Twogether Updates

COVID Vaccine Information- HCS, TxHmL, ICF

by

blue and white labeled bottle

 

February 23rd, 2021

IDD Vaccine Plan Approved (HCS/TxHmL/ICF)

Good News! The plan for Tarrytown Expocare to provide the COVID vaccine to persons receiving services through the ICF/IID, HCS and TxHmL programs has been approved. This includes staff and paid caregivers. The plan applies to those who have yet to receive the vaccine through either the federal pharmacy partnership program or other sources.
The three IDD associations will meet to discuss logistics.  I believe this is set to be implemented as of March 8, 2021.

February 12th, 2021

HCS/TxHmL:  

Today DSHS reported it has finalized its presentation of the Tarrytown Expocare vaccine plan that the three IDD associations, Tarrytown and DSHS have been working on for many weeks.  DSHS says the plan will be presented to DSHS Vaccine Leadership and the Commissioner today and also the Expert Vaccine Allocation Panel (EVAP) at its next meeting Monday morning.  They expect to present this plan to the Governor’s Office Monday evening at which point DSHS feels it will have a final answer as to whether the plan is approved. Currently, we are not sure when it will be approved.
**This plan was developed using data the three IDD associations obtained from their respective members which include number of vaccines needed in both ICF/IID and HCS/TxHmL programs.  Thank you for all the work our IDD associations do for providers and individuals in the program!)
  • HHSC has not made a decision whether this same reporting requirements ICF requires, will be established for the HCS/TxHmL program.

February 12th, 2021                                                                  Image result for very important clipart free

ICF/IID:

HHSC will soon release emergency rules and a Provider Letter related to the process it will use to identify which facilities (staff and residents) have already received the vaccine.

A stand-alone webinar on the requirement will also be held.  Here is the link to draft Provider Letter and draft emergency rules 
(So remember to update your policies and procedures for COVID-19 /infection control policies and procedures!!!)
ICF/IID providers will be required to complete a survey indicating how many residents and staff have received the vaccine (1st, 2nd, or both doses).  The survey will be open for at least the duration of the emergency rule, requiring providers to add any new information about the status of the vaccines given  This will allow providers to report 2nd doses given if such was not reflected in a provider’s first data entry (that is provided the individual received a 2-dose vaccine.  Some vaccines will only have 1 dose- i.e. Astrozenica), or to report receipt of newly first-doses given.
After this three week period, HHSC will reconcile the data to identify where gaps exist. This process will include contacting providers as needed to confirm the information reported through the survey.  HHSC anticipates the reconciliation process taking 2 or 3 days.
The data will then be sent to DSHS to be used to link providers still in need of the vaccine (whether 1st or 2nd dose) for the individuals they serve and their staff.  This process will take about 2 weeks.  The full process should take 5 weeks total, assuming HHSC completes its reconciliation process in a timely manner and DSHS is able to link providers to a vaccine entity in a speedy and efficient manner.
Other information shared or discussed includes the following:
  • Providers will not be cited on the rule, but it is possible to receive a citation from a desk audit (HHSC did not elaborate on this).
  • The survey does not capture (and is not intended to capture) data on individuals who have opted not to receive the vaccine.
  • Recognizing that not all providers are aware of or are tracking the vaccination status of their staff, providers only need only to report the number of staff of which they are aware have received the vaccine.

.

COVID-19 Information

by

February 22nd, 2021

COVID-19 FAQ’s From HHSC for HCS/TxHML

https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/long-term-care/hcs-txhml-general-covid-faq.pdf

January 24th, 2021

COVID-19 Emergency Rules for HCS and TxHmL Program Providers Extended!

Emergency rules related to COVID-19 mitigation and response for HCS/TxHmL providers that were scheduled to expire on January 22, 2021, have been extended. The extension took effect on January 22 and will expire on March 22, 2021.

The following rules are extended:

Email PolicyRulesTraining@hhsc.state.tx.us or call 512-483-3161 for questions about these rules.

January 10th, 2021

Federal Pharmacy Partnership Program:

Contact Information for COVID-19 Vaccines

Long-term care providers with questions about CVS or Walgreens COVID-19 vaccinations administered through the Federal Pharmacy Partnership program should contact the following:

CVS:
833-968-1756
Email COVID Vaccine Clinics LTCV.

Walgreens:
Email Immunize ILTC.

January 7 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

The presentation can be found here.

Future meeting notices and information will continue to be shared on these sites, so please check back regularly.

COVID-19 Provider Information

COVID-19 Client Information

December 22, 2020

DSHS Issues Guidance About Moderna Vaccination Readiness for Vaccine Administrators

A recording of the DSHS Vaccination Readiness for the Moderna COVID-19 Vaccine webinar held on Dec. 20 and Dec. 21, 2020 is available for vaccinators who could not attend.

Register for and view the Dec. 21 webinar recording here.
View the Dec. 21 webinar slide presentation (PDF)

Register for and view the Dec. 20 webinar recording here.
View the Dec. 20 webinar slide presentation (PDF)

Helpful Vaccination Information

Moderna EUA Storage and Handling Instructions (PDF) includes the following:

  • Moderna EUA Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers)
  • Moderna EUA Fact Sheet for Recipients and Caregivers

v-safe After Vaccination Health Checker Instructions (PDF)
Moderna EUA “What to Expect” Card for Healthcare Professionals (PDF)
Moderna EUA “What to Expect” Card for Vaccine Recipients (PDF)

CDC’s Moderna Clinical website is live: Moderna COVID-19 Vaccine Information. This website includes the following documents:

  • Storage and Handling Summary
  • BUD Guidance and Labels
  • Storage and Handling Labels
  • Vaccine Expiration Date Tracking Tool
  • Freezer Storage Loggers (F) and (C)
  • Prep and Administration Summary
  • Standing Orders Template

December 2, 2020

HHSC Publishes Revised Guidance for Requesting Free COVID-19 Point of Care Antigen Test Kits (PL 20-49)

HHSC has published a revised version of PL 20-49, Process to Request Free COVID-19 Point of Care Antigen Test Kits (PDF), for NF, ALF, ICF/IID, HCS and HCSSA providers. The letter has been revised to update the link for the BinaxNOW training for staff who will be administering COVID-19 tests using the BinaxNOW Ag card.

Survey – DSHS Bamlanivimab Allocations in Texas Long-term Care Facilities

The Texas Department of State Health Services wants to ensure that all nursing facilities and other long-term care facilities have the chance to be included in future allocations of the novel monoclonal antibody bamlanivimab and possibly other novel therapeutics.

This month, the U.S. Health and Human Services announced its plan to ship bamlanivimab — the Eli Lilly monoclonal antibody treatment issued emergency use authorization by the FDA Monday, November 9 — to states as provided by the federal government. The federal government initially directed that the product be distributed only to hospitals or hospital-affiliated facilities; however, U.S. HHS is planning to change their initial policy and allow product to be distributed to other types of facilities as early as this week. These facilities may include nursing facilities and infusion centers, among others.

Because bamlanivimab is authorized for use in outpatients, DSHS would like to have a better understanding of outpatient settings that would be willing to act as a provider of this novel therapeutic. A survey of healthcare facilities is provided at the end of this alert that will allow facilities to report their interest in becoming a provider of this scarce resource.

Bamlanivimab is still a scarce resource with an extremely limited supply coming to Texas, and those supplies are being directed to regions with the greatest burden of COVID-19. Because of this, many healthcare facilities will not receive an allocation of bamlanivimab. However, nursing facilities and other long-term care facilities could be important partners in maximizing the potential of this therapeutic and DSHS would like to know which facilities would be willing to provide it to their residents.

DSHS would like to ensure that there are providers across the state that are able to provide this therapeutic to higher risk individuals.

Some of the information for which you will be asked in the survey includes your facility’s point of contact, address, phone number, email address, and pharmacy license number. Please read the bamlanivimab EUA and healthcare provider fact sheet prior to completing the survey to ensure that your facility and patient population will meet product use requirements.

If your facility has interest in becoming a provider of bamlanivimab, please respond to this survey.

DSHS and HHSC Long-term Care Regulation appreciate everything that you and your facility is doing to keep Texans healthy and safe. Thank you for your consideration of becoming a provider of this novel therapeutic.

December 2, 2020

Reminder: Requirements and Protocol for COVID-19 Emergency Staffing Requests

HHSC LTCR offers emergency staff for facilities facing severe critical shortages. Emergency staffing is only approved for facilities that can’t provide necessary care to residents due to staffing shortages. Emergency staffing is temporary while facilities get alternative staffing resources.

Facilities must have staffing contingency plans in place to address potential staffing shortages due to COVID-19. (42 CFR §483.73(b)(6)).

Facilities are required to have separate staff assigned to each COVID-19 cohort and not share staff between cohorts unless necessary to maintain adequate staffing (40 TAC §19.2802(i)).

Facilities may only request emergency staffing from HHSC if all the following contingency strategies have been exhausted.

  • Share staff between unknown COVID-19 status and positive COVID-19 cohorts (see CDC guidance).
  • Contact staffing agencies, nearby health care facilities, partners, or local colleges or health care centers to identify supplemental staff. (40 TAC §19.2802(j))
  • Identify alternate facilities with adequate staffing to care for residents with COVID-19.
  • Note: Nursing facilities must contact their LTCR Regional Director and local health department before using staff who are asymptomatic and have, or may have, COVID-19. This is generally only allowed in emergencies. Implement or attempt all other staffing contingency strategies listed above before this step.

If a facility has implemented or attempted each item listed above and still does not have adequate staff to meet critical staffing levels, the facility must contact the Regional Director for their LTCR Region to request emergency staffing.

If approved for emergency staffing, facilities must submit a transition plan for addressing shortages that includes the following.

  • Forecasted timeline for when COVID-19 positive staff will return to work, using the CDC’s Return to Work criteria, and when emergency staff can be released.
  • Acquiring temporary staff or recruiting new hires.
  • All other strategies for ensuring critical staffing shortages are fulfilled as soon as possible.

December 2, 2020

HRS Inc
Risk/Benefit Return to Activity Form (Free from our friends at HRS) 
This could be very helpful for considerations for returning to work, Day Hab, Volunteer Jobs, etc…
https://hrstonline.com/download/risk-benefit-return-to-activity-form/?wpdmdl=3104&refresh=5fc779cf9f80e1606908367

Risk/Benefit Return to Activity Form

 

November 22, 2020

COVID-19 Guidance for Activities, Dining, and Volunteers for the Holidays (PL 20-53)

HHSC publishes Provider Letter 20-53 Guidance for Activities, Dining, and Volunteers (PDF). The letter outlines provider responsibilities for resident activities, including communal dining and holiday-related activities.

The letter also gives specific stipulations on the use of volunteers and guidance on the protocol for residents who leave a facility.

This guidance can be used as a general reference through the duration of the COVID-19 pandemic.

HHSC Issues Guidance to HCS/TxHmL Providers on Covid-19!!!!

July 27, 2020

HHSC Long-term Care Regulation has updated the COVID-19 Response Plan for HCS residential providers (PDF). The document provides guidance on response actions in the event of a COVID-19 exposure.

Provider Letter 20-12, HHSC Guidance to HCBS and TxHmL Program Providers on Covid-19, is now available. HHSC encourages program providers to review this guidance. Remember, no non-essential visitors, see definition in the letter and providers must refrain from sending individuals to Day Habilitation and Community Events!  See link below.

https://hhs.texas.gov/about-hhs/communications-events/news/2020/03/hhsc-issues-guidance-hcs-txhml-providers-covid-19

July 28th, 2020      COVID-19 Update For Group Homes- HCS/ICF

The three IDD associations met with HHSC met on 7/28/20 to discuss ongoing COVID-related matters.  A summary of the discussions is presented below.  In reviewing please know that due to time constraints, not all agenda items were able to be discussed.  HHSC will provide the associations with a written update on these items by close of business on July 29, 2020.
 
These are 2 major concerns discussed along with the clarifications about those concerns relayed by HHSC.
1.  Regulatory Staff Entering Group Homes When Screening Requirements are not Met (in particular temperature requirements): Based on provider reports from some regions across the state, the 3 IDD associations requested this item be discussed. In response to these reports, HHSC Regulatory stated that no ICF/IID or HCS surveyor (or other persons) should be admitted into a group home if they do not pass screening requirements, and Regional Program Directors should not intervene (as reported in at least one case) by telling providers they have to let them in.  Before denying admission, however, providers should retake a surveyor’s temperature to rule out any misread of or error in the initial taking of one’s temperature.  Also, surveyors should not be wearing/using the same PPE as they go from home to home. They are required to change PPE prior to each home visit.  Persons experiencing issues with either of these matters are encouraged to contact:
Alyssa Naugle (WS&C) –  Alyssa.Naugle@hhsc.state.tx.us –  or
Renee Blanch-Haley (ICF/IID) –  renee.blanch-haley@hhsc.state.tx.us
2.  In-Home Visits by Guardians:  IDD association representatives discussed issues providers are facing with some guardians (whether ‘professional’ or family member guardians) becoming more insistent about wanting to enter group homes.  It was reported that, in some cases, guardians are just entering the homes or telling direct support staff that they have the  ‘right’ or the ‘authority’ to be in the homes, making it difficult at times for direct support staff to counter.  While all acknowledge the strain current visitor restriction policies place on individuals, guardians and other family members, HHSC encouraged providers and staff to remind guardians and other family members of the current in-home visitation restrictions and the other options available (such as virtual visits, outside visits with appropriate social distancing, etc.) for communicating and visiting with their loved ones.  HHSC added that providers should document these events. 

Reminder to LTC Facilities about Death Reporting Requirements

July 22, 2020

The following are HHSC’s requirements for care facilities to report resident/individuals’deaths to HHSC, including deaths from COVID-19.

  • Intermediate care facilities must report all deaths to Complaint and Incident Intake within one hour. See:
  • Home and Community-based Services and Texas Home Living Program Providers must report all deaths of people receiving HCS or TxHmL services to HHSC by the end of the next business day following the death or the program provider’s learning of the death. See IL 12-28.

***Note: If the death may have been from abuse, neglect or exploitation, more reporting requirements may exist.

COVID-19 HCS Interest List Reduction and Promoting Independence Slot Releases 

Information letter (IL) 2020-27 was released to provide updated information on Home and Community-based Services and Local Intellectual and Developmental Disability Authorities. It replaces IL 20-15, COVID-19 HCS Interest List Reduction Slots, previously issued on April 9 and revised on April 23, 2020.

HHSC is resuming the release of HCS Interest List Reduction Slots starting June 1, 2020. HHSC is continuing releases of HCS Promoting Independence Slots. LIDDAs will request the following HCS Promoting Independence Slots:

  • Crisis diversion
  • Nursing facility diversion
  • Young adults aging out of foster care
  • Nursing facility transition
  • Nursing facility transition for children
  • SSLC transition

 

The weekly webinars for Medicaid CHIP COVID-19 Information have been canceled and instead, HHSC will be providing a post to a  pre-recorded session online for viewing at your convenience to reduce the potential for technical difficulties. These information sessions will continue to share information about the actions taken to implement various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic. HHSC will continue to work on additional flexibilities across the programs and will update stakeholders each week on new implementations and issued guidance. Links to each week’s information session will be posted on the HHS COVID-19 Medicaid & CHIP webpage (https://hhs.texas.gov/services/health/coronavirus-covid-19/medicaid-chip-services-information-providers) by 1:00 p.m. CT on April 16, and each Thursday going forward.


LTC Providers Required to Report COVID-19 to HHSC

Effective immediately, a provider must report every confirmed case (only confirmed cases) of COVID-19 in staff and individuals receiving services from the provider as a self-reported incident. A presumptive or confirmed case is considered a critical incident.

Providers (other than HCS and TxHmL providers) must notify HHSC through TULIP or by calling Complaint and Incident Intake (CII) at         1-800-458-9858.

HCS and TxHmL providers must notify HHSC at waiversurvey.certification@hhsc.state.tx.us

Though not stated in the message below, in accordance with the April 8, 2020 HHSC COVID-19 HCS/TxHmL webinar, HCS and TxHmL providers are to include the following information when reporting confirmed COVID-19 cases to  waiver, survey and certification: 
~  Provider Name
~  Component Code
~  Contract #
~  Point of Contact Name and Contact Information
~  Individuals:  Name & CARE ID; Number at home; and Number in hospital
~  Number of Staff
 
Report Only Confirmed COVID-19 Cases to HHSC
Providers report only confirmed cases of COVID-19 in staff and individuals receiving services from the provider as a self-reported incident. This is effective immediately. Providers, other than HCS and TxHmL providers, must notify HHSC through TULIP or by calling Complaint and Incident Intake at 800-458-9858. 
HHSC previously required reporting of both presumptive and confirmed cases of COVID-19.
Providers are also required to report communicable diseases to the health authority with jurisdiction over their facility (LOCAL HEALTH DEPT.) This is in accordance with the Communicable Disease and Prevention Act, Texas Health and Safety Code, Chapter 81. It’s also specified in Title 25 of the Texas Administrative Code, Chapter 97.

List of Local Health Authorities for COVID-19 from DSHS

https://www.dshs.texas.gov/regions/Coronavirus-(2019-nCoV)-Local-Health-Entities/

See Link below to handout on the role of the Local Health Authorities 

https://www.dshs.state.tx.us/region1/documents/tmp-LocalHealthAuthority.pdf 

FAQ’s For Covid-19

04/02/20

From Stakeholder’s Meetings March 16th-31st  (Draft)

 

Contact Information For Other Questions:

 

Can individuals eat meals together?

Answer: As stated in PL 20-22, HHSC recommends canceling communal dining, however, HHSC is not prohibiting individuals in a three-person, four-person, or host home/companion care residence from dining together. HHSC recommends that if individuals dine together, staff members help ensure that the individuals practice social distancing at the dining table. HHSC also recommends that staff members plate the individuals’ food and help ensure they do not share serving spoons, utensils, plates, cups, or other related items.

Do local shelter-in-place orders prohibit an individual from leaving and returning to the home?

Answer: Shelter-in-place orders issued by local governments may vary, but in many instances require individuals to stay home unless they need to take care of a medical-related issue, go to the grocery store, or exercise outdoors while practicing social distancing. Many also require non-essential businesses to close. They do not prevent persons from returning to their residence. Program providers will need to comply with the restrictions and orders issued by their local government. Departures that are not health-related are strongly discouraged, and HHSC recommends that if an individual chooses to temporarily leave a three-person, four-person, or host home/companion care residence, the individual be allowed to return to the residence. If an individual leaves a residence temporarily for any reason, the individual must be screened upon return. If the individual meets any of the screening criteria described on page 2 of PL 20-22, HHSC recommends that the program provider isolate that individual in one area of the residence to protect other individuals in the residence.

Can providers tell people not to return for a period of time after vacation, home visit, etc.?

Answer: HHSC recommends that a program provider advise an individual of any local social distancing requirements, public gathering restrictions, or shelter-in-place orders. Departures that are not health related are strongly discouraged, and HHSC also recommends that if an individual chooses to temporarily leave a three-person or four-person residence or residence in which host home/companion care is provided, the individual be allowed to return to the residence. If an individual leaves a residence temporarily for any reason, the individual must be screened upon return. If the individual meets any of the screening criteria listed on page 2 of PL 20-22, HHSC recommends that the program provider isolate that individual in one area of the residence to protect other individuals in the residence.

What signage should be posted at the entrance of a home?

Answer: HHSC’s recommendations about signage at a three-person or four-person residence or a residence in which host home/companion care is provided are addressed on page 3 of PL 20-22.

If there is a fire or an emergency medical situation, do emergency responders need to be screened before entering a home?

Answer: Three-person, four-person or host home/companion care homes should not require screening of emergency services personnel in the event of an emergency.

Who is expected to screen PAS/HAB staff at an own home or family home?

Answer: HHSC does not have requirements governing the screening of these staff before they enter an individual’s own home or family home. HHSC recommends that the program provider assist the individual or the individual’s family members in monitoring the health of CFC PAS/HAB service providers as much as possible.

Are individuals required to continue receiving all services, or will there be exceptions for non-essential services?

Answer: As stated in PL-20-22, program providers are required to ensure that an individual’s critical needs are met. HHSC is not prohibiting the provision of non-critical services to individuals; however, providers must comply with any social distancing requirements, public gathering restrictions, or shelter-in-place orders issued by local governments. Providers can arrange for non-critical services to be delivered to an individual through a method other than an in-person visit to a health care professional, such as by telephone, Skype etc.

Can providers suspend routine doctor visits/therapy visits and/or use electronic visits instead?

Answer: Program providers can reschedule appointments for non-critical services, including routine doctor and therapy visits, or arrange for those services to be delivered through a method other than an in-person visit, such as by telephone, Skype etc.

Are individuals allowed to attend day hab if they want to attend?

Answer: HHSC has issued IL 20-09, which explains changes to allow day habilitation to be provided in the home. HHSC recommends program providers protect individuals by refraining from attending day habilitation, and events in public where more than 10 people are gathered. HHSC is not prohibiting the provision of non-critical services to individuals, which might include day habilitation. However, program providers must comply with any social distancing requirements, public gathering restrictions, or shelter-in-place orders issued by local governments.

Can providers bill for in-home day habilitation for host home companion care? If so, when?

Answer: HHSC has issued IL 20-09, which explains changes to billing requirements for the provision of day habilitation in an individual’s residence.

I have staff who have called in sick and simply can no longer work due to child care issues. What do I do when there are not enough staff for coverage?

Answer: As stated in PL-20-22, program providers are required to staff homes and ensure that an individual’s critical needs are met.

We have quite a few service recipients working. The guidance calls for limiting visitors but does not speak to whether providers should try to keep people home from work. What do we do?

Answer: HHSC recommends that a program provider advise an individual of any local social distancing requirements, public gathering restrictions, or shelter-in-place orders. Further, if an individual chooses to leave a three-person, four-person, or host home/companion care residence to work, HHSC recommends the individual be allowed to return to the residence but be screened upon the return. If the individual meets any of the screening criteria described on page 2 of PL 20-22, HHSC recommends that the provider isolate the individual in one area of the residence to protect other individuals in the residence.

How do HCS and TxHmL program providers get personal protective equipment (PPE)?

Answer: Program providers can contact the following organizations to ask about obtaining PPE:

  • State of Texas Assistance Request (STAR)

https://olympus.soc.texas.gov/files/docs/StarGuides/2020_STAR_SOC_QuickReference_Guide.pdf

  • Public Health Region

https://www.dshs.state.tx.us/regions/default.shtm

  • Local Public Health Organizations

https://www.dshs.state.tx.us/regions/lhds.shtm

  • Texas Division of Emergency Management:

https://tdem.texas.gov/

  • Regional Advisory Councils

https://dshs.texas.gov/emstraumasystems/etrarac.shtm

Where do HCS and TxHmL program providers go for COVID-19 information?

Answer: Reliable sources of information include:

  • The Centers for Disease Control and Prevention
  • The Texas Department of State Health Services
  • The Health and Human Services Commission

Who do I call if staff or individual tests positive for COVID-19?

Answer: Contact the local health department, or the Department of State Health Services (DSHS) if there is no local health department. Additionally, program providers must also report this information to HHSC at:waiversurvey.certification@hhsc.state.tx.us

 

HHS 3 Line Logo

ICF COVID-19 Info from HHSC

April 13, 2020

A recording of the April 9, 2020, ICF/IID COVID-19 Q&A with HHSC LTC Regulatory and DSHS is now available. It’s for those who could not attend the webinar.

View the COVID-19 Q&A recording here.

TCDD
The Texas Council for Developmental Disabilities (TCDD) is seeking stories about the impact of COVID-19 on persons with disabilities.  The information will be used to inform state agencies, legislators and other state leaders about the needs of the ID/DD population as they make critical decisions regarding policy and funding related to this crisis.
We encourage you to share this information with persons you serve and their families. 
To access details about this TCDD initiative, go to:  https://tcdd.texas.gov/resources/covid-19-information/texas-covid-stories/

HHS 3 Line Logo

New Guidance for LTCR Providers on Coronavirus

LTCR urges all providers to review the Centers for Disease Control’s new guidance on strategies to prevent the spread of COVID-19 in long-term care facilities. To ensure you have the most current information on COVID-19, visit the CDC and DSHS websites. For questions or guidance, call one of the DSHS hotlines:

  • 888-963-7111
  • 877-570-9779

All providers must continue to follow all laws, regulations, guidance and their own internal policies and procedures related to infection control.

 

From The CDC website:

Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs)

COVID-19 cases have been reported in all 50 states, the District of Columbia, and multiple U.S. territories; many having wide-spread community transmission. Given the high risk of spread once COVID-19 enters a LTCF, facilities must act immediately to protect residents, families, and staff from serious illness, complications, and death.

  1. Keep COVID-19 from entering your facility:
    • Restrict all visitors except for compassionate care situations (e.g., end-of- life).
    • Restrict all volunteers and non-essential healthcare personnel (HCP), including consultant services (e.g., barber, hairdresser).
    • Implement universal use of source control for everyone in the facility.
    • Actively screen anyone entering the building (HCP, ancillary staff, vendors, consultants) for fever and symptoms of COVID-19 before starting each shift; send ill personnel home. Sick leave policies should be flexible and non-punitive.
    • Cancel all field trips outside of the facility.
  1. Identify infections early:
    • Actively screen all residents daily for fever and symptoms of COVID-19; if symptomatic, immediately isolate and implement appropriate Transmission-Based Precautions.
      • Older adults with COVID-19 may not show typical symptoms such as fever or respiratory symptoms. Atypical symptoms may include new or worsening malaise, new dizziness, or diarrhea. Identification of these symptoms should prompt isolation and further evaluation for COVID-19.
    • Notify your state or local health department immediately (<24 hours) if these occur:
      • Severe respiratory infection causing hospitalization or sudden death
      • Clusters (≥3 residents and/or HCP) of respiratory infection
      • Individuals with suspected or confirmed COVID-19
  1. Prevent spread of COVID-19:
    • Actions to take now:
      • Cancel all group activities and communal dining.
      • Enforce social distancing among residents.
      • Ensure all residents wear a cloth face covering for source control whenever they leave their room or are around others, including whenever they leave the facility for essential medical appointments.
      • Ensure all HCP wear a facemask or cloth face covering for source control while in the facility. Cloth face coverings are not considered personal protective equipment (PPE) because their capability to protect healthcare personnel (HCP) is unknown. Cloth face coverings should NOT be worn instead of a respirator or facemask if more than source control is required.
    • If COVID-19 is identified in the facility, restrict all residents to their rooms and have HCP wear all recommended PPE for care of all residents (regardless of symptoms) on the affected unit (or facility-wide depending on the situation). This includes: an N95 or higher-level respirator (or facemask if a respirator is not available), eye protection, gloves, and gown. HCP should be trained on PPE use including putting it on and taking it off.
      • This approach is recommended because of the high risk of unrecognized infection among residents. Recent experience suggests that a substantial proportion of residents could have COVID-19 without reporting symptoms or before symptoms develop.
      • When a case is identified, public health can help inform decisions about testing asymptomatic residents on the unit or in the facility.
  1. Assess supply of personal protective equipment (PPE) and initiate measures to optimize current supply:
    • If you anticipate or are experiencing PPE shortages, reach out to your state/local health department who can engage your local healthcare coalition.
    • Consider extended use of respirators, facemasks, and eye protection or prioritization of gowns for certain resident care activities.
  1. Identify and manage severe illness:
    • Designate a location to care for residents with suspected or confirmed COVID-19, separate from other residents.
    • Monitor ill residents (including documentation of temperature and oxygen saturation) at least 3 times daily to quickly identify residents who require transfer to a higher level of care.

Winter Storm Federal Disaster Assistance Information

by

Image result for disaster relief clipart

February 21st, 2021

Winter Storm Federal Disaster Assistance Update

Posted on HHSC Provider Alerts:

“In response to Texas’ request for a federal disaster declaration related to the recent winter storm, the Office of the Governor announced that the President has approved a Major Disaster Declaration for Individual Assistance in 77 counties and for Public Assistance (Emergency Protective Measures Only) in all 254 counties.

The following counties were approved for Individual Assistance:

Angelina, Aransas, Bastrop, Bee, Bell, Bexar, Blanco, Brazoria, Brazos, Brown, Burleson, Caldwell, Calhoun, Cameron, Chambers, Collin, Comal, Comanche, Cooke, Coryell, Dallas, Denton, DeWitt, Ellis, Falls, Fort Bend, Galveston, Gillespie, Grimes, Guadalupe, Hardin, Harris, Hays, Henderson, Hidalgo, Hood, Jasper, Jefferson, Johnson, Kaufman, Kendall, Lavaca, Liberty, Madison, Matagorda, Maverick, McLennan, Montague, Montgomery, Nacogdoches, Nueces, Orange, Palo Pinto, Panola, Parker, Polk, Rockwall, Sabine, San Jacinto, San Patricio, Scurry, Shelby, Smith, Stephens, Tarrant, Travis, Tyler, Upshur, Van Zandt, Victoria, Walker, Waller, Wharton, Wichita, Williamson, Wilson, and Wise Counties.

Individuals and business owners in counties included in the President’s declaration who sustained losses in the designated area can begin applying for assistance by registering online at www.DisasterAssistance.gov or by calling 1-800-621-3362 or 1-800-462-7585.

For more information on presidential disaster declarations, including the distinction between Individual and Public Assistance, see FEMA.gov.

 

In addition, the Office of the Governor and the Texas Division of Emergency Management (TDEM) are encouraging Texans to complete the Self Reporting Damage Survey to help the state identify damages across Texas and help emergency management officials gain an understanding of damages that occurred during the recent winter weather. This data is also needed to provide information to FEMA and highlight the need for federal disaster assistance for individuals in all 254 counties, including the ones that have not yet been included in the President’s disaster declaration.

Businesses and individuals are encouraged to fill out the Self Reporting Damage Survey. The voluntary survey, available in both English and Spanish, can be accessed by visiting www.TDEM.texas.gov/warm. (NOTE: Reporting damage to the Texas Division of Emergency Management is a voluntary activity, is not a substitute for reporting damage to an insurance agency, and does not guarantee disaster relief assistance.)”

Resources For Emergencies (Includes Recent Winter Storm)

by

HHSC Notice:  In the event you did not receive or inadvertently overlooked, see below for the notice HHSC issued earlier today regarding resources for LTC providers during the winter storm, or click HERE

LTC Provider Resources During an Emergency

Long-term care providers impacted by the current severe weather event should be implementing emergency management plans. LTC providers in need of resources or assistance during an emergency, such as the current severe weather, are reminded that you can:

  • Contact your LTCR regional office regarding events that are affecting residents (such as no heat, evacuation, frozen fire sprinkler systems, etc.). They can initiate an emergency request.
  • Contact your local emergency management or Regional Advisory Council, who can initiate a STAR request.
  • Contact your local power company if you are having power issues. Nursing facilities, assisted living facilities, and inpatient hospices should inform the power company that you are a LTC provider, as those providers are prioritized for service restoration per the Public Utility Commission rules.
  • Contact your Texas Department of Emergency Management District Coordinator if you are having challenges getting generator fuel.

If you need guidance or assistance in relocating residents, work with your LTCR Regional Director. All requests to exceed licensed capacity must be approved by the Director of Survey Operations. If your facility is projected to exceed its licensed capacity because it is accepting residents who have been evacuated from another facility, email Renee Blanch-Haley and include State Capacity Increase Request in the subject line.

Please refer to Provider Letter 2018-19 (PDF) as applicable and to your program’s rules for additional important information regarding emergency preparedness. If you have any questions, contact your LTCR regional office, email LTCR Policy Rules and Training or call 512-438-3161.

E-Learning From HHSC-New Providers Please Take These Trainings

by

The e-learning portal.
This is where Abuse, Neglect, Exploitation Training ( the ANE training) for you and your staff is. All staff at the facility should take this at least initially and maybe every 1-2 years
1. The portal also has direct service worker training (good for all your SL, RSS, CFC staff in particular)
2. Program Manager and Owner are required to take the HHS Contractors training.
3.  I would also have Program Manager, Case and Nurse as well as anyone else involved in developing the IP’s, like the RN, take the Person-Centered Training.  CFC rules mandate that persons involved in the development of the PDP and IP take Person-Centered Thinking Training.  Currently, this should be done within a year of their hire date or in that position at your facility. There is also an introductory training on the site for those working with the individuals and implementing the IP- Direct Support Workers, Families, Individuals, LAR’s/Guardians.
4. There is a short introductory Person-Centered training as well in there for direct support staff and HH/CC providers and family.  Your course is the one with the extensive modules to complete.
5.  These are the courses you should take below and they are all free.

HCS Provider Applicant- Provider Applicant Training (PAT) and Test Information Update

by

Feb 9th, 2021

HCS/TxHmL-Provider Applicant Training (PAT) and Provider Applicant Test (Update)

 

“My application was accepted to become an HCS &/or TxHmL Waiver Provider, now what do I do?”

 

Online Training FAQ’s
How can I access the HHS Learning Portal?
Once your Contract Manager has informed you via email of your approved application, you will receive an email approving your application with a link to the HHS Portal, and the Program Manager will have to create an account to complete the training. Please contact IDDWaiverContractEnrollment@hhsc.state.tx.us, or call 512-438-3234 to confirm with your assigned Contract Manager.
What are the steps to complete the training?
• Once you set up your new account, find and select the Medicaid Long Term Services and Support Training under “Course Categories.”
• Select the Provider Applicant Training (PAT) link. The training is compiled in three different steps. Helpful tips are available on this page.
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
➢ Each module must be completed to advance to the next module.
Step 3: Evaluation and Certificate
➢ Complete the mandatory survey to gain access to the Provider Applicant Training Certificate
➢ Make sure to save your certificate of completion
➢ You will be notified via email of your test dates
How many modules are in the course?
There are 12 modules.
How long can I take to complete the training?
The training can be completed at your own pace.
TEST FAQ’s
Note: The program manager will not be allowed to take the test until the training has been completed and a certificate of completion has been generated.
How long do I have to complete the test?
You will have 40 minutes to complete the test. No additional time will be allotted.
May I change my answers?
Yes, but only within the 40 minutes allotted.
How do I get my score?
The system will grade your test immediately after completing it.
The program manager passed the test, what is the next step?
Your HHS Contract Manager will contact you via email to explain the next steps, which will include scheduling a pre-award site visit.

Is there a retake if I failed the test?
There will be two opportunities to take the test. If you fail a second time you will be required to retake the training
.After completion of the training you will have an opportunity for a third test.
If you do not pass the third test attempt, please submit a new application if you would still like to become a provider.
** DO NOT submit a copy of the previously denied application. Previously denied applications submitted will be rejected and cause a significant delay in your enrollment. To reapply, visit our resources found on our website, along with instructions on how to fill out the forms  For more information see the link below:

“Study & Prep Session For HCS Provider Applicant Test” (Pre-Recorded Webinar)

Contact us to purchase a link to the previously recorded session on February 1st, 2021

(We will be reviewing some TxHmL information as well)

Cost:  $150/person

 

Topics:      

Description of HCS & TxHmL Waivers and Basic Terminology Needed

Tips for Preparing For The HCS Provider Certification Test.  

Important Sections of the HCS & TxHmL Handbook,

Frequently Asked Questions found on the HHSC HCS/TxHmL home pages.  

Frequently Cited TAC Codes  (HCS & TxHmL)

How to Access  Important Information on the HHSC Website: Joint Training Opportunities, HCS/TxHmL Waiver Training, Resources, Contact Information, etc.. 

Information on Person-Centered Training Opportunities and The Importance of This Training

What Happens After I Pass My Test?

HCS Practice Test during the session, so that you may become comfortable with the type of questions that may be asked during the PAT testing session

 

Don’t forget to study for your test!!!

Links to TAC (Texas Administrative Codes)  provided below to Study 

HCS  https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=40&pt=1&ch=9&sch=D&rl=Y

TxHmL: https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=40&pt=1&ch=9&sch=N&rl=Y

 

HCS Provider Applicant- Provider Applicant Training (PAT) and Test

Okay, for those of you who are going through the HCS or TxHmL provider applicant process and had your application approved, a lot of people are contacting me inquiring about when the orientation (PAT) and testing are going to happen as some of you have been waiting a very long time.

Just FYI- I am unclear about testing, as we have been getting lots of different possible release dates for the Test.  It should be available online sometime between December 2020 and February 2021, but I have also heard that it could still be on hold due to COVID-19.  There will be some sort of “Proctor” (test monitor) during the testing.

What I do know is that the orientation or what is now called the Provider Applicant Training, has been available online since at least April or May of this year, through the HHSC e-learning portal.  You must receive a letter via email inviting you to the training and/or testing.

**If you received your application approval letter with a link to the online portal PAT training when they just started and you have completed your Provider Applicant Training (PAT) and printed the certificates, and still have not received an invitation to take the test yet, please go back and login to the e-learning orientation in the portal. If you log in and it no longer says 100% complete, and now says something like 80% complete, you will need to go back into the complete it.

HHSC has apparently added some new steps at the end of the Provider Applicant Training (PAT), that were not there when some of you completed your initial orientation and printed your certificates. There is an evaluation for step 3 and I believe there is a step 4. I think step 4 is some kind of attestation that you are the individual that will be taking the HCS or TxHmL applicant test and that you will not look at any other material while taking the test.  FYI- The “Program Manager” listed in your HCS application is the person who must take the test by the way.

I am unclear as to why there was no notification of the changes in the e-learning process and that you would have to go back and complete that before HHSC can approve you at 100%, but that could be why you have not heard back about testing for quite some time.

In addition, there are 2 persons listed as test approvers for the portal, I believe in just the past few days, according to some of you who have done the online orientation process.  My guess is this probably means that HHSC is getting very close to getting back to Provider Applicant Testing, but that it will be online. I am hopeful that many of you out there can finally take your test and get your certification to become a provider.  I know some applicants have been in limbo for quite some time.

As I said at previously, the last information we received indicated the test will be online and will start being offered sometime between Dec. 2020 and Feb. 2021.  The PAT applicant will have to schedule a time to go to a testing “site” and to take the test online with a “proctor” in the room or the proctor may be watching “online” to monitor the person taking the test.

Start studying now, if you haven’t already!!

Remember to get prepared and please study. You may have been waiting a long time to test, but I know that applicants sometimes don’t study as much as they need to, to take the test.  If you have come this far, you do not want to fail the test and have to start all over again!  Please contact us if you need help in preparing for the test.  We do provide services such as study prep sessions, practice tests, etc… 

Be sure to study the HCS Handbook and the Texas Administrative Codes for HCS (& TxHmL if you applied for this certification as well).     See links below:

Go to this site.  These sections are the HCS Handbook and are a “non-legalize” explanation of the HCS Texas Administrative Code.  They also tell you who is responsible for what. LIDDA Vs. Provider.   But your specific questions for the test will most likely be coming from the HCS TAC code.  This is just a better explanation to make you understand those rules.

https://hhs.texas.gov/laws-regulations/handbooks/home-community-based-services-handbook

New Revised TAC (Texas Administrative Code) for HCS

(Home & Community Based Services) was put into effect in October 2019.

 Title 40 Part 1 Chapter 9 Subchapter D

https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=40&pt=1&ch=9&sch=D&rl=Y

Section 9.151 through 9.192.

New Revised TAC (Texas Administrative Code) for TxHmL

(Texas Home Living Waiver was put into effect in October 2019.

https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=40&pt=1&ch=9&sch=N&rl=Y

 Title 40 Part 1 Chapter 9 Subchapter N 

Section 9.551 through 9.587

 

ICF/IID Updates

by

February 8th, 2021

Draft ICF/IID Rule Changes

Attached please find the following:
Proposed changes of significant importance to ICF/IID providers are those under section 551.42 related to Infection Prevention and Control and section 551.236 related to Administrative Penalties.  See below for details.
Section 551.42:  According to HHSC this section incorporates provisions in  HB 1848  (86th – Klick) as well as clarifies the intent of 42 CFR §483.470 (l) which contains requirements to which ICF/IID providers must already adhere.  Please review the provisions under this section (starts at bottom of page 34) carefully.  Note:  As shared via a previous notice about House bills filed between January 5, 2021 thru January 31, 2021, Representative Campos has filed HB 1221 relating to communicable disease and infection prevention and control measures for certain long-term care facilities; authorizing an administrative penalty. The bill applies to ICFs/IID, NHs and ALFs.
Section 551.236:  The changes are the result of HB 3803 (86th – Guillen & Klick) which were intended to reinstate administrative penalty caps in the ICF/IID program that existed prior to Sunset for the legacy Department of Aging and Disability Services (DADS) in 2015.  As proposed in the attached rule, however, the rule allows the total penalty amounts allowed by law to be levied on a per day basis which conflicts with the intent of HB 3803.  In other words, and as recognized by HHSC during the 86th legislative process, the administrative penalty cap would be a total cap on penalties, not penalties accrued per day (though penalties prior to the cap are accrued on a daily basis).   See page 99 of the attached draft rule
.
In a conversation the three IDD associations had with HHSC regarding this matter, HHSC acknowledged that the rule was not consistent with the intent of HB 3803.
HHSC agreed to discuss the matter internally and report back to the three provider associations.  Concerned that HHSC will not implement the rule as intended, the three IDD associations will either pursue an amendment to the current statute to ensure intent clarity of Chapter 252, Health and Safety Code, Section  252.065 or request a letter of intent from the authors of HB 3803, or both.
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  

HHSC Email  Update
“These information letters listed below, provide confirmation of the agency’s intent to seek CMS approval for a retainer or bed hold payment, discusses the emergency rule, and directs providers to share prepared information with clients who are affected by these changes. We understand that the turnaround time to inform clients and their families is minimal; however, we wanted to give families time to decide next steps and providers time to adjust to the families’ decision.”  (November  1st, 2020 is the deadline).  Basically if the individual has been away from the facility during COVID-19, they will need to make a decision of whether they are coming back to occupy a “bed”, pay themselves to keep the “bed” or if they will discontinue services (discharge) without receiving any ICF services at this time.  There is a sample letter to send to the individual and their families to get them ready to make this decision.

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)

(Section) Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs)
31.Question:
How should an ICF handle the discharge summary when a client is admitted on a temporary emergency basis from the community or another ICF?

Answer: Regulations regarding ICF/IID discharge have not been waived. A discharge, even on a temporary emergency basis, requires that key developmental, behavioral, social, health and nutritional information be shared with the accepting facility in the community or non-facility provider. CMS is aware that staffing shortages and/or client surges due to the PHE create a high demand on available staff time that makes it difficult to complete a full discharge summary for each client. Each ICF will need to evaluate what amount and detail of documentation is necessary to ensure that critical health information is shared with the accepting facility or other provider. When available and if appropriate, the Interdisciplinary Team (IDT) should maximize the use of telehealth for the completion of a client’s discharge plan during the PHE.

32.Question:
How should an ICF handle the development of a Comprehensive Functional Assessment (CFA) and an Individual Program Plan (IPP) when a client is admitted on a temporary emergency basis from the community or another ICF?
Answer: Clients who are admitted on a temporary emergency basis to an ICF during the PHE will nonetheless continue to need to have a Comprehensive Functional Assessment (CFA) and an Individual Program Plan (IPP) in accordance with 42 CFR 483.440(c). Completion of these documents will provide an opportunity for the IDT and staff to meet the basic and critical care needs of the client. CMS is aware that staffing shortages and/or client surges due to the PHEmay create a high demand on available staff time that makes it difficult to complete a full CFA and IPP. Each ICF will need to evaluate what amount and detail of documentation is necessary to ensure that critical health and treatment information is identified to allow active treatment during the PHE. This health and treatment information will support successful adjustment for the client to the new temporary living environment. When available and if appropriate, the IDT should maximize the use of telehealth for the development of a client’s IPP for temporary emergency admissions during the PHE.
33.Question:
During the PHE are ICFs still required to have and use a specially constituted committee or committees?
Answer: Yes. CMS believes that the use of this committee may be of value during the time of the COVID-19 PHE. The committee can provide an opportunity to support and make suggestions to facilities as they may need to adapt policies and procedures as well as why and how services are being provided to clients, which clients may find difficult to understand and potentially lead to inappropriate adaptive behavior. When available and if appropriate, the specially constituted committee should maximize the use of telecommunications to convene this committee as a resource to support the challenges faced by staff and clients during the PHE.
34.Question:
When a client has tested positive for COVID-19 and the ICF/IID implements quarantine procedures, client rights are immediately abridged and severe behaviors are likely to occur. What is the guidance from CMS on balancing the CDC expectations with the rights of the individual?
Answer: The health and safety of the clients, visitors, and staff at an ICF/IID are of the utmost importance for CMS. Based on the ICF Emergency Preparedness plan, and in accordance with the requirement at 42 CFR 483.440(c)(3)(v) that the IPP assess the client’s health status in the context of a COVID-19 diagnosis, the ICF/IID must revise the client’s IPP to reflect specific procedures and steps that will be taken to quarantine the client while also taking every step reasonable to protect the rights, safety, and health of the infected client, as well as those of the staff and other clients. ICF/IIDs are encouraged to use telehealth and assistive technology to minimize social isolation to the extent possible.
35.Question:
Are intermediate Care Facilities required to participate in the COVID-19 CDC National Healthcare Safety Network (NHSN) reporting requirements?
Answer: ICF/IIDs do not have a regulatory requirement for the reporting of communicable diseases, healthcare-associated infections, and potential outbreaks to Federal (such as the CDC), State and/or local health departments. ICF/IIDs do have a requirement under 42 CFR 483.420(c)(6), which addresses communication to family and/or guardian when a client’s condition changes, including the onset of serious illness (such as COVID-19). Although reporting to CDC is not required, ICF/IIDs may voluntarily report COVID-19 cases to the CDC, and CMS encourages them to do so to facilitate public health tracking of the pandemic. You may find the following CDC resource links helpful:
https://www.cdc.gov/nhsn/pdfs/covid19/ltcf/covid19-enrollment-508.pdf and
https://www.cdc.gov/nhsn/pdfs/covid19/ltcf/cms-covid19-req-508.pdf.
Rural Health Clinics (RHC)/Federally Qualified Health Centers (FQHCs)
36.Question:
Has CMS implemented any flexibilities to help RHCs and FQHCs respond to the PHE posed by COVID-19?

Answer: Yes. CMS has temporarily waived certain regulatory requirements providing flexibilities to assist RHCs and FQHCs in furnishing services during the COVID-19 PHE. This includes temporarily modifying the following:(a)50% mid-level staffing requirement for RHCs;(b)Physician supervision requirement for nurse practitioners (NPs), to the extent permitted by State law; and(c)Location requirements for existing RHCs and FQHC to allow additions of temporary service locations.Please see https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf for additional waiver information. Additional flexibilities, including guidance for RHCs and FQHCs furnishing telehealth services during the PHE, are also described in this CMS MLN Article: https://www.cms.gov/files/document/se20016.pdf

37.Question:
When do these flexibilities go into effect?
Answer: The flexibilities for staffing requirements, physician supervision of nurse practitioners, and temporary expansion sites are retroactively effective beginning March 1, 2020, through the end of the emergency declaration and CMS issues an end of outbreak notification.
38.Question:
Do these flexibilities apply to all RHCs and FQHCs?
Answer: The flexibilities for physician supervision of NPs apply to all RHCs and FQHCs, to the extent permitted by state law. Flexibilities to the 50% mid-level staffing requirement apply to RHCs only as the mid-level requirement is RHC specific. Lastly, flexibilities to the location requirement apply to existing RHCs and FQHCs.
39.Question:
How does the mid-level practitioner 50% flexibility benefit an RHC? Are RHCs required to submit any documentation to CMS for this waiver?
Answer: This waiver provides RHCs with flexibilities with regards to the percentage of operating hours the facility has a mid-level practitioner available to furnish patient care services. While the waiver offers flexibilities with staffing mixes, a physician, NP, physician assistant, certified nurse midwife, clinical social worker, or clinical psychologist must be available on site to furnish patient care services whenever the RHC is open and operating. CMS does not require any submission of documentation for this waiver.
40.Question:
How does the waiver affect the physician supervision of NPs?
Answer: During the PHE, NPs may function to the fullest extent possible without physician supervision, and to the extent of applicable state law. However, the physician continues to be responsible for providing the overall medical direction for the RHC/FQHC’s health care activities, consultation for, and medical supervision of all other health care staff, either in person or through telehealth and other remote communications.
41.Question: Can an RHC/FQHC provide patient care services at temporary locations?

Answer: Yes. During the COVID-19 PHE, CMS is allowing currently approved RHCs/FQHCs to provide patient care services in temporary expansion sites to help address the urgent need for supplementary care. These temporary sites are not restricted to the rural/shortage area location requirements. Each location is obligated to follow RHC/FQHC regulations to the extent not waived. Therefore, the RHC/FQHC may provide services provided at a temporary location under the CMS Certification Number (CCN) for the permanent location. The RHC/FQHC is expected to be operating in a manner not inconsistent with its state’s emergency preparedness plan. Note: FQHCs must also have an updated Health Resource and Service Administration (HRSA) Notice of Award, expanding the scope of service to include the temporary location(s) to support response to the COVID-19 PHE.

42.Question:
Do these flexibilities apply to temporary locations established in a parking lot?
Answer: Yes. During the COVID-19 PHE, CMS is allowing RHC/FQHCs to establish temporary expansion sites in a parking lot; either on or off its premises. As with other temporary expansion locations, the parking lot site must meet the same RHC/FQHC regulations as the main site, unless otherwise waived. Therefore, the RHC/FQHC may provide for those services via the existing CCN of its approved permanent location. RHC/FQHC is expected to be operating in a manner not inconsistent with its state’s emergency preparedness plan.
43.Question:
Can an RHC/FQHC provide patient care services to a patient in the patient’s vehicle?
Response:During the COVID-19 PHE, to help minimize transmission, an RHC/FQHC visit can take place if the patient is in a vehicle on the premises of the RHC/FQHC and all requirements for a billable visit are met (e.g. medically-necessary, face-to-face visits with an RHC/FQHC practitioner). The RHC/FQHC would provide the services using its existing CCN. All services provided are held to all RHC/FQHC regulations, unless otherwise waived. This includes, but is not limited to, the provisions of services as per 42 CFR 491.9(c). RHCs/FQHCs must consider the clinical appropriateness of services before conducting a visit and/or treating a patient in their vehicle.
44.Question:
Will a RHC or FQHC seeking approval of its temporary location as being consistent with the emergency response and pandemic plan be provided with evidence of approval or denial from the state?
Answer: State emergency plans and processes will vary. RHCs/FQHCs should retain any communications with the State emergency preparedness representatives to demonstrate that its temporary location(s) are not inconsistent with the state emergency preparedness and pandemic plan for the COVID-19 PHE. Once the state has approved the addition of temporary location(s), there are no additional CMS enrollment or reporting requirements. The RHC/FQHC may begin utilizing the temporary expansion location throughout the duration of the COVID-19 PHE.
45.Question:
May an RHC or FQHC continue providing RHC/FQHC services at the temporary location once the COVID-19 PHE ends?
Answer: No. All waived CoPs, CfCs, requirements, and most temporarily revised regulations will terminate at the end of the PHE. If the RHC/FQHC wishes to continue services at the temporary expansion location after the PHE has ended, the facility must submit form 855A to begin the process of enrollment and initial certification as a RHC or FQHC under the regular process and meet all applicable requirements, including 42 CFR 491.5.
46.Question:

My RHC participates in Medicare through one of the two CMS-approved RHC Accreditation Organizations (AOs). Do waivers of CMS regulations apply to CMS-approved accrediting programs? Do I need to notify the AO of my desire to temporarily add a service location during the COVID-19 PHE?

Answer: The flexibilities apply to both accredited and non-accredited RHCs. Notifying your AO of the temporary location is recommended.
47.Question:
Where can I find answers to COVID-19 flexibilities regarding Medicare Fee-for-Service (FFS) billing for RHCs and FQHCs?

Answer: To assist RHCs and FQHCs in furnishing service during the COVID-19 PHE, CMS has provided additional flexibilities related to billing for services. These temporary flexibilities currently include Expansion of Virtual Communication Services for RHCs and FQHCs to include online digital evaluation and management services using patient portals, and Revision of Home Health Agency Shortage Area Requirement for Visiting Nursing Services Furnished by RHCs and FQHCs. Please see the Medicare FFS Billing FAQ document available at https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf. Please see Section II.L of the Interim Final Rule with Comment Period, “Medicare and Expanded Flexibilities for Rural Health Clinics (RHCs) Medicaid Programs; Policy and Federally Qualified Health Centers (FQHCs) During Regulatory Revisions in Response to the COVID-–19 Public Health Emergency (PHE)”(85 FR 19230, 19253), available at https://www.federalregister.gov/documents/2020/04/06/2020-06990/medicare-and-medicaid-programs-policy-and-regulatory-revisions-in-response-to-the-covid-19-public, for more information on regulatory changes for RHCs and FQHCs.

Webinar info:  How to prevent infectious diseases and the spread of infectious diseases in ICF-Specifically COVID-19 (May 27th, 2020)

See the following pdf link from HHSC

https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/icfiid-covid-updates-qa-webinar-may-27-2020.pdf

March 13th ICF FAQ’s  See link below:
https://hhs.texas.gov/sites/default/files/documents/services/health/coronavirus-covid-19/covid-icf-iid-faq.pdf

Survey Operations Resume as of June 15th, 2020

From HHSC
As of June 15, 2020, Survey Operations has begun to resume some normal survey activity, and Enforcement is also resuming enforcement processes and activities. This means we will be issuing various due process notice letters to individuals, agencies, and facilities that have been on hold due to COVID.
Please contact Enforcement Director Derek Jakovich by email at derek.jakovich@hhsc.state.tx.us if you have questions.
In response to questions regarding what normal survey and enforcement activities are resuming as of June 15 and what programs are affected, HHSC replied as follows:
As of June 15, 2020 Survey Operations is resuming some survey activity such as complaints with lower priorities, and possibly some licensure and certification surveys. For Enforcement, due process notice letters such as denials, revocations, and imposition of administrative penalties will be issued and the opportunity to appeal will be provided. Of course, the COVID circumstances may affect these activities.
The notice applies to NF, ALF, DAHS, PPECC, HCSSA, and ICF/IID.

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.

 

Contact Information
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.

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

Online basic training for Core Appendix Q is available on the Integrated Surveyor Training
Website at the following link:https://surveyortraining.cms.hhs.gov/
This basic training is intended to provide Regional Office and State Survey Agency surveyors, management staff, and
training coordinators, as well as providers, suppliers, and laboratories, and other stakeholders with
the ability to identify immediate jeopardy
.
NOTE: This is a required training for RO and SA staff involved in immediate jeopardy
determinations. All RO and SA surveyors, members of management, and training coordinators
are expected to take this training as soon as practicable, but not later than March 22, 2019.
Point of Contact:
For questions related to this information, please add in subject line
“Immediate Jeopardy Inquiry” and send your email to:
QSOG_GeneralInquiries@cms.hhs.gov  
.
Effective Date:
Immediately-This policy should be communicated to all survey and certification staff, their managers and the State
and Regional Office training coordinators within 30 days of this memorandum.

 

SOMA appendix Q Section  Immediate Jeopardy 

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

II.  Proposed ICF/IID Rates: Below please find the link to information about the August 2, 2019 HHSC public hearing on the proposed ICF/IID rates.  The hearing will be at 3:00 p.m. and held in the HHSC public hearing room (first floor of HHSC).  Additional information about the hearing (specifically, needed member action) will be forthcoming.
Though the above link provides the proposed rates, below is a chart which reflects both the current and proposed ICF/IID rates.  Note that with the exception of LON 9, all LON categories and facility settings/sizes are proposed to receive an increase.  Also, at this time, the specifics regarding the impact of the increases on the rate categories (residential direct and indirect  & day habilitation direct and indirect) are not yet available.  According to HHSC the ‘specifics’ should be available on or after this Friday (July 19, 2019).

LON & Facility Size

Current Rates

Proposed Rates

SMALL

 

 

LON 1

$144.25

$150.31

LON 5

$160.74

$167.90

LON 8

$182.82

$191.85

LON 6

$223.88

$236.59

LON 9

$406.11

N/C

MEDIUM

 

 

LON 1

$118.04

$123.14

LON 5

$134.06

$140.24

LON 8

$158.90

$166.92

LON 6

$190.24

$200.79

LON 9

$385.84

N/C

LARGE

 

 

LON 1

$112.09

$116.30

LON 5

$119.64

$124.64

LON 8

$133.22

$139.44

LON 6

$179.40

$188.96

LON 9

$387.25

N/C

 

 

EVV (Electronic Visit Verification) Updates

by

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

Letter Notification Stock Illustrations – 8,275 Letter Notification Stock Illustrations, Vectors & Clipart - Dreamstime

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

Resources Stock Illustrations – 88,491 Resources Stock Illustrations, Vectors & Clipart - Dreamstime

 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:
Process for organizations/associations escalating issues on behalf of their members:
  • Email HHSC EVV Operations, Electronic_Visit_Verification@hhsc.state.tx.us, regarding:
    • EVV Policy and Compliance Questions
    • General EVV Inquiries and Complaints
    • Good idea to CC your provider association, if you are a member (PPAT, PACSTX..)
  • Email TMHP, EVV@tmhp.com, regarding TMHP issues and EVV vendor complaints/issues.
    • Copy Evan Wilkerson on urgent TMHP or EVV vendor issues.
Reminder:  It’s critical that provider associations and their members send any issues to the official mailboxes (electronic_visit_verification@hhsc.state.tx.us and EVV@tmhp.com) for tracking purposes.  Providers and associations may email Evan Wilkerson (TMHP) on urgent issues, but be sure to also send to the official HHSC and TMHP email boxes.
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:

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:

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
NEW LOGO - SMALLER
Blue Gradient

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!!

October 21, 2020

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.

 

 

 

Clarification: No EVV For In-Home DH (3 & 4-bed Homes or Host Homes)
September 11, 2020

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

HCS/TxHmL

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.

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

Trainings Available:

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)

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.

 

Online, interactive EVV training courses are available

in the HHS Learning Portal and TMHP Learning Management System. Completing these courses help program providers meet EVV training requirements.

The HHS Learning Portal includes training about HHSC EVV Policy.

The TMHP Learning Management System includes training about:

  • EVV Vendor Selection
  • EVV Portal
  • EVV Portal Standard Reports and Search Tools
  • EVV Claims Submission and Billing

COVID-19 Resources

by

COVID-19 Resources

 

HHSC & DSHS Publish LTC COVID-19 Vaccination Options

The Health and Human Services Commission and the Department of State Health Services have published Long-term Care COVID-19 Vaccination Options (PDF).

The resource document provides COVID-19 vaccination options to:

  • Nursing Facilities
  • Assisted-Living Facilities
  • State Supported Living Centers
  • Community-based intermediate care facilities for individuals with an intellectual disability or related condition regardless of size
  • Small group home residence settings (three and four-person residences) that are owned and operated by certified Home and Community-based Services Medicaid Waiver Program providers.

 

Federal Pharmacy Partnership Program:

Contact Information for COVID-19 Vaccines

Long-term care providers with questions about CVS or Walgreens COVID-19 vaccinations administered through the Federal Pharmacy Partnership program should contact the following:

CVS:
833-968-1756
Email COVID Vaccine Clinics LTCV.

Walgreens:
Email Immunize ILTC.

 

COVID 19 CMS/CHIPS meeting notices and information will continue to be shared on these sites listed in links below, so please check back regularly. 

These webinar meetings are held every Thursday

COVID-19 Provider Information

COVID-19 Client Information

Thank you for your interest in listening to the January 21 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

The presentation can be found here.

For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.

Helpful Vaccination Information

Moderna EUA Storage and Handling Instructions (PDF) includes the following:

  • Moderna EUA Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers)
  • Moderna EUA Fact Sheet for Recipients and Caregivers

v-safe After Vaccination Health Checker Instructions (PDF)
Moderna EUA “What to Expect” Card for Healthcare Professionals (PDF)
Moderna EUA “What to Expect” Card for Vaccine Recipients (PDF)

CDC’s Moderna Clinical website is live: Moderna COVID-19 Vaccine Information. This website includes the following documents:

  • Storage and Handling Summary
  • BUD Guidance and Labels
  • Storage and Handling Labels
  • Vaccine Expiration Date Tracking Tool
  • Freezer Storage Loggers (F) and (C)
  • Prep and Administration Summary
  • Standing Orders Template

 

CDC   Coronavirus Disease 2019 (COVID-19)

Resources For Posters For The Facility For Staff & Individuals

https://www.cdc.gov/coronavirus/2019-ncov/communication/print-resources.html?Sort=Date%3A%3Adesc&Search=stop%20the%20spread%20of%20germs

 

 

 

 

AADMD Webinar Series to Return in January 2021

Catch up on the webinars you may have missed.

 

https://open.texas.gov/

Texas HHS Home

HHSC COVID-19 Provider Information

https://hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information

Webinar – NHSN November 2020 Updates to LTCF COVID-19 Module Pathways

The National Healthcare Safety Network had updated the Long-term Care Facility COVID-19 Module pathways, specifically the Resident Impact and Facility Capacity and Staff and Personnel Impact. Revised forms, form instructions, and CSV templates are now available on the LTCF COVID-19 Module website.

The webinar will review the November 2020 updates.

Long-term Care Facility Webinar

November 24, 2020

10:00 – 10:45 a.m. CST

See Recording below

Register for the Webinar.

 

DSHS Video on Long-term Care Facilities COVID-19 Infection Prevention and Control Now Available

The Department of State Health Services has published a recorded training for long-term care providers on COVID-19 precautions to take and how to accomplish them.

View the video training.

Coalition of Texans with Disabilities

https://www.txdisabilities.org/news-events/coronavirus-information-resources

ANCOR’s COVID-19 Resource Center

https://www.ancor.org/covid-19

CDC information for persons with IDD

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-disabilities.html

Resources from HRS

“As the situation with Coronavirus (COVID-19) develops, HRS is committed to providing those who work in the field of IDD supports with practical, sensible, and usable health information regarding identifying those at most risk and steps that can be taken to reduce the severity of the impact of this disease.”

Below are links to free helpful resources from HRS  (Training Videos, Webinars, and Bulletins)

https://hrstonline.com/covid-19-resources/

 

December 22, 2020

HRS Inc
Risk/Benefit Return to Activity Form (Free from our friends at HRS) 
This could be very helpful for considerations for returning to work, Day Hab, Volunteer Jobs, etc…
https://hrstonline.com/download/risk-benefit-return-to-activity-form/?wpdmdl=3104&refresh=5fc779cf9f80e1606908367

 

Risk/Benefit Return to Activity Form

 

HHSC Contacts for HCS, TxHmL, ICF, and CLASS

by

HCS/TxHmL & CLASS Programs

If you have questions about CLASS Program Policy, call 512-438-5077, 877-438-5658 or email ClassPolicy@hhsc.state.tx.us.

For questions about HCS Program Policy, call 512-438-4478 or email HCSPolicy@hhsc.state.tx.us.

For questions about TxHmL Program Policy, call 512-438-4639 or email TxHmlPolicy@hhsc.state.tx.us.

(TxHmL) billing and payment reviews, call the Billing and Payment Hotline at: 512-438-5359 or email: HCS.TxHml.BPR@hhsc.state.tx.us.

For questions about policy for HCS TxHmL, email: HCSpolicy@hhsc.state.tx.us  or
TxHmLpolicy@hhsc.state.tx.us.

For questions about HCS, TxHmL, CLASS, or DBMD Program Enrollment/Utilization Review (PE/UR): Intellectual Disability‑Related Conditions (ID/RC) Assessment Purpose Codes, Level of Need, Level of Care, and Individual Plan of Care (IPC),

call HCS or TxHmL at: 512-438‑5055 or Fax: 512-438‑4249.
Call CLASS or DBMD at: 512-438-4896 or Fax: 512-438-5135.

For questions about Vendor Holds for HCS/TxHmL, call 512-438-3234 or email: IDDWaiverContractEnrollment@hhsc.state.tx.us.

For questions about Individual Rights (individual/family complaints concerning LIDDA, HCS, and TxHmL), call IDD Ombudsman at 800-252-8154 or email: OmbudsmanIDD@hhsc.state.tx.us. Learn more about the IDD Ombudsman at https://hhs.texas.gov/idd-help.

If you have questions about Medicaid eligibility, applied income, and name changes, contact a Medicaid for the Elderly and People With Disabilities (MEPD) worker, or the Integrated Eligibility and Enrollment (IEE) Call Center at telephone number 2‑1‑1 or visit the website: https://yourtexasbenefits.hhsc.texas.gov/.

If you have questions about Days paid and services paid information for cost reports, use TexMedConnect to submit a batch of CSIs.

If you have questions about Rate Analysis contacts visit this website:
https://rad.hhs.texas.gov/long-term-services-supports/contact-list. Contact information is listed by subject.

If you have questions about how to prepare a cost report (forms and instructions) and approved rates posted, visit this website: rad.hhs.texas.gov/long-term-services-supports then select the appropriate program.

If you have questions about how to sign up for, or obtain direct deposit, or how to sign up for electronic funds transfer, call Accounting at: 512-438‑2410.

If you have questions about how to obtain IRS Form 1099‑Miscellaneous Income, call Accounting at: 512-438‑3189.

For questions about ICF/IID durable medical equipment (DME), DME authorizations, Home and Community‑Based Services (HCS), Texas Home Living Waiver (TxHmL), home modifications, adaptive aids, and dental services approvals, call Provider Claims Services at: 512-438‑2200, Option 5.

ICF/IID

If you have questions about ICF/IID and nursing facility contract enrollment, call 512-438‑2630.

If you have questions about the HHS Quality Monitoring Program, email: QMP@hhsc.state.tx.us.

For questions about Payment information for cost reports or a Quality assurance fee (QAF), call 512-424-6552.

For questions about Health and Human Services Commission Network (HHSCN) connection problems, call 512-438‑4720 or 888-952-4357.

For questions about ICF/IID durable medical equipment (DME), DME authorizations, Home and Community‑Based Services (HCS), Texas Home Living Waiver (TxHmL), home modifications, adaptive aids, and dental services approvals, call Provider Claims Services at: 512-438‑2200, Option 5.

For questions about ICF/IID/Residential Care (RC) Individual Movement Form IMT/service authorization, call Provider Claims Services at: 512-438-2200, Option 1.

For Client Assessment Registration (CARE) System Help Desk for ICF/IID, call 888-952-4357.
Request HHSC Field Support staff.

For questions about Program enrollment/Utilization Review (PE/UR), Intellectual Disability‑Related Conditions (ID/RC) Assessment Purpose Codes, Level of Need, & Level of Care call 512-438‑5055 or Fax: 512-438‑4249.

For questions about Provider contracts and vendor holds for ICF/IID or Provider access to ICF/IID CARE system, call 512-438‑2630.

For questions about MDS 3.0, MDS Purpose Code E, and Forms 3618 and 3619 missing/incorrect information, call Provider Claims Services at: 512-438‑2200, Option 1.

For questions about Rehabilitation and specialized therapy/emergency dental/Customized Power Wheelchair (CPWC) service authorizations, call Provider Claims Services at: 512-438‑2200, Option 6, or
Fax: 512-438-2302.

For questions about invalid or inappropriate recoupments for ICF/IIDs, call the HHSC Help Desk at: 512-438-4720 or 800-214-4175.

For questions about Consumer Rights and Services, call Consumer Rights and Services at: 800‑458‑9858, email: ciicomplaints@hhsc.state.tx.us, or visit the website at: https://hhs.texas.gov/about-hhs/your-rights/consumer-rights-services.

EVV Contact Information

by

February 7th, 2021

Electronic Visit Verification (EVV) Contact Information

For questions about Claims, providers should call the TMHP EDI Helpdesk at: 888-863-3638,
Option 4, including questions about:
•
Electronic Data Interchange (EDI) – Submitting Claims for EVV.
•
Claim Rejections (excluding Long-Term Care [LTC] claim rejections with error code F, RJ, and/or AC).

 

For questions about EVV Claims Processing, contact the entity that pays or denies your claims

(i.e., the managed care organization [MCO]. There is a list of MCO phone numbers at the end of this post).

For questions about EVV Claims Processing that are specific to TMHP call:
•
LTC: 800-626-4117, Option 1, then Option 6.
•
Acute Care: 800-925-9126, Option 7.

 

 

For EVV general complaints questions, contact:
•
HHSC Program Providers email: Electronic_Visit_Verification@hhsc.state.tx.us.
•
MCO Program Providers at your MCO’s EVV mailbox (listed at end of this post)

For questions about MCO complaints, email: HHSC Managed Care Compliance and Operations at:
HPM_Complaints@hhsc.state.tx.us.

For questions about EVV Vendor complaints, email the TMHP EVV mailbox at: EVV@tmhp.com.

If you have questions about policy and compliance, contact:
email the HHSC EVV Operations mailbox at: Electronic_Visit_Verification@hhsc.state.tx.us.

Questions may include:
•
Rules.
•
Programs and Services Required to Use EVV.
•
The 21st Century Cures Act.

For general questions about EVV policy and compliance reviews, contact HHSC Program Providers at: Electronic_Visit_Verification@hhsc.state.tx.us

or

the MCO Program Providers at your MCO’s EVV mailbox (See page 18 for a list of email addresses).

Questions may include:
•
Allowable Phone Identification and Recoupment.
•
Compliance Oversight.
•
Reason Codes.
•
EVV Usage.
•
Policy and Requirements.
•
EVV Reports and Understanding EVV Reports.
•
Visit Maintenance and Unlock Request Policy.
•
Reason Codes.

For questions about the EVV Portal, email the TMHP EVV mailbox at
EVV@tmhp.com

or

contact the EVV Vendor (See EVV Vendor list at the end of this post).

Questions may include:
•
General Support.
•
EVV Provider Onboarding.
•
EVV Reports in the Vendor System.
•
EVV Visit Transactions – Includes Accepted and/or Rejected EVV Visit Transactions.

For questions about TexMedConnect and Electronic Data Interchange call the TMHP EDI Helpdesk at: 888-863-3638, Option 4.

Questions may include:
•
File Submission Errors.

•
Form Processing (i.e., EDI Agreement, TPA, and TPAEF).
•
PIMS Assistance.
•
Submitter IDs – Creation and Modification.
•
TexMedConnect and EDI – Account Setup, Submitting Claims for EVV.

For questions about training on the EVV Vendor System, contact the EVV Vendor (See EVV Vendor list at the end of this post).

Questions may include:
•
General questions.
•
Accessing Reports.
•
EVV Clock In and Clock Out Methods.
•
Making Corrections through Visit Maintenance.

For questions about TMHP Systems training, email questions to the TMHP EVV mailbox at:EVV@tmhp.com.
Note: For non-system-related EVV Policy questions email the HHSC Program Providers at:Electronic_Visit_Verification@hhsc.state.tx.us

or

the MCO Program Providers at your MCO’s EVV mailbox (See below for a list of email addresses).

Questions may include:
•
EVV Portal and EVV Standard Reports.
•
Claims submission.

EVV Vendor list

DataLogic Software, Inc./Vesta:
Phone: 844-880-2400
Email: info@vestaevv.com

First Data Government Solutions/AuthentiCare:
Phone: 877-829-2002
Email: AuthenticareTXSupport@firstdata.com

MCO EVV Contact Information/Contact Information for MCOs

Aetna
844-787-5437
evvmailbox@aetna.com

Amerigroup
800-454-3730
TXEVVSupport@amerigroup.com

Blue Cross Blue Shield
877-784-6802
BCBSTX_EVV_Questions@bcbstx.com

Children’s Medical Center Health Plan
800-947-4969
cmchpevv@childrens.com

Cigna-Health Spring
877-653-0331
providerrelationscentral@healthspring.com

Community First Health
855-607-7827
cfhpevv@cfhp.com

Cook Children’s Health Plan
800-964-2247
CCHPEVV@cookchildrens.org

Driscoll Children’s Health Plan
877-324-7543
evvquestions@dchstx.org

Molina Healthcare of Texas
866-449-6849
mhtxevv@molinahealthcare.com

Superior Health Plan
877-391-5921
SHP.EVV@superiorhealthplan.com

Texas Children’s Health Plan
800-731-8527
EVVGroup@texaschildrens.org

United Health Group
888-887-9003
uhc_evv@uhc.com

TMHP LTC and HHSC IDD Operations Portal For Providers

by

February 7th, 2021

Claims Submission
Beginning August 2, 2021, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers must submit claims for dates of service on or after August 1, 2021, using Texas Medicaid & Healthcare Partnership (TMHP) online claim submission tools, TexMedConnect or the Electronic Data Interchange (EDI). To become an EDI submitter, visit the TMHP EDI web page for more information. Providers should review the Portal Security Training Manual, and complete the Electronic Data Interchange Agreement for Long-Term Care Providers.

Forms Submission
Beginning August 2, 2021, HCS and TxHmL providers and Local Intellectual or Development Disability Authorities (LIDDAs) must submit forms online through the TMHP Long-Term Care (LTC) Online Portal. These form submission updates will help improve accuracy and will allow for more timely processing and payments for providers.

The following forms will be available for submission on the TMHP LTC Online Portal on August 2, 2021:
• HCS or TxHmL Pre-enrollment
• 8578 Intellectual Disability/Related Condition Assessment
• 8582 TxHmL Individual Plan of Care
• 3608 HCS Individual Plan of Care
• HCS Provider Location Update (PLU)
• Individual Movement (IMT)
• Local Intellectual and Developmental Disability Authority (LIDDA) Reassignments
• Request Individual Update
• Service Coordinator Update
• Initiate Individual Suspensions
• 3615 Request to Continue Suspension of Waiver Program Services
• 3616 Request for Termination of Services Provided by HCS/TxHmL Waiver Provider

Account Preparation and Additional Resources
To prepare for this transition to the TMHP LTC Online Portal, HCS and TxHmL providers that have never used the LTC Online Portal will need an administrator or user account. Providers can find directions for creating an account in the Long-Term Care (LTC) Online Portal Basics computer-based training (CBT) in the TMHP Learning Management System (LMS), and the Long-Term Care (LTC) User Guide for General Information, Online Portal Basics, and Program Resources on the TMHP website and in the TMHP LMS.

Note: To access the LMS, users will need to register for the LMS by clicking the Don’t Have an Account? Sign Up Here button beneath the login field.

HCS and TxHmL providers that use third-party software and third-party vendors to submit claims can register for the TMHP Electronic Data Interchange (EDI). Providers wanting to use EDI will need to complete software testing on the TMHP EDI Testing website.

Additionally, providers are encouraged to visit the TMHP Long-Term Care web page. In the left-hand menu of the LTC web page, providers can find Medicaid and LTC training materials and navigational videos.

Providers can find more information in  the “Recent News” section, of the LTC Bulletin in future articles and on the TMHP website. 

For any questions related to the HCS & TxHmL Forms and Claims Migration Project, email HCS_TxHmL_Form_Migration@hhs.texas.gov.
For EDI-related questions, call the EDI Help Desk at 888-863-3638.

April 15th, 2019

As of April 1, 2019, Long-term care intellectual and developmental disability providers and local IDD authorities can electronically submit and receive documents to and from HHS IDD Program Eligibility and Support and IDD Utilization Review.

Who Can Use the Portal?

If you contract with HHS to provide IDD services in the following programs, you can register and begin using the portal:

  • Community First Choice
  • Community Living Assistance and Support Services
  • Deaf-Blind with Multiple Disabilities
  • Home and Community-based Services
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities
  • Texas Home Living

What Are the Benefits?

To learn more, read the IDD Operations Portal Flyer (PDF).

Where Do I Register and Learn How to Use the Portal?

Complete the Initial Account Setup and register your business with the portal at txhhs.force.com. To learn more, read the IDD Operations Portal User Guide (PDF).

HHS will use email alerts, information letters, training webinars and in-person communications via existing stakeholder meetings to provide portal updates.

For technical issues, contact the IDD Operations Portal Team at IDD_Ops_Portal@hhsc.state.tx.us.

HCS & TxHmL Webinars & FAQ’s (Recordings)

by

December 01, 2020

Website Link:

For Previously Recorded Webinars & FAQ’s

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/hcs-txhml-webinars-faqs

Updated COVID-19 Frequently Asked Questions for HCS and TxHmL Providers

HHSC has published an updated Frequently Asked Questions about COVID-19 for Home and Community-based Services and Texas Home Living providers.

Read the Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF).

Feb 25. HCS & TxHmL Provider Responsibilities: Death Notifications & Investigation Reports Webinar

This webinar will provide information about program provider responsibilities for reporting abuse, neglect and exploitation and providing notifications of death.

Feb. 25
1-3 p.m.
Register for the webinar.

Jan. 5 Recording Webinar Available – HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview

A recording of the Jan. 5, 2021, HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview webinar is available for those unable to attend.

Listen to the webinar recording here.

Jan. 7 Recording of HCS and TxHmL Administrative Penalties and Amelioration Available

A recording of the Jan. 7, 2021 HCS and TxHmL Administrative Penalties and Amelioration webinar is available for those unable to attend.

Listen to the webinar recording here.

DSHS Video on Long-term Care Facilities COVID-19 Infection Prevention and Control Now Available

The Department of State Health Services has published a recorded training for long-term care providers on COVID-19 precautions to take and how to accomplish them.

View the video training

Additional Training Opportunities

by

 

MEDICAID WAIVER PROGRAM WEB-BASED TRAINING FROM HHSC

Abuse Neglect and Exploitation Competency Training and Exam     

( WE RECOMMEND HCS/TXHML PROVIDERS HAVE DIRECT SUPPORT STAFF COMPLETE THIS TRAINING)

This training is designed to meet the basic ANE training requirements for staff providing direct care in a community setting. By the end of the training, staff should be able to identify which acts constitute ANE, how to recognize ANE, understand risk factors for ANE, and what methods can be used to address ANE. Additionally, this training includes an introduction to trauma and its impact on the people we serve.

Service providers must complete a test with a score of 80 percent or higher. A training certificate can be printed at the end of this training and kept in staff personnel files to meet training requirements.

To access and complete this free online training, please go to the HHS Learning Portal’s ANE Competency Training course page, create a user login, and follow instructions.

December 11, 2020

Plan of Removal

Plan of Removal 

This course provides a reference guide for a plan of removal and shows how such a plan differs from a plan of correction.

Intermediate Care Facilities 

Writing Acceptable Plans of Correction for ICFs/IDD 

https://apps.hhs.texas.gov/PROVIDERS/Training/jointtraining.cfm to register and learn more about other joint provider training.

Scope and Severity Webinar Now Available

HHSC is currently offering a webinar to explain scope and severity for providers impacted by House Bill 2025, 85th Texas Legislature, Regular Session, 2017. The training is designed specifically for providers for whom scope and severity is new to the survey process.

Register for the Scope and Severity Training for ALF, DAHS, ICF/IID and PPECC Providers webinar to see available dates and times here.

Please continue to monitor the website for additional dates and times if you are unable to participate during the dates currently being offered. The webinar will be offered on a regular basis for the next few months.

  Register at:   https://apps.hhs.texas.gov/providers/training/jointtraining.cfm

Changes to the MWH-IDD Website where TIC Training is Accessed

HHSC Long-term Care Regulatory has issued Provider Letter (PL) 19-08: Trauma-informed Care (TIC) Training to replace PL 16-15. The PL informs providers of changes to the Mental Health Wellness for Individuals with Intellectual and Developmental Disabilities website where TIC training is accessed.

This PL is addressed to Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions providers. Read the details of this PL here.

HCS Certification Principals Training Webinars & Recordings

by

February 2021 HCS/TxHmL Provider Certification Principle Webinars

The following webinars are part of the ongoing HCS and TxHmL Certification Principles training series.

Certification Principle 9.177: Staff Member and Service Provider Requirements

This webinar will cover TAC §9.177 which outlines staff member and service provider requirements for HCS and TxHmL programs.

Feb. 2
2-5 p.m.
Listen to the webinar recording here.

Certification Principles 9.179 & 9.180: Restraints and Prohibitions

This webinar will cover TAC §9.179 and §9.180 relating to HCS and TxHmL provider responsibilities regarding restraints and prohibitions.

Feb. 4
2-5 p.m.
Register for the webinar.

Certification Principle 9.178: Quality Assurance

This webinar will cover TAC §9.178 relating to quality assurance in the delivery of HCS and TxHmL program services.

Feb. 9
2-5 p.m.
Register for the webinar.

Certification Principle 9.173: Rights of Individuals

This webinar will review TAC §9.173 relating to the rights of individuals receiving HCS and TxHmL program services.

Feb. 11
2-5 p.m.
Register for the webinar.

Certification Principle 9.175/9.585: Abuse, Neglect and Exploitation

This webinar will cover HCS and TxHmL program provider responsibilities related to abuse, neglect and exploitation.

Feb. 16
2-5 p.m.
Register for the webinar.

Certification Principle 9.174: Service Delivery

This webinar will review HCS program provider requirements related to delivery of HCS program services.

Feb. 18
2-5 p.m.
Register for the webinar.

January 2021 HCS Provider Certification Principle Webinars

The following webinars are a repeat of last year’s HCS and TxHmL Certification Principles series.

Each webinar will cover a certification principle or principles outlined in TAC Title 40 Chapter 9 and will include examples of program provider violations.

Certification Principle 9.172: Mission, Development and Philosophy of Program Operations/Top Ten Deficiencies for HCS and TxHmL

This webinar is part of the WSC Certification Principles training series. This presentation will cover the requirements detailed in TAC §9.172 and the top ten deficiencies for program providers.
Jan. 26
2-5 p.m.
Register for the webinar.

Comprehensive Nursing Assessment

This webinar is part of the WSC Certification Principles training series. This presentation will go over the requirements for the Comprehensive Nursing Assessment
Jan. 28
9-12 p.m.
Register for the webinar.

Introduction To Importing And Exporting 3rd August - Webinar Icon - 400x400 PNG Download - PNGkit

PREVIOUSLY RECORDED WEBINARS

Dec 3rd, 2020 Recording of Certification Principles:

Quality Assurance– Webinar for HCS and TxHmL Providers Available

A recording of the December 3, 2020, Certification Principles: Quality Assurance webinar for HCS and TxHmL providers is available for those unable to attend.

View the webinar recording here.

Dec 10th, 2020 Recording of Certification Principles:

Rights Of The Individual– Webinar for HCS and TxHmL Providers Available

A recording of the December 10, 2020, Certification Principles: Rights of Individuals webinar for HCS and TxHmL providers is available for those unable to attend.

View the webinar recording here.

Dec 15th, 2020 Recording of Certification Principles:

Abuse, Neglect, Exploitation– Webinar for HCS and TxHmL Providers Available

A recording of the December 15, 2020, Certification Principles: Abuse, Neglect and Exploitation webinar for HCS and TxHmL providers is available for those unable to attend.

View the webinar recording here.

Dec 17th, 2020 Recording of Certification Principles:

Service Delivery– Webinar for HCS and TxHmL Providers Available

A recording of the December 17, 2020, Certification Principles: Service Delivery webinar for HCS and TxHmL providers is available for those unable to attend.

View the webinar recording here.

November 12th, 2020 Recording of Certification Principles:

Staff Member and Service Provider Requirements Webinar for HCS and TxHmL Providers Available

A recording of the November 12, 2020, Certification Principles: Staff Member and Service Provider Requirements webinar for HCS and TxHmL providers is available for those unable to attend.

View the webinar recording here.

November 19th, 2020 Recording of Certification Principles:

Restraints and Prohibitions Webinar for HCS and TxHmL Providers Available

A recording of the November 19, 2020, Certification Principles: Restraints and Prohibitions webinar for HCS and TxHmL providers is available for those unable to attend.

View the webinar recording here.

IRS-Certain Medicaid Waiver Payments May Be Excludable From Income

by

Certain Medicaid Waiver Payments May Be Excludable From Income

See the following IRS page for the full FAQ

https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income

Last Update: New Q&A’s 1-20 were added on February 23, 2015. The original text and Q&A’s follow at the end.

On January 3, 2014, the Internal Revenue Service issued Notice 2014-7, 2014-4 I.R.B. 445. Notice 2014-7 provides guidance on the federal income tax treatment of certain payments to individual care providers for the care of eligible individuals under a state Medicaid Home and Community-Based Services waiver program described in section 1915(c) of the Social Security Act (Medicaid Waiver payments).

Section 1915(c) enables individuals who otherwise would require care in a hospital, nursing facility, or intermediate care facility to receive care in the individual care provider’s home. The notice provides that the Service will treat these Medicaid waiver payments as difficulty of care payments excludable from gross income under § 131 of the Internal Revenue Code.

Individual care providers who receive Medicaid waiver payments for the care of eligible individuals in their homes and payers of Medicaid waiver payments have raised several questions not addressed in Notice 2014-7. The following questions and answers clarify the notice and provide guidance on the information reporting requirements, and the employment tax requirements for Medicaid waiver payments described in the notice.

Individual Care Provider Questions

Q1. I receive payments under a state Medicaid program other than a Medicaid Home and Community-Based Services waiver program for the personal care of my adult disabled son in our home. May I exclude these payments from gross income?

A1. Whether the Service will treat payments under a state program other than a state Medicaid Home and Community-Based Services waiver program as difficulty of care payments excludable from gross income will depend on the nature of the payments and the purpose and design of the program.

Q2.  I moved into my elderly mother’s home to care for her, and I do not have a separate home where I reside. I receive payments under a state Medicaid Home and Community-Based Services waiver program for personal care and supportive home care. Am I considered to be providing care in “the provider’s home” for purposes of Notice 2014-7?

A2. Yes. Under § 131, “the provider’s home” means the place where the provider resides and regularly performs the routines of the provider’s private life, such as shared meals and holidays with family. See Stromme v. Commissioner, 138 T.C. 213 (2012). In this situation, the mother’s home became the provider’s home because it is where the provider resides and regularly performs the routines of the provider’s private life.

Q3. I am an individual who cares for an unrelated elderly person five days a week in her home, and I have a room in the care recipient’s home where I sleep four nights a week. I receive Medicaid waiver payments for this care. On weekends and holidays, I reside with my family in our separate home. May I exclude these payments from gross income?

A3. No. In this situation, the provider works in the care recipient’s home, but the provider has a separate home where the provider resides and regularly performs the routines of the provider’s private life, such as shared meals and holidays with family. Therefore, the provider does not provide care for the care recipient in the provider’s home, and the provider may not exclude the Medicaid waiver payments from gross income.

Q4. I am an individual who cares for an unrelated elderly person seven days a week in her home where I live. I receive Medicaid waiver payments for this care. I do not have another home. May I exclude these payments from gross income?

A4. Yes. In this situation, the care recipient’s home is also the care provider’s home, and the care provider does not have a separate home. Therefore, the Medicaid waiver payments are excludable from the care provider’s gross income for the care furnished in the shared home.

Q5. I am the parent of a disabled child, and I receive state Medicaid Home and Community-Based waiver payments excludable from gross income under Notice 2014-7 for the care of my child in our home. My sister lives with me, and she also receives state Medicaid Home and Community-Based waiver payments for the care of my child. May she exclude the Medicaid waiver payments from gross income?

A5. Yes. More than one care provider living in the home with the care recipient may exclude state Medicaid Home and Community-Based waiver payments from gross income under Notice 2014-7.

Q6. I am a respite care provider, and I provide personal care and supportive services to disabled individuals in their homes, or in my home where the care recipient does not live. I receive payments for this care under a state Medicaid Home and Community-Based Services waiver program. May I exclude these payments from gross income?

A6. No. The exclusion only applies to payments for care in the individual care provider’s home where the care recipient lives under the recipient’s plan of care.

Q7. I am an individual care provider, and I receive payments under a state Medicaid Home and Community-Based Services waiver program for the care of a disabled individual who lives with me in my home under the individual’s plan of care. The program has a cost-sharing provision that may require an individual to pay the administrator of the program a portion of the total amount that the administrator pays me for the care of the disabled individual. May I exclude the entire payment that I receive from the administrator for the individual’s care?

A7. Yes. You may exclude the entire payment that you receive under the state Medicaid waiver program for the care of the disabled individual in your home even though the individual is required to pay the administrator part of the cost of the care. By contrast, an individual care provider may not exclude direct payments from a care recipient who pays part or all of the cost of the recipient’s care with the care recipient’s private funds.

Q8. I am an individual care provider, and I receive vacation pay from the state, as well as Medicaid waiver payments for the care that I provide to a disabled individual living in my home under the individual’s plan of care. May I exclude the vacation pay from gross income?

A8. No. The only amounts excludable from gross income under Notice 2014-7 are payments for the care of the disabled individual.

Q9. I received payments described in Notice 2014-7 that are treated as difficulty of care payments under § 131. May I choose to include these payments in earned income for purposes of the earned income credit (EIC) or the additional child tax credit (ACTC)? (Added May 8, 2020.

A9. Yes, for open tax years, you may choose to include all, but not part, of these payments in earned income for determining the EIC or the ACTC, if these payments are otherwise earned income (wages or income from self-employment).

Q10. If I received payments described in Notice 2014-7 in an earlier year, may I file an amended return to exclude the payments from gross income that I reported as income in the earlier year?

A10. Yes. You may file a Form 1040-X, Amended U.S. Individual Income Tax Return, if you received payments described in the notice in an earlier year and the time for claiming a credit or refund has not expired under § 6511 of the Internal Revenue Code. A taxpayer generally may file a claim for refund within three years from the date the return was filed or two years from the date the tax was paid, whichever is later. For more information, see “When To File” in the instructions to Form 1040-X or Tax Topic 308, Amended Returns, available at /taxtopics/tc308.html. In Part III of Form 1040-X, you should explain that the payments are excludable under Notice 2014-7. Excluding payments described in the notice in an earlier year may affect deductions or credits that you claimed for the earlier year, as well as other tax items for the earlier year. To help expedite the processing of your amended return, you should include the following to substantiate your claim: (1) the full name of the individual receiving care (and the care recipient’s social security number or other taxpayer identifying number, if available); (2) copies of documents from third parties to show that you and the individual receiving care resided in the same home in the year to which the claim relates (such as a driver’s license or other government-issued document, social agency document, bank statement, medical bill, or utility bill); and (3) evidence that the individual is receiving care under a state Medicaid waiver program.

To read more of this FAQ go to…. https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income

Please Check Out “Instant Purchase” Services At Our “Store”

by

Check out our instant services you can purchase at our “Store” page on the website:  https://twogetherconsulting.com/store/

1 hr consulting

 

OFF-SITE CONSULTATION:  $75/hr

You can purchase 1, 3, 6, 9 or 12 hrs of off-site consultationfor assistance with HCS, TxHmL, or ICF and Additional IDD Waiver Programs.
This includes: research, phone calls, video chats, webinars, emails and texts. 
You may use this off-site consultation time as needed or all at once.  You can schedule a conference call, video chat or short training webinar with us, depending on your needs or contact us via email or text for questions you might have.  We bill a minimum of 15 mins. per contact.
After you make payment for a service, someone will contact you to schedule an appt. as soon as possible to set up initial services.  Please be sure to email us with your basic contact information and purpose for services at:
https://twogetherconsulting.com/contact-us/  
or info@twogetherconsulting.com

Check out our instant services you can purchase at our “Store” page on the website:  https://twogetherconsulting.com/store/

 OFF-SITE NURSING CONSULTATION:  $75/hr

There is a separate 1-hour payment tab for nursing consultation.  You may add on as many nursing hours as you want to the payment tab!
If you would like to schedule a teleconference or video conference with our RN Consultant and your nursing department or other members of your team, please contact us at info@twogetherconsulting.com  
This is a great way to prepare for a survey, discuss post-survey concerns, develop ideas for plans of correction, discuss nursing concerns about an individual prior to admission, or assist nurses with new admissions to the program.  
This service does not include the actual development of policy & procedure or assistance with writing plans of correction/corrective action plans..

**We also offer an initial hour of consultation to see if we can help you with applying to become an HCS/TxHML provider.   $75.00 for 1 hr max/ Initial consultation only. 

We do not provide more than 1 hr at this rate! 

This service is for persons considering applying to become an HCS or TxHmL provider, who may need our assistance with completing their forms for the application or need help deciding if they actually want to become a provider.   This does not include the cost of actual assistance with the application.

Informal Dispute Resolution Process-HCS/TxHmL/ICF

by

HCS/TxHmL IDR Process Coming Soon!  

Currently, the IR process is still in place, but the new IDR process for HCS/TxHmL should be in place sometime in February 2021.  We will keep you posted.

If you would like to appeal a citation/violation currently, continue to use the IR process until the time IDR Process is rolled out!

FYI-With the IR process, this may be requested immediately after receiving draft report from the survey visit at exit.  The IDR process works a bit differently, the provider will not be able to request an IDR until they receive the final survey report.  So in the meantime, you will still have to submit POC’s for all violations and you should continue to work on making corrections while waiting on the IDR process. 

.

 

The Informal Dispute Resolution (IDR) process gives nursing facilities, assisted living facilities, intermediate care facilities, Home and Community-based Service and Texas Home Living waiver providers the opportunity to informally dispute regulatory survey findings. (Texas Government Code §531.058 and Human Resources Code §161.0892).

In accordance with Senate Bill 304, 84th Texas Legislature, 2015, and House Bill 2590, 85th Legislature, 2017, the Texas Health and Human Services Commission has contracted with Michigan Peer Review Organization (MPRO) to perform IDR reviews and make a recommendation of compliance or non-compliance.

To request an IDR, facilities must submit via email a fully executed IDR Request Form to the HHSC IDR Department within 10 calendar days of receiving the official Statement of Deficiencies (Forms 2567/3724) or Final Report. If a timely request is made for an IDR, HHSC will forward the request to MPRO. Facilities/providers are then required to submit a rebuttal letter and supporting documentation directly to MPRO within the required timeframes.

Request Forms

Due Dates

Supporting documentation due dates are as follows:

  • For NFs, ICF and the HCS/TxHML waiver providers the due date is the 5th calendar day after submitting the IDR Request form to HHSC on time.

Note: If the due date falls on a Saturday, Sunday or legal holiday, the due date becomes the next business day.

Where to Submit Your Supporting Documentation

All rebuttal information may be submitted via MPROs IDR Secure Application. Find instructions and link at www.mpro.org/texas-idr, or by mail to the address below:

MPRO – IDR Department
22670 Haggerty Road, Suite 100
Farmington Hills, MI 48335
www.mpro.org/texas-idr

For questions or problems with submitting supporting documentation, contact MPRO:

Aris Rhodes-Bond, IDR Project Specialist
248-465-7405

Charlene Kawchak-Belitsky, IDR Senior Manager
248-465-1038

Email: iidrgroup@mpro.org

Texas Administrative Code rules for IDR

For questions or problems with submitting the IDR Request Form, contact IDR:

HHSC IDR Department
IDR@hhsc.state.tx.us
512-706-7268

THERAP Information and Resources

by

Therap services website

Therap National 2021 Conference Feb 2nd, 3rd & 4th: 

Registration link: https://www.therapservices.net/2021-national-conference/

If you need assistance with your current Therap services or with information on getting these services, please contact:

Stacy Wilson (Business Development Consultant at Therap Services, LLC)

 Here is her linkedin page

https://www.linkedin.com/posts/stacydentonwilson_activity-6757331578927513600-Lz2d

 

https://www.therapservices.net/

For more information on Therap please see link below:

https://www.therapservices.net/products/comprehensive-esolution-for-texas-providers/

Comprehensive Documentation and Information Management System

Data-Driven:

Person-centered solutions your organization can use to support agency workflows, communication, compliance, organizational outcomes, and revenue management

 

 

HCS Administrative Penalties, Survey, Billing Guideline’s Update, and Provider User Guide for CARE

by

January 10th, 2021

Jan. 5 Recording Webinar Available – HCS and TxHmL Changes to Survey Process and “Hold Harmless Period” Overview

A recording of the Jan. 5, 2021, HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview webinar is available for those unable to attend.

Listen to the webinar recording here.

Jan. 7 Recording of HCS and TxHmL Administrative Penalties and Amelioration Available

A recording of the Jan. 7, 2021 HCS and TxHmL Administrative Penalties and Amelioration webinar is available for those unable to attend.

Listen to the webinar recording here.

December 28th, 2020

Letter: PL 20-55  Administrative Penalties HCS & TxHmL

https://apps.hhs.texas.gov/providers/communications/2020/letters/IL2020-19.pdf

December 23rd, 2020

Upcoming HCS and TXHmL Webinars For:

“Hold Harmless” Period & Administrative Penalties & Amelioration

Hold Harmless Period Overview

This webinar will cover the “Hold Harmless” period for the new survey process for HCS and TxHmL.

Jan 5, 2021
2 p.m. – 4 p.m.

Here’s the link to record session:

https://attendee.gotowebinar.com/recording/4225828217950682891

For a copy of the handouts, you can email: Shelley.Gusky01@hhs.texas.gov

Administrative Penalties and Amelioration

This webinar will review the new survey process for HCS and TxHmL which begins on March 1, 2021 and will include and overview of administrative penalties and amelioration.
Jan 7, 2021
1 p.m. – 4 p.m.
Register for the webinar.

For a link to the recording of this session and a copy of the handouts, you can email: Shelley.Gusky01@hhs.texas.gov

HHSC Publishes Administrative Penalty Process for HCS & TxHmL Program Providers (PL 20-55)

November 25, 2020

HHSC Long-term Care Regulation has published PL 20-55 – Administrative Penalty Process for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Program Providers (PDF). The PL provides guidance to providers on the rules regarding administrative penalties.

 Billing Guideline Changes

September 1, 2020

The HCS, TxHml, and CFC billing guidelines have been updated effective September 1, 2020. A summary of the revisions can be found on page 25 of the CFC (PDF), page 146 of the HCS (PDF)  and page 122 of the TxHmL (PDF). Send questions about the billing guidelines to HCS.TxHml.BPR@hhsc.state.tx.us.

 

June 20, 2020

Survey Process:  Timelines

As everyone is aware, due to the COVID pandemic, the past several months have affected the Long-Term Care survey and enforcement processes and activities that are unrelated to the virus. As of June 15, 2020, Survey Operations has begun to resume some normal survey activity, and Enforcement is also resuming enforcement processes and activities, such as complaints or issues related to COVID-19.  No other regular survey activities have begun for HCS/TxHmL programs.
Please contact Enforcement Director Derek Jakovich by email at derek.jakovich@hhsc.state.tx.us if you have questions.
In response to questions regarding what normal survey and enforcement activities are resuming as of June 15 and what programs are affected, HHSC replied as follows:
To clarify, as of June 15, 2020, Survey Operations is resuming some survey activity such as complaints with lower priorities, and possibly some licensure and certification surveys. For Enforcement, due process notice letters such as denials, revocations, and imposition of administrative penalties will be issued and the opportunity to appeal will be provided. Of course, the COVID circumstances may affect these activities.
At this point, since we’re not enforcing administrative penalties in HCS/TxHmL until September, the notice applies to NF, ALF, DAHS, PPECC, HCSSA, and ICF/IID.

HHSC Provider User Guide (CARE)       

Please go to the following link:

https://hhsportal.hhs.state.tx.us/helpGuide/Content/16_CARE/WaiverPDF/HCS%20Provider%20User%20Guide.pdf

.

Joint Training From HHSC For Providers

by

Texas Health and Human Services

Joint Training From HHSC For Providers (Online with CEU’s/CNE’s)

For registration for any of these dates and more information, please go to:   https://apps.hhs.texas.gov/providers/training/jointtraining.cfm

January 2021

Nursing Facility Infection Control (course description)

Thursday, January 14th, 2021

1:00 PM – 3:30 PM

Webinar
(50 MAX)

 

Culture Change:  Improving Quality of Life in Long Term Care (course description)

Tuesday, January 20th, 2021

1:30 PM – 3:30 PM

Webinar
(50 MAX)

 

Nursing Scope of Practice For Long-Term Care Communities (course description)

Thursday, January 21st, 2021

2:00 PM – 3:30 PM

Webinar
(50 MAX)

 

Emergency Preparedness in Long-Term Care Facilities (course description)

Tuesday, January 26th, 2021

1:30 PM – 4:30 PM

Webinar
(500 MAX)

 

Infection Control Basics Personal Protective Equipment (PPE) course description

Tuesday, January 26th, 2021

1:30 PM – 4:30 PM

Webinar
(50 MAX)

 

Weight Loss In Older Adults (course description)

Friday, January 29th, 2021

10:00 AM – 12:30 PM

Webinar
(50 MAX)

 

 

Renewals of ID/RC Assessments/ and IPC’s and  Requirements for Revised IPCs and Transfer IPC

by

12/28/20

reminder clipart free 8526 png Free Download in 2020 | Free clip art, Clip art, Happy birthday clip art

IMPORTANT REMINDER!

HCS and TxHmL Program Providers and LIDDA Service Coordinators- IL20-45

HHSC is automatically renewing individual plans of care and Intellectual Disability/Related Condition assessments that expire on or before Dec. 30, 2020. This is due to the COVID public health emergency. The renewal is for one year from the expiration date.

HHSC is not automatically renewing IPCs and ID/RCs that expire on or after Dec. 31, 2020.  This is explained in IL 20-45 (PDF). Program providers and LIDDA service coordinators must conduct service planning team meeting on or before the effective date of the renewal IPC to develop proposed renewal IPCs and updated ID/RCs for submission to HHSC. The effective date of the renewal IPC is the day after the IPC expires.

You may conduct the SPT meeting to renew the ID/RC by telehealth. You my conduct the SPT meeting to renew the IPC by telehealth or phone. If you are not able to get the signature of the individual or legally authorized representative on the proposed renewal IPC, you must get their oral agreement to the renewal IPC and document such agreement in the individual’s record.

Program providers cannot bill for services provided when a renewal IPC is not authorized by HHSC. This means that if a SPT meeting does not occur on or before the effective date of the renewal IPC, the program provider cannot bill for services provided between the date of the meeting and the effective date of the renewal IPC.

10/29/20

IL20-45 Renewals of ID/RC Assessments/ and IPC’s and  Requirements for Revised IPCs and Transfer IPC

This information letter (IL)explains:

-renewal intellectual disability or related condition (ID/RC) assessments and individual plans of care (IPCs) are automatically renewing for one year from the expiration date for ID/RCs and IPCs expiring through December 30, 2020

     -beginning with ID/RCs and IPCs set to expire December 31, 2020, renewal ID/RCs and IPCs will be completed by the provider or service               coordinator before the expiration date;

      -renewal ID/RCs can be completed via telehealth and renewal IPCs can be completed via telehealth or telephone; and

      -continued exception to the requirement that an individual or legally authorized representative (LAR) sign IPC and supporting documentation.          These actions help ensure individuals do not experience a gap in services due to the COVID-19 public health emergency and there is  continued flexibility for limiting face-to-face contact for waiver renewals and service plan revisions.

In addition, if an individual loses waiver eligibility during the PHE, the individual will maintain waiver services

For more information:  Click on this link:  https://apps.hhs.texas.gov/providers/communications/2020/letters/IL2020-45.pdf

Flu Vaccine Guidance During COVID-19

by

January Webinar – Flu & COVID: What You Need to Know

HHSC is holding this webinar for all our providers to offer guidance on flu and COVID-19.

In this webinar, we will review:

  • The similarities and the differences between flu and COVID-19
  • The importance of getting a flu shot
  • How flu vaccination along with good infection control practices protect everyone
  • Centers for Disease Control and Prevention guidance on administering flu vaccines this season amid the coronavirus pandemic.

This webinar is appropriate for all provider types. No continuing education hours or units are available for this webinar. A certificate of attendance will be provided.

Jan. 5, 2021
10 – 11 a.m.
Register for the Jan. 5 COVID-19 webinar.

Jan. 21, 2021
10 – 11 a.m.
Register for the Jan. 21 COVID-19 webinar.

HHSC Publishes Flu Vaccine Guidance During COVID-19 (PL 20-50)

HHSC publishes Provider Letter 20-50 Influenza Vaccine Guidance During COVID-19. The letter provides a brief overview of the Adult Influenza Vaccine Initiative and guidance on the administration of the influenza vaccine to residents and staff with and without COVID-19.

The letter also informs facilities when an individual should receive the influenza vaccine, even if the facility is not the vaccine administrator.

(AADMD) American Academy Of Developmental Medicine & Dentistry

by


D E C // 1 8 // 2 0 2 0

AADMD Releases Statement on Covid-19 Vaccine Equity for People with IDD
Read the Official Statement – and Join the Movement

The Covid-19 vaccine is here – and AADMD joined forces with like-minded organizations to issue a Joint Position Statement on “Equity for People with Intellectual and Developmental Disabilities (IDD) Regarding COVID-19 Vaccine Allocation and Safety.”

NCD Opportunity

Through board member Rick Rader, MD — who was appointed to the National Council on Disability earlier this year — AADMD was also given the opportunity to review the NCD’s official vaccine statement as well. In response to this honor, Emily Johnson, MD VP of Policy issued the below statement:

“The AADMD was pleased to see the NCDs Statement on the allocation of COVID19 vaccines for people with intellectual disabilities was in alignment with the principles initiated, proposed and promoted by the AADMD.”

AADMD’s Joint Position Statement

“The development of a safe, effective vaccine is a critical component of the global response to the coronavirus disease 2019 (COVID-19) pandemic. Vaccine distribution and allocation must be done in a safe and equitable manner, and individuals with intellectual and developmental disabilities (IDD) must be explicitly addressed in any framework for vaccine allocation. The aim of this joint position statement is to address the risks facing people with IDD during the pandemic and to recommend how they should be included in vaccine allocation frameworks. The final provisions for vaccine allocation will ultimately be determined on a state level, and many different allocation frameworks exist. The following recommendations are intended to be broadly adaptable to state and national allocation frameworks…”  

Read more, click on link below:

https://static1.squarespace.com/static/5cf7d27396d7760001307a44/t/5fd9690f9e3b1725e3d0d3e2/1608083731221/Covid19Vaccine-IDD-Statement.pdf

 

 

 

 

 

ADP Services

by

 

You all may be familiar with our other contact, Mitchell Deter.  He will still be assisting providers that work with HCS/TxHmL/and ICF with 50 employees or greater..  Some of you may already be working with him. Katie DeMayo works with our providers who need Payroll and HR services for under 50 employees

Our newest HCS/TxHmL/ICF provider liason is Katie DeMayo, (District Manager for Central Texas).  Katie and Mitch are our personal resource team from ADP for those of you who are IDD Providers and also for many of you who also have Home Health Agencies.

Katie’s contact info:  724-205-4716 and her email is,Katie.DeMayo@adp.com

Mitchell’s contact info:  803-730-7861  and his email is mitchell.deter@adp.com 

Click here for ADP’s COVID-19 Resource Center

As more people continue to return to the workplace, ADP is excited to share tools that are designed to help them, and their people transition back safer, easier, and more effectively. To ensure we are consulting our clients on the best solutions for their business, we are constantly evaluating our preferred vendors. As a result, Twogether Consulting has developed a relationship with ADP where our clients will receive preferred pricing. Our local point of contact, Katie DeMayo, consults with small businesses to streamline their payroll and HR processes, to help them improve their cash flow, retain high-quality employees, and keep businesses in compliance from an HR perspective.

Please check the following items that you would like information on:

  • Payroll Processing
  • Direct Deposit
  • Medical and Dental Benefits                                                                                 
  • Employee Background Checks
  • Employee Handbook
  • Workers Comp Insurance Pay as you go system: Helps you manage cash – you pay for what you owe per payroll with NO prepay in advance and no worry of the unknown audits
  • Web-Based Time and Attendance system: Time clocks that interface directly into payroll (eliminate keying)
  • 401k Plan/SEP/Simple IRA plans: We do plan documentation, investing and all necessary year-end reporting
  • Section 125 Premium Only Plan: Pre-tax medical/dental
  • Compliance Posters: Employer mandatory Federal, and State labor law posters

 

Agency Workforce Management

Use of Agency Workforce Management for EVV compliance in conjunction with ADP payroll.

  • Agency Workforce Management includes a powerful payroll rules engine that automates all pre-payroll calculations such as pay differentials, holiday pay, New York Sick Leave regulations and Spread of Hours and overtime
  • Most other EVV systems lack strong payroll integration capabilities leaving providers struggling with the costs and risks of manual payroll data entry or adjustments 

The agency is implementing Time and Attendance, Documentation, Billing Reporting, Payroll Rules, Reporting and Integration for ADP, Alerts, Communications and integration with eMedNY.

Check out the 12 EVV Must Haves eBook to learn more.

To talk to an Agency Software Consultant, email agencysuccessteam@mitcsoftware.com.


How is ADP addressing Covid-19 with their clients?  See links below:

Don’t forget if you are trying to develop training and policies around Covid-19, ADP can help!!

https://www.adp.com/about-adp/data-security/client-resources/adp-covid-19-preparedness.aspx

https://www.adp.com/spark/articles/2020/03/covid-19-protecting-your-employees-and-business.aspx

http://chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/https://www.adp.com/-/media/who%20we%20are/pdf/business-resiliency-brochure.ashx?la=en&hash=0125A6ECCCF06EDBF9E503030B18EA7023358032

EVV 

ADP is now partnering with TSheets and also MITC, which will be great for our HCS/TxHmL providers who use ADP or who want to use ADP for Payroll and HR support.

Even if you have ADP already and want to upgrade your package, call or email Katie DeMayo or Mitchell Deter at ADP ( she is Twogether Consulting’s liaison we have been working with) to assist our HCS/TxHmL and ICF providers. I hope this makes it easier for some of you who are concerned about having to get another separate service for Electronic Visit Verification.

Supercharge your ADP Time Cards with T-Sheets!

EVV (Electronic Visit Verification) Tracking

Manage Scheduling

Track Time By The Job

Easy Accurate Time Sheets

Mobile Time Tracking

Who’s Working Now and Where?

Alerts & Approvals

Reports

If you have questions concerning COVID-19  HR concerns: 
–  EIDL (Economic Injury Disaster Loans), 
-CARES Act,(Coronavirus Aid, Relief, and Economic Security) and 
-FFCRA (Families First Corona Virus Response Act)  
 
ADP can provide you with assistance as well as with your “Policy & Procedure” needs surrounding COVID-19.  ADP also can provide you with some free resources through ADP, even if you do not currently use ADP Payroll & HR services! 
 
Example:  An employee advocacy center-where employees can call in to see where they can get free testing and set up a telehealth appointment with a real doctor, if you already have health insurance through your business already, a free COVID-19 tool kit for small businesses including a podcast and more to help you. 
They can discuss some other ways ADP can help you as well: other HR issues, staying in compliance and developing a safety manual.
 
 
Please see previous ADP presentations on these topics and more at our Gotostage channel

 

Please remember to mention how you found out about ADP through “Twogether Consulting/ Julie Blacklock” 

For those of you looking for payroll and HR services for your HCS , TXHmL, and ICF Programs, especially in the Houston and surrounding areas, I urge you to contact ADP about these services and more.  These are our main contacts for HCS/TxHmL provider client base in the Austin and Houston area for the most part, and their specific needs.  They do work with providers in other parts of the state as well. They have now also added OIG and LEIE monthly checks to part of the HR services they can provide.  Woo hoo!

ADP can help you with everything from payroll, to employee handbooks for your company, to tracking items due for your HR files, etc… Whether you are new, small, or large business we could all use some help.  At a time when Providers really need to watch every penny, it is nice to also be informed or updated about changes coming!

Some of The Helpful ADP Free Training Webinars & Recordings

 

Title: Workplace Spotlight: COVID-19 Legislative Updates – How the Paycheck Protection Program Flexibility Act (PPPFA) Changed PPP Loan Forgiveness

Duration: 1 hour

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2425491&sessionid=1&key=BA14109722A0F3C21600A063428446C4&regTag=&sourcepage=register

Title: How to Create Instant Cash-flow for Small Businesses Leveraging CARES Act and R&D Tax Credits

Duration: 1 hour, 3 minutes

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&referrer=https%3A%2F%2Fwww.adp.com%2Fresources%2Fevents.aspx&eventid=2386032&sessionid=1&key=A4098DF17F17CDBB4582C737C4113CA4&regTag=&sourcepage=register

Title: Workplace Spotlight: CARES Act & COVID-19: Understanding the Employee Retention Tax Credit and Other Tax Implications

Duration: 1 hour, 1 minute

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2281116&sessionid=1&key=811BF8DD403E27DEC8601E210E210CCD&regTag=&sourcepage=register

Title: SPECIAL EDITION: Protecting Your Workforce and Understanding Policies as Your Organization Responds to COVID-19- Part I

Duration: 35 minutes

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2218023&sessionid=1&key=B0D8739554A6735C19B30AA5ECDAE3FD&regTag=&sourcepage=register

Title: SPECIAL EDITION – PART 2: Protecting Your Workforce and Understanding Policies as Your Organization Responds to COVID-19

Duration: 1 hour, 2 minutes

Available On Demand

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&partnerref=web&eventid=2225067&sessionid=1&key=1E14A512E04471768B1056BB7453393A&regTag=&sourcepage=register

PEO 101: HOW HR OUTSOURCING CAN HELP YOU AND YOUR CLIENTS DURING UNCERTAIN TIMES

Register

Cost Free

CPE Credits1.0 hour

CE Credits0.0 hours

Course Description

During these uncertain times, it is even more important for businesses to have help navigating employee issues like workplace safety, compliance, HR, payroll and employee benefits.  Outsourcing HR through a Professional Employer Organization (PEO) solution is something accounting professionals and their clients can consider for that level of support. Join our panel of CPAs and industry experts as they discuss the most critical elements you need to know about PEOs, from how they work and their benefits to the role they can help play in a crisis so your firm and your clients can both continue moving your business forward.

 

ADPhttps://www.adp.com/

 

 

 

COVID-19 Update to Temporary Change in HCS and TxHmL Policy for Service Providers of Respite and CFC PAS/HAB

by

Service Providers of Respite and CFC PAS/HAB

HHSC is lifting the prohibition on service providers of respite and CFC PAS/HAB from living in the same home as the person receiving Home and Community-based Services and Texas Home Living program services. This provides access to needed services for people living in their own or family’s home. A person’s spouse or a minor child’s parent is still prohibited from being a paid service provider of these services due to guidelines found in the following:

This is a temporary policy change. It is effective March 27, 2020 through Dec. 31, 2020.
Program providers must complete the required background checks for all service providers. They must follow:

Email the HCS program policy or the TxHmL program policy with questions.

FYI- Don’t forget that currently (Due to COVID-19) HHSC has said if you need to add on more CFC PAS/HAB units on the IPC,  you are not required to request SC to update the CFC PAS/HAB assessment.  The provider need only complete an IPC revision and IP update.

Our Services!

by

Twogether Consulting has added some new services to include:

DEVELOPMENT OF INFECTION CONTROL POLICIES & PROCEDURES, or at least to update your one with COVID-19 policies and protocols.  

(Based on Guidance noted in the HCS & ICF COVID-19 Response Plans                                                      

HCS-covid-response-plan.pdf     ICF-covid-19-plan.pdf

DEVELOPMENT OF EMERGENCY EVACUATION PLANS  In particular, so HCS/TxHmL providers are able to meet  compliance with Appendix K:  Emergency Preparedness and Response and COVID-19 Addendum

Appendix K-Emergency Preparedness and Response-COVID-19

Both of these items will most likely be requested of the provider, at some point during the survey process in the near future. (That’s if you have not already been asked to provide these items.)  This is especially true if the surveyor sees that you are not in compliance with HHSC’s COVID-19 Response Plan Guidance for the providers and CDC guidelines that are referred to in both of these documents.  These of course will definitely tie into TAC code citations and ICF Tags, particularly nursing and possibly ANE TAC codes for both programs (neglect in particular). 

For both of these services, contact us at:  info@twogetherconsulting.com   We would be glad to invoice you or you can notify us to make arrangements and then make payment at https://twogetherconsulting.com/payments/ 

OFF-SITE SERVICES TIME BLOCKS:  We now offer packages of 1 hr, 3 hrs, 6 hrs, 9 hrs and 12 hrs for those of you who need quite a bit of periodic off-site assistance services including but not limited to:: Question & Answer Sessions, Resources, Individual Policies or Procedures, Creating Forms,  and Other Inquiries.  Previously we only had 3, 6, and 9 hr blocks.  12-hr blocks purchased at one time will be at $60/hr (Total= $720)  For more information go to:  https://twogetherconsulting.com/services/off-site-services/   You may request an invoice or make direct payment instead to:  https://twogetherconsulting.com/payments/

This does not include Complete/extensive Policies and Procedures, Employee Handbooks, CAPs/POC’s , DIT’s, Webinars, or Off-site Training.  Please be sure to contact me directly if you have or are going to purchase online, and you would like to schedule some specific time for consultation javasbja@aol.com 

OFF-SITE RN CONSULTATION:   RN only consultation is available for $75 per hr.  
This is an option to pre-purchase hours with our RN Consultant who specializes in assistance to HCS/TxHmL and ICF providers.
For those of you who need periodic assistance off-site, including but not limited to:: General Inquiries about nursing services and concerns in these programs (via phone calls, video chat, email or text).  If you would like to schedule a teleconference or video conference with our RN Consultant and your nursing department or other members of your team, please contact us at info@twogetherconsulting.com  This is a great way to prepare for a survey, discuss post-survey concerns, develop ideas for plans of correction, discuss nursing concerns about an individual prior to admission, or assist nurses with new admissions to the program.  
 
This service does not include:  the actual development of policy & procedure or assistance with writing plans of CAP’s/POC’s, DIT’s, Webinars, or Off-site Training.  Please contact us at info@twogetherconsulting.com if you need these services.
 LON INCREASE PACKETS: 
(This is for off-site assistance only with LON increase packets)
 As a provider often times you may realize that some of your individuals do not have the correct LON (Level of Need)/  Now you may be aware that you have to request a new level of need, but do you know how to go about requesting that increase in the level of need?  Do you know what goes into the LON increase request packet?  Even if you know what to do, do you have time to fool with completing one?   Let us help!  We will have you send your documents to a private and secure shared folder, or you may choose to fax your documents  We will review the items and discuss them with you: what documents are missing, incomplete, or issues that may need to be addressed, as well as and concerns we have about the individual.  We provide recommendations and a list of all the appropriate documents including the order to put them in, to the provider.  We also write your cover letter for the increase and fill out your IDRC.  The provider will be responsible for then putting copies of those items in a packet and sending it off to the Utilization Review Department at HHSC for review.   You may choose hourly rate of $80/hr or flat rate of $800 for each LON increase packet we assist with off-site.  Please be sure to contact me directly prior to payment, even if you are going to purchase the flat rate directly online, so we can discuss your arrangements for off-site services including shared file options.  javasbja@aol.com 

SCORING ICAPS: Some providers are brand new or may have a small number of individuals in their program.  Sometimes you just can’t afford the initial cost of purchasing the ICAP scoring system or you simply don’t know how to use the scoring system very well.  So if you have ICAP renewals due or are requesting a LON increase, for example, we will be glad to score your ICAP’s for you.  Please give us at least 5 days’ notice, if possible.  The cost is $25 per ICAP online if you purchase at our “Store”. https://twogetherconsulting.com/store/

We can provide a discounted rate if you have more than 5 ICAP’s at one time that needs to be scored. Contact us at:  info@twogetherconsulting.com   We would be glad to invoice you,

Nursing Peer Review Process-If your facility needs training on the Nursing Peer Review Process or needs help with performing a Nursing Peer Review, please let us help.  You can contact us at info@twogetherconsulting.com to request assistance.  Remember, the provider can often use this process to assist the nurse and to prevent the nurse from going before the BON (Board of Nursing) if it is determined that the issues can and should be addressed by the facility and the nurse.  The nurse uses a group of his/her peers to assess the situation, determine the seriousness of the concern or allegation, and recommend appropriate corrections and solutions by the nurse and the facility.  This process can be used to correct certain nursing citations as well and again, possibly prevent the nurse from being reported to the BON. 

FYI-If you have 10 or more nurses working for your program (ICF, HCS, TXHmL, etc….), the BON requires the facility to have a “Nursing Peer Review Committee” to review Nursing Infractions and all facilities could benefit greatly from having some kind of “Nursing Peer Review Process” in place.

 [NPR §303.0015 ]

“Any person or entity that employs, hires, or contracts for the services of 10 or more nurses (RNs, LVNs or any combination thereof) must have a Peer Review Plan; however, peer review of RNs is not mandatory if the facility employs less than 5 RNs. A person or entity required to have nursing peer review may contract with another entity to conduct nursing peer review.”

 What is Peer Review? [Nursing Peer Review (NPR) §303.001(5)]

Peer review is the evaluation of nursing services, the qualifications of a nurse, the quality of patient care rendered by nurses, the merits of a complaint concerning a nurse or nursing care, and a determination or recommendation regarding a complaint including:

  1. the evaluation of the accuracy of a nursing assessment and observation and the appropriateness and quality of the care rendered by a nurse;
  2. a report made to a nursing peer review committee concerning an activity under the committee’s review authority;
  3. a report made by a nursing peer review committee to another committee or to the Board as permitted or required by law; and
  4. implementation of a duty of a nursing peer review committee by a member, an agent, or an employee of the committee.

A Peer Review Committee may review the nursing practice of an LVN, RN, or APN (RN with advanced practice authorization).

There are two kinds of nursing peer review:

  1. Incident-based (IBPR), in which case peer review is initiated by a facility, association, school, agency, or any other setting that utilizes the services of nurses; or
  2. Safe Harbor (SHPR), which may be initiated by an LVN, RN or APN prior to accepting an assignment or engaging in requested conduct that the nurse believes would place patients at risk of harm, thus potentially causing the nurse to violate his/her duty to the patient(s). Invoking safe harbor in accordance with rule 217.20 protects the nurse from licensure action by the BON as well as from retaliatory action by the employer.

See revised rules 217.19 (Incident-Based Nursing Peer Review and Whistleblower Protections) and 217.20 (Safe Harbor Peer Review and Whistleblower Projections){http://www.bon.state.tx.us/nursinglaw/rr.html}

We are sorry to say, that our plan to start providing training again with Nursing CNE’s has been put on hold, due to the Pandemic (COVID-19).  We will keep you posted.

 Provider Specific Training offered by Twogether Consulting

  • Training (Off-site) to Providers concerning Direct Care staff’ssurvey interviewer interaction with Surveyors during interviews and how this can affect the provider, particularly the nursing department, as well as preparing for the survey in general.  (HCS, TXHmL, and ICF)
  • Training (Off-site) to Providers concerning “Expectations of The Nurse Part I and II”  (HCS, TXHmL, and ICF)
  • Training (Off-site) to Providers concerning Nursing Staff’s interaction with the Surveyors, particularly during the interview process with the nurse.  (HCS, TXHmL, and ICF)
  • Training (Off-site) Other Direct Care staff training such as Abuse Neglect & Exploitation Reporting and Follow-Up for HCS/ICF, including PPT handouts,  Quiz and Inservice Sheet for your records or Certificates of Completion. This training does meet the new requirements listed in the current HCS TAC Code 9.175     Geared towards CM’s, QIDP’s, Nurses, Quality Assurance, Program Managers and  other Administrative Staff                                                   
  • Other Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:
  • Abuse/Neglect/Exploitation-specific to Direct Support Staff
  • Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),
  • Elements of the Behavior Support Plan & The Importance of Your Documentation,
  • Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations), 
  • When and What to Report To The Nurse,
  • SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), ,
  • Host Home/Companion Care Service Provider Responsibilities,
  • What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.

Letter From Twogether Consulting To Providers-Update

by

November 23rd, 2020

Hello Friends,

Please check out our “Updates” page.  It has been reformatted so you are able to navigate from one “post” to the other. If you want to read more on each section, just click on “read more”.  We have also updated the “Off-site Services” page so that you can pay for hours of off-site consultation right on the same page.  Remember there is a discount for blocks of time larger than 3 hours, purchased on the site.  This discount is only available online on this “Off-site Services” page. Twogether Consulting also has also added our “Store” page on the dropdown menu under “Services”.  In addition to the off-site hourly packages in the “Store”, we will be adding some additional services in the near future for a flat rate, for purchase on this page..

Currently, all our services are technically “off-site”, due to COVID-19, but these consultation package prices on the “Off-Site Services” page are only for just that, consultation by phone, email, video chat, or text. They do not include our rates for developing policies and procedures, LON increase request packets, or any other services we provide.

Twogether Consulting is continuing to work to ensure minimal disruptions to our business while putting the safety and well-being of our providers, their individuals in the program, and our contractors as our highest priority. Please see below for specific information:

  • In-person group trainings/conferences: Suspended until at least January 31st, 2021 at this time.  Most of these classes have already been moved to online webinars or training.  We also have pre-recorded sessions of some of these trainings as well.
  • Online training (Webinars): Proceeding as planned.  We will be posting upcoming webinars to the website regularly on the homepage: www.twogetherconsulting.com 
    • Webinar Registration:  Click on calendars on our website at www.twogetherconsulting.com or https://events.time.ly/anatx6f
    • Recordings of Free Webinar Series:  https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b
    • “Updates Page”  https://twogetherconsulting.com/updates/
    • We will continue to provide 1 on 1 webinar training and any general trainings done for a specific facility/ provider for Care Coordination, Nursing Services, Direct Support Staff, etc.…
    • We have pre-recorded sessions with handouts for those of you who can’t attend live sessions or can’t wait for a live session. They range from $25-$150 per session.  These range from 1 hr- 3.5 hrs per session.
    • “Pop-Up Webinars”:  We will occasionally send out invitations to some webinars to those of you who are already clients of Twogether Consulting or who are on our mailing list.  These won’t be posted for the general public.  These will be fairly short notice and based on topics that we receive a large number of requests to provide.  They will also be limited registration.  (15-30 persons max).
    • Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:  Abuse/Neglect/Exploitation, Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),  Elements of the Behavior Support Plan & The Importance of Your Documentation, Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations),  When and What to Report To The Nurse, SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), Preparing For Survey in the Group Home/Surveyor Expectations in the Group Home, Host Home/Companion Care Service Provider Responsibilities, What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.
  • Consultant Support: Twogether Consultants continue to be available to assist with your HCS/TxHmL and ICF needs as usual.  We will provide anything you request of us, that we can off-site.
    • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  We charge $75/hr and we can offer blocks of time for more than 3 hrs at a slight discount if you pay online at: https://twogetherconsulting.com/services/off-site-services/
    • if there is an extensive project (anything over 6 hrs, we will discuss flat rate options or daily rates.)
    • We continue to provide as-needed off-site consultation including, but not limited to: Development or assistance with policy and procedure, Monthly/Quarterly QA via Taskmaster Pro, Therap, or any other cloud-based services, Survey and Audit Prep, and you are welcome to contact us if you need us to QA or review documents through our secure cloud storage system. We also provide off-site nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is temporarily suspended at this time, due to the recent Guidelines from HHSC for HCS/TxHmL providers as of 3/17/20 by HHSC.  See link below:
  • https://apps.hhs.texas.gov/providers/communications/2020/letters/PL2020-12.pdf
  • We are not considered “essential visitors” at this time, according to HHSC.
  • Concerning our ICF providers, we will follow the same guidelines ICF has provided at this time.
  • Remember for ICF we can still provide Directive Inservice Trainings (DIT) if necessary, but we prefer to provide these off-site via webinar, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know. If this must be done in person, it must be for 8 or less attendees at a time. All attendees must be screened for possible Covid-19 symptoms.
  • Payments:  We prefer payment via our PayPal Invoices, with Credit Card/Debit/ or PayPal.  You are also welcome to pay via e-check, or request to pay by Venmo.  You may also use our online link below to pay:  https://twogetherconsulting.com/payments/
    • If you must pay by check, please let us know prior to mailing the check.  Thank you.  Send all checks to:

Twogether Consulting  P.O. Box 90426 Austin, Tx 78709.

Any updates to our COVID-19 response will be posted at:  https://twogetherconsulting.com/updates/

Note: We will continue to send out the newsletter 2 x per month.  If you want to me on the mailing list, please contact us at:  info@twogetherconsulting.com

You may contact us by phone with any questions at:  512-294-8032.  You may email me directly at:  javasbja@aol.com or javasbja@gmail.com

Thank you and be well,

Julie Andrews Blacklock/Owner & IDD Waiver Consultant

 

BinaxNOW COVID-19 Test Training Link

by

November 22nd, 2020

Navica and BinaxNow Covid Ag CardUpdated Training Link Available for the BinaxNOW COVID-19 Test

A BinaxNOW COVID-19 Ag Card training video that provides detailed step-by-step guide to the test process is on the Abbott website. The training video is for people without medical training, who will conduct COVID-19 testing using the BinaxNOW Ag card. As part of the request for free BinaxNOW test kits, providers will confirm that staff performing the COVID-19 tests have completed the BinaxNOW COVID-19 Ag Card training.

The BinaxNOW COVID-19 Ag Card (PDF) is a rapid point-of-care antigen test which detects the presence of antigens in persons infected with the virus that causes COVID-19. This test is approved for use under an Emergency Use Authorization by the Food and Drug Administration.

View the free online training here

HHSC Publishes Revised Attestation for Free Testing Kits

HHSC has published a revised attestation form for free BinaxNOW point-of-care antigen COVID-19 test kits for NF, ALF, ICF, HCS and HCSSA providers. The form was revised to correct the BinaxNOW training link required for staff who do not have medical training and will be administering the COVID-19 tests using the BinaxNOW Ag card.

Don’t Forget Annual Vendor Submission Due (Nov.1st-Jan31st) HCS/TxHmL!

by

HCS and TxHmL Annual Vendor Submission Timeframe
11/17/2020
NEW LOGO - SMALLER
Blue Gradient

HCS and TxHmL Annual Vendor Submission Timeframe

The timeframe to submit for annual vendor approval is Nov.1, 2020 through Jan. 31, 2021. Required documentation for annual vendor requests are in the HCS and TxHmL Billing Guidelines, Section 6160(b)(2), Approval of Annual Vendor. Email packet submissions to Billing and Payment with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received.

If you are unable to meet the deadline to submit, please request an extension by emailing Kaliope Schmidt, the Billing and Payment manager. Email Billing and Payment or call at 512-438-5359 with your questions.

Free Webinar Series

by

Our free webinar session recordings previously recorded are currently posted on our “Gotostage” page.
https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b

 We are pleased to announce our first guest presenters for  January 2021!

Free Webinars!!

 

Guest presenters:

Brittany Brown/Insurance Broker

Date:January 12th, 2021

Time:  Noon-1pm (Central Time)

Cost:  Free!!!

Where:  Webinar

To register for the session:

Please register for Free Webinar: Presented By AssuredPartners (Texas) Group Health Insurance “Employee Advocacy & Long-Term Strategic Planning For on Jan 12, 2021 12:00 PM CST at:

https://attendee.gotowebinar.com/register/8401752488419813645

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

Brought to you by GoToWebinar®
Webinars Made Easy®

 

Brittany and her team help to provide assistance for finding group health insurance benefits for companies with 40+ employees.  They provide a 2-year blueprint on approaching health benefits strategically.  You can receive one of these “blueprints” for free, even if you are not signed up with them yet.  Please contact Brittany for more information if you would like to have a custom “blueprint” completed for your facility/company. They are the 12th largest agency with offices all over.  Brittany is located in the Houston area but can work with you wherever your facility or company is located.  If your company insurance for your employees is not adequately covering costs or is now too much for your employees to afford, then they can help you to find what will work for you and your company. They have locations in the Dallas and Houston areas as well as other cities in Texas.

For more information contact Brittany Brown at:  Brittany.brown@assuredpartners.com 

You may also go to their website at: https://www.assuredpartners.com/Houston 

Previous Free Webinars in Oct. and Nov. 2020- Liks to Recorded Sessions Available Below !

 

Guest presenters:  Erin Langlais & Mitchell Deter

From:  ADP Payroll & HR Services

“As more people continue to return to the workplace, ADP is excited to share tools that are designed to help them, and their people transition back safer, easier, and more effectively. ADP’s free webinar will provide guidance on how to return to the workplace safely and compliantly, and cover topics like the Payroll Tax Deferral Memorandum, and how to accurately classify 1099 vs. W-2 employees.”

Date: Tuesday –October 27th, 2020 (Session ended)

Time:  Noon-1pm (Central Time)

Cost:  Free!!!

Watch recorded webinar session at the link below:

https://1drv.ms/v/s!AsXbls7Zifn4nW5JmM1v4LJYt5kW

Topic:  “ReturnTo Work” COVID-19 Concerns & Provider Resources

(Including Information on Property Tax Deferral Memorandum!!)

“As more people continue to return to the workplace, ADP is excited to share tools that are designed to help them, and their people transition back safer, easier, and more effectively. ADP’s free webinar will provide guidance on how to return to the workplace safely and compliantly, and cover topics like the Payroll Tax Deferral Memorandum, and how to accurately classify 1099 vs. W-2 employees.”

HRS Inc

Guest presenter:

Hillary Gaytan  (Business Development Representative)

From:  HRS

Date: Wednesday -October  28th, 2020  Session Ended

Time:  Noon-1pm (Central time)

Cost:  Free!!!

Where:  See recorded link below:

https://attendee.gotowebinar.com/recording/3788852608729403404

Here is a link to a short, introductory video about the HRST: https://hrstonline.com/video/index.php?id=410335893

Topic:  Health Risk Screening Tool

HRST  (Health Risk Screening Tool) is an assessment tool that can identify & detect health risks in vulnerable populations. This tool and other services offered by HRS are based on person-centered practices. Here is a little more information about HRS from their website. The Health Risk Screening Tool (HRST) identifies and tracks health risks in vulnerable populations, making it possible to design a plan tailored to meet the unique health and safety needs of each individual in the least restrictive setting. The instrument can objectively justify resources allocated both financially and in service intensity. Used by Case Managers, supervisors, and direct support professionals. HRS also helps the provider to comply with CMS Rules and assist with Person-Centered planning and continuity of care.  It is field-tested, reliable, and user-friendly

“Health Risk Screening, Inc.’s roots began in 1992. Along with training courses, webinars, and materials, HRS is the sole developer, producer, and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with intellectual and developmental disabilities.

HRS was established on the principles of person-centered practices. Our founder, Karen Green McGowan was a pioneer in the early formative days of the person-centered movement..  Our focus is on developing tools and training for the person-centered support of vulnerable populations. Through the education of government agencies and service providers, we have helped improve people’s lives. Along with training courses, webinars and materials, HRS is the sole developer and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with disabilities.”

For more information, please contact  Hillary Gaytan at:  Phone: 727.754.9539  Email: hilary@hrstonline.com
You can also go to their website:  www.hrstonline.com 

Check out this great page they have devoted to COVID-19 Resources:  https://hrstonline.com/covid-19-resources/

 

HRS Inc

Guest presenter:

Patrick Lane  (PCT Mentor & Trainer)

From:  HRS

Date: Thursday -November 12th, 2020  (Session ended)

Time:  11am-12pm (Central Time)

Cost:  Free!!!

Where:  See recorded link below:

https://attendee.gotowebinar.com/recording/1049673375643527182

Topic:  Person-Centered Services 

Patrick will be talking about some of the Person-Centered Services offered at HRS including software that helps the provider develop Person-Centered Descriptions. These can be used as a resource for making annual plans Person-Centered by using these same person-centered skills practiced in PCT sessions. 

“Person-Centered Planning Training is designed to help you approach support from a more holistic angle, with person-centered practices that respect the autonomy of those with intellectual and developmental disabilities while providing them with the highest possible level of care.”

Improve The Quality of Life

  • Balancing personal choice with personal responsibility by establishing and maintaining things that are important to the person with things that are important for the person
  • Being integrated in one’s community so that the person is known and respected for her or his contributions.
  • Being respectfully communicated with as a person, using language consistent with being a typical adult as opposed to using clinical or system language
  • Receiving support that is consistent so that new staff and others know and respect the person’s values and choices, as well as how others can help the person.
  • Being matches with staff, housemates, or others that the person making life more enjoyable.
You can contact Patrick at: patrick@hrstonline.com     For more info about HRS PCT services, please see the following link: https://hrstonline.com/person-centered-services/

 

 

Guest presenter:

Steve Cardie

From:     Abundant Health

Date: Tuesday -November 17th, 2020  (Session ended)

Time:  Noon-12:45 pm (Central Time)

Cost:  Free!!!

Where:  See link to the recorded session below:

https://attendee.gotowebinar.com/recording/5931551182568587528

Topic:  Cellular Blood Pressure Monitoring System   (Free To Medicare Patients!)  

Abundant Health is the distributor of a remote blood pressure monitoring system for Medicare patients that is the best on the market. It is the only FDA approved cellular blood pressure monitor. It makes it easy to report regular blood pressure monitoring to your physician with little to no effort and proving complete HIPPA compliance.  The system is much like your standard wrist BPM cuff, but it has a SIM card in it that reports all data instantly to your physician and can supply records that can be printed out by the client or facility for the individual’s records.  This would be a great system as well for individuals living in their own family home or in a host home setting that may want to be as independent as possible or may cut down on needing as much staff assistance and/or supervision.  Abundant Health works with providers, clinics, hospitals, and physicians across the country.   Here is a quote from one of them:

“Our new Cellular Blood Pressure Monitor System connects automatically to cell towers and transmits your patient’s information directly to your practice. This device makes it simple for seniors who tend to be more technology challenged to utilize Medicare’s RPM program without the difficulty of connecting to cell phones or the internet. No passwords, no Bluetooth, no internet connections required.

The rapid advance of medical device design plus an enormous upgrade in telecommunications makes Remote Patient Monitoring (RPM) suddenly possible for virtually everyone. Anywhere.  In November 2018 CMS officially approved three new billing codes for Remote Patient Monitoring (RPM).  The telehealth industry experts agree that this is the biggest financial incentive to date in the history of digital medicine.”

Register for the webinar at    https://attendee.gotowebinar.com/register/3642654945259750160

You can contact Ayshe at:

 

Guest presenters:

Brittany Brown/Insurance Broker

Date: January 12th, 2021

Time:  Noon-1pm (Central Time)

Cost:  Free!!!

Where:  Webinar

Brittany and her team help to provide assistance for finding group health insurance benefits for companies with 40+ employees.  They provide a 2-year blueprint on approaching health benefits strategically.  You can receive one of these “blueprints” for free, even if you are not signed up with them yet.  Please contact Brittany for more information if you would like to have a custom “blueprint” completed for your facility/company. They are the 12th largest agency with offices all over.  Brittany is located in the Houston area but can work with you wherever your facility or company is located.  If your company insurance for your employees is not adequately covering costs or is now too much for your employees to afford, then they can help you to find what will work for you and your company. They have locations in the Dallas and Houston areas as well as other cities in Texas.

For more information contact Brittany Brown at:  Brittany.brown@assuredpartners.com 

You may also go to their website at: https://www.assuredpartners.com/Houston 

 

 

Pre-Webinar Survey For: “Round Table Discussion For Nursing Concerns In IDD Programs” (HCS/TxHmL/ICF)

by

Pre-Webinar Survey

For those Nurses registered or planning to register for our Dec 11th, 2020 follow-up session:                                                                                      “Round Table Discussion For Nursing Concerns In IDD Programs” (HCS/TxHmL/ICF)

We did not get to at least 4 of our questions primarily on COVID during the 1st Round Table Discussion on 11/5/20.  We still have some questions on RN Delegations that we need feedback on for future sessions and COVID-19.  We felt they were very important and did not want to wait until the Feb. quarterly session.  Thanks.
Please print out this page and document your answers and responses to help us to develop topics of discussion during our 1st session as well as future round table sessions.
You will need to scan your completed survey and email them as soon as possible, but by no later than 12/08/20, to info@twogetherconsulting.com or you may also submit them when you complete your registration prior to 11/1/20 to Meghan Jones.  Her email is:  meghanjones.tx@gmail.com if you prefer.  You do not have to put your name on the survey!   You can also fax them to 512-291-9075

Survey:

Short Nurse input: Please let us know what you are hoping this forum achieves for you specifically;
(in a few short words)

Survey Questions:  

Points to Ponder
“The National Developmental Disabilities Nurses Association categorizes the responsibilities of IDD nurses as fitting into eleven categories”: Our present focus today is to develop input from the nurses as it relates to delegation and assignment:
“The responsibilities of delegation and authority contribute to the ambiguous role of the IDD nurse. Delegation is the process by which responsibility and authority for performing a task are transferred to another individual. In the delegation process, the delegator remains accountable for the task that has been delegated. However, in many settings, the IDD nurse does not have supervisory authority over the unlicensed direct support staff who provide much of the hands-on day to day care of people
with IDD.”

 

1. Does your employer possess a basic understanding of RN delegation responsibility and practice guidelines, and acknowledge your role in the delegation decision-making process?
a. Yes, my employer is supportive & knowledgeable in the basic delegation decision process
b. I am assigned delegations and there is not a cohesive framework or systematic process
c. I believe that the Program Manager, Case Manager, and UAP are willing to learn from the RN and improve basic
knowledge as well as move towards an educational and systematic approach to safe RN Delegation processes.

ANA Quote
“The American Nurses Association describes unlicensed support staff as individuals trained to function in an assistive role to the registered nurse. Without supervisory authority, IDD nurses have little opportunity to intervene when necessary to ensure safe and appropriate healthcare. This inability to practice to the full extent of licensure can lead to frustration for the IDD nurse”.

2. Do you have supervisory authority and do you understand the scope of your delegation authority: (i.e. input on related policies, recommendations for UAP’s, concerns with repetitive medication errors, or lack of correct implementation by UAP related to delegated tasks performed in accordance with protocols).
a. Yes
b. No

Describe your input on a solution (if you are an RN):

 

c. N/A  (Not an RN)

3. TRUE OR FALSE (circle one)
I find that the rules are fragmented and regulations may be misunderstood and standardized nursing practice is difficult to achieve.

 

4. TRUE or FALSE (circle one)
Covid 19 Processes: we have processes in place. We are following CDC guidelines, and I am clear on the established Policies and Protocols that are mandated.

If you answered “false” to this question briefly describe your needs:  (i.e. -education, sample policies, etc…)

 

COVID-19 – “Food For Thought”:  There are a lot of considerations and concerns in the workplace for Providers of IDD services, in particular nurses as well as staff. Has protocol and training been developed, implemented and how are we monitoring this?  How can we do this effectively?  Other questions like: Is this protocol actually occurring?  Is it being implemented correctly by nurses and staff?  In addition, are we ensuring we are following the most ethical standards and considering the feelings, mental state and concerns of our individuals?  Are we taking into proper consideration the safety of our own family members in our daily protocol, for when we come and go from the facility?  Are we trying to mitigate COVID-19 in every way possible?  Is “burn out” happening with ourselves or our staff and what can we do to prevent it?

5.  Do you feel isolated as a nurse, during the pandemic at your work?

a. Yes    b. No

If you answered “yes”, please comment:  (i.e. In what way do you feel isolated in the workplace?)

Comment:

 

6.  Do you feel “burn out” yourself or among your fellow nursing staff?

a. Yes    b. No

If you answered “yes”, what do you think we might be able to do about it?  (Or ways facility might be able to help manage it?)

Comment:  

 

7: What obligation do you think you have to yourself and/or your family (while in the workplace during the pandemic)?

Comment:

 

 

 

Very Important HHSC Alerts!

by

November 22nd, 2020

COVID-19 Guidance for Activities, Dining, and Volunteers for the Holidays (PL 20-53)

HHSC publishes Provider Letter 20-53 Guidance for Activities, Dining, and Volunteers (PDF). The letter outlines provider responsibilities for resident activities, including communal dining and holiday-related activities.

The letter also gives specific stipulations on the use of volunteers and guidance on the protocol for residents who leave a facility.

This guidance can be used as a general reference through the duration of the COVID-19 pandemic.

November 22, 2020

HCS Training Webinars on the TAC Principals for November 2020

https://hhs.texas.gov/about-hhs/communications-events/news/2020/10/november-hcs-provider-certification-principle-webinars

Future topics:
9.178 Quality Assurance
9.173 Rights of Individuals
9.174 Service Delivery
9.181 and 9.182 Administrative Penalties and Amelioration

 

October 11th, 2020

IPC COVID-19 Policy Guidance for CLASS, DBMD, HCS and TxHmL Programs         

HHSC is not requiring a face-to-face meeting with an individual or their legally authorized representative for individual plan of care revisions. This is per COVID-19 guidance IL-20-11.

In addition, until further notice by HHSC, signatures from the individual or the LAR on the IPC or supporting documentation is not required before submitting to HHSC.

All required signatories that are not the individual or LAR (SC and Provider Representative) must sign the IPC and supporting documentation before submission.

For meetings currently conducted by phone or videoconference to revise an IPC, required individual or LAR signatures on the IPC and supporting documentation can be done electronically, by fax, by mail, or in person if face-to-face restrictions have been lifted and it is safe to do so. If unable to obtain a signature by the methods mentioned, document the following:

  • The date of the meeting held by phone or videoconference
  • The reason for the meeting and what was discussed
  • If the individual or LAR agree with the services as indicated on the revised IPC

September 30th, 2020

Information Letter No. 20-42

Residential Services During COVID-19

HHSC has been informed that some individuals living in a three-person or four-person residence are temporarily staying with family during the COVID-19 public health emergency (PHE). In accordance with the HCS Billing Guidelines, a program provider is unable to bill for residential support or supervised living if an individual is away from a three-person or four-person residence for longer than 14 consecutive days.
HHSC is in the process of seeking approval from the Centers for Medicare and Medicaid Services (CMS) to make retainer payments to HCS program providers during the PHE for residential support and supervised living for up to 90 days an individual is absent from the residence in excess of the 14-consecutive day period. If CMS approves, HHSC will provide information to program providers about billing retainer payments for the period of March 20, 2020, through October 23, 2020, and conditions a program provider must meet to receive the payments. By October 5, 2020, HCS program providers must provide an electronic or hard copy of the attached letter to an individual (or the individual’s legally authorized representative) whose residential location is a three-person or four-person residence and who is temporarily staying with family because of the PHE.
Questions regarding this information letter can be directed to HCSpolicy@hhsc.state.tx.us
The letter to send to the individual and their LAR’s is attached to information letter No-20-42
“…Since you have not received residential services for an extended period during the PHE, to ensure your individual service plan accurately reflects the services you need, you must decide to do one of the following by November 1, 2020
:•return to your three-person residence or four-person residence; or
•change your residential location from “three-person residence” or “four-person residence” to “own home/family home”;or
•change your residential location from “three-person residence” or “four-person residence” to “host home/companion care”
if your provider can contract with a person in your own home or family’s home to deliver the “host home/companion care” service. By November 1, 2020, your program provider will contact you about the decision you have made. If your decision is to change your residential location, the program provider will initiate revisions to your individual plan of care (IPC) and person-directed plan (PDP)…”
For more information and the complete letter to the individual and LAR’s, please see the entire information letter.

September 15th, 2020

Abuse, Neglect, and Exploitation Competency Training and Exam

Now Available in Spanish!!   

HHSC’s Abuse, Neglect and Exploitation Competency Training and Exam is now available in Spanish.

This training is designed to meet the basic ANE training requirements for staff providing direct care in a community setting.

To access the training and exam:

  1. Go to the Texas HHS Learning Portal
  2. Staff members, service providers and volunteers must first sign up on the Learning Portal to access HHSC-approved trainings, if they have not already created an account.
  3. Click “Medicaid Long Term Services and Supports Training” and select “Curso para la prevención del abuso, negligencia y explotación (ANE)” to access the ANE training and test in Spanish.

ANE Competency Training & Exam

The training and exam requirements for the following long-term services and supports programs can be found below:

Home and Community-Based Services

TAC §9.175 Certification Principles: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual

HCS Handbook Appendix XII, Abuse, Neglect, and Exploitation Training and Competency Test

Texas Home Living

TAC §9.585 Certification Principles: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual

TxHmL Appendix IX, Abuse, Neglect, and Exploitation Training and Competency Test

Reporting a Death to HHSC in the HCS/TxHmL Programs

September 3rd, 2020

To report a death, HCS/TxHmL providers should complete Form 8493, Notification Regarding a Death in HCS, TxHmL programs by the end of the next business day following the program provider becoming aware of the individual’s death. Then fax the completed form to HHSC to 512-206-3999according to the newest version of form 8493 that was updated in May of 2020.

FYI-The previous fax # was 512-438-4148, which is still noted on the HHSC website as of now.  Please make sure you are faxing to the fax # listed on form 8493.

 

August 10th, 2020

Administrative Penalties Update!

HHSC Postpones the Implementation of Administrative Penalty Rules for HCS and TxHmL Providers

Due to COVID-19, HHCS is delaying the implementation of the administrative penalty rules for HCS and TxHmL providers until January 1, 2021.

If you missed the most recent webinar for Home and Community-based Services and Texas Home Living providers Long-term Care Regulation to discuss questions and answers related to administrative penalties on July 9th, please register to watch recorded session below.

Register for the WSC Q&A Webinar Regarding Administrative Penalties.

If you missed the initial Joint Provider’s webinar on June 25th discussing Administrative Penalties, you may see the webinar recording of the session below. 

June 25, 2020

A recording of June 25, 2020, HCS and TxHmL Joint Provider Training on Administrative Penalty Rules webinar is available for those unable to attend.

View the webinar recording here

June 7th, 2019

Revised: IL20-11 Temporary Guidance Extended Through Oct. 30 for IPC’s & IDRC’s

To ensure people do not experience a gap in services due to the temporary suspension of face to face service coordination visits for COVID-19, the Texas Health and Human Services Commission will extend Intellectual Disability/Related Condition assessments and individual plans of care expiring at the end of June 2020. This is for people enrolled in the Home and Community- based Services Program or the Texas Home Living Program.

HHS revised IL20-11, Extensions of Eligibility and Individual Plan of Care Revisions for Individuals in HCS and TxHmL Due to COVID-19 (PDF). It was previously issued on March 26 and extends the temporary guidance through Oct. 30, 2020.

Call the IDD Program Enrollment Support message line at 512-438-2484 for ID/RC assessment questions.

Call the IDD Utilization Review message line at 512-438-5055 for IPC extension or revision.

Billing Guideline Updates For HCS

November 20, 2019

The HCS, TxHml, and CFC billing guidelines have been updated effective Nov. 15, 2019. A summary of the revisions can be found on page 25 of the CFC PDF, page 147 of the HCS PDF and page 129 of the TxHmL PDF. Send questions about the billing guidelines to HCS.TxHml.BPR@hhsc.state.tx.us.

TAC Updates for HCS

Effective Oct. 1, 2019

Texas Administrative Code has been updated effective Oct. 1, 2019.

Locate program rule updates at 40 TAC Chapter 9 – Home and Community-based Services and Texas Home Living Programs and 40 TAC Chapter 49 Contracting for Community Services.

Send questions about rule updates to hcspolicy@hhsc.state.tx.us or txhmlpolicy@hhsc.state.tx.us and to COS_CFCMTools@hhsc.state.tx.us
for 40 TAC Chapter 49 Contracting for Community Services.

Please pay particular attention to 9.175 (ANE Reporting Rules) in HCS and changes to Tac 9.178 Quality Assurance

Please see the link below to verify the current TAC changes.

https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=9

. Both HCS and TxHmL rules can be accessed here.

Email medical_and_social_services@hhsc.state.tx.us with your questions.

HHSC Launches IDD Operations Portal for HCS, TxHmL, ICF-IID, CFC Non-Waiver Providers and LIDDAs

The Texas Health and Human Services Commission are pleased to announce the implementation of the Intellectual and Developmental Disability Operations Portal. Local Intellectual and Developmental Disability Authorities, Home and Community-based Services, Texas Home Living, Intermediate Care Facility for Individuals with Intellectual Disabilities providers may begin registering to use the IDD Operations Portal starting April 1, 2019.

The IDD Operations Portal is an online system that allows secure submission of electronic documents to and from the IDD Program Eligibility and Support and IDD Utilization Review departments. This portal is not replacing any of the systems you use today, such as TMHP or CARE. It is intended to result in a more timely and efficient submission of documents, and allows providers to check the status of submissions online.

Staggered implementation is happening now. Providers and LIDDAs with DBAs starting with C-G can now register for portal access.

Please see the full implementation schedule detailed in the information letter listed here.

HCS/ICF Provider Job Openings & Job Positions Desired

by

Based on the many phone calls, emails and contacts through our social media pages concerning Job Positions Desired and Job Openings with HCS providers, I have decided to use our “Updates” page to provide a place where both those persons desiring a position with an HCS Provider and those Posting a Job Position can find each other!

We will not be posting the job description or information on this page directly.  If you contact Meghan Jones at meghanjones.tx@gmail.com and let her know where you are posting a position and who to contact, we can put a link and the contact person’s name, # and/or email.  For example, you are posting on Indeed, Linkedin, BenefitMall, Facebook, PACSTX job postings, an online newspaper, etc…

We will also continue to repost openings when we can on our Linkedin page as well as our Facebook and Instagram pages for Twogether Consulting.

There is no charge, we just ask you all to keep referring us to others who don’t know about us for their HCS business needs and of course we hope you will continue to use our services to assist you with your training needs, on-site and off-site assistance. 

Julie Blacklock/ Owner

 

Current Job Postings (See below)

Down Home Ranch   (Posted 11/16//20)                                                                                                                                                                                                                             (Elgin, Tx)
Position opening:  Part-time LVN
Please go to the following add on Indeed to respond
20250 FM619
Elgin, TX 78621

 

Direct Support Training Resources

by

College of Direct Support  http://www.directcourseonline.com/direct-support/about/

DirectCourse | “College of Direct Support brings training in line with the latest research and partners with other leaders in the field of Intellectual and Developmental Disabilities”

Has a fantastic training curriculum for Direct Support Staff and their supervisors.  See a list of courses from the 2019 catalog in the link below:

https://www.directcourseonline.com/wp-content/uploads/2019/07/2019-CDS-catalog_Final.pdf

Direct Support Professionals 

From the DSP Perspective: Exploring the Use of Practices That Align With Trauma-Informed Care in Organizations Serving People With Intellectual and Developmental Disabilities
An article in the June 2020 issue of Intellectual and Developmental Disabilities by an author affiliated with Indiana University Bloomington discusses a study that explored the extent to which intellectual and developmental disabilities organizations utilize practices that align with trauma-informed care with their DSP workforce. (abstract free of cost, full-text access available with a fee)

The Impact of Ongoing Staff Development on the Health and Safety of People With Intellectual and Developmental Disabilities
An article published in the Journal of Developmental and Physical Disabilities by an author affiliated with the Council on Quality and Leadership reports on a study exploring how ongoing staff development impacts the health and safety of people with intellectual and developmental disabilities. (abstract free of cost, full-text access available with a fee)

 

Free Online Training at The Center For Start Services:  The  National Leaders in the Mental Health Aspects
of Intellectual and Developmental Disabilities                                                                                                                                                                                                     For all their training go to  https://www.centerforstartservices.org/community-resources

Free Video Training from the NADSP and AADMD  “The Role of The DSP and The Corona Virus”,  Part I-check out this amazing training video.    https://youtu.be/ud4Q4e_hcuw

Part II of this DSP Video Training session is as follows:  “The Role Of The DSP and The Corona Virus” Part II  https://youtu.be/VfErVzMn9-A

Free Training For Those Who Support Persons With IDD

https://hhs.texas.gov/about-hh s/communications-events/news/2017/01/free-training-people-who-support-clients-idd

In-Home Day Habilitation Temporary Policy Changes During COVID-19

by

HHSC’s information letter (IL) revises IL 20-19, In-Home Day Habilitation Information for Program Providers for COVID-19, previously revised on July 30, 2020, to extend the temporary guidance through November 30, 2020.In response to COVID-19andtoprovide access to needed day habilitation services, the Health and Human Services Commission(HHSC)is temporarily waiving certain requirements in Sections4320and 3710of the HCS Billing Guidelines and the TxHmL Billing Guidelines. Specifically, Section 4320 permits day habilitation to be provided to an individual in the individual’s residence only if justified because of the individual’s medical condition or behavioral issues or because the individual is of retirement age. Section 3710 prohibits one service provider from providing different service components or subcomponents at the same time to the same individuals.
Below are descriptions of the temporary policy changes.
See page two for the current policy under Sections 4320 and 3710. Effective March 13, 2020, through November 30, 2020:
●HCS or TxHmL program providers may provide day habilitation to an individual in the individual’s permanent or temporary residence without having the justification required by Section 4320. This includes individuals residing in their own homes or family homes.
●HCS program providers may, if an individual in the HCS Program is receiving day habilitation in the individual’s temporary or permanent residence, allow the individual’s service provider of residential support, supervised living, or
●host home/companion care to provide day habilitation to the individual at the same time the service provider provides residential support supervised living, or host home/companion care to the individual.  For more information please read information letter IL 20-19 
https://apps.hhs.texas.gov/providers/communications/2020/letters/IL2020-19.pdf

HCS Expanded Visitor And Emergency COVID-19 Mitigation Rules

by

HHSC Publishes HCS Expanded Visitor Attestation Rules & Guidance Letter

September 25th, 2020

HHSC Visitor Expansion Rule.  See the following rules in PDF updated on 9/25/20.  https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/hcs/hcs-covid-19-updated-emergency-rules.pdf

PL-20-40 is the letter providing guidance for the new rules  The new attestation form is at the bottom of this alert letter from HHSC.  See the following PDF of PL-20-40:  https://apps.hhs.texas.gov/providers/communications/2020/letters/PL2020-40.pdf

 

 

 

HCS Emergency COVID-19 Mitigation Rules 

Click on link below to see new rules that were adopted!

hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/hcs/hcs-covid-19-emergency-rules.pdf

LTC Expanded Facility Visitation Rules For Re-Openings in Texas

by

 

 

An ICF resident, as well as an individual living in an HCS group home, may have up to 2 Essential caregivers, as defined in the emergency rules, and they must have a negative COVID-19 test result from a test performed no more than 14 days before the first essential caregiver visit unless the facility chooses to perform a rapid test prior to entry into the facility.  Providers are still seeking clarification for some of the new COVID-19 emergency mitigation rules (including visitation rules) for persons receiving HH/CC services.  We plan to keep you updated!
Expanded ReopeningVisitation:
Phase 1 requirements all remain in place (except for compassionate care visits, which are being replaced with less restrictive essential caregiver visits.)
All facilities without an active facility acquired outbreak can move to visitation as outlined in the emergency rules(including those with isolation wings), but visitation is only allowed for residents/individuals,  who are NOT COVID positive and in areas away from COVID positive isolation areas.
Essential caregivers will be trained by the facility on PPE use and infection control, and they must meet the testing requirement.
Reopening is optional for facilities; those that do not feel they have the resources to re-open safely will not be mandated to open or allow for essential caregivers.
See the link below for more information on Visitation Rules for LTC Facilities, including ICF and HCS
https://hhs.texas.gov/sites/default/files/documents/services/health/coronavirus-covid-19/reopening-visitation-ltc-facilities.pdf 

HCS Billing Guidelines Revised-Sept. 2020

by

September 6, 2020

HCS Billing Guidelines Revised-Sept. 2020

Please pay special attention to the changes and clarifications for Nursing Services!  We will be reviewing these in our “Billable Services-HCS-2020” webinar on Sept. 21st, 2020.  For more information please contact Meghan Jones to register:  meghanjones.tx@gmail.com   If you attended the recent Billable Nursing Services training in August (Part I and II) we did add these to your handouts at the time of the training.  You have the updated ppt. copy.  Thanks.  Here is the link to the HCS BG’s: 

https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/resources/hcs/hcs-billing-guidelines.pdf

TMHP-Launching Redesigned Website

by

Texas Medicaid Health Portal
TMHP is announcing the launching of their newly redesigned website available on September 14, 2020!
As TMHP.com receives approximately 2.5 million views per month, it important to have a website that is functional and easy to navigate.  Major improvements have been made to increase the website user experience for providers.
Highlights of new improved features include:
o   Simplified navigation with program information, topics, and resources are more easily accessible.
o   Ability to filter news articles and forms by program, topic, or category.
o   Mobile-friendly design construction allowing providers to view the site on a computer, tablet, or phone.
o   Easy entry points to online portals and manuals.
Please note:  Since the website has been completely redesigned, URLs have changed for all pages with the exception of the homepage of tmhp.com. If providers have links embedded in their websites or applications, they will need to update the links. If a “favorite” has been saved in their browser, providers will need to update their shortcut.
A video showing a preview tour of the NEW website is available on TMHP’s YouTube channel.
TMHP posted an article entitled Reminder: TMHP Website Redesign Beginning September 14, 2020 last week sharing the news.
Please send an email to provider.relations@tmhp for any questions related to the new website redesign.

HCBS Settings Regulation Implementation -Timeline Extension!

by

Frequently Asked Questions:
HCBS Settings Regulation Implementation and Heightened Scrutiny Reviews of Presumptively Institutional Settings:
July 2020 Update
1.Question:
What is the new deadline for states to assure that all settings are in compliance with the home and community-based services (HCBS) settings criteria?
Answer: States have been granted an additional year to demonstrate compliance and should ensure all settings are in full compliance with the HCBS settings criteria by March 17, 2023. This date to demonstrate compliance replaces the March 17, 2022 timeline included in CMS guidance issued May 9, 2017.1 Several states have requested an extension to demonstrate compliance with the HCBS settings criteria due to an inability to complete site-specific assessment and remediation activities due to the COVID-19 public health emergency (PHE). Social-distancing requirements in response to the PHE are resulting in the inability to complete activities outlined in approved statewide transition plans and/or activities required to obtain final approval of those plans.
During this extension, CMS urges states to continue to identify settings in need of remediation and work on the development, approval, and implementation of their Statewide Transition Plans, including close consultation with relevant stakeholders. In light of the risks associated with congregate settings during the COVID-19 PHE, states may wish to give particular priority to those provisions of the rule regarding making available non-disability specific settings among the range of options available to individuals with disabilities, including to individuals currently residing in disability-specific congregate settings (for whom transition supports may be necessary to make the option available).
In addition, CMS reminds states that they continue to have independent obligations to comply with the Americans with Disabilities Act, Section 1557 of the Affordable Care Act, and Section 504 of the Rehabilitation Act, including their requirements under Olmstead v. L.C.2, which remain in effect during this public health emergency. Technical assistance is available from the HHS Office for Civil Rights and the Department of Justice Civil Rights Division.
2.Question:

What assistance is available to states to address the impact of the COVID-19 PHE on statewide transition plan activities?

Answer: States can review up-to-date guidance on flexibilities available for the delivery of HCBS on the CMS website.
 States can also avail themselves of individual and small group technical assistance from CMS, including alternative ways to gather site-specific assessment data and conduct validation activities. CMS also is available to offer assistance with approaches to gather information from beneficiaries and other stakeholders when face-to-face contact is impacted by state or local restrictions due to the COVID-19 PHE.

On-Site Trainings Available Upon Request

by

Currently, all “On-site Training” is on hold due to COVID-19.  If you require any of these trainings, please check our calendars on our website for current webinars or contact us at:  info@twogetherconsulting.com for some of our pre-recorded training options.

Live Training On-Site (Please contact us if you want us to provide these trainings on-site for your program):

HCS/TxHmL: Care Coordination in the HCS Program, Using Person-Centered Thinking To Develop The IP (Implementation Plan), Changes in the HCS Progam, Quality Assurance, Changes in The Survey Process In HCS (we are adding one for ICF), Changes in The Billing Audit Process in HCS and TxHmL, Nursing in HCS/TxHmL Programs, Common Nursing Errors In The HCS/TxHmL Programs & Corrective Action Planning, ICAP/IDRC/ and LON Increase Packet Training.

ICF: The Role & Responsibilities of the QIDP, DIT on Active Treatment, Changes To the ICF Surveyor’s Guide-Appendix J- “How It Affects Your Program”, as well as DIT Trainings-A/N/E,  “Common Nursing Tags in the ICF Program-How to Prevent & Correct Them“, Nursing In The ICF Program as well as ICAP/IDRC/ and LON Increase Packet Training.

Direct Support Staff Training:  “Expectations of the Nurse from the Direct Support Staff”, “Abuse, Neglect, and ANE” (including recent changes in the HCS TAC), “When and What to Report To The RN”, Documentation Expectations for Direct Support Staff”, “Behavior Support Plans-general concepts and purpose of support plans”, “Interacting With Individuals with Developmental Disabilities in Your Program” (Effective Communication, Verbal Intervention, Appropriate/Inappropriate Reactions, Body Language, and more).

Employment Assistance & Supported Employment Training Options From HHSC

by

Employment Assistance & Supported Employment Training Options From HHSC

There are two Home and Community-based Services and Texas Home Living trainings in this series:

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

Each training has a corresponding quiz.

 

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

Enhanced Provider Portal, Relief Fund Payments Available For Providers!

by

Tuesday, June 9, 2020

HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid & CHIP Providers

Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution. HHS is also announcing the distribution of $10 billion in Provider Relief Funds to safety-net hospitals that serve our most vulnerable citizens. The safety net distribution will occur this week.

“Healthcare providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19,” said HHS Secretary Alex Azar. “HHS is using funds from Congress, secured by President Trump, to provide new targeted help for America’s safety-net providers and clinicians who treat millions of Medicaid beneficiaries.”

HHS is providing support to healthcare providers fighting the COVID-19 pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers, including those disproportionately impacted by this pandemic.

ENHANCED PROVIDER RELIEF FUND PORTAL

On Wednesday, HHS is launching an enhanced Provider Relief Fund Payment Portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve.

The initial General Distribution provided payments to approximately 62 percent of all providers participating in state Medicaid and CHIP programs. The Medicaid and CHIP Targeted distribution will make the Provider Relief Fund available to the remaining 38 percent. HHS has already provided relief funding to over one million providers, and today’s announcement is expected to reach several hundred thousand more providers, many of whom are safety net providers operating on thin margins.

Clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received General Distribution funding may submit their annual patient revenue information to the enhanced Provider Relief Fund Portal to receive a distribution equal to at least 2 percent of reported gross revenues from patient care. This funding will supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19. Examples of providers serving Medicaid/CHIP beneficiaries possibly eligible for this funding include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based services, providers.

To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. Close to one million health care providers may be eligible for this funding.

More information about eligibility and the application process is available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/index.html

For updated information and data on the Provider Relief Fund, visit hhs.gov/providerrelief

News Releases below:                                                                                                                                                                                           

media@hhs.gov
www.hhs.gov/news
Twitter @SpoxHHS

Webinars

by

Please go to www.twogetherconsulting.com for more information and registration. Click on  “the calendar” of the Webinar you want to attend. 
********We also have pre-recorded webinars you can purchase for use at your facility.  Please contact Meghan Jones at: meghanjones.tx@gmail.com for more information, registration, and payment.

June & July

 

“Prep Session For HCS Provider Applicant Test” (Webinar)
(We will be reviewing some TxHmL information as well)

Date:  Tuesday- July 2nd, 2020

Time:  (6pm-8:30pm)  Central time

Cost:  $150/person

 

 

 

“Description & Development of The Comprehensive Nursing Assessment”  (HCS/TxHmL)

Date:  July 20th, 2020   

Time:  10AM-12:30 PM

Cost: $55/person

For:  Nursing Staff, Quality Assurance Staff, Program Managers, Administrators

Presenter:  Gina Peterson, RN Consultant

Please register for this webinar on or before June 20th, 2020  10:00 AM CDT

After you have made payment for this webinar,  you will receive a confirmation email containing the handouts and a link to register with “Gotowebinar” to attend that session.  

 

The Importance of SAM’s & Special Needs Training:                                     “RN Considerations for Training In IDD Programs”

(HCS/TxHmL/ICF)  July 30th, 2020  

 

Case Management/Care Coordination Webinar Series for HCS Providers 

(You can purchase pre-recorded sessions)

LIDDA Vs. HCS Provider: “Roles And Responsibilities-Timelines And Communication”

Webinar via Go To Webinar

Time:  2.5 hrs

Cost:  $50/person

You will receive a link to register for the webinar and the training handouts once we have received payment for the session.

For:  HCS Care Coordinator/Case Manager,  Program Manager, Administrator, Quality Assurance Staff, Nurses and more

Description:  This class is designed for anyone who is first starting out in the HCS Waiver Program as a new provider and for those persons coordinating services (case management) for the individuals in the HCS Waiver Program. This class is also effective for Nursing staff who need to know how the program works overall as they are part of the coordination of services for the individuals in the program.  Lastly, this is also a great session for those providing oversight and quality assurance for the program.

The discussion will include:

-What Does the LIDDA (Local IDD Authority) do?

-Who is the SC (Service Coordinator) at the LIDDA and what is their role and responsibilities?

-What are the HCS Provider’s role and responsibilities?

-When does the provider have to communicate with the SC?

-What are the timelines for certain responsibilities and expected communications on both sides?

-Who does “what” during enrollments, transfers, temporary suspensions, and permanent discharges?

-And much more

 

“Developing The IP (Implementation Plan) with Person-Centered Thinking in The HCS Program”

 

Time:  2.5 hrs

QA Session from 12:30 pm – 12:45 pm 

Cost: $50 per person

For:  Program Administrators, Program Directors, Care Coordinators, LIDDA Representatives- Service Coordinators, etc..

The webinar will be via “Go To ”Webinar

Instructions for the webinar and training handouts will be sent to your email after payment is made online or check is received.

Topics:

A review of basic components of a PDP (Person Directed Plan) completed by the LIDDA service coordinator and how this fits in with the IP (Implementation Plan) completed by the HCS provider.

Review of IP components and how to use the PDP to develop the complete IP. Review of some sample IP’S for various services on the IPC ( Individual Plan of Care).

Defining the terms: Action Plan, Desired Outcome, Objective, strategies, justifications.

 

 

LON/ICAP/IDRC Training for HCS, TxHmL, and ICF/IID Programs

 

 

Time:  2.5 hrs

QA Session from 12:30 pm – 12:45 pm 

Cost: $50 per person

For:  Program Administrators, Program Managers, Care Coordinators/Case Managers, Service Coordinators, Nurses etc..

The webinar will be via “Go To ”Webinar

Instructions for the webinar and training handouts will be sent to your email after payment is made online or check is received.

Topics:

-A review of the definition of LON (Level of Need) in the HCS, TxHmL, and ICF/IID programs

-What is the ICAP (Inventory for Client & Agency Planning) and how is it utilized?

-When does the provider complete an ICAP and Why Do They Need To?

-What is the IDRC (Intellectual Disability/Related Condition) form

-When is the IDRC filled out and by who?

-What does LON mean (Level of Need)?  (assistance needed, dollars required for that assistance level, etc…)

-How do I get a Level of Need increase?  Who applies for the Level of Need increase?  

-Utilization Review Department- what is their role?  (Monitoring units in CARE and Utilization of services, Approving Levels of Needs, etc…)

 

 

“Billable Services In The HCS Program″

You will receive a link to register for the webinar and handouts after we receive payment.

 

Time:2.5 hrs

Cost:  $65 per person

Presenter:  Julie Blacklock/IDD Waiver Consultant

For: Administrators, Program Managers, Quality Assurance Staff, Care Coordinators, Nurses, Billing/Data Entry Staff

Topics:  

-Definition of all Billable Services on the IPC (Individual Plan of Care)

–Hourly and Daily Unit services such as RSS/SL, HH/CC, CFC (PAS-HAB), DH, REH, PT, OT, SP, DI, BES, CRT, AU, SW, CDS, etc…

-Other Services (Units in dollars only):  Adaptive Aids, Minor Home Modifications, Dental, Pre-Minor Home Mod and OT Assessment, TAS

– Recent and some Upcoming Changes in the HCS Billing Guidelines

-How does this affect the Provider?

-How can I use this change to improve services

-How do I document to capture the most billing?-How to prevent billing for non-billable services?

 

Texas Workforce Commission (Supported Employment)

by

Texas Workforce Commission

Update on TWC services Provider Manual and Resources 

The following revisions to the Vocational Rehabilitation Standards for Providers Manual (VR-SFP) are available for 30-day review on the Vocational Rehabilitation Providers’ Resources page and will go into effect on June 29, 2020.

Chapter 2: Obtaining a Contract for Goods and Services—updated Section 2.8.1 Adding Counties or Services, Goods, and/or Equipment to a Contract, to indicate that provider contracts awarded after January 2020 will be statewide and therefore will not list the counties to be served.

Chapter 17: Basic Employment Services—updated Section 17.4.1 Bundled Job Placement Services Service Description and its associated form VR1845B, Bundled Job Placement Services Plan—Part B and Status Report, to clarify which types of placements are acceptable for VR customers.

Chapter 18: Supported Employment Services—updated Section 18.1, Supported Employment Overview, and its associated form VR1643, Supported Employment Services Plan 2—Placement, Job Analysis &Training Plan, to clarify which types of placements are acceptable for VR customers.

Cost Reporting Update!

by

Cost Report/Accountability Report has been extended to June 15, 2020

A notice has been posted to the LTSS web-page and the vendor will be updating the STAIRS system by Monday.  HHSC has stated they do not anticipate any additional extensions will be made at this point; however, if this occurs they will keep everyone updated.

Notice:

The new due date for submission of the 2019 Cost Report and/or 2019 Accountability Report has been extended to June 15, 2020.

This new due date supersedes the original notification and any reminder emails that providers may have already received. 

This extension is for the following program types/services. 

  • Community Living Assistance and Support Services – Direct Service Agency (CLASS-DSA)
  • Deaf-Blind Multiple Disabilities Waiver (DBMD)
  • Early Childhood Intervention (ECI) – Case Management
  • Early Childhood Intervention (ECI) – Specialized Rehabilitative Services
  • Home and Community-based Services / Texas Home Living (HCS/TxHmL)
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions State Supported Living Centers/Bond Homes (SSLC/BH)
  • Nursing Facility (NF)
  • Primary Home Care (PHC)
  • Rehabilitation Services – Mental Health
  • Residential Care (RC)
  • School and Health and Related Services (SHARS)
  • Service Coordination – ICF/IID
  • STAR+PLUS services affiliated with the above service types
  • Targeted Case Management (TCM) – Mental Health

 The deadline for 24-Hour Residential Child Care (24RCC) and Day Activity and Health Services (DAHS) is still May 15, 2020, with one exception. If the 24RCC or DAHS provider is serving a COVID-19 confirmed positive client(s), the provider can be granted an extension to June 15, 2020. 

These providers will need to contact costinformation@hhsc.state.tx.us to request the extension to June 15, 2020.

Utilization Review Department News!

by

Last Friday HHSC posted the following CARE banner:  Due to the 09/01/2019 HCS rate increase, service authorizations are being updated to ensure they are in line with their corresponding IPCs. This will not cause any payment changes.
Upon inquiry as to what this meant, Holly Lindsey, UR, HHSC provided the explanation below.  Hopefully the explanation and guidance will be of assistance to you should an action (revision, renewal or transfer) be taken on an IPC which prompts a notice that the IPC exceeds the cost cap.
Message from Holly Lindsey:  Since the effective dates of the rate increases, providers have been paid at the appropriate rate for the corresponding service. However, the C62 and C72 screens do not update until a provider takes an action on the IPC that was effected. This can be a revision, a renewal, or a transfer. That is why providers are suddenly seeing “Exceeds” messages in CARE for the same services that were under the 100% capitation rate ($83,734) previously. The services cost more so the total cost is higher. This actually occurred months ago with the rate increase, however, it takes an action on the IPC for it to update.
Any IPC that is over the $83,734 level requires a packet to be submitted (TAC 9.160(d). However, since we are removing flags to allow for billing during COVID, it is not necessary to send a packet at this time. The next time an action is taken on the IPC, however, an “Exceeds” message will occur again, and CARE will prompt them to send a packet.
Removing the flag is currently a manual process, so providers can contact me (Holly Lindsey) directly through this email for flags related to cost.
Note from Twogether Consulting: If you have tried to enter a renewal on an IPC or IDRC into CARE and you are having problems, remember that IPC’s and IDRC’s are automatically renewed through April 30th, 2020.
For Assistance with either issue:
They can call the main UR # 512-438-5055 or
Holly Lindsey:  512-438-5704;  holly.lindsey@hhsc.state.tx.us

Person Centered Planning/ Practices Training Opportunities

by

Person-Centered Training Opportunities

 

HHSC Person Centered Planning/Practice Training Information

What Training Is Required?

Online Introductory Course

The Texas Health and Human Services Online Introductory Course is appropriate for any member of the planning team, including:

  • Legally authorized representatives
  • Family members
  • Friends
  • Nurses (required in some instances)
  • Behavior specialists (required in some instances)
  • Employment specialists (required in some instances)
  • Attendants (required in some instances)
  • Direct support professionals (required in some instances)
  • Anyone asked to be a member of the planning team

Note: To access and complete this free online training, please go to the HHS Learning Portal, create a user login, and follow instructions to complete the training.

 

Person-Centered Thinking Classroom Course

To register for the Person-Centered Thinking 2-day classroom course, please go to the HHS Learning Portal, create a user login, and follow instructions to register for a class that is most convenient to your location. Begin Training An introductory course also is offered by DirectCourseOnline. The online offering includes courses in Person-Centered Counseling (PCC) and Person-Centered Thinking and Practice. There are 12 lessons in all.

HHS Approved Full Training

The following training is approved by Texas Health and Human Services for people required to take the full training, specifically case managers, service managers and service coordinators. If you would like to submit a training course to HHS for approval, email: Medicaid_HCBS_Rule@hhsc.state.tx.us. Remember to keep your training certificate.

Live Classes

by

 

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

 

   

STATUS OF HCS RATES!

by

Status of HCS Rates as of Oct. 11th, 2019:

As of October 11th, 2019, members of the HHSC Rate Workgroup were notified that the proposed rule amendments to implement the HCS rates that will be effective Jan. 1, 2020 thru August 31, 2021 have been sent to the Texas Register and will be published next Friday. 
. Any claims with DOS 11/10/19, and after will pay at the new rates. Claims billed prior to 11/10/19 will be reprocessed over the next three months and conclude by January 31.  Provider letter should go out next week.
These are the increases that will be applied to the LON 1, 5 & 8 residential rates and the additional rate increases that will be applied to the LON 6 & 9 residential rates. 
 Note:  A public hearing on the rule amendments and rates will be held at HHSC in its Public Hearing Room on November 4, 2019.
 HHSC Rate Analysis Director, has indicated that the rate increases for RSS LON 6 and 9, Day Habilitation and Supported Home Living/CFC will be posted Monday, October 14, 2019 (at the latest, Tuesday, October 15, 2019).
Remember:  These rates will be implemented as proposed in July, 2019 and will be retroactively effective to September 1, 2019.

SUMMARY OF PROPOSED PAYMENT RATES
Effective September 1, 2019

PROPOSED RATES:   HHSC proposes to increase the payment rates for the HCS Supervised Living / Residential Support Services, Day Habilitation, Supported Home Living Transportation, Community First Choice (CFC) Supported Home Living, and CFC Consumer Directed Services Supported Home Living in accordance with the 2020-21 General Appropriations Act, 86th Legislature, Regular Session, 2019 (Article II, HHSC, Rider 44).
METHODOLOGY AND JUSTIFICATION
The proposed payment rates were calculated in accordance with 1 TAC Section 355.723, which addresses the reimbursement methodology for the HCS program.  See HCS rates packet proposal below for Sept 1st, 2019.  Click on link to HCS rates document. 

09-01-19-hcs-rate-packet

Please contact the Rate Analysis Department’s Customer Information Center at (512) 424-6637 or by email at RAD-LTSS@hhsc.state.tx.us should you have any questions regarding the information in this document.

BEHAVIORAL SUPPORT SERVICES PROVIDER POLICY TRAINING

by

Behavioral Support Services

HCS and TxHmL Behavioral Support Services Provider Policy Training

(Has been mandated for HCS & TxHmL providers to ensure their contracted Behavioral Support Services providers to take since March 2015)

This course informs service providers of behavioral support services in the HCS and TxHmL programs related to the provision of behavioral support services in those programs.  All new behavior support service providers must complete the WBT before providing services to an individual. All providers must complete the course every three years.

***To document successful course completion, participants must print a copy of the certificate provided at the end of the training and submit a copy to a program provider with whom they are employed or contracted.

Our Awesome Admin. Asst.

Our Awesome Admin. Asst.

by

Meghan Jones

Meghan Jones is our awesome Admin. Assistant, otherwise known as our “Jill of All Trades”.  She handles our registration, keeps up with our enormous provider contact list, our company schedule and calendar, and she is our main point of contact for scheduling, other than myself.  We couldn’t make it without our Meghan!  I know many of you have talked to Meghan over the phone.

You may contact her to complete registrations, set up on-site visits from our consultants, request invoice sent to you directly, or for other questions at: meghanjones.tx@gmail.com

TASKMASTER PRO “Cloud-Based” Services For HCS, TXHmL, ICF, and CLASS Providers

by

logo

Discounted Rates Available for Small Providers (20 individuals or less) if you demo with Twogether Consulting to get signed up for TMP! 

As you know, we often provide webinars for providers receiving TaskMaster Pro services and this year some exciting new changes are taking place.  We are having a webinar on January 28th to review some of the new changes added to the nursing component of TaskMaster Pro, which include Comprehensive Nursing Assessment addition.  For those of you who are not receiving TaskMaster Pro currently, we also provide free demos.  Contact us at:  javasbja@gmail.com or meghanjones.tx@gmail.com to sign up for demo!

Developed by a provider for providers!

TaskMaster Pro is a web-based cloud computing system designed specifically for managing Waiver and ICF/DD programs. TaskMaster Pro was created by Larry Hill of Hill Resources in Abilene and his team. Through the internet, you will be able to access information and monitor activity from wherever you are and whenever you want and when regulatory changes occur or required forms are updated, TaskMaster Pro is updated so it will never be obsolete. Now this user-friendly, integrated system is available to you.

Request a TaskMaster Pro Demonstration

Manage your program anytime and from anywhere in the world with TaskMaster Pro!

This comprehensive, easy-to-use system has these features:

  •   Secure Communication Center
  •   Program Planning for QMRP’s, Case Managers, and Program Managers
  •   Complete Medical Module
  •   Psychological/Behavioral Module
  •   Service Delivery Log/Billing Waivers
  •   Client Budget
  •   Direct Care Reporting
  •   Incident/Accident Reporting
  •   Scheduling
  •   Report Tracking
  •   Human Resources
  •   Staff Development and Training Module
  •   Time and Attendance
  •   Electronic Data Signature
  •   Off-Site Secure Hosting
  •   Automated File Backup
  •  Customizable Access Control

Whether you have a large, mid-size, small or new start-up company, TaskMaster Pro will work for you!

For a FREE on-line demonstration of how TaskMaster Pro can save you time and money, please contact Julie Blacklock at  512-294-8032 or click on the Request a TaskMaster Pro Demonstration link to sign up.

Please note that before you can receive a demonstration, you must download and complete the Non-disclosure agreement and either fax the form to 512-291-9075 or scan it in and email it back to us available on our website: www.twogetherconsulting.com on the “TaskMaster Pro” page.