December 31st, 2025

From Twogether Consulting

Happy New Year!

I hope everyone enjoyed a wonderful holiday season.  Twogether Consulting will be closed January 6th- January 15th, 2025, as I will not be in the office.  Feel free to contact Meghan Jones to make an appointment with us after January 15th, 2026, by emailing her at:  meghanjones.tx@gmail.com

We are not accepting any new clients for HCS, TxHml, until January 16th.  We do still have our other contractors available during this time for those of you who are current customers and have an emergency or are currently working with us on a project.  Sheila Hanson (HCS/TxHmL), Marcus Denman(HCS/TxHmL), and Jo Beth Collier (ICF only) will all still be available during this time for things like 1-1 webinars, mentoring or consultation, assistance with POC’s (Plans of Correction), and other emergencies, of course.

We will be checking email, and you can contact us at our general email at:  info@twogetherconsulting.com or my regular email address for those of you who already have it.

January 2026 Training:

If any of you need QIDP training in the ICF program, we do have some sessions scheduled for Jan 13th, 16th, 20th, and 23rd.  You may contact Meghan Jones at meghanjones.tx@gmail.com to register or info@twogetherconsulting.com for information.

Jan 13th, 2026:  Roles & Responsibilities of The QIDP in ICF-Part I (Active Treatment, Admission, 30-day staffing, Annual Staffing, Interim Staffings, Discharges, and Other Important Documentation) 3 PM-5 PM

Jan 16th, 2026:  Roles & Responsibilities of the QIDP in ICF-Part II (Important W-Tags) 2 PM-4 PM

Jan 20th, 2026– Rights, Rights Restrictions, and Human Rights Committee (3 PM-5 PM)

Jan 23rd, 2026– Surrogate Decision Maker/Making Committee and Immediate Jeopardy/IJ’s  (2 PM-4 PM)

Please contact Meghan Jones at: meghanjones.tx@gmail.com.  The cost is $65/person.  We can provide the handouts as well as a link to the recording, once you have paid.  Please notify Meghan Jones, for payment and to receive the link to registration for the training on “Gotowebinar” and all handouts will be provided prior to the session.  

We are still available for facility and 1 on 1 requests for webinars and live training in January, but we will be taking a break from the live on-site trainings, through January 20th, 2025. We will, however, be having webinars in January.  Remember, for all scheduled webinars and our general live sessions open to the public, you can view all calendar postings on our Twogether Consulting website. 

Here are the webinars for January.  Others may be posted in the near future

ISS: TAC Changes: Updates, Clarifications, & Survey Expectations – moved to January 28th (10am-12:00pm) 

Host Home/Companion Care Service Provider: Job Description– moved to January 19th, 2026 (10am-noon)

Please continue to check our website for these sessions.  We will post them on the website “calendar” page

We have a variety of pre-recorded webinar trainings for program managers, case managers and nurses, and direct care,  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.

Here are just a few of the recent pre-recorded webinar trainings available for purchase:  “Admission, Post-Admission & Other Follow-Up Requirements-HCS Program”, ICAPs/LON’s/IDRC’s-ICF Program” (Also have for HCS program), “Development of The Comprehensive Nursing Assessment & Nursing Service Plan-HCS or ICF”, “Best Practices For HCS Providers: How To Remain In Compliance With TAC Ch 565”, “Role & Responsbilities of The Q”,  “Surrogate Decision Making Process, Rights Restrictions & Immediate Jeopardy-ICF Program”, “Licensed ISS Providers: What You Really Need To Know.”, We also have a ore-recorded 5 part Care Coordination/Case Management series as well for the HCS program. All of these sessions and many more come with handouts as well as the link to the pre-recorded session

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

December 31st, 2025

Now Effective: LTCOP HCS and TxHmL Transfer Form Submission Sequencing Enhancements

On December 18, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) released enhancements to the Long-Term Care Online Portal (LTCOP) that are designed to streamline the transfer process for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs. These updates are now in effect for use by providers and local intellectual and developmental disability authorities (LIDDAs).

• A TMHP enhancement for HCS and TxHmL is scheduled to deploy 12/18:
  • When a transfer includes a change in residence address or county, the receiving provider will no longer need to submit a separate IMT individual update – the system will auto-generate the required update.
  • LIDDA users will only see counties in their catchment area, reducing data entry errors.
  • If a location code is inactive, the system will flag it.

A future enhancement will apply the same logic to revision IPCs when only the residential type changes (same contract number), so a separate individual update form will not be required in those

For more information, see the full posting at TMHP.com Now Effective: LTCOP HCS and TxHmL Transfer Form Submission Sequencing Enhancements | TMHP

December 14th, 2025

LTCOP HCS and TxHmL Transfer Form Submission Sequencing Enhancements

On Dec. 18, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Long-Term Care Online Portal (LTCOP) to improve form sequencing requirements and transfer processing for the HCS & TxHmL programs. These updates will help HCS and TxHmL waiver program providers and local intellectual and developmental disability authorities (LIDDAs) to submit forms accurately and reduce manual processing needs. 

Hopefully, this should make transfers occur in a much more timely fashion with fewer errors in the transfer process and accountability for transfer steps by appropriate parties.

For more information, see the full posting at TMHP.com

Coming Soon: LTCOP HCS and TxHmL Transfer Form Submission Sequencing Enhancements | TMHP

Timely Submission of IPC Renewals

HHSC reminds HCS and TxHmL providers and local intellectual and developmental disability authorities (LIDDAs) to submit individual plan of care (IPC) renewals for individuals enrolled in the HCS and TxHmL waiver programs as early as program rules allow.

For HCS, renewal IPCs must be submitted at least 30, but no more than 60, calendar days before the current IPC end date.

TxHmL program providers and LIDDAs are encouraged to use the same timeframe for the submission of TxHmL renewal IPCs. Failure to do so can result in delays in processing and service authorization approval.

Important note for individuals transferring:

For a transfer involving two LIDDAs, the individual movement local authority reassignment form must be submitted and processed (status Processed/Complete or PCS Processed/Complete) prior to submission of the transfer IPC.

Guidance on HCS and TxHmL IPC submissions:

• For program rules, refer to 40 TAC §166 for HCS and 40 TAC §9.568 for TxHmL.

Note: There have been no changes in who is responsible for submitting IPCs since the migration of the HCS and TxHmL forms and claims from the legacy HHS Client Assignment and Registration system to the TMHP Long-Term Care Online Portal.

• For information on how to submit forms in the LTCOP portal, refer to Long-Term Care (LTC) Online Portal User Guides for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs: TMHP Learning (exceedlms.com).

Questions:

For policy questions, email your program policy inbox: HCS Policy or TxHmL Policy.

For issues encountered while submitting the IPC on the TMHP Long-Term Care Online Portal, please contact TMHP at 800-626-4117.

December 30th, 2025

January 27th, Register for HCS, TxHmL and PI Quarterly Webinar

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

Jan. 27, 2026

10–11 a.m.

Register for the webinar.

Email LTCR Policy to request agenda items or for questions related to this webinar.

October 5th, 2025

October 29th, IDD and PI Quarterly Webinar with HHSC LTCR

HHSC Long-Term Care Regulation (LTCR) will host a webinar on the latest information from LTCR for providers for the following programs: HCS, TxHmL, ISS, PI, and ICF.

Date:  Oct. 29, 2025

Time:  2–3 p.m.

Register for the webinar.

If it is difficult to register for the webinar using Internet Explorer, try using another browser, such as Google Chrome or Microsoft Edge.

For questions or to request an agenda, email LTCR Policy using “IDD and PI Quarterly Webinar” for the subject line.

Future Webinar Dates

Jan. 28, 2026
April 29, 2026

July 28th, 2025

July 30th, IDD and PI Quarterly Webinar with HHSC LTCR

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

July 30, 2025

2-3 p.m.

Register for the webinar.

Email LTCR Policy to request agenda items or ask any questions related to this webinar.

Future Webinar Dates

Oct. 29, 2025

Jan. 28, 2026

May 16th, 2025

February 12th, 2025

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.

December 24th, 2025

New Renewal Requirements for the Direct Care Careers Platform

Direct Care Careers (DCC) is a free online platform to connect people seeking work as personal care attendants with employers delivering home and community-based services.

To ensure DCC candidates have access to current and active opportunities, all job posts on the DCC platform now require renewal every 90 days. We encourage employers to review their active job posts regularly to ensure the quality, accuracy, and relevance of postings for DCC candidates.

New Renewal Process Features

• Automatic Reminders: Employers will receive reminders to renew their postings at 60, 75, and 90 days from the original posting date.
• Action Required to Renew: Employers must renew job posts before the 90-day period ends to remain visible to candidates.
• Unpublished After 90 Days: If a job post is not renewed within 90 days, the platform will unpublish it. It will no longer be visible to candidates.
• Where to Find Unpublished Job Posts: You can find unpublished job posts under My Job Posts, Closed Jobs. You can revise and renew them at any time.

Thank you for helping us maintain a high-quality experience for DCC users.

If you need help with the renewal process, please contact the DCC Help Desk or use the live chat by clicking “Chat with us” on the DCC website.

For general inquiries or questions about becoming a DCC Employer, contact the HHSC Office of Disability Services Coordination.

May 28th, 2024

Direct Care Careers Enhancements

HHSC launched Direct Care Careers August 2023, an optional, online portal that will connect potential employees with employers delivering home and community-based services through the state plan and HCBS authorities (1915(c), 1915(i), 1915(j), and 1115). To provide the best user experience possible, HHSC is excited to announce the following enhancements and improvements to the platform.

All Users (Employers and Candidates)

• New options added to filter jobs.

• New drop-down menu options for easier site navigation.

Candidates

• Direct message employers to express interest in a job post.
• Save prospective job posts and view later.

Employers

• Select and download multiple resumes to view or print.
• Resumes can be viewed in selected language.
• Direct message candidates to express interest or invite to interview.
• Create a screened candidate list for job posts.
• View all candidates and refer prospects to job posts.

CDS Employers

• Create and use job templates.

Email questions to HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov.

December 24th, 2025

Critical Incident Management System (CIMS) Monthly Provider Demonstrations

FEI Systems will host a monthly provider demonstration webinar on Jan. 13, 2026, from 10-11 a.m. Monthly provider demonstration webinars are offered to providers with access to the Critical Incident Management System (CIMS). The Health and Human Services Commission (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.

December 22nd, 2025

Texas Flu Pre-Book Webinar January 9th, 2026

Join the Texas Department of State Health Services (DSHS) for the Texas Vaccines for Children (TVFC) 2026–2027 Influenza Pre-Book Webinar. 

Register for the following date: 

January 9, 2026, from 11:00 a.m. to 12:30 p.m.

Registration Link:

https://attendee.gotowebinar.com/register/2301876423463217497 

After registering, you will receive a confirmation email containing information about joining the webinar. 

Topics the webinar will cover include: 

• Available flu vaccines for the 2026–2027 season 
• Tips for completing your flu pre-book 
• How to place a flu pre-book in VAOS 
• TVFC Flu Dashboards and reporting tips 

The webinar will include a live Q&A session where subject matter experts will answer questions in real time. 

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

December 22nd, 2025

EVV System Interruptions

EVV Aggregator Visit Files Not Being Processed

HHSC and the Texas Medicaid & Healthcare Partnership (TMHP) are aware of an issue with some EVV nightly files not being processed by the EVV Aggregator. This issue will be resolved by tomorrow, Wed., Dec. 24. These files will automatically be reprocessed.

EVV Visits Being Rejected

HHSC and TMHP are aware of an issue with certain EVV visits being rejected in error by the EVV Aggregator due to LTC Medicaid member eligibility verification issues. Please do not resubmit these visits with eligibility issues until further notice as TMHP is actively working to resolve the rejection issue.

As a reminder, before billing claims, program providers and financial management services agencies (FMSAs) should review their visits in their EVV system or the EVV Portal to ensure they have been accepted by the EVV Aggregator.

EVV Aggregator Authorization Webservice Missing Data

HHSC and TMHP are aware of an issue with the EVV Authorization Web Service not being able to pull back all information for certain LTC Medicaid members.

Program providers and FMSAs should enter the missing information manually to complete the Medicaid Member profile setup, so the electronic visit record can be captured. Program providers and FMSAs can see their authorization data through the MESAV in TexMedConnect.

Once these issues have been resolved, a follow-up GovDelivery will be sent out.

Contact EVV with questions.

November 15th, 2025

HHAeXchange EVV Mobile App Update

On Nov. 3, some HHAeXchange+ users who have automatic updates enabled received the latest version of the HHAeXchange+ app automatically after signing in. HHAeXchange+ users who do not have automatic updates enabled will need to manually update the HHAeXchange+ app through their mobile device app store.

The update is being released in phases, and some service providers may receive the update sooner than others.

By Dec. 3, all service providers will have access to the latest version of the HHAeXchange+ mobile app.

Phased Rollout:

• General Availability (up to 5% user download allowed) – Nov. 3
• Early Adopters (up to 50% user download allowed) – Nov. 10
• Final Phase Begins (up to 100% user download allowed) – Nov. 17
• In-App Upgrade notifications – Nov. 18 – Dec. 3
• In-App Force Update – Dec. 4

How to Enable Automatic Updates:

Use the following instructions to enable automatic updates for Apple (iOS) and Android applications.

• Apple (iOS):
  • Open the Settings app on the device.
  • Select App Store.
  • Select Automatic Downloads, and toggle App Updates to the on (indicated as a green color).
• Android:
  • Open the Play Store app on the device and select the profile picture icon in the top-right.
  • Select Manage Apps & Device, then select Manage.
  • Locate and select the HHAeXchange+ App.
  • Select the ellipsis (three dots) and turn on Enable Auto Update.

Other Resources:

• Email HHAeXchange at TXsupport@hhaexchange.com
• Submit requests through the HHAeXchange Client Support Portal
• Dial 1-833-430-1307

EVV Mobile App: For New Users

  How to download:

• iPhone & Android: Open the App Store (iPhone) or Google Play Store (Android), search for “HHAeXchange+”, then tap Get or Install to download the HHAeXchange+ app.

Tips & Tricks:

• Check your account: Make sure you’re signed in with your Apple ID (iPhone) or Google Account (Android) before downloading apps.
• Use the search bar: Type the exact app name (HHAeXchange+) to avoid downloading an incorrect app.
• Update your device and store apps: Keeping your App Store/Play Store and system updated ensures smoother downloads and access to the latest features.

Helpful Reminders:

• If a service provider does not have automatic updates enabled, they’ll need to manually update the app in their app store by Dec. 3.
• Service providers downloading the HHAeXchange+ app for the first time after Nov. 3 will immediately be on the updated version.

November 6th, 2025

EVV Impacts due to Dual Demonstration Pilot Program Discontinued effective Jan. 1

Beginning Jan. 1, 2026, HHSC will discontinue the Dual Demonstration Program with the Medicare-Medicaid Plans (MMPs) in the demonstration counties listed below:

• Bexar County: Molina Healthcare of Texas.
• Dallas County: Molina Healthcare of Texas and Superior Health Plan.
• El Paso County: Molina Healthcare of Texas.
• Harris County: Molina Healthcare of Texas and United Healthcare.
• Hidalgo County: Molina Healthcare of Texas and Superior Health Plan.

HHSC will end the MMP plan codes in the demonstration counties. MMP members will choose a STAR+PLUS managed care organization (MCO) in their service area to continue their services.

**STAR+PLUS MCOs are listed in the table and in Appendix XXIX, STAR+PLUS Plan Codes and Contract Numbers | Texas Health and Human Services

Resources:

• Review: Dual Eligible Integrated Care Demonstration Project | Texas Health and Human Services.
• For more information about the Dual Demonstration Transition, contact Managed_Care_Initiatives@hhs.texas.gov.

October 3rd, 2025

FYI: HHAeXchange Mobile Application Issue Resolved Last Month

HHSC was made aware of an issue that prevented service providers from using the HHAeXchange mobile application to record visits on Saturday, Sept. 20. The issue was resolved at 6:17 p.m. that day.

If service providers were unable to clock in or clock out during the outage, program providers, financial management services agencies and Consumer Directed Services employers responsible for visit maintenance must enter these visits manually into the EVV system within the visit maintenance time frame, which is 95 days after the date of service delivery.

Select the following reason code:   Reason Code: No Electronic Clock In or Clock Out Number: 210 Description: J — EVV system down

Contact EVV with questions.

September 20th, 2025

Updated EVV Policy Handbook and Revision Log

The revised Electronic Visit Verification Policy Handbook was published on Sept. 2, 2025. EVV Operations has published a Revision Log that outlines the specific changes in the revision. The Revision Log allows users to easily identify the specific policies that have changed in each section of the handbook.

The new revision log (PDF) is located on the EVV webpage.

The handbook revision includes updated EVV standards and policy requirements for:

• Program providers, including those approved as a Proprietary System Operator (PSO)
• Financial Management Services Agencies, including those approved as a PSO
• Consumer Directed Services employers
• Payers, such as HHSC and managed care organizations

Email EVV Operations for questions.

March 12th, 2025

The EVV Policy Handbook Revision

The Electronic Visit Verification Policy Handbook (EVV) has been revised. This revision is effective March 12, 2025.

The Electronic Visit Verification Policy Handbook as well as Revision Log has been revised.

These revisions are outlined in the new revision log (PDF) located on the EVV webpage. The Revision Log outlines the specific changes and allows users to identify which policies have been updated in each section of the EVV Policy Handbook.

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

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

 Review the revisions here and Email HHSC EVV Operations with questions.

March 08, 2025

EVV System Daylight Savings Time Change

On March 9, the state provided EVV system, HHAeXchange, and EVV proprietary systems, will automatically adjust for Daylight Savings Time.

This means that the actual hours worked and billable time for EVV Visits recorded during the time change will decrease by one hour in the EVV systems.

For manual visits, the actual time should be recorded in the EVV system based on when the service provider started and ended delivery of services.

The EVV system will automatically account for the daylight savings time change.

No action is required from program providers, financial management services agencies, or CDS Employers.

Reminder: Register for HHAeXchange EVV System Training for CDS Employers

HHAeXchange is hosting an EVV system training webinar on Wednesday, Feb. 12, from 11 a.m. – 12 p.m. Central time for Consumer Directed Services (CDS) employers who use HHAeXchange as their EVV system.

Attending the webinar will complete the annual EVV system training requirement for CDS employers.

Agenda

• HHAeXchange System Login
• Managing the HHAeXchange Services Portal
• Walkthrough of the EVV Clock in and Clock Out Methods
• Support Resources
• Q&A Session

Register for the webinar.

Email HHAeXchange with any questions.

January 19th, 2025

EVV Visit Maintenance Unlock Request Updates

Texas HHSC has updated the Electronic Visit Verification (EVV) Visit Maintenance Unlock Request (VMUR) templates, VMUR job aids, and VMUR policy on the EVV webpage.

Policy

HHSC has posted an advanced notice of the revised 9060 VMUR policy that will be added to the EVV Policy Handbook in an upcoming handbook revision. These revisions are outlined in the 9060 Visit Maintenance Unlock Request (PDF) and became effective Nov. 12, 2024. The revisions are also available on the EVV webpage.

Revisions include:

• Standardizing the timeframes for processing a VMUR.
• Clarifying the roles of program providers, financial management services agencies (FMSAs), consumer directed services (CDS) employers, proprietary system operators (PSOs), payers, state provided EVV system vendors, and EVV proprietary system vendors.

Updates to VMUR Templates and VMUR Job Aids

HHSC published EVV VMUR templates for Program Providers and FMSAs (Excel) and for CDS employers (Excel) on the EVV webpage.

These updates include:

• A new option to select a Former EVV System from the drop-down list when submitting a VMUR for legacy visits.
• Adding all approved PSOs in the Current EVV System and Former EVV System drop-down list.
• Removal of the Service Area column.
• Revised instructions tab to reflect these changes.

The VMUR job aids contains information on the VMUR process, including examples of the most common VMURs. The EVV VMUR Job Aid for Program Providers and FMSAs (PDF) and EVV VMUR Job Aid for CDS Employers (PDF) are available on the EVV webpage.

Email questions to your payer, EVV or your managed care organization.

January 14th, 2025

Correction to the EVV PSO Operation Readiness Review Sessions Updates

HHSC published a notice on Dec. 4 about the EVV Proprietary System Operator (PSO) Onboarding Process Overview and Timeline to the TMHP EVV Proprietary Systems webpage.

The correction includes the revised document titles and publications of the EVV PSO Onboarding Paths:

• EVV PSO Onboarding Overview and Timeline Standard Path Process (PDF).
• EVV PSO Onboarding Overview and Timeline Expedited Path Process (PDF).

Standard Path Demonstration note:

Proprietary system vendors onboarding with a program provider or financial management services agencies (FMSA) in a Standard Path onboarding session are strongly encouraged to consider all EVV system functionality that onboarding program providers or FMSAs and future program providers or FMSAs may require to support their EVV-required service delivery when preparing for demonstrations during the Standard Path ORR.

A program provider or FMSA wishing to onboard with a previously approved proprietary system who isn’t approved for EVV functionality that the program provider or FMSA requires, must complete a modified Standard Path ORR with the previously approved proprietary system vendor to get approval to use the new functionality.

Email TMHP EVV PSO with any questions.

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 14th, 2025

ICF/IID UPL Supplemental Payment Program:  Enrollment Portal Update

HHSC has updated the location of the enrollment portal for the federal fiscal year (FFY) 2026 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) Upper Payment Limit (UPL) supplemental payment program.

Enrollment for the FFY 2026 program year opened on Dec. 1, 2025, and will remain open until 11:59 p.m. Dec. 31, 2025. Enrollment instructions can be downloaded from the portal.

To log in and enroll, enter your email address on the portal’s landing page, and a login code will be sent to you via email. If you do not receive a response email within a few minutes, reach out to Provider Finance Long-Term Services and Support for assistance.

December 7th, 2025

ICF/IID UPL Supplemental Payment Program

Enrollment for the federal fiscal year (FFY) 2026 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) Upper Payment Limit (UPL) supplemental payment program opened on Dec. 1, 2025. The enrollment portal will remain open until 11:59 p.m. Dec. 31, 2025. Instructions are available for download in the portal.

Per Title 1 Texas Administrative Code, Section 355.458, non-state government-owned ICF/IID providers are eligible for this supplemental payment program. The eligibility list for FFY 2026 can be found on the ICF/IID UPL Supplemental Payment Program Website.

Questions regarding eligibility, enrollment, or the program calendar should be directed to Provider Finance Long-Term Services and Support.

April 12th, 2025

HHSC is providing notification of the Intergovernmental Transfer (IGT) call for the Intermediate Care Facilities Upper Payment Limit (ICF UPL) 2Qtr2025 payment.

The federal fiscal year 2025 ICF UPL Quarterly Payments file was updated on April 15, 2025, and can be found on the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) UPL Supplemental Payment Program website. IGT amounts due are in Column J, under the “2nd Quarter Maximum IGT” heading.

Below are the pertinent dates associated with the 2025 ICF UPL 2nd Qtr. 2025 Payment:

• May 7, 2025: Last date to schedule transfer in TexNet.
• May 8, 2025: IGT Settlement Date.
• May 28, 2025: Payments expected to be released by the Comptroller.

Select the ICF UPL bucket in TexNet when you enter your IGT. Funds should be transferred through TexNet using the TexNet instructions. After transferring funds, send a screenshot or PDF copy of the confirmation or trace sheet from TexNet to the Provider Finance Department Payments Team.

December 11th, 2025

ICF Quarterly Webinar with HHSC LTCR 

For ICF Providers, and will discuss the latest information from LTCR.

November 15th, 2025

UPL (Upper Payment Limit) Supplemental Payment Program FFY 2026 Eligibility List Published

The HHSC Provider Finance Department has published the eligibility list for the federal fiscal year (FFY) 2026 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) Upper Payment Limit (UPL) supplemental payment program on the program webpage.

Per Title 1 of the Texas Administrative Code, Section 355.458, non-state government-owned ICF/IID providers are eligible for this supplemental payment program.

Under this program, a participating non-state government entity would contribute the “state share” of the supplemental payment in the form of inter-governmental transfers (IGTs). The state will claim matching funds and will make a supplemental payment to the ICF/IID facility based on the supplemental amount calculated by the state and the IGT amount transferred by the entity.

Enrollment for the FFY 2026 program will open on Dec. 1, 2025, and will last for 30 days.

**HHSC will publish both a link to the enrollment portal and a GovDelivery alert when the enrollment period opens.

September 15th, 2025

Updated ICF/IID Services Payment Rates

HHSC has published updated fee schedules for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) regarding the approved payment rates for services.

The HHSC Provider Finance Department (PFD) webpage has more information about the approved payment rates.

If you have further questions, email HHSC PFD, Long-term Services and Supports (LTSS), Center for Information and Training, or call us at (737) 867-7817.

June 26th, 2025

HHSC Publishes Revised Process for Reporting Incidents, Complaints and HHSC Investigations of Abuse, Neglect, and Exploitation (PL 2025-02) for ICF

HHSC Long-Term Care Regulation updated Provider Letter (PL) 2025-02 Process for Reporting Incidents, Complaints and HHSC Investigations of Abuse, Neglect, and Exploitation for Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID) to include the facility must report the alleged abuse, neglect, and exploitation (ANE) to HHSC Complaint and Incident Intake within one hour of suspecting or learning of the allegation. This includes instances in which the facility learns of the alleged ANE when the surveyor enters the ICF on the complaint investigation and informs the provider of the allegation. This PL replaces PL 2024-04.

For questions contact LTCRPolicy@hhs.texas.gov.

April 8th, 2025

April & May Trainings for ICF

Reporting Abuse, Neglect, Exploitation Changes and Self-Reporting Incidents for Intermediate Care Facilities
Wednesday, April 9
10 – 11 a.m.
Register here for the webinar.

Reporting Abuse, Neglect, Exploitation Changes and Self-Reporting Incidents for Intermediate Care Facilities
Thursday, May 22
2 – 3 p.m.
Register here for the webinar.

Hurricane Season – Ready or Not! Preparedness for Intermediate Care Facilities (ICF)
Wednesday, May 28
10 a.m. – noon
Register here for the webinar.

February 22nd, 2025

HHSC LTCR Updates Tag Crosswalks for Intermediate Care Facilities

LTCR has updated the ICF federal, licensure and state standards of participation tag crosswalks to the most current version.

Each crosswalk provides a detailed table that identifies the applicable tag numbers, title, Code of Federal Regulations and Texas Administrative Codes for providers to reference.

These documents are posted on the ICF Provider Portal HHSC website.

For questions, email LTCRPolicy@hhs.texas.gov.

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

December 7th, 2025

STEPS Replacing STAIRS -December Update

Starting in early 2026, HHSC will transition to a new web-based software application to collect information from providers for Medicaid and non-Medicaid cost reports, Supplemental and Directed Payment Program enrollments, and legislatively directed reports. The new system, the State of Texas Electronic Provider System (STEPS), will update and simplify the reporting and directed payment program enrollment processes. The current system, the State of Texas Automated Information Reporting System (STAIRS), will remain in use until the transition is complete.

STEPS Provider Webinar

The HHSC Provider Finance Department (PFD) will host a webinar about the STEPS system on Dec. 10, 2025, from 10 a.m. to 11:30 a.m. CST.

Register for the webinar here through GoToWebinar.

Webinar ID 641-739-747

STEPS Resources

1. STEPS Webpage

The STEPS webpage is the central location for major announcements and resources. Updates regarding STEPS will be posted regularly before the system goes live.

2. Frequently Asked Questions (FAQ)

The STEPS webpage includes an FAQ document to address your questions. This document is updated in response to questions received through the online portal referenced below.

3. STEPS Transition Guides – Updated Dec. 1

The STEPS webpage includes transition guides that provide more details regarding access to the new STEPS system, training, and other related topics. New guides will be added as information is available.

4. PFD Cost Report Webpages

The PFD Cost Report Information and PFD Cost Report Training webpages have been updated with new information about STEPS, cost report cycles, and cost report training requirements.

Questions?

HHSC encourages providers to submit additional questions not answered in the FAQ and transition guides through the online questions and feedback portal. These questions will not receive a direct response, but they will help guide future updates.

October 6th, 2025

October Update

HHSC will switch to a new web-based software application that will be used to collect information from providers for Medicaid and non-Medicaid cost reports, Supplemental and Directed Payment Program enrollments, and legislatively directed reports, starting in early 2026. The new system, State of Texas Electronic Provider System (STEPS), will update and simplify the reporting and directed payment program enrollment processes. The current system, the State of Texas Automated Information Reporting System (STAIRS), will remain in use until the transition is complete.

Resources

1. STEPS Webpage

• The STEPS webpage will serve as a central location for major announcements and resources.
• Updates regarding STEPS will be posted regularly before the system goes live.

2. Frequently Asked Questions (FAQ)

• The STEPS webpage includes an FAQ document to address your anticipated questions. This document has been updated in response to questions received through the online portal referenced below.

Questions

HHSC encourages providers to submit additional questions not answered in the FAQ through the online questions and feedback portal. These questions will not receive a direct response but will help guide updates to the FAQ.

December 4th, 2025

Very Important:  IDRC Form Updated

Form used for: HCS/TxHml/ICF/CLASS/DBMD

Form 8578 Intellectual Disability or Related Conditions Assessment and Instructions Update:

An update to Form 8578 Intellectual Disability or Related Conditions Assessment and Instructions is now available.

The effective date for the form and form instructions is the date of publication, Nov. 14, 2025.

Click here for the new form.

December 4th, 2025

December 2025 LTCR Provider Webinar Training Opportunities

Home and Community-Based Services and Texas Home Living Provider (HCS/TxHmL) Joint Training Webinars

Plan of Removal for HCS/TxHmL Providers
Tuesday, Dec. 16
2–3:30 p.m.
Register here for the webinar.

Medication Management for HCS/TxHmL Providers
Monday, Dec. 22
1:30–3 p.m.
Register here for the webinar.

For more training opportunities, visit the Joint Training Course Catalog.

December 3rd, 2025

The Texas Department of State Health Services (DSHS) Immunization Section has announced the release of the National Influenza Vaccination Week (NIVW) 2025 Digital Toolkit.

NIVW takes place each December and highlights the importance of flu vaccination during influenza season. This week-long observance reinforces that it is not too late for Texans to receive a flu vaccine and protect themselves, their families, and their communities.

The NIVW 2025 Digital Toolkit provides communication materials to support your outreach efforts from December 1–5, 2025, including:

• Key flu vaccination messages        
• Daily themes and talking points
• Social media copy
• Printable posters and flyers
• Fact sheets and educational resources

We encourage you to share these resources through your websites, social media platforms, newsletters, clinics, schools, and community channels throughout NIVW and the flu season.

You may access the complete toolkit on the DSHS website at Order Publications | Texas DSHS.

If you have questions or need additional support, please contact the Immunization Section at immunization.info@dshs.texas.gov.

November 18th, 2025

Holiday Season Availability:

Twogether Consulting will be closed from November 25th, 2025-November 30th, 2025. 

We will be closed from December 17th, 2025-January 4th, 2026. 

You may email of course, and we will be checking it periodically, but we will not be taking on any new client projects or assignments these days, as no one will be available in the office. If you already have scheduled dates and projects with us during that time, we will still be providing those services.  We do have other consultants that may be available during those times to refer out to, so please email us at info@twogetherconsulting.com or my regular email address for those of you who already have it.

November 16th, 2025

HCS providers have been contacting Twogether Consulting about certain requirements and/or changes in what surveyors are asking for this year from HCS providers. Below are a few things you should make sure you have completed and/or corrected prior to your survey.  I will try to update this as we receive feedback from providers, provider associations, and even HHSC staff.

Here are some areas surveyors are focusing on:

1. 1.  Smoke detectors: must be in working order and have working batteries, and they need to have appropriate placement inside each bedroom and “immediately” outside of the bedrooms
      1. (This last part is subject to interpretation, but to be safe we would recommend you have a smoke detector just outside of each bedroom, even if they are in the same hallway)
         1. This goes for Host Homes and Group Homes
      2. In some cases, surveyors have asked providers for their “smoke detector” policy, but I am assuming this is due to the fact that batteries were not being replaced regularly..
         1. We advise making this part of a regular inspection process of the home or scheduling your direct care staff in the home to inspect 1 x a month/qtr, or perhaps if you have maintenance staff or residential/house managers, this might be a part of their responsibilities.
   2. Emergency evacuation plans, policies, and training
      1. Provider must have a current and appropriately updated ER/EVAC Plan. Review and revise at least annually
      2. ER/EVAC policy and procedures
      3. Evidence of training on ER/EVAC plans to staff
      4. Posting of exit routes/egresses
      5. Fire drills:
         1. Must be completed quarterly for both Group Home and Host Home
            1. Group Homes: (1 per shift, per qtr/Q 90 days)
            2. Host Homes: (quarterly).  At least 2 of which must be overnight/when individuals are asleep.
         2. Documentation: For each drill, the facility must maintain a record that includes the date, time, and the name of the staff member who conducted the drill. Copies must be maintained in the home.
         3. Reporting: Providers must complete and maintain the HHSC Fire Drill Report form (4719) for each drill.  Please be sure you are using this form. 
         4. Availability: Records must be provided to HHSC surveyors upon request
         5. Staff training:
            • New staff must participate in a fire drill within 90 days of being hired.
            • Staff must participate in a fire drill at least once per year.
            • The provider must ensure staff can explain the emergency plan for the residence.
            • If a staff member does not follow the emergency plan during a drill, they must receive additional training
   3. Registering with the new emergency communication tool-AlertMedia  ( This also applies to  providers of ICF/IID,TxHmL, HCSSAs and DAHS which includes ISS)
   4. Matresses
      1. In the Group Home or Host Home
      2. Must have a mattress cover
      3. mattress must not be on the floor (needs to be on bed frame)
      4. Any modification (a reason for not having the mattress cover or having an individual sleeping on a matress on the floor) must be discussed with SPT, approved by SPT, and written into the PDP
   5. Adaptive Aids
      1. Are the individuals’ AA’s in the home of the individual requiring them?
      2. Are AA’s in working order?
      3. Has the individual and/or all appropriate staff received training on the AA?
      4. Is there evidence of this training with signatures and inservice sheet or material for any staff trained?
      5. Have they been replaced if the equipment is broken/not working anymore and did you document when that was replaced?
   6. Ensuring that Group Homes have working equipment for taking vitals signs (blood pressure devices, digital thermometer or other device for temps, pulse oximeters for SAO2’s, etc.. specifically for persons with these  “special needs” requiring for them to have regular vitals taken (blood pressure, temperature, oxygen saturation levels, etc.
      1. If you do have someone in the home requiring regular vital checks it might be a good idea to have staff check the equipment regularly (monthly/quarterly) to ensure the items are in the home, working and have working batteries is necessary

Note:  Enforcement and Survey are 2 different departments. Enforcement applies the administrative penalties based on scope and severity of the violation.

In addition, please be sure to appeal any violations you do not agree with, including the severity (critical vs non-critical), immediately upon receiving your final report.  You only have 10 days from receiving your final report/ statement of deficiencies to request an informal dispute resolution (IDR).  If you need help with your IDR or Plans of Correction (POC’s), please contact us at: info@twogetherconsulting.com.  We have resources, contractors, and other consultants who can help you.

November 16th, 2025

The IDD Preadmission Screening and Resident Review (IDD-PASRR) Handbook, revision 25-1, updates the handbook.

This revision is effective Nov. 12, 2025. Review the updates linked here.

November 16th, 2025

HHSC will be providing ongoing opportunities for CLASS and DBMD providers and FMSAs to hear about recent program updates.

CLASS and DBMD Quarterly Webinar

December 17, 2025

10 a.m. – 11:30 a.m.

Topics discussed will include:

• CLASS – Training Module Updates, Adding AA to an IPC
• DBMD – Region 1 Update, SPT meetings
• PES – Submission standards for ID/RCs, IPC Pre and Enrollment Packets
• Fair Hearings – The appeals process with a loss of financial eligibility
• HCS – Crisis Diversion and NF Diversion process
• EVV – Updates
• CAPM – New PM webpage and monitoring documentation

Register here for the webinar.

Run a test of your computer’s connectivity if you have never attended a webinar from your computer. You can run this test at any time before the date of the webinar. Perform this test early to allow time to address any technical issues.

Email questions to:

CLASSPolicy@hhs.texas.gov and DBMDPolicy@hhs.texas.gov

February 28th, 2025

HHSC will be providing ongoing opportunities for CLASS and DBMD providers and FMSAs to hear about recent program updates.

CLASS and DBMD Quarterly Webinar

March 19, 2025 10–11:30 a.m.

Topics to be discussed will include:

• CLASS/DBMD — Upcoming form updates, June webinar.
• UR/PES — UR/PES responsibility changes.
• EVV — EVV updates.
• Fair Hearing — Fair hearings information.

Register for the webinar.

Email CLASSPolicy@hhs.texas.gov and DBMDPolicy@hhs.texas.gov with any questions.

November 15th, 2025

November 14th, 2025

If you were unable to attend the virtual conference, copies of the handouts can be found below

Cross-Agency Employment Conference 2024 Program Handout

PowerPoint Handout

HHSC was not able to able to record the event nor did they allow time for Q&A.

Questions, however, may be submitted to:  employment_services_virtual_conference@hhs.texas.gov

November 11th, 2025

A recording of the October 30 DAHS and Individualized Skills and Socialization provider webinar with HHSC Long-term Care Regulation is now available. The presentation (PDF) is also available.

Listen to the webinar recording.

Email LTCR Policy for a transcript.

May 4th, 2025

A recording of the April 24 DAHS and Individualized Skills and Socialization provider webinar with HHSC Long-term Care Regulation is now available. The presentation (PDF) is also available.

Listen to the webinar recording.

Email LTCR Policy for a transcript.

November 10th, 2025

HHSC Rider 23 from the 2026-2027 General Appropriations Act, Senate Bill 1, 89th Texas Legislature

HHSC has published the Information Letter IL 2025-25 regarding the Rider 23: Texas Administrative Code Rule Amendments, Personal Attendant Base Wage Discontinuation, Rate Enhancement Discontinuation, Established Average Hourly Wage Assumed in Methodology, and Established Direct Care Wage and Benefits Expense Ratio, effective September 1, 2025. Review the IL for more information.

More information about the attendant programs and payment rates is available on the HHSC Provider Finance Department (PFD) webpage.

If you have questions, contact the HHSC PFD, Long-term Services and Supports (LTSS), Center for Information and Training at PFD-LTSS@hhs.texas.gov or (737) 867-7817.

Nov 10th, 2025

The November 2025 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com.

Visit the TMHP LTC homepage regularly for news, reminders, training opportunities, and other important program updates.

May 5th, 2025

The May 2025 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com.

Visit the TMHP LTC homepage regularly for news, reminders, training opportunities, and other important program updates.

February 15, 2025

The February 2025 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com.

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.

LIVE In-Person Training

Writing Acceptable Plans of Correction for HCS and TxHmL In-Person Training

HHSC Long-Term Care Regulation will provide an in-person training event for HCS and TxHmL Providers. This course will cover the necessary components for a Plan of Correction and the Informal Dispute Resolution process along with other related topics. This is an interactive training, and participants will be expected to engage with one another and the instructor during the training.  Continuing education credit will not be offered for this training, but a certificate of attendance will be provided to all participants who meet attendance requirements.

Writing Acceptable Plans of Correction for HCS and TxHmL Providers
Thursday, Oct. 2, 2025
9:30 a.m. to 4 p.m.
Brownwood, TX

Register for the class here.

License Types for Individualized Skills and Socialization Providers (course description)

Wednesday, April 23, 2025

1:00 PM – 2:00 PM

Registration

Tuesday, May 6, 2025

2:00 PM – 3:00 PM

Registration

Writing Acceptable Plans of Correction for ISS Providers (course description)

Thursday, April 24, 2025

1:30 PM – 3:30 PM

Registration

Death Notifications and Provider Investigation Reports for HCS/TxHmL Providers (course description)

Friday, April 25, 2025

2:30 PM – 3:30 PM

Registration

Understanding Reportable Incidents for Individualized Skills and Socialization Providers (course description)

Tuesday, May 20th, 2025

3:30 PM – 4:30 PM

Registration

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

Wednesday, May 21, 2025

3:00 PM – 4:00 PM

Registration

From Awareness to Action: Responding to Abuse, Neglect and Exploitation 
Tuesday, May 6
8:30 a.m. to 4:30 p.m.
Amarillo, TX
Register for in-person training

Infection Control – Break the Chain of Infection 
Wednesday, May 7
8:30 a.m. to 4:30 p.m.
Amarillo, TX
Register for in-person training.

Web-Based Training

Top 10 Citations for Home and Community-based Services and Texas Home Living Fiscal Year 2023

Long-Term Care Regulation

https://apps.hhs.texas.gov/business/CBT/deficiences/hcs-txhml-2023/

November 7th, 2025

The October 29th recording of the IDD Programs and Provider Investigations Quarterly Webinar with Long-term Care Regulation is now available.

Listen to the webinar recording.

Read the IDD and PI Quarterly Webinar PDF

Email LTCR Policy for the transcript.

October 31st, 2025

Now Is The Time To Start Prepping For Winter Weather  Emergencies

It finally feels like fall weather in Texas, and before you know it, winter will be upon us.  As IDD providers, you all know that you can’t wait til the last minute.

For winter weather preparation, IDD providers should focus on creating an emergency kit with supplies like food, water, medication, and batteries, and ensuring a backup heat and power source. It is crucial to make a plan for both individuals and staff, including communication and transportation, and to ensure all necessary equipment, medication, and clothing are available for each individual. 

• Emergency kit: Assemble a kit with non-perishable food, water, medications, first-aid supplies, and extra warm clothing for each individual.
• Medication and medical supplies: Refill all necessary prescriptions in advance and have an emergency supply of medical items.
• Backup power: Have a backup power source, such as a generator, and ensure batteries for medical equipment and flashlights are fully charged and extra batteries are on hand.
• Backup heat: Plan for an alternative heat source if the primary one fails, such as a fireplace or a space heater, and have the necessary safety equipment, like a fire extinguisher.
• Home insulation: Seal windows and doors to prevent cold air from entering.
• Plumbing: Winterize pipes to prevent them from freezing and bursting. 

• Communication plan: Create a plan for how to communicate during an outage, including having a battery-powered radio to receive weather alerts.
• Charging devices: Keep all mobile phones and other essential devices charged and have a plan for charging them if power is lost.
• Transportation: Plan for accessible transportation options in case of evacuation or an emergency.
• Vehicle preparedness: Ensure vehicles are winter-ready with proper fluid levels, good tires, and a winter storm kit in the car. 

• Assistive devices: Tune up and prepare assistive technology devices, making sure they have their own emergency kits and model information.
• Service animals: Prepare service animals with necessary gear like coats and boots for extreme cold.
• Stay informed: Sign up for local alerts and warnings and stay informed about the weather forecast.
• Dress in layers: Advise individuals to dress in layers and wear waterproof, insulated boots, and a hat to stay warm.
• Know the risks: Be aware of the signs of cold-related illnesses like hypothermia and frostbite. 

• Community resources: Connect with community groups or organizations like religious communities or food banks that may host clothing drives.
• Emergency committee: Create a winter weather emergency committee to oversee preparation and response efforts.
• Staffing: Plan for staff coverage and ensure there are enough people to care for individuals in the event of transportation issues. 

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.

October 28th, 2025

Medicaid Eligibility Reports – SSI Medicaid

HHSC has been working on enhancements to improve awareness and visibility of the Medicaid recertification date to increase timely submission.  HHSC announced that be making changes to the current training video on this subject and will release info about this in the near future.

Current video on this topic (updated 7 months ago) is available at:  https://www.youtube.com/playlist?list=PLIe60BLvrbESNOLho-L03v4Vf-GH4TNv1

March 25th, 2025

Video About Medicaid Eligibility Reports on the LTCOP Dashboard Now Available on YouTube

An educational video focused on Medicaid eligibility reports on the Long-Term Care Online Portal (LTCOP) Dashboard has been added to the Texas Medicaid & Healthcare Partnership’s HCS and TxHmL YouTube Playlist. Read the full alert.

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.

October 28th, 2025

Click On The Webinar Name Below To Register For Upcoming Webinars From Consolidated Planning Group

The Team at Consolidated Planning Group

contact@cpgcares.net   

281-690-1177

https://www.consolidatedplanninggroup.com/

October 28th, 2025

October 28th, 2025

OIG Beginning Auditing of Cost Reports

October 5th, 2025

What triggers an OIG audit or investigation?

October 27th, 2025

October 27th, 2025

October 23rd, 2025

HCS Program & Cameras in Private Areas: 

HHSC Medicaid division sent Regulatory staff at HHSC an email informing them that “CMS thinks there’s a privacy concern regarding cameras being allowed in private areas (even if justifications are in place), and that CMS will no longer permit this practice.”

According to HHSC, currently, there are no HCS rules specific to this matter.  HHSC stated that more details will be forthcoming, but for now, members should be informed that, in the future, this will no longer be permissible. They will provide more clarification in the near future.

October 23rd, 2025

October 22nd, 2025

April 15th, 2025

Beginning May 30, the Provider Enrollment and Management System (PEMS) will be enhanced to streamline the process for Texas Medicaid enrollment, managed care organization (MCO) and dental maintenance organization (DMO) credentialing.

PEMS will feature a new Credentialing Tab for the credentialing application that will allow providers to complete and submit their credentialing information as part of the enrollment process, the reenrollment process, or as a maintenance request.

For more information, refer to Coming Soon: PEMS to Be Updated to Allow Provider Credentialing on TMHP’s Provider Enrollment webpage.

October 14th, 2025

Post Convention Report

This year’s AAIDD-Texas Chapter 49th Annual Convention was on Sept. 30th-Oct. 3rd, 2025, and we had a wonderful turnout.  As you may or may not know, this is my first year on the board, and it was an awesome experience.  I know there were some providers, LIDDA’s, and individuals who just didn’t have funding to come this year or possibly the timing was just not right, and we thank all of you who could make it to the convention.  This has been a tough year for everyone in IDD services, especially in the state of Texas.

Next year is our 50th anniversary,  so I hope even more of you can attend the convention next year.  We plan to go all out for the event!  Please don’t forget to sign up to be a member of AAIDD, which gets you so many professional resources, including free material, webinars, and discounts on other resources for IDD, as well discounted rate on the registration for our annual Texas Chapter of AAIDD Convention.  Basic Membership cost is very good rate ($90-$185 per year for basic) for national membership, and there is no extra cost for Texas Chapter membership.

I would like to thank all board members for their tireless work to make this happen this year, as well as all the sponsors and vendors.  I would like to also thank all the wonderful presenters for the breakout sessions, like Nursing Innovations, Rachel Hopkins from Molina Health Care,  and the Transition Support Team members from several of the LIDDAs– Integral Care, Texana, Nueces County. We had an incredible guest, James Meadours for the Opening Session.  James is a passionate self-advocate for persons with disabilities and for those who have suffered abuse and has been presenting across the US for many years.

Shelbi Davenport (of the Shelbi Show podcast) did a wonderful job in the general session of hosting her live podcast interview with 3 incredible individuals with Down Syndrome:  Martha Haythorn, Jenny Stone (now Underwood), and Austin Underwood. The premise of the interview was to look at the personal perspective of 3 incredible people with Down Syndrome and how the lives of these three people were given the support and freedom to pursue their dreams and how they are now living their best lives.

Austin and Jenny Underwood were actually married not long ago and are both working in jobs they love, which has been a lifelong dream for both of them.  After earning a certificate as a prep chef and working as a head of house and chef at an Italian restaurant,  Austin founded his own company in 2016 and owns a food truck called “Austin’s Underdawgs” in the DFW area. I have been told they also cater for events!   Jenny and Austin both have amazing family support, and we were able to meet their parents at this year’s convention.  Jenny has worked as a Teacher’s Aide at the KinderFrogs School at Texas Christian University (TCU) for 20 years. KinderFrogs is a family-focused, early intervention program for children with developmental delays. In her role as a teacher’s aide, Jenny performs many duties from assisting with circle time to preparing lunches and assisting children on the playground.

Martha Haythorn came all the way from Atlanta, Georgia to be with us, and she stole everyone’s heart this week.  Martha is incredibly passionate and quite funny, I discovered as well!  She was a recipient of a scholarship from Ruby’s Rainbow that allowed her to fund her college time at Georgia Tech and graduate.  She has been asked to present at Emory College in 2026 and now has a job providing social media marketing for a medical supplier of respiratory aids that also happens to help many individuals with Down Syndrome with respiratory issues.  Martha also sits on the Council for Developmental Disabilities for the State of Georgia.  It was my privilege to ask her to present this year and host her for her time here. So happy I got to meet her in person.

Check out some of our photos of the convention!

August 29th, 2025

We invite you to this year’s Texas State Chapter of AAIDD 49th Annual Convention. I am officially a board member this year (Julie Blacklock), and I will also be presenting a breakout session on October 2nd, 2025 especially for HCS providers. Please share with providers, families, and individuals.  All are welcome to come. For more information and registration, go to:  https://www.aaiddtx.org/2025-convention

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KEYNOTE SPEAKER

Opening Session
Wednesday, October 1, 8:45 – 10:30 a.m.
James Meadours, Self-Advocate, National Speaker, Disability Rights Leader

A Journey from Group Living to Independent Living

James Meadours, a nationally recognized self-advocate, shares his powerful story of moving from a group home to living independently in “The Right Direction.” With honesty and courage, James outlines the milestones, setbacks, and supports that helped him take control of his life. From building daily living skills and speaking up for his rights, to embracing community inclusion, James offers a message of hope and empowerment. Attendees will leave with deeper insight into how to support others on their own path to independence.

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GENERAL SESSION

Wednesday, October 2nd, 3:00 p.m.-4:30 p.m.

Taking Our Lives in the Right Direction

• Shelbi Davenport, B.S. Better Lives Senior Associate/Practicum Coordinator at TAMU

• Martha Haythorn, Georgia Tech ExCel Graduate, Policy Specialist-Georgia State Legislature

• Austin Underwood, Operator-Austin’s UnderDawgs

• Jenny Stone, Outspoken Self-Advocate and Austin’s partner

This presentation is intended to be a general session in the format of a structured interview that will provide the audience with a personal perspective on how the lives of three people with Down Syndrome were given the support and freedom to doggedly pursue their dreams and who are now living their best lives, with even better things to come. Shelbi Davenport of The Shelbi Show will host the session, interspersing interview questions with video snippets to facilitate and drive the discussion. The audience will be motivated to encourage others with disabilities to let nothing get in the way of following their desired path.

 

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For Complete Program PDF

OR

Click on: Tx Chapter AAIDD Convention 2025-brochure-agenda

Remember, as an AAIDD member, you receive a discounted rate for this year’s Texas Convention

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Membership: How To Join AAIDD

AAIDD welcomes you to become a member or renew your annual membership now. Click on the link below to choose from the benefit packages that best match your needs.

https://www.aaidd.org/about-aaidd/membership-join/member-types

AAIDD membership advantages include access to a global network of professionals, free webinars, discounts on publications and the annual meeting, eligibility to vote and hold office, access to members-only content like Interest Networks and newsletters, and subscriptions to peer-reviewed journals like AJIDD and Inclusion. Members can also participate in scholarship opportunities and join the Students and Early Career Professionals (SECP) Interest Network.

 

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Why Should I Join AAIDD?

Joining AAIDD lets you tap into a network of top professionals from around the globe on IDD, who can show you the ropes, deepen your involvement in your profession, and advance your career.

Professional Development & Information

• Journals and Publications:

  Members gain access to peer-reviewed journals and resources on the latest research and policy developments in the field of intellectual and developmental disabilities (IDD).
• Webinars:

  Free access to educational webinars and an archive of past sessions is available to members.
• Interest Networks:

  Members can join specialized groups to connect with peers who share similar interests or disciplines.

Networking & Community

• Global Network:

  Connect with a worldwide network of professionals working in the IDD field.
• Interest Networks:

  These provide a forum to share information, network, and find leadership opportunities.

Discounts & Savings

• Annual Meeting: Receive discounts on registration for the AAIDD Annual Meeting.
• Bookstore: Get discounts on books and other resources from the AAIDD bookstore.

Other Advantages

Information on Job Opportunities working with IDD services

Member Updates on Upcoming Events

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For more information about one of our guest presenters, Martha Haythorn, check out some of her “Ruby’s Rainbow” YouTube videos and accomplishments

https://youtu.be/VkRMprhDevM?si=auICd6tya2989oDS

https://www.youtube.com/watch?v=LDojMQ4SzuA

https://www.youtube.com/watch?v=AmepFahwCn0 

October 12th, 2025

 DO NOT CLICK FILES, LINKS, OR FWD!

The Texas Health and Human Services Commission has identified an active phishing attempt.

The message may appear to come from a trusted colleague, sender, or HHSC email address and often includes links, meeting invites, or file attachments that appear to be legitimate.

If you receive an unexpected or suspicious email, don’t click on the links, open the attachments, or accept the invite.

HHSC is actively working to resolve this issue and will communicate updates.

**Tip From Twogether Consulting:

If you are unsure and know the sender or sender’s email, or if you are expecting an email from HHSC, you may want to contact them by phone or contact them some other way directly to ensure they did actually send you an email, especially if it contains links or attachments.

October 6th, 2025

TULIP System Updates

PLEASE BE ADVISED THAT HHSC WILL BE PERFORMING SYSTEM UPDATES TO TULIP.  

Don’t forget all EMR checks (Misconduct & Nurses Aids checks) are done through TULIP for HCS/TxHmL/ISS Providers

TULIP will be unavailable from October 31st, 2025 @ 5:00pm to November 3, 2025 @ 8:00am.

These updates are necessary to improve system performance and reliability.   More details on issues like password reset will be sent out as they approach the transition date.

October 5th, 2025

 Texas Human Services Commission (HHSC) will be hosting free in-person Employment First/Employment Services trainings across the state from October to December 2025.  

What: Employment First/Employment Services Training

Where: Wichita Falls, San Angelo, Weslaco, Lufkin, Sugar Land, and San Antonio

When: Various dates from October to December 2025

Time: 9 a.m. to 4 p.m. CST

Register: Select your session and register now.

Space is limited to 50 seats per event, so register early to reserve your seat.

About the Training

This training is specifically designed for any staff member who has a role in supporting people with disabilities who set employment goals. This includes people with direct, hands-on roles such as:

• Service coordinators,
• Employment specialists,
• Direct care staff,
• Day habilitation staff, and
• Job coaches, supervisors, and others who support individuals as they pursue competitive and integrated employment.

Training topics include:

• Overview of Employment First and the national movement,
• Providing employment services,
• Employment and soft skills,
• Apprenticeship programs, and
• Employer relationships.

October 5th, 2025

HHSC Long-term Care Regulation will host a webinar for Day Activity and Health Services (DAHS) and Individualized Skills and Socialization providers

Date: October 30, 2025

Time: 11 a.m. to noon.

Place:  Webinar

DAHS and Individualized Skills and Socialization providers should attend this and all webinars with HHSC LTCR.

LTCR will provide the latest updates and answer questions from participants.

Register for the webinar.

October 3rd, 2025

Save the date for the second annual Cross Agency Employment Conference on Thursday, November 13, 2025.

What: Cross Agency Employment Conference

When: Thursday, November 13, 2025

Where: Online

Registration: Registration will open in mid-October.

More Information

The Cross Agency Employment Conference will feature presenters from Texas HHS, the Texas Workforce Commission, and the Texas Education Agency.

The conference is open to agency staff, job seekers, providers, family members, and advocates who want to understand the job seeker’s journey to employment, and the services and support available to them through each life stage.

ASL/CART services will be provided for this event.

This conference is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $27.7 million with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

Oct 3rd, 2025

HHSC is hosting a free webinar on World Mental Health Day, Friday, October 10, 2025, from 9:30 a.m. to 11 a.m. CST.

What: Webinar on Advances in Trauma Informed Care

When: Friday, October 10, 2025, 9:30 a.m. to 11 a.m. CST

Register Now: Register for the webinar.

Trauma is not just an event, it’s an experience that disrupts a person’s sense of safety, stability, and connection. It can alter brain development, behavior, and emotional regulation. For many people, trauma leaves invisible wounds that shape how they learn, relate, and navigate the world. We’ll unpack how trauma manifests across developmental stages and why people with intellectual or developmental disabilities face heightened risks. We’ll also share how professionals, caregivers, and advocates can foster environments of psychological safety, healing, and resilience

September 19th, 2025

September 17th, 2025

August 30th, 2025

August 29th, 2025

Information below is from PPAT for Registration and Info!

September 17th, 2025

Employability Status Check Changes As Of September 7th, 2025

HHSC recently moved the Employability Status Check search to the Texas Unified Licensure Information Portal (TULIP).

FYI-An issue was found by HHSC, during the transition process, with the Employability Status Check data retrieval process, which is causing some difficulty for providers conducting due diligence searches.

HHSC is working diligently to resolve the problem..  Providers will be notified about a workaround if it is not fixed in a timely fashion.

• What do you need to do?

  • Providers must now use the my.site.com/EMR/ link to conduct employability status checks in TULIP.
  • If the previous Employability Status Check website is accessed, please click on the home link to be directed to the new employability searches in TULIP.
  • The new searches in TULIP now display the search criteria and “no results found” on the same screen. A fix is now deployed to include a User Guide.
  • The Employability Status Check search checks licensure status (Nurse Aides, Medication Aides and NFAs).
  • The Employability Status Check search does not display anything when no records are found. The lack of results means the person is not part of the searched registry. Screenshot this search, including the search criteria and computer date and time. Until a fix is deployed, follow this guidance.
  • The EMR search displays the first name, last name and social security number when no records are found. To download the results, click the download button in the top right corner of the yellow results bar. The download contains the date and time of the search. If no date is present under “Misconduct Registry Enter Date,” the searched person is NOT on the EMR.
  • Please reference the User Guide which can be accessed on the new Employability Status Check search page under the heading “additional links” located at the bottom left-hand side of the page.
  • To remain in compliance, providers must redo all searches conducted from Sept. 7, 2025, to Sept. 12, 2025, and take a screenshot of the results, including the date and time for searches that yield “no results found.” 
• As required by Title 26 of the Texas Administrative Code, Chapter 561, Rule 561.3, providers must search the Employee Misconduct Registry and Nurse Aide Registry to determine if the person applying for employment is listed as unemployable on either registry. With the transition of the Employability Status Check to TULIP, providers are now required to conduct both searches in TULIP.

For questions, email CARE@hhs.texas.gov.

September 11th, 2025

Employability Status Check (Nurse’s Aide/Misconduct Registry) Update

As of Sept. 11th, 2025

September 5th, 2025

ISS FAQ’s Updated Sept. 2nd, 2025

The current revision has added the link to PL 2025-01 (AlertMedia), updated TAC links to the new TAC website, added information about AlertMedia and information for providing information to HHSC during an emergency, and added a response regarding after-hour care and charging families.

In addition, there are comments to some of the questions concerning the revisions made to Emergency Response Plans and Fire Drills, and various sections containing the old TAC links.

ISS FAQ’s

August 15th, 2025

Current ISS Rules-July 24th, 2025 edition

Alert letter PL2023-01

August 1st, 2025

HHSC has published the following proposed amendments to the rules governing an ISS program provider.  They are currently taking comments until August 25th, 2025.  Please notify your provider association that your program is affiliated with for assistance with submitting comments. (PPAT, PACSTX, etc…)

Also provided below are the proposed schedule of administrative penalties for ISS providers and the current schedule of administrative penalties for DAHS providers.   As you will see, the DAHS administrative penalties are less than the ISS provider penalties; however, HHSC has no say over the ISS administrative penalties, as they are under DAH’s Enforcement Division.

Proposed Amendments to ISS Rules

ISS Scope & Severity Grid For Penalties

DAHS Scope & Severity Grid For Penalties

July 23rd, 2025

HHSC Publishes Revised PL 2019-24

HHSC has published revised Provider Letter 2019-24, Informal Dispute Resolution Process for Day Activity and Health Services (DAHS), DAHS with Individualized Skills and Socialization, and DAHS with Individualized Skills and Socialization Only providers. Revisions include updated hyperlinks to reflect the new website location for TAC rules, clarification to distinguish the Informal Dispute Resolution (IDR) request process for each provider type, and non-substantial revisions throughout this Provider Letter to enhance clarity.

DAHS and ISS IDR revise process

April 6th, 2025

Register Now for April 24 DAHS and Individualized Skills and Socialization Provider Webinar with HHSC LTCR

HHSC Long-term Care Regulation will host a webinar for Day Activity and Health Services (DAHS) and Individualized Skills and Socialization providers on April 24 from 11 a.m. to noon.

DAHS and Individualized Skills and Socialization providers should attend this and all webinars with HHSC LTCR.

LTCR will provide the latest updates and answer questions from participants.

Register for the webinar.

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:

September 3rd, 2025

Individuals that reside in institutions such as a nursing facility, state-supported living center (SSLC), or intermediate care facilities, who have IDD often have many significant medical, psychiatric, and behavioral needs that create challenges to living successfully in the most integrated community setting. Serving individuals who transition or divert from these institutions often requires specialized staff, intensive training, and expertise across several fields of study as well as ongoing support and technical assistance.  As these individuals transition to an HCS program, for example, providers and family members have a difficult time finding the needed support for their individual in the community, particularly in rural areas, to maintain the care they need.

The Texas Health and Human Services Commission (HHSC) secured Money Follows the Person (MFP) Demonstration funding to help individuals who have complex medical and behavioral needs and want to live or remain in the community to receive the services and supports they need.

Texas has 8 regional Transition Support Teams (TSTs), often referred to as Hubs, to serve all 254 Texas counties, including all 39 local intellectual and developmental disability authorities (LIDDAs) and the community waiver providers within a designated region. These interdisciplinary teams provide the following support services:

• Educational and training activities and materials, such as webinars, videos, and other correspondence, are provided at least quarterly and focus on increasing the expertise of LIDDAs, providers, and community members in supporting individuals with complex needs.
• Technical assistance provided to LIDDAs, program providers, and other community support services on specific disorders and diseases, emerging and best practices, and evidence-based services for individuals with significant challenges.
• Case consultations and peer reviews are provided to service coordinators, crisis intervention staff, direct care staff, and other members of an individual’s service planning team who need assistance providing effective care for an individual.

A licensed professional, such as a clinical social worker, serves as each TST coordinator. TSTs include licensed medical staff such as physicians, physician’s assistants, nurse practitioners, and registered nurses as well as psychiatrists, psychologists, behavioral specialists, and other professionals who have expertise working with individuals with IDD. These interdisciplinary teams support the LIDDAs and service providers within their designated service areas.

TSTs are also designed to address unique regional and cultural issues and challenges as well as identify gaps in medical, psychiatric, and behavioral resources. They report information about these identified gaps to Texas HHSC.

If you need help to locate offices that can help you with intellectual or developmental disabilities, aging, behavioral health, and other disability services, please visit Where Can I Find Services?

August 30th, 2025

CMS has approved the 1915 (c) waiver amendments with an effective date of September 1, 2025. This means that the rates funded by Rider 23 and posted by HHSC on August 19, 2025 will be effective September 1, 2025.

Copy of Information Letter 2025-17 and link to approved rates –  https://www.hhs.texas.gov/sites/default/files/documents/il2025-17.pdf

August 15th, 2025

In September 2025, Texas will see changes to HCS (Home and Community-based Services) rates, including the discontinuation of the Attendant Compensation Rate Enhancement program and increased rates for identified attendant services. These changes are tied to the 2026-27 General Appropriations Act, specifically Rider 23

• Discontinuation of Attendant Compensation Rate Enhancement:

  .

  The current program will end, effective September 1, 2025. 
• Rate Increases for Attendant Services:

  .

  HHSC will propose increased rates for certain attendant and attendant-like services, also effective September 1, 2025. 
• Funding for Wage Increases:

  .

  The 2026-27 General Appropriations Act, Rider 23, provides funding for HHSC to increase the wage for personal attendants to $13.00 per hour and adjust related payroll costs. 

June 21st, 2025

HHSC is accepting comments on the amendment of the 1915(c) Home and Community-based Services Waiver. View the HCS amendment details.

Through this amendment, HHSC updated the attendant rates and increased the HCS individual cost limits. The cost limits were updated as described below:

• Intermittent (LON 1), Limited (LON 5), and Extensive (LON 8)

  • The amount is going from $167,468 to 210 percent of the annualized cost of care in an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (ICF/IID) using the fiscal year 2026 non-state-operated small facility daily rate for Level of Need (LON) 8, rounded to the nearest dollar, which is estimated to be $169,182 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

• Pervasive (LON 6):

  • The amount is going from $168,615 to 210 percent of the annualized cost of care in an ICF/IID using the fiscal year 2026 non-state-operated small facility daily rate for LON 6, rounded to the nearest dollar which is estimated to be $211,822 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

• Pervasive plus (Level of Need 9):

  • The amount is going from: $305,877 to 210 percent of the annualized cost of care in an ICF/IID using the fiscal year 2026 non-state-operated small facility daily rate for LON 9, rounded to the nearest dollar which is estimated to be $392,318 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

Comments will be accepted until July 21, 2025.

Email comments to the Texas Medicaid Waivers inbox.

July 28th, 2025

Home and Community-based Services (HCS)

HCS Home page

July 22nd, 2025

From HHSC’s PAT  FAQ’s as of Jan. 1st, 2023

“Frequently Asked Questions for Providers Applicant Training (PAT) for HCS/TXHML”

-When is the Provider Applicant Training (PAT) and Test available?
This training is available online at this time (training modules). The PAT Test itself is being revamped and is not available to take until  September of 2025.

If you are trying to apply for an HCS/TxHmL contract at this time, you will not be able to submit HCS/TxHmL applications without the PAT Test Certificate of Completion (must have passing grade of 85%), until you can schedule the test in September of 2025.  

Beginning Sept. 1st, the training modules will still be available online, but applicants will no longer be able to take the test online!.  Applicants will need to take the practice modules online and then schedule a time to take the test “in person”.  We will keep you posted as to whether they will be available at various testing centers or at one specific location. 

The PAT training is one of the first steps for HCS/TxHmL applicants to obtain a contract with HHSC.

Please do not submit your application without the PAT certificate that reflects a passing score of 85% or above.

-Who can take the training and test?
Applicants listed on Form 3681, Section 8.a and 8.b must complete the online PAT training. The Program Manager noted on this form, must complete the training and pass the test with an 85% or above.
See Texas Administrative Code Title 40, Chapter 49, Rule §49.204. You must provide a copy of HHSC Form 3681 along with your certificate of passing by at least 85% to HHSC.  The program manager must be the person taking the PAT test.

-How can I access the HHS Learning Portal?
• HHS Learning Portal (texas.gov).
• Set up your new account. You will need to confirm your new account through the email address used.
• Find and select the Medicaid Long Term Services and Support Training under “Course Categories.”
• Select the Provider Applicant Training (PAT) link. Select “Enroll me” to access the Training and get access to the “Welcome” page.

The training is compiled in four different steps.

Step 1. Important to know Before you Get Started
 Fill out the Provider Applicant Training (PAT) Information form. This form must be completed to access the introduction and the training modules.

Step 2. Training Modules
 Complete each module must be completed to advance to the next module.

Step 3. Evaluation and Certificates
 Complete the mandatory survey

Step 4. Provider Competency Exam
 Schedule your test with HHSC, after you have completed training modules.  Please save your exam certificate upon completion of test.  HHSC will issue you your results. Submit the certificate along with your completed application

PAT FAQ’s read more

IMPORTANT:  You must take the PAT before you can apply to be an HCS Provider!!!.  You must pass the Test by 85 %  If you fail the test, you can’t retake the test for a period of 6 months, so please study the TAC before and pay careful attention to the PAT modules before answering test questions.

Note: If you do not pass on your first attempt, please DO NOT apply.

July 23rd, 2025

Program providers and other interested stakeholders can now register for the upcoming HCS and TxHmL quarterly webinar.

HCS and TxHmL Quarterly Webinar

August 28, 2025

10:00am-12:00pm

Register here for the August 28 HCS-TxHmL Quarterly Webinar

Webinar topics include:

• Form Updates

• TMHP: Claims Data Export & Enrollment Form Processing Enhancements for HCS and TxHmL

• Level of Need Submission Requirements and Resources
• EVV Required Services and Documentation