Intellectual and Developmental Disability Authority Handbook (LIDDA) revision 24-2 updates Sections 13000, 15000, 19000, 21000 and 24000, and adds Appendix VI and Appendix VII.

This revision is effective Aug. 15, 2024. Click this link to see the updates.

August 14th, 2024

27^th ANNUAL PPAT CONFERENCE

Doubletree Hotel Austin

6505 IH-35 North, Austin, TX 78752

*Twogether Consulting will have an exhibitor booth at this event. Please come by and meet us.

Join PPAT for Their Annual PPAT Conference, September 4th-6th, 2024!

Online Registration available at: 2024_PPAT_Conf_Registration

---

Keynote Speaker:   Robert Canino, JD, Regional Attorney, Dallas District Office, U.S. EEOC.  Mr. Canino who prosecuted the case of EEOC v. Hill Country Farms, Inc., dba Henry’s Turkey Services will discuss how the EEOC used the American with Disabilities Act (ADA) to win compensatory and punitive damages for intentional discrimination of the 32 Texas men with intellectual and developmental disabilities who lived the majority of their adult lives in deplorable and abusive conditions for over 30 years working, unnoticed, in a turkey processing plant in Iowa.  If you are not familiar with the case and the history of its origins, this is a ‘must hear’ presentation.  Even if you have previously heard Mr. Canino speak on this topic or even if you’ve read the book – The Boys in the Bunkhouse –  you need to hear the story again!

---

Preview of Sessions (The list is not inclusive and is subject to change)

Re-establishing Medicaid Eligibility:  Help is on the Way!

Billing for Nursing Services:  Helpful Tips from the Experts

Updates on HHSC Office of Disability & Coordinating Services Activities

EVV:  New billing codes, extension of PCS grace period & more 

Fair Housing Act:  Impact of city ordinances on group homes

Building Collaborative Relationship with Your LIDDA

89th Legislative Session:  What to Expect, How to Prepare (All Hands on Deck Needed)

Abuse, Neglect & Exploitation Investigative Processes for ICF/IID & HCS

Regulatory Year in Review & More:  Joanalys B. Smith, Attorney at Law

Employment Services:  Contracting with TWC/Helping persons obtain employment

Medicaid Revalidation Process/PEMS:  ICF/IID & HCS

Change of Ownership (CHOW):  Step-by-step review of process

Best Practices:  Caring for persons with IDD with dementia

Individualized Skills & Socialization (ISS):

• PPAT Conference:   A session on ISS has been added to the PPAT Conference program.  Kaliope Schmidt, HHSC, will review billable and non-billable services, frequently cited billing errors and touch on ISS-related HCBS Settings rules requirements.

• ISS Proposed  Licensing Rule Amendments:  Last spring HHSC requested ‘informal’ comment on proposed amendments to the ISS Licensing rules under Chapter 559.   According to HHSC, the proposed amendments will be presented at the November HHSC Executive Council meeting.  It’s not known whether the proposed amendments will be published in the Texas Register for formal comment before or after the November meeting.

Implementation Status of HB 4696 (Nobel) & HB 1009 (Turner) in ICF/IID and HCS:  In confirming HHSC’s presentation on these two bills at PPAT’s conference, HHSC stated it will only be able to review newly implemented ANE reporting and investigating processes in the ICF/IID program, but will provide an update on implementation plans related to HCS/TxHmL.

---

Registration Information & Marketing Opportunities:

Call the PPAT Office at 512-452-8188 or email Jaim Kaysonphet, Administrative Assistant at jaimppat@aol.com.

Online Registration available at:   2024_PPAT_Conf_Registration

 

---

Hotel Information & Reservation Link:

DoubleTree Hotel:  6505 IH 35 North ~ Austin, TX 78752 ~ 512.454.3737

Make room reservations NOW at:  2024PPATConf-HotelReservationLink

You can also make reservations with the DoubleTree Hotel toll-free national reservation center line at 1.800.866.3126, by the August 16, 2024 designated cut-off date to receive the special rate of $169.00 Single/Double.  Identify yourself with the Private Providers Association of Texas (promotional code PPA).  Reservations are subject to space and availability.  All reservations must be guaranteed by credit card or advance deposit.  Reservations must be canceled by 1:00 PM (noon) local time, 48 hours before the day of arrival or the first night of the stay will be charged.

Parking:

Covered self-parking for conference attendees is $10/day.  Parking based on availability.

From our friends at PACSTX!

2024 Annual PACSTX Conference October 1st-3rd

Embassy Suites Conference Center

San Marcos, Tx

Members: $350 | Non-Members: $375   Early bird pricing ends September 1.   Group pricing is available.

FOR MORE INFORMATION CLICK HERE

FOR REGISTRATION

HOTEL REGISTRATION

July 29th, 2024

A waiver was received from CMS to extend renewals for individuals who receive Medical Assistance Only for Medicaid for the Elderly and People with Disabilities due for renewal in October through December 2024 for 12 months.

To clarify this would apply to the individuals who are receiving Medicaid due to a disability (SSDI) or being over 65 years of age, and would include individuals receiving a waiver program or residing in a facility. Their Medicaid will continue unless there is a change in circumstance. 

NOTE: The extension does not apply to individuals receiving Medicaid due to receipt of Supplemental Security Income or SSI.  

SEE NOTICE BELOW:

July 26th, 2024

New PCS Contact

July 25th, 2024

Register Now For Extra Help Before a Power Outage

Great resource I just saw from the city of Austin that providers may need for some of their more medically fragile individuals during a power outage with medical equipment requiring power. 

July 24th, 2024

Correction to “LTC Dashboard Data Export Report Column Names”

Regarding the Excel Export Reports on the Long-Term Care (LTC) Dashboard:

On June 21, 2024, two mislabeled column names were corrected on several LTC Dashboard Data Export Reports:

• Column O – Previously mislabeled as ‘Medicaid Eligibility End Date’ is now correctly labeled as ‘Last Billed Date;’ and

• Column P – Previously mislabeled as ‘Last Billed Date’ is now correctly labeled as ‘Medicaid Eligibility End Date.’

The corrected column names are reflected on the following LTC Dashboard Data Export Reports:

Past Due

• Medicaid Eligibility

• LOC/LON Assignment

• Individual Plan of Care

Due

• Medicaid Eligibility due in 90 days

• LOC/LON Assignment due in 60 days

• Individual Plan of Care due in 60 days

Exceptions

• Suspension Over 30 days

• Pending Termination Over 60 days

• NO Billed Svcs. Over 60 days

Other Dashboard Data

• Individual by Program

• Individual by LA

• Individual by WCA

• Individual by Status

For more information, contact the LTC Help Desk at 800-626-4117 (select option 1).

July 23rd, 2024

SEVERE WEATHER POLICY REMINDER

In response to the recent severe weather, HHSC is issuing the following guidance for EVV program providers, financial management services agencies (FMSAs) and Consumer Directed Services (CDS) employers.

All service delivery for an EVV-required service must be documented in the EVV system. If an EVV clock in and clock out method (home phone landline, mobile, or alternative device) was not available due to the severe weather, service providers and CDS employees must make best efforts to document service delivery visits according to program policies.

For visits which were not recorded using an EVV clock in and clock out method, program providers, CDS employers and FMSAs must:

• Create manual visits in the EVV system based on the program requirements , and ensure the visit is accepted into the EVV Aggregator/Portal within 95 calendar days from the date of the visit.
• Keep all supporting service delivery documentation available as required by program policy.

As a reminder, claims matching for all EVV required services began April 1, 2024. If a claim is submitted for an EVV required service, a valid EVV visit must be on file.

EVV Reason Code

See the following EVV reason code example when performing visit maintenance on visits affected by the hurricane (including creating manual visits):

Reason Code: Disaster

Number: 130

Description: B – Hurricane

EVV Compliance Impacts

Program providers, CDS employers and FMSAs are currently in a grace period for EVV usage and landline reviews. This means that anytime a manual visit is entered into the EVV system, it will affect your EVV Usage Score. Per the HHSC EVV Policy Handbook, Payers must perform due diligence before taking any enforcement action. Manual entries with a reason code for natural disaster lowering a stakeholder’s overall EVV Usage Score would be considered before taking any enforcement action during a non-grace period.

Contact EVV with questions.

July 15th, 2024

July 12th, 2024